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Abnormal Psychology
A N I N T E G R AT I V E A P P R O A C H
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SEVENTH EDITION
Abnormal Psychology
A N I N T E G R AT I V E A P P R O A C H
David H. Barlow
B O S TO N U N I V E R S I T Y
V. Mark Durand
U N I V E R S I T Y O F S O UT H F L O R I DA – S T. P E T E R S B U R G
Australia • Brazil • Mexico • Singapore • United Kingdom • United States
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Abnormal Psychology: An Integrative © 2015, 2012 Cengage Learning
Approach, Seventh Edition
WCN: 02-200-203
David H. Barlow, V. Mark Durand
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I dedicate this book to my mother, To Wendy and Jonathan, whose
Doris Elinor Barlow-Lanigan, patience, understanding, and love
for her multidimensional influence provided me the opportunity to
across my life span. complete such an ambitious project.
D. H. B. V. M. D.
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About the Authors
David H. Barlow is an 2000, was named Honorary Visiting Professor at the Chinese Peo-
internationally recognized pioneer ple’s Liberation Army General Hospital and Postgraduate Medical
and leader in clinical psychology. A School in Beijing, China. In addition, the annual Grand Rounds in
professor of psychology and psychiatry Clinical Psychology at Brown University was named in his honor,
at Boston University, Dr. Barlow is and he was awarded the first graduate alumni scholar award at
Founder and Director Emeritus of the University of Vermont. During the 1997–1998 academic year,
the Center for Anxiety and Related he was Fritz Redlich Fellow at the Center for Advanced Study in
Disorders, one of the largest research the Behavioral Sciences in Menlo Park, California. His research
clinics of its kind in the world. has been continually funded by the National Institute of Mental
From 1996 to 2004, he directed Health for over 40 years.
the clinical psychology programs at Dr. Barlow has edited three journals, has served on the edi-
David H. Barlow
Boston University. From 1979 to 1996, torial boards of more than 20 different journals, and is currently
he was distinguished professor at the editor in chief of the “Treatments That Work” series for Oxford
University at Albany–State University University Press.
of New York. From 1975 to 1979, he was professor of psychiatry and He has published more than 500 scholarly articles and writ-
psychology at Brown University, where he also founded the clinical ten more than 65 books and clinical manuals, including Anxiety
psychology internship program. From 1969 to 1975, he was professor and Its Disorders, 2nd edition, Guilford Press; Clinical Handbook
of psychiatry at the University of Mississippi, where he founded the of Psychological Disorders: A Step-by-Step Treatment Manual,
Medical School psychology residency program. Dr. Barlow received 5th edition, Guilford Press; Single-Case Experimental Designs:
his B.A. from the University of Notre Dame, his M.A. from Boston Strategies for Studying Behavior Change, 3rd edition, Allyn &
College, and his Ph.D. from the University of Vermont. Bacon (with Matthew Nock and Michael Hersen); The Scientist–
A fellow of every major psychological association, Dr. Barlow Practitioner: Research and Accountability in the Age of Managed
has received many awards in honor of his excellence in scholarship, Care, 2nd edition, Allyn & Bacon (with Steve Hayes and Rose-
including the National Institute of Mental Health Merit Award mary Nelson-Gray); Mastery of Your Anxiety and Panic, Oxford
for his long-term contributions to the clinical research effort; the University Press (with Michelle Craske); and more recently The
Distinguished Scientist Award for applications of psychology from Unified Protocol for Transdiagnostic Treatment of Emotional
the American Psychological Association; and the James McKeen Disorders with the Unified Team at BU. The book and manuals
Cattell Fellow Award from the Association for Psychological have been translated into more than 20 languages, including
Science honoring individuals for their lifetime of significant intel- Arabic, Chinese, and Russian.
lectual achievements in applied psychological research. Other Dr. Barlow was one of three psychologists on the task force
awards include the Distinguished Scientist Award from the that was responsible for reviewing the work of more than 1,000
Society of Clinical Psychology of the American Psychological mental health professionals who participated in the creation of
Association and a certificate of appreciation from the APA section DSM-IV, and he continued on as an Advisor to the DSM-5 Task
on the clinical psychology of women for “outstanding commitment Force. He also chaired the APA Task Force on Psychological Inter-
to the advancement of women in psychology.” In 2004, he received vention Guidelines, which created a template for clinical practice
the C. Charles Burlingame Award from the Institute of Living and guidelines. His current research program focuses on the nature
was awarded an Honorary Doctorate of Humane Letters degree and treatment of anxiety and related emotional disorders.
from the Massachusetts School of Professional Psychology. He At leisure he plays golf, skis, and retreats to his home in
also received career contribution awards from the Massachusetts, Nantucket, where he loves to write, walk on the beach, and visit
Connecticut, and California Psychological Associations, and, in with his island friends.
