This Book is Available on YakiBooki.

com

https://www.yakibooki.com/download/abnormal-psychology-8th-edition/
 eighth edition

psychology
THOMAS F.

OLTMANNS
Washington University in St. Louis

ROBERT E.

EMERY
University of Virginia

Boston Columbus Indianapolis New York San Francisco Upper Saddle River
Amsterdam Cape Town Dubai London Madrid Milan Munich Paris Montréal Toronto
Delhi Mexico City São Paulo Sydney Hong Kong Seoul Singapore Taipei Tokyo
 To Gail, Josh, Sara, Billy, Presley, Riley,
and Kinley—T.F.O.

To Kimberly, Maggie, Julia, Bobby,

Lucy, and John—R.E.E.

Editor-in-Chief: Dickson Musslewhite Procurement Manager: Mary Fischer

Senior Acquisitions Editor: Amber Chow Procurement Specialist: Diane Peirano
Editorial Assistant: Alex Stavrakas Interior/Cover Designer: DeMarinis Design LLC
VP, Director of Marketing: Brandy Dawson Digital Media Editor: Tom Scalzo
Senior Marketing Manager: Jeremy Intal Digital Media Project Manager: Pamela Weldin
Marketing Assistant: Frank Alarcon Full-Service Project Management: PreMediaGlobal
Director, Project Management Services: Printer/Binder: R. R. Donnelley and Sons
Lisa Iarkowski Cover Printer: Lehigh-Phoenix Color/Hagerstown
Senior Managing Editor: Linda Behrens Cover Image: Terry Vine/Blend Images/Getty Images
Project Manager: Shelly Kupperman Text Font: Adobe Garamond Pro 10.5/13
Program Manager: Annemarie Franklin

Credits and acknowledgments borrowed from other sources and reproduced, with permission, in this textbook
appear on the appropriate page of appearance and on pages 561–563.

Copyright © 2015, 2012, 2010 by Pearson Education, Inc. All rights reserved. Printed in the United States
of America. This publication is protected by Copyright and permission should be obtained from the publisher
prior to any prohibited reproduction, storage in a retrieval system, or transmission in any form or by any means,
electronic, mechanical, photocopying, recording, or likewise. To obtain permission(s) to use material from this
work, please submit a written request to Pearson Education, Inc., Permissions Department, One Lake Street,
Upper Saddle River, New Jersey 07458 or you may fax your request to 201-236-3290.

Library of Congress Cataloging-in-Publication Data

Oltmanns, Thomas F.
Abnormal psychology \ Thomas F. Oltmanns, Washington University in St. Louis, Robert E. Emery, University
of Virginia.—Eighth edition.
pages cm
ISBN 978-0-205-97074-2
1. Psychology, Pathological. 2. Mental illness. I. Emery, Robert E. II. Title.
RC454.O44 2014
616.89—dc23

2013037915

10 9 8 7 6 5 4 3 2 1

Student Edition
ISBN-10: 0-205-97074-5
ISBN-13: 978-0-205-97074-2
Books à la Carte
ISBN-10: 0-205-97106-7
ISBN-13: 978-0-205-97106-0
brief
1 Examples and Definitions of Abnormal Behavior 1
2 Causes of Abnormal Behavior 24
3 Treatment of Psychological Disorders 52
4 Classification and Assessment of Abnormal Behavior 77
5 Mood Disorders and Suicide 105
6 Anxiety Disorders and Obsessive-Compulsive Disorder 143
7 Acute and Posttraumatic Stress Disorders, Dissociative Disorders,
and Somatic Symptom Disorders 174
8 Stress and Physical Health 206
9 Personality Disorders 231
10 Feeding and Eating Disorders 262
11 Substance-Related and Addictive Disorders 284
12 Sexual Dysfunctions, Paraphilic Disorders, and Gender
Dysphoria 318
13 Schizophrenia Spectrum and Other Psychotic Disorders 348
14 Neurocognitive Disorders 379
15 Intellectual Disabilities and Autism Spectrum Disorders 404
16 Psychological Disorders of Childhood 435
17 Adjustment Disorders and Life-Cycle Transitions 465
18 Mental Health and the Law 489

iii
rief
Preface xii About the Authors xix

1 Examples and Definitions

of Abnormal Behavior 1
Systems Theory 31
Holism
Causality
31
31
Overview 2 RESEARCH methods: 33
Recognizing the Presence of a Disorder 4 Correlations: Does a Psychology Major Make You Smarter? 33
Developmental Psychopathology 33
Defining Abnormal Behavior 5
Harmful Dysfunction 6 Biological Factors 34
The Neuron and Neurotransmitters 34
Mental Health Versus Absence of Disorder 7
Neurotransmitters and Psychopathology 35
Culture and Diagnostic Practice 7
Mind–Body Dualism 35
THINKING CRITICALLY about DSM-5:
Revising an Imperfect Manual 7 Major Brain Structures 36
Cerebral Hemispheres 38
CRITICAL THINKING matters:
Is Sexual Addiction a Meaningful Concept? 9 Psychophysiology 38
Behavior Genetics 39
Who Experiences Abnormal Behavior? 10
Frequency in and Impact on Community Populations 11 Psychological Factors 42
Cross-Cultural Comparisons 13 Human Nature 42

