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UNIT 12
Abnormal Psychology
OUTLINE OF RESOURCES
I.
Introducing Abnormal Psychology
Introductory Exercise: Fact or Falsehood? (p. 4)
Lecture/Discussion Topic: Using Case Studies to Teach Psychological Disorders (p. 4)
Student Project: Diagnosing a “Star” (p. 4)
Feature Films and TV: Introducing Psychological Disorders (p. 4)
II. Perspectives on Psychological Disorders
A. Defining Psychological Disorders
Classroom Exercises: Introducing Psychological Disorders (p. 5)
Defining Psychological Disorder (p. 5)
Student Project: Encounters with a “Mentally Ill” Person (p. 6)
Student Projects/Classroom Exercises: Adult ADHD Screening Test (p. 6)
Normality and the Sexes (p. 7)
Psychology Video Tool Kit: ADHD and the Family*
B. Understanding Psychological Disorders
Lecture/Discussion Topics: Tourette Syndrome (p. 7)
Culture-Bound Disorders (p. 8)
Classroom Exercise: Multiple Causation (p. 8)
Video: Scientific American Frontiers, 2nd ed., Segment 33: Cop Psychiatrists*
C. Classifying Psychological Disorders
PsychSim 5: Mystery Client (p. 9) (or might be used after the unit has been read)
D. Labeling Psychological Disorders
Classroom Exercise: The Effects of Labeling (p. 9)
Lecture/Discussion Topic: Mental Health as Flourishing (p. 9)
Psychology Video Tool Kit: Postpartum Psychosis:The Case of Andrea Yates*
III. Anxiety Disorders
Classroom Exercise: Penn State Worry Questionnaire (p. 10)
Video: Psychology: The Human Experience, Module 37: Three Anxiety Disorders*
ActivePsych: Digital Media Archive, 2nd ed.: Experiencing Anxiety*
*Video, ActivePsych, and Psychology Video Tool Kit titles followed by an asterisk are not repeated within the core
resource unit. They are listed, with running times, in the Preface of these resources and described in detail in their
Faculty Guides, which are available at www.worthpublishers.com/mediaroom.
1
2 Unit 12 Abnormal Psychology
A. Generalized Anxiety Disorder
Classroom Exercises: Taylor Manifest Anxiety Scale (p. 10)
The Posttraumatic Cognitions Inventory (PTCI) (p. 11)
B. Panic Disorder
C. Phobias
Lecture/Discussion Topic: Discovery Health Channel Phobia Study (p. 11)
Classroom Exercises: Fear Survey (p. 12)
Social Phobia (p. 12)
Video: Scientific American Frontiers, 2nd ed., Segment 32: Arachnophobia*
D. Obsessive-Compulsive Disorder
Lecture/Discussion Topic: Obsessive Thoughts (p. 14)
Classroom Exercise: Obsessive-Compulsive Disorder (p. 13)
Feature Film: As Good As It Gets and OCD (p. 13)
Video: Psychology: The Human Experience, Module 36: Obsessive-Compulsive Disorder*
Psychology Video Tool Kit: Obessive-Compulsive Disorder: A Young Mother’s Struggle*
Those Who Hoard*
E. Post-Traumatic Stress Disorder
Lecture/Discussion Topic: Concentration Camp Survival (p. 15)
Psychology Video Tool Kit: Post-Traumatic Stress Disorder: A Vietnam Combat Veteran*
PTSD: Returning from Iraq*
F.
Understanding Anxiety Disorders
Psychology Video Tool Kit: Fear, PTSD, and the Brain*
IV. Somatoform Disorders
Lecture/Discussion Topic: Factitious Disorder (p. 15)
Psychology Video Tool Kit: Beyond Perfection: Female Body Dysmorphic Disorder*
V. Dissociative Disorders
Classroom Exercise: The Curious Experiences Inventory (p. 16)
Lecture/Discussion Topic: Psychogenic Versus Organic Amnesia (p. 16)
A. Dissociative Identity Disorder
Lecture/Discussion Topic: The Dissociative Disorders Interview Schedule and Dissociative Identity Disorder
(p. 17)
Videos: The Brain, 2nd ed., Module 23: Multiple Personality*
Digital Media Archive: Psychology, 1st ed., Video Clip 31: Multiple Personality Disorder*
B. Understanding Dissociative Identity Disorder
VI. Mood Disorders
A. Major Depressive Disorder
Classroom Exercises: Depression Scales (p. 17)
The Automatic Thoughts Questionnaire (p. 18)
Depression and Memory (p. 18)
Loneliness (p. 18)
Video: Psychology: The Human Experience, Module 38: Mood Disorders: Major Depression and Bipolar
Disorder*
Psychology Video Tool Kit: Depression*
Unit 12 Abnormal Psychology 3
B. Bipolar Disorder
Lecture/Discussion Topic: Bipolar Disorder (p. 19)
Video: The Mind, 2nd ed., Module 31: Mood Disorders: Mania and Depression*
C. Understanding Mood Disorders
Lecture/Discussion Topics: The Sadder-but-Wiser Effect (p. 20)
Cognitive Errors in Depression (p. 21)
Commitment to the Common Good (p. 25)
Classroom Exercises: Attributions for an Overdrawn Checking Account (p. 21)
The Body Investment Scale and Self-Mutilation (p. 22)
Understanding Suicide (p. 23)
The Expanded Revised Facts on Suicide Quiz (p. 24)
Videos: The Mind, 2nd ed., Module 32: Mood Disorders: Hereditary Factors*
Digital Media Archive: Psychology, 1st ed., Video Clip 33: Mood Disorders*
Psychology Video Tool Kit: Suicide: Case of the “3-Star” Chef*
VII. Schizophrenia
A. Symptoms of Schizophrenia
Classroom Exercise: Magical Ideation Scale (p. 26)
Lecture/Discussion Topic: Infantile Autism (p. 26)
Student Project: The Eden Express and Schizophrenia (p. 26)
Videos: The Brain, 2nd ed., Module 26: Schizophrenia: Symptoms*
Psychology: The Human Experience, Module 39: Schizophrenia*
The Brain, 2nd ed., Module 29: Autism*
PsychSim 5: Losing Touch With Reality (p. 26)
ActivePsych: Digital Media Archive, 2nd ed.: Schizophrenia: New Definitions, New Therapies*
Overcoming Schizophrenia: John Nash’s Beautiful Mind*
Psychology Video Tool Kit: John Nash: “A Beautiful Mind”*
B. Onset and Development of Schizophrenia
C. Understanding Schizophrenia
Videos: The Brain, 2nd ed., Module 27: Schizophrenia: Etiology*
Digital Media Archive: Psychology, 1st ed., Video Clip 29: The Schizophrenic Brain*
VIII.
Personality Disorders
Lecture/Discussion Topic: Narcissistic Personality Disorder (p. 27)
Classroom Exercise: Schizotypal Personality Questionnaire (p. 28)
Psychology Video Tool Kit: Trichotillomania: Pulling Out One’s Hair*
A. Antisocial Personality Disorder
Classroom Exercise: Antisocial Personality Disorder (p. 28)
Feature Film: In Cold Blood (p. 29)
B. Understanding Antisocial Personality Disorder
Videos: The Mind, 2nd ed., Module 35: The Mind of the Psychopath*
Digital Media Archive: Psychology, 1st ed., Video Clip 30: The Mind of the Psychopath*
IX. Rates of Psychological Disorders
Lecture/Discussion Topic: The Commonality of Psychological Disorders (p. 29)
4 Unit 12 Abnormal Psychology
UNIT OUTLINE
I.
times (from appearance of the production company’s
full name to the start of the clip):
Introducing Abnormal Psychology
(pp. 561–562)
Introductory Exercise: Fact or Falsehood?
The correct answers to Handout 12–1, as shown below,
can be confirmed on the listed text pages.