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V. Mark Durand is known for his body of work in the field of autism spectrum disorder.
worldwide as an authority in the Dr. Durand is currently a member of the Professional Advisory
area of autism spectrum disorder. Board for the Autism Society of America and is on the board
He is a professor of psychology at of directors of the International Association of Positive Behav-
the University of South Florida– ioral Support. He is co-editor of the Journal of Positive Behavior
St. Petersburg, where he was the Interventions, serves on a number of editorial boards, and has
founding Dean of Arts & Sciences more than 125 publications on functional communication, edu-
and Vice Chancellor for Academic cational programming, and behavior therapy. His books include
Affairs. Dr. Durand is a fellow Severe Behavior Problems: A Functional Communication Training
of the American Psychological Approach; Sleep Better! A Guide to Improving Sleep for Children
V. Mark Durand
Association. He has received more with Special Needs; Helping Parents with Challenging Children:
than $4 million in federal funding Positive Family Intervention; the multiple national award win-
since the beginning of his career to ning Optimistic Parenting: Hope and Help for You and Your
study the nature, assessment, and treatment of behavior problems Challenging Child; and most recently Autism Spectrum Disorder:
in children with disabilities. Before moving to Florida, he served A Clinical Guide for General Practitioners.
in a variety of leadership positions at the University at Albany, Dr. Durand developed a unique treatment for severe behavior
including associate director for clinical training for the doctoral problems that is currently mandated by states across the country
psychology program from 1987 to 1990, chair of the psychology and is used worldwide. He also developed an assessment tool that
department from 1995 to 1998, and interim dean of Arts and is used internationally and has been translated into more than 15
Sciences from 2001 to 2002. There he established the Center for languages. Most recently he developed an innovative approach to
Autism and Related Disabilities at the University at Albany, SUNY. help families work with their challenging child (Optimistic Par-
He received his B.A., M.A., and Ph.D.—all in psychology—at the enting), which was validated in a 5-year clinical trial. He has been
State University of New York–Stony Brook. consulted by the departments of education in numerous states
Dr. Durand was awarded the University Award for Excel- and by the U.S. Departments of Justice and Education. His current
lence in Teaching at SUNY–Albany in 1991 and was given the research program includes the study of prevention models and
Chancellor’s Award for Excellence in Research and Creative treatments for such serious problems as self-injurious behavior.
Scholarship at the University of South Florida–St. Petersburg In his leisure time, he enjoys long-distance running and has
in 2007. He was named a 2014 Princeton Lecture Series Fellow completed three marathons.
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Copyright 201 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
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Brief Contents
1 Abnormal Behavior in Historical Context 1
2 An Integrative Approach to Psychopathology 28
3 Clinical Assessment and Diagnosis 68
4 Research Methods 98
5 Anxiety, Trauma- and Stressor-Related, and Obsessive-Compulsive and
Related Disorders 122
6 Somatic Symptom and Related Disorders and Dissociative Disorders 180
7 Mood Disorders and Suicide 212
8 Eating and Sleep–Wake Disorders 268
9 Physical Disorders and Health Psychology 316
10 Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria 354
11 Substance-Related, Addictive, and Impulse-Control Disorders 396
12 Personality Disorders 440
13 Schizophrenia Spectrum and Other Psychotic Disorders 476
14 Neurodevelopmental Disorders 510
15 Neurocognitive Disorders 542
16 Mental Health Services: Legal and Ethical Issues 570
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Copyright 201 Cengage Learning. All Rights Reserved. May not be copied, scanned, or duplicated, in whole or in part. Due to electronic rights, some third party content may be suppressed from the eBook and/or eChapter(s).
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Contents
1 Abnormal Behavior in Historical Context 1
Understanding Psychopathology 1 The Psychological Tradition 13
What Is a Psychological Disorder? / 2 Moral Therapy / 13
The Science of Psychopathology / 4 Asylum Reform and the Decline of
Historical Conceptions of Abnormal Moral Therapy / 15
Behavior / 6 Psychoanalytic Theory / 15
Humanistic Theory / 20
The Supernatural Tradition 7
The Behavioral Model / 21
Demons and Witches / 7
Stress and Melancholy / 7 The Present: The Scientific Method and
Treatments for Possession / 9 an Integrative Approach 23
Mass Hysteria / 9
Modern Mass Hysteria / 9 Summary 24
The Moon and the Stars / 10 Key Terms 25
Comments / 10 Answers to Concept Checks 25
Media Resources 25
The Biological Tradition 10
Hippocrates and Galen / 10
The 19th Century / 11
The Development of Biological Treatments / 12
Consequences of the Biological Tradition / 13
2 An Integrative Approach to Psychopathology 28
One-Dimensional versus Neuroscience and Its
Multidimensional Models 29 Contributions to
What Caused Judy’s Phobia? / 29 Psychopathology 38
Outcome and Comments / 31 The Central Nervous System / 38
The Structure of the Brain / 40
Genetic Contributions to The Peripheral Nervous System / 42
Psychopathology 31 Neurotransmitters / 44
The Nature of Genes / 32
Implications for Psychopathology / 48
New Developments in the Study of Genes and
Psychosocial Influences on Brain Structure and
Behavior / 33
Function / 49
The Interaction of Genes and the
Interactions of Psychosocial Factors and
Environment / 34
Neurotransmitter Systems / 51
Epigenetics and the Nongenomic “Inheritance”
of Behavior / 36
xi
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