The Mental Health Professions 14 CRITICAL THINKING matters:

Do Vaccinations Cause Autism? 43
Psychopathology in Historical Context 15 Temperament 44
The Greek Tradition in Medicine 15
Emotions 45
The Creation of the Asylum 16
Learning and Cognition 45
Worcester Lunatic Hospital: A Model Institution 16
The Sense of Self 46
Lessons from the History of Psychopathology 17
Stages of Development 46
Methods for the Scientific Study of Mental Disorders 18 Social Factors 48
The Uses and Limitations of Case Studies 18
Close Relationships 48
RESEARCH methods: Gender and Gender Roles 48
Who Must Provide Scientific Evidence? 19
Prejudice, Poverty, and Society 49
Clinical Research Methods 20
getting HELP 50
getting HELP 21
summary 50 the big picture 51 key terms 51
summary 21 the big picture 22 key terms 23

Treatment of Psychological
2 Causes of Abnormal
Behavior 24
3 Disorders 52
Overview 53
Overview 25 Four Views of Frances 54
Brief Historical Perspective 26 Biological Treatments 55
The Biological Paradigm 26 Psychopharmacology 55
The Psychodynamic Paradigm 27 THINKING CRITICALLY about DSM-5:
THINKING CRITICALLY about DSM-5: Diagnosis and Treatment 56
Diagnosis and Causes of Mental Disorders 28 Electroconvulsive Therapy 57
The Cognitive-Behavioral Paradigm 29 Psychosurgery 58
The Humanistic Paradigm 30 Psychodynamic Psychotherapies 58
The Problem with Paradigms 30 Freudian Psychoanalysis 58

iv
Ego Analysis 60 Validity 86
Psychodynamic Psychotherapy 60 THINKING CRITICALLY about DSM-5:
Scientific Progress or Diagnostic Fads? 87
Cognitive-Behavior Therapy 60
Problems and Limitations of the DSM-5 System 88
Systematic Desensitization 61
Other Exposure Therapies 61 Basic Issues in Assessment 90
Aversion Therapy 61 Purposes of Clinical Assessment 90
Contingency Management 61 Assumptions About Consistency of Behavior 91
RESEARCH methods: Evaluating the Usefulness of Assessment Procedures 91
The Experiment: Does Treatment Cause Improvement? 62 CRITICAL THINKING matters:
Social Skills Training 63 The Barnum Effect and Assessment Feedback 92
Cognitive Techniques 63 Psychological Assessment Procedures 92
Beck’s Cognitive Therapy 63 Interviews 92
Rational–Emotive Therapy 63 Observational Procedures 94
“Third-Wave” CBT 64 Personality Tests and Self-Report Inventories 96
Humanistic Therapies 64 Projective Personality Tests 99
Client-Centered Therapy 64 Biological Assessment Procedures 100
A Means, Not an End? 64 Brain Imaging Techniques 100
Research on Psychotherapy 65 getting HELP 102
Does Psychotherapy Work? 65 summary 103 the big picture 103 key terms 104
CRITICAL THINKING matters:
Are All Therapies Created Equal? 66
The Allegiance Effect 68
Psychotherapy Process Research
Ethnic Minorities in Psychotherapy
69
70 5 Mood Disorders
and Suicide 105
Couple, Family, and Group Therapy 72
Couple Therapy 72
Overview 106
Family Therapy 73 Symptoms 109
Group Therapy 73 Emotional Symptoms 109
Prevention 74 Cognitive Symptoms 110
Somatic Symptoms 110
Specific Treatments for Specific Disorders 74
Behavioral Symptoms 111
getting HELP 75
Other Problems Commonly Associated with Depression 111
summary 75 the big picture 76 key terms 76
Diagnosis 111
THINKING CRITICALLY about DSM-5:

4 Classification and Assessment

of Abnormal Behavior 77
Depression or Grief Following a Major Loss?
Criteria for Major Depressive Episode
Criteria for Diagnosis of Manic Episode
113
114
112

