David H. Barlow – Abnormal Psychology (7th edition)

Автор: David H. Barlow
Название книги: Abnormal Psychology (7th edition)
Формат: PDF
Жанр: Психология
Страницы: 790
Качество: Изначально компьютерное, E-book

Science is a constantly evolving field, but every now and then
something groundbreaking occurs that alters our way of
thinking. For example, evolutionary biologists, who long
assumed that the process of evolution was gradual, suddenly had
to adjust to evidence that says evolution happens in fits and starts
in response to such cataclysmic environmental events as meteor
impacts. Similarly, geology has been revolutionized by the discovery
of plate tectonics.
Until recently, the science of psychopathology had been compartmentalized,
with psychopathologists examining the separate
effects of psychological, biological, and social influences. This
approach is still reflected in popular media accounts that describe,
for example, a newly discovered gene, a biological dysfunction
(chemical imbalance), or early childhood experiences as a “cause”
of a psychological disorder. This way of thinking still dominates
discussions of causality and treatment in some psychology textbooks:
“The psychoanalytic views of this disorder are . . . ,” “the
biological views are . . . ,” and, often in a separate chapter, “psychoanalytic
treatment approaches for this disorder are . . . ,” “cognitive
behavioral treatment approaches are . . . ,” or “biological treatment
approaches are . . .”
In the first edition of this text, we tried to do something very
different. We thought the field had advanced to the point that it
was ready for an integrative approach in which the intricate interactions
of biological, psychological, and social factors are explicated
in as clear and convincing a manner as possible. Recent
explosive advances in knowledge confirm this approach as the
only viable way of understanding psychopathology. To take just
two examples, Chapter 2 contains a description of a study demonstrating
that stressful life events can lead to depression but that not
everyone shows this response. Rather, stress is more likely to cause
depression in individuals who already carry a particular gene
that influences serotonin at the brain synapses. Similarly, Chapter
9 describes how the pain of social rejection activates the same
neural mechanisms in the brain as physical pain. In addition, the
entire section on genetics has been rewritten to highlight the new
emphasis on gene–environment interaction, along with recent
thinking from leading behavioral geneticists that the goal of basing
the classification of psychological disorders on the firm foundation
of genetics is fundamentally flawed. Descriptions of the
emerging field of epigenetics, or the influence of the environment
on gene expression, is also woven into the chapter, along with new
studies on the seeming ability of extreme environments to largely
override the effects of genetic contributions. Studies elucidating
the mechanisms of epigenetics or specifically how environmental
events influence gene expression are described.
These results confirm the integrative approach in this book:
psychological disorders cannot be explained by genetic or environmental
factors alone but rather arise from their interaction.
We now understand that psychological and social factors directly
affect neurotransmitter function and even genetic expression.
Similarly, we cannot study behavioral, cognitive, or emotional
processes without appreciating the contribution of biological and
social factors to psychological and psychopathological expression.
Instead of compartmentalizing psychopathology, we use a
more accessible approach that accurately reflects the current state
of our clinical science.
As colleagues, you are aware that we understand some disorders
better than others. But we hope you will share our excitement
in conveying to students both what we currently know about the
causes and treatments of psychopathology and how far we have
yet to go in understanding these complex interactions.
Integrative Approach
As noted earlier, the first edition of Abnormal Psychology pioneered
a new generation of abnormal psychology textbooks,
which offer an integrative and multidimensional perspective.
(We acknowledge such one-dimensional approaches as biological,
psychosocial, and supernatural as historic trends.) We include
substantial current evidence of the reciprocal influences of biology
and behavior and of psychological and social influences on
biology. Our examples hold students’ attention; for example, we
discuss genetic contributions to divorce, the effects of early social
and behavioral experience on later brain function and structure,
new information on the relation of social networks to the common
cold, and new data on psychosocial treatments for cancer. We
note that in the phenomenon of implicit memory and blind sight,
which may have parallels in dissociative experiences, psychological
science verifies the existence of the unconscious (although it
does not much resemble the seething caldron of conflicts envisioned
by Freud). We present new evidence confirming the effects
of psychological treatments on neurotransmitter flow and brain
function. We acknowledge the often-neglected area of emotion
theory for its rich contributions to psychopathology (e.g., the
effects of anger on cardiovascular disease). We weave scientific
findings from the study of emotions together with behavioral,
biological, cognitive, and social discoveries to create an integrated
tapestry of psychopathology.
