Chapter 1

Question 1

psychological disorder

Answer 1

, a psychological dysfunction associated with distress or impairment in functioning and a
response that is not typical or culturally expected. Before
examining exactly what this means, let’s look at one individual’s situation

Question 2

phobia

Answer 2

Her reaction was severe,
thereby meeting the criteria for phobia, a psychological disorder characterized by marked and persistent
fear of an object or situation

Question 3

A psychological disorder, or abnormal behavior, is

Answer 3

a psychological dysfunction that is associated with distress or
impairment in functioning and a response that is not typical or culturally expected (see l Figure 1.1). These three
criteria may seem obvious, but they were not easily arrived
at and it is worth a moment to explore what they mean

Question 4

. Drawing the line between normal and abnormal dysfunction is often difficult. For this reason,

Answer 4

these
problems are often considered to be on a continuum rather
than either present or absent (McNally, 2011; Widiger &
Crego, 2013). This, too, is a reason why just having a dysfunction is not enough to meet the criteria for a psychological disorder

Question 5

udy was clearly impaired by her phobia, but many

people with less severe reactions are not impaired. This difference again illustrates the i

Answer 5

e important point that most psychological disorders are extreme expressions of otherwise
normal emotions, behaviors, and cognitive processes

Question 6

psychopathology

Answer 6

Psychopathology is the scientific study of psychological
disorders. Within this field are clinical and counseling psychologists, psychiatrists, psychiatric social workers, and
psychiatric nurses, as well as marriage and family therapists and mental health counselors. Clinical psychologists
and counseling psychologists receive the PhD degree, doctor
of philosophy (or sometimes an EdD, doctor of education, or PsyD, doctor of psychology) and follow a course of
graduate-level study lasting approximately 5 years, which
prepares them to conduct research into the causes and
treatment of psychological disorders and to diagnose, assess, and treat these disorders. Counseling psychologists
tend to study and treat adjustment and vocational issues
encountered by relatively healthy individuals, and clinical
psychologists usually concentrate on more severe psychological disorders. Psychologists with other specialty training,
such as experimental and social psychologists, investigate
the basic determinants of behavior but do not assess or
treat psychological disorders.

Question 7

Psychiatric social workers and psyciatric nurses

Answer 7

Psychiatric social workers typically earn a master’s degree
in social work as they develop expertise in collecting information relevant to the social and family situation of the
individual with a psychological disorder. Social workers
also treat disorders, often concentrating on family problems associated with them. Psychiatric nurses have advanced degrees and specialize in the care and treatment of
patients with psychological disorders, usually in hospitals
as part of a treatment team.
=

Question 8

Finally, marriage and family therapists and mental health

counselors

Answer 8

typically spend 1–2 years earning a master’s
degree and are employed to provide clinical services by
hospitals or clinics

Question 9

scientist practictioners

Answer 9

Many mental health professionals take a
scientific approach to their clinical work and therefore are
called scientist–practitioners

Question 10

Mental health
practitioners function as scientist–practitioners in three
ways

Answer 10

. First, they keep up with the latest
developments in their field and therefore use the most current diagnostic and treatment procedures. In this sense,
they are consumers of the science of psychopathology.
Second, they evaluate their own assessments or treatment
procedures to see whether they work. They are accountable not only to their patients but also to government
agencies and insurance companies that pay for the treatments, so they must demonstrate that their treatments
work. Third, scientist–practitioners conduct research that
produces new information about disorders or their treatment. Such research attempts to do three basic things: describe psychological disorders, determine their causes, and
treat them (see l Figure 1.3). These three categories compose
an organizational structure that recurs throughout this
book. A general overview of each will give you a clearer
perspective on our efforts to understand abnormalit

Question 11

episodic and time-limited course

Answer 11

that they tend to last a long time. Other disorders, like
mood disorders (see Chapter 6), follow an episodic course,
in that the individual is likely to recover within a few
months only to suffer a recurrence of the disorder at a later
time. Still other disorders may have a time-limited course,
meaning they will improve without treatment in a relatively
short period.