Overview 78
Course and Outcome 116
Basic Issues in Classification 80 Depressive Disorders 116
Categories Versus Dimensions 80 Bipolar Disorders 116
From Description to Theory 80
Frequency 117
Classifying Abnormal Behavior 81 Incidence and Prevalence 117
The DSM-5 System 81 Risk for Mood Disorders Across the Life Span 117
Labels and Stigma 82 Gender Differences 118
Criteria for Obsessive-Compulsive Disorder 83 Cross-Cultural Differences 118
Culture and Classification 83
Causes 119
Evaluating Classification Systems 85 Social Factors 119
Reliability 85 Psychological Factors 121
RESEARCH methods: Biological Factors 122
Reliability: Agreement Regarding Diagnostic Decisions 85 Integration of Social, Psychological, and Biological Factors 127

CONTENTS v
RESEARCH methods: Obsessive-Compulsive and Related Disorders 162
Analogue Studies: Do Rats Get Depressed, and Why? 127
Symptoms of OCD 163
Treatment 128 Diagnosis of OCD and Related Disorders 165
Depressive Disorders 128 Course and Outcome of OCD 167
Cognitive Therapy 128 Frequency of OCD and Related Disorders 168
Bipolar Disorders 130 Causes of OCD 168
CRITICAL THINKING matters: Treatment of OCD 169
Do Antidepressant Drugs Cause Violent Behavior? 131
CRITICAL THINKING matters:
Electroconvulsive Therapy 132 Can a Strep Infection Trigger OCD in Children? 169
Seasonal Mood Disorders 132 getting HELP 171
Suicide 132 summary 171 the big picture 172 key terms 172
Classification of Suicide 133
Frequency of Suicide 135
Causes of Suicide 136
Common Elements of Suicide 137 Acute and Posttraumatic Stress
Disorders, Dissociative
Treatment of Suicidal People
getting HELP 139
138
7 Disorders, and Somatic
Symptom Disorders 174
summary 140 the big picture 141 key terms 141

Overview 175
Anxiety Disorders and Acute and Posttraumatic Stress Disorders 175
6 Obsessive-Compulsive
Disorder 143
Symptoms of ASD and PTSD
Diagnosis of ASD and PTSD
176
177
Criteria for Posttraumatic Stress Disorder 178
Overview 144
Criteria for Acute Stress Disorder 179
Symptoms of Anxiety Disorders 145 The Trauma of Sexual Assault 180
Anxiety 145
Frequency of Trauma, PTSD, and ASD 181
Excessive Worry 146
Causes of PTSD and ASD 182
Panic Attacks 147
Prevention and Treatment of ASD and PTSD 184
Phobias 147
Dissociative Disorders 186
Diagnosis of Anxiety Disorders 147 Hysteria and the Unconscious 187
Criteria for Panic Disorder 148
CRITICAL THINKING matters:
THINKING CRITICALLY about DSM-5: Recovered Memories? 188
Splitting Up the Anxiety Disorders 149
Symptoms of Dissociative Disorders 189
Course and Outcome 150
Diagnosis of Dissociative Disorders 190
Frequency of Anxiety Disorders 151 Frequency of Dissociative Disorders 192
Prevalence 151 THINKING CRITICALLY about DSM-5:
Comorbidity 151 More on Diagnostic Fads 192
Gender Differences 151 Causes of Dissociative Disorders 194
Anxiety Disorders Across the Life Span 151 RESEARCH methods:
Cross-Cultural Comparisons 152 Retrospective Reports: Remembering the Past 195
Treatment of Dissociative Disorders 196
Causes of Anxiety Disorders 152
Adaptive and Maladaptive Fears 152 Somatic Symptom Disorders 196
Social Factors 153 Symptoms of Somatic Symptom Disorders 196
Psychological Factors 154 Diagnosis of Somatic Symptom Disorders 197
Biological Factors 156 Criteria for Illness Anxiety Disorder 198
Frequency of Somatic Symptom Disorders 199
Treatment of Anxiety Disorders 158
Causes of Somatic Symptom Disorders 200
Psychological Interventions 158
Treatment of Somatic Symptom Disorders 202
Biological Interventions 160
RESEARCH methods: getting HELP 203
Statistical Significance: When Differences Matter 161 summary 204 the big picture 204 key terms 205

vi CONTENTS
 CRITICAL THINKING matters:

8 Stress and Physical

Health 206
Can Personality Disorders Be Adaptive? 238
Cluster B: Antisocial, Borderline, Histrionic, and Narcissistic
Personality Disorders 239
Overview 207 Cluster C: Avoidant, Dependent, and Obsessive-Compulsive
Personality Disorders 241
Defining Stress 208
A Dimensional Perspective on Personality Disorders 241
Stress as a Life Event 209
THINKING CRITICALLY about DSM-5:
Stress as Appraisal of Life Events 210 Is a Dimensional Model Too Complicated? 243
Symptoms of Stress 210
Frequency 245
Tend and Befriend: The Female
Prevalence in Community and Clinical Samples 245
Stress Response? 211
Gender Differences 246
Psychophysiological Responses to Stress 211
Stability of Personality Disorders over Time 246
Coping 213
Culture and Personality 247
Health Behavior 214
RESEARCH methods:
CRITICAL THINKING matters:
Cross-Cultural Comparisons: The Importance
Resilience 214
of Context 248
Illness as a Cause of Stress 217
Schizotypal Personality Disorder (SPD) 249
Diagnosis of Stress and Physical Illness 217
Symptoms 249
THINKING CRITICALLY about DSM-5:
Criteria for Schizotypal Personality Disorder 250
Is the Descriptive Approach Too Literal
Sometimes? 217 Causes 250
Treatment 250
Psychological Factors and Some Familiar Illnesses 218
Cancer 218 Borderline Personality Disorder (BPD) 251
Criteria for Psychological Factors Affecting Impulse Control Disorders 252
Other Medical Conditions 218 Symptoms 252
Acquired Immune Deficiency Syndrome (AIDS) 219 Criteria for Borderline Personality Disorder 253
Pain Disorder 220 Causes 253
Sleep-Wake Disorders 220 Treatment 254
Cardiovascular Disease 221 Antisocial Personality Disorder (ASPD) 255
Symptoms of CVD 222 Symptoms 256
Diagnosis of CVD 222 Criteria for Antisocial Personality Disorder 256
Frequency of CVD 222 Causes 257
Causes of CVD 222 Treatment 259
RESEARCH methods: getting HELP 259
Longitudinal Studies: Lives over Time 223
summary 260 the big picture 261 key terms 261
Prevention and Treatment of CVD 226
getting HELP 228
summary 229 the big picture 229 key terms 230

10 Feeding and Eating

Disorders 262
9 Personality Disorders 231 Overview 263
Eating Disorders in Males 264
Overview 232
Symptoms of Anorexia 265
Symptoms 234 Significantly Low Weight 265
Social Motivation 234
Fear of Gaining Weight 266
Cognitive Perspectives Regarding Self and Others 235
Disturbance in Experiencing Weight or Shape 266
Temperament and Personality Traits 235
Amenorrhea 266
Context and Personality 237
Medical Complications 266
Diagnosis 237 Struggle for Control 266
Cluster A: Paranoid, Schizoid, and Schizotypal Personality Disorders 238 Comorbid Psychological Disorders 266

CONTENTS vii
Symptoms of Bulimia 267 DSM-5 296
Binge Eating 268 Course and Outcome 297
Inappropriate Compensatory Behavior 268 Criteria for Alcohol Use Disorder 297
Excessive Emphasis on Weight and Shape 268 Other Disorders Commonly Associated with Addictions 298
Comorbid Psychological Disorders 269 Frequency 298
Medical Complications 269 Prevalence of Alcohol Use Disorder 299
Diagnosis of Feeding and Eating Disorders 269 Prevalence of Drug and Nicotine Use Disorders 300
THINKING CRITICALLY about DSM-5: Risk for Addiction Across the Life Span 301
Is Binge Eating a Mental Disorder? Is Obesity? 269 CRITICAL THINKING matters:
Criteria for Anorexia Nervosa 270 Should Tobacco Products Be Illegal? 301
Criteria for Bulimia Nervosa 271 Causes 302
Frequency of Anorexia and Bulimia 271 Social Factors 302
Standards of Beauty 272 Biological Factors 303
CRITICAL THINKING matters: Psychological Factors 306
The Pressure to Be Thin 273 Integrated Systems 307
Age of Onset 273 RESEARCH methods:
Causes of Anorexia and Bulimia 274 Studies of People at Risk for Disorders 307

Social Factors 274 Treatment 308

Psychological Factors 275 Detoxification 308
Biological Factors 277 Medications During Remission 308
Integration and Alternative Pathways 277 Self-Help Groups: Alcoholics Anonymous 309

Treatment of Anorexia 278 Cognitive Behavior Therapy 310

Course and Outcome of Anorexia Nervosa 278 Outcome Results and General Conclusions 311

Treatment of Bulimia 279 Gambling Disorder 312

Cognitive Behavior Therapy 279 THINKING CRITICALLY about DSM-5:
Is Pathological Gambling an Addiction? 312
Interpersonal Psychotherapy 279
Antidepressant Medications 279 Symptoms 313
Diagnosis 314
RESEARCH methods:
Psychotherapy Placebos 280 Frequency 314
Course and Outcome of Bulimia Nervosa 280 getting HELP 315
Prevention of Eating Disorders 280 summary 315 the big picture 316 key terms 317
getting HELP 282
summary 282 the big picture 283 key terms 283 Sexual Dysfunctions, Paraphilic
12 Disorders, and Gender
Dysphoria 318

11 Substance-Related
and Addictive Disorders 284
Overview 319
Brief Historical Perspective 321
Sexual Dysfunctions 321
Overview 285
Symptoms 321
Symptoms 287 Diagnosis 323
Alcohol 289
RESEARCH methods:
Tobacco 290 Hypothetical Constructs: What Is Sexual Arousal? 325
Amphetamine and Cocaine 291 Frequency 327
Opiates 292 Causes 328
Sedatives, Hypnotics, and Anxiolytics 293 Treatment 330
Cannabis 294 CRITICAL THINKING matters:
Hallucinogens and Related Drugs 294 Does Medication Cure Sexual Dysfunction? 332
Diagnosis 295 Paraphilic Disorders 332
Brief History of Legal and Illegal Substances 295 Symptoms 333

viii CONTENTS
Diagnosis 333 getting HELP 376
THINKING CRITICALLY about DSM-5: summary 377 the big picture 378 key terms 378
Two Sexual Problems That Did Not Become
New Mental Disorders 339
Frequency
Causes
340
340 14 Neurocognitive Disorders 379

Treatment 341
Overview 380
Gender Dysphoria 343
Symptoms 383
Symptoms 343
Frequency 344 Delirium 383

Causes 344 Criteria for Delirium 383

Treatment 345 Major Neurocognitive Disorder 384

Memory Changes in Normal Aging 385
getting HELP 345
Diagnosis 388
summary 346 the big picture 346 key terms 347
Brief Historical Perspective 388
Specific Types of Neurocognitive Disorder 389
Criteria for Major Neurocognitive Disorder 389

13 Schizophrenia Spectrum and

Other Psychotic Disorders 348
CRITICAL THINKING matters:
How Can Clinicians Establish an Early Diagnosis
of Alzheimer’s Disease? 390
Overview 349 Frequency of Delirium and Major
Symptoms 351 Neurocognitive Disorders 394
Positive Symptoms 352 Prevalence of Dementia 394
Negative Symptoms 353 RESEARCH methods:
First-Person Account of Delusional Beliefs 353 Finding Genes That Cause Behavioral Problems 395
Disorganization 354 Prevalence by Subtypes of Neurocognitive Disorder 396
Cross-Cultural Comparisons 396
Diagnosis 355
DSM-5 355 Causes 396
Criteria for Schizophrenia 356 Delirium 396
Subtypes 356 Neurocognitive Disorder 396

CRITICAL THINKING matters: Treatment and Management 399

Why Were the Symptom-Based Subtypes Medication 399
of Schizophrenia Dropped from DSM-5? 357
THINKING CRITICALLY about DSM-5:
Related Psychotic Disorders 357 Will Patients and Their Families Understand
Course and Outcome 358 “Mild” Neurocognitive Disorder? 400
Frequency 359 Environmental and Behavioral Management 401
Gender Differences 359 Support for Caregivers 401
Cross-Cultural Comparisons 360 getting HELP 402

Causes 360 summary 402 the big picture 403 key terms 403
Biological Factors 360
Social Factors 366
Psychological Factors
RESEARCH methods:
367 15 Intellectual Disabilities and
Autism Spectrum Disorders 404
Comparison Groups: What Is Normal? 369 Overview 405
Interaction of Biological and Environmental Factors 369 Intellectual Disabilities 405
The Search for Markers of Vulnerability 370 Symptoms of Intellectual Disabilities 407
THINKING CRITICALLY about DSM-5: Criteria for Intellectual Disability (Intellectual
Attenuated Psychosis Syndrome Reflects Wishful Developmental Disorder) 407
Rather Than Critical Thinking 370
RESEARCH methods:
Treatment 372 Central Tendency and Variability: What Do IQ Scores Mean? 408
Antipsychotic Medication 372 Diagnosis of Intellectual Disabilities 410
Psychosocial Treatment 374 Frequency of Intellectual Disabilities 411

CONTENTS ix