Abnormal Psychology Syllabus

The University of Iowa
Division of Continuing Education
CONTINUING EDUCATION
Study Guide for:
PSY:3320 (031:163)
ABNORMAL PSYCHOLOGY
College of Liberal Arts and Sciences
Department of Psychological and Brain Sciences
Coursewriters:
Michael OHara, Ph.D.

Graham Nelson, M.A.
About this Course:
Semester Hours Earned at Completion 3
Written Assignments - 6
Examinations 3
Approved for GE: None
Copyright 2012 The University of Iowa. All rights reserved.
PSY:3320 (031:163)
Abnormal Psychology
No part of this publication may be reproduced in any form by any means

without permission in writing from the publisher.
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The University of Iowa prohibits discrimination in employment and in its educational

programs and activities on the basis of race, national origin, color, creed, religion, sex, age,
disability, veteran status, sexual orientation, gender identity, or associational preference.
The University also affirms its commitment to providing equal opportunities and equal
access to University facilities. For additional information on nondiscrimination policies,
contact the Coordinator of Title IX, Section 504, and the ADA in the Office of Equal
Opportunity and Diversity, (319) 335-0705 (voice) or (319) 335-0697 (text), 202 Jessup
Hall, The University of Iowa, Iowa City, Iowa 52242-1316.
If you are a person with a disability who requires reasonable accommodations in order to
participate in this program, please contact the Division of Continuing Education to discuss
your needs.
Guided Independent Study
Division of Continuing Education
250 Continuing Education Facility
Iowa City, IA 52242-0907
Telephone: 319-335-2575 Toll free: 1-800-272-6430
Fax: 319-335-2740 E-mail: dce@uiowa.edu
Web: http://distance.uiowa.edu/
Continuing Education GIS
COURSE CONTENTS
About the Coursewriters ..................................................................................................................................... 4
About This Course ................................................................................................................................................. 5
Required Course Materials: ............................................................................................................................................ 7
Course Work Requirements: .......................................................................................................................................... 8
Before You Begin ................................................................................................................................................ 12
Studying in This Course (and in other courses too) ........................................................................................... 12
The SQ4R Study System* ............................................................................................................................................... 12
Lesson 1 Introduction and Historical Overview................................................................................... 20
Lesson 2 Current Paradigms in Psychopathology ............................................................................... 26
Written Assignment #1: Part A ................................................................................................................................... 30
Lesson 3 Diagnosis and Assessment ......................................................................................................... 31
Written Assignment #1: Part B ................................................................................................................................... 38
Lesson 4 Research Methods in the Study of Psychopathology ........................................................ 40
LESSON 5 MOOD DISORDERS............................................................................................................................. 45
Examination #1 ............................................................................................................................................... 52
Lesson 6 Anxiety Disorders ......................................................................................................................... 53
Lesson 7 Obsessive-Compulsive Related and Trauma-Related Disorders ................................. 59
LESSON 8 DISSOCIATIVE DISORDERS AND SOMATIC SYMPTOM DISORDERS ............................................. 63
LESSON 9 SCHIZOPHRENIA ................................................................................................................................. 66
LESSON 10 SUBSTANCE RELATED DISORDERS ............................................................................................... 73
Examination #2 ............................................................................................................................................... 78
Lesson 11 Eating Disorders ......................................................................................................................... 79
LESSON 12 SEXUAL DISORDERS ........................................................................................................................ 84
LESSON 13 DISORDERS OF CHILDHOOD .......................................................................................................... 88
LESSON 14 LATE LIFE AND NEUROCOGNITIVE DISORDERS .......................................................................... 94
LESSON 15 PERSONALITY DISORDERS............................................................................................................. 98
Written Assignment #6: Part A ................................................................................................................................ 101
LESSON 16 LEGAL AND ETHICAL ISSUES ....................................................................................................... 102
Written Assignment #6: Part B ................................................................................................................................ 105
Final Examination ........................................................................................................................................ 106
Appendix A: Self-Test Exercises .................................................................................................................. 108
Appendix B: Answers to Self-Test Exercises .......................................................................................... 157
Wrapping Things Up ........................................................................................................................................ 161
3
PSY:3320 (031:163)
Abnormal Psychology
ABOUT THE COURSEWRITERS

MICHAEL OHARA, PH.D. MICHAEL OHARA has taught Abnormal
Psychology, Behavior Modification, and Introduction to Clinical
Psychology at the undergraduate level. He also teaches a course in

psychopathology at the graduate level. In addition to teaching,
Professor OHara supervises clinical psychology graduate students in

the psychotherapy practicum at the Carl E. Seashore Psychology
Training Clinic. His research interests are in the area of postpartum
depression and womens health. Dr. OHara is the instructor for this
course.
GRAHAM NELSON, M.A. COMING SOON
ABOUT THIS COURSE

Abnormal psychology is the study of disturbed human behavior. Abnormal behavior may be
disturbing to either the individual or society and often to both. Note that, in this course, the terms
abnormal psychology, abnormal behavior, and psychopathology will be used interchangeably.
This course will provide an introduction to the psychology of several types of psychopathology,
relying primarily upon material presented in the course textbook, Abnormal Psychology. The first
four chapters of the text will provide a historical context for current perspectives of abnormal
behavior. They will also provide you with an introduction to the different perspectives from which
abnormal behavior is viewed and introduce you to the research methods used by psychologists to
study abnormal behavior. Part 2 of the text describes each disorder and reviews research that
addresses causal factors and treatment. The last chapter of the text will address legal and ethical
issues pertaining to abnormal behavior.
Our goals for students who take this course are the following: (a) to appreciate the great diversity
of human behavior; (b) to understand differences among various types of psychopathology; and (c)
to appreciate the different research methods in the study of psychopathology. Finally, we hope that
students become intelligent consumers of popular and scientific literature, as these apply to the
causes of psychopathology and treatment.
Abnormal psychology should not be your first course in psychology. At the very least, you should
have had some type of introductory psychology course before taking this course. A course in
statistics would also be helpful. Students enrolled at The University of Iowa must have had a
statistics course before taking this course or any upper-level undergraduate course.
Course Structure:
Course Organization
The course study guide is divided into two units of study, each of which consists of a number of
lessons. Each lesson assigns a chapter from the Kring, Johnson, Davison, and Neale text (all page
and chapter citations in this study guideunless otherwise statedrefer to the Kring, Johnson,
Davison, and Neale text). Some lessons ask you to complete a written assignment (one or more brief
questions about assigned reading material); you should complete this work as you progress
through each lesson of a given unit of study. However, you should not submit these assignments
until the study guide indicates that you should do so. All written assignments will be
composed of two partswritten work from two lessons. Always submit the two parts
PSY:3320 (031:163)
Abnormal Psychology
together. As you work through a unit of study, the study guide will indicate when you should
submit them as a collected written assignment. In this course you must type all assignments.
The general organization of the course in terms of its units, lessons, written assignments, and
exams may be found in the table of contents in this study guide.
Unit Organization
As indicated above, each course unit is divided into lessons, each of which has a READING
ASSIGNMENT from the Kring, Johnson, Davison, and Neale text. For each lesson, we provide the list
of LESSON GOALS and KEY TERMS/FIGURES from the book. Some of the key terms and figures are
boldfaced. Although all of the key terms and figures may be included on examination questions, we
regard the boldfaced items as those that are most basic to the understanding of the material
covered in the chapter. The lists of key terms and key figures are not exhaustive, but a good
familiarity with them will be an indication of your mastery of the chapter material.
We will also provide COMMENTS on various aspects of each chapter in the textbook. The purpose
of this discussion is to highlight important issues and to alert you to other points of view not shared
by textbook authors. Following the discussion on a chapter in the textbook, we will provide a SELFTEST EXERCISE consisting of fifteen multiple-choice questions that you can use to test your
comprehension of the chapter material. These self-test exercises and the answers are provided in
the APPENDIX of the study guide and an interactive version is provided on the ICON course site.
Provided with each correct answer is a page number (or numbers) in the Kring, Johnson, Davison,
and Neale text. The page number indicates the source for the correct answer. Do not submit your
work on these self-test questions for grading. Finally, each lesson ends with a few THOUGHT
QUESTIONS and suggestions for FURTHER READING. Answering the thought questions and
reading the works suggested in the further reading section are not required for this course, and
your answers to these questions should not be submitted for grading. Rather, they are meant to
stimulate further thinking on topics of particular interest.
After completing the self-test exercise, you should complete the lesson's WRITTEN ASSIGNMENT
(if any). Remember to submit your written assignments only when your study guide indicates that
you should do so.
Instructions for submitting assignments electronically in the ICON Drop Box are posted on the ICON
course site under "Submit Assignments."
Required Course Materials:

Materials Provided by the Division of Continuing Education (DCE):
The following items may be downloaded from the course site at no additional charge (ICON >
Content); use your Hawk ID and password to login.
Syllabus (PDF)
Study Guide (PDF)
Guided Independent Study Policies (PDF)
Textbook for you to purchase:
The following materials are listed on the Textbook and Materials Order Form for this course, along
with vendor information where they may be purchased. If you purchase items from an alternate
bookseller, it is imperative that you obtain the correct editions.
Kring, A.M., Johnson, S.L., Davison, G., & Neale, J. Abnormal Psychology,
thirteenth edition. New York: John Wiley and Sons, 2015
This textbook may be ordered from the vendor of your choice or from a local
bookstore. Listed below are bookstores from the Iowa City area; students may order books from
these vendors online (visit vendor website), by phone, or in person. Exact editions are required.
Overseas students are encouraged to request airmail shipment.
Iowa Book, L.L.C. Web: http://www.iowabook.com/ Phone: 319.337.4188
University Bookstore. Web: http://www.book.uiowa.edu/ Phone: 319.335.3179
Print-based Materials for Purchase:
For a $75 materials fee, the course materials listed above (e.g. Study Guide) may be purchased in a
print-based format from the Division of Continuing Education. When applicable, along with the
print materials, you will receive a CD-Rom or DVD containing required course media (i.e. movie
clips, audio tracks). To purchase print-based materials, complete the Course Materials Order Form.
PSY:3320 (031:163)
Abnormal Psychology
Course Work Requirements:

Written Assignments:
Writing assignments will be graded satisfactory/unsatisfactory. Students must complete five
satisfactory written assignments to earn a final grade in this course. Students may skip one
assignment at their discretion and redo any unsatisfactory assignment until it is satisfactory.
Assignments are to be submitted electronically to the ICON Dropbox as Word documents.
Format your written assignments as follows:
Give your document a title like myname&lastname_essay1.doc. Do not leave out your name from
the file name.
Note: If you are working on Word 2007, save your document as described above, but using the
extension .docx to avoid possible compatibility issues.
Begin each assignment providing the following information: name and last name, course number,
date, and assignment number (i.e. Unit 1 - Essay).
Use double line spacing to leave space for instructor corrections and comments.
Number your pages; use 1-1 inch margins all around to allow for instructor feedback.
Examinations:
The course requires three 75-minute supervised examinations. Each exam consists of sixty
multiple-choice items. Local students will take their exams online in the Distance Education Testing
Center; students who are not local will complete online exams using an online proctored exam
service.
The first exam is after Lesson 5, the second is after Lesson 10, and the final is after Lesson 16. Each
exam tests material covered since the previous exam (none is comprehensive). Most questions will
probe about basic definitions and general concepts from your text rather than specific names of
researchers, results from specific studies, or names of particular medications to treat
psychopathology. When a section in your text contains a large amount of detail on which you will
not be tested, we indicate so in the discussion in this study guide.
Exam Registration: Information regarding exam registration, scheduling, and policies is posted
on the course homepage (ICON - see DCE-GIS Exam Registration box). On campus students
taking exams at the Continuing Education Testing Center should complete the online Exam
Registration Form at least two business days before their intended examination day. Off
campus students (with ProctorU) should register for their exam two weeks before their
intended examination day.
Before registering for your first exam, please take a few minutes to read the Examination
Information page. A direct link to this page, and to the Exam Registration Form (for both
on campus and off campus students), is posted on the course homepage.
The Continuing Education Testing Center is located the Continuing Education Facility
(CEF) - 30 S. Dubuque St - Room 234 (second level of the US Bank Building).
Course Grade:
Your grade for the course will be determined by evaluation of your written assignments and by
your scores on the course examinations. You will receive a standard letter grade of A, B, C, D, or F,
with a plus/minus mark assigned as appropriate.
Writing assignments are graded satisfactory/unsatisfactory. Students must have at least five
satisfactory writing assignments to successfully complete this course. Students may skip one
assignment at their discretion and redo any unsatisfactory assignment until it is satisfactory.
Each examination is worth a third of your course grade.

Written Assignments (5)
Exam 1
Points
% of final grade
Satisfactory/
Unsatisfactory
0%
Exam 2
60
33.3%
60
33.3%
60
Exam 3
Total Points:
180
33.3%
100%
Course grades will be determined based on the following point system.

A
159-180 A+
139-143 B+
119-122 C+
87-104 D
0-86 F
144-147 A-
123-127 B-
105-108 C-
148-158 A
128-138 B
109-118 C
PSY:3320 (031:163)
Abnormal Psychology
Web and E-mail Options:

The materials needed to complete this course (i.e. Study Guide) are
available on the World Wide Web via ICON (Iowa Courses Online). To
access the course site:
1. Go to: http://icon.uiowa.edu/ .
2. Login to ICON using your Hawk ID and Password.
Hawk ID Help:
Forgot your Hawk ID password? Cant find the letter that was sent with
Visit ICON to
- Access materials needed

to complete this course.
- Submit your assignment
packages to the ICON
Dropbox.
- Pick up graded
your Hawk ID password? Call the ITS Help Desk (319.384.4357) at The
assignments and/or
toll-free number (800.272.6430) and select the phone routing option
instructor on the
University and ask them to reset your password. You may also call our
(#2) that connects you with the ITS Help Desk. For additional
feedback left by your

Dropbox.
information about your Hawk ID (Hawk ID Guide), visit

http://hawkid.uiowa.edu/.
Online Tutorials:
Flash based tutorials* are available online to provide basic instruction on how to log in to ICON and
use some of its tools (i.e. Dropbox, Quizzes, Calendar). Additional tutorials are provided that can
assist you in the use of Webmail, Hawk ID Tools, ISIS, and more. To view the online tutorials go to
http://www.uiowa.edu/~online/tutorials/tutorial.html. Be aware that Continuing Education
courses do not use all of the components explained in the ICON tutorial.
* Require a Flash Player be installed on your computer. For a free download, go to:
http://continuetolearn.uiowa.edu/facultysupport/idev/connect/
Technical Support for Online Students:
For technical assistance, including FAQs, software demos and downloads:
1. Visit our Technical Help page at http://continuetolearn.uiowa.edu/tech-
support/index.html; or
2. Contact us by email at dce-techsupport@uiowa.edu.
E-mail Alias:
A University of Iowa e-mail alias was created for you when you enrolled in this course (i.e. name-
lastname@uiowa.edu), if you didnt already have one. All subsequent e-mail contact from our office
will go to your UI alias and be routed to the e-mail routing address you specified on ISIS.
10
To update/modify your current routing address, login to http://isis.uiowa.edu/. Then click
on My UIowa >My Email> Update Email Routing Address. Modify your routing address as
desired, and click on the Update Email Routing Address button to submit your change.
For additional information about your UI email account, visit:
http://its.uiowa.edu/hawkmail
E-mail is an official method of communication at The University of Iowa. This means that
instructors and students can expect to receive important communications via email.
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Abnormal Psychology
BEFORE YOU BEGIN

You should spend some time, before your course texts arrive, reviewing the study guide. When your
reading materials arrive, you should be ready to begin your work. However, before you begin
working on the first lesson, carefully read the material on the following pages entitled,
Studying in this course (and in other courses too). Good luck!
Studying in This Course (and in other courses too)

I'm convinced, though it may be hard to prove, that few students get bad grades because they are
not intelligent. There is little in the average college curriculum (including abnormal psychology)
that is beyond the intellectual capacities of most college students. I am convinced that most
students get poor grades because they do not know how to study.
Being a student is a job. The hours are long and the pay is non-existent, but it is still a job. The
payoff is the knowledge you gain and the grades you get. You have been at this "job" for many years,
and you are probably not through with it. If this is your job, it makes sense to learn how to become
good at it. Are you learning? Are you working efficiently and getting the results you should get? This
study guide incorporates features to help you develop good study skills. If you spend a little time
consciously working on your study skills, you can help the process along.
This chapter is intended to help you review and improve your study skills. The first part of the
chapter describes a variant of a system, SQ4R, you can use in this, or almost any, course. The second
part of the chapter contains suggestions for dealing with common study problems.
The SQ4R Study System*
As you begin to study a new chapter, follow this plan.

Survey
First, briefly survey the entire chapter. Take five to ten minutes to get a general idea of the material.
Look over the titles and pictures, read the overview, chapter summary, and essential concepts of
this study guide and the introduction and summary in the text. While doing this, actively ask
yourself what you will be studying. Figure out how the text is organized to cover the topic. Do not
*Reprinted
with permission of John Wiley and Sons, Inc., from Study Guide: Abnormal Psychology, fifth edition, by
Douglas Hindman. Copyright by John Wiley and Sons.
12
read the chapter in detail yet. The brief survey will help you focus your attention and familiarize
you with new vocabulary and concepts. Research suggests that surveying the chapter can reduce
your study time by 40 percent.
Read
Read the chapter actively. To read actively, take the first portion of the chapter and turn the main
heading or topic into a question. What are you being told? Then read the first portion, looking for an
answer to your question. It is important that you actively seek the answer as you read. Deliberately
try not to read every word. Instead, read for answers. Continue on in this way until you complete
the chapter.
Typically, a text will make several points regarding each general topic. Look for words indicating
these points such as "first," "furthermore," or "finally." Generally, a paragraph contains one idea.
Additional paragraphs may elaborate on or illustrate the point. You may find it helpful to number
each point in the text as you come to it.
Write
Write down the answer. This step is important. By writing the answer, you confirm that you
actually understand it. Occasionally you will discover that you do not really understand the idea
when you try to write it down. That is fine and to be expected on occasion. Go back and read some
more until you figure it out.
As you write the answer, strive to use as few words as possible. Being concise is important. Try to
come up with a few key words that convey the idea. When you condense a long portion of text into a
few key words that express the whole idea, you know you understand the idea clearly. The few key
words you write down will be meaningful to you so you will remember them. Do not write
complete sentences or elaborate excessively. The fewer words you can use, the better you probably
understand and will remember the concept.
Recite
After you finish the chapter, go back and quiz yourself. Do this aloud. Actively speaking and
listening to yourself will help you remember. Look at each question and try to repeat the answer
without looking. Cover your answers with a sheet of paper so you do not peak accidentally. If you
have done the earlier steps as well, this phase will not take much time.
13
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Abnormal Psychology
Review
Set aside a few minutes every week to recite the material again. Put several questions together and
try to recite all the answers to a whole general topic. If you do this regularly, you will find that it
takes little time to refresh yourself for an exam.
Ask a friend to read the questions and tell you if your answers make sense. This step helps you to
understand (not just memorize) the material. As you discuss your answers with someone else, you
develop new ways of looking at the material. This can be especially helpful when the test questions
are not phrased quite the way you expected.
This technique is one variation of a study method called SQ4R (Survey, Question, Read, Rite,
Recite, Review). If you are not used to it, it may seem a bit complicated at first. If you check around,
though, you will find that many of the "good" students are already using it or a similar system.
Research suggests that SQ4R works. It takes a bit of extra effort to get used to, but remember that
studying is a skill and that learning any skill (like typing, driving, and playing ball) takes time and
practice. You will find, though, that your efforts will pay off in this and in your other courses.
Coping with Study Problems
The previous section of this chapter described an active study technique that has proven useful to
many students. This section talks about common study complaints and what to do about them.
Finding the Time
Does it seem like you never have time to studyor that you study all the time and still are not
getting the results? Admittedly, studying takes time, but that time can be used more efficiently.
The traditional rule of thumb is that you should study two hours outside of class for every hour in
class. If that sounds like a lot, consider. The average college student class load is 15 semester hours.
If you study two hours for each class hour, that is 30 additional hours, for a "work week" of 45
hours.
If you have trouble finding that 45 hours, it is time to examine how you spend your time. Make a
"time log." You can copy the time log at the end of this section or make one of your own. Use it to
record how you spend your time for a week or so. Do not try to change what you are doing. Just
record it. After a week or so, stop and look at how you are using your time. There are 90 hours
between 8:00 a.m. and 11:00 p.m. in a six-day week. If you devote half of those hours to the "job" of
being a student, you will still have 45 hours left. It is your time.
14
You may want to schedule your time differently. You will need to decide what works for your style
and situation. If you set up a schedule, be sure to include time for things you really enjoy as well as
time to eat, do your laundry, etc. Schedule adequate studying time and actually spend it studying. If
you get everything done and have time left over, use it to get ahead in some class. When your study
time is over, you should be able to enjoy other activities without worrying about your "job."
Getting Started
Do you find it difficult to actually get down to work when it is study time? Many students find it
helpful to find or make a specific study place. It could be a desk in your room, the library, or any
place where you will not be disturbed and have access to books and materials.
Use your study place only to study. If it must be a place where you do other things, change it in
some way when you use it to study. For example, if you use the kitchen table, clear it off and place a
study light on it before you start to study. If you are interrupted, leave your study place until the
interruption is over and you can return to studying.
If you do this, you will soon get into the habit of doing nothing by studying in your own study place
and will be able to get to work as soon as you sit down.
Reading the Material
Some students think that effective study means to read the chapter three or four times. This could
be called the "osmosis approach" to studying. You expose yourself to the words in the text and hope
something will sink inlike getting a sun tan. This approach does not work.
If you just read the chapter, you will often realize that you have been looking at words but have no
idea what they mean. If you come to a difficult idea, you are likely to skip over it. When you re-read
the chapter, you are likely to recall that the idea was difficult and skip over it again. The result is
that you end up having read the chapter three or four times without understanding most of it.
Instead, use an active study technique like the SQ4R system described earlier. Research indicates
that active study techniques can dramatically increase how fast you learn material and how much of
it you recall.
Underlining the Text

Many students underline or highlight their texts, and it works wellsometimes. For most people,
underlining is not as efficient as taking notes. The danger in underlining things is that you tend to
underline things to be learned later rather than learning them now. Thus, you can end up with half
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Abnormal Psychology
of the chapter underlined and none of it learned. If you must underline, try to underline as few
words as possible in the same way as the "key words" approach described in the "Write" section
described earlier. Avoid using textbooks that someone else underlined. That person may have been
a poor underliner. More importantly, the value of underlining (like the value of taking notes) is in
doing it yourself and in learning what is important in the process.
Reading Speed
Are you a slow reader? Slow reading can lead to a number of problems. Most obviously, it takes too
long to get through this material. More importantly, you lose interest before you get to the main
point. You forget the first part of an idea before you get to the end. You may not understand a
concept unless it is clearly stated in one sentence. You may misinterpret material because you take
so long getting through it that you start reading in your own ideas.
If the description above sounds familiar, you might want to check your reading speed. To check
your speed, have someone time you while you read for exactly five minutes. Estimate the total
number of words you read and divide by five. To estimate the total words you read: count the
number of words in five lines and divide by five to get the average number of words per line. Then
count the number of lines you read and multiply the number of words per line.
For textbook material, an efficient reading speed is about 350 to 400 words per minute
depending on the difficulty of the topic and your familiarity with it. For novels and other leisure
reading, many students can read 600 to 800 words per minute. Speed-readers can read much
faster. Remember that understanding and flexibility in your reading style is more important than
mere reading speed. But often, increased speed actually improves your understanding.
You can increase your reading speed to some extent by conscious effort. If you watch someone read,
you will notice that their eyes move in "jerks" across the line. Our eyes can read words only when
stopped; we read a group of words, then move our eyes, read the next group of words, and so on. To
increase reading speed, try to take in more words with each eye stop. Do not be concerned with
every "and" and "but." Try to notice only the words that carry the meaning. Read for ideas, not
words.
If you read very slowly, you should consider seeking special help. Most campuses now have reading
laboratories where you can get specialized instruction and help to increase your reading speed. [If
you are a student at The University of Iowa, contact the Reading Lab at the Department of Rhetoric.]
16
Analyzing Tests
Perhaps you studied hard but still did poorly on the test. How can you make sure that the same
thing does not happen again?
You will find it helpful to analyze what went wrong on each question you missed. [If you live in the
Iowa City area, you may review your exam at Continuing Education Testing Center, 250 CEF, 30
South Dubuque Street. If you live elsewhere, we can send your graded exam to your proctor, who
will allow you to review the exam under supervision. Exams cannot be kept by students.]
Review the test and your study notes or study guide. Look at each question you got wrong and
reconstruct what happened. Did you have the answer in your notes? If so, why did you not
recognize it on the test? Do this for each question you got wrong and look for a pattern. Here are
some possibilities.
Was the answer not in your study notes at all? Perhaps your study notes are incomplete. If they did
not cover the entire chapter, then you did not study everything. Make sure your notes are complete
the next time.
If your study notes seem complete, go back and compare them to the text. Perhaps you misread the
text, got the concept wrong, or only got part of it. Make sure you read the entire section of the text.
Sometimes the first sentence of a paragraph only seems to convey the idea. Perhaps, also, you need
to read faster. Slow readers often have trouble with complex concepts that are not clearly stated in
one sentence.
Perhaps the answer was in your study notes, but you did not remember it on the test. You can be
pleased that you had it in your notesbut why did you not remember it? Were you too tense? Do
you need to recite/review more?
Perhaps you knew the answer but did not recognize it because of the way the question was
phrased. That suggests you are stressing memorization too much. Try to review with someone else.
Get them to make you explain your answers and discuss ways they would say it differently. This
will help you understand ideas when they are stated differently.
More Help
If you are a student at The University of Iowa, you can contact the University Counseling Service
(335-7294; http://www.uiowa.edu/~ucs/ ) for help in improving study skills. At least once a
semester, the Counseling Service puts on a special series of informational meetings dealing with
study skills. If you are not an admitted University of Iowa student or if you do not live in the Iowa
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City area, call one of our academic advisors at the Center for Credit Programs (335-3575 locally or 1
(800) 272-6430 toll-free), who will be glad to offer guidance concerning ways to improve study
skills.
18
Time Log
Time
Doing What?
Date:
Where?
_________________
Comments
7:007:308:008:309:009:3010:0010:3011:0011:3012:0012:301:001:302:002:303:003:304:004:305:005:306:006:307:007:308:008:309:009:3010:0010:3011:00-
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Abnormal Psychology
LESSON 1 INTRODUCTION AND HISTORICAL OVERVIEW

Objectives:
READING ASSIGNMENT:
By the end of this lesson, you should know:

1. The definitions of psychopathology and abnormal
behavior.
2. The different types of professionals involved in the
Kring, Johnson, Davison