Question 12

prognosis

Answer 12

The anticipated course of a disorder is
called the prognosis. ex- If the disorder is likely to last a long
time (become chronic), however, the individual might want
to seek treatment.

Question 13

We call the study of changes in behavior over time

Answer 13

developmental psychology, and we refer to the study of
changes in abnormal behavior as developmental psychopathology. Because we change throughout our lives, researchers study development in adolescents, adults, and
older adults as well as in children. Study of abnormal behavior across the entire age span is referred to as life-span
developmental psychopathology

Question 14

etiology

Answer 14

Etiology, or the study of origins, has to do with why a disorder begins and includes biological, psychological, and
social dimensions.

Question 15

why are there no sepearate chapters on different treatment approaches

Answer 15

More recently, as our science has advanced, we have developed specific effective treatments that do not always adhere neatly to one theoretical approach or another but that have
grown out of a deeper understanding of the disorder in
question. (pg 37)

Question 16

It followed that individuals “possessed” by evil spirits were
probably responsible for

Answer 16

any misfortune experienced by
people in the local community, which inspired drastic action against the possessed. Treatments included exorcism,
in which various religious rituals were performed to rid the
victim of evil spirits. Other approaches included shaving
the pattern of a cross in the hair of the victim’s head and
securing sufferers to a wall near the front of a church so
that they might benefit from hearing Mass

Question 17

In the 14th century, one of the chief advisers to the king

of France, Nicholas Oresme, suggested that m

Answer 17

melancholy
(depression) was the source of some bizarre behavior,
rather than demons. Oresme pointed out that much of the
evidence for the existence of sorcery and witchcraft, particularly among those considered insane, was obtained
from people who were tortured and who, quite understandably, confessed to anything.

Question 18

Another fascinating phenomenon is characterized by largescale outbreaks of bizarre behavior. During the Middle
Ages, they lent support to the notion of possession. In
Europe

Answer 18

whole groups of people were simultaneously compelled to run out in the streets, dance, shout, rave, and
jump around in patterns as if they were at a particularly
wild party (still called a rave today, but with music). This
behavior was known by several names, including Saint
Vitus’s Dance and tarantism. Several reasons were offered
in addition to possession. One reasonable guess was reaction to insect bites. Another possibility was what we now
call mass hysteria. Consider the following example

Question 19

mass hysteria

Answer 19

a girl at a school complained of a smell causing unpleasant physical symptoms and a bunch of kids and teachers all had the same symptoms but the hospital found nothing to be wrong with them.

Question 20

emotion contagion

Answer 20

Mass hysteria may simply demonstrate the phenomenon
of emotion contagion, in which the experience of an emotion
seems to spread to those around us (Hatfield, Cacioppo, &
Rapson, 1994; Wang, 2006). If someone nearby becomes
frightened or sad, chances are that, for the moment, you
also will feel fear or sadness. When this kind of experience
escalates into full-blown panic, whole communities are affected

Question 21

People are also suggestible when

Answer 21

they
are in states of high emotion. Therefore, if one person identifies a “cause” of the problem, others will probably assume
that their own reactions have the same source. In popular
language, this shared response is sometimes referred to as
mob psychology

Question 22

full moon (see pg 40 for more)

Answer 22

Despite
much ridicule, millions of people around the world are convinced that their behaviors are influenced by the stages of
the moon or the positions of the stars. This belief is most
noticeable today in followers of astrology, who hold that
their behavior and the major events in their lives can be
predicted by their day-to-day relationship to the position of
the planets. No serious evidence has ever confirmed such a
connection, however

Question 23

women and hysteria, pg 40

Answer 23

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Question 24

hippocrates

Answer 24

The Greek physician Hippocrates (460–377 b.c.) is considered to be the father of modern Western medicine. In a
body of work called the Hippocratic Corpus, written between 450 and 350 b.c. (Maher & Maher, 1985a), he and
others suggested that psychological disorders could be
treated like any other disease.

