Contents Features xiii Unresolved Issues Are We All Becoming DSM-5: A Quick Guide xv Mentally Ill? The Expanding Horizons of Mental Disorder 29 Preface xvii Summary 30 About the Authors xxiii Key Terms 31 1 Abnormal Psychology: Overview 2 Earliest Views of Abnormal and Research Approaches 1 Behavior 32 What Do We Mean by Abnormality? 3 The First Views of Mental Disorders 33 Indicators of Abnormality 3 Demonology, Gods, and Magic 33 The World Around Us Extreme Generosity Hippocrates’ Early Medical Concepts 33 or Pathological Behavior? 6 Early Philosophical Conceptualizations of The DSM-5 and the Definition of Mental Disorder 7 Abnormal Behavior 34 Thinking Critically about DSM-5 What Is the DSM Developments in Thinking Melancholia and Why Was It Revised? 7 (Depression) Through the Ages 35 Classification and Diagnosis 8 Early Chinese Conceptualizations of What Are the Disadvantages of Classification? 8 Abnormal Behavior 36 How Can We Reduce Prejudicial Attitudes Toward Views of Abnormality During the Middle Ages 36 People Who Are Mentally Ill? 9 Views of Abnormal Behavior in the 1500s Culture and Abnormality 10 and 1600s 38 How Common Are Mental Disorders? 12 The Resurgence of Scientific Questioning Prevalence and Incidence 12 in Europe 38 Prevalence Estimates for Mental Disorders 13 The Establishment of Early Asylums 38 The Global Burden of Disease 15 Humanitarian Reform 39 Treatment 15 Pinel’s Experiment and Tuke’s Work in England 39 Mental Health Professionals 16 Rush and Moral Management in America 40 Research Approaches in Abnormal Psychology 16 Dix and the Mental Hygiene Movement 41 Sources of Information 17 Views of the Causes and Treatment of Mental Case Studies 17 Disorders in the 1800s and 1900s 42 Self-Report Data 18 Nineteenth Century Views of Mental Disorders and the Increasing Role of Psychiatrists 42 Observational Approaches 18 Mental Hospital Care in the Twentieth Century 42 Forming and Testing Hypotheses 19 The World Around Us Chaining Mental Health Sampling and Generalization 20 Patients 43 Internal and External Validity 20 Criterion and Comparison Groups 21 The Emergence of Modern Views of Abnormal Behavior 44 Correlational Research Designs 21 Biological Discoveries: Establishing the Link Measuring Correlation 22 Between the Brain and Mental Disorders 44 Statistical Significance 22 Developments in Research The Search Effect Size 23 for Medications to Cure Mental Disorders 45 Meta-Analysis 24 The Development of a Classification System Correlations and Causality 24 for Mental Disorders 46 Retrospective versus Prospective Strategies 24 Development of the Psychological Basis of The Experimental Method in Abnormal Psychology 25 Mental Disorder 46 Developments in Research The Importance of The Evolution of the Psychological Research Replication 25 Tradition: Experimental Psychology 48 Studying the Efficacy of Therapy 26 Unresolved Issues Deinstitutionalization 50 Single-Case Experimental Designs 27 Summary 51 Animal Research 29 Key Terms 52 iv vi Contents Stress and Mental Health 143 Panic Disorder 175 Adjustment Disorder 143 DSM-5 Criteria for. . . Panic Disorder 175 Adjustment Disorder Caused by Unemployment 144 Agoraphobia 176 Posttraumatic Stress Disorder 144 DSM-5 Criteria for. . . Agoraphobia 176 Thinking Critically about DSM-5 Changes to the Prevalence, Age of Onset, and Gender Differences 177 Diagnostic Criteria for PTSD 145 Comorbidity with Other Disorders 178 Acute Stress Disorder 146 The Timing of a First Panic Attack 178 Posttraumatic Stress Disorder: Causes Biological Causal Factors 178 and Risk Factors 146 Psychological Causal Factors 180 Prevalence of PTSD in the General Population 147 Developments in Research Nocturnal Rates of PTSD after Traumatic Experiences 147 Panic Attacks 182 DSM-5 Criteria