1.
2.
3.
4.
5.
F (p. 562)
F (p. 568)
F (p. 568)
T (p. 569)
T (p. 575)
6.
7.
8.
9.
10.
F (p. 578)
T (p. 583)
T (p. 584)
T (pp. 594–595)
T (p. 599)
Lecture/Discussion Topic: Using Case Studies to Teach
Psychological Disorders
You can effectively teach psychological disorders using
a case study approach. Beyond those presented in the
text, Robert L. Spitzer’s DSM-IV-TR Case Book provides an extremely useful resource for examples of all
the major disorders. Each case is brief and is followed
by a discussion of the DSM-IV-TR diagnostic issues
raised. You can use them to introduce each major category of disorder. Alternatively, after students have read
the text, the cases can be presented as puzzles to solve,
either to your class as a whole or in small groups.
Spitzer, R. L. (Ed). (2002). DSM-IV-TR casebook: A
learning companion to the Diagnostic and Statistical
Manual of Mental Disorders (4e). Arlington, VA:
American Psychiatric Publishing.
Feature Films and TV: Introducing Psychological
Disorders
Psychological disorders are frequently depicted in novels, short stories, television programs, and popular
films. Amy Badura recommends several specific movie
clips for introducing and stimulating student interest in
the topic. All are very brief and illustrate different classes of disorders.
Before showing the clips you might ask students to
watch with the following questions in mind: Where
should we draw the line between normality and abnormality? How should we define psychological disorders?
How should we understand disorders—as sicknesses
that need to be diagnosed and cured or as natural
responses to a troubling environment? After showing
the clips and eliciting student responses, highlight the
text definition. Many mental health workers label
behavior as disordered when they judge it to be deviant,
distressful, and dysfunctional. You may also want to
identify the specific disorders illustrated by the clips or
wait until you discuss each disorder more fully. Here
are the films, scenes, specific disorders, and running
1. Con Air: voice-over introduction to John
Malkovich’s character as he enters the airplane:
antisocial personality disorder (0:15:16–0:15:57)
2. The English Patient: Juliette Binoche rides in a caravan with her patient, her best friend’s jeep hits a
landmine, her reaction: acute stress disorder
(0:10:45– 0:14:52)
3. As Good As It Gets: Jack Nicholson visits Greg
Kinnear’s apartment and finds him upset: major
depressive disorder (0:58:14–1:00:41) (See also
later discussion of use of this film.)
4. Primal Fear: Jailhouse interview in which Ed
Norton displays personality switch for his attorney:
dissociative identity disorder (1:12:00–1:15:41)
5. Copy Cat: Sigourney Weaver retrieves a newspaper
from her apartment hallway: panic disorder with
agoraphobia (0:19:11–0:20:39)
Television programs also provide a ready source of
material for classroom presentation and student projects. You might have your students (individually or in
small groups) identify examples from popular TV
shows. For example, the popular, Emmy-winning comedy Monk provided a good example of OCD (all seasons
are available on DVD).
For more on the use of contemporary film in teaching psychological disorders, see Danny Wedding, Mary
Ann Boyd, and Ryan Niemiec’s Movies and Mental
Illness: Using Films to Understand Psychopathology
2nd ed. (2005, Hogrefe).
Recently, Wedding, Boyd, and Niemiec also
authored a 75-page resource guide titled Films
Illustrating Psychopathology. The guide provides brief
descriptions of hundreds of films that can be used to
illustrate various psychological disorders. The films
(each rated on a 5-point scale) are classified according
to major category (e.g., anxiety disorders, mood disorders, substance use disorders). This very helpful guide
can be found at the Office of Teaching Resources in
Psychology (sponsored by the Society for the Teaching
of Psychology). See http://teachpsych.org/otrp/
resources/dw08film.pdf
Badura, A. S. (2002). Capturing students’ attention:
Movie clips set the stage for learning in abnormal psychology. Teaching of Psychology, 29, 58–60.
Student Project: Diagnosing a “Star”
W. Brad Johnson describes a well-received student project that he has used for his abnormal psychology
course; it can readily be adapted to the introductory
course either as an individual or small-group project. It
provides an excellent opportunity for students “to think
Unit 12 Abnormal Psychology 5
like a psychologist” in applying this unit’s subject matter. The assignment is for students to select any “star”
or famous person (a musician, movie star, politician,
historical figure, or criminal) whom they believe has a
clinical disorder. Students should prepare an oral or
written report on that person, including the identification of symptoms that reflect one of the specific disorders covered in the text and some discussion of possible
causes and treatment recommendations. Encourage students to use magazines, books, Internet sites, and even
television interviews for making their case. It is important that their report be consistent with existing evidence about the person’s behavior and symptoms.
Johnson, W. B. (2004). Diagnosing the stars: A technique
for teaching diagnosis in abnormal psychology. Teaching
of Psychology, 31, 275–277.
II. Perspectives on Psychological Disorders
(pp. 562–568)
A. Defining Psychological Disorders (pp. 562–563)
Classroom Exercise: Introducing Psychological
Disorders
Steven M. Davis provides an effective exercise for
introducing psychological disorders. Davis notes that,
although the concept of “mental” or psychological disorder is familiar to students, their beliefs about what
constitutes a disorder are unexamined and may even be
contradictory. Handout 12–2 (which Davis reports
adapting from a similar exercise designed by John
Suler) challenges students to define psychological disorder as well as confront any inconsistencies in their
beliefs. The handout also serves to raise important political, cultural, and social issues concerning the definition of psychological disorders.
Before students have read the text definition of
psychological disorder, have them read through the case
studies quickly and decide whether the person has a
“psychological disorder.” Then organize students into
groups of four or five, and instruct each group to pretend that they are a committee that is advising the
American Psychiatric Association on the writing of the
DSM-V. They are to decide whether each case should
be included as a psychological disorder in the DSM-V.
They are to try to reach agreement and, most importantly, to keep track of the criteria they use for including or
excluding each case.
After about 25 minutes, reconvene the entire class
and consider each case in turn. Write on the chalkboard
the criteria that each group identified for including or
excluding each case. Note consistencies as well as contradictions between the small groups. Finally, introduce
the text definition of psychological disorder.
Davis notes that this activity provides numerous
learning opportunities for students. For example, students are often surprised to discover inconsistencies in
how they define psychological disorders and are also
surprised at the arbitrariness inherent in any “official”
definition. Sometimes, students discover that they want
to exclude all cases that have a clear biological etiology
as well as all cases that have a clear environmental origin—which theoretically leaves very few examples of
psychological disorders. Issues surrounding stigma,
labeling, the medical model, cultural relativism, and
person-environment fit are also likely to arise.
Davis, S. M. (2003, January). Utilizing contradictions in
students’ implicit definitions of “mental disorder” in an
introductory psychology course. Poster presented at the
25th Annual National Institute on the Teaching of
Psychology, St. Petersburg, FL, January 2003.
Classroom Exercise: Defining Psychological Disorder
As a simple alternative to the previous exercise, have
students form small groups of four or five and come up
with a definition for “psychological disorder.” Instruct
them to be specific, identifying the criteria they would
apply in drawing the line between normality and abnormality. After 20 to 30 minutes, have each group report
its definition to the class. Inadequacies are certain to be
pointed out, and the rest of the session can be spent in
considering the difficulty of satisfactorily defining the
term. The text. indicates that behavior is considered
disordered when it is deviant, distressful, and
dysfunctional.
In highlighting each of these criteria, Larry Bates
makes some important observations. First, what is considered deviant depends on the context or cultural setting. For example, should someone speak in an unfamiliar language while standing, dancing, and finally fainting in front of class, the behavior might be considered
deviant (Bates suggests that should it occur in his class,
he would probably call an ambulance!). Yet for some
religious groups, such behavior is considered normal,
even laudatory.