& Neale
Chapter 1
pp. 1-30
field of mental health.
3. How abnormal behavior was treated in the past.
4. When and by whom the biological and psychological viewpoints were first postulated.
5. What mental hospitals are like today.
Key Terms:
anal stage
asylums
behavior therapy
behaviorism
conditioned response
(CR)
conditioned stimulus
(CS)
counseling
psychologist
defense mechanism
cathartic method
demonology
extinction
id
marriage and family

therapist
operant conditioning
positive
reinforcement
psychoactive
medications
psychopathology
stigma
unconditioned
response (UCR)
classical conditioning
ego
fixation
latency period
modeling
oral stage
psyche
psychoanalysis
psychotherapy
superego
unconditioned
stimulus (UCS)
clinical psychologist
electroconvulsive
therapy (ECT)
genital stage
law of effect
moral treatment
phallic stage
psychiatric nurse
psychoanalytic theory
reality principle
systematic
desensitization
unconscious
collective unconscious
exorcism
harmful dysfunction
libido
negative reinforcement
pleasure principle
psychiatrist
psychological disorder
social worker
transference
20
Key Figures:
Alfred Adler
Aaron Beck
Josef Breuer
Dorothea Dix
Hippocrates
Carl Jung
Franz Anton Mesmer
Paracelsus
Jean Martin Charcot

Ivan Pavlov
Edward Thorndike
Instructor Notes:
Albert Ellis
Philippe Pinel
John B. Watson
Sigmund Freud
Benjamin Rush
Joseph Wolpe
Francis Galton
B.F. Skinner
Abnormal psychology is the study of the causes, symptoms, and effects of mental illness. Kring,
Johnson, Davison, and Neale regard abnormal behavior as being comprised of four key
characteristics: (1) personal distress, (2) disability, (3) violation of social norms, and (4)
dysfunction. It is important to keep in mind that many individuals in society display aberrant
behaviors that should not be labeled as psychopathology. The key to a diagnosis of
psychopathology is whether the behavior causes distress or life interference in the individual or in
others around him or her.
Your text indicates that definitions of psychopathology have changed over time. For example,
homosexuality was considered a form of psychopathology thirty years ago. However, today it is
realized that most individuals are well-adjusted, productive members of society regardless of their
sexual orientation. In contrast, some concepts put forth many years ago by individuals who studied
mental illness have remained influential in the field of abnormal psychology. Hippocrates proposed
that abnormal behavior was the result of some brain pathology almost 4,000 years ago, and it
continues to be one of the dominant viewpoints regarding the causes of abnormal behavior.
The treatment of individuals with psychopathology has also evolved. Early civilizations adhered to
the doctrine of demonology, which suggests that evil beings reside within individuals with mental
illness and control their minds and bodies. Mentally ill individuals often were subject to exorcism,
with the belief that the procedure would drive out the evil spirits. Although Hippocrates' biological
theory of mental illness advanced the notion that abnormal behavior is a result of an imbalance of
bodily substances, Europeans in the Dark Ages reverted to condemning individuals with
psychopathology as being influenced by evil. In the fifteenth and sixteenth centuries, asylums were
created to provide housing for individuals with mental illness. However, residents of these
institutions were horribly mistreated and lived in deplorable conditions. Individuals such as
Philippe Pinel and Dorothea Dix crusaded against these conditions and advocated for the humane
treatment of individuals with mental illness. Unfortunately, today many mental hospitals are sterile,
21
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Abnormal Psychology
understimulating environments that appear to do little more than house individuals with severe
psychopathology.
The study of contemporary psychopathology is shaped by two opposing viewpoints: the biological
approach and the psychological approach. Francis Galton, a proponent of the biological viewpoint,
was one of the earliest genetic researchers. His twin studies, conducted in the late 1800s led him to
conclude that many behavioral characteristics were hereditary. Individuals aligned with the
psychological approach used techniques such as hypnosis and catharsis to treat individuals with
mental illness, especially hysteria. Early theories of psychoanalysis, behaviorism, and cognition
continue to influence the field of psychopathology today.
Psychoanalytic theory, pioneered by Sigmund Freud, posits that abnormal behavior emerges as a
result of unresolved conflicts in the unconscious. Freud delineated several structures at work in
personality development, such as the id, ego, and superego. He outlined four stages of childhood
development, and he speculated that failure to resolve conflicts inherent in each of these stages
results in adult psychopathology. One of Freud's biggest contributions was his characterization of
defense mechanisms, or ways of coping with anxiety. Examples of defense mechanisms include
repression, displacement, and sublimation. There are instances when each of us uses these defense
mechanisms in handling stress associated with daily life. Currently, the concept of defense
mechanisms is still considered in formulating psychotherapy cases. Although the psychoanalytic

paradigm has been criticized extensively for its lack of empirical support, your text highlights
several ways this paradigm has influenced thinking about psychopathology (p. 20-21).
Another important perspective within the psychological approach to abnormal behavior is
behaviorism: a school of thought that considers the effects of stimuli in the environment on
observable behavior only (i.e., not on consciousness or mental functioning). Two types of learning
are central to this approach, and you have probably encountered them in other psychology classes.
Classical conditioning is a simple methodology in which a neutral stimulus is paired with a
stimulus that has meaning. After many associations, the neutral stimulus takes on the same
meaning. For example, let's suppose that every time a child's grandmother visits, he is showered
with affection. When he receives the affection, he feels happy and warm. The unconditioned
stimulus is the affection and giftsthis stimulus inherently produces feelings of warmth and
happiness, which are the unconditioned responses. As the child gets older, he begins to associate
his grandmother with affection. After several visits, he feels warmth and happiness whenever he
sees his grandmother, even before she showers him with affection. The grandmother has become
22
the conditioned stimulus, and the warmth and happiness that he feels when he sees his
grandmother have become the conditioned responses. Suppose the grandmother stopped
showering him with affection. After a while, the child would no longer associate warmth and
happiness with seeing his grandmother. This represents a process called extinction. In the context
of abnormal psychology, classical conditioning has the most relevance to the development of
phobias (see Chapter 6).
The other main type of learning is called operant conditioning. In the classical conditioning
example above, the child was a passive recipient of the conditioning; that is, he did not exert any
behavior for the learning to occur. In contrast, learning occurs in operant conditioning when an
individual's behavior is reinforced in some manner. Let's continue to consider the child in the above
example. Suppose he receives an A on his first spelling test, and his grandmother takes him out for
ice cream. This is an example of positive reinforcement because the grandmother is strengthening
his tendency for him to do well in spelling by rewarding him with a positive event. Negative
reinforcement also strengthens responses, but it does so by removing an aversive event or
stimulus. Say that one of the boy's chores is to wash dishes every night, a task that he despises.
Because he gets an A on his spelling test, his mother tells him that he does not need to wash dishes
that night. Thus, his mother rewarded him for doing well on the test by relieving him from a duty
that he finds aversive. The rule of thumb is that the word reinforcement always means that behavior
is rewarded. Punishment, on the other hand, decreases the frequency of a behavior. Suppose this
boy was caught picking on his younger sister. If his parents were to give him a spanking, this would
be an example of positive punishment because he received an aversive event for his behavior. A
negative punishment would signify that a pleasant stimulus or event was taken away from him,
such as the privilege of watching his favorite TV show.
Your text briefly discusses other psychological approaches to abnormal psychology such as
cognitive therapy. In the context of abnormal psychology, cognitive therapists evaluate faulty
thought patterns and relate them to an individual's abnormal behavior, relationships, and mood.
For example, in Albert Elliss rational-emotive therapy, irrational beliefs are identified and
challenged. A depressed individual may think that she fails at everything she attempts. A rationalemotive therapist might attempt to modify this belief into "I fail at some things and succeed at
others, much like everyone else."
Today, the biological and psychological approaches to treating mental illness are not mutually
exclusive. That is, individuals with mental illness are often classified by a particular diagnosis,
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Abnormal Psychology
consistent with a biological perspective, and participate in psychotherapy, consistent with a
psychological perspective. Both of these approaches to the study of psychopathology have utility in
treating mentally ill individuals.
Throughout this course we will rely on scientific methods to increase our understanding of
abnormal behavior. However, a commitment to science in the study of abnormal behavior is a
relatively recent phenomenon. Nonscientific approaches to the study of abnormal behavior were
prevalent through the beginning of the twentieth century. Often, Kring, Johnson, Davison, and Neale
use the term paradigm to describe a basic set of assumptions that guides theorizing and research
within a field such as abnormal psychology. Even within the scientific study of abnormal behavior,
there are different paradigms (or perspectives) from which we view abnormal behavior. These
different scientific perspectives will be elaborated in future chapters of Kring, Johnson, Davison,
and Neale.
Self-Test Exercise
Complete the Chapter 1 Self-Test Quiz on the ICON course site, or use the one provided in the
appendix at the end of this study guide.
Thought Questions (Optional)
To more thoroughly study this topic, consider the following questions. They are intended for your
own use as you seek to more deeply understand the material; do not submit them for grading.
1. Describe the roles of different types of mental health professionals. Which one fits best with
the way you would approach an emotional or psychiatric difficulty?
2. What are the different aspects of abnormal behavior? How does the conceptualization
outlined in Kring, Johnson, Davison, and Neale differ from your view before you entered this
course?
3. What is your view of abnormal psychology as a science?
Further Reading (Optional)
James, W. The Principles of Psychology, volumes 1 and 2. New York: Dover, 1890/1950.
Sternberg, R. J., editor. Career Paths in Psychology. Washington, D.C.: American Psychological
Association, 1997.
24
There is no written assignment for Lesson 1. You will submit

Written Assignment #1 following Lesson 3. GO on to Lesson 2.
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Abnormal Psychology
LESSON 2 CURRENT PARADIGMS IN PSYCHOPATHOLOGY

Objectives:
READING ASSIGNMENT:

1. The role of paradigms in the study of abnormal
psychology.
2. The general methods of behavioral genetics and the

& Neale
Chapter 2
pp. 31-65
type of information behavioral genetics studies

yield.
3. Some of the basic facts about the genetic, neuroscience, and cognitive behavioral paradigms.
For example:
a. Proposed causes (etiologies) of abnormal behavior.
b. The major proponents of each paradigm.
c. Empirical support.
d. Strengths and weaknesses.
4. The extent to which any one paradigm is adequate in its account of abnormal behavior.
5. Factors that influence psychopathology across the paradigms.
6. The concept of diathesis-stress and how this concept may serve to integrate other
paradigms.
Key Terms:
agonist
allele
amygdala
behavior genetics
behavior medicine
behavioral activation
(BA) therapy
anterior cingulate
cardiovascular disease
cognitive behavioral
paradigm
cortisol
emotion
gamma-aminobutyric
acid (GABA)
genetic paradigm
heritability
attachment theory
cerebellum
cognitive restructuring
diathesis
epigenetics
gene
genotype
hippocampus
Autonomic nervous
system (ANS)
cognition
copy number variation

(CNV)
diathesis-stress
exposure
gene expression
gray matter
HPA-axis
antagonist
behavior genetics
brain stem
cogenitive behavior
therapy (CBT)
corpus collosum
dopamine
frontal lobe
gene-environment
interaction
health psychology
hypothalamus
26
in-vivo
Interpersonal therapy
(IPT)
molecular genetics
neuron
object-relations theory
occipital lobe
paradigm
parasympathetic
nervous system
polymorphism
neuroscience paradigm
parietal lobe
prefrontal cortex
septal area
single nucleotide
polymorphism (SNP)
thalamus
white matter
neurotransmitters
phenotype
pruning
serotonin
sympathetic nervous
system
time-out
nonshared
environment
polygenic
reuptake
serotonin transporter
gene
synapse
transcription
norepinephrine
schema
shared environment
temporal lobe
ventricles
Key Figures:
Mary Ainsworth
Thomas Kuhn
Aaron Beck
John Bowlby
Sigmund Freud
Instructor Notes:
Each of the major schools of psychopathology is discussed in the assigned chapter. The authors of
your text have often been identified with the cognitive behavioral paradigm. Toward the end of the
chapter, they write that they really subscribe to a diathesis-stress view that incorporates the
behavioral and biological paradigms. Which of the paradigms that they describe seems most
compelling to you? You will probably come to believe that each school of psychopathology has
something unique to offer our understanding of abnormal behavior.
Proponents of the genetic paradigm are interested in how our genes interact with our environment
to determine behavior. One area of research within the genetic paradigm is behavioral genetics.
This type of research attempts to identify the extent to which psychopathology can be attributed to
the transmission of genes. There are three main methodologies in behavior geneticsthe family
method, the twin method, and the adoption method. As you will see in later chapters, each of
these methods has yielded evidence that the onset of some psychiatric disorders, such as
schizophrenia, is partially due to genetic causes. Another area of research within the genetic
paradigm is molecular genetics which attempts to identify specific genes and their functions.
Proponents of the neuroscience paradigm hypothesize that mental disorders are a result of
irregular brain processes. One such area of research in this paradigm pertains to the structure and
27
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Abnormal Psychology
function of the brain. For example, studies show that the amygdale is critical to the induction and
experience of fear. One such study found that a patient with bilateral amygdala damage did not
demonstrate a fear response when exposed to a variety of stimuli (e.g., poisonous spiders) even
though she reported knowing that she should be afraid of such stimuli (Feinstein, Adolphs, Damasio,
& Tranel, 2011).
The cognitive behavioral paradigm stems from behaviorism and cognitive theory that were
introduced in Chapter 1. Behavioral activation therapy, systematic desensitization and exposure,

and cognitive behavioral therapy are all treatments consistent with the cognitive behavioral
paradigm. For example, Aaron Becks cognitive therapy for depression is based on the hypothesis
that depression results from peoples negative cognitions (e.g., Im not good enough). Becks
model proposes that depressed people show biased processing of information (i.e., pay more
attention to criticism than praise) and his cognitive therapy attempts to help patients challenge and
change their negative cognitions.
Unlike the other paradigms discussed in Chapter 2, the diathesis-stress paradigm takes an
integrative approach to psychopathology. It posits that biological vulnerabilities predispose the
development of psychopathology, and an environmental stressor causes the psychopathology to be

expressed.
The book highlights three different factors that play an important role in understanding
psychopathology: emotion, sociocultural factors, and interpersonal factors. For example, because of
the important role interpersonal factors play in psychopathology, interpersonal therapy (IPT) aims
to guide a patient in solving problems in their interpersonal relationship. Notably, IPT is studied as
a treatment for postpartum depression and depression during pregnancy at the University of Iowa
by Dr. OHara.
Self-Test Exercise:
Thought Questions: (Optional)
1. Does the genetics paradigm make the other paradigms obsolete?
28
2. Reread the case of Jack and Felicia. on pages 1-2 of Chapter 1. How might the genetics
paradigm be applied to these cases? The neuroscience paradigm? The cognitive behavioral
paradigm? The diathesis-stress paradigm?
3. Suppose you are a therapist treating an individual who presents as having "relationship
problems" with his wife. What parts of the various paradigms would you adopt in
formulating a treatment plan for this person? Now examine your treatment plan. Does it
mainly borrow approaches from one paradigm, or is your treatment plan truly eclectic?
Further Reading (Optional):
Appleton, W. S. Prozac and the New Antidepressants. New York: Penguin Books, 1997.
Freud, Sigmund. The Basic Writings of Sigmund Freud, translated by A. A. Brill. New York: Random
House, Modern Library Series, 1995.
Kramer, P. D. Listening to Prozac. New York: Viking Books, 1993.
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Abnormal Psychology
WRITTEN ASSIGNMENT #1: PART A

Write a brief discussion of the topic below, following the guidelines for written assignments
laid out in the Introduction of this study guide. Your discussion should be no longer than one
or two type-written, double-spaced pages.
At this point in the course, which paradigm do you believe is the most adequate to explain
abnormal behavior? Why?
After completing this assignment go on to Lesson 3. You will submit
this assignment as Part A of Written Assignment #1 following Lesson 3.
30
LESSON 3 DIAGNOSIS AND ASSESSMENT

Objectives:
READING ASSIGNMENT:

1. The purposes of diagnosis and assessment.
2. The different types of reliability and validity.
3. The basic features, historical changes, strengths,

& Neale
Chapter 3
pp. 66-104
and weaknesses of the DSM.
4. The goals, strengths, and weaknesses of psychological and neurobiological approaches to

assessment.
5. The ways in which culture and ethnicity impact diagnosis and assessment.
Key Terms:
alternate-form
reliability
behavioral assessment
BOLD
categorical
classification
content validity
criterion validity
CT of CAT scan
diagnosis
clinical interview
Diagnostic and
Statistical Manual of
Mental Disorders
(DSM-5)
comorbidity
dimensional
diagnostic system
concurrent validity
ecological momentary
assessment (EMA)
construct validity
electrocardiogram
(EKG)
electrodermal
responding
electroencephalogram
(EEG)
functional magnetic
resonance imaging
(fMRI)
intelligence test
Minnesota Multiphasic
Personality Inventory
(MMPI)
neurologist
neuropsychological
tests
neuropsychologist
internal consistency
reliability
interrater reliability
personality inventory
PET scan
reliability
Research Domain
Criteria (RDoC)
projective test
standardization
Thematic Apperception
Test (TAT)
psychological tests
stress
validity
magnetic resonance
imaging (MRI)
metabolite
predictive validity
projective hypothesis
Rorschach Inkblot Test
self-monitoring
psychophysiology
structured interview
reactivity
test-retest reliability
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Abnormal Psychology
Key Figures:
American Psychiatric
Association
Alfred Binet
Hermann Rorschach
Instructor Notes:
The Diagnostic and Statistical Manual of Mental Disorders, or DSM, is the system that describes the
symptoms that make up categories of psychopathology. The DSM-V, released in May of 2013,
represents the current version of an attempt by the American Psychiatric Association to remedy
many of the problems that brought its older systems so much criticism (see Focus on Discovery 3.1
in Kring, Johnson, Davison, and Neale, pg. 66 for a history of classification). Nevertheless, many
psychologists question whether any diagnostic system is useful.
Your book includes a great deal of information on the changes made in the new DSM-5. Each time
the DSM is revised, improvements are made to the classification system based on current research.
Your book notes a number of changes in the DSM-5 including: removal of the multiaxial system,
organizing diagnoses by causes (though diagnoses are still defined by symptoms), enhanced
sensitivity to the developmental nature of psychopathology, new or combined diagnoses, clearer

criteria, and a greater emphasis on ethnic and cultural considerations in diagnosis.
The DSM-5 does not contain the multiaxial classification system found in DSM-IV-TR. This is an
approach by which individuals are rated on five dimensions that cover a broad range of
information. Axes I and II characterize psychopathology. Whereas Axis I includes most categories of
mental disorders, Axis II reflects long-standing personality or developmental difficulties that affect
mental functioning. For example, depression is an Axis I disorder and mental retardation is an Axis
II disorder. Axis III communicates information about medical conditions that are relevant to the
level of an individual's functioning or distress. Axis IV reflects psychosocial difficulties that might
contribute to the expression or severity of a disorder, such as unemployment, lack of social support,
or inadequate housing. Finally, Axis V incorporates information about a variety of areas of an
individual's life to estimate an overall level of the individual's adaptive functioning. Scores on Axis V
range from 0100. Consider an individual who presents to a clinic for depression. After a thorough
assessment, the clinician determines that this individual has a history of affective lability, chaotic
interpersonal relationships, and self-harm behavior. Moreover, she recently has been diagnosed
with breast cancer, and there are few, if any, family members to whom she can turn for support. As
a result of these difficulties, she has been functioning below what is expected at work and has
32
isolated herself from her few friends. An example of a multiaxial diagnosis for this person is as
follows:
Axis I:
Major Depressive Disorder
Axis II: Borderline Personality Disorder

Axis III: Breast Cancer
Axis IV: Problems with primary support group
Axis V: Global Assessment of Functioning (GAF; current) = 45
The new DSM-5 removes this multiaxial system, instead instructing clinicians to simply note
psychiatric and medical diagnoses rather than use Axes I-III.
There are several criticisms of diagnostic classification systems and of the DSM, in particular. First,
it can be argued that labeling individuals with a category of psychopathology does not communicate
the unique situation of that person. Moreover, the mere fact that an individual has a psychiatric
diagnosis may lead to prejudice or ridicule. Also, the DSM-V is a system of categorical
classification. That is, a person either has or does not have a particular disorder. In contrast, many
psychologists argue that a dimensional system best captures symptoms of psychopathology. They
suggest that we all have some levels of depression, anxiety, and personality traits that make up the
personality disorders. This debate is still very much alive, but for now, the categorical approach to
classification remains.
Reliability and validity are important concepts to understand in evaluating diagnostic
classification systems. According to the text, reliability refers to "consistency of measurement (p.
64)." For example, the category of major depression is considered reliable only if several clinicians
would come to the independent conclusion that an individual meets criteria for this disorder.
Validity pertains to the meaningfulness of the category. If an individual is given a diagnosis of major
depression, that label should communicate accurate information about the etiology (cause),
symptoms, and prognosis of the disorder.
The concepts of reliability and validity are not only important in understanding diagnostic
classification, but they are also critical concepts in assessment generally. Your text refers to
reliability and validity as the cornerstones of diagnosis and assessment. Without them,
psychological assessment would be useless. Kring, Johnson, Davison, and Neale refer to specific
types of reliability to give the reader an idea of the manner in which reliability is determined. Testretest reliability, for example, is calculated when the same individuals take a test on two different
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Abnormal Psychology
occasions. Reliability is determined by correlating the scores obtained at Time 1 and Time 2. If test-
retest reliability is very low even when a great deal of time has passed between test taking
occasions, then one must question whether the test is really assessing a stable personality trait.
Validity ensures that the test measures what it is supposed to measurethat it is meaningful. The
most difficult type of validity for students to understand is construct validity. Construct validity
reflects the extent to which the variable that is measured by a test (i.e., depression) is related to
other variables that would be predicted theoretically. For example, one subtype of depression is
called melancholic depression, and it is characterized by guilt, sleep disturbance, loss of interest in
activities, and lack of reactivity to pleasurable stimuli. For a measure of melancholic depression to
have construct validity, individuals with this subtype of depression who score high on this
inventory must report a high number of sleepless nights, increased guilt, and lack of interest in
activities on other inventories that are related theoretically. Assessment has always been an
important activity of psychologists. Intellectual, neuropsychological, personality, and behavioral

assessment generally have been the province of the psychologist, rather than the psychiatrist or
social worker. Historically, psychologists received training in these techniques, which were largely
unavailable to other professional groups. This unique emphasis on psychological assessment in the
training of psychologists stands in contrast to the emphasis that most mental health disciplines
place on training in psychotherapy.
Your text describes several methods of psychological assessment. Kring, Johnson, Davison and
Neale describe the clinical interview as an important method of psychopathological assessment.

Although the clinical interview can lead to low reliability of diagnoses, several structured
interviews have been developed in the past twenty years to increase interviewer reliability (i.e., the
extent to which interviewers make the same diagnosis). A structured interview is one in which
the interview questions assess symptoms that make up DSM diagnoses and are asked in a standard
manner. Questions and decision rules are specified in advance so that the interviewer uses his or
her judgment only in rare instances. One example is the Structured Clinical Interview for DSM-IV,
and is discussed in more detail on page 81 of your text. Of course, it is important to realize that
building rapport with the individual is important in obtaining information in any type of clinical
interview.
Psychological tests are those in which the performance of an individual is compared to normative
values in order to assess his or her relative standing on psychological variables. For example,
personality inventories are self-report measures that assess a variety of adaptive and maladaptive
personality traits. Your text describes at length the most well-known personality inventory, the
34
Minnesota Multiphasic Personality Inventory (MMPI). The MMPI measures a wide range of traits
associated with personality and psychopathology, such as depression, hypochondriasis, and mania.
However, many other inventories are much shorter and assess only one or two variables. The Beck
Depression Inventory, for example, is a standard measure of self-reported depressive
symptomatology. It consists of twenty-one items assessing variables such as lack of interest and
suicidality.
Projective tests are some of the most controversial methods of psychological assessment.
Proponents of projective tests believe that the unstructured format allows an individual's
unconscious motives and attitudes to emerge. However, many psychologists question the reliability
and validity of projective tests. Moreover, these tests often take an inordinate amount of time to
score and interpret. At present, the use of projective assessments is declining.
Your text describes several methods to assess cognitive abilities. Intelligence tests consist of tasks
assessing language, abstract thinking, visuo-spatial skills, attention and concentration, nonverbal
reasoning, and speed of processing. Together, scores on these subtests make up an individual's
intelligence quotient (IQ). Neuropsychological assessment uses testing in order to localize areas
of the brain that are not functioning properly. Typically, neuropsychologists give a large battery of
tests to individuals undergoing a neuropsychological assessment. Tests in such a battery usually
include those that assess attention, verbal and visual memory, and perception. Often, older adults
complete neuropsychological assessments to measure whether their cognitive abilities are
declining.
Kring, Johnson, Davison, and Neale describe several methods of neurobiological assessment. It is
important to be aware of these methodologies, as they are becoming increasingly important in
psychological research. In particular, neurotransmitter assessment is important because
dysregulation of neurotransmitters is thought to underlie psychopathology. While it is important
for you to recognize the names of these assessment techniques and parts of the brain to which they
correspond, you are not responsible for knowing the details of this section. Psychophysiology is
another assessment approach that combines biological approaches with the study of behavior. Skin
conductance, for example, is an important marker for fear and anxiety. When individuals
experience anxiety, such as in anticipation of an electric shock, their skin conductance tends to
increase. Psychophysiological methods are usually used in research rather than in clinical settings
because of the high cost of the purchase and maintenance of the equipment.
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Abnormal Psychology
Self-Test Exercise:
Thought Questions (Optional):
1. Consider the following DSM-I diagnostic criteria for Obsessive Compulsive Reaction:
In this reaction, the anxiety is associated with the persistence of unwanted ideas and of
repetitive impulses to perform acts which may be considered morbid by the patient. The
patient himself may regard his ideas and behavior as unreasonable, but nevertheless is
compelled to carry out his rituals. The diagnosis will specify the symptomatic expression of
such reactions, as touching, counting, ceremonials, hand-washing, or recurring thoughts
(accompanied often with a compulsion to repetitive action). This category includes many
cases formerly classified as "psychasthenia."
Your task is to develop better operational definitions of the criteria listed. Does this
example help you to better understand the task faced by the committee to revise DSM?
2. Are learning disabilities mental disorders?
3. What is your view on how culture should be considered in making diagnoses of mental
illness?
4. Suppose you are a psychologist and an individual presents for therapy with test anxiety.
This individual performs well below what is expected on timed tests, and lately she has
become down about her low grades. How would you proceed with a psychological
assessment?
5. How do you define intelligence? Based on the little you read in the text and in the
discussion, do you feel that intelligence tests are valid? Why or why not? What additional
variables would you include and how would you measure them?
6. What psychophysiological variables correspond with the physical experience of anxiety?