for. . . Posttraumatic Treatments 183 Stress Disorder 148 Generalized Anxiety Disorder 185 Causal Factors in Posttraumatic Stress Disorder 150 DSM-5 Criteria for. . . Generalized Anxiety Disorder 185 Individual Risk Factors 150 Prevalence, Age of Onset, and Gender Differences 186 Biological Factors 151 Comorbidity with Other Disorders 187 Sociocultural Factors 152 Psychological Causal Factors 187 Long-Term Effects of Posttraumatic Stress 153 Biological Causal Factors 189 Prevention and Treatment of Stress Disorders 154 Treatments 190 Prevention 154 Obsessive-Compulsive and Related Disorders 190 Treatment for Stress Disorders 154 Obsessive-Compulsive Disorder 190 The World Around Us Does Playing Tetris Thinking Critically about DSM-5 Why Is OCD After a Traumatic Event Reduce Flashbacks? 155 No Longer Considered to Be an Anxiety Disorder? 191 Trauma and Physical Health 157 DSM-5 Criteria for. . . Obsessive-Compulsive The World Around Us Virtual Reality Exposure Disorder 191 Treatment for PTSD in Military Personnel 157 Prevalence, Age of Onset, and Unresolved Issues Why Is the Study of Trauma Gender Differences 193 So Contentious? 158 Comorbidity with Other Disorders 194 Summary 158 Psychological Causal Factors 194 Key Terms 160 Biological Causal Factors 195 6 Panic, Anxiety, Obsessions, and Treatments 197 Body Dysmorphic Disorder 199 Their Disorders 161 DSM-5 Criteria for. . . Body Dysmorphic The Fear and Anxiety Response Patterns 162 Disorder 199 Fear 162 Hoarding Disorder 202 Anxiety 163 Trichotillomania 203 Overview of the Anxiety Disorders and Cultural Perspectives 203 Their Commonalities 164 The World Around Us Taijin Kyofusho 204 DSM-5 Criteria for. . . Specific Phobia 165 Unresolved Issues The Choice of Treatments: Specific Phobias 165 Medication or Cognitive-Behavior Therapy? 205 Prevalence, Age of Onset, and Summary 205 Gender Differences 166 Key Terms 207 Psychological Causal Factors 166 Biological Causal Factors 168 7 Mood Disorders and Suicide 208 Treatments 169 Mood Disorders: An Overview 209 Social Anxiety Disorder 170 Types of Mood Disorders 209 DSM-5 Criteria for. . . Social Anxiety Disorder DSM-5 Criteria for. . . Manic Episode 210 (Social Phobia) 171 The Prevalence of Mood Disorders 210 Prevalence, Age of Onset, and Gender Differences 171 Unipolar Depressive Disorders 211 Psychological Causal Factors 172 Major Depressive Disorder 212 Biological Causal Factors 173 DSM-5 Criteria for. . . Major Depressive Disorder 212 Treatments 174 Persistent Depressive Disorder 215 A01_HOOL0906_18_SE_FM.indd Page 7 16/10/18 7:00 PM ganga /207/OHL00014/9780135190906_HOOLEY/HOOLEY_ABNORMAL_PSYCHOLOGY18_SE_9780135190906/ ... Contents vii DSM-5 Criteria for. . . Persistent DSM-5 Criteria for. . . Illness Anxiety Disorder 264 Depressive Disorder 215 Conversion Disorder (Functional Neurological Other Forms of Depression 216 Symptom Disorder) 264 Thinking Critically about DSM-5 Was It Wise to DSM-5 Criteria for. . . Conversion Disorder 265 Drop the Bereavement Exclusion for Major Range of Conversion Disorder Symptoms 265 Depression? 217 Important Issues in Diagnosing Developments in Thinking A New DSM-5 Conversion Disorder 266 Diagnosis: Premenstrual Dysphoric Disorder 217 Prevalence and Demographic Characteristics 266 Causal Factors in Unipolar Mood Disorders 218 Causes of Conversion Disorders 267 Biological Causal Factors 218 Developments in Research What Can Psychological Causal Factors 223 Neuroimaging Tell Us about Conversion Disorder? 267 Developments in Research Why Do Sex Treatment of Conversion Disorder 268 Differences in Unipolar Depression Emerge Developments in Practice Treatment of a Patient During Adolescence? 