In some cases, deviance may be extremely difficult
to detect. Some people seem fine on the outside—smiling, joking, performing their work well each day, and
putting their kids to bed every night. Unknown to us,
however, they may cry themselves to sleep because they
no longer find life enjoyable or meaningful. When they
engage in the activities that once brought pleasure, they
feel nothing. In such cases, internal distress more clearly characterizes the psychological disorder.
Finally, almost all disorders have a threshold they
must cross that meets the requirements of a psychological disorder. If a person is terrified of flying but has no
real reason to fly, the fear is probably not considered a
6 Unit 12 Abnormal Psychology
psychological disorder. Only when this fear interferes
with the person’s daily life—for example, if he or she is
promoted to regional manager and must travel—is it
considered dysfunctional and thus a psychological
disorder.
Bates, L. (2007, January 3). Abnormal/atypical. Message
posted to PSYCHTEACHER@ list.kennesaw.edu.
Student Project: Encounters with a “Mentally Ill”
Person
Irwin and Barbara Sarason suggest an exercise you
might use to introduce the topic of psychological disorders. As compared with 30 years ago, when most chronic mental patients were institutionalized, it is now much
more likely that students will have encountered a person
with a chronic mental disorder in the supermarket, at
the shopping mall, on the bus, or on the street corner.
Ask your students to recall one incident in which they
have personally encountered a chronic “mentally ill”
person. Ask them to reflect on what happened, then
write down the details of that encounter. What made
them decide the person was mentally ill? Also ask them
to indicate whether they felt comfortable or uncomfortable, whether the person’s behavior seemed predictable
or unpredictable, and whether the person seemed dangerous or nondangerous.
It may also be worth asking where the encounter
occurred, whether other people were present, and
whether the mentally disordered person actually
approached or spoke to them. Collect the accounts and
tabulate the number of students who found the encounters to be uncomfortable, unpredictable, and dangerous.
As the Sarasons note, research on public attitudes has
shown that most people feel uncomfortable with the
mentally ill and find their behavior to be both unpredictable and dangerous. Did the students react that way?
Did they observe similar reactions in others? If not,
how might the setting, the presence or absence of other
people, and the actions of the psychologically disordered person change one or more of their reactions?
Use the students’ descriptions to define “psychological disorder.” The students’ examples will illustrate
how behavior is considered psychologically disordered
when it is deviant, distressful, and dysfunctional.
Sarason, I., & Sarason, B. (2005). Abnormal psychology
(11th ed.). Upper Saddle River, NJ: Prentice Hall.
Student Project/Classroom Exercise: Adult ADHD
Screening Test
Handout 12–3, designed by the World Health
Organization, can be used to help respondents recognize
the signs of adult attention-deficit hyperactivity disorder (ADHD) (see the Thinking Critically box for a good
introduction to the disorder). The questionnaire is not
meant to replace consultation with a trained professional—obviously, an accurate diagnosis can be made only
through clinical evaluation—but respondents who
checked “sometimes,” “often,” or “very often” four or
more times may want to talk with a psychologist about
being evaluated for ADHD.
Researchers estimate that as many as 4 to 5 percent
of U.S. adults have ADHD, but perhaps only 20 percent
of them are aware of it. Although ADHD was once considered to be only a childhood disorder that was outgrown, researchers now believe that between 35 and 60
percent of children with ADHD continue having symptoms in adulthood. Some people who did not have
symptoms as children in school do have difficulty multitasking in adulthood. Furthermore, because awareness
of the disorder is relatively recent, some adults now in
their thirties and forties may have had the disorder as
children but their symptoms were not recognized.
ADHD tends to run in families. Psychiatrist Lenard
Adler of New York University suggests that if a child is
diagnosed with ADHD, there is a 40 percent chance that
one parent has it as well. Factors such as exposure to
alcohol and tobacco in pregnancy are also linked with
the condition. Although boys are more likely than girls
to be diagnosed with the disorder, adult ADHD affects
men and women equally. Some hypothesize that girls
are less likely to be disruptive in the classroom, and
thus teachers may be more likely to overlook it.
Adults with the disorder are easily distracted, frequently forget appointments, and constantly lose things.
They may fidget, talk excessively, and feel an internal
restlessness. Other symptoms include a failure to follow
through on instructions or finish a task, difficulty
organizing, and an inability to attend to details. “One of
the tell-tale signs is when someone has a hard time staying in the conversation with you without interrupting,”
states Carol Gignoux, a Boston-based executive coach
who specializes in working with people who have
ADHD.
Adults with ADHD sometimes become workaholics, using deadlines as the motivation to complete
complex projects. The structure and routine of work
becomes easier to deal with than their free time.
However, ADHD can interfere with job performance as
well as with interpersonal relationships. Those with the
disorder are more likely to divorce, engage in substance
abuse, and have more driving accidents. They are also
more likely to suffer other psychological disorders,
including depression.
As the text indicates, ADHD raises fundamental
questions about the nature and definition of psychological disorder. Like most disorders, attention disorder has
a “spectrum diagnosis” with widely varying symptoms.
Is the problem with attention really disabling or within
the parameters of being normal? “Where does the disor-
Unit 12 Abnormal Psychology 7
der begin?” asks Russell Barkley at the Medical
University of South Carolina. “It begins where impairment begins. You may have a high degree of ADD
symptoms, but it just means you have a sparkling personality because there is no impairment.”
The U.S. Food and Drug Administration (FDA) has
approved adult use of drugs such as Adderall, a stimulant similar to Ritalin, which is widely prescribed to
children diagnosed with the condition. The FDA has
also approved Straterra, the first nonstimulant medication for adults with the disorder. The success rate for
treatment is considered very good, especially when coupled with coaching that provides organizing strategies.
Rubin, R. (2003, December 3). ADHD focuses on adults.
USA Today, pp. 1D–2D.
Szegedy-Maszak, M. (2004, April 26). Driven to distraction. U.S. News & World Report, 53–62.
Weaver, J. (2004, September 9). Are you an adult with
ADHD? Message posted at http://msnbc.msc.com/
id/5889089.
Student Project/Classroom Exercise: Normality and the
Sexes
In 1970, Inge Broverman and her associates found that
mental health professionals (psychiatrists, psychologists, and social workers) viewed the mature, healthy
male differently from the mature, healthy female. For
example, the healthy male was more likely to be viewed
as ambitious, adventurous, self-confident, logical, and
independent, while the healthy female was viewed as
tactful, aware of others’ feelings, gentle, expressive of
tender feelings, and in need of security. The researchers
further found that the characteristics they linked to a
healthy adult person more closely resembled those of
the healthy male than those of the healthy female.
As either a student project or a classroom exercise,
have both male and female students complete Handout
12–4. Collect and tabulate the data. (Items, 1, 3, 6, 7,
and 9 were more likely to be attributed to the healthy
male in Broverman’s study; items 2, 4, 5, 8, and 10, to
the healthy female.)
Discuss the results in class. Do the earlier results
still hold for students in the 2000s? Has sensitivity to
the problem of sexism eliminated the double standard
for normality, or does it still exist? Is the view of a
healthy adult person still closer to the male than to the
female ideal? If so, what does it mean for women who
are taught that by being normal, competent people, they
are not normal?
In fairness to mental health professionals, we
should note that research suggests that they evaluate
and treat men and women similarly. Sex-role stereotypes may have weakened, or they may become irrele-
vant when clinicians are confronted with a particular
individual.
Broverman, I. K., Broverman, D. M., Clarkson, R. E.,
Rosenkrantz, P. S., & Vogel, S. R. (1970). Sex role
stereotypes and clinical judgments of mental health.
Journal of Consulting and Clinical Psychology, 34, 1–7.