Anger? Happiness? Surprise? How would you measure these variables?
American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders-Fourth

Edition. Washington, D.C., 1994.
36
Kirk, S. A. and H. Kutchins. The Selling of DSM: The Rhetoric of Science in Psychiatry. Hawthorne,
New York: Aldine De Gryter, 1992.
Journal of Clinical and Consulting Psychology 64 (1996). [A special issue devoted to the topic of
developing theoretically coherent alternatives to the DSM-IV.]
Lezak, M. D. Neuropsychological assessment, third edition. New York: Oxford University Press, 1995.
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WRITTEN ASSIGNMENT #1: PART B

Create a log, graph, and response to the activity described below, following the guidelines for
written assignments laid out in the Introduction of this study guide. Your response should be
no longer than one page.
There are many types of assessment procedures used in clinical psychology. One commonly used
procedure is to have a person pay attention to a particular behavior systematically over a period of
time. Very often these are behaviors that a person might want to increase or decrease (e.g.,
smoking, exercise). We call this procedure self-monitoring (see Kring, Johnson, Davison, and
Neale, pgs. 93-94). Try this assessment method out on yourself. Pick a behavior of yours that you
consider to be annoying (e.g., smoking, fingernail biting, hair pulling) or important but burdensome
(e.g., studying, household tasks). Keep a daily log of that behavior for one week. You will want to
carry a piece of note paper on which to record your behavior. Be sure to take notes on each
occurrence as soon as possible after it happens, noting the time of the day and where or in what
situation the behavior occurred. Your completed log should indicate the frequency of the behavior
and when and where it occurred during the week.
After your week of self-monitoring, make a graph of your behavior like the example on the
following page. Were you surprised by either how often (more or less than you expected) or when
or in what situations the behavior occurred? Write a response in which you briefly describe what
you learned about this type of behavioral assessment.
38
Example Log:
[The behavior graph illustrates a log of problematic smoking behavior. The y-axis measures number of cigarettes, from 0
to 14; the x-axis measures days, from 1 to 7. Day 1 indicates 12 cigarettes, day 2 indicates 8 cigarettes, day 3 indicates
10 cigarettes, day 4 indicates 5 cigarettes, day 5 indicates 5 cigarettes, day 6 indicates 12 cigarettes, and day 7 indicates
8 cigarettes.]
SUBMIT WRITTEN ASSIGNMENT #1 to the ICON Dropbox.

Review Part A of your written assignment (from Lesson 2), and submit it along with
Part B (from this lesson) as Written Assignment #1.
Instructions for submitting assignments electronically are provided on the course site
under Content > Assignments and Exams.
AFTER SUBMITTING WRITTEN ASSIGNMENT #1 GO ON TO LESSON 4.
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LESSON 4 RESEARCH METHODS IN THE STUDY OF PSYCHOPATHOLOGY

Objectives:
READING ASSIGNMENT:

1. How to define science and the scientific method.
2. The advantages and disadvantages of case studies,

correlational designs, and experimental designs.
3. Common types of correlational and experimental

& Neale
Chapter 4
pp. 105-131
designs.
4. The standards and issues in conducting psychotherapy outcome research.

5. The basic steps in conducting a meta-analysis.
Key Terms:
ABAB design
adoptees method
analogue experiment
association study
correlation
correlation coefficient
correlational method
cross-fostering
case study
cross-sectional design
dissemination
effectiveness
experiment
genome-wide
association studies
(GWAS)
clinical significance
cultural competence
dizygotic twins (DZ)
efficacy
experimental effect
high risk method
concordance
dependent variable
double-blind procedure
empirically supported
treatment
external validity
hypothesis
control group
directionality problem
effectiveness
epidemiology
family method
incidence
independent variable
index cases
internal validity
longitudinal design
prevalence
probands
random assignment
randomized control
trials (RCTs)
meta-analysis
reversal designs
theory
Instructor Notes:
monozygotic (MZ)
twins
risk factor
third variable problem
placebo
single-case
experimental design
treatment outcome
research
placebo effect
statistical significance
twin method
Kring, Johnson, Davison, and Neales final introductory chapter lays important groundwork for your
understanding of the research on psychopathology presented in subsequent chapters. In these
40
chapters, your text presents the design of several important studies that reveal information about
the symptoms of psychopathology. Pay particular attention to the differences between correlational
and experimental methods. We can infer causality only when we manipulate a variable and observe
its effect on another variable (an experiment). However, much of the research on abnormal
psychology is correlational. For example, if we compared depressed patients and normal controls
and find that they differ on variable x, such as a measure of self-esteem, we cannot say anything
about the contribution of that variable to depression. That is, we cannot say that self-esteem causes
depression, nor can we say that depression causes low self-esteem. Rather, we only can say that
depression is associated with self-esteem. We know that the variable is related to depression in
some way and that it may be causally related; but because we did not manipulate the variable, we
cannot say anything about its causal relation to depression. As stated in your text, correlational
designs are subject to the bidirectionality and third variable problems in interpreting the data.
Despite the elegance and the power of the experiment for answering questions regarding the
direction of effect between two variables (e.g., stressful life events and depression), there are
significant limitations to the use of experimental research in psychopathology. Obviously, there are
ethical problems with trying to create psychopathology where none existed before in order to test
some theory. One context in which experimental designs can be used is when a theory makes a
prediction about factors that should reduce abnormal behavior. For example, a depression theory
might hypothesize that poor social skills lead to depressionthe corollary being that increased
social skills should lead to a reduction in depression. In this case, the researcher could randomly
assign depressed individuals to an experimental condition in which social skills training is provided
and to another experimental condition that does not include social skills training. The results of this
experiment would allow the researcher to answer the question regarding the effect of social skills
training on depression. An affirmative answer would provide some (though not definitive) support
to the hypothesis that poor social skills cause depression.
There are other important methodologies that you should be sure to learn well. For example, your
text goes into some detail describing the case study methodology. Although psychologists regard
the case study as less rigorous than the correlational or the experimental design, it has played an
important role in the description of psychopathology. It is especially useful for presenting
information on rare instances of abnormal behavior. Your text also describes epidemiological
research, which is the study of the frequency and distribution of a disorder in a population.
Epidemiological research is important in identifying mental disorders that affect a large percentage
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Abnormal Psychology
of the population, such as depression, so that preventative and educational efforts may be initiated.
Be sure to know the difference between the terms prevalence and incidence. Analogue
experiments are those that investigate variables that are related but not identical to
psychopathology for ethical and convenience reasons. Studies that use subjects with
psychopathology are typically very expensive. However, most psychologists at universities have
access to undergraduate subjects for free. Often, college students who score high on particular selfreport measures of psychopathology participate in analogue experiments in order to shed light on
some aspect of psychopathology. ABAB designs are experimental studies that can be conducted on
single subjects. In these studies, variables of interest are measured first when an individual is not
receiving a particular treatment, then they are measured when the subject is receiving a treatment,
and they are measured once again in each of these conditions. If the measurements differ as a
function of when the individual was receiving the treatment, it can be concluded tentatively that the
treatment has some effect on these variables.
Most research in psychopathology relies on statistically significant findings. Statistical
significance refers to the likelihood that results from a research study are due to chance. Typically,
psychologists regard findings as statistically significant if there is less than a 5 percent possibility
that results were obtained due to chance. Say you are conducting a correlational study looking at
the relation between mood and energy level. If you obtained a correlation of .10, would you
conclude that there is a relation between mood and energy? What if you obtained a correlation of
.80? In general, the larger an obtained correlation, the more likely it is to be a relation that is
significantly different than no relation at all. It is likely that a correlation of .10 is not statistically
significant, meaning that we cannot conclude that there is a relation between mood and energy in
this case. Although statistically significant correlations depend on sample size (i.e., the more
research subjects in a study, the smaller the correlation needs to be to achieve statistical
significance), most correlations of at least .30 are significant in psychopathology research.
Random assignment is a concept that is crucial for understanding the experimental design.
Interpretation of results of an experiment rest on the premise that, all things being equal, a
difference between the control and experimental group results from the variable that was
manipulated. This assumes that the groups were equal on all other relevant variables. Imagine that
you conducted a study examining medication versus psychotherapy for depression. You allow
subjects to choose whether they want to join the medication or psychotherapy group. Suppose you
find that individuals in the medication group score significantly lower on standard measures of
42
depression than individuals in the psychotherapy group. Can you conclude that medication is more
effective in the treatment of depression than psychotherapy? Some research shows that individuals
choose psychotherapy only when they do not improve with medication. In other words, individuals
who present for psychotherapy may have more severe depression than individuals who do not.
Now you do not know whether the medication group scored lower on measures of depression
because medication is more effective than psychotherapy or because the subjects in the
psychotherapy group were more depressed and had a worse prognosis. By randomly assigning
subjects to either group, it is assumed that these extraneous or confounding variables would be
equally distributed between the two groups.
Finally, your text introduces the statistical procedure of meta-analysis. Because it is important that
research findings be replicated, numerous studies may exist that test the same question.
Furthermore, all of these studies may differ in their conclusions. Meta-analysis provides a method
to integrate studies that test a similar research question. Lets take for example, all of the studies
that examine the correlation between anxiety and marital satisfaction. Some of these studies may
find a large, significant correlation and others may find no significant correlation between
depression and marital satisfaction. Through the use of meta-analysis we can determine the
average correlation between depression and marital satisfaction across all studies.
Congratulations for sticking with the course so far. After finishing this chapter, you will have the
proper background and orientation to intelligently study the material on abnormal behavior
presented in subsequent lessons.
Self-Test Exercise:
1. Suppose you are interested in investigating whether Prozac is an effective medication for
the treatment of depression. What research methodology would be the most appropriate to
apply to this issue? How would you design the study?
2. List some examples of abnormal behavior that would be appropriate for a case study.
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3. Have you ever participated as a subject in research? What were you asked to do? What was
the purpose of the study? What type of research methodology was utilized?

44
LESSON 5 MOOD DISORDERS

Objectives:
READING ASSIGNMENT:

1. The symptoms of depression and mania, the
diagnostic criteria for depressive disorders and
bipolar disorders, and the epidemiology of these

& Neale
Chapter 5
pp. 132-172
disorders.
2. The genetic, neurobiological, social, and psychological factors that contribute to mood
disorders.
3. The medication and psychological treatments of depressive and manic symptoms as well as
the current views of electroconvulsive therapy.
Key Terms:
anterior cingulate
antidepressant
attribution
attributional style
Cushings syndrome
cyclothymic disorder
deep brain stimulation
disruptive mood
dysregulation disorder
behavioral couples
therapy
dorsolateral prefrontal
cortex
hopelessness theory
mania
bipolar I disorder
episodic disorder
hypomania
melancholic
mood disorders
negative triad
psychomotor
retardation
rapid cycling
persistent depressive
disorder
seasonal affective
disorder
peripartum onset
selective serotonin
reuptake inhibitors
(SSRIs)
bipolar II disorder
expressed emotion
(EE)
lithium
mindfulness-based
cognitive therapy
(MBCT)
neuroticism
psychoeducational
approaches
reward system
striatum
cognitive biases
flight of ideas
major depressive
disorder (MDD)
monoamine oxidase
(MAO) inhibitors
nonsuicidal self-injury
(NSSI)
psychomotor agitation
rumination
suicide
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transcranial magnetic
stimulation
tricyclic
antidepressants
tryptophan
neuroticism
premenstrual
dysphoric disorder
psychoeducational
approaches
psychotic features
rapid cycling
norepinephrine
reward system
selective serotonin
reuptake inhibitors
(SSRIs)
suicide prevention
centers
Instructor Notes:
positive effect
schema
serotonin
tricyclic
antidepressants
postpartum onset
seasonal affective
disorder
somatic arousal
prefrontal cortex
second messengers
suicide
tryptophan
With this lesson, we begin our study of specific psychological disorders. You should be alert to a
phenomenon called the "medical student's syndrome." Medical students studying the
symptomatology of diseases often "recognize" the symptoms in themselves. You may have the same
experience when studying, for example, the anxiety disorders or depression. Recognizing one or
two symptoms in yourself does not mean that you have a disorder. In fact, it is normal to experience
some symptoms of anxiety and depression in your life. Having one or two symptoms reinforces the
case for proponents of a dimensional diagnostic system of psychopathology. Rarely is depression or

anxiety an "all or none" phenomenon.
Depression is the "common cold" of psychopathology. This sentiment and others like it frequently
have been expressed by clinicians and researchers. Major depressive disorder is characterized by
the experience of at least two weeks of depressed mood and/or loss of interest or pleasure. In
addition to qualify for a diagnosis of MDD an individual must experience at least several of a
number of other symptoms, including poor appetite or overeating, sleeping too much or too little,
psychomotor agitation or retardation, loss of energy, feelings of worthlessness, difficulty
concentrating, and thoughts of death or suicide. The text cites a study estimating that 16.2 percent
of people in the U.S. meet criteria for MDD at some point in their lives. Depression is an episodic
disorder due to the tendency of symptoms to improve, and then recur later. Because of the high
prevalence of depression, active research is being carried out by psychologists, psychiatrists, and
other scientists. Mania, in contrast, is an intense emotional state that is accompanied by flight of
ideas, feelings of grandiosity, and rapid speech. Because an abnormal mood state is the hallmark
feature of both disorders, they are classified as the mood disorders.
46
The official diagnostic classifications for mood disorders are somewhat confusing. As your book
highlights, the DSM-5 categorizes mood disorders into two categories. The first of these mood
disorder categories is depressive disorders. The depressive disorder category is characterized by A

person diagnosed with major depressive disorder (MMD) has a history of experiencing one type
of abnormal mood statemood that is lower than normal. In contrast, the second category of mood
disorders, known as bipolar disorders, is characterized by the experience of both types of abnormal
mood states, (i.e., both mania and depression). Yet, individuals who experience a manic episode are
given the diagnosis of bipolar disorder even if they have never been depressed because it is
assumed that they will experience a depression at some point in their lifetime. This observation has
led many researchers to speculate that unipolar and bipolar disorders represent different levels of
severity of the same disorder, with bipolar disorder being more severe. Another complicated
diagnostic issue is the difference between bipolar I and bipolar II disorders. Individuals who are
diagnosed with bipolar I disorder have experienced a full-fledged manic episode in their lifetimes,
whereas individuals who are diagnosed with bipolar II disorder have experienced episodes of
elevated mood that are less intense than mania. These less intense periods of elevated mood are
called hypomanic episodes. Another difference between these two bipolar disorders is that bipolar
I disorder does not require the experience of a major depressive episode, whereas bipolar II
disorder does. A related bipolar condition is cyclothymic disorder, characterized by frequent
periods of depressed mood and hypomania, with intermittent periods of normal mood of up to two
months duration. Dysthymia, a mood disorder in the depressive disorder category, is a chronic
depressive state similar to unipolar depression, but characterized by at least three depressive
symptoms (rather than five) and a lack of suicidality.
Your book discusses three main factors that researchers focus on when studying the etiology of
depression: psychological, social, and neurobiological factors. Psychological factors include by
personality and cognitive theories of depression. For example, the personality trait of neuroticism
(a tendency to experience negative emotions such as irritability, stress, anxiety, etc) is shown to be
associated with depression. There are numerous theories suggesting how cognitive factors may
lead to the development of depression. The original cognitive theory of depression put forth by
Aaron Beck states that depression is caused and maintained by the way depressed individuals
interpret events in their environment. Depressed individuals often exhibit the negative triad; that
is, they have negative views of the self, the world, and the future. This manner of viewing the
environment causes depressed individuals to make cognitive biases, or distortions, when
interpreting events in their surroundings. For example, a depressed student who does poorly on
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Abnormal Psychology
one test may conclude that he is unfit to be in college. This cognitive bias is called
overgeneralization. Another cognitive theory of depression is the hopelessness theory. The
hopelessness theory highlights the role of attributional styles and how certain attributional styles
lead to hopelessness, and possible depression. Attributional style is the manner in which an
individual formulates explanations for events that occur in his or her life. An individual with a
negative attributional style is likely to attribute negative life events to stable (i.e., unable to be
changed) and global (i.e., affect many areas of his or her life) factors. Such an attributional style
leads to hopelessness because the individual concludes that desirable outcomes will not occur and
that he or she is unable to change the situation. A final cognitive theory of depression is the
rumination theory. This theory proposes that a persons tendency to dwell on negative thoughts
may increase the risk of depression.
In addition to psychological factors, your book also discusses social factors in explaining the
etiology of depression. For example, interpersonal theories of depression posit that depressed
individuals elicit negative reactions from others due to inadequate social skills or constant need for
positive reinforcement. Further, high levels of life stress and low levels of social support are
associated with increased symptoms of depression.
Finally, your text also describes neurobiological theories of mood disorders. For example, genetic
studies show that relatives of individuals with mood disorders are at a higher risk than normal to
also experience mood disorders. Your book cites the results from twin and adoption studies that
support the heritability of mood disorders. Although your text outlines the neurochemical and
neuroendocrine systems at work in mood disorders, you do not need to know the specific details of
this section. In general, neurotransmitters may play an important role in the onset of a depressive
episode. Most of the drugs used to treat depression affect neurotransmitter levels, usually to
increase them.
Because bipolar disorders are characterized by both depression and mania, researchers have also
examined factors that predict the onset of manic symptoms. Your book highlights two models that
may explain the development of mania. These models include the reward sensitivity model and the
sleep deprivation model.
Psychological therapies for depression are some of the most established psychotherapies in the
field of psychology. At The University of Iowa, we have established the efficacy of interpersonal
therapy (IPT, p. 157) for women with postpartum depression. This therapy grew out of the
psychodynamic tradition, and it focuses on modifying problematic interpersonal interactions and
48
relationships that contribute to an individual's depression. Cognitive therapy is aimed at altering

maladaptive thought patterns and incorporates a behavioral component called behavioral
activation. Behavioral activation therapy helps patients to increase their engagement with
positively reinforcing activities. Research has compared the use of cognitive therapy (which
includes behavioral activation) to the use of behavioral activation therapy alone. This research
suggests that behavioral activation therapy is just as effective when used without cognitive therapy
in treating depression (see pg. 158-159 of your text).
Treatment of bipolar disorders typically involves medication. However, your book notes that
psychological treatments may be used in addition to medications when treating bipolar disorders.
There are also several biological treatments for depressive disorders. For example,
electroconvulsive therapy (ECT) is used to treat profoundly depressed individuals. Further,
depression may also be treated by antidepressant drugs such as monoamine oxidase inhibitors,
tricyclic antidepressants, or selective serotonin reuptake inhibitors. Your book notes that there are
important concerns that arise with regard to the published research, side effects, and efficacy of
antidepressants (see pg. 161-162).
Finally, your text closes with a section on suicide. Suicide is perhaps the most disturbing behavior
to a mental health professional. Your text describes several theories of suicide that attempt to
account for characteristics of individuals who kill themselves. There are many suicide-prevention
centers located around the United States to address this serious issue. Although most individuals
with psychopathology do not commit suicide, it is important for mental health professionals to take
an individual seriously when he or she expresses suicidal ideation.
Self-Test Exercise:
1. As stated in the discussion and in the text, there are psychological, social, and biological,
approaches to depression. Think of a time in your life when you were feeling more down or
low in mood than normal. What were the thoughts that ran through your head? What were
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Abnormal Psychology
your interactions like with your friends and relatives? Consider how each of the approaches
to conceptualizing depression fits with your own experience.
2. There is an ongoing debate in the fields of psychology and psychiatry about drugs such as
Prozac. Put simply, there is concern that numerous individuals are taking the medication for
conditions that are not psychiatric diagnoses. For example, some individuals want to take
medication because they feel it transforms their personality. Moreover, some psychologists
feel that medication is a "quick fix" to psychiatric disorders that addresses the symptoms
but not the underlying causes of psychopathology. Formulate your opinions about these
issues.

Beck, A. T., A. J. Rush, B. F. Shaw, and G. Emery. Cognitive Therapy of Depression. New York: The
Guilford Press, 1979.
Bongar, B. The Suicidal Patient: Clinical and Legal Standards of Care. Washington, D.C.: American
Psychological Association, 1991.
Burns, D. D. Feeling Good: The New Mood Therapy. New York: Avon Books, 1980.
Jamison, K. R. An Unquiet Mind: A Memoir of Moods and Madness. New York: Vintage Books, 1995.
50

laid out in the Introduction of this study guide. Your discussion should be no longer than two
type-written, double spaced pages.
Depression touches our lives in many ways. Based on a newspaper or magazine article,
book, movie, or personal contact with a depressed relative or friend, describe in some detail
the effects of a depressive episode on a real person. Select one area of his or her life and
describe it based on what you were able to find out. Was the individual similar to the
individuals described in the text? In what ways?
After completing this assignment, TAKE EXAM #1 AND THEN
PROCEED TO LESSON 6. You will submit this assignment as Part A of

Written Assignment #2 following Lesson 6.
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EXAMINATION #1
0
A supervised, 75-minute examination follows Lesson 5. You must complete and submit Written
Assignment #1 prior to taking Exam #1. Exam #1 is worth 60 points and covers the material in Lessons
1-5 of this study guide and Chapters 1-5 of the textbook.
Your first examination is a 75-minute supervised exam consisting of 60 multiple-choice items. The
exam will cover material presented in Chapters 1-5 of your textbook, and Lessons 15 of this study
guide. The exam will emphasize your ability to recognize the right answer rather than produce it
from memory. This is NOT an open-book examination. Good luck!
Information regarding exam registration, scheduling, and policies is posted on the course
homepage (ICON). On campus students taking exams at the Continuing Education Testing Center
should register for their exam at least two business days before their intended examination day. Off
campus students (with ProctorU) should register for their exam two weeks before their intended
examination day. Each student is responsible for registering for their exam by the posted deadlines.
Reminder:
You must take this examination before submitting subsequent written assignments, although you
may work ahead on these assignments if you wish.
On-Campus Students: Students in the Iowa City area who complete the exam online
at the DCE Testing Center will receive a grade upon submission of the online exam.
Off-Campus Students: Students outside the Iowa City area will take exams using an
online proctored exam service and receive a grade upon submission of the online
exam. Off-campus students must have access to a computer with a webcam and
headset/microphone in a quiet/private location. Off-campus students are
responsible for proctoring fees.
Exams cannot be returned to students.
52
LESSON 6 ANXIETY DISORDERS

Objectives:
READING ASSIGNMENT:

1. The clinical features of anxiety disorders.
2. How anxiety disorders tend to occur with each

other.

& Neale
Chapter 6
pp. 173-199
3. How gender and culture influence the prevalence of

anxiety disorders.
4. The commonalities in etiology across the anxiety disorders, as well as the factors that shape
the expression of specific anxiety disorders.
Key Terms:
agoraphobia
anxiety
anxiety disorders
Anxiety Sensitivity
Index
depersonalization
derealization
fear
fear circuit
anxiolytics
fear-of-fear hypothesis
locus ceruleus
panic control therapy

(PCT)
selective
norepinephrine
reuptake inhibitors
(SNRIS)
behavioral inhibition
generalized anxiety
disorder (GAD)
medial prefrontal
cortex
panic disorder
social anxiety disorder
benzodiazepines
in vivo exposure
Mowrers two-factor
model
prepared learning
specific phobia
D-cycloserine
interoceptive
conditioning
panic attack
safety behaviors
Key Figures:
Little Albert
Instructor Notes:
Whereas we can describe the various disorders very well, our understanding of their etiology
(cause) is generally quite limited. In this chapter, as in others, Kring, Johnson, Davison, and Neale
discuss anxiety disorders in light of the theories of psychopathology presented in Chapter 2.
Moreover, they emphasize factors that contribute to the development of anxiety disorders in
general and factors that play a role in the etiology of specific anxiety disorders. Research by
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psychologists and psychiatrists is continuing on many fronts to increase our understanding of these
disorders.
Early in the chapter, your text discusses comorbidity among anxiety disorders (pg. 180). Simply
put, comorbidity is the co-occurrence of two or more psychiatric disorders. According to your text,
comorbidity among anxiety disorders is common because many of the disorders share common
features, such as worry or physiological reactivity. Kring, Johnson, Davison, and Neale go on to say
that comorbidity among anxiety disorders likely occur due to 1) the overlap of symptoms among
anxiety disorders and 2) a shared etiology among different anxiety disorders. In reality, anxiety
disorders are not the only psychiatric disorders that have high rates of comorbidity. Depression is
another disorder that often co-occurs with anxiety disorders, eating disorders, and personality
disorders. In fact, there is such a high rate of comorbidity between anxiety and depression
(sometimes as high as 90 percent) that some psychologists feel that it is actually the same disorder
expressed in two different ways. We are having you study the chapters on anxiety and mood
disorders before the chapters on the other disorders because anxiety and depressive symptoms are
features of many psychiatric difficulties.
Specific phobias are fears caused by particular objects or situations. Specific phobias range from
fears of spiders and snakes to blood and injections to elevators or more generally, closed places.
Phobias often cause some life interferenceit is common for individuals with blood phobia, for
example, to avoid going to the doctor or dentist even when it is necessary. Although the etiology of
phobias can be explained by many of the paradigms presented in Chapter 2, the authors emphasize
the dominant model of behavioral conditioning in explaining the development of specific phobias.
Social phobia is an anxiety disorder characterized by excessive fear of negative evaluation or
embarrassment. Although this disorder is termed social phobia in the DSM-IV-TR, your book notes
that the term social anxiety disorder has been proposed for use in the DSM-5 because symptoms of
social anxiety tend to interfere with a broader range of activities than the other phobias. Some
individuals with social anxiety disorder only fear certain situations, such as eating in front of others
or public speaking, whereas others fear almost any interaction, even those with family members!
Research shows that individuals with social anxiety disorder are less likely to get married and often
choose to enter professions well below their ability. The etiology of social anxiety disorder can also
be explained using numerous paradigms (e.g. psychoanalytic, behavioral, cognitive, social skills
deficits, and predisposing biological factors). Pay particular attention to the behavioral and
54
cognitive theories of etiology described in the chapter, as these two approaches tend to be most
widely followed by anxiety researchers.
The remaining anxiety disorders have several distinctive features. Panic disorder is characterized
by recurrent, out-of-the-blue panic attacks consisting of symptoms such as racing heart, feeling of
choking, shortness of breath, and/or sweating. Panic attacks come on all of a sudden and generally
last no more than 1015 minutes. While it is relatively common for people to experience panic
attacks in response to stressful or unusual situations, panic disorder is distinct because (1) the
panic attacks sometimes occur even in situations where the person does not expect to be nervous
or anxious, and (2) they cause excessive worry or change in behavior in order to avoid having
another attack. Often, individuals with panic disorder will develop agoraphobia, or a fear of being
in situations in which escape is difficult. Such situations include driving, being in crowds, or being in
open spaces. Individuals with severe agoraphobia dislike venturing out of their house. Sometimes
people have difficulty distinguishing between social phobia and agoraphobia. The distinguishing
feature is why the individual is afraid of going out of the house. An individual with social anxiety
disorder fears going out in public because of scrutiny/criticism by or possible interaction with
others, whereas an individual with agoraphobia is afraid of having a panic attack in a place where
there is no easy escape. Numerous biological hypotheses exist attempting to explain the etiologies
for panic disorder (e.g. genetics, noradrenergic activity, abnormal physiological responses) and
your book highlights the role of neurobiological factors in the development of panic disorder.
Psychological theories of the etiology of panic attacks include classical conditioning (behavioral)
and misinterpretation of stimuli models (cognitive). Psychological theories of agoraphobia such as
the fear of fear hypothesis (i.e. agoraphobia as a fear of having a panic attack rather than a fear of
public spaces) also exist.
The core feature of generalized anxiety disorder (GAD) is uncontrollable worry. Often,
individuals with generalized anxiety disorder worry so much that they experience physical
difficulties such as muscle tension or insomnia. Your book notes that because GAD has high rates of
comorbidity with other anxiety disorders, that the general factors in predicting onset of anxiety
disorders is relevant to the study of GAD (i.e., fear conditioning, genes, neurobiology, personality).
Beyond these general theories, your book highlights the role of cognitive factors in the development
of GAD.
In general, the predominant treatment strategy for anxiety disorders is exposure. Although
behavioral and cognitive behavioral therapies utilize exposure during treatment, they approach
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exposure to the feared stimulus in different ways. Your book highlights some of these methods (e.g.,
systematic desensitization, in-vivo exposure, panic control therapy). It is noteworthy that
regardless of the anxiety disorder being treated all behavioral and cognitive approaches
incorporate exposure to a feared stimulus or situation. These treatments may be administered in

either an individual or group format. Your book also highlights the use of medications in the
treatment of anxiety disorders. Although this is a common treatment approach, research suggests
that using some of these medications during therapy can be counterproductive. This is because the
anti-anxiety medication prevents the patient from coming into full contact with their fears. In other
words, taking medication may be viewed as a safety behavior.
Self-Test Exercise
1. Have you ever had to speak in public? What was that experience like? After reading the
textbook chapter, are you able to identify some of the symptoms of anxiety that you
experienced in that situation?
Public speaking anxiety is included in the domain of social phobia. However, well over 50
percent of the population reports having an intense fear of public speaking. Do you feel that
public speaking anxiety is a psychological disorder? What types of symptoms do you feel an
individual with this fear should exhibit in order to receive a diagnosis of social phobia?
2. There is some evidence that certain fears are normal in some developmental stages. Infants,
for example, go through a normal period in which they fear separation from their mothers.
Other research shows that normal childhood fears include the dark, death of a parent, and
injury. What types of childhood fears did you experience? Did your siblings and/or peers
experience those fears as well? How did you get over those fears? Do they have any bearing
on fears that you have currently?
56

Beck, A. T. and G. Emery. Anxiety Disorders and Phobias. New York: Basic Books, 1985.
Hallowell, E. M. Worry: Controlling It and Using It Wisely. New York: Ballantine Books, 1997.
Markway, B. G., C. N. Carmin, C. A. Pollard, and T. C. Flynn. Dying of Embarrassment: Help for Social
Anxiety and Phobia. Oakland, California: New Harbinger Publications, 1992.
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Write a couple of paragraphs on each question below, following the guidelines for written
assignments laid out in the Introduction of this study guide.
Why is anxiety normal in some situations but not in others?