Question 25

One of the more influential legacies of the

Hippocratic–Galenic approach is the humoral theory of disorders. H

Answer 25

Hippocrates assumed that normal brain functioning
was related to four bodily fluids or humors: blood, black
bile, yellow bile, and phlegm. Blood came from the heart,
black bile from the spleen, phlegm from the brain, and choler or yellow bile from the liver. Physicians believed that
disease resulted from too much or too little of one of the
humors; for example, too much black bile was thought to
cause melancholia (depression). In fact, the term melancholy, from melancholer, which means “black bile,” is still
used to refer to aspects of depression. The humoral theory
was, perhaps, the first example of associating psychological
disorders with a “chemical imbalance,” an approach that is
widespread today

Question 26

explain the humoral theory

Answer 26

The four humors were related to the Greeks’ conception
of the four basic qualities: heat, dryness, moisture, and
cold. Each humor was associated with one of these qualities. Terms derived from the four humors are still sometimes
applied to personality traits. For example, sanguine (literal
meaning “red, like blood”) describes someone who is ruddy
in complvexion, presumably from copious blood flowing through the body, and cheerful and optimistic, although insomnia and delirium were thought to be caused by excessive
blood in the brain. Melancholic means depressive (depression was thought to be caused by black bile flooding the
brain). A phlegmatic personality (from the humor phlegm)
indicates apathy and sluggishness but can also mean being
calm under stress. A choleric person (from yellow bile or
choler) is hot tempered

Question 27

Excess humors were treated by

Answer 27

regulating the environment to increase or decrease heat, dryness, moisture, or
cold, depending on which humor was out of balance.

Question 28

In ancient China and throughout Asia, a similar idea existed. But rather than “humors,” the Chinese focused on
the movement of air or “wind” throughout the body.

Answer 28

Unexplained mental disorders were 
caused by blockages of wind 
or the presence of cold, dark 
wind (yin) as opposed to 
warm, life-sustaining wind 
(yang). Treatment involved 
restoring proper flow of 
wind through various methods, including acupuncture.

Question 29

somatic symptom disorders

Answer 29

Hippocrates also coined
the word hysteria to describe a concept he learned
about from the Egyptians,
who had identified what we
now call the somatic symptom disorders. In these disorders, symptoms, such as
paralysis and some kinds
of blindness, appear to be
the result of a problem for which no physical cause can be found, Because these disorders occurred primarily in women, the Egyptians (and
Hippocrates) mistakenly assumed that they were restricted
to women

Question 30

They also presumed a cause:

Answer 30

The empty uterus
wandered to various parts of the body in search of conception (the Greek word for “uterus” is hysteron). Numerous
physical symptoms reflected the location of the wandering
uterus. The prescribed cure might be marriage or, occasionally, fumigation of the vagina to lure the uterus back to
its natural location (Alexander & Selesnick, 1966). Knowledge of physiology eventually disproved the wandering
uterus theory; however, the tendency to stigmatize dramatic women as hysterical continued into the 1970s. As
you will learn in Chapter 5, somatic symptom disorders are
not limited to one sex.

Question 31

cures for some disease- pg 42

Answer 31

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Question 32

insulin shock therapy

Answer 32

In 1927, a Viennese physician, Manfred Sakel,
began using increasingly higher dosages until, finally, patients convulsed and became temporarily comatose (Sakel,
1958). Some actually recovered their mental health, much
to the surprise of everybody, and their recovery was attributed to the convulsions. The procedure became known as
insulin shock therapy, but it was abandoned because it was
too dangerous, often resulting in prolonged coma or death.
Other methods of producing convulsions had to be found.

Question 33

electroconvulsive therapy

Answer 33

Following suggestions
on the possible benefits of applying electric shock directly
to the brain—notably, by two Italian physicians, Ugo Cerletti and Lucio Bini, in 1938—a surgeon in London treated
a depressed patient by sending six small shocks directly
through his brain, producing convulsions (Hunt, 1980). The
patient recovered. Although greatly modified, shock treatment is still used. The controversial modern uses of electroconvulsive therapy are described in Chapter 6

Question 34

In the late 19th century, Grey and his colleagues ironically
reduced or eliminated interest in treating mental patients,
because they thought mental disorders were the result of
some as-yet-undiscovered brain pathology and were therefore incurable. The only available course of action was to
hospitalize these patients. Around the turn of the century,

Answer 34

some nurses documented clinical success in treating mental
patients but were prevented from treating others for fear of
raising hopes of a cure among family members. In place
of treatment, interest centered on diagnosis and the study
of brain pathology itself

Question 35

Emil Kraepelin (1856–1926) was the dominant figure 
during this period. He was influential in

Answer 35

advocating the
major ideas of the biological tradition, but he was little
involved in treatment. His lasting contribution was in the
area of diagnosis and classification. Kraepelin (1913) was
one of the first to distinguish among various psychological disorders, seeing that each may have a different age of
onset, different symptoms, and probably a different cause.