B. Understanding Psychological Disorders
(pp. 564–565)
Lecture/Discussion Topic: Tourette Syndrome
A discussion of Tourette syndrome may give students a
clearer picture of the different perspectives on psychological disorders. Symptoms of this unusual disorder
include involuntary twitching—facial grimacing, head
jerking, finger snapping, whirling, hopping—and the
making of unusual sounds—hooting, barking, screeching, grunting, even cursing uncontrollably. It is estimated that about 100,000 Americans suffer from the more
severe symptoms of Tourette syndrome and that 3 million others may have a milder form of the disorder. The
first symptom may appear by age 7 and can be as
insignificant as repeated eye-blinking or clearing of the
throat. In a few instances, the person may simply echo
another’s words. The movements and words seem to
have no purpose or meaning. Although victims are
unable to overcome the symptoms, many can temporarily suppress them, sometimes for hours.
Tourette syndrome was originally thought to be the
work of the devil. Exorcism was the only cure.
Psychoanalytic theorists have provided a variety of
explanations for the disorder—from a defense against
thumb-sucking to repressed aggression. It has now
become clear that Tourette syndrome has physical
causes. Many believe the disorder is hereditary. The
most conclusive evidence comes from a study of
Mennonite farmers in Alberta, Canada, in which 54 of
the 136 family members have the syndrome or at least
some of the minor symptoms, such as facial twitches
and humming. A dominant gene has been implicated,
although Tourette’s symptoms do not appear in everyone who inherits it. Virtually all males who have the
gene show at least minor symptoms, but only two-thirds
of the females do. Moreover, females who display its
symptoms tend to show more obsessive-compulsive
traits, for example, touching every lightpost on the
street. Both dopamine, which helps control movement,
and norepinephrine, which helps the body respond to
stress, seem to be involved in Tourette syndrome. A satisfactory treatment has yet to be found. The antipsychotic haloperidol is effective in about three-quarters of
all cases but often with adverse side effects, including
depression and, paradoxically, violent muscle spasms.
Another antipsychotic medication, risperidone, and the
8 Unit 12 Abnormal Psychology
blood pressure medication clonidine also significantly
reduce tics. Side effects include weight gain, fatigue,
and dry mouth.
Most researchers have not found behavioral intervention to be effective in the treatment of Tourette syndrome. For example, 55 percent of medical professionals believe that the tics cannot be controlled, and 77
percent believe that if they are suppressed, they will
become even worse later. Recently, Douglas Woods and
his research team have challenged those assumptions.
Children between the ages of 8 and 11 were rewarded
for every 10-second interval they did not exhibit a tic.
The children significantly suppressed their tics. They
expressed a tic during 16 percent of the 10-second
intervals that they were rewarded as opposed to 50 percent of the intervals at the beginning of the experiment.
Another study conducted by Raymond Miltenberger and
his colleagues found no rebound effect for tic suppression in five people with Tourette syndrome, ranging in
age from 7 to 20. Both lines of research highlight the
role that environmental factors may play in the expression of Tourette.
Dingfelder, S. (2006). Nix the tics. Monitor on
Psychology, 37, 18.
Himle, M. B., & Woods, D. G. (2005). An experimental
evaluation of tic suppression and the tic rebound effect.
Behavior Research and Therapy, 43, 1443–1451.
Miltenberger, R.G. (2005). Habit Reversal. In A. Gross &
R. Drabman (Eds.), Encyclopedia of behavior modification and cognitive behavior therapy, Vol.II (pp. 873-877).
Thousand Oaks, CA: Sage.
Seligman, M., Walker, E., & Rosenhan, D. L. (2001).
Abnormal psychology (4th ed.). New York: Norton.
West, S. (1987, November/December). The devil’s disorder. Hippocrates, 66–71.
Woods, D. W., Walther, M. R., Bauer, C. C., Kemp, J. J.,
& Conelea. C. A. (2009). The development of stimulus
control over tics: A potential explanation for contextually-based variability in the symptoms of Tourette syndrome. Behavior Research and Therapy, 47, 41–47.
Classroom Exercise: Multiple Causation
As the text notes, today’s psychologists argue that all
behavior arises from the interaction of nature and nurture. The biopsychosocial approach recognizes that psychological disorders have multiple causes. Clearly, we
ought to resist the pervasive temptation to expect simple
explanations.
Handout 12–5 is Gregory Kimble’s classroom exercise to demonstrate the problems caused when we use
simple explanations. In brief, it asks students whether
they can remember events in their lives that were
painful enough to bring on a mental breakdown. Most
people can.
Give students 10 minutes or so to respond to the
scenario in Handout 12–5. (If you want to give them
more time and thus obtain more detailed responses,
make it a homework assignment.) Also ask students to
clearly indicate at the end of their response whether you
may share it with the rest of the class. Between class
periods, review the responses and pick a few of the
more poignant answers to share with the entire class.
Kimble suggests that everyone has a traumatic
experience that can cause psychological disorder but
that not everyone succumbs. Such single episodes do
not qualify as causes of psychological disorders. Too
often, Kimble notes, we think that behavioral phenomena are single entities that have single causes. The medical model of psychopathology falls into this trap. It
promotes the myth that disorders are single maladies
brought on by single causes such as a traumatic experience. Although this perspective might be appropriate for
certain medical conditions, it typically does not apply to
psychological disorders, which may be full-blown or
borderline and express an array of dispositions.
Typically, psychological disorders involve faulty knowledge, inappropriate feelings, and disordered behavior. A
single cause, suggests Kimble, of such multiple and
varied symptoms is unlikely.
Kimble, G. (1996, August). Secondary school psychology: The challenge and the hope. Paper presented at the
104th Annual Convention of the American Psychological
Association, Toronto.
Lecture/Discussion Topic: Culture-Bound Disorders
The text indicates that evidence of environmental
effects on psychological disorder comes from links
between culture and disorder. Although some disorders
such as schizophrenia and depression are worldwide,
others are not. For example, anorexia nervosa and
bulimia nervosa are disorders that occur mostly in
Western cultures. On the other hand, susto, marked by
severe anxiety, restlessness, and a fear of black magic is
a disorder found only in Latin America. You can expand
on this disorder as well as other culture-bound disorders
in class.
Susto is most likely to occur in infants and young
children. In addition to anxiety and restlessness, the disorder is often marked by depression, loss of weight,
weakness, and rapid heartbeat. Those within the culture
claim that the susto is caused by contact with supernatural beings or with frightening strangers, or even by bad
air from cemeteries. Treatment involves rubbing certain
plants and animals against the skin.
Latah occurs among uneducated middle-aged or
elderly women in Malaya. Unusual circumstances (such
as hearing someone say “snake” or even being tickled)
produce a fear response that is characterized by
repeating the words and actions of other people, utter-
Unit 12 Abnormal Psychology 9
ing obscenities, and acting the opposite of what other
people ask.
Koro is a pattern of anxiety found in Southeast
Asian men. It involves the intense fear that one’s penis
will withdraw into one’s abdomen, causing death.
Tradition holds that koro is caused by an imbalance of
“yin” and “yang,” two natural forces thought to be the
fundamental components of life. In one form of treatment, the individual keeps a firm hold on his penis
(often with the assistance of family members) until the
fear subsides. Another is to clamp the penis to a
wooden box.
Amok, a disorder found in the Philippines, Java,
and certain parts of Africa. occurs more often in men
than in women. Those suffering the affliction jump
around violently, yell loudly, and attack objects and
other people. These symptoms are often preceded by
social withdrawal and a loss of contact with reality. The
outburst is often followed by depression, then amnesia
regarding the symptomatic behavior. Within the culture,
it is thought that stress, shortage of sleep, alcohol consumption, and extreme heat are the primary causes.
Winigo, the intense fear of being turned into a cannibal by a supernatural monster, was once common
among Algonquin Indian hunters. Depression, lack of
appetite, nausea, and sleeplessness were common symptoms. This disorder could be brought on by coming
back from a hunting expedition empty-handed.