What would life be like without anxiety?

58
LESSON 7 OBSESSIVE-COMPULSIVE RELATED AND TRAUMA-RELATED DISORDERS

Objectives:
READING ASSIGNMENT:

1. The symptoms and epidemiology of the obsessivecompulsive related disorders and the trauma-
related disorders.

& Neale
Chapter 7
pp. 200-223
2. The commonalities in the etiology of obsessive-
compulsive related disorders, as well as the factors that shape the expression of the specific
disorders in this chapter.
3. How the nature and severity of trauma, as well as biological and psychological risk factors,
contribute to whether trauma-related disorders develop.
4. The medication and psychological treatments for obsessive-compulsive related and traumarelated disorders.
Key Terms:
acute stress disorder

(ASD)
body dysmorphic
disorder
caudate nucleus
compulsion
obsession
obsessive-compulsive
disorder (OCD)
orbitofrontal cortex
posttraumatic stress
disorder (PTSD)
dissociation
thought suppression
Instructor Notes:
exposure and response

prevention (ERP)
yedasentience
hoarding disorder
imaginal exposure
Obsessive-compulsive-related disorders and trauma-related disorders were categorized as anxiety

disorders in the DSM-IV. This is because many of the symptoms, causes and treatments for these
disorders are similar to the anxiety disorders. However, as your book highlights, the obsessive-
compulsive-related disorders and trauma-related disorders have unique etiologies compared to the
anxiety disorders. Because of this, the DSM-5 proposal is for these two categories of disorders to be
separate from the anxiety disorders chapter.
Obsessive-compulsive disorder (OCD) is one of three disorders proposed for inclusion in the
DSM-5 chapter on obsessive-compulsive-related disorders. This is a very serious disorder
characterized by intrusive thoughts and odd behavioral rituals. A person needs only to demonstrate
either obsessions or compulsions in order to receive a diagnosis. Common compulsions include
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Abnormal Psychology
cleaning or washing hands, checking, and counting. Psychological theories of etiology include the
cognitive-behavioral perspectives which view compulsions as learned behaviors aimed at reducing

fear and obsessions as resulting from failed attempts at thought suppression. Biological factors
deemed important to OCD etiology are genetic and neurobiological risk factors (e.g., orbitofrontal
cortex, caudate nucleus, anterior cingulate cortex).
The other two disorders proposed for inclusion in the DSM-5 obsessive-compulsive-related
disorders chapter are body dysmorphic disorder (BDD) and hoarding disorder. Body
dysmorphic disorder occurs when an individual becomes preoccupied over perceived
abnormalities in part or parts of his or her body. Hoarding disorder occurs when an individual has
significant difficult getting rid of possessions, even when these possessions are viewed as having no
value by others. Further, a diagnosis of hoarding disorder also requires that the individuals
difficulty discarding possessions results in rooms that are so cluttered that they can no longer be
used (e.g., the kitchen is so cluttered you cant cook in it). The treatment of BDD and hoarding
disorder are similar to that of OCD including the use of medications and exposure therapy. Your
book provides greater detail of the ways that psychological treatments are tailored to each of the
three obsessive-compulsive-related disorders.
Posttraumatic stress disorder (PTSD) is characterized by anxiety experienced in response to
trauma or a severe stressor. For DSM-5, there are four proposed symptom clusters of PTSD: 1)
intrusion symptoms, 2) avoidance symptoms, 3) mood and cognitive changes, and 4) increased
arousal and reactivity. PTSD was introduced into the 3rd edition of DSM in 1980, and it caused a
great deal of controversy because many felt that the stressors/traumas are abnormal, not the
victims. As previously discussed, the etiology of PTSD overlaps with that of other anxiety disorders
(e.g., genetic risk, abnormal brain activity, personality traits, operant conditioning). However, your
book highlights the unique etiology of PTSD, including the importance of type and severity of
trauma event. Research suggests that the most effective treatment for PTSD is exposure therapy
with a focus on the trauma-related event.
Self-Test Exercise:
60

1. In what is now becoming a classic film, Jack Nicholson played a character with obsessive
compulsive disorder (OCD) in As Good As It Gets. What were the OCD symptoms that he
demonstrated? How could the disorder have been portrayed more realistically?
2. Think of a time when you were confronted by a particularly stressful or traumatic event.
Following the event, did you notice symptoms of PTSD? For example, did you have
distressing memories/dreams of the event? Did you avoid people/places/activities that

reminded you of the event?
Further Readings (Optional):
Rapoport, J. L. The Boy Who Couldn't Stop Washing. New York: Penguin Books, 1991.
Phillips, K. A. The Broken Mirror: Understanding and Treating Body Dysmorphic Disorder. New York:
Oxford University Press, 1996.
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Write a couple of paragraphs on each question below, following the guidelines for written
assignments laid out in the Introduction of this study guide.
Reflect on a time when you have encountered obsessive-compulsive-related symptoms. For
example, maybe a friend or family member engages in repetitive behaviors such as checking
the locks on the door several times or washing their hands again and again. Or maybe you
remember a character from a book or movie that had difficulty discarding the large number
of possessions they accumulated over time. Be creative; you can find examples of these
symptoms in magazines and on the internet.
After you think of an example, 1) describe the persons obsessive-compulsive-related
symptoms, 2) describe how these symptoms affect the persons life, and 3) relate your
description back to what you read in the book. Are there similarities? Differences?
After completing this assignment go on to Lesson 8. You will submit
this assignment as Part A of Written Assignment #3 following Lesson 9.
62
LESSON 8 DISSOCIATIVE DISORDERS AND SOMATIC SYMPTOM DISORDERS

Objectives:
READING ASSIGNMENT:

1. The symptoms of the dissociative and somatic
symptom disorders.
2. The current debate regarding the etiology of

& Neale
Chapter 8
pp. 224-249
dissociative identity disorders.
3. The etiological models of somatic symptom disorders.
4. The available treatments for dissociative and somatic symptom disorders.
Key Terms:
conversion disorder
depersonalization /
derealization disorder
dissociative amnesia
dissociative disorders
iatrogenic
illness anxiety disorder
implicit memory
malingering
dissociative identity
disorder (DID)
posttraumatic model of
DID
Instructor Notes:
explicit memory
sociocognitive model of
DID
factitious disorder
somatic symptom
disorder
fugue subtype
The somatoform and dissociative disorders are among the most interesting psychological
disorders. Newspaper accounts often chronicle the trials and tribulations of individuals who have
lost their memories or who have multiple personalities (diagnosed with DSM-IV criteria as having
dissociative identity disorder). As notorious as these disorders are, they are relatively
uncommon compared to the anxiety and depressive disorders. Moreover, individuals with
somatoform disorders are more likely to seek help from their physician rather than a psychologist.
Relatively little empirical work has been done with the somatoform and dissociative disorders,
especially therapy research.
Students sometimes find it difficult to make the fine distinctions among particular disorders that
comprise these classes of psychopathology. In the class of somatoform disorders, one must be sure
to differentiate between illness anxiety disorder, complex somatic symptom disorder, and
functional neurological disorder. These are the three somatic symptom disorders proposed for
use in DSM-5. Illness anxiety disorder is characterized by preoccupation and worry over the
possibility of having a serious medical condition, even though the patient has no somatic symptoms.
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Abnormal Psychology
In contrast, individuals with complex somatic symptom disorder experience anxiety/worry over
actual physical symptoms that cause distress and/or interfere with daily functioning. Finally,
functional neurological disorder is rarely diagnosed in clinical settings at present. Unlike the other
two somatic symptom disorders, individuals with functional neurological disorder exhibit
seemingly severe physical difficulties that are often neurological in nature, but they act as if they do
not care about their symptoms.. Pay close attention to the historical psychodynamic
conceptualization of conversion disorder that is described in your text (p. 242-243). In an age
where cognitive and behavioral explanations are dominant in conceptualizing psychopathology,
this may be the best example of the influence of psychoanalytic thought in current approaches to a
particular disorder. Another point you should take away from the chapter is that it is important to
have ongoing medical consultation in the treatment of these disorders, as there is often at least
some physical basis to their symptoms even if they are not readily evident.
Dissociative disorders are equally difficult to distinguish, as many symptoms are shared among the
disorders that comprise this class. For example, all three proposed DSM-5 dissociative disorders
dissociative amnesia, depersonalization/derealization disorder, and dissociative identity
disorderhave at their core symptoms of dissociation, or a disruption of consciousness.
Dissociative identity disorder (formerly multiple personality disorder) is perhaps the most highly
publicized dissociative disorder. However, it may also be the disorder that is debated most among
psychologists. Many psychologists still question whether dissociative identity disorder even exists.
Although it is clear that individuals who are diagnosed as having multiple personalities are
disturbed, some psychologists wonder whether they are exhibiting a mixture of other types of
dissociative phenomena, posttraumatic stress disorder, and personality disorders. It is also likely
that, in general, dissociative disorders are difficult to conceptualize in our current framework
because psychologists still grapple with the definition and components of consciousness.
Focus on Discovery 8.1 (pages 230-231 in your textbook) describes some of the controversy
surrounding repressed memories of child sexual abuse. There is no doubt that child sexual abuse is
a widespread phenomenon. However, many psychologists believe that popular writings and
therapist suggestions may influence individuals to recall instances of abuse that did not actually
occur. It is likely that some therapists discern the presence of abuse from nonspecific symptoms
such as low self-esteem and substance abuse, which are symptoms of several types of disorders and
may result from an array of psychosocial factors. Moreover, empirical studies show that memory is
easily influenced. It will be important for you to keep these factors in mind as you evaluate media
reports of instances of individuals prosecuted for child sexual abuse.
64
Self-Test Exercise:
1. Although diagnoses of dissociative disorders are rare, recent research shows that brief
instances of dissociative phenomena are quite common. Even episodes such as "zoning out"
and "daydreaming" are very mild instances of dissociative symptoms. Have you ever
experienced any of these symptoms? What were they like for you? How did you "snap
yourself out" of these episodes? Would your coping techniques have any implications for
treatment of dissociative disorders?
2. Have you encountered any local court cases in which recovered memories of abuse played a
part? How would you evaluate these cases after reading this chapter?
Caudill, M. A. Managing Pain Before It Manages You. New York: The Guilford Press, 1995.
Chase, T. When the Rabbit Howls. New York: Jove Books, 1987.
Ross, C. A. Dissociative Identity Disorder: Diagnosis, Clinical Features, and Treatment of Multiple
Personality, second edition. New York: John Wiley and Sons, 1997.
There is no written assignment for Lesson 8. You will submit Written

Assignment #3 following Lesson 9. GO on to Lesson 9.
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LESSON 9 SCHIZOPHRENIA
Objectives:
READING ASSIGNMENT:

1. The clinical symptoms of schizophrenia, including
positive, negative, and disorganized symptoms.
2. The genetic factors, both behavioral and molecular,

& Neale
Chapter 9
pp. 250-285
in the etiology of schizophrenia.
3. How the brain has been implicated in schizophrenia.
4. The role of stress and other psychological factors in the etiology and relapse of
schizophrenia.
5. The medication treatments and psychological treatments for schizophrenia.
Key Terms:
alogia
anhedonia
anticipatory pleasure
antipsychotic drugs
catatonia
clinical high-risk study
cognitive enhancement
therapy (CET)
(cognitive remediation
training)
consummatory
pleasure
asociality
avolition
delusional disorder
delusions
grandiose delusions
hallucinations
disorganized speech
negative symptoms
schizophrenia
social skills training
Key Figures:
Emil Kraeplin
disorganized symptoms
positive symptoms
schizophreniform
disorder
sociogenic hypothesis
blunted affect
brief psychotic disorder
dementia praecox
disorganized behavior
ideas of reference
loose associations
(derailment)
expressed emotion
(EE)
prefrontal cortex
second-generation
antipsychotic drugs
familial high-risk study
schizoaffective disorder
social selection
hypothesis
Eugen Bleuler
66
Instructor Notes:
Schizophrenia is regarded as a very serious mental disorder for two reasons. First, the
symptomatology of schizophrenia is extremely disruptive to an individual's daily functioning and is
generally disturbing to individuals who come into contact with a schizophrenic. The proposed DSM-
5 criteria for schizophrenia are provided on page 254 of your text, with the different symptoms
detailed on pages 254-258. Note the main categories of schizophrenia symptoms: positive, negative,
disorganized and movement symptoms. The other serious problem with schizophrenia is that for
most schizophrenics, prognosis is relatively poor. Emil Kraeplin, who first clearly differentiated
schizophrenia from manic-depressive psychosis, characterized schizophrenia as an early onset
dementia that progressively worsened. Though not every individual who receives a diagnosis of
schizophrenia will continue to deteriorate over the rest of his or her life, complete and full recovery
to normal functioning is not common.
Knowing the history of schizophrenia as a diagnosis is important because it helps to understand the
manner in which this profession arrived upon our current diagnostic classification. Emil Kraeplin
and Eugen Bleuler, each emphasized different symptoms as being primary in schizophrenia. In
particular, Kraeplin defined the disorder by its early onset and deteriorating course. He focused on
the symptoms that differentiated it from another serious mental illness, manic-depression. In
addition, Kraepelin proposed three of the diagnostic subtypes of schizophrenia contained within
the DSM-IV (i.e. disorganized, catatonic, and paranoid). In contrast, Bleuler posited that the
essential feature was a "loosening of associative threads," meaning that individuals with
schizophrenia often lacked goal-directed, efficient communication and thinking. Both of these
perspectives is represented somehow is the proposed DSM-5 criteria for schizophrenia. Because
there are so many distinct features of this disorder, DSM-5 proposal for the schizophrenia chapter
is to be called Schizophrenia Spectrum and other Psychotic Disorders. Various disorders that
share similar symptoms with schizophrenia will be included in this chapter and are briefly
mentioned in your text (pg. 258-259).
Like bipolar disorder, schizophrenia is thought to have a large genetic component. We know that
schizophrenia runs in families and that blood relatives who are more closely related to a
schizophrenic are more likely to become schizophrenic than blood relatives who are more distantly
related. The closest relative one can have is an identical twin (monozygotic twin) because twins
share exactly the same genes; first-degree relatives (e.g., mother) share only about 50 percent of
one's genes. Having an identical twin that is schizophrenic puts an individual at great risk for
developing the disorder. While these findings can be accounted for in part by the common
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Abnormal Psychology
environments that identical twins share, studies have shown that first-degree relatives of
schizophrenics who are raised away from their biological families still have higher than normal
rates of schizophrenia. Thus, the evidence for at least some genetic contribution to schizophrenia is
compelling. Your text outlines several methods to study genetic contributions, including behavior
genetics (i.e., family, twin, and adoption studies) and molecular genetics. While you should be able
to distinguish among these methodologies, you do not need to focus on the details of these types of
investigations. Rather, you should focus on the general results obtained by these methods and how
they contribute to conclusions about genetic contributions to schizophrenia. If you go on to
graduate school in clinical psychology, you will undoubtedly encounter these methods again!
Your text also describes several biological differences between individuals with and without
schizophrenia. The dopamine theory posits that an excess of or oversensitivity of the receptors for
the neurotransmitter, dopamine, is related to schizophrenia. There are several lines of evidence for
this theory. First, antipsychotic drugs are useful in treating schizophrenia, and these medications
reduce brain levels of dopamine. Second, antipsychotic drugs produce side effects similar to those
seen in Parkinson's Disease, which are caused by too little dopamine. Finally, amphetamines are
substances that increase levels of brain dopamine, and they often produce a state similar to
symptoms seen in paranoid schizophrenia. Recent developments in the dopamine theory of
schizophrenia suggest that increased/ overly sensitized dopamine receptors in some areas of the
brain are mainly related to the positive symptoms of schizophrenia. However, underactive
dopamine receptors in other areas of the brain, particularly the prefrontal cortex, are related to
negative symptoms (Figure 9.3). Thus, it appears that the dopamine theory is important in
conceptualizing the biological processes involved in schizophrenia, although more research is
clearly needed before psychologists can make definitive conclusions. Your text also describes other
neurotransmitters and brain abnormalities implicated in schizophrenia, but you will not be tested
on the details of this section.
Thus far, evidence for a biological and/or genetic diathesis for schizophrenia has been presented.
However, researchers generally agree that in addition to the existence of a diathesis for
schizophrenia, stress must occur for the diathesis to be activated. Several psychological variables
have been implicated in the development and exacerbation of the symptoms of schizophrenia. It has
long been known that social class and the prevalence of schizophrenia are correlated. Two
explanations exist for this correlation: the sociogenic hypothesis and social-selection
hypothesis (pg. 271) each of which links social class to schizophrenia in a causal manner, but in
opposing directions. Early studies suggested that cold, dominant parents (especially mothers)
68
induced the onset of schizophrenia in their children. Although research does not substantiate this
conclusion, it has been shown that other family variables are related to severity and relapse of
symptoms. For example, High expressed emotion is a term used to describe families who have
high levels of conflict and emotional involvement. It has been shown that family therapy is
successful in decreasing expressed emotion, which in turn reduces the risk of relapse in
schizophrenia. Your book discusses other psychological and environmental factors that may
contribute to the onset of schizophrenia. Finally, developmental studies of schizophrenia are
another method researchers utilize in an effort to determine risk factors for the disorder. These
developmental studies may utilize methods such as studying the records of children and
adolescents who later developed schizophrenia.
Treatment of schizophrenia changed fundamentally with the introduction of the phenothiazines
(antipsychotic drugs) in the 1950's. Although active treatments such as prefrontal lobotomies and
convulsive therapies were used before the advent of phenothiazines, warehousing of mental
patients was the primary treatment. Antipsychotic medications are useful in controlling symptoms
such as hallucinations and thought disorder; however, they have much less effect on social function.
Behavior therapies, in particular social skills training, have been used successfully to help the
schizophrenic learn daily living skills and interpersonal skills such as making casual conversation
with friends. At present, virtually all individuals being treated for schizophrenia are taking some
sort of medication, and research suggests that treatment will be most effective if it is combined with
some sort of psychological intervention with the goal of returning the individual to at least partial
independence in his or her community.
Self-Test Exercise:
1. Examine your reactions to the following poem (see below), written by a woman with
schizophrenia. How do you think your reactions resemble the manner in which other family
members may react to their relative with schizophrenia?
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Abnormal Psychology
I
am
the
rear tire
of a bicycle,
not trusted enough
to be a
front tire,
expected to go
round and round
in one narrow rut,
never going very far,
ignored
except
when I
break down.
Then
I get lots of
frightening,
angry
attention
and
I am put into
a
garage,
sometimes for months,
where
I
forget my function
and
I become afraid
to function
and all functions seem useless.
Next time out
I think I will be
an off-ramp
from a
freeway.
2. Earlier in the century, individuals with schizophrenia often lived their entire lives in mental
institutions where they received minimal treatment. A movement called
deinstitutionalization occurred in the 1960's, and many individuals with schizophrenia
were allowed to live in the community. However, this movement resulted in a dramatic
increase in homelessness. At present, it is estimated that 4050 percent of homeless
individuals in major metropolitan areas have schizophrenia. Think about the advantages
70
and disadvantages of mental institutions and deinstitutionalization. How could treatment

within the context of each of these settings be made more effective? That is, how could
treatment for schizophrenia be improved in mental institutions, and what interventions

would be necessary to make deinstitutionalization effective?
3. What are the similarities and differences between schizophrenia and dissociative identity
disorder?

Gottesman, I. I. Schizophrenia Genesis: The Origins of Madness. New York: W. H. Freeman and
Company, 1991.
Sechehaye, Marguerite and Frank Conroy. Autobiography of a Schizophrenic Girl: The True Story of
"Renee." Translated by G. Rubin-Rabson. New York: Meridian Books, 1951.
Torrey, E. F. Surviving Schizophrenia: A Manual for Families, Consumers, and Providers, third edition.
New York: Harper Collins, 1995.
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type-written, double-spaced pages.
What sorts of treatment(s) would you provide to a newly diagnosed schizophrenic client?
Link the treatment(s) used to their related theory of etiology (e.g. genetic, biochemical,
brain abnormality, social class, stress) as described in your text.

72
LESSON 10 SUBSTANCE RELATED DISORDERS

Objectives:
READING ASSIGNMENT:
1. The epidemiology and symptoms of drug and

alcohol abuse and dependence.
2. The major etiological factors for substance use

& Neale
Chapter 10
pp. 286-326
disorders, including genetic factors, neurobiological
factors, mood and expectancy effects, and sociocultural factors.
3. The approaches to treating substance-related disorders, including psychological treatments,

medications, and drug substitution treatments.
4. The major approaches to prevention of substance use disorders.
Key Terms:
addiction
amphetamines
Antabuse
caffeine
delirium tremens (DTs)
detoxification
Ecstasy
fetal alcohol syndrome

(FAS)
cocaine
hashish
hydrocodone
methadone
opiates
stimulants
Instructor Notes:
controlled drinking
hallucinogen
LSD
methamphetamine
oxycodone
substance use
disorders
crack
hashish
marijuana
nicotine
PCP
tolerance
cross-dependent
heroin
MDMA
nitrous oxide
secondhand smoke
withdrawal
Substance use and abuse are of continuing concern to police, politicians, and citizens, as well as to
mental health professionals. The use of alcohol is related to a high percentage of fatal automobile
accidents and homicides. Moreover, chronic drinking causes many serious health problems. Your
text indicates that almost every tissue and organ in the body is affected negatively by heavy
drinking. Women who consume alcohol during pregnancy may be putting their unborn child at risk
for fetal alcohol syndrome. Over five years ago in 2006, the accumulated costs of alcoholism, such
as treatment expenses, money spent on liquor, criminal justice expenditures, and lost work
efficiency, totaled over $200 billion dollars.
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Effects of other substances cause equally astounding costs to society as well. Marijuana use, for
example, is related to severe lung diseases even more than cigarette use because users inhale more
deeply and retain it in their lungs for a longer period of time. Most heroin users are involved in
crime and other illegal activities just to financially support their habit. Abuse of sedatives
sometimes results in accidental (or intentional) death from overdoses. Women who use cocaine
during pregnancy often give birth to babies who are addicted to the drug. Some of the drugs
discussed in this chapter are legal, such as alcohol and some types of sedatives, while others are
illegal, such as marijuana, heroin, and cocaine. Keep in mind that the distinction between licit and
illicit drugs is arbitrary. Alcohol, for example, is more dangerous than marijuana as a drug;
however, in our society, alcohol has been an integral part of our social fabric. When considering this
topic, it is important to distinguish between the psychological and physiological consequences of
drug use and the social/legal consequences. Finally, an increasing concern for society is polydrug
abuse, or the concurrent use of more than one drug. Effects of polydrug abuse are particularly
alarming because the negative health consequences of using many substances may be
multiplicative.
Your text also mentions nicotine as a harmful drug. Cigarette users, for example, often experience
medical problems such as lung cancer, emphysema, larynx and esophagus cancer, and
cardiovascular diseases. Although studies show that the prevalence of cigarette smoking is
decreasing, it is still a large societal problem, especially for blue-collar workers and individuals of
low socioeconomic status. Smoking has been banned from many public places as a result of
research showing the deleterious effects on health of secondhand smoke.
Just because a physician has prescribed a medication does not mean it cannot be abused. Minor
tranquilizers (sedatives) such as Valium and Librium are among the most frequently prescribed
drugs. These drugs are habit forming, and many individuals find it quite painful to give them up.
Patients will sometimes consult several physicians and obtain prescriptions from each one for
minor tranquilizers over a long period of time. It is thought that depression is often one of the
consequences of withdrawal from minor tranquilizers. Unfortunately, there is little doubt that they
are overprescribed in this country.
The current medical wisdom is that alcoholism is a disease. However, many behavioral scientists
disagree and posit that it is a learned behavior. Your text outlines several sociocultural,
psychological, and biological variables, which suggest that substance abuse and addiction arise
from a combination of factors. Sociocultural variables include family variables, effects of the media,
74
and the social milieu to which an individual belongs. One example of a psychological variable that is
related to substance use and abuse is a person's expectations. For example, it has been shown that
alcohol use reduces tension in individuals who expect that it will do so. Another psychological
variable that may be important in understand the etiology of substance use is personality. For
example, high levels of negative emotionality and low levels of constraint have been linked to
substance use. Biological variables associated with substance use include genetic and
neurobiological factors.
Your text describes a wide range of treatment approaches to substance abuse and dependence.
Hospitalization is often required for purposes of detoxification, or withdrawing the individual

from the substance. Biological treatments are often given to discourage further use of the
substance. Antabuse, for example, causes vomiting if a person consumes alcohol. Heroin addicts
often take methadone, a heroin substitute that reduces the body's craving for the substance but
does not cause the high. However, it is widely believed that some sort of psychological intervention
should supplement hospitalization and/or biological approaches to treatment. Many individuals
find that Alcoholics Anonymous (AA) and Narcotics Anonymous (NA) are extremely helpful in
overcoming their addictions. These groups are self-help groups formed by recovering addicts, and
they provide emotional and social support and peer counseling. Couples and family therapies are
often useful to address the pain that an addict causes his or her family. In addition, several
cognitive-behavioral approaches have been shown to be effective in treating alcohol and drug
abuse. One controversial cognitive-behavioral approach is controlled drinking, or the
encouragement of "a pattern of alcohol consumption that is moderate, avoiding the extremes of
total abstinence and inebriation (p. 316)." In contrast, many mental health professionals believe
that total abstinence is the only effective approach to treating substance abuse. Proponents of
controlled drinking put forth that total abstinence is unrealistic and that controlled drinking allows
the individual to exercise self-control, enhanced social skills, and assertiveness skills.
Due to the difficulties people face once addicted to substances, many believe that prevention efforts
are the most logical approach to limiting substance abuse. Numerous prevention efforts are
targeted at children and adolescents and are therefore conducted in school settings. Drug
prevention messages became commonplace in the media during the 1990s with the start of the
just say no campaign. Your text highlights the components used in tobacco prevention campaigns
(pp. 325-326). Similar tactics are used in the prevention of the use other substances as well.
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Self-Test Exercise:
1. Organizations like Alcoholics Anonymous assert that the only way to insure that a substance
will not be abused in the future is never again to partake of the substance. Is it true that
once you are an alcoholic, you are always an alcoholic? Is one drink sufficient to begin
bingeing? Can alcoholics be taught to become controlled social drinkers? What are the
consequences of AA's stance, and what are the consequences of challenging that stance?
2. Many of you may have been exposed to a drug prevention program during elementary
school or junior high, ranging from a police officer coming to the class to show various
drugs and caution the children about the adverse consequences and illegality of drug use, to
a formal "Just Say No" or "DARE" program. What were your personal experiences regarding
the effectiveness or lack of effectiveness of these prevention efforts? In your opinion, how
could these prevention efforts be more effective?
3. Your text describes several interventions to treat and prevent substance abuse. Can you
think of any other ways to approach the problem? How would your approach be more
effective than those described in the text? Does your approach address biological,
psychological, sociocultural, or legal issues?
Further Readings (Optional):
Ellis, A. and E. Velton. When AA Doesn't Work for You: Rational Steps to Quitting Alcohol. New York:
Baricade Books, 1992.
The Little Red Book. Hazelden Foundation, 1986.
McGovern, G. Terry: My Daughter's Life-and-Death Struggle with Alcoholism. New York: Plume,
1997.
Woititz, J. G. Adult Children of Alcoholics. Deerfield Beach, Florida: Health Communications, Inc,
1990.
76