230 Who Was Mute 269 Bipolar and Related Disorders 233 Factitious Disorder 269 Cyclothymic Disorder 233 DSM-5 Criteria for. . . Factitious Disorder 269 Bipolar Disorders (I and II) 233 Identifying Factitious Disorder 269 Causal Factors in Bipolar Disorders 236 Distinguishing Between Different Types of Somatic Biological Causal Factors 236 Symptom and Related Disorders 270 Psychological Causal Factors 238 Dissociative Disorders: An Overview 271 Sociocultural Factors Affecting Unipolar Depersonalization/Derealization Disorder 272 and Bipolar Disorders 239 DSM-5 Criteria for. . . Depersonalization/ Cross-Cultural Differences in Derealization Disorder 274 Depressive Symptoms 239 Dissociative Amnesia 274 Cross-Cultural Differences in Prevalence 239 DSM-5 Criteria for. . . Dissociative Amnesia 275 Treatments and Outcomes 240 Thinking Critically about DSM-5 Where Does Pharmacotherapy 240 Conversion Disorder Belong? 277 Alternative Biological Treatments 242 Dissociative Identity Disorder 277 Psychotherapy 243 DSM-5 Criteria for. . . Dissociative Identity Disorder 278 Suicide: The Clinical Picture and the Causal Pattern 246 Who Attempts and Dies by Suicide? 247 Causal Factors and Controversies about DID 279 Psychological Disorders 248 The World Around Us DID, Schizophrenia, and Split Personality: Clearing Up the Confusion 279 The World Around Us Warning Signs for Suicide 249 Current Perspectives 282 Other Psychosocial Factors Associated with Suicide 250 Biological Factors 250 Cultural Factors, Treatments, and Outcomes in Dissociative Disorders 284 Theoretical Models of Suicidal Behavior 251 Cultural Factors in Dissociative Disorders 284 Suicide Prevention and Intervention 252 Treatment and Outcomes in Treatment of Mental Disorders 252 Dissociative Disorders 285 Crisis Intervention 252 Unresolved Issues DID and the Reality of Focus on High-Risk Groups and Other Measures 253 “Recovered Memories” 286 Unresolved Issues Is There a Right to Die? 253 Summary 287 Summary 254 Key Terms 289 Key Terms 256 8 Somatic Symptom and Dissociative 9 Eating Disorders and Obesity 290 Disorders 257 Clinical Aspects of Eating Disorders 292 Anorexia Nervosa 292 Somatic Symptom and Related Disorders: An Overview 258 DSM-5 Criteria for. . . Anorexia Nervosa 292 Somatic Symptom Disorder 259 Bulimia Nervosa 294 DSM-5 Criteria for. . . Somatic Symptom Disorder 259 DSM-5 Criteria for. . . Bulimia Nervosa 294 Causes of Somatic Symptom Disorder 260 Binge-Eating Disorder 295 Treatment of Somatic Symptom Disorder 262 DSM-5 Criteria for. . . Binge-Eating Disorder 296 Illness Anxiety Disorder 263 Age of Onset and Gender Differences 297 A01_HOOL0906_18_SE_FM.indd Page 9 16/10/18 7:00 PM ganga /207/OHL00014/9780135190906_HOOLEY/HOOLEY_ABNORMAL_PSYCHOLOGY18_SE_9780135190906/ ... Contents ix Causal Factors in Psychopathy 363 Treatments and Outcomes 399 Developmental and Social Perspectives on Hallucinogens 399 Psychopathy 365 LSD 399 Treatments and Outcomes in Mescaline and Psilocybin 399 Psychopathic Personality 366 Ecstasy 400 Unresolved Issues DSM-5: How Can We Marijuana 400 Improve the Classification of Personality The World Around Us Should Marijuana Be Disorders? 367 Marketed and Sold Openly as a Medication? 402 Summary 368 Gambling Disorder 403 Key Terms 370 DSM-5 Criteria for. . . Gambling Disorder 403 11 Substance-Related Disorders 371 Unresolved Issues Exchanging Addictions: Is This an Effective Treatment Approach? 