Ashamed of his failure, the hunter might fall victim
to deep and lingering depression. Some afflicted
hunters actually did kill and eat members of their own
households.
Comer, R. J. (2007). Abnormal psychology (6th ed.).
New York: Worth.
C. Classifying Psychological Disorders
(pp. 565–567)
PsychSim 5: Mystery Client
This program is a review for those who have already
read the text unit. The program includes six cases, one
for each of the major diagnostic (DSM-IV) categories
mentioned in the text. The student is to try to guess the
category from the description. The program randomly
selects the order of cases but keeps track of them within
a session so that cases are not repeated.
D. Labeling Psychological Disorders (pp. 567–568)
Classroom Exercise: The Effects of Labeling
Once a diagnostic label is attached to someone, we
come to see that person differently. Labels create
preconceptions that can bias our interpretations and
memories. One result is that erroneous diagnoses can
sometimes be self-confirming, because clinicians will
search for evidence in a client’s life history and hospital
behavior that is consistent with the diagnosis. David
Rosenhan, whose controversial demonstration of the
biasing power of diagnostic labels is reported in the
text, gives the example of one pseudopatient who told
the interviewer that he
had a close relationship with his mother but was rather
remote from his father during his early childhood.
During adolescence and beyond, however, his father
became a close friend, while his relationship with his
mother cooled. His present relationship with his wife was
characteristically close and warm. Apart from occasional
angry exchanges, friction was minimal. The children had
rarely been spanked.
Knowing the person was diagnosed as having schizophrenia, the clinician “explained” the problem in the
following manner.
This white 39-year-old male . . . manifests a long history
of considerable ambivalence in close relationships, which
begins in early childhood. A warm relationship with his
mother cools during his adolescence. A distant relationship to his father is described as becoming very intense.
Affective stability is absent. His attempts to control emotionality with his wife and children are punctuated by
angry outbursts and, in the case of the children, spankings. And while he says that he has several good friends,
one senses considerable ambivalence embedded in those
relationships also.
To show how readily we can explain people’s personalities in terms of an earlier sketch of their motives
and behavior, present the top half of Handout 12–6 to
small groups in your class, and the bottom half to the
remaining groups. The sketch of Tom W. is adapted
from a description prepared by Daniel Kahneman and
Amos Tversky. Ask each group to read its answers to
the questions to the class. Regardless of which outcome
they have been given, the groups will have no difficulty
identifying psychological indicators that pointed to
Tom’s present status.
Kahneman, D., & Tversky, A. (1973). On the psychology
of predictions. Psychological Review, 80, 237–251.
Lecture/Discussion Topic: Mental Health as Flourishing
Corey L. M. Keyes argues that mental health is not
merely the absence of mental illness but the presence of
human flourishing. The key clusters and associated
dimensions of human flourishing include the following:
Positive emotions (or emotional well-being)
Positive affect (regularly cheerful, interested in life,
in good spirits, happy, calm, peaceful, full of life)
Avowed quality of life (mostly or highly satisfied
with life overall)
10 Unit 12 Abnormal Psychology
Positive psychological functioning (or psychological
well-being)
Self-acceptance (Holds positive attitudes toward
self)
Personal growth (Seeks challenge, has insight
into own potential, feels a sense of continued
development)
Purpose in life (Finds own life has direction and
meaning)
Environmental mastery (Exercises ability to select,
manage, and mold personal environs to suit needs)
Autonomy (Is guided by own, socially accepted,
internal standards and values)
Positive relations with others (Has, or can form,
warm, trusting interpersonal relationships)
Positive social functioning (or social well-being)
Social acceptance (Holds positive attitudes toward,
acknowledges, and is accepting of human
differences)
Social actualization (Believes people, groups, and
society have potential and can evolve or grow
positively)
Social contribution (Sees own daily activities valued by society and others)
Social coherence (Interested in society and social
life and finds them meaningful and somewhat
intelligible)
Social integration (A sense of belonging to, and
support from, a community)
According to Keyes, to be diagnosed as flourishing
in life, a person must exhibit high levels on at least 1 of
the 2 measures of emotional well-being and high levels
on at least 6 measures of the 11 measures of positive
functioning. Interestingly, the prevalence of flourishing
is about 20 percent of the adult population. Keyes suggests this low percentage highlights the need for a
national program for mental health promotion that complements our long-standing efforts to prevent and treat
mental illness.
The benefits of flourishing to individuals and society are reflected in research findings that indicate that
completely mentally healthy adults miss the fewest days
of work; have the lowest risk of cardiovascular disease,
the lowest number of chronic physical diseases, and the
fewest health limitations on activities of daily living;
and are the least likely to use health care services.
Keyes et al. (2005) Mental illness and/or mental health?
Investigations axioms of the complete state model of
health. Journal of Consulting and Clinical Psychology,
73(3), Table 1, page 543. Copyright 2005 Adapted for
permission by the American Psychological Association.
III. Anxiety Disorders (pp. 569–576)
Classroom Exercise: Penn State Worry Questionnaire
Handout 12–7, the Penn State Worry Questionnaire
(PSWQ) designed by T. J. Meyer and his colleagues,
provides a good introduction to the anxiety disorders.
In scoring the scale, students should reverse their
responses to items 1, 3, 8, 10, and 11 (1 = 5, 2 = 4,
3 = 3, 4 = 2, 5 = 1), then add the numbers in front of all
16 items. Total scores can range from 16 to 80, with
higher scores reflecting a greater tendency to worry.
The mean score of 405 psychology students was 48.8
(mean for females = 51.2, for males, 46.1).
The authors note that generalized anxiety disorder
is primarily defined by chronic worry, and the process
of worry is pervasive throughout all the anxiety disorders. Thus, identifying the nature and functions of
worry should significantly contribute to our understanding of anxiety and its disorders. In research on
the scale, Meyer and his colleagues report that PSWQ
scores were linked to lower self-esteem but higher
levels of perfectionism, time urgency, and selfhandicapping. Worry as measured by the questionnaire
was also associated with more maladaptive levels of
coping.
Meyer, T. J., Miller, M. L., Metzger, R. L., & Borkovec,
T. D. (1990). Development and validation of the Penn
State Worry Questionnaire. Behavior Research and
Therapy, 28, 487–495.
A. Generalized Anxiety Disorder (p. 570)
Classroom Exercise: Taylor Manifest Anxiety Scale
Handout 12–8 is the Taylor Manifest Anxiety Scale,
which attempts to assess level of anxiety. The average
score for college students is about 14 or 15 answers that
match the “true” answers at the top of the next page. If
you have your students complete the scale, you might
want to compare the average for college students with
that of your students. An answer of “true” indicates
anxiety related to that item.
Learning theorists have explained the development
of anxiety in terms of classical conditioning. Rats given
unpredictable shocks in the laboratory may become
apprehensive whenever placed in the laboratory environment; they may develop more specific phobias if a
given object or activity is associated with shock.
Researchers believe that a number of factors influence
the conditioning process. Janet Taylor Spence has
focused on individual differences in emotional responsiveness. She asked five clinical psychologists to judge
which items from the Minnesota Multiphasic Personality Inventory indicate chronic anxiety. Those on which
the psychologists agreed were put through an item
analysis, and the 50 surviving items constitute the present Manifest Anxiety Scale.
Unit 12 Abnormal Psychology 11
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
F
T
F
F
T
T
T
T
F
T
T
F
T
T
F
T
T
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
F
T
F
T
T
T
T
T
T
T
T
F
T
T
F
T
T
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
T
T
T
F
T
T
T
T
T
T
T
T
T
T
T
F
Psychoanalysts, of course, have a very different
view of anxiety. Freud saw it as a product of unresolved
conflict that occurs when defense mechanisms are
weak. Karen Horney, a neo-Freudian, argues that an
inadequate self-concept is the basis for anxiety. We
presumably construct an ego ideal that is designed to
gain the unconditional approval of our parents. This
ideal self is too rigid and impossible to attain, so we
consistently give ourselves a poor self-evaluation. Selfcensure follows, which is the worst form of anxiety for
it is the most difficult both to escape and to satisfy.