Write a brief discussion of one of the topics below, following the guidelines for written
assignments laid out in the Introduction of this study guide. Your discussion should be no
longer than one or two type-written, double-spaced pages.
Cigarette smoking is a habit that many individuals have acquired and find very difficult to
give up. If you are a smoker, describe the circumstances that led you to begin smoking. Also,
if you have quit or tried to quit, describe the difficulties involved. What are the similarities
and differences between your efforts to quit and the difficulties that drug addicts have in
quitting?
If you have never smoked, how did you resist the temptation to begin? What was it like to
have friends whom smoked when you were an adolescent? Describe the efforts of someone
you know to overcome the smoking habit. Ask a friend what strategies he or she used. What
was easy? What was difficult? Did your friend experience a relapse? To what did your friend
attribute success or failure?
After completing this assignment, TAKE EXAM #2 AND THEN
PROCEED TO LESSON 11. You will submit this assignment as Part A of

Written Assignment #4 following Lesson 11.
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EXAMINATION #2
0
Assignments #2 and #3 prior to taking Exam #2. Exam #2 is worth 60 points and covers the material in
Lessons 6-10 of this study guide and Chapters 6-10 of the textbook.
Your second examination is a 75-minute supervised exam consisting of 60 multiple-choice items.
The exam will cover material presented in Chapters 6-10 of your textbook, and Lessons 6-10 of this
study guide. The exam will emphasize your ability to recognize the right answer rather than
produce it from memory. This is NOT an open-book examination. Good luck!
Reminder:
You must take this examination before submitting subsequent written assignments, although you
may work ahead on these assignments if you wish.
78
LESSON 11 EATING DISORDERS

Objectives:
READING ASSIGNMENT:

1. The symptoms associated with anorexia, bulimia,
and binge eating disorder and be able to distinguish

among the different eating disorders.

& Neale
Chapter 11
pp. 327-355
2. The neurobiological, sociocultural, and
psychological factors implicated in the etiology of eating disorders.
3. The issues surrounding the growing epidemic of obesity in the United States.
4. The treatments for eating disorders and the evidence supporting their effectiveness.
Key Terms:
Anorexia nervosa
obese
binge eating disorder
body mass index (BMI)
bulimia nervosa
Key Figures:
Salvador Minuchin
Instructor Notes:
The importance of the deleterious effects of eating disorders is becoming apparent, as evidenced by
their inclusion into the DSM-IV as a separate category of psychopathology. Anorexia nervosa and
bulimia nervosa are the two major disorders in this category. Anorexia is characterized by body
weight that is much less than what is considered normal for the person's age and height (see page
328), an intense fear of gaining weight, and a distorted body image. Your text indicates that a
pervious criterion for anorexia nervosa, the disruption of menstruation, is being removed in DSM-5.
Anorexia nervosa has been linked to depression and several personality disorders (to be described
in Lesson 15 of this study guide). Individuals with anorexia usually appear emaciated despite their
belief that at least a part of their body appears overweight. The weight of individuals with bulimia
nervosa, on the other hand, usually appears normal or even overweight. The hallmark features of
bulimia nervosa are the presence of excessive intakes of food (binges) and inappropriate
compensatory behavior to counteract the effects of eating so much. Typically, the compensatory
behavior involves some sort of purging (e.g., vomiting, taking laxative), although excessive exercise
can also be included in this category. A new diagnostic category that has been proposed for
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Abnormal Psychology
inclusion in DSM-5 is binge eating disorder. This disorder is characterized by episodes of
excessive intake of food with the absence of weight loss or compensatory behavior. An additional
criterion for binge eating disorder is the presence of a combination of three or more of the
following characteristics: rapid eating, eating alone, distress about bingeing, eating until over-full,
and eating large amounts of food when not hungry. Your text states that binge eating disorder is
more prevalent than either anorexia or bulimia and that it is associated with obesity, impaired
work/social functioning, depression, and substance use disorders (to be described in Lesson 10),
among other things.
Similar to other disorders, research suggests that it is a combination of factors that influence the
development of eating disorders. For example, it appears that individuals with relatives who have
an eating disorder are at risk themselves for developing an eating disorder. Biological theories have
considered malfunctions in the hypothalamus, a brain structure linked to hunger and eating
behavior, and in endogenous opioids, but neither of these lines of research has proven to be fruitful.
Many individuals point to sociocultural variables as causal factors in eating disorders. It is wellknown that models portrayed in magazines have become thinner over time, and the Barbie doll
portrays a figure of unattainable proportions. Although these explanations are attractive and most
likely play some role in the maintenance of eating disorders, it is important to acknowledge that
they have not been shown to be causal factors.
Several personality variables have been linked to eating disorders, such as perfectionism and
affective instability. A particularly interesting personality variable related to eating disorders is a

lack of interoceptive awareness ("the extent to which people can distinguish different biological
states of their bodies [p. 347-348]") which along with negative emotionality was found to
prospectively predict the onset of eating disorders. Cognitive-behavioral approaches to anorexia
nervosa suggest that the maintenance of thinness is negatively reinforced by reducing anxiety. That
is, individuals with anorexia and bulimia are preoccupied with being thin, which produces anxiety.
Engaging in behaviors that appear to maintain thinness reduces the individual's anxiety that about
being fat. Additionally, the sense of self-mastery associated with dieting and weight loss may be
positively reinforcing for those with anorexia. Cognitive-behavioral theories regarding bulimia
nervosa states that those low in self-esteem and high in negative affect die tin an attempt to
enhance their mood and self-image. However, problems arise when food is too severely restricted,
resulting in the diet being broken and an associated binge episode. The person then engages in
compensatory behaviors (e.g. vomiting, laxative use, extreme exercise) in an attempt to reduce
their fears associated with gaining weight.
80
A high rate of childhood physical and/or sexual abuse has been found in those suffering from eating
disorders, particularly bulimia nervosa. Researchers are currently uncertain whether childhood
abuse plays an etiological role in the development of eating disorders. It is also important to note
that childhood abuse is found at high rates across diagnostic categories and is therefore not a risk
factor specific to eating disorders.
Your text paints a somewhat dismal picture of treatment for anorexia and bulimia. Most individuals
with these disorders are not in treatment. Although antidepressant medications show some
promise in the treatment of eating disorders, many individuals with eating disorders discontinue
medications prematurely because of unfavorable side effects. The principal treatment for anorexia
nervosa is family therapy, focusing on problematic family characteristics (enmeshment,
overprotectiveness, rigidity, lack of conflict resolution). Cognitive-behavioral therapy and
interpersonal psychotherapy have been found to be helpful in some eating disordered patients, but
more research is needed to determine how best to treat this type of psychopathology. You book
discusses the role of preventative interventions such as psychoeducation in targeting children and
adolescents before an eating disorder develops.
Self-Test Exercise:
1. If you were a mental health professional treating an individual with anorexia or bulimia,
what would be the most important aspects of the disorder to target in treatment?
2. Your book includes little about the etiology and treatment of binge eating disorder relative
to the other eating disorders. What do you think may be some of the biological,
sociocultural, and psychological causes of this disorder? What do you think would be the
components of an effective treatment?
3. Are there other categories of eating disorders that should be considered in the DSM?
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Abnormal Psychology

Hornbacher, M. Wasted: A Memoir of Anorexia and Bulimia. New York: Harper Collins, 1998.
Sacker, I. M. and M. A. Zimmer. Dying to Be Thin. New York: Time Warner, 1987.
82

type-written, double-spaced pages.
Think about your own attitudes about eating and body weight. Which attitudes are healthy?
Which are unhealthy? How did those attitudes develop? Your answers may provide some
insight about the etiology of eating disorders.

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LESSON 12 SEXUAL DISORDERS

Objectives:
READING ASSIGNMENT:

1. The influence of culture and gender on sexual
norms.
2. The sexual response cycle for men and women.

& Neale
Chapter 12
pp. 356-384
3. The symptoms, causes, and treatments for sexual

dysfunctions and paraphilias.
Key Terms:
delayed ejaculation
desire phase
erectile disorder
excitement phase
frotteuristic disorder
gender dysphoria
genito-pelvic
pain/penetration
disorder
incest
resolution phase
sexual dysfunctions
exhibitionistic disorder
female orgasmic
disorder
male hypoactive sexual

desire disorder
orgasm phase
sexual masochism
disorder
sexual response cycle
penile plethysmograph
vaginal
plethysmograph
premature ejaculation
voyeuristic disorder
female sexual
interest/arousal
disorder
fetishistic disorder
paraphilic disorders
pedophilic disorders
sexual sadism disorder
spectator role
Key Figures:
William Masters
Instructor Notes:
Virginia Johnson
Many people find it difficult to understand gender identity disorders. Our sense of being male and
female has pervaded our consciousness for as long as we can remember. Yet there are individuals
whose deeply held gender identity does not match their anatomical sex. The issue of whether or not
trangender individuals should be considered as having a mental illness continues to be very
controversial. Kring, Johnson, Davison, and Neale indicated that gender dysphoria is one of the most
debated DSM diagnoses. Because of this, the authors of your book state that they did not include
gender dysphoria in their chapter on Sexual Disorders (see Focus on Discovery 12.1).
84
Whereas transsexuals rarely cause most of us concern on a day-to-day basis, the paraphilias are
often the focus of significant attention. Most of the paraphilias are, in fact, illegal; individuals often
reach treatment centers via the court/police systems. Page 372 of your text lists the proposed
paraphilias for inclusion in DSM-5. You text highlights the point that a number of the behaviors that
are considered paraphilias have become relatively common. However, it is important to note that
the diagnosis of a paraphilia requires that the behavior causes marked distress, impairment, or
when the sexual activity occurs with a nonconsenting person. Paraphilias are more common in
males and many of the disorders begin in adolescence. Some of the most disturbing paraphilias
involve sexual acts with children, a sexual disorder termed pedohebephilic disorder. Although
most of us have little sympathy for the pedophile, it is important to acknowledge that many studies
reveal that perpetrators are characterized by social isolation, poor social skills, and negative affect.
Treatment for sex offenders often adopts a multifaceted approach including aversion therapy,
social skills training, and sex education. These treatments are only successful, however, if the
perpetrator takes responsibility for his or her actions and is motivated to change. Child sexual
abuse also causes many harmful effects on the victim. Focus 12.3 describes some of these adverse
effects, such as anxiety, depression, low self-esteem, and learning problems.
Rape is included in this edition of the textbook because of its deleterious effects on its victims and
because perpetrators often exhibit signs of psychopathology. Effects on victims of rape include
many of the same symptoms of victims of child sexual abusedepression, anxiety, posttraumatic
stress disorder, and low self-esteem. Rape victims are prone to developing PTSD and phobias
involving environmental stimuli associated with the rape (e.g. being indoors/outdoors, darkness).
The text indicates that there is no one psychological profile of a rapist. However, most perpetrators
have in common a sense of hostility toward women and antisocial/impulsive personality traits.
Cognitive and behavioral approaches to treatment with rapists have shown some promise in future
rape prevention. Therapeutic approaches with rape victims typically focus on normalizing the
victims responses, behavioral activation, and the health of the victims current relationships. As
previously noted, rape victims are prone to developing PTSD; thus, treatment of rape victims will
often involve therapeutic techniques discussed in the section on PTSD (see Chapter 7).
The sexual dysfunctions proposed for DSM-5 are divided into three categories: desire/arousal
disorders, orgasmic disorders, and sexual pain disorders. Sexual dysfunction can be extremely
distressing to both men and women. For example, the male who is unable to perform sexually may
begin to doubt his masculinity. Ironically, the more concerned an individual is regarding sexual
dysfunction, the more likely it is to continue. Some individuals will drink alcohol to reduce the
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Abnormal Psychology
anxiety of possible failure. Alcohol, a central nervous system depressant, temporarily reduces
anxiety but often interferes with sexual function. A vicious cycle may develop, particularly for
erectile failure, where an initial failure because of alcohol consumption or fatigue may prompt
worry and concern on the part of the male, which further interferes with sexual function. Clearly,
expectations play an important role in sexual function. However, according to Masters and
Johnson, there are several other factors that may interact to cause sexual dysfunction. These
variables include religious orthodoxy, psychosexual trauma, homosexual inclination, inadequate

counseling, excessive alcohol intake, physiological problems and sociocultural factors. These
historical factors contribute to current/proximal causes for sexual dysfunction (i.e. fear of
performance and the spectator role). Although Masters and Johnson's treatment for sexual
dysfunction (Focus 12.2) may be the most well-known intervention, the text describes several other
approaches to treatment, such as anxiety reduction, procedures to change attitudes and thoughts,
skills and communication training, couples counseling, directed masturbation, and medical
procedures.
Self-Test Exercise:
1. Clinicians now recognize that, in select cases, sex-reassignment surgery may be an
appropriate intervention in transsexual adolescents. Support or refute this view.
2. Some psychologists have argued that therapists should not help homosexuals who want to
change their sexual orientation to do so, for in acquiescing to this request the therapist is
reinforcing society's prejudice that homosexuality is abnormal. What are your views about
psychotherapy for homosexuality?
3. What components of psychotherapy would you include in treating an individual who is HIVpositive?

Kaplan, H. S. Disorders of Sexual Desire. New York: Brunner/Mazel, 1979.
86
Zilbergeld, B. Male Sexuality. New York: Bantam Books, 1978.

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LESSON 13 DISORDERS OF CHILDHOOD

Objectives:
READING ASSIGNMENT:

1. The issues in the classification of psychopathology
in children.
2. The description, etiology, and treatments for

& Neale
Chapter 13
pp. 385-428
externalizing problems, including ADHD and
conduct disorder, and for internalizing problems, including depression and anxiety
disorders.
3. How to distinguish between the different learning disabilities, dyslexia and dyscalculia, as
well as our current understanding of the causes and treatments for dyslexia.
4. The description and diagnosis of intellectual development disorder and the current
research on causes and treatments.
5. The symptoms, causes, and treatments for autism spectrum disorders.
Key Terms:
attentiondeficit/hyperactivity
disorder (ADHD)
autism spectrum
disorder
child onset fluency

disorder (stuttering)
communication
disorders
dyslexia
externalizing disorders
fragile X syndrome
intellectual
disability
conduct disorder
internalizing disorders
parent management
training (PMT)
specific learning
disorder
developmental
psychopathology
joint attention
phenylketonuria
speech sound disorder
Down syndrome
motor disorders
pronoun reversal
dyscalculia
multisystemic
treatment (MST)
separation anxiety
disorder
Key Figures:
American Association
of Intellectual and
Developmental
Disabilities (AAIDD)
Gerald Patterson
Leo Kanner
Kenneth Dodge
Ivar Lovaas
Head Start
88
Instructor Notes:
Childhood disorders are often the subject of a separate course. Thus, Kring, Johnson, Davison, and
Neale examine developmental psychopathology only in a cursory fashion. Nevertheless, several
important themes emerge from their discussion.
Many disorders experienced by adults are self-defined; with children, however, the existence of a
psychological disorder is defined by adults, particularly parents. Clearly, most attention in
childhood disorders has been focused on children who are disruptive (e.g., conduct disorder and
attention-deficit/hyperactivity disorder [ADHD]). When examining mood disorders in children and

adolescents, the DSM criteria for adults are used, with some age-specific features (i.e. irritability
and/or aggressive behavior) included as well. The symptom profiles of children can differ
somewhat from those of adults. Depression is a recurrent disorder in children as in adults.
Prevalence estimates differ according to child age, with adolescent rates equivalent to the adult
population. As in adults, childhood depression is often comorbid with other conditions, thereby
complicating diagnosis and treatment. Although medication for depression is effective in adults, it is
important to acknowledge that it does not seem to be beneficial in the treatment of childhood
depression. Psychological treatments for childhood depression are often similar to those used with
adults (e.g. IPT, CBT), but often also incorporate family and school environments.
The principal concern is that the decision as to whether a child needs psychological help often can
be more of a function of the parents' psychological state than the child's. It is noteworthy that some
parents believe their children need psychological services when their children are exhibiting
normal, age-appropriate behaviors. As we saw in the anxiety disorders chapter (Chapter 6), many
fears are normal at particular ages in childhood. Likewise, temper tantrums are normal between
the ages of two and four. In many places, your text reinforces the fact that psychopathology affects
children and their parents in a bi-directional fashion. For this reason and others, many clinicians
who work with disturbed children also include the parents and sometimes the whole family. The
child's deviant behavior, if it is indeed deviant, is seen as operating within a family context.
A topic that is increasingly covered in the media is the use of Ritalin in treating ADHD. Many
individuals in society are concerned that children are being medicated because parents and
teachers are not capable of handling them (see Focus on Discovery 13.4). Your text discusses
behavioral interventions for ADHD which is typically based on operant-conditioning principles and
applied in both the home and classroom settings. As your book points out, intensive behavioral
therapy may be an effective alternative to medication.
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Abnormal Psychology
Conduct disorder (CD) is another externalizing disorder of childhood that encompasses those
children who engage in behaviors which violate societal norms and the rights of others. Children
with CD can be callous, vicious, and unremorseful, setting the stage for CD as a precursor to adult
antisocial personality disorder. The course of CD is somewhat uncertain and may vary according to
subgroups for the disorder (i.e. life-course-persistent and adolescent limited; see pg. 408) with
those in the life-course-persistent subgroup experiencing more chronic and severe problems even
into early adulthood. Etiological factors for CD are numerous including: genetics,
neuropsychological deficits, learning theories (i.e. Dodges social-information processing theory),
peer rejection, association with deviant peers, social class, and urban living. Treatments for CD are
often involve the family such as parental management training (PMT) and multisystemic treatment
(MST). Oppositional Defiant Disorder (ODD) is a less well defined externalizing disorder that is
diagnosed if the child does not meet CD criteria, but exhibits less extreme behavioral problems (i.e.
noncompliance, temper tantrums, argumentativeness). Complicating diagnosis further is the fact
that CD, ODD, and ADHD all co-occur at high rates. Interestingly, the internalizing disorders (i.e.
anxiety and depression) are also highly comorbid with the externalizing disorders.
Your text outlines several categories of learning disabilities: learning disorders, communication
disorders, and motor skills disorders. Learning disabilities typically occur in children of average
or above average intelligence who fail to develop skills in a specific area to the degree expected
given their intelligence level. Learning disabilities are usually identified and treated in the schools
rather than in clinics. Treatments for these conditions not only should involve direct interventions
to remedy the particular deficit, but they should also include components to reinforce the child's
sense of mastery and self-esteem. Usually, individuals with learning disabilities ultimately function
adequately in society, although they may experience a great deal of frustration as they go through
school. Your text focuses on the etiologies of dyslexia (i.e. visual/auditory & language deficits, brain
activation deficits, and genetics) and dyscalculia (i.e. brain activation deficits, impaired ability to
manipulate numbers, and genetics).
The DSM-IV diagnosis of mental retardation is proposed to be changed to intellectual
developmental disorder in DSM-5. This disorder is especially stigmatizing in a society like ours
that stresses superior intellectual function. Keep in mind that intelligence in all forms is on a
continuum and that any point on that continuum which designates mental retardation is
necessarily an arbitrary one. Moreover, an intelligence test-score below 70 is not the only
characteristic required for a diagnosis of mental retardationone must also exhibit a deficit in
adaptive functioning as measured by standardized scales, and the onset must be prior to age 18.
90
The approach of the American Association on Intellectual and Developmental Disabilities
(AAIDD) differs from that of the DSM-IV in that it focuses on identifying an individuals strengths
and weaknesses as well as the supports needed to foster adaptive functioning. Therefore, the
AAIDs assessment approach is more individualistic and is useful in treatment planning.
Finally, autism spectrum disorder (ASD) represents a new diagnosis proposed for DSM-5.
Previously, diagnoses such as autistic disorder and Aspergers disorder were separate categories.
However, these disorders, along with a few others are being collapsed into a diagnosis of autism
spectrum disorder. Many of us are familiar with portrayals in the media of autistic individuals who
have unusual abilities and talents (or individuals called savants). In actuality, a high percentage of
individuals with ASD also have intellectual developmental disorder, which renders them much
lower functioning than most autistic individuals on television. Your text does an excellent job of
describing the major features of ASD, such as social/emotional deficits, communication deficits, and
repetitive/ritualistic acts. Early accounts of ASD originating in the 1960s suggested that early
childhood trauma and/or cold, distant parenting caused this disorder. However, more recent
research suggests that genetic and biological factors play a large role in the etiology of ASD. The
primary approach to treatment of ASD is Ivar Lovaas operant conditioning behavioral approach
which incorporates intensive therapy administered by clinicians, parents, and teachers in a
collaborative effort. Although psychological treatments of ASD are the most promising, your text
also discusses drug treatments for this disorder.
Self-Test Exercise:
1. Think back to some of your classmates in elementary school. In retrospect, would you say
that any of the "bullies" would have been diagnosed with an undercontrolled disorder? Did
any of your classmates have a learning disability? How did these disorders affect their
academic performance? Their interactions with their peers?
2. How has your understanding of autism spectrum disorder changed after reading this
chapter?
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Abnormal Psychology

Grandin, T. Thinking in Pictures and Other Reports from My Life with Autism. New York: Vintage
Books, 1995.
Grandin, T. and M. M. Scariano. Emergence: Labeled Autistic. Novato, California: Warner Books,
1986.
Hartman, T. ADD Success Stories. Grass Valley, California: Underwood Books, 1995.
Park, C. Without Reason: A Family Copes with Two Generations of Autism. New York: Harper &
Row, 1989.
92

laid out in the Introduction of this study guide. Your discussion should be no longer than a
couple of type-written, double-spaced paragraphs.
You are a child clinical psychologist conducting an assessment of a preschool age child
referred for developmental concerns. You suspect a diagnosis of autism and/or mental
retardation. What signs/symptoms are common to the two disorders? How would you
determine the appropriate diagnosis? What signs/symptoms would differentiate the

disorders, thereby aiding your decision-making?
After completing this assignment go on to Lesson 14. You will
submit this assignment as Part A of Written Assignment #5 following

Lesson 14.
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LESSON 14 LATE LIFE AND NEUROCOGNITIVE DISORDERS

Objectives:
READING ASSIGNMENT:

1. The common misconceptions about age-related
changes and understand the genuine age-related
changes.

& Neale
Chapter 14
pp. 429-450
2. The issues involved in conducting research on

aging.
3. The prevalence of psychological disorders in the elderly and issues involved in estimating
the prevalence.
4. The symptoms, etiology, and treatment of dementia and delirium.
Key Terms:
age effects
Alzheimers disease
cognitive reserve
cohort effects
frontotemporal
dementia (FTD)
mild cognitive
impairment
neurofibrillary tangles
plaques
delirium
selective mortality
dementia
social selectivity
Instructor Notes:
dementia with Lewy

bodies
time-of-measurement
effects
disorientation
vascular dementia
Your text emphasizes that it is important to consider research design when evaluating studies
investigating psychopathology in older adults. It is easy, for example, to conclude that there are
differences between older and younger adults when results in fact are obtained because of a cohort
effect, or "the consequences of growing up during a particular time period (p. 447)." An example of
a cohort effect was presented in the section on sexuality. Although older adults may report less
frequent sexual activity and enjoyment, they grew up in a time period in which sexuality was not
discussed openly. Thus, older adults may experience equally frequent and enjoyable sexual activity
as younger adults, but are more hesitant to report it. Other methodological issues that are
important to consider with investigating psychopathology in older adults are response biases and
selective mortality (see pg. 448).
Dementia is the disorder most frequently associated with the elderly. Your text states that
Alzheimer's Disease accounts for 80 percent of all dementia patients. However, it is important to
94
acknowledge that there are several other types of dementia, such as encephalitis (inflammation of
the brain tissue), meningitis (inflammation of the membranes covering the outer brain), endocrine
problems (e.g., hyperthyroidism), HIV, nutritional deficiencies, and head traumas. Moreover, your
text asserts that it is important to rule out delirium before making a diagnosis of dementia. A cure
for dementia has not yet been discovered. Therefore, psychological and lifestyle treatments are
important in helping individuals and their families cope with the effects of the disease.
As your text makes clear, older adults are no more likely to experience major types of
psychopathology than younger adults. In fact, Table 14.2 in your book shows that psychological
disorders are less common in the elderly. My colleagues and I investigated the prevalence of
depression in 3,000 older adults living in rural areas of Iowa. We found that only 2 percent of these
adults could be diagnosed as clinically depressed. One fact that may have contributed to this low
rate of depression was that a large proportion of these elderly had family and friends with whom
they had a great deal of contact. Moreover, these individuals were heavily involved in many
religious and secular organizations. Relationships with others are thought to provide social support
to the individual. We know that social support in times of crisis may diminish the negative effects of
the stress and thus prevent depression or other problems.
Throughout the chapter, Kring, Johnson, Davison, and Neale describe several unique symptom
profiles of older adults and compare them to symptoms in younger adults. For example, sleep
difficulties affect approximately 25 percent of elderly individuals, as many older adults have
problems with pain and sleep apnea that disrupt the quality of their sleep. Further, your text
emphasizes that older adults have just as much interest in and enjoyment of sex than younger
adults. However, they usually take longer to become aroused and experience orgasm than younger
adults.
Self-Test Exercise:
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1. What services have older adults in your life utilized? How effective have they been?
2. If you were the director of a nursing home, what activities or services would you encourage
to maintain the functioning of the residents?
3. How would you go about deciphering whether an older individual is experiencing dementia,
delirium, or depression?
96

laid out in the Introduction of this study guide. Your discussion should be no longer than one
type-written, double-spaced page.
Clinicians often debate about whether or not to tell an individual that he or she is suffering
from Alzheimer's disease. Clinicians who do not disclose diagnoses to patients reason that
the diagnosis cannot be made with certainty prior to autopsy, therapeutic options are
limited, and the label may lead to stigmatization by insurers, health professionals, and
others in society. The case for telling an individual that he or she is suffering from
Alzheimer's disease includes that patients cannot make informed decisions about whether
to accept or forego treatment without knowing the truth, persons with a progressive illness
should be given the opportunity to make choices about their future while they are still
competent to make decisions, and patients may prefer to express their thoughts and fears
before they are unable to. To which viewpoint do you adhere? Provide additional reasons to
support your viewpoint.