Question 36

psychosocial treatment

Answer 36

The best
treatment was to reeducate the individual through rational
discussion so that the power of reason would predominate
(Maher & Maher, 1985a). This was a precursor to modern
psychosocial treatment approaches to the causation of
psychopathology, which focus not only on psychological
factors but also on social and cultural ones as well.

Question 37

moral therapy

Answer 37

During the first half of the 19th century, a psychosocial approach to mental disorders called moral therapy became
influential. The term moral actually referred more to emotional or psychological factors rather than to a code of conduct. Its tenets included treating institutionalized patients
as normally as possible in a setting that encouraged normal
social interaction (Bockoven, 1963). Relationships were
carefully nurtured. Individual attention emphasized positive
consequences for appropriate interactions and behavior,
and restraint and seclusion were eliminated

Question 38

As with the biological tradition, the principles of moral

therapy date back to Plato and beyond. For example,

Answer 38

the
Greek Asclepiad Temples of the 6th century b.c. housed the
chronically ill, including those with psychological disorders. Here, patients were well cared for, massaged, and
provided with soothing music. S

Question 39

what happened to moral therapy after the mid 19th century

Answer 39

Unfortunately, after the mid-19th century, humane treatment declined. It was widely recognized that moral therapy
worked best when the number of patients in an institution
was 200 or fewer, allowing for a great deal of individual
attention. But after the Civil War, enormous waves of
immigrants arrived in the United States, and patient loads
in hospitals increased to 1,000 or 2,000, and even more.
Because immigrant groups were thought not to deserve the
same privileges as native-born Americans (whose ancestors
had immigrated perhaps only 50 or 100 years earlier!), they
were not given moral treatments even when there were
sufficient hospital personnel.

Question 40

what was the name of dorothea dix work

Answer 40

Having worked in various institutions, she had
firsthand knowledge of the deplorable conditions imposed on patients with insanity, and she made it her life’s
work to inform the American public and their leaders of
these abuses. Her work became known as the mental
hygiene movement

Question 41

what problems happened as a result of her work.

Answer 41

Unfortunately, an unforeseen
consequence of Dix’s efforts was a substantial increase in the
number of mental patients. This influx led to a rapid transition from moral therapy to custodial care. Dix reformed our
asylums and inspired the construction of new institutions
here and abroad. But even her tireless efforts could not ensure sufficient staffing to allow the individual attention
necessary to moral therapy.
A final blow to the practice
of moral therapy was the
decision, in the middle of
the 19th century, that mental illness was caused by
brain pathology and, therefore, was incurable.

Question 42

psychoanalysis and behaviorism

Answer 42

based on sigmund freuds theory of the structure of the mind and the role of unconscious processes in determining behavior. The second was behaviorism, associated with John B.
Watson, Ivan Pavlov, and B. F. Skinner, which focuses
on how learning and adaptation affect the development
of psychopathology

Question 43

mesmers treatments on pg 45- look at them, its a lot to write.

Answer 43

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Question 44

While his patients were
in the highly suggestible state of hypnosis, Breuer asked
them to describe their problems, conflicts, and fears. Breuer
observed two important phenomena during this process.

Answer 44

First, patients often became extremely emotional as they
talked and felt relieved and improved after emerging from
the hypnotic state. Second, seldom would they have gained
an understanding of the relationship between their emotional problems and their psychological disorder. In fact, it
was difficult or impossible for them to recall some details
they had described under hypnosis. In other words, the
material seemed to be beyond the awareness of the patient.
With this observation, Breuer and Freud had “discovered”
the unconscious mind and its apparent influence on the
production of psychological disorders.