405 Alcohol-Related Disorders 373 Summary 405 The Prevalence, Comorbidity, and Demographics of Key Terms 407 Alcohol Use Disorder 373 The Clinical Picture of Alcohol-Related Disorders 374 DSM-5 Criteria for. . . Alcohol Use Disorder 375 12 Sexual Dysfunctions, Gender Developments in Research Fetal Alcohol Dysphoria, and Paraphilic Syndrome: How Much Drinking Is Too Much? 377 Disorders 408 Causal Factors in Alcohol Use Disorder 379 Sexual Dysfunctions 409 Biological Causal Factors in Alcohol Use Disorder 379 DSM-5 Criteria for. . . Different Sexual Psychosocial Causal Factors in Alcohol Abuse Dysfunctions 410 and Dependence 380 Sexual Dysfunctions in Men 412 The World Around Us Binge Drinking Male Hypoactive Sexual Desire Disorder 412 in College 382 Erectile Disorder 413 Sociocultural Causal Factors 383 Premature (Early) Ejaculation 414 Treatment of Alcohol-Related Disorders 383 Delayed Ejaculation Disorder 415 Use of Medications in Treating Alcohol Abuse and Dependency 384 Sexual Dysfunctions in Women 415 Psychological Treatment Approaches 384 Female Sexual Interest/Arousal Disorder 415 Controlled Drinking versus Abstinence 386 Genito-Pelvic Pain/Penetration Disorder 416 Alcoholics Anonymous 386 Female Orgasmic Disorder 417 Outcome Studies and Issues in Treatment 387 Gender Dysphoria 418 Relapse Prevention 388 The Clinical Picture 418 Substance Use Disorder 388 DSM-5 Criteria for. . . Gender Dysphoria in Opium and Its Derivatives 389 Children 418 Biological Effects of Morphine and Heroin 390 DSM-5 Criteria for. . . Gender Dysphoria in Social Effects of Morphine and Heroin 391 Adolescents and Adults 418 Causal Factors in Opiate Abuse and Dependence 391 Treatment for Gender Dysphoria 420 Neural Bases for Physiological Addiction 392 Paraphilic Disorders 420 Addiction Associated with Psychopathology 393 Voyeuristic Disorder 421 Treatments and Outcomes 393 DSM-5 Criteria for. . . Several Different Stimulants 393 Paraphilic Disorders 422 Cocaine 393 Exhibitionistic Disorder 422 Amphetamines 394 Frotteuristic Disorder 423 Methamphetamine 395 Sexual Sadism Disorder 423 Thinking Critically about DSM-5 Can Changes Sexual Masochism Disorder 425 to the Diagnostic Criteria Result in Increased Fetishistic Disorder 425 Drug Use? 396 Transvestic Disorder 426 Caffeine and Nicotine 396 Causal Factors and Treatments for Paraphilic Disorders 427 Sedatives 398 Effects of Barbiturates 398 Sexual Abuse 427 Causal Factors in Barbiturate Abuse Childhood Sexual Abuse 428 and Dependence 398 Pedophilic Disorder 429 A01_HOOL0906_18_SE_FM.indd Page 10 16/10/18 7:00 PM ganga /207/OHL00014/9780135190906_HOOLEY/HOOLEY_ABNORMAL_PSYCHOLOGY18_SE_9780135190906/ ... x Contents Thinking Critically about DSM-5 Pedophilia and Cytoarchitecture 467 Hebephilia 430 Brain Development in Adolescence 467 Incest 431 Synthesis 468 Rape 432 Neurochemistry 468 Treatment and Recidivism of Sex Offenders 434 Psychosocial and Cultural Factors 471 The World Around Us Megan’s Law 435 Do Bad Families Cause Schizophrenia? 471 Unresolved Issues How Harmful Is Childhood Families and Relapse 471 Sexual Abuse? 437 Urban Living 473 Summary 438 Immigration 473 Key Terms 439 Cannabis Use and Abuse 474 A Diathesis–Stress Model of Schizophrenia 475 13 Schizophrenia and Other Treatments and Outcomes 476 Psychotic Disorders 440 Clinical Outcome 476 Pharmacological Approaches 477 Schizophrenia 441 Psychosocial Approaches 479 Origins of the Schizophrenia Construct 441 Unresolved Issues Why Are Recovery Rates in Epidemiology 442 Schizophrenia Not Improving? 481 Clinical Picture 443 Summary 482 Delusions 443 Key Terms 483 DSM-5 Criteria for. . . Schizophrenia 444 Hallucinations 444 14 Neurocognitive Disorders 484 The World Around Us Stress, Caffeine, and Brain Impairment in Adults 485 Hallucinations 445 Clinical Signs of Brain Damage 486 Disorganized Speech 446 Thinking Critically about DSM-5 Is the Inclusion Disorganized Behavior 446 of Mild Neurocognitive Disorder a Good Idea? 486 Negative Symptoms 447 Diffuse versus Focal Damage 487 Other Psychotic Disorders 447 The Neurocognitive/ Schizoaffective Disorder 448 Psychopathology Interaction 489 DSM-5 Criteria for. . . Schizoaffective Disorder 448 Delirium 490 Schizophreniform Disorder 448 Clinical Picture 490 DSM-5 Criteria