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LESSON 15 PERSONALITY DISORDERS

Objectives:
READING ASSIGNMENT:

1. The difference between the DSM-IV-TR and the
proposed DSM-5 approaches to personality and

personality disorders.

& Neale
Chapter 15
pp. 451-479
2. The personality trait domains in the proposed DSM-
5, and to define the key features of each DSM-5 personality disorder.
3. The genetic, neurobiological, social, and psychological risk factors for the DSM-5 personality
disorders.
4. The available medication and psychological treatments for DSM-5 personality disorders.
Key Terms:
antisocial personality
disorder
avoidant personality
disorder
borderline personality
disorder
dependent personality
disorder
paranoid personality
disorder
personality disorder
personality trait
domains
personality trait facets
dialectical behavior
therapy
psychopathy
Key Figures:
Heinz Kohut
Instructor Notes:
histrionic personality
disorder
schizoid personality
disorder
Hervey Cleckley
narcissistic personality
disorder
schizotypal personality
disorder
personality disorder
Marsha Linehan
Personality disorders are a heterogeneous group of disorders coded on that reflect life-long
characteristic patterns of behavior considered to be dysfunctional for the person and/or society.
Although there are several subtypes of personality disorders, differential diagnosis is often very
difficult. Individuals commonly meet criteria for several personality disorders, and diagnoses arent
particularly stable over time. It is for this reason that a dimensional approach to characterizing
personality disorders is advocated by many researchers. A number of other concerns with the
personality disorders in DSM-IV have led the proposal of a new assessment of personality in DSM-5.
Your book highlights the changes proposed for DSM-5, including a reduction of personality disorder
types from 10 to six (see Table 15.1 in your text) and dimensional personality trait scores. The
98
personality trait scores are meant to address the research showing that the characteristics
composing personality disorders are traits that every individual has, but in a more extreme form.
As noted in your book, the proposed changes to the personality disorders in DSM-5 represent a
complex assessment strategy that includes three types of personality ratings: level of personality
functioning, personality disorder types, and personality trait domains and facets. This
assessment model allows a person to be diagnosed with a personality disorder even when they do
not match one of the six types (to be discussed below). For example, in the case that someone
demonstrates significant impairment in functioning, but doesnt match one of the personality
disorder types, they can be diagnosed with personality disorder trait specified. In this case, the
clinician would note which of the persons personality trait domains and/or facets (see Table 15.4)
are pathological.
DSM-5 includes 10 personality disorders, 6 of which are also found in the alternative model. The 10
personlaity disorders are divided into three clusters: the odd/eccentric cluster, the
dramatic/erratic cluster, and the anxious/fearful cluster. Your book describes each of these clusters
and their constituent disorders in detail (see pgs. 469-483). One of these personality disorders is
borderline personality disorder (BPD). Research increasingly shows that individuals with
borderline personality disorder are some of the most difficult patients to treat in psychotherapy.
Characteristics of borderline personality disorder include impulsivity, rapid alterations between
idealization and devaluation, chronic feelings of emptiness, frantic attempts to avoid abandonment,
and self-injurious behavior. Theorized etiologies for BPD include a genetic diathesis, deficient
serotonin system functioning, childhood abuse, and a diathesis-stress theory. The diathesis-stress
theory for BPD incorporates the proposed theories of etiology in that it proposes the existence of a
biological diathesis for emotional dysregulation (e.g. genetics or deficient serotonin) that when
activated by psychological stressors (e.g. invalidating environment, interpersonal difficulties)
results in the development of BPD. Marsha Linehan has developed an efficacious therapeutic
approach to the treatment of borderline personality disorder, Dialectical Behavior Therapy,
which includes cognitive-behavioral components, social skills training, and elements from Zen
philosophy. This treatment approach recognizes that therapists often become frustrated with
borderline patients, and provisions are made for therapists to garner support from their peers.
Finally, your text discusses the treatment of personality disorders. As you just read, dialectical
behavior therapy is used in the treatment of borderline personality disorder. Although most
patients with personality disorders come to therapy for other reasons (e.g., interpersonal
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difficulties), it is very important for a therapist to consider whether the patient exhibits personality
pathology because it is likely to affect the course of therapy (i.e., slower improvements). There are
various approaches to treating personality disorders including psychodynamic therapy, cognitive
behavioral therapy, and medication. Further, your book highlights the promising alternative of day
treatment programs for personality disorders.
Self-Test Exercise:
1. If personality disorders are maladaptive personality traits that interfere with functioning,
should they be considered "mental disorders?" Are they disorders in the same sense as
bipolar disorder and agoraphobia?
2. Are there other maladaptive personality traits that are not considered in the DSM? What are
they? How are they dysfunctional?
3. The different personality disorders show high rates of co-occurrence. Which personality
disorders would you expect to co-occur in patients? Why?
Black, D. W. Bad Boys, Bad Men: Confronting Antisocial Personality Disorder. New York: Oxford
University Press, 1999.
Linehan, M. M. Cognitive-Behavioral Treatment of Borderline Personality Disorder. New York: The

Guilford Press, 1993.
Wanklin, J. Let Me Make It Good: A Chronicle of My Life with Borderline Personality Disorder.
Buffalo, NY: Mosaic Press, 1997.
100

laid out in the Introduction of this study guide. Your discussion should be no longer than
one-and-a-half type-written, double-spaced pages.
Describe someone you know who has the characteristics of one or more personality
disorders. What symptoms do you see as present and what sorts of problems do these
problems cause in the person's life?
After completing this assignment go on to Lesson 16. You will
submit this assignment as Part A of Written Assignment #6 following

Lesson 16.
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LESSON 16 LEGAL AND ETHICAL ISSUES

Objectives:
READING ASSIGNMENT:

1. How to differentiate the legal concepts of insanity
and the various standards for the insanity defense.
2. The issues surrounding competency to stand trial.

& Neale
Chapter 16
pp. 480-508
3. The conditions under which a person can be

committed to a hospital under civil law.
4. The difficulties associated with predicting dangerousness and the issues surrounding the
rights to receive and refuse treatment.
5. The ethics surrounding psychological research and therapy.
Key Terms:
American Law Institute

guidelines
assisted outpatient
treatment
civil commitment
competency to stand
trial
informed consent
insanity defense
irresistible impulse
least restrictive
alternative
confidentiality
MNaghten rule
Instructor Notes:
criminal commitment
not guilty by reason of

insanity (NGRI)
guilty but mentally ill

(GBMI)
privileged
communication
in absentia
According to your text, the insanity defense is "the legal argument that a defendant should not be
held responsible for an illegal act if it is attributable to mental illness or intellectual disability that
interferes with rationality or that results from some other excusing circumstance, such as not
knowing right from wrong (p. 495)." The insanity defense has its roots in English common law, and
it has been generally accepted as necessary by the legal and psychiatric/psychological professions.
Nevertheless, cases do arise in which the successful use of the insanity defense results in
community outrage. An example is the attempted assassination of President Ronald Reagan by John
Hinckley (March, 1981). Hinckley was found not guilty by reason of insanity, despite having been
seen on national television seriously wounding the president and several other men, and despite
the testimony at his trial of his own psychiatrist against him. Nevertheless, the juryapplying the
federal standard of insanityfound there was a "reasonable doubt" that he was sane at the time of
the shooting. Most experts familiar with the testimony at the trial believed that the jury made the
102
correct decision, given the current federal law regarding the insanity plea. Currently, there are two
different insanity pleas: not guilty by reason of insanity and guilty but mentally ill. The differences
between these two pleas are outlined in your text (see pg. 487).
Most individuals who enter the mental health system are not criminals, yet some are incarcerated
against their will for a long period of time. Involuntary civil commitment is the process by which
mentally ill individuals believed to be a danger to themselves or to others are committed to a
mental hospital until they are judged to be no longer dangerous. As your text points out, this
awesome responsibility in our systema system that places a premium on individual libertyhad
been regarded rather lightly in the past. Involuntary commitments and lengthy incarcerations were
not uncommon pre-1970. Recent court rulings have served to make the standards for involuntary
commitments more stringent, to improve the care of individuals who are hospitalized, and to
provide for prompt release. Your text raises many issues in this chapter; quite apart from your
interest in psychology, you should be informed, as a citizen, about how our legal system and
psychology interact.
Predicting dangerousness has been a hotly debated topic in psychology throughout the years. Some
studies have shown that psychologists make predictions that are no different than the average lay
person! Further, issues of the reliability and validity of assessment tools must be considered in this
arena. Many psychologists speculate whether individuals in our profession ethically can make
predictions about an individual's behavior given the unreliability in most of our measures.
According to your text, the best predictor of future violence is past violence.
Finally, your text includes an important section on ethical dilemmas in therapy and research. If you
choose to enter the profession of psychology, you will quickly be exposed to an official document
published by the American Psychological Association outlining ethical principles for psychologists.
In the context of research, psychologists must explain the risks and benefits associated with
participation in a study, and they must obtain informed consent that the individual is voluntarily
agreeing to participate in the study. Further, all information that the research participant provides
must remain confidential unless he or she gives written permission to share his or her individual
results with others. As illustrated in your text, it is clear that many research participants do not
fully understand the implications of studies in which they participate when they give their informed
consent. In accordance with the "Ethical Principles," the burden is on the shoulders of psychological
researchers to ensure that potential research participants truly understand the procedures, risks,
and benefits of studies and the manner in which data will be used.
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Self-Test Exercise:
1. Formulate specific criteria that you feel are important in evaluating an individual's (1)
danger to the self; and (2) danger to others.
2. Have you ever participated in psychological research? If so, what were the instructions
provided to you before participating in the study? Do you feel that you were provided the
proper information and that care was taken to ensure that you understood what was
expected of you? If not, what could the researcher have done differently?
Ceci, S. J. and M. Bruck. Jeopardy in the Courtroom: A Scientific Analysis of Children's Testimony.
Washington, D.C.: American Psychological Association, 1995.
Imber, S. D. et al. "Ethical Issues in Psychotherapy Research: Problems in a Collaborative Trials

Study." American Psychologist 41 (1986): 137146.
104

laid out in the Introduction of this study guide. Your discussion should be no longer than
one-and-a-half type-written, double-spaced pages.
How accurate are we at identifying people who become dangerous to themselves or others
in the future? How good do you feel we need to be to justify committing a person without
trial? Use the section in your text on civil commitment to inform your discussion of these
issues.

CONGRATULATIONS ON COMPLETING ALL OF THE WRITTEN ASSIGNMENTS FOR THIS COURSE!
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FINAL EXAMINATION
0
Assignments #4 , #5, and #6 prior to taking this final exam. The final exam is worth 60 points and
covers the material in Lessons 11-16 of this study guide and Chapters 11-16 of the textbook.
This final examination is a 75-minute supervised exam consisting of 60 multiple-choice items. The
exam is not comprehensive, but will cover only material presented in Chapters 11-16 of your
textbook and Lessons 11-16 of this study guide. Like the previous exams, this exam will emphasize
your ability to recognize the right answer rather than produce it from memory. This is NOT an
open-book examination. Good luck!
106
WRAPPING THINGS UP
Course Evaluation:
At the end of the semester you will receive an email inviting you to submit a Course Evaluation.
Please take a few moments to complete it; your evaluation and additional written comments will
help us improve the Distance Education courses we offer.
When will the evaluation be forwarded to my instructor? Student evaluations and
additional written comments are not forwarded to instructors until all final grades have
been submitted.
Completing the course in two semesters? Students who complete their GIS course in two
semesters will receive the email invitation at the end of the second semester.
Transcript:
Upon completion of this course your final grade will be entered on your permanent student record
at The University of Iowa. Official transcripts of your permanent record can be obtained from the
Office of the Registrar, The University of Iowa, 1 Jessup Hall, Iowa City IA 52242-1316.
For information on the current transcript fee or to access the transcript request form, visit
http://registrar.uiowa.edu/transcripts/.
Transcripts may be ordered:
o Electronically through ISIS - http://isis.uiowa.edu/
o By phone Call the Office of the Registrar with your request (319) 335-0230.
o By mail or fax Print, complete, and mail your transcript request form to: Office of
the Registrar, Attn: Transcripts, 1 Jessup Hall, Iowa City IA 52242. Completed forms
can also be faxed to: (319) 335-1999. Note: Your signature is required on the request.
Requests are fulfilled in a minimum of two working days.
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APPENDIX A: SELF-TEST EXERCISES

Notes:
Self-Test Exercise:
Score:
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CHAPTER 1 SELF-TEST EXERCISE

After completing this self-test, check your answers with the ones for this chapter at the end
of this Appendix. If you have answered any items incorrectly, check your reading to find the
source of your error. Alongside each of the correct answers, you will find the page(s) in the
Kring, Johnson, Davison, and Neale text from which the self-test item was derived.
1. Edith was accused of being a witch in 1532. She most likely lived in
2.
3.
4.
a)
b)
c)
d)
Russia.
China.
Europe.
Japan.
Esther was a patient of Mesmer, who was treating her for blindness. What was the likely
scenario when she entered his treatment room?
a) a quiet room, with a soft reclining chair
b) a 'bleeding device' used to drain blood believed to be in excess that resulted in psychogenic
blindness
c) a stock of chemical- filled rods, with Mesmer presiding over the room
d) a sterile, well-lit room with several doctors in white laboratory coats
Dr. Smith argues that the desire to hunt is built into all men dating back to the times of cave
men. Dr. Smith is relying on the concept of
a)
b)
c)
d)
positive reinforcement.
collective unconscious.
self-actualization.
sublimation.
a)
b)
c)
d)
the needle
blood
fainting
blood flow
a)
b)
c)
d)
operant conditioning
cognitive behavior therapy
modeling
Fiona faints when her doctor begins to draw blood. What is the unconditioned response?
5. Sally is currently in a hospital where she earns tokens for specified behaviors. These tokens are
later exchanged for goods, such as food. This token economy is based on what behavioral
principles?
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Abnormal Psychology
6. Clinical psychologists, counseling psychologists, and social workers are all likely to be involved
in
a)
b)
c)
d)
conducting research.
providing psychotherapy.
teaching.
prescribing psychoactive medication.
a)
b)
c)
d)
abnormal behavior arises from discussions of abnormal behavior.

abnormal behavior is learned.
insight is important in changing behavior.
defenses are associated with resolving anxiety.
a)
b)
c)
d)
distinguishing medicine from religion and magic.

debunking the notion that the four humors were related to disorders.
reforming mental hospitals.
suggesting mental illness was punishment from God.
a)
b)
c)
d)
Childhood experiences help shape adult personality.

There are unconscious influences on behavior.
The causes and purposes of human behavior are not always obvious.
Sexual drives are key in the development of the self.
a)
b)
c)
d)
receive training in scientific bases of behavior.

receive training in diagnosis of psychopathology.
undergo personal analysis as part of their training.
prescribe medication.
a)
b)
c)
d)
diagnoses
fears
insecurities
preconceived notions
a)
b)
c)
d)
A label applied to a group of people that distinguishes them from others.

A label applied to a group of people that breaks the law.
The label is linked to deviant or undesirable attributes by society.
People with the label face unfair discrimination.
7. Behaviorists advocate that
8. Hippocrates influenced psychology by
9. Which of the following psychodynamic assumptions is NOT considered true today?
10. Psychiatrists differ from clinical psychologists in that psychiatrists
11. Students often have __________, which makes it difficult to remain objective when learning about
psychopathology.
12. Which of the following is NOT a characteristic of stigma?
110
13. The germ theory of disease, which states that disease is caused by infection of the body by tiny
organisms, was put forth by
a)
b)
c)
d)
Emil Kraepelin.
Franz Anton Mesmer.
Jean Charcot.
Louis Pasteur.
a)
b)
c)
d)
mild exorcism.
uncovering early child abuse.
acting as an anesthetic.
treating hysteria.
a)
b)
c)
d)
emotional reactions
irrational thoughts
disturbed perceptions
angry obsessions
14. Hypnosis, as originally used by Mesmer, was used for
15. According to Albert Ellis, __________ are caused by internal sentences that people repeat to
themselves.
Answers are located at the end of the Appendix.
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1. Ted is a "workaholic;" he works 15 hours a day and never has time to spend with his family or
on things he enjoys. Which of the following is a cognitive explanation of Ted's behavior?
a)
b)
c)
d)
Ted is imitating the behavior of his hard-working father.

Ted believes he can only be a good person if he excels in everything he does.
Ted is actually afraid of getting close to others.
Ted lacks the assertiveness to stand up to his boss' demands.
a)
b)
c)
d)
African-Americans; Caucasians
Hispanics; Caucasians
Caucasians; African-Americans
African-Americans; Hispanics
a)
b)
c)
d)
physical movement of the body.

regulation of sleep and arousal.
attention to emotional stimuli.
language formation.
a)
b)
c)
d)
panic disorder
depression
schizophrenia
none of the above
a)
b)
c)
d)
increase objectivity.
slow innovation.
increase confidence in our conclusions regarding mental illness.
enable us to gather knowledge in a systematic manner.
2. Studies of psychopathology among different cultures and ethnicities have shown that eating
disorders are more common among __________, while schizophrenia is more common among
__________.
3. It was found through a brain scan that a man had higher than normal levels of activity in his
amygdala. This man probably was having difficulty with
4. A genotype is illustrated by which of the following?
5. Paradigms in the study of psychopathology
112
6. Turkheimer and colleagues study of IQ showed that

a)
b)
c)
d)
heritability for IQ is high.

heritability depends upon the environment.
achievement is highly heritable regardless of environment.
linkage analysis is a sound research method.
a)
b)
c)
d)
HPA axis
serotonin
dopamine
nerve impulses
a)
b)
c)
d)
brief psychodynamic therapy.

token economy.
systematic desensitization.
ego analysis.
a)
b)
c)
d)
events versus interpretations of events.

feelings versus thoughts.
reinforcement versus free-will.
childhood experiences versus current events.
a)
b)
c)
d)
spirituality.
values.
emotions.
rational thoughts.
a)
b)
c)
d)
most disorders are only prevalent in the United States.

all disorders in the DSM-IV-TR can be identified in every culture studied.
treatments are universally effective for all disorders.
a number of disorders are indeed observed in diverse parts of the world.
7. Which of the following is central to the body's response to stress?
8. Jane is afraid of elevators. Her psychologist, Dr. Schwartz, teaches her how to relax deeply. Then
Dr. Schwartz helps her develop a list of situations with elevators that vary in how frightening or
anxiety- producing they are. Finally, while relaxed, Jane imagines the series of situations with
elevators. Eventually Jane is able to tolerate imagining increasingly more difficult situations in
elevators such as riding an elevator 100 floors alone. By the end of the 16th therapy session,
Jane states that her fear of elevators has disappeared. Dr. Schwartz used
9. Behavioral and cognitive theorists differ in their emphasis on
10. Newer CBT treatments differ from the original CBT treatments in that they emphasize all of the
following EXCEPT:
11. Cultural and ethnic studies of psychopathology conducted around the world indicate that
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12. When a scientist chooses a paradigm to understand psychopathology, it

a)
b)
c)
d)
has little effect on clinical practice.

leads to an overly narrow perspective.
is generally too narrow in focus.
specifies which problems they will investigate and how they will go about investigating
them.
13. The carriers of the genetic information passed from parent to child are called
a)
b)
c)
d)
nature.
genes.
zygotes.
DNA.
14. Which of the following statements is FALSE?
a) A person could hold a neuroscientific view about the nature of a psychological disorder, yet
still recommend psychological intervention.
b) Reductionism refers to the view that whatever is being studied can and should be reduced
to its more basic elements.
c) In recent decades, neuroscience research on causes and treatment of psychopathology has
been proceeding quite slowly.
d) Most neurobiological interventions have not been derived from knowledge of what causes a
given disorder.
15. After the first day of class, Jack (who is always an optimist) decides the class will be fun while
Jan (who struggles over grades) decides the class will be hard. Their different reactions
illustrate the role of their
a)
b)
c)
d)
non-shared environment.
schemas.
previous exposures.
childhood experiences.
114

1. The Rorschach may have validity in identifying
a)
b)
c)
d)
depression, anxiety, and schizophrenia.

schizophrenia, borderline personality disorder, and dependent personality traits.
dependent personality traits, depression, and anxiety.
schizophrenia, dependent personality traits, and anxiety.
a)
b)
c)
d)
They cannot measure brain functioning during normal daily activity.

Little is known about the functioning of individual neurons
Psychological measures have low reliability and validity.
People differ in how well they cope with brain dysfunctions.
a)
b)
c)
d)
structure is to function.
function is to structure.
cognitive is to behavioral.
projective is to objective.
2. Why should we not expect a one-to-one relationship between psychological and physical
measures of brain functioning?
3. PET is to CT scan as
4. An example of a self-report cognitive assessment consistent with Beck's theory of depression is

a) Internal-External Attribution Questionnaire.
b) Dysfunctional Attitude Scale.
c) Attributional Style Questionnaire.
d) Cognitive Thought Record.
5. Which of the following is NOT a feature of the DSM-5 as compared to previous versions of the
DSM?
a)
b)
c)
d)
Enhanced sensitivity to the developmental nature of psychopathology.

Removal of the multiaxial system.
New gender-specific diagnoses.
Increased emphasis on ethnic and cultural considerations in diagnosis.
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6. When Dr. Smith diagnoses a patient with schizophrenia and Dr. Jones diagnoses that same
patient with obsessive-compulsive disorder, we would say that Dr. Smith and Dr. Jones have
a)
b)
c)
d)
low validity.
low reliability.
low accuracy.
low criteria.
a)
b)
c)
d)
misdiagnose him as having schizophrenia if he fails to take cultural factors into account.
ignore this information if he fails to take cultural factors into consideration.
correctly diagnose him as having schizophrenia despite any cultural factors.
None of the above.
a)
b)
c)
d)
They do not think the setting is an important influence on people's behavior.

Such assessments avoid the problem of reactivity.
They want to see how people respond in unusual situations.
It is often difficult to control the conditions in natural settings.
7. Jose, a Puerto Rican living in New York, was being assessed by Dr. Jones, a doctor born in the
U.S. Jose casually states that he feels there are spirits surrounding him. Dr. Jones may
8. Why do behavioral assessors sometimes set up contrived situations in which to observe

behavior?
9. If Jose wants to know if the scale at the grocery store he uses to weigh his tomatoes has
alternate-form reliability he could
a) take them home and weigh them again in an hour.
b) weigh the tomatoes on two other scales in the produce department and see if they weighed
the same.
c. ask another shopper what she thinks the tomatoes weigh.
d. take the tomatoes and put them on-and-off the scale several times and see if they weigh the
same each time.
10. The MMPI is an example of a(n)

a) projective test.
b) personality inventory.
c) intelligence test.
d) structured clinical interview.
11. The construct validity of intelligence tests is limited by
a) how psychologists define intelligence.

b) the nature of the population tested with the instruments.
c) their generally low reliability.
d) none of the above.
116
12. Average intelligence is associated with a score of approximately

a)
b)
c)
d)
130.
70.
100.
Average intelligence cannot be determined.
a)
b)
c)
d)
projective tests.
personality inventories.
neuropsychological tests.
brain imaging tests.
a)
b)
c)
d)
suggest a diagnosis of mood disorder.

suggest a diagnosis of schizophrenia.
suggest that there is a good prognosis for treatment.
recommend a second opinion.
13. PET and MRI are specific types of
14. If a clinician is informed that a prospective client, who is seeing things that are not actually
there, is African-American and in a lower income bracket, the clinician may be more likely to
15. The best way for clinicians to avoid bias in the diagnosis of patients from ethnic minority
groups is to
a) avoid seeing such patients in their practice.
b) avoid diagnosing such patients.
c) employ only those personality measures that have been specifically designed for that ethnic
group.
d) learn to consider and test alternative hypotheses when evaluating clients from different
ethnic groups.
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1. The more intelligent a person is the higher grades he or she receives in school. Most likely, this
finding comes from which type of research?
a)
b)
c)
d)
case study
epidemiology
correlational study
experiment
a)
b)
c)
d)
incidence
prevalence
risk factor
correlation coefficient
a)
b)
c)
d)
within-groups variance.
experimental effect.
internal validity.
none of the above.
a)
b)
c)
d)
Confirming theoretical propositions.

Generating research hypotheses.
Demonstrating universal relationships.
Showing cause-effect relationships.
a)
b)
c)
d)
family method
twin method
experiment
cross-fostering
2. "About 2% of adults have obsessive-compulsive disorder." This is a statement about the

__________ of obsessive-compulsive disorder.
3. In a study of 100 people with panic disorder, 50 were treated with psychotherapy and 50 were
treated with medication. At the end of 12 weeks of treatment, the psychotherapy group had an
average score of 25 on a scale of panic severity, while the medication group had an average
score of 75. This difference is called the
4. Case studies can be effective for which of the following purposes?
5. In this method, children are adopted and reared with adopted parents who have a particular
disorder.
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6. Which of the following can disprove but not prove a hypothesis?

a)
b)
c)
d)
correlation
case study
experiment
questionnaire
a)
b)
c)
d)
It is not reliable.
It does not make sense.
It is not theoretical.
It is not testable.
a)
b)
c)
d)
replaceable.
replicable.
unique.
original.
7. The primary problem is an unconscious anger toward his mother. What makes this statement
unscientific?
8. When testing a theory, each scientific observation must be
9. Meta-analyses summarize the findings of different studies through the use of

a) correlation coefficients.
b) effect sizes.
c) between-group variance.
d) within-group variance.
10. Case studies are not useful in
a)
b)
c)
d)
providing the means for ruling out alternative hypotheses.

providing a rich description of clinical phenomena.
disproving an allegedly universal hypothesis.
generating hypotheses.
a)
b)
c)
d)
there will be 3.5% of new cases of panic disorder in the population over the next year.
there is a 3.5% chance of developing panic disorder following the interview until death.
of individuals interviewed, 3.5% had experienced panic disorder at some point in their life.
the proportion of chronic panic sufferers is 3.5%.
a)
b)
c)
d)
They are experimental.