Question 45

catharsis pg 45

Answer 45

They also discovered that it is therapeutic to recall and
relive emotional trauma that has been made unconscious
and to release the accompanying tension. This release of
emotional material became known as catharsis. A fuller
understanding of the relationship between current emotions and earlier events is referred to as insight. As you shall
see throughout this book, the existence of “unconscious”
memories and feelings and the importance of processing
emotion-filled information have been verified.

Question 46

psychoanalytic model

Answer 46

Freud expanded these basic observations into the psychoanalytic model, the most comprehensive theory yet constructed on the development and
structure of our personalities. He also speculated on
where this development could go wrong and produce
psychological disorders. Although many of Freud’s
views changed over time, the basic principles of mental functioning that he originally proposed remained
constant through his writings and are still applied by
psychoanalysts today

Question 47

ID

Answer 47

The id is the source of our strong
sexual and aggressive feelings or energies. It is, basically, the
animal within us; if totally unchecked, it would make us all
rapists or killers.

Question 48

libido

Answer 48

The energy or drive within the id is the libido.
Even today, some people explain low sex drive as an absence
of libido. A

Question 49

thanatos

Answer 49

A less important source of energy is the death instinct, or thanatos.

Question 50

these two basic drives, toward life and fulfillment on the one hand and death and destruction on the
other,

Answer 50

are continually in opposition.

Question 51

good definitions on page 46

Answer 51

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Question 52

Id

Answer 52

The id operates according to the pleasure principle, with
a goal of maximizing pleasure and eliminating any associated tension or conflicts. The goal of pleasure, which is
particularly prominent in childhood, often conflicts with
social rules. The id has its own characteristic way of processing information; referred to as the primary process,
this type of thinking is emotional, irrational, illogical,
filled with fantasies, and preoccupied with sex, aggression,
selfishness, and envy

Question 53

ego

Answer 53

The part
of our mind that ensures that we act realistically is called the
ego, and it operates according to the reality principle instead
of the pleasure principle. The cognitive operations or thinking styles of the ego are characterized by logic and reason
and are referred to as the secondary process, as opposed to
the illogical and irrational primary process of the id

Question 54

superego

Answer 54

The third important structure within the mind, the 
superego, or what we might 
call conscience, represents 
the moral principles instilled 
in us by our parents and our 
culture. It is the voice within 
us that nags at us when we 
know we’re doing something 
wrong. Because the purpose 
of the superego is to counteract the potentially dangerous aggressive and sexual 
drives of the id, the basis for 
conflict is apparent

Question 55

what is the role of the ego

Answer 55

The role of the ego is to
mediate conflict between
the id and the superego. The
ego is often referred to as
the executive or manager of our minds. If it mediates successfully, we
can go on to higher intellectual and creative pursuits. If it is unsuccessful, and
the id or superego becomes too strong,
conflict will overtake us and psychological
disorders will develop.

Question 56

intrapsychic conflicts

Answer 56

Because these conflicts are all within the mind, they are referred to as intrapsychic conflicts. Freud
believed that the id and the superego are
almost entirely unconscious. We are fully
aware only of the secondary processes
of the ego, which is a relatively small part
of the mind.

Question 57

defense mechanisms

Answer 57

The ego fights a continual battle to stay on top of the warring
id and superego. Occasionally, their conflicts produce anxiety. The anxiety alerts the ego to marshal defense mechanisms, unconscious protective processes that keep emotions
associated with conflicts in check so that the ego can continue
to function. Although Freud first conceptualized defense
mechanisms, it was his daughter, Anna Freud, who developed the ideas more fully

Question 58

More severe internal conflicts that produce a lot of anxiety or other emotions can trigger self-defeating defensive
processes or symptoms like what

Answer 58

Phobic and obsessive symptoms
are especially common self-defeating defensive reactions
that, according to Freud, reflect an inadequate attempt to
deal with such conflicts. Phobic symptoms typically incorporate elements of the conflict. For example, a dog phobia
may be connected to an infantile fear of castration; that is,
a man’s internal conflict involves a fear of being attacked
and castrated, a fear that is consciously expressed as a fear
of being attacked and bitten by a dog, even if he knows the
dog is harmless

Question 59

psychosexual stages of development

Answer 59

Freud also theorized that during infancy and early childhood we pass through a number of psychosexual stages of
development. The stages—oral, anal, phallic, latency, and
genital—represent distinctive patterns of gratifying our basic
needs and satisfying our drive for physical pleasure.