Life-Span Developmental Influences
No modern view of abnormal psychology can ignore the importance
of life-span developmental factors in the manifestation
and treatment of psychopathology. Studies highlighting developmental
windows for the influence of the environment on gene
expression are explained. Accordingly, although we include a
Neurodevelopmental Disorders chapter (Chapter 14), we consider
the importance of development throughout the text; we discuss
childhood and geriatric anxiety, for example, in the context of the
Anxiety, Trauma- and Stressor-Related, and Obsessive-Compulsive
and Related Disorders chapter. This system of organization, which
is for the most part consistent with DSM-5, helps students appreciate
the need to study each disorder from childhood through
adulthood and old age. We note findings on developmental considerations
in separate sections of each disorder chapter and, as
appropriate, discuss how specific developmental factors affect
causation and treatment.
Scientist–Practitioner Approach
We go to some lengths to explain why the scientist–practitioner
approach to psychopathology is both practical and ideal. Like
most of our colleagues, we view this as something more than simple
awareness of how scientific findings apply to psychopathology.
We show how every clinician contributes to general scientific
knowledge through astute and systematic clinical observations,
functional analyses of individual case studies, and systematic
observations of series of cases in clinical settings. For example,
we explain how information on dissociative phenomena provided
by early psychoanalytic theorists remains relevant today. We also
describe the formal methods used by scientist–practitioners,
showing how abstract research designs are actually implemented
in research programs.
Clinical Cases of Real People
We have enriched the book with authentic clinical histories to illustrate
scientific findings on the causes and treatment of psychopathology.
We have both run active clinics for years, so 95% of the
cases are from our own files, and they provide a fascinating frame
of reference for the findings we describe. The beginnings of most
chapters include a case description, and most of the discussion of
the latest theory and research is related to these very human cases.
Disorders in Detail
We cover the major psychological disorders in 11 chapters, focusing
on three broad categories: clinical description, causal factors,
and treatment and outcomes. We pay considerable attention to case
studies and DSM-5 criteria, and we include statistical data, such
as prevalence and incidence rates, sex ratio, age of onset, and the
general course or pattern for the disorder as a whole. Since one of
us (DHB) was an appointed Advisor to the DMS-5 task force, we
are able to include the reasons for changes as well as the changes
themselves. Throughout, we explore how biological, psychological,
and social dimensions may interact to cause a particular disorder.
Finally, by covering treatment and outcomes within the context of
specific disorders, we provide a realistic sense of clinical practice.
Treatment
One of the best received innovations in the first six editions was
our discussing treatments in the same chapter as the disorders
themselves instead of in a separate chapter, an approach that is
supported by the development of specific psychosocial and pharmacological
treatment procedures for specific disorders. We have
retained this integrative format and have improved upon it, and
we include treatment procedures in the key terms and glossary.
Legal and Ethical Issues
In our closing chapter, we integrate many of the approaches and
themes that have been discussed throughout the text. We include
case studies of people who have been involved directly with many
legal and ethical issues and with the delivery of mental health
services. We also provide a historical context for current perspectives
so students will understand the effects of social and cultural
influences on legal and ethical issues.
Diversity
Issues of culture and gender are integral to the study of psychopathology.
Throughout the text we describe current thinking about
which aspects of the disorders are culturally specific and which
are universal, and about the strong and sometimes puzzling effects
of gender roles. For instance, we discuss the current information
on such topics as the gender imbalance in depression, how panic
disorders are expressed differently in various Asian cultures, the
ethnic differences in eating disorders, treatment of schizophrenia
across cultures, and the diagnostic differences of attention
deficit/hyperactivity disorder (ADHD) in boys and girls. Clearly,
our field will grow in depth and detail as these subjects and
others become standard research topics. For example, why do
some disorders overwhelmingly affect females and others appear
predominantly in males? And why does this apportionment sometimes
change from one culture to another? In answering questions
like these, we adhere closely to science, emphasizing that gender
and culture are each one dimension among several that constitute
psychopathology.