They cannot measure prevalence, only incidence.
They often draw on samples that are not representative of the population being studied.
They do not use undergraduate samples.
11. The lifetime prevalence rate of panic disorder is 3.5%. This statement indicates that
12. What is a common problem in epidemiological studies?
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13. A genetic explanation of schizophrenia would be supported by which of the following choices?
a) Higher concordance between MZ than DZ twins.

b) MZ twins reared apart are likely to share the disorder.
c) First-degree relatives of someone with schizophrenia are more likely to have schizophrenia
than third-degree relatives.
d) All of these support a genetic explanation.
14. Lenny is enrolled in a study examining the psychological treatment of phobias. He sees a
therapist weekly and receives support and encouragement, but no gradual exposure. Lenny is
most likely in
a)
b)
c)
d)
a treatment group.
a placebo control group.
an independent variable group.
a low severity group.
a)
b)
c)
d)
repeatedly introducing and removing the treatment.

repeatedly measuring different behaviors.
the statistical procedure used to analyze the results.
repeating the procedure with additional subjects.
15. In a single-subject ABAB design, ABAB refers to
120

1. In the opening clinical case, Mary M. reported feeling a lack of energy, difficulty sleeping, loss of
appetite, difficulty concentrating, and a loss of interest in activities she previously enjoyed.
Based on this information, which of the following is the most likely diagnosis for Mary M.?
a)
b)
c)
d)
Eating disorder
Major depressive disorder
Bipolar disorder
Generalized anxiety disorder
a)
b)
c)
d)
Cyclothymic disorder
Major depressionmelancholic subtype
Seasonal affective disorder
Natalies symptoms reflect normal mood fluctuations and would not be given a DSM-5
diagnosis.
2. Every winter for the past three years, Natalie has felt extremely depressed for a period of
months and is unable to keep up with her responsibilities because of her low energy and
difficulty concentrating. She always appears to feel better by early spring and is at her best
during the summer. Which of the following DSM-5 diagnoses would best fit Natalie?
3. The DSM-5 proposes __________ new depressive disorders.

a)
b)
c)
d)
2
3
4
5
a)
b)
c)
d)
cortisol levels are often poorly regulated.

most have Cushing's syndrome as well.
levels of dexamethasone are dysregulated.
All of the above are correct.
a)
b)
c)
d)
the amount of time the person has felt suicidal.

the things in a person's life that prevent suicide.
the motivation for committing suicide.
how people will react to the examinees suicide.
4. Among individuals who are depressed
5. The Reasons for Living inventory focuses upon
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6. Jill is seeking treatment for depression, which started after she ended a long-term relationship.
Which of the following would be a global depressive attribution she might make?
a) "My relationships end badly because I drive them away."

b) "There must be something wrong with me, because I always attract people who are wrong
for me."
c) Sometimes I feel there is something the matter with me."
d) "My next relationship will likely be better."
7. For a period of one week, Alan experienced episodes of extreme elation that caused significant
functional impairment. Based on this information only, Alan was experiencing a
a)
b)
c)
d)
manic episode.
hypomanic episode.
depressive episode.
none of the above.
a)
b)
c)
d)
impulsivity
mania
drug abuse
helplessness
a)
b)
c)
d)
just lost their job.

had a best friend die suddenly.
recently broken up with their partner.
low social support.
a)
b)
c)
d)
are particularly important to the first episode of depression.

are important in triggering all episodes of depression.
play little role in the onset of depressive episodes.
mediate the relationship between genetics and environment.
a)
b)
c)
d)
One quarter.
Half.
Two thirds.
Three quarters.
a)
b)
c)
d)
two parts of the autonomic nervous system

antidepressant medications
neurotransmitters
structures in the limbic system
8. While many difficulties might get a person thinking about suicide, __________ seems to predict the
switch from suicidal thoughts to suicidal actions.
9. People who are depressed most commonly have
10. Stressful life events
11. About __________ of people who have experienced a major depressive disorder will experience at
least one more episode during their lifetime.
12. Norepinephrine and serotonin are __________ implicated in mood disorder etiology.
122
13. Stressful life events appear to be a causal factor in depression based on research showing
a)
b)
c)
d)
depressed people experience more losses of marriages and jobs.

many people report life stresses before they become depressed.
depression rates increase after major disasters.
lab induced stress leads to increased depression.
a)
b)
c)
d)
The medication is effective only for the first few weeks of use.
Medication is effective in treating bipolar but not unipolar patients.
The medications are only effective for children and adolescents.
Patients often do not recover or relapse after they stop taking the medication.
a)
b)
c)
d)
pessimistic views of self, world, and future.

negative beliefs about how things work in the world.
negative schemata triggered by negative life events.
distorted ways of reaching conclusions about events.
14. Given that antidepressant medications have been demonstrated to be effective, why are other
treatments for depression still used?
15. The depressive negative triad, according to Becks cognitive theory of depression, are
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1. Social anxiety disorder generally begins during:
a)
b)
c)
d)
early childhood
middle childhood
adolescence
early adulthood
a)
b)
c)
d)
modeling; classical conditioning

vicarious learning; avoidance learning
modeling; prepared learning
prepared learning; diathesis
a)
b)
c)
d)
are unlikely to be comorbid.

are one of the least costly psychiatric disorders to society.
cause little interpersonal problems.
are the most common type of psychiatric diagnosis.
a)
b)
c)
d)
obsessive-compulsive disorder.
social anxiety disorder.
specific phobia.
panic disorder.
a)
b)
c)
d)
exhibits paranoid symptoms, believing others are plotting to hurt him or her.
exhibits anxiety about having panic attacks in public.
is terrified of being in public places and may become housebound.
becomes extremely anxious when in certain situations that involve activities done in the
presence of other people.
2. After viewing tapes of monkeys apparently showing fear of snakes, lambs, and flowers,
monkeys who viewed these tapes were only fearful of snakes. This provides only partial
support for __________ but better support for __________.
3. As a group, anxiety disorders
4. John is persistently and excessively afraid of snakes. Whenever he sees one, he feels intense
anxiety and thus avoids snakes at all costs. John realizes, however, that this fear is unrealistic.
John most likely has
5. An individual diagnosed with social anxiety disorder
124
6. Lola is low in neuroticism. Compared with people who have high levels of neuroticism, Lola
a)
b)
c)
d)
is more likely to experience anxiety and depression.

is less likely to develop an anxiety disorder.
is probably characterized by a tendency to react to events with negative effect.
is more likely to have OCD.
a)
b)
c)
d)
repeated early life experiences of having control.

previous experiences of control during highly threatening circumstances.
being controlled by an understanding parent.
both a and b.
a)
b)
c)
d)
negative life events often buffer against the development of anxiety disorders.
negative life events often precede the onset of anxiety disorders.
negative life events are unrelated to the onset of anxiety disorders.
none of the above.
a)
b)
c)
d)
panic disorder
phobic disorder
generalized fear disorder
posttraumatic stress disorder
a)
b)
c)
d)
Edna has agoraphobia, but does not meet criteria for panic disorder.
Edna does not have agoraphobia.
Edna is faking her symptoms.
Edna has more severe panic but is able to cope with the symptoms.
a)
b)
c)
d)
Women may show more biological reactivity to stress than men.

Women tend to be more nervous than men in general.
Men may be raised to believe more in personal control over situations.
Men may experience more social pressure than women to face fears.
a)
b)
c)
d)
chronic anxiety creates negative cognitions.

fixating on dots for long periods of time may create anxiety.
the way we focus our attention can influence anxious mood.
none of the above.
7. Which of the following might buffer someone against developing an anxiety disorder?
8. In terms of the social environments role in the development of anxiety disorders, which of the
following statements is true?
9. Which of the following is NOT an anxiety disorder?
10. Edna does not currently have panic disorder. However, she cannot leave her house and had
required home sessions when she began therapy. It is likely that
11. According to the text, which of the following is NOT a theory as to why women are more likely
to develop anxiety disorders than men?
12. Laboratory studies, like the ones using the dot probe task, have provided evidence for the
theory that
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13. Factors that may increase risk for more than one anxiety disorder include all of the following
EXCEPT
a)
b)
c)
d)
behavioral conditioning.
genetic vulnerability.
culture of origin.
neuroticism.
a)
b)
c)
d)
serves as an avoidance mechanism.

is adaptive.
increases psychophysiological signs of arousal.
helps people remember traumatic images.
a)
b)
c)
d)
real life.
memories of trauma.
social anxiety disorder.
anxiety developed in the womb.
14. According to Borkovec and colleagues, worry
15. In vivo exposure to feared objects simulates
126

1. Approximately one third of people with hoarding disorder also engage in
a)
b)
c)
d)
food hoarding.
animal hoarding.
collectibles hoarding.
all of the above.
a)
b)
c)
d)
OCD
PTSD
BDD
ASD
a)
b)
c)
d)
Exposure
Imaginal exposure
Cognitive processing
None of the above
a)
b)
c)
d)
made OCD and trauma-related disorders part of the chapter on anxiety disorders.
made OCD and trauma-related disorders their own chapter.
eliminated OCD and trauma-related disorders.
none of the above.
a)
b)
c)
d)
operant conditioning.
reinforcement.
neutral stimulus.
modeling.
a)
b)
c)
d)
repeatedly checking that the water is turned off.

humming a tune over and over.
having a recurring fear that one is giving others illnesses when they actually are not.
having excessive worry over finances.
2. Extreme response to a severe stressor that includes increased anxiety, avoidance of stimuli
associate with an event, and symptoms of increase arousal are symptoms of which disorder?
3. __________ therapy is designed to help victims of rape and childhood sexual abuse to dispute
tendencies towards self-blame.
4. The proposed DSM-5 differs from the DSM-IV-TR in that it
5. The two-factor model of conditioning for PTSD involves classical conditioning and
6. Which of the following is an obsession?
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7. Which of the following is a compulsion?

a)
b)
c)
d)
A persistent fear of getting dirty.

Having persistent doubts about whether the stove was turned off that morning.
Persistent checking for one's keys.
Persistent thoughts about harming ones spouse.
a)
b)
c)
d)
trying unsuccessfully to suppress, ignore, or neutralize the obsession.

self-soothing.
insecurity and separation anxiety.
volatile mood swings.
a)
b)
c)
d)
have Steve meditate daily.

have Steve challenge the idea that it is necessary to be clean.
have Steve purposely get dirty.
have Steve say stop to himself quietly when he feels he must wash.
a)
b)
c)
d)
acute stress disorder

generalized anxiety disorder
posttraumatic stress disorder
anxiety disorder not otherwise specified
a)
b)
c)
d)
irrational beliefs.
generalized anxiety.
obsessions.
compulsions.
a)
b)
c)
d)
an irrational belief.
generalized anxiety.
an obsession.
a compulsion.
a)
b)
c)
d)
exposure treatment
flooding
affective rehearsal treatment
8. A common symptom associated with OCD is
9. A strictly behavioral therapist treating Steve for contamination fear due to OCD would use
which of the following interventions?
10. Iris was in an automobile accident. She goes to a psychologist one week after the accident. If she
is experiencing nightmares, flashbacks, headache, and is ruminating about the accident, she will
likely receive which diagnosis?
11. Intrusive, irrational and unwanted thoughts are called
12. Oscar feels the urge to turn a light switch on and off 12 times before leaving a room. This would
be referred to as
13. __________ is the primary treatment for PTSD.
128
14. More than __________ percent of people diagnosed as having OCD also have a comorbid mood
disorder.
a)
b)
c)
d)
25
50
75
100
a)
b)
c)
d)
between middle childhood and adolescence.

between adolescence and middle adulthood.
between infancy and middle childhood.
between middle childhood and early adulthood.
15. OCD tends to begin
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Abnormal Psychology

1. According to Claire's friends, she never exhibited signs of DID. However, after watching Sybil on
TV and visiting a therapist regularly, Claire began exhibiting different personalities. A sociocultural theory of the development of Claire's DID would suggest that
a)
b)
c)
d)
Claire must have been sexually abused as a child.

Claire must have come from a dysfunctional family and had few friends growing up.
Claire's alters appeared in response to exposure to media and therapists' suggestions.
Claire has repressed memories for too long.
a)
b)
c)
d)
superior outcome when psychodynamic treatment is employed.

integration of alters is easily achieved in most people with DID.
psychotropic medications are effective in eliminating alters.
none of the above; no controlled outcomes studies on DID exist.
a)
b)
c)
d)
Conversion disorder and socioeconomic status are unrelated.

High socioeconomic status is associated with conversion disorder.
Low socioeconomic status is associated with conversion disorder.
Socioeconomic status is the primary cause of conversion disorder.
a)
b)
c)
d)
Functional neurological disorder was actually more common in 19th century England.
It fails to recognize that differing rates may be caused by variations in diagnostic practices.
Functional neurological disorder is fundamentally different from the somatoform disorders.
None of the above is correct.
a)
b)
c)
d)
His depression will improve, but his pain will persist.

All his symptoms will improve.
His pain will subside, but his depression may still persist.
He will not improve.
2. The controlled outcome studies on dissociative identity disorder (DID) show
3. Which of the following statements about conversion disorder and socioeconomic status is true?
4. "The finding that functional neurological disorder is currently more common in Libya than in
England means that cultures with increased medical sophistication are less likely to have
somatoform disorders." What is a flaw in this argument?
5. Isaac was being treated for somatoform pain disorder, and his psychiatrist prescribed
imipramine, an antidepressant, in a very low dose for his symptoms. Assuming Isaac is also
depressed, what is his likely treatment outcome?
130
6. The goal of treatment of dissociative disorders should be to
a) encourage repression of the underlying trauma.

b) encourage others to reinforce symptoms.
c) convince the person that splitting into different personalities is no longer necessary to deal
with traumas.
d) provide a confrontational setting where symptoms are not needed.
7. Which of the following is not a symptom or feature of depersonalization/derealization

disorder?
a)
b)
c)
d)
experiences of detachment from ones mental processes or body

impairments in reality testing
experiences of unreality of surroundings
persistent/recurrent symptoms
a)
b)
c)
d)
They lead to the disorders being under-diagnosed

The conditions are widely varied.
The criteria are too subjective
The diagnoses can be highly stigmatizing
a)
b)
c)
d)
la belle indifference.
hysteria.
hypochondriasis.
Briquet's syndrome.
a)
b)
c)
d)
left leg.
sexual dysfunction.
her right side, beginning with her arm.
scalp, nose, and lips.
a)
b)
c)
d)
at least 3 distinct personalities.

selective amnesia.
at least 2 distinct personalities.
depersonalization.
a)
b)
c)
d)
explicit; implicit
implicit; explicit
short term; working
working; short term
8. Which of the following is not a common criticism of the diagnostic criteria for somatoform
disorders?
9. Conversion disorder was first studied by Freud; before then it was referred to as
10. In the case of Anna O., her functional neurological disorder symptoms involved her
11. Dissociative identity disorder must involve
12. Individuals with dissociative identity disorder perform better on tests of ________ memories
experienced by alters than on tests of _______________ memories.
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13. Pain and somatic symptoms can be increased by

a)
b)
c)
d)
anxiety.
depression.
hormones.
all of these factors can increase somatic symptoms.
a)
b)
c)
d)
studies suggest that alters can share some implicit memories.

studies suggest that alters share more explicit memories, but they are just repressed.
studies indicate that most alters are completely fabricated.
research suggests that role-playing is the best explanation of DID.
a)
b)
c)
d)
An ulcer caused by stress.

A persistent unsubstantiated fear of having cancer.
Having obsessions with an imagined physical defect, such as facial wrinkles.
Experiencing recurring pain with no physical basis.
14. Although different alters report an inability to share memories,
15. Which of the following best illustrates hypochondriasis?
132

1. James suffers from schizophrenia and flails his limbs wildly with excitement. This is most
appropriately labeled as
a)
b)
c)
d)
catatonia.
mania.
hallucinations.
delusions.
a)
b)
c)
d)
somatic passivity
waxy flexibility
catatonic immobility
inappropriate affect
a)
b)
c)
d)
schizophreniform disorder
brief psychotic disorder
reactive schizophrenia
process schizophrenia
a)
b)
c)
d)
schizophreniform disorder.
schizoaffective disorder.
delusional disorder.
bipolar disorder with delusions.
2. Mr. Hart spends long hours sitting in a chair with his arms behind his back and his left leg
tucked under. No matter what is going on around him, he remains in this position. This is an
example of which symptom of schizophrenia?
3. Howard had a psychotic episode following the death of his wife. He had hallucinations in which
he would hear her speaking to him, telling him to kill himself. Howard developed elaborate
delusions about his ability to communicate with his wife's spirit. Howard recovered from this
episode after one week. What DSM-IV-TR diagnosis would fit Howard's case?
4. Sam believes the Queen of England is in love with him. He does not have any other symptoms.
His most likely diagnosis would be
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5. Michael suffers from schizophrenia and was recently released from the hospital. Which of his
behaviors are most likely to elicit critical comments from his family when he returns home?
a) Believing that NASA has planted a tracking device in his head.

b) Sitting on the couch for most of the day and refusing to go for walks with his mother, an
activity he greatly enjoyed before his hospitalization.
c) Hearing a voice telling him to kill himself.
d) Wearing a winter coat, galoshes, and a ski mask while inside the house.
6. Sam is being treated with medication for schizophrenia. He involuntarily smacks his lips and
seems unable to control his motor movements. Sam most probably is suffering from
a)
b)
c)
d)
extrapyramidal side effects.

tardive dyskinesia.
dystonia.
neuroleptic malignant syndrome.
7. The DSM-5 will likely remove the subtypes of schizophrenia included in DSM-IV-TR. This is
because:
a)
b)
c)
d)
They are not clearly defined.

They each have different responses to treatment.
Each one describes a broad range of behaviors.
There is considerable overlap between subtypes.
8. According to the DSM 5, schizoaffective disorder requires

a) A depressive episode
b) A manic episode
c) Either a or b
d) Both a and b
9. Which of the following is true about the genetic mutations that play a role in the etiology of
schizophrenia?
a) The mutations are very common
b) Having the mutations ensures that one will develop schizophrenia
c) These mutations are specific to schizophrenia
d) none of the above
10. Which area of the brain is associated with cognitive control deficits in schizophrenia?
a) Parietal lobe
b) Temporal lobe
c) Prefrontal cortex
d) Hippocampus
134
11. Which of the following suggests that dopamine receptors are mainly related to positive (not
negative) symptoms of schizophrenia?
a)
b)
c)
d)
Antipsychotic drugs reduce only positive symptoms.

Administering dopamine produces little increase in positive symptoms.
MRIs of schizophrenics with positive symptoms show more receptors.
Parkinson's Disease involves similar symptoms.
a)
b)
c)
d)
restlessness.
constant aching of muscles.
severe confusion.
severe vertigo.
a)
b)
c)
d)
thoughts have been placed inside their heads for outside sources.
their thoughts are being broadcasted or transmitted to others.
they are all powerful and knowing.
all of the above.
a)
b)
c)
d)
schizophrenogenic mother theory.

triangulation theory.
expressed emotion theory.
dopamine theory.
a)
b)
c)
d)
akathisia.
anhedonia.
avolition.
alogia.
12. A possible side effect of antipsychotic medication used to treat schizophrenia is
13. Those diagnosed with schizophrenia may believe that
14. Research investigating the role of the family in schizophrenia best supports the
15. Carlos has schizophrenia and is living with his parents. One of his symptoms is a difficulty
initiating any activity, and once started, he is unable to finish. This is an example of
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Abnormal Psychology

1. Nicotine is the addicting agent in
a)
b)
c)
d)
marijuana.
hashish.
tobacco.
cocaine.
a)
b)
c)
d)
correlational theory.
multi-determined theory.
social facilitation theory.
gateway theory.
a)
b)
c)
d)
reduce nausea for patients undergoing chemotherapy.

increase immune function.
improve attention and maintain medication adherence.
prevent additional infection.
a)
b)
c)
d)
genetically predisposed to alcoholism.

developing a tolerance to alcohol.
acquiring behavioral skills in modulating her drinking.
deluding herself. This is not physically possible.
2. The stepping-stone theory of drug use is also referred to as the
3. The benefit of marijuana when used for chronic illnesses is primarily to
4. Wanda drinks frequently and requires more alcohol now than she did six months ago to achieve
the same effect. She reports that she can out-drink most people. Wanda is probably
5. Exposure of a nonsmoker to secondhand smoke
a) is less harmful than smoking because of the lower levels of nicotine and tar in secondhand
smoke.
b) has been shown to have far fewer negative effects than the media has suggested.
c) can lead to lung damage.
d) has negative effects on the fetuses of pregnant nonsmokers but not on the women
themselves.
136
6. Mark is experiencing the following symptoms after taking a drug: he feels an initial rush of
ecstasy, has great self-confidence and has lost all his worries and fears. At the same time, he is
feeling drowsy and relaxed. Which of the following drugs is Mark most likely to have taken?
a)
b)
c)
d)
heroin
alcohol
marijuana
cocaine
a)
b)
c)
d)
to focus upon sobriety as a major criteria for discharge.

helping the individual admit there is a problem.
increasing nutrition and creating a behavior that inhibits alcohol consumption.
detoxification.
a)
b)
c)
d)
marijuana
ecstasy
heroin
cocaine
a)
b)
c)
d)
The encouragement of minor behavioral changes (e.g., not driving past bars)
Calculating the amount of money spent on alcohol per year
Achieving recognition that he has become completely powerless over alcohol
Utilizing an empathic, supportive approach
a)
b)
c)
d)
men.
women.
the prevalence of binge drinking is equal in men and women.
state schools versus private schools.
a)
b)
c)
d)
amphetamine.
methamphetamine.
crack.
freebase.
7. A major goal of inpatient hospital-based treatment for alcohol abuse is
8. After taking a particular drug, Hal began feeling that time was passing very slowly, and he
began having profound thoughts about the nature of time and the universe. While this first
experience was at first deeply moving, leading to feelings of elation, the next time Hal tried this
drug, he felt anxious and depressed. What drug did Hal probably take?
9. Jared is receiving guided self-change therapy for his alcohol abuse. Accordingly, he is also
learning strategies for controlling his behaviors associated with drinking, as well as actual
drinking. In such a program, which of the following would NOT be a factor?
10. Among college students, binge drinking is more common in
11. In the 1980's a new form of cocaine which comes in a rock crystal form was introduced and
called
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12. LSD is a(n)

a)
b)
c)
d)
amphetamine.
methamphetamine.
stimulant.
hallucinogen.
13. Studies on the effects of smoking marijuana on the brain have shown that it is associated with
a) impaired short-term memory and increased blood flow to brain regions associated with
emotion.
b) impaired long-term memory and decreased blood flow to brain regions associated with
emotion.
c) impaired short-term memory and increased blood flow to brain regions associated with
attention.
d) impaired long-term memory and decreased blood flow to brain regions associated with
attention.
14. The goal of scheduled smoking is
a)
b)
c)
d)
gradual reduction in nicotine intake.

controlled smoking, in which smoking continues but much more moderately.
to help smokers quit abruptly by scheduling a stop smoking day in advance.
identification of triggers associated with smoking.
a)
b)
c)
d)
appears to be an effective strategy in delaying the onset of smoking.

has shown little promise in delaying the onset of smoking.
actually increases smoking in young people.
is less effective than resistance training, such as DARE.
15. Changing beliefs about the prevalence of smoking in young people
138

1. Cathy stopped eating meals over two months ago. Now, she eats very little, and only when
under some family pressure. She has lost over 22 pounds, and is now about 15% below normal
body weight for her height. She probably has
a)
b)
c)
d)
anorexia, restricting type.

anorexia, binge-eating-purging type.
bulimia nervosa.
binge eating disorder.
2. Studies of perfectionism in anorexia nervosa indicate that which of the following statements
would be most typical of an anorexic?
a) I must complete all my work before I can enjoy a night out.

b) I can't stand it when my boyfriend lets me down by not buying me flowers on special
occasions.
c) I've got to show my teacher that I can meet his goal for me of winning the debate
championship.
d) I can't possibly be expected to meet the unrealistically high standards that my parents have
set for me.
3. Margaret, a Canadian, and Rosemary, a Nigerian, are asked to rate the attractiveness of a
drawing of an obese woman. Which of the following is most likely to occur?
a) They will similarly rate the woman as highly unattractive.

b) They will similarly rate the woman as highly attractive.
c) Rosemary will rate the woman as more attractive compared to Margaret's rating of the
woman.
d) Margaret will rate the woman as more attractive compared to Rosemary's rating of the
woman.
4. Adelaide, who has bulimia, is being treated solely with fluoxetine (Prozac). If she stops taking
the drug, she will most likely
a)
b)
c)
d)
Relapse.
become obese.
develop anorexia nervosa.
maintain normal eating patterns over the long term.
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5. The loss of menstrual period is known as

a)
b)
c)
d)
amenorrhea.
dismenorrhea.
premenstrual syndrome.
fibrosis.
a)
b)
c)
d)
while alone.
after stress.
after a negative social interaction.
all of the above
a)
b)
c)
d)
childhood obesity.
critical comment regarding being overweight.
childhood physical or sexual abuse.
all of the above
a)
b)
c)
d)
Bulimia; anorexia
Anorexia; nervosa
Nervosa; anorexia
Anorexia; bulimia
a)
b)
c)
d)
binge eating disorder

anorexia nervosa, binge-eating/purging type
anorexia nervosa, restricting type
bulimia nervosa
a)
b)
c)
d)
hunger and the obsession with food.

body image disturbance.
fear of becoming fat.
all of the above
a)
b)
c)
d)
breaking self-rules about dieting.

ambivalence over social pressure to be thin.
excessive desire for peer approval.
not accepting responsibility for actions.
6. In bulimia nervosa, binge eating typically occurs
7. Risk factors associated with developing binge eating disorder include
8. __________ refers to a loss of appetite, while __________ indicates that it is due to emotional reasons.
9. Which of the following is most prevalent?
10. Although the hypothalamus has been considered a part of the biological etiology of anorexia, a
limitation of this account is that it does not account
11. The cognitive-behavioral view of bulimia suggests that binges result from
140
12. Which of the following is NOT listed as a type of preventive intervention for eating disorders?
a)
b)
c)
d)
psychoeducational approaches
de-emphasizing sociocultural influences
banning junk foods from elementary schools
risk factor approach
a)
b)
c)
d)
weight loss
purging
excessive exercise
body dissatisfaction
a)
b)
c)
d)
relieving stress and negative affect.

increasing energy and thus mood.
feeling in control of the situation.
distracting oneself from inner pain.
a)
b)
c)
d)
They have limited predictive validity.