for. . . Schizophreniform Disorder 448 DSM-5 Criteria for. . . Delirium 490 Delusional Disorder 448 Treatments and Outcomes 491 DSM-5 Criteria for. . . Delusional Disorder 449 Major Neurocognitive Disorder 491 Brief Psychotic Disorder 449 DSM-5 Criteria for. . . Major DSM-5 Criteria for. . . Brief Psychotic Disorder 449 Neurocognitive Disorder 492 Genetic and Biological Factors 449 Parkinson’s Disease 492 Genetic Factors 450 Huntington’s Disease 493 The World Around Us The Genain Quadruplets 451 Alzheimer’s Disease 494 Prenatal Exposures 456 Clinical Picture 494 Developments in Thinking Could Schizophrenia Prevalence 495 Be an Immune Disorder? 457 Causal Factors 496 Genes and Environment in Schizophrenia: Neuropathology 498 A Synthesis 458 Developments in Research Depression Increases A Neurodevelopmental Perspective 459 the Risk of Alzheimer’s Disease 498 Thinking Critically about DSM-5 Attenuated Treatment and Outcome 500 Psychosis Syndrome 461 Early Detection 500 Structural and Functional Brain Abnormalities 461 Developments in Research New Approaches to Neurocognition 461 the Treatment of Alzheimer’s Disease 501 Social Cognition 463 Supporting Caregivers 502 Loss of Brain Volume 463 The World Around Us Exercising Your Way to a Affected Brain Areas 465 Healthier Brain? 502 White Matter Problems 465 Neurocognitive Disorder Resulting from Brain Functioning 465 Vascular Problems 503 xii Contents 17 Societal and Legal Issues in Organized Efforts for Mental Health 600 The Federal Government and Mental Health 600 Abnormal Psychology 585 Professional Organizations and Mental Health 601 Perspectives on Prevention 586 The Role of Volunteer Organizations and Agencies 601 Universal Interventions 586 Mental Health Resources in Private Industry 601 Selective Interventions 588 The World Around Us International Efforts Indicated Interventions 590 for Mental Health 602 Inpatient Mental Health Treatment 590 Challenges for the Future 603 The Mental Hospital as a Therapeutic Community 590 The Need for Planning 603 Aftercare Programs 591 The Individual’s Contribution 603 Involuntary Commitment 592 Unresolved Issues What Is the Goldwater Rule Civil Commitment 592 and Why Is It Important Now? 604 Assessment of “Dangerousness” 593 Summary 606 Therapists and the Duty to Warn 594 Key Terms 607 Patients’ Rights 595 The Insanity Defense 596 Glossary 608 Notable NGRI Cases 596 References 631 What Exactly Do We Mean by Insanity? 598 Name Index 703 Competence to Stand Trial 599 Subject Index 721 Mental Health Problems and Recidivism 600 A01_HOOL0906_18_SE_FM.indd Page 14 16/10/18 7:00 PM ganga /207/OHL00014/9780135190906_HOOLEY/HOOLEY_ABNORMAL_PSYCHOLOGY18_SE_9780135190906/ ... xiv Features Do Psychiatric Medications Help or Harm? 583 DSM-5 Criteria for. . . Different Sexual Dysfunctions 410 What Is the Goldwater Rule and Why Is It DSM-5 Criteria for. . . Gender Dysphoria in Children 418 Important Now? 604 DSM-5 Criteria for. . . Gender Dysphoria in Adolescents and Adults 418 DSM-5 Boxes DSM-5 Criteria for. . . Several Different Paraphilic DSM-5 Criteria for. . . Posttraumatic Stress Disorder 148 Disorders 422 DSM-5 Criteria for. . . Specific Phobia 165 DSM-5 Criteria for. . . Schizophrenia 444 DSM-5 Criteria for. . . Social Anxiety Disorder DSM-5 Criteria for. . . Schizoaffective Disorder 448 (Social Phobia) 171 DSM-5 Criteria for. . . Schizophreniform Disorder 448 DSM-5 Criteria for. . . Panic Disorder 175 DSM-5 Criteria for. . . Delusional Disorder 449 DSM-5 Criteria for. . . Agoraphobia 176 DSM-5 Criteria for. . . Brief Psychotic Disorder 449 DSM-5 Criteria for. . . Generalized Anxiety Disorder 185 DSM-5 Criteria for. . . Delirium 490 DSM-5 Criteria for. . . Obsessive-Compulsive Disorder 191 DSM-5 Criteria for. . . Major Neurocognitive DSM-5 Criteria