Existential theorists have yet a different view of
anxiety. They suggest that it is based in our growing
awareness that we exist and that we are responsible for
the choices we make. The accompanying realization of
nonexistence, or death, is particularly important in
understanding the roots of anxiety. Our awareness of
our inevitable death leads to deep concern over whether
we are living a meaningful and fulfilling life.
Napoli, V., Kilbride, J., & Tebbs, D. (1995). Adjustment
and growth in a changing world (5th ed.). St. Paul, MN:
West Publishing.
Classroom Exercise: The Posttraumatic Cognitions
Inventory (PTCI)
The Posttraumatic Cognitions Inventory (PTCI)
designed by Edna B. Foa and her colleagues (Handout
12–9) may help students understand why some victims
of traumatic experiences develop post-traumatic stress
disorder (PTSD) while others do not. Completing and
scoring the PTCI may also foster students’ appreciation
for the cognitive perspective in explaining psychological disorders.
The inventory asks respondents to report their
thoughts after experiencing traumatic stress—that is,
experiencing or witnessing severely threatening, uncontrollable events with a sense of fear, helplessness, or
horror. If students report never having had such an
experience, ask them to respond to the items in terms of
their most upsetting life experience. The scoring key
follows the inventory and is part of the handout.
Many theorists have argued that traumatic events
can produce changes in victims’ thoughts and beliefs.
Those changes account for the development of PTSD.
Specifically, Foa and her colleagues proposed two basic
dysfunctional cognitions that mediate the development
of PTSD: the world is completely dangerous and one’s
self is totally incompetent. The researchers further suggested that there may be two distinct ways by which
people acquire these dysfunctional cognitions. Those
who enter the traumatic experience with the idea that
the world is extremely safe and that they are extremely
competent have difficulty in assimilating the experience
and therefore overaccommodate their schemas about
self and world. For others, particularly those who have
experienced upsetting experiences throughout their
lives, the traumatic experience primes existing schemas
of the world as a dangerous place and oneself as incompetent. In short, the existence of rigid concepts about
self and the world (positive or negative) renders people
vulnerable to develop PTSD. Those who make finer distinctions about degrees of safety and competence are
better able to interpret the trauma as a unique experience that does not have general implications for the
nature of the world and the nature of their ability to
cope with it.
As the scoring key indicates, factor analyses of the
items reveal three separate factors. These include negative cognitions about self, negative cognitions about the
world, and self-blame. Mean scores are obtained for
each subscale and can range from 1 to 7, with higher
scores reflecting greater acceptance of each factor.
Items 13, 32, and 34 are experimental and thus are not
included in the scoring. Foa and her colleagues report
that each scale predicts PTSD severity, depression, and
general anxiety in traumatized individuals. In fact, the
ability of the PTCI to discriminate between traumatized
individuals with and without PTSD was maintained
even after controlling for depression and state anxiety,
as well as for age, sex, race, and type of assault.
Foa, E. B., Ehlers, A., Clark, D. M., Tolin, D. F., &
Orsillo, S. M. (1999). The Posttraumatic Cognitions
Inventory (PTCI): Development and validation.
Psychological Assessment, 11, 303–314.
B. Panic Disorder (p. 570)
C. Phobias (p. 571)
Lecture/Discussion Topic: Discovery Health Channel
Phobia Study
What do people fear? In August 2000, Discovery Health
Channel commissioned Penn, Schoen, & Berland
Associates to conduct a nationally representative tele-
12 Unit 12 Abnormal Psychology
phone survey of 1000 Americans to answer that question. Students will find the following results interesting.
The top 10 fears (men and women combined) were the
following:
1. Fear of snakes
2. Fear of being buried alive
3. Fear of heights
4. Fear of being bound or tied up
5. Fear of drowning
6. Fear of public speaking
7. Fear of hell
8. Fear of cancer
9. Fear of tornadoes and hurricanes
10. Fear of fire
Top 5 fears of men?
1. Fear of being buried alive
2. Fear of heights
3. Fear of snakes
4. Fear of drowning
5. Fear of public speaking
Top 5 fears of women?
1. Fear of snakes
2. Fear of being bound or tied up
3. Fear of being buried alive
4. Fear of heights
5. Fear of public speaking
The greatest difference between men and women
was in the fear of being bound or tied up (women 27
percent versus men 2 percent). Results also indicated
that we fear giving a speech (36 percent) more than
meeting new people (12 percent), embarrassing ourselves in a sport (44 percent) more than asking someone
for a date (35 percent), being stranded in the ocean (62
percent) more than being stranded in the desert (24
percent), and the IRS (57 percent) more than God (30
percent). The things we fear equally are rats and dentists (58 percent), elevators and flying (52 percent), and
public speaking and being alone in the woods (40 percent). While the pollsters found the level of fear in
American society to be high, they also reported that few
seek treatment. Among those who say they have a phobia or extreme fear, only 11 percent indicated that they
sought professional help.
Classroom Exercise: Fear Survey
What do we fear? James Geer has developed a scale to
measure fear, which is provided in Handout 12–10. He
asked 124 research participants to list their fears on an
open-ended questionnaire. Fifty-one specific fears were
mentioned two or more times; these were included in
the survey in Handout 12–10. The following 11
received the highest intensity ratings: untimely or early
death, death of a loved one, speaking before a group,
snakes, not being a success, being self-conscious, illness or injury to loved ones, making mistakes, looking
foolish, failing a test, suffocating. Students will be
interested in comparing their fears with those of their
classmates, so you may wish to collect the surveys and
report the overall results back to the class.
Psychiatrists and psychologists have labeled over
700 specific fears and estimate that there are thousands
more. When such fears are persistent and debilitating,
they are considered to be phobias. Among those specifically identified are the following, listed under their
appropriate Greek or Latin name.
Acrophobia: Heights
Gephyrophobia: Bridges
Aerophobia: Flying
Herpetophobia: Reptiles
Agoraphobia: Open spaces
Mikrophobia: Germs
Ailurophobia: Cats
Murophobia: Mice
Amaxophobia: Vehicles, driving
Numerophobia: Numbers
Anthophobia: Flowers
Nyctophobia: Darkness
Anthropophobia: People
Ochlophobia: Crowds
Aquaphobia: Water
Ophidiophobia: Snakes
Arachnophobia: Spiders
Ornithophobia: Birds
Astraphobia: Lightning
Phonophobia: Speaking aloud
Brontophobia: Thunder
Pyrophobia: Fire
Claustrophobia: Closed spaces
Thanatophobia: Death
Cynophobia: Dogs
Trichophobia: Hair
Dementophobia: Insanity
Xenophobia: Strangers
You might also ask students if they have heard of
triskaidekaphobia (the number 13), uxoriphobia (one’s
wife), Santa Claustrophobia (getting stuck in a chimney), panaphobia (everything), or phobophobia (fear
itself).
Geer, J. H. (1965). The development of a scale to measure fear. Behavior Research and Therapy, 3, 45–53.
Classroom Exercise: Social Phobia
Handout 12–11, the Social Thoughts and Beliefs Scale
(STABS), was designed by Samuel Turner and his colleagues to assess cognitions associated with social phobia. The disorder is marked by social timidity, social
inhibition, the avoidance of social situations, and, in
many cases, extreme social debilitation. Students obtain
a total score by adding the numbers they provided in
response to all 21 items. Patients diagnosed with social
phobia obtained a mean of 52.4, those with other anxiety disorders had a mean of 28.0, and controls without
any psychiatric diagnosis had a mean score of 22.3.
Factor analysis suggested that STABS points to two factors being involved in social phobia: social comparison,
a belief that others are more socially competent and
capable, and social ineptness, a belief that one will act
awkwardly in social situations or appear anxious in
front of others.
Turner and his colleagues note that while social
phobia originally was thought to be a condition developing in mid-adolescence, findings suggest that it can
Unit 12 Abnormal Psychology 13
be diagnosed as early as 8 years of age. Research suggests that 6.8 percent of people in the United States and
other Western countries experience a social phobia in
any given year. It is more common among women than
among men. About 12 percent develop this disorder at
some point in their lives.
As the text indicates, socially anxious people seek
to avoid potentially embarrassing social situations. If
they cannot avoid contact, they often experience physical symptoms such as trembling, profuse perspiration,
and nausea. For some, the greatest fear is that others
will detect their signs of anxiety, such as blushing,
tremors of the hand, and shaking voice. The earliest
signs of social phobia often occur in late childhood or
early adolescence, with fear of public speaking and eating in public being common symptoms.
Irwin and Barbara Sarason note that phobias about
interpersonal relationships often include fear of criticism and of making a mistake. Those who suffer social
phobia may attempt to compensate by involving themselves in school and work, never quite sure of their abilities or talents. When successful, they may be dismissive: “I was just lucky—being in the right place at the
right time.” They may even feel like imposters, fearing
that one day they will be discovered.
Among the self-help guidelines that therapists
have provided for dealing with social phobia are the
following:
1. In dealing with the symptoms of anxiety, respond
with approach rather than avoidance.
2. Greet people with eye contact.
3. Create a list of possible topics of conversation and
listen carefully to others.
4. Initiate conversation by asking questions. This
strategy demonstrates that you want to speak but at
the time focuses attention on the other person.
5. Speak clearly and without mumbling.
6. Be willing to tolerate some silences.
7. Wait for cues from others in deciding where to sit,
when to pick up a drink, and what to talk about.
8. Learn to tolerate criticism and be willing to introduce a controversial topic at an appropriate point.
Comer, R. J. (2007). Abnormal psychology (6th ed). New
York: Worth.
Hartman, L. M. (1984). Cognitive components of anxiety. Journal of Clinical Psychology, 40, 137–139.
Sarason, I., & Sarason, B. (2005). Abnormal behavior:
The problem of maladaptive behavior (11th ed.). Upper
Saddle River, NJ: Prentice Hall.
Turner, S. M., et al. (2003). The social thoughts and
beliefs scale: A new inventory for assessing cognitions in
social phobia. Psychological Assessment, 15, 384–391.
D. Obsessive-Compulsive Disorder (pp. 571–572)
Feature Film: As Good As It Gets and OCD
As noted earlier, feature films can provide wonderful
case studies in all of the psychological disorders covered in the text. As Good As It Gets, starring Jack
Nicholson, was also mentioned. Following are some
specifics about the film in relation to OCD. The film is
about Melvin Udall, who displays numerous obsessions
and compulsions. Perhaps the best single scene to show
in class begins 3:34 minutes into the film and runs just
97 seconds. Udall locks and unlocks his apartment door
exactly five times, turns lights on and off five times.
Then, using multiple bars of soap stacked high in his
medicine cabinet, he demonstrates his obsession with
cleanliness, washing his hands with scalding water. The
rest of the story finds him eating every day at the same
table in the same restaurant. He insists on the same
waitress, always orders the same meal, and brings his
own paper-wrapped plastic flatware to avoid contamination. He wipes off door handles before opening doors
and carefully avoids stepping on sidewalk cracks in his
visits to his therapist’s office. If anything disrupts his
routine, he becomes both angry and anxious.
Classroom Exercise: Obsessive-Compulsive Disorder
Handout 12–12, the Obsessive Compulsive Inventory,
was developed by Edna Foa and her colleagues. Total
score is obtained by adding the numbers circled and can
range from 0 to 72. In one study, patients with OCD
obtained a mean score of 28.01; a sample of 477 psychology students at the University of Delaware scored a
mean of 18.82. The scale has six components that introduce common symptoms of OCD, including washing
(5, 11, 17), obsessing (6, 12, 18), hoarding (1, 7, 13),
ordering (3, 9, 15), checking (2, 8, 14), and mental neutralizing (4, 10, 16).
Obsessive-compulsive disorder traps people in
seemingly endless cycles of repetitive thoughts (obsessions) and in feelings that they must repeat certain
actions over and over (compulsions). Approximately 20
percent of those with OCD have only obsessions or
only compulsions; all others experience both. While the
OCI does not provide separate scores for obsessive
thoughts and compulsive behaviors, Richard Halgin and
Susan Krauss Whitbourne provide good examples of
obsessions and their closely related compulsions.
Obsession: A young woman is continuously terrified by the thought that cars might careen onto the
sidewalk and run over her. Compulsion: She always
walks as far from the street pavement as possible
and wears red clothes so that she will be immediately visible to an out-of-control car.
14 Unit 12 Abnormal Psychology
Obsession: A mother is tormented by the concern
that she might inadvertently contaminate food as
she cooks dinner for her family. Compulsion:
Every day she sterilizes all cooking utensils in boiling water, scours every pot and pan before placing
food in it, and wears rubber gloves while handling
food.
Obsession: A woman cannot rid herself of the
thought that she might accidentally leave her gas
stove turned on, causing her house to explode.
Compulsion: Every day she feels the irresistible
urge to check the stove exactly 10 times before
leaving for work.
Obsession: A college student has the urge to shout
obscenities while sitting through lectures in classes.
Compulsion: Carefully monitoring his watch, he
bites his tongue every sixty seconds in order to
ward off the inclination to shout.
adulthood, the incidence is slightly higher in women
than in men.
OCD does tend to run in families, sometimes in
two, three, or even four consecutive generations. About
15 to 20 percent of those with OCD come from families
in which another immediate family member has the
same problem. Although it was once thought that this
might be the result of learning, researchers have found
that when OCD occurs in the next generation, it often
takes a different form. For example, a parent may be a
“checker,” while the son or daughter is a compulsive
washer. Many researchers now believe that there is a
biological basis for OCD. What is transmitted is the
predisposition to develop OCD symptoms under certain
conditions, but not a specific obsession or compulsion.
Foa, E. F., et al. (2002). The obsessive-compulsive inventory: Development and validation of a short version.
Psychological Assessment, 14, 485–496.
Gibb, G., Bailey, J., Best, R., & Lambirth, T. (1983). The
measurement of the obsessive compulsive personality.
Educational and Psychological Measurement, 43,
1233–1237.
Obsession: A young boy worries incessantly that
something terrible might happen to his mother
while sleeping at night. Compulsion: On his way
up to bed each night, he climbs the stairs according
to a fixed sequence of three steps up, followed by
two steps down in order to ward off danger.
Halgin, R., & Whitbourne, S. (2008). Abnormal psychology: Clinical perspectives on psychological disorders
(5th ed.) Boston: McGraw-Hill.
An important reason that obsessions generate so
much anxiety and have so much power over people is
that their victims do not seem to “know” anything with
certainty. Their own senses are unconvincing. For example, they may see that their hands look clean but wash
anyway. In fact, they may have to repeat the action 10,
20, or more times. Their doubt may lead them to believe
that they are taking unbearable risks if they don’t perform their rituals. In other areas of their lives, sufferers
of OCD may use the normal process of reasoning.
Victims may even recognize that their obsession is
“crazy” and receive no pleasure in what they are doing.
Still, they cannot escape the hold the disorder has over
them.
Until the 1980s, OCD was considered relatively
rare. Now, some researchers estimate that about 4 million Americans have OCD at some time in their life.