Clinicians find them useful.
They can be used to effectively predict prognosis.
both A and B
13. The key difference between anorexia nervosa and bulimia nervosa is:
14. Recent studies on cognitive-behavioral factors involved in bulimia nervosa have shown that
bingeing and purging may function as means of
15. Which of the following is true of the restricting and binge-eating/purging subtypes of anorexia
nervosa?
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1. Elizabeth is slipping into her nightgown and watching her husband get into bed. She is
fantasizing about what they will soon be doing together. In which phase of the human sexual
response cycle is Elizabeth at this moment?
a)
b)
c)
d)
resolution
orgasm
desire
excitement
a)
b)
c)
d)
female orgasmic disorder.

dyspareunia.
imperforate hymen.
vaginismus.
a)
b)
c)
d)
sensate focus.
sensuality training.
physical redirecting.
cognitive restructuring.
a)
b)
c)
d)
transvestic disorder
transsexualism
voyeuristic disorder
exhibitionistic disorder
2. Joan experiences pain during sexual intercourse. The frequency of pain has been so great that
she now dreads the prospect of possible sexual encounters despite experiencing sexual arousal
while observing films depicting sexual acts other than intercourse. Joan most likely is suffering
from
3. Bill and Deborah are in sex therapy. One exercise that they are directed to practice involves
touching each other and feeling comfortable with contact, but without any sexual intercourse.
This intervention is called
4. Ben can only become sexually aroused when he is wearing women's clothing. He especially
enjoys having sexual relations with his wife while he is wearing her garments. Which of the
following diagnoses would fit Ben's case?
142
5. Persistent disruptions in the ability to experience sexual arousal, desire, or orgasms, or by pain
associated with intercourse is called
a)
b)
c)
d)
sexual dysfunction.
sexual function.
paraphilia.
all of the above.
a)
b)
c)
d)
1950s.
1970s.
1980s.
1990s.
a)
b)
c)
d)
early ejaculation
genito-pelvic pain disorder
sexual sadism disorder
delayed ejaculation disorder
a)
b)
c)
d)
5 percent
22 percent
43 percent
74 percent
a)
b)
c)
d)
lack of orgasm and no desire.

lack of orgasm without direct clitoral stimulation.
lack of orgasm despite normal sexual excitement and stimulation.
orgasm during masturbation only, if at all.
a)
b)
c)
d)
psychosexual trauma
fear of performance
excessive intake of alcohol
homosexual inclinations
a)
b)
c)
d)
inanimate objects or nongenital body parts.

exposing themselves to people while masturbating.
observing other people engaging in sexual activity.
children.
6. Homosexuality was listed as a disorder in the DSM until the
7. Which of the following is considered to be a paraphilia, according to the proposed DSM-5?
8. Approximately what percentage of women report experiencing some symptoms of sexual

dysfunction?
9. Female orgasmic disorder is defined as
10. Which of the following is a current or proximal cause of sexual dysfunctions, according to
Masters and Johnson?
11. Fetishists are sexually aroused by
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Abnormal Psychology
12. Which is a common component of psychological treatment of paraphilias?

a)
b)
c)
d)
support groups modeled on alcoholics anonymous

challenging distorted beliefs
reinforcing appropriate sex
exercise and diet to reduce urges
a)
b)
c)
d)
fetishistic disorder.
exhibitionistic disorder.
pedohebephilic disorder.
gender identity disorder.
a)
b)
c)
d)
androgens.
progesterone.
estrogen.
all of the above.
a)
b)
c)
d)
an excess
inhibition
the amount
the type
13. According to the proposed DSM-5 diagnoses, someone who derives sexual pleasure from
contact with prepubertal children would have
14. Speculations about the role of hormones in paraphilias center on
15. In contrast to views from the 19th and early 20th century, the contemporary Western world
believes that __________ of sexual expression contributes to problems.
144

1. Attention-deficit/hyperactivity disorder is characterized by all of the following EXCEPT
a)
b)
c)
d)
poor academic work.

shyness.
difficulty getting along with peers.
distractibility.
a)
b)
c)
d)
genetic; environmental
behavioral; psychoanalytic
biochemical; behavioral
labeling; biological
a)
b)
c)
d)
pervasive developmental disorder

intellectual developmental disorder
dyscalculia
attention deficit disorder
a)
b)
c)
d)
conduct disorder is primarily genetically determined.

the different behaviors of conduct disorder reflect differential genetic influences.
the concordance rates of MZ twins are not appreciably different from DZ twins.
biological factors play a more prominent role in late-onset antisocial behavior than earlyonset antisocial behavior.
2. Both __________ and __________ theories of the etiology of conduct disorder have empirical support.
3. Which of the following is a learning disability?
4. Research on the role of genetics in conduct disorder has found that
5. Research on the role of parenting in the etiology of anxiety disorders in youth suggest
a)
b)
c)
d)
parenting is crucial in determining anxiety in children.

over-controlling parenting almost always results in social phobia in children.
parenting practices play a small role in childhood anxiety.
how parents discipline their children has a strong effect on the development of childhood
anxiety.
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6. Wanda, a 12-year-old girl with severe intellectual developmental disorder, was taught to dress
herself using the following approach: First, her teacher broke down the behavior of getting
dressed into a number of smaller steps, like pulling the neck hole over her head, putting her
arm into a shirt sleeve, and then putting the other arm in. Each step was then demonstrated to
Wanda, and she was rewarded for each small movement toward the goal. This approach is
called
a)
b)
c)
d)
behavioral rehearsal.
applied behavior analysis.
self-instructional training.
behavior contracting.
a)
b)
c)
d)
is based upon destructiveness at any given age.

is developmentally determined; that is, normal behavior at one age is abnormal at another.
can be reliably determined across age groups.
is typically associated with a lack of control.
a)
b)
c)
d)
depression.
social withdrawal.
anxiety.
ruminating.
a)
b)
c)
d)
extreme distractibility
anxiety
problems only in classroom
poor social understanding
a)
b)
c)
d)
extreme physical aggressiveness

temper tantrums
refusing to follow directions
annoying others deliberately
a)
b)
c)
d)
life-course persistent conduct problems.

adolescence-limited conduct problems.
antisocial development disorder.
explosive personality disorder.
7. Abnormal behavior in children
8. All of the following are examples of internalizing disorders EXCEPT
9. Which of the following distinguishes children with ADHD from other children?
10. Which of the following is NOT a symptom of oppositional-defiant disorder?
11. Sam is a 16-year-old adolescent who feels that he is unable to be an adult, despite the fact that
he's nearly 6 feet, 3 inches tall and has grown a beard. Although he led a normal childhood,
when he was about 11, he began to get into frequent fights at school and has had trouble with
the law ten times. According to Moffitt, Sam would be categorized as having
146
12. The Parkers read about Ivar Lovaas' pioneering work with autistic children and were relieved
when he agreed to accept their son into his program. What type of treatment would the Parker's
autistic boy be likely to receive in Lovaas' clinic?
a) a supportive, loving milieu program within a residential setting
b) careful attention to diet and treatment with fenfluramine
c) group therapy geared toward encouraging the children to express their anger and
frustration more openly
d) behavior therapy based on social-learning principles
13. Jim, a 10-year-old boy with intellectual developmental disorder, must learn how to spell simple
words. However, Jim is highly distractible and has no one around who is willing to sit with him
and repeatedly go over such a simple task. Jim would likely benefit from
a)
b)
c)
d)
living in a residential facility with 24-hour nursing care.

Ritalin.
computer-assisted instruction.
applied behavior analysis.
a)
b)
c)
d)
aggressiveness.
noncompliance.
impulsiveness.
social withdrawal.
a)
b)
c)
d)
after age 6.
after age 12.
after age 18.
after age 21.
14. Externalizing disorders include all of the following EXCEPT
15. A diagnosis of intellectual developmental disorder may not be made if the problem begins
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1. After being released from a brief hospitalization for minor surgery, 70-year-old Mrs. Bee
seemed distractible and disoriented. She did not even recognize her husband when he came to
pick her up from the hospital. After they returned home, they discussed their plans for the
weekend and Mrs. Bee seemed fine, but as night came on, she could not sleep and began
accusing Mr. Bee of throwing away her belongings while she was away. Which of the following
disorders best fits Mrs. Bee's symptoms?
a)
b)
c)
d)
delusional (paranoid) disorder

early dementia, probably Alzheimer's disease
delirium
depression
a)
b)
c)
d)
someone who has suffered amnesia.

a child.
someone who is depressed.
someone who is drunk.
a)
b)
c)
d)
Attachment theory
Social desirability
Social selectivity
Relationship pruning
a)
b)
c)
d)
are lonely.
are unhappy.
complain about minor physical symptoms.
have mild cognitive losses.
a)
b)
c)
d)
testing several different age groups on two or more measures.

testing age effects vs. cohort effects in a population.
testing one cohort over time.
testing the effects of time-of-measurement.
2. If you are talking to a person with delirium, it may feel like you are talking to
3. Which of the following refers to the phenomenon in which as we age we cultivate a smaller
number of important social relationships?
4. Generally older adults
5. Longitudinal studies involve
148
6. Which of the following age ranges fits the label old-old?

a)
b)
c)
d)
65-74
75-84
85-94
95+
a)
b)
c)
d)
difficulty remembering things.

disorientation.
aggressive behavior.
depression.
a)
b)
c)
d)
they are not tested on the elderly, only on young people.

side effects are more common.
toxicity is more of a problem.
all of the above.
a)
b)
c)
d)
age effects.
cohort effects.
time-of-measurement effects.
none of these answers are correct.
7. The most prominent symptom of dementia is
8. Psychoactive drugs can be dangerous when used with the elderly because
9. The consequences of growing up during a particular time period with its unique challenges and
opportunities are called
10. Psychological treatments for individuals with Alzheimer's
a) focus on helping the individual admit to and understand their cognitive deficiencies and
limitations.
b) are usually psychodynamic.
c) focus on helping patients and families deal with the effects of the disease.
d) can remove their memory deficits.
11. Individuals with dementia are at high risk for

a)
b)
c)
d)
delirium.
meningitis.
schizophrenia.
dehydration.
a)
b)
c)
d)
substance abuse
cardiovascular disease
compromised immune function
all of the above
12. Adults with diagnoses of psychological disorders are more likely to die earlier due to
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Abnormal Psychology
13. The prescribing of multiple drugs to a person is called

a)
b)
c)
d)
drugging.
polypharmacy.
over dosage.
all of the above.
a)
b)
c)
d)
selective mortality
response biases
cohort effects
lack of anonymity
a)
b)
c)
d)
20%
40%
50%
70%
14. Which of the following is NOT a methodological issue when studying psychological disorders in
late adulthood?
15. Approximately __________ of practicing psychologists conduct clinical work with older adults.
150

source of your error. Alongside each of the answers, you will find the page(s) in the Kring,
Johnson, Davison, and Neale text from which the self-test was derived.
1. Lucy exhibits a strong need to be the center of attention, inappropriate sexually seductive
behavior, and rapidly shifting, shallow emotions. Which diagnosis fits Lucys symptoms?
a)
b)
c)
d)
Borderline personality disorder

Histrionic personality disorder
Narcissistic personality disorder
Dependent personality disorder
a)
b)
c)
d)
dependent
narcissistic
schizoid
a)
b)
c)
d)
avoidant
schizoid
histrionic
borderline
a)
b)
c)
d)
narcissistic
borderline
histrionic
avoidant
2. Peter not only works 70 hours a week, but he spends his off hours planning a schedule for his
family. He dictates what time his wife will be home, when dinner will be served, and when they
will go to bed. He is such a perfectionist that he actually finds it difficult to get work done
efficiently, despite the amount of time he spends trying. Which of the following personality
disorders best fits Peter?
3. Which personality disorder is most appropriate for Joe? He lives alone in a cabin in the woods
where he does the minimum to get by. When approached, he responds appropriately but is not
interested in conversation or making friends.
4. Veronica imagines that she will one day have great success in business, although she now is
working as a waitress. She has difficulty getting along at work because she envies her boss'
position of authority (feeling she is more intelligent than he) and expects special favors such as
not having to clean the stove like the other waitresses. Which of the following personality
disorders best fits Veronica?
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5. According to the proposed DSM-5, those diagnosed with schizotypal personality disorder
a)
b)
c)
d)
have social deficits.

are anxious in social situations.
feel like outcasts or outsiders.
all of these answers are correct.
a)
b)
c)
d)
perfectionistic.
preoccupied with details.
focused on rules and schedules.
all of the above
a)
b)
c)
d)
openness to experience
detachment
antagonism
disinhibition
a)
b)
c)
d)
Trait scores provide more information about severity than categorical diagnoses.
Trait ratings are more stable over time than disorder diagnoses.
Trait dimensions are related to many aspects of psychological adjustment.
all of the above
a)
b)
c)
d)
thought problems
suspiciousness or paranoia
restricted or flattened affect
delusions
a)
b)
c)
d)
none
a small proportion
most individuals
all individuals
a)
b)
c)
d)
dependent
borderline
avoidant
histrionic
6. The person with obsessive-compulsive personality disorder is
7. Which of the following is not a personality trait domain in the alternative DSM 5 model for
personality disorders?
8. Which of the following is a strength of using a dimensional trait approach to assess personality
disorders?
9. Most individuals with schizotypal personality disorder do not develop which common symptom
of schizophrenia?
10. What proportion of individuals with schizotypal personality disorder go on to develop

schizophrenia?
11. Some researchers have argued that what personality disorder is a chronic form of social anxiety
disorder?
152
12. According to research, about 80% of individuals with avoidant personality disorder also have
comorbid:
a)
b)
c)
d)
Borderline personality disorder

Schizophrenia
Depression
Alcohol dependence
a)
b)
c)
d)
abused.
treated by their parents as if they are special, one-of-a-kind people.
not getting enough approval from their parents.
only children or first children.
a)
b)
c)
d)
Ten-Factor Model.
Five-Factor Model.
Eight-Factor Model.
Twelve-Factor Model.
a)
b)
c)
d)
psychopathy/sociopathy.
evilness.
antiempathic.
none of the above.
13. Narcissism, as proposed by Kohut, develops when children are
14. The model designed by McCrae and Costa to distinguish between healthy personality
characteristics is called the __________
15. Antisocial personality disorder has previously been referred to as
153
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Abnormal Psychology

1. You are an attorney appointed to represent a poor client accused of rape who has a history of
mental illness. During your first several meetings, the man is completely incoherent. Which of
the following issues should you address first?
a)
b)
c)
d)
competency to stand trial

possibility of mens rea
a possible insanity defense
possible civil commitment
a)
b)
c)
d)
Brian cannot be forced to take Haldol, an antipsychotic medication.

Brian can be deemed competent even if his competency is the result of medication alone.
He may not be able to serve as his own defense attorney.
all of the above
a)
b)
c)
d)
Yes, since he is clearly a danger to others.

Yes, but only if he is found to have a prior record of criminal activity.
Yes, but only if he is judged to be mentally ill.
No, because this would violate the principle forbidding "preventive detention."
a)
b)
c)
d)
conflict about who is the client

It is not clear what choice of techniques is appropriate.
informed consent
confidentiality
a)
b)
c)
d)
Middle Ages.
7th Century B.C.
20th Century
21st Century
2. Brian has been diagnosed with schizophrenia. He is accused of stealing from a jewelry store and
is currently being treated in a psychiatric hospital to assess his competency. Which of the
following are correct regarding Brian's situation?
3. Mr. J stood near an elementary school with a loaded gun, staring at the children and teachers,
every day for a week. Could he be committed, even though he had a license for the gun and had
not been seen committing a crime?
4. A child in a residential treatment center is refusing to participate in treatment. The director of

the center tells the child's therapist that unless the child's aggressive behavior improves, the
child will be discharged. What ethical dilemma is raised here?
5. Some version of the insanity defense has been used since the
154
6. The M'Naghten rule states that the insanity defense is appropriate if a person
a)
b)
c)
d)
has an irresistible impulse leading him or her to commit a crime.

has a diagnosable mental illness.
is not competent to stand trial.
does not know right from wrong at the time of the criminal act.
a)
b)
c)
d)
that she knew right from wrong.

she was not mentally ill at the time of the murders.
that she killed her children.
All of the above are correct.
a)
b)
c)
d)
His mental health deteriorated to the point of becoming a walking vegetable.

His family begged for mercy.
He was the only child left alive for a dying mother.
He had been abused as a child.
a)
b)
c)
d)
guilty but mentally ill.

irresistible impulse.
MNaghten rule.
insanity lea.
7. The prosecution and defense in the trial of Andrea Yates agreed
8. Horace Kelly, a 39-year-old man who had been found guilty of two rapes and the slaying of an
11-year-old boy was found guilty and sentenced to death. What happened that made the Court
rule that the execution would be considered cruel and unusual punishment?
9. If the person can be found legally guilty of a crime thus maximizing the chances of
incarceration and the persons mental illness plays a role in how he or she is dealt with it is
addressed by the notion of
10. A major result of the Insanity Defense Reform Act was
a) to require that a documented, preexisting mental condition exist at the time of a crime in
order to use an insanity defense.
b) to clarify what specific crimes may be associated with insanity.
c) to restrict the insanity defense to multiple offenders.
d) to eliminate the irresistible impulse as a plausible insanity defense.
11. The difference between insanity and competency is that insanity

a)
b)
c)
d)
involves a person's state at the time of the crime.

is a legal, not a mental health, category
has less serious consequences.
criteria are more clear-cut.
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12. An informal civil commitment
a) applies only if there is no imminent danger.

b) can be used only if the person agrees.
c) is a short-term emergency procedure that can be accomplished without involving the
courts.
d) requires a court order.
13. Which of the following is true regarding the right to refuse treatment?
a)
b)
c)
d)
It does not apply if a person is judged to be at risk for becoming dangerous to others.
It does not apply if a person is a danger to themselves or to others.
It applies only to those in the least restrictive environment.
It applies to criminal commitment but not civil commitment.
a)
b)
c)
d)
liberty
justice
independence
discipline
14. The philosophical ideal of the U.S. government is to allow citizens the maximum degree of
__________ consistent with preserving order in the community at large.
15. Deinstitutionalization has been described as an improper label because
a) most patients end up in treatment in outpatient clinics, thus visiting other institutions.
b) most patients who are deinstitutionalized remain mentally ill.
c) patients typically end up in other institutions such as nursing homes, prisons, and mental
health departments of nonpsychiatric hospitals.
d) few patients are actually discharged from the hospital.
156
APPENDIX B: ANSWERS TO SELF-TEST EXERCISES

Chapter 1: Self-Test Answer Key
(1) c, pg. 10 (2) c, pg. 17 (3) b, pg. 21 (4) c, pg. 23-24 (5) a, pg. 24 (6) b, pg. 2829 (7) b, pg. 23-25 (8) a, pg. 9-10 (9) d, pg. 22 (10) d, pg. 29 (11) d, pg. 2 (12)
b, pg. 2-3 (13) d, pg. 16 (14) d, pg. 17 (15) a, pg. 26

(1) b, pg. 49-50 (2) c, pg. 55 (3) c, pg. 42 (4) d, pg. 33 (5) d, pg. 31-32 (6) b, pg.
34 (7) a, pg. 43 (8) c, pg. 48-49 (9) a, pg. 48-52 (10) d, pg. 52 (11) d, pg. 54-55
(12) d, pg. 31-32 (13) b, pg. 32 (14) c, pg. 46-47 (15) b, pg. 49

(1) b, pg. 91 (2) d, pg. 100 (3) b, pg. 95-96 (4) b, pg. 94 (5) c, pg. 73-76 (6) b,
pg. 80 (7) a, pg. 101-102 (8) d, pg. 93 (9) b, pg. 68 (10) b, pg. 87-89 (11) a, pg.
91-92 (12) c, pg. 91 (13) d, pg. 96 (14) b, pg. 101-102 (15) d, pg. 102-103

(1) c, pg. 109-110 (2) b, pg. 113 (3) b, pg. 117 (4) b, pg. 109 (5) d, pg. 115
(6)b, pg. 107-109 (7) d, pg. 105-106 (8) b, pg. 106 (9) b, pg. 128 (10) a, pg.
106-107(11) c, pg. 113 (12) c, pg. 113-114 (13) d, pg. 114-115 (14) b, pg. 121
(15) a, pg. 126
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Abnormal Psychology

(1) b, pg. 133-134 (2) c, pg. 136 (3) a, pg. 135 (4) a, pg. 147-148 (5) b, pg. 168
(6) b, pg. 152 (7) a, pg. 138 (8) a, pg. 168-169 (9) d, pg. 150 (10) a, pg. 149
(11) c, pg. 134 (12) c, pg. 145 (13) b, pg. 149 (14) d, pg. 162 (15) a, pg. 151

(1) c, pg. 177 (2) c, pg. 187-188 (3) d, pg. 174 (4) c, pg. 175 (5) d, pg. 177 (6)
b, pg. 185 (7) d, pg. 185-186 (8) b, pg. 185-186 (9) c, pg. 175 (10) a, pg. 178-
179 (11) b, pg. 180-181 (12) c, pg. 186 (13) c, pg. 182-186 (14) a, pg. 191-192
(15) a, pg. 195

(1) b, pg. 205 (2) b, pg. 213-215 (3) c, pg. 221 (4) b, pg. 201 (5) a, pg. 217 (6)
c, pg. 202 (7) c, pg. 202-203 (8) a, pg. 203 (9) c, pg. 210 (10) a, pg. 215 (11) c,
pg. 202 (12) d, pg. 202-203 (13) a, pg. 220 (14) b, pg. 205-206 (15) d, pg. 203

(1) c, pg. 233 (2) d, pg. 235 (3) c, pg. 244 (4) b, pg. 244 (5) c, pg. 248 (6) c, pg.
235 (7) b, pg. 227 (8) a, pg. 236 (9) b, pg. 239 (10) c, pg. 239 (11) c, pg. 231
(12) b, pg. 234 (13) d, pg. 241 (14) a, pg. 234 (15) b, pg. 238
158

(1) a, pg. 257 (2) c, pg. 257 (3) b, pg. 259 (4) c, pg. 259 (5) b, pg. 271-272 (6)
b, pg. 276- (7) d, pg. 258-259 (8) c, pg. 258 (9) d, pg. 264 (10) c, pg. 263(11) a,
pg. 265 (12) a, pg. 276 (13) d, pg. 252-253 (14) c, pg. 271-272 (15) c, pg. 255

(1) c, pg. 291 (2) d, pg. 295 (3) a, pg. 296 (4) b, pg. 287 (5) c, pg. 292 (6) a, pg.
298 (7) d, pg. 314 (8) b, pg. 304 (9) c, pg. 316 (10) a, pg. 288-289 (11) c, pg.
301 (12) d, pg. 302 (13) a, pg. 296 (14) a, pg. 318 (15) a, pg. 325

(1) a, pg. 329-330 (2) c, pg. 348 (3) c, pg. 346 (4) a, pg. 350 (5) a, pg. 328 (6)
d, pg. 332 (7) d, pg. 334-336 (8) b, pg. 328 (9) a, pg. 336 (10) d, pg. 338 (11) a,
pg. 341-342 (12) c, pg. 353 (13) a, pg. 332 (14) a, pg. 341-342 (15) d, pg. 329330

(1) c, pg. 360 (2) b, pg. 365 (3) a, pg. 369 (4) a, pg. 372 (5) a, pg. 361 (6) b, pg.
357 (7) c, pg. 372 (8) c, pg. 362 (9) c, pg. 364-365 (10) b, pg. 369 (11) a, pg.
373 (12) b, pg. 381 (13) c, pg. 374 (14) a, pg. 378 (15) b, pg. 356
159
PSY:3320 (031:163)
Abnormal Psychology

(1) b, pg. 388 (2) a, pg. 397-399 (3) c, pg. 412-413 (4) b, pg. 397 (5) c, pg. 408
(6) b, pg. 417 (7) b, pg. 386 (8) d, pg. 402 (9) a, pg. 388 (10) a, pg. 394 (11) b,
pg. 395-396 (12) d, pg. 425-426 (13) c, pg. 418 (14) d, pg. 387 (15) c, pg. 414

(1) c, pg. 447-448 (2) d, pg. 448 (3)d, pg. 431 (4) d, pg. 431 (5) c, pg. 433 (6)
b, pg. 430 (7) a, pg. 437 (8) d, pg. 432 (9) b, pg. 432 (10) c, pg. 445 (11) a, pg.
448 (12) d, pg. 436 (13) b, pg. 432 (14) d, pg. 432-434 (15) d, pg. 431

(1) b, pg. 466(2) d, pg. 472-473 (3) b, pg. 460 (4) a, pg. 467 (5) a, pg. 460 (6)
d, pg. 472-473 (7) a, pg. 456 (8) d, pg. 457 (9) d, pg. 461 (10) b, pg. 471 (11) c,
pg. 471 (12) c pg. 471 (13) c, pg. 469 (14) b, pg. 472 (15) a, pg. 461

(1) a, pg. 497 (2) d, pg. 500 (3) c, pg. 503-504 (4) a, pg. 515 (5) b, pg. 492 (6)
d, pg. 492 (7) c, pg. 499 (8) a, pg. 502 (9) a, pg. 496 (10) d, pg. 494 (11) a, pg.
492 (12) c, pg. 504 (13) b, pg. 509-510 (14) a, pg. 490 (15) c, pg. 511
160
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161

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The University of Iowa

Division of Continuing Education

Study Guide for:

Michael OHara, Ph.D.

No part of this publication may be reproduced in any form by any means

The University of Iowa prohibits discrimination in employment and in its educational

Continuing Education GIS

The University of Iowa

ABOUT THE COURSEWRITERS

Psychology, Behavior Modification, and Introduction to Clinical

Psychology at the undergraduate level. He also teaches a course in

Professor OHara supervises clinical psychology graduate students in

Training Clinic. His research interests are in the area of postpartum

GRAHAM NELSON, M.A. COMING SOON

Continuing Education GIS

The University of Iowa

ABOUT THIS COURSE

Continuing Education GIS

The University of Iowa

Required Course Materials:

Study Guide (PDF)

Guided Independent Study Policies (PDF)

Textbook for you to purchase:

Iowa Book, L.L.C. Web: http://www.iowabook.com/ Phone: 319.337.4188

University Bookstore. Web: http://www.book.uiowa.edu/ Phone: 319.335.3179

Print-based Materials for Purchase:

Course Work Requirements:

Continuing Education GIS

The University of Iowa

on campus and off campus students), is posted on the course homepage.

(CEF) - 30 S. Dubuque St - Room 234 (second level of the US Bank Building).

Each examination is worth a third of your course grade.

Course grades will be determined based on the following point system.

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access the course site:

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feedback left by your

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BEFORE YOU BEGIN

Studying in This Course (and in other courses too)

The SQ4R Study System*

As you begin to study a new chapter, follow this plan.

Douglas Hindman. Copyright by John Wiley and Sons.

Continuing Education GIS

The University of Iowa

Continuing Education GIS

The University of Iowa

Underlining the Text

Continuing Education GIS

The University of Iowa

thing does not happen again?

Continuing Education GIS

The University of Iowa

LESSON 1 INTRODUCTION AND HISTORICAL OVERVIEW

By the end of this lesson, you should know: