Abnormal Psychology

Preface xxxi

individual in a case that was presented in a From the Inside or From the Outside

section. Students are asked to reread the case carefully and determine which DSM-

IV-TR criteria are met and are not met and whether there is enough information to

warrant a diagnosis. If the students would like more information in order to make

a diagnosis (or to decide whether a diagnosis is not appropriate), we ask them to

describe what information—specifi cally—they want and to explain how it would

inform their diagnosis. The Making a Diagnosis feature can be used as homework

or as a springboard for small-group or class discussions.

Making a Diagnosis

• Reread Case 12.1 about Emilio, and then determine whether or
  not his symptoms met the minimum criteria for a diagnosis of
  schizophrenia. Specifi cally, list which criteria apply and which
  ones do not. If you would like more information to determine
  his diagnosis, what information—specifi cally—would you want,
  and in what ways would the information influence your deci-
  sion? If you decide that a diagnosis of schizophrenia is appro-
  priate for Emilio, do you think he has the defi cit or nondefi cit
  subtype, and why?

End-Of-Chapter Review: Summing Up

The end-of-chapter review, called Summing Up, has three elements, each of which is

designed to help students further consolidate the material in memory and to foster

their critical thinking about the material (which itself furthers learning):

• Section summaries. These summaries repeat the important information in the end-

of-section summaries, allowing students to review what they have learned in the

broader context of the entire chapter’s material.

SUMMING UP

Summary of Depressive

Disorders

A major depressive episode (MDE) is the build-

ing block for a diagnosis of major depressive

disorder (MDD); when a person has an MDE,

he or she is diagnosed with MDD. Symptoms

of an MDE can arise in three areas: affect,

behavior, and cognition.

Depression is becoming increasingly prev-

alent in younger cohorts. Depression and anxi-

ety disorders have a high comorbidity—around

50%. MDD may arise with melancholic fea-

tures, catatonic features, or psychotic features.

Symptoms may also fall into less common pat-

terns, as in atypical depression and chronic

depression.

A diagnosis of dysthymic disorder re-

quires fewer symptoms than does a diagnosis

of MDD; however, the symptoms of dys thymic

disorder must persist for a longer time than do

symptoms of MDD. People who have both

dysthymic disorder and MDD are said to have

double depression.

Neurological factors related to depression

include low activity in the frontal lobes, and

abnormal functioning of dopamine, serotonin,

and norepinephrine. The stress–diathesis

model of depression highlights the role of in-

creased activity of the HPA axis and of excess

Thinking like a clinician

Suppose that a friend began to sleep through

morning classes, seemed uninterested in go-

ing out and doing things together, and became

quiet and withdrawn. What could you con-

clude or not conclude based on these observa-

tions? If you were concerned that these were

symptoms of depression, what other symp-

toms would you look for? What if your friend’s

symptoms did not appear to meet the criteria

for an MDE—what could you conclude or not

conclude? If your friend was, in fact, suffering

from depression, how might the three types of

factors explain the depressive episode? What

treatments might be appropriate?

Summary of Bipolar

Disorders

The four building blocks for diagnosing bipolar

disorders are major depressive episode (MDE),

manic episode, mixed episode, and hypomanic

episode. Symptoms of a manic episode include

grandiosity, pressured speech, fl ight of ideas,

distractibility, poor judgment, decreased need

for sleep, and psychomotor agitation. A mixed

episode is characterized by symptoms of both

an MDE and a manic episode and may include

psychotic features and suicidal thinking. A

hypomanic episode involves mood that is per-

Social factors that are associated with

bipolar disorders include disruptive life

changes and social and environmental stres-

sors. The different factors create feedback

loops that can lead to a bipolar disorder or

make the patient more likely to relapse.

Mood stabilizers are one treatment that

targets neurological factors; when manic,

patients may receive an antipsychotic medica-

tion or a benzodiazepine.

Treatment that targets psychological

factors—particularly CBT—helps patients

recognize warning signs of mood episodes,

develop better sleeping strategies, and, when

appropriate, stay on medication.

Treatments that target social factors

include interpersonal and social rhythm ther-

apy (IPSRT), which can increase the regularity

of daily events and decrease social stressors;

family therapy and education; and group ther-

apy or a self-help group, which is intended to

decrease shame and isolation.

Thinking like a clinician

You get in touch with a friend from high school

who tells you that she recently had a hypo-

manic episode. What are two possible DSM-

IV-TR diagnoses that she might have had (be

specifi c)? What will determine which diagno-

sis is most appropriate? What are a few of the

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