This makes OCD more common than panic disorder or
even schizophrenia. Moreover, the disorder affects
adults, teenagers, and even small children. It occurs
across all social and economic levels. Generally, it
appears before the age of 25. In fact, less than 15 percent of people develop the disorder after age 35. If it
occurs early in life, it seems to be linked to a stressful
event and affect boys more often than girls; if it occurs
in the teen years, it affects males and females equally
and, in 80 percent of all cases, it involves washing rituals linked to contamination fears. If it appears first in
Lecture/Discussion Topic: Obsessive Thoughts
Typically, we deal with unwanted thoughts by trying to
suppress them. Research by Daniel Wegner and his colleagues indicates that this strategy may backfire. The
more we attempt to suppress obsessive ideas, the more
likely we are to become preoccupied with them.
The researchers instructed college students not to
think about white bears and then asked them to dictate
their ongoing thoughts into a tape recorder. Each time a
white bear came to mind they were to ring a bell.
Results indicated that the students rang the bell or mentioned the bear more than once a minute during a 5minute session. Not thinking about white bears proved
very difficult. It seems that actively attempting to suppress a thought ironically makes us think of it more.
Wegner and his colleagues suggest a way to rid
ourselves of obsessive thoughts. In a second experiment, they told students to think about a red
Volkswagen every time they thought of a white bear.
The strategy worked. Using a single distracting thought
helped students to avoid thinking of the dreaded white
bear. Although more work needs to be done, the
researchers believe the technique may be useful not
only for eliminating obsessions but also in the treatment
of addictions, such as smoking.
For students who want more information on
obsessive-compulsive disorder, the OCD Foundation
Unit 12 Abnormal Psychology 15
offers advice, information, newsletters, and referrals to
treatment centers. It even offers “support groups” to
OCD sufferers and their families in all 50 states. Write
OCD Foundation, P.O. Box 961029, Boston, MA 02196
or go to the website at www.ocfoundation.org.
Neath, J. (1987, December). Suppress now, obsess later.
Psychology Today, 10.
E. Post-Traumatic Stress Disorder (pp. 572–574)
Lecture/Discussion Topic: Concentration Camp Survival
In the discussion of post-traumatic stress disorder, the
text describes the productive lives of American Jews
who survived the Holocaust trauma. Examining the
coping skills they used in the concentration camps provides an intriguing case study that reinforces much of
the literature of this unit. Researchers have identified
seven major strategies that seem to have contributed to
their survival. They include the following, as reviewed
by Chris Kleinke.
1. Differential focus on the good. Despite the horrible
events that surrounded them, some inmates focused
their attention on whatever good they could find—
for example, seeing a sunset or finding a small carrot in the field.
2. Survival for some purpose. Inmates continued to
look for and find meaning in their existence. For
some, it was simply the determination to tell the
world about what had happened.
3. Psychological distancing. Prisoners used a variety
of strategies to distance themselves from the experiences in the camp. These included intellectualizing (e.g., Bruno Bettelheim assumed the role of an
observer who would study the situation and write
about it), religious conviction (e.g., for some, religious convictions made the suffering less personal
and provided hope for some kind of existence after
death), time focus (e.g., it was possible to distance
oneself from the magnitude of the horror by living
1 day, 1 hour, or even 1 minute at a time), and
finally, humor (e.g., in the most difficult of times,
some prisoners were still able to laugh).
4. Mastery. Although opportunities were sharply limited, there was still the challenge to use one’s mind,
to devote oneself to helping others, and to maintain
a sense of worthiness and self-esteem.
5. Will to live. Simply the human determination not to
give up but to survive can be a powerful source of
strength.
6. Hope. It often matters not how realistic the hope is
so long as it is held and nurtured.
7. Social support. Some drew on social support from
individual friendships and from simply being in
groups of people who shared the same life
situation.
Dimsdale, J. (1974). The coping behavior of Nazi concentration camp survivors. American Journal of
Psychiatry, 131, 792–797.
Kleinke, C. (1998). Coping with life challenges (2nd
ed.). Belmont, CA: Wadsworth.
F. Understanding Anxiety Disorders (pp. 574–576)
IV. Somatoform Disorders (pp. 576–577)
Lecture/Discussion Topic: Factitious Disorder
People with factitious disorder purposefully produce or
fake physical symptoms in order to assume a patient’s
role. In some cases, they may take extreme measures to
create the appearance of illness. For example, they may
inject drugs to cause bleeding. In contrast, high fevers
are relatively easy to produce. Those with factitious disorder are often very knowledgeable about their ailments, including possible treatments. If challenged
about the reality of their illness, they are likely to
change doctors. The disorder usually begins in early
adulthood and seems to be more common among
women than men. However, men tend to show more
severe forms of the disorder.
Factitious disorder seems to be more common
among those who received extensive medical treatment
for a true physical disorder in childhood; experienced
abuse in childhood; carry a grudge against the medical
profession; have worked as a nurse, laboratory technician, or medical aide; or have an underlying personality
problem such as extreme dependence. Typically, they
are socially isolated, enjoying little social support or
family life. The extreme and long-term form of facititious disorder is call Munchausen syndrome.
In Munchausen syndrome by proxy, parents fake or
actually produce physical illnesses in their children that
may lead to painful diagnostic tests, medication, and
surgery. Typically, the parent (most often the mother) is
emotionally needy and craves attention and praise for
her devoted care of her sick child. This disorder, first
identified in 1977, is often viewed as a crime by law
enforcement authorities. The caregiver may have administered drugs, contaminated a feeding tube, or may even
have attempted to smother the child. Ronald Comer
makes the important observation that parents who resort
to such actions are obviously experiencing serious
psychological disturbance and in need of therapeutic
intervention.
The child’s illnesses may take almost any form but
the more common symptoms are bleeding, seizures,
comas, diarrhea, fevers, and infections. Between 6 and
16 Unit 12 Abnormal Psychology
30 percent of victims die and 8 percent are permanently
disfigured or physically impaired. The disorder is difficult to diagnose because the parent seems so devoted
and caring. Yet when child and parent are separated, the
physical problems disappear.
Comer, R. (2007). Abnormal psychology (6th ed.). New
York: Worth.
V.
Dissociative Disorders (pp. 577–579)
Classroom Exercise: The Curious Experiences
Inventory
Dissociation is often defined as an incapacity to integrate one’s thoughts, feelings, or experiences into one’s
present consciousness. Dissociative symptoms have
been implicated in such diverse conditions as amnesia,
fugue states, dissociative identity disorder, and even
post-traumatic stress disorder. Handout 12–13 represents the shortened version of Lewis R. Goldberg’s The
Curious Experiences Survey, which measures selfreported dissociative experiences. Total score is simply
the sum of the numbers placed before the 17 items.
Thus, scores can range from 17 to 85, with higher
scores reflecting more experience with dissociation.
An analysis of the full-length 31-item scale
revealed the presence of three factors in dissociation:
depersonalization (“Had the experience of feeling that
my body did not belong to me”), self-absorption (“Find
that I sometimes sit staring off in space, thinking of
nothing, and am not aware of the passage of time”), and
amnesia (“Found evidence that I had done things that I
did not remember doing”).
The frequency of self-reported dissociation was
positively correlated with measures of neuroticism (particularly depression) and imagination, and negatively
related to conscientiousness (particularly dutifulness),
agreeableness, and, to a lesser extent, age. No relationships were found with gender, educational level, intelligence, vocational skills, or self-reported skills. Behavioral acts that were most highly positively correlated
with dissociative experiences included the following:
Spent an hour at a time daydreaming
Stayed away from a social event in order to finish some
work
Had a nightmare
Ate until I felt sick
Drove faster than normal because I was angry
Borrowed money
Received public assistance (such as food stamps or
welfare)
Borrowed something and lost it, broke it, or never
returned it
Stayed up all night
Did something I thought I would never do
Discussed sexual matters with a male friend
Smashed a vase or other object in anger or frustration
Goldberg, L. R. (1999). The Curious Experiences Survey,
a revised version of the