for. . . Body Dysmorphic Disorder 199 Disorder 492 DSM-5 Criteria for. . . Manic Episode 210 DSM-5 Criteria for. . . Conduct Disorder 522 DSM-5 Criteria for. . . Major Depressive Disorder 212 DSM-5 Criteria for. . . Attention-Deficit/Hyperactivity DSM-5 Criteria for. . . Persistent Depressive Disorder 215 Disorder 527 DSM-5 Criteria for. . . Somatic Symptom Disorder 259 DSM-5 Criteria for. . . Autism Spectrum Disorder 530 DSM-5 Criteria for. . . Illness Anxiety Disorder 264 Thinking Critically About DSM-5 DSM-5 Criteria for. . . Conversion Disorder 265 DSM-5 Criteria for. . . Factitious Disorder 269 What Is the DSM and Why Was It Revised? 7 DSM-5 Criteria for. . . Depersonalization/Derealization Changes to the Diagnostic Criteria for PTSD 145 Disorder 274 Why Is OCD No Longer Considered to Be an Anxiety DSM-5 Criteria for. . . Dissociative Amnesia 275 Disorder? 191 DSM-5 Criteria for. . . Dissociative Identity Disorder 278 Was It Wise to Drop the Bereavement Exclusion for Major Depression? 217 DSM-5 Criteria for. . . Anorexia Nervosa 292 Where Does Conversion Disorder Belong? 277 DSM-5 Criteria for. . . Bulimia Nervosa 294 Other Forms of Eating Disorders 298 DSM-5 Criteria for. . . Binge-Eating Disorder 296 Why Were No Changes Made to the Way Personality DSM-5 Criteria for. . . Paranoid Personality Disorder 335 Disorders Are Diagnosed? 332 DSM-5 Criteria for. . . Schizoid Personality Disorder 336 Nonsuicidal Self-Injury: Distinct Disorder or DSM-5 Criteria for. . . Schizotypal Personality Disorder 337 Symptom of Borderline Personality Disorder? 346 DSM-5 Criteria for. . . Histrionic Personality Disorder 338 Can Changes to the Diagnostic Criteria Result in DSM-5 Criteria for. . . Narcissistic Personality Disorder 340 Increased Drug Use? 396 DSM-5 Criteria for. . . Antisocial Personality Disorder 342 Pedophilia and Hebephilia 430 DSM-5 Criteria for. . . Borderline Personality Disorder 347 Attenuated Psychosis Syndrome 461 DSM-5 Criteria for. . . Avoidant Personality Disorder 350 Is the Inclusion of Mild Neurocognitive Disorder a DSM-5 Criteria for. . . Dependent Personality Disorder 351 Good Idea? 486 DSM-5 Criteria for. . . Obsessive-Compulsive What Role Should Cultural Changes Have in Personality Disorder 353 Developing Medical Terminology? 537 DSM-5 Criteria for. . . Alcohol Use Disorder 375 What Are Some of the Clinical Implications of the DSM-5 Criteria for. . . Gambling Disorder 403 Recent Changes? 578 A01_HOOL0906_18_SE_FM.indd Page 15 16/10/18 7:00 PM ganga /207/OHL00014/9780135190906_HOOLEY/HOOLEY_ABNORMAL_PSYCHOLOGY18_SE_9780135190906/ ... DSM-5: A Quick Guide Many changes occurred from DSM-IV-TR to • Premenstrual dysphoric disorder has been promoted DSM-5. Here is a summary of some of the most from the appendix of DSM-IV-TR and is now listed as important revisions. Many of these changes are a new diagnosis. highlighted in the “Thinking Critically about DSM-5” • A new diagnosis of persistent depressive disorder now boxes throughout this edition. subsumes dysthymia and chronic major depressive disorder. • The chapters of the DSM have been reorganized to reflect a consideration of developmental and lifespan • The bereavement exclusion has been removed in the issues. Disorders that are thought to reflect develop- diagnosis of major depressive episode. mental perturbations or that manifest early in life (e.g., • The diagnosis of phobia no longer requires that the per- neurodevelopmental disorders and disorders such as son recognize that his or her anxiety is unreasonable. schizophrenia) are listed before disorders that occur • Panic disorder and agoraphobia have been unlinked later in life. and are now separate diagnoses in DSM-5. • The multiaxial system has been abandoned. No • Obsessive-compulsive disorder is no longer