Question 60

oral

Answer 60

For
example, the oral stage (birth to about age 2) is characterized by a focus on the need for food. In the act of sucking,
necessary for feeding, the lips, tongue, and mouth become
the focus of libidinal drives and, therefore, the principal
source of pleasure. Freud hypothesized that if we did not
receive appropriate gratification during a specific stage or if
a specific stage left a particularly strong impression (which
he termed fixation), an individual’s personality would reflect the stage throughout adult life. For example, fixation
at the oral stage might result in excessive thumb sucking
and emphasis on oral stimulation through eating, chewing
pencils, or biting fingernails. Adult personality characteristics theoretically associated with oral fixation include dependency and passivity or, in reaction to these tendencies,
rebelliousness and cynicism

Question 61

phallic stage

Answer 61

girls like their dads and boys like their moms

Question 62

castration anxiety

Answer 62

Furthermore, strong fears develop that the father may punish that lust by removing the
son’s penis—thus, the phenomenon of castration anxiety.

Question 63

neuroses

Answer 63

In Freud’s view, all nonpsychotic psychological disorders
resulted from unconscious conflicts, the anxiety that resulted from those conflicts, and the implementation of defense
mechanisms. Freud called such disorders neuroses, or
neurotic disorders.

Question 64

Anna Freud (1895–1982), Freud’s daughter, concentrated
on how defense mechanisms determine behavior. In doing
so, she was the first proponent of the modern field of ego
psychology. According to Anna Freud,

Answer 64

, the individual slowly
accumulates adaptational capacities, skills in reality testing,
and defenses. Abnormal behavior develops when the ego is
deficient in regulating such functions as controlling impulses or in marshaling appropriate defenses to internal
conflicts.

Question 65

. In another modification of Freud’s theories, Heinz

Kohut (1913–1981) focused on

Answer 65

the formation of self-concept
and the attributes of the self that allow an individual to
progress toward health, or conversely, to develop neurosis.
This psychoanalytic approach became known as selfpsychology (Kohut, 1977)

Question 66

object relations

Answer 66

A related area is object relations—the study of how
children incorporate the images, the memories, and sometimes the values of a person to whom they were (or are)
emotionally attached. Object in this sense refers to these
important people, and the process of incorporation is
called introjection.

Question 67

free association

Answer 67

Freud developed techniques of free association, in which
patients are instructed to say whatever comes to mind. Free
association is intended to reveal emotionally charged material that may be repressed because it is too painful or
threatening to bring into consciousness.

Question 68

dream analysis

Answer 68

Freud’s patients
lay on a couch, and he sat behind them so that they would
not be distracted. Other techniques include dream analysis
(still quite popular), in which the therapist interprets the
content of dreams, supposedly reflecting the primary-process thinking of the id, and relates the dreams to symbolic
aspects of unconscious conflicts

Question 69

psychodynamic psychotherapy

Answer 69

Psychoanalysis is still practiced, but many psychotherapists employ a loosely related set of approaches referred to as
psychodynamic psychotherapy. Although conflicts and unconscious processes are still emphasized, and efforts are
made to identify trauma and defense mechanisms, therapists
use a mixture of tactics, including (1) a focus on affect and
the expression of patients’ emotions; (2) an exploration of
patients’ attempts to avoid topics or hinder the progress of
therapy; (3) the identification of patterns in patients’ actions,
thoughts, feelings, experiences, and relationships; (4) an emphasis on past experiences; (5) a focus on interpersonal experiences; (6) an emphasis on the therapeutic relationship; and
(7) an exploration of patients’ wishes, dreams, or fantasies

Question 70

bf skinner and reinforcement- pg 53

Answer 70

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