classified as distinction is now made between Axis I and Axis II an anxiety disorder. DSM-5 contains a new chapter that disorders. covers obsessive-compulsive and related disorders. • DSM-5 allows for more gender-related differences to be • New disorders in the obsessive-compulsive and related taken into consideration for mental health problems. disorders category include hoarding disorder and exco- • It is extremely important for the clinician to understand riation (skin-picking) disorder. the client’s cultural background in appraising mental • Posttraumatic stress disorder is no longer considered to health problems. DSM-5 contains a structured inter- be an anxiety disorder. Instead, it is listed in a new chap- view that focuses on the patient’s cultural background ter that covers trauma- and stressor-related disorders. and characteristic approach to problems. • The diagnostic criteria for posttraumatic stress disorder • The term intellectual disability is now used instead of the have been significantly revised. The definition of what term mental retardation. counts as a traumatic event has been clarified and made • A new diagnosis of autism spectrum disorder now more explicit. DSM-5 now also recognizes four-symp- encompasses autism, Asperger’s disorder, and other tom clusters rather than the three noted in DSM-IV-TR. forms of pervasive developmental disorder. The diag- • Dissociative fugue is no longer listed as a separate diag- nosis of Asperger’s disorder has been eliminated from nosis. Instead, it is listed as a form of dissociative amnesia. the DSM. • The DSM-IV-TR diagnoses of hypochondriasis, somato- • Changes to the diagnostic criteria for attention deficit form disorder, and pain disorder have been removed disorder now mean that symptoms that occur before and are now subsumed into the new diagnosis of age 12 (rather than age 7) have diagnostic significance. somatic symptom disorder. • A new diagnosis, called disruptive mood dysregulation • Binge-eating disorder has been moved from the appendix disorder, has been added. This will be used to diagnose of DSM-IV-TR and is now listed as an official diagnosis. children up to age 18 who show persistent irritability • The frequency of binge-eating and purging episodes and frequent episodes of extreme and uncontrolled has been reduced for the diagnosis of bulimia nervosa. behavior. • Amenorrhea is no longer required for the diagnosis of • The subtypes of schizophrenia have been eliminated. anorexia nervosa. • The special significance afforded to bizarre delusions • The DSM-IV-TR diagnoses of dementia and amnestic dis- with regard to the diagnosis of schizophrenia has been order have been eliminated and are now subsumed into removed. a new category called major neurocognitive disorder. • Bipolar and related disorders are now described in a • Mild neurocognitive disorder has been added as a new separate chapter of the DSM and are no longer listed diagnosis. with depressive disorders. xv A01_HOOL0906_18_SE_FM.indd Page 16 16/10/18 7:00 PM ganga /207/OHL00014/9780135190906_HOOLEY/HOOLEY_ABNORMAL_PSYCHOLOGY18_SE_9780135190906/ ... xvi DSM-5: A Quick Guide • No changes have been made to the diagnostic criteria • Included for the first time in Section III of DSM-5 are for personality disorders, although an alternative several new disorders regarded as being in need of model is now offered as a guide for future research. further study. These include attenuated psychosis • Substance-related disorders are divided into two sepa- syndrome, nonsuicidal self-injury disorder, Internet rate groups: substance use disorders and substance- gaming disorder, and caffeine use disorder. induced disorders. • A new disorder, gambling disorder, has been included in substance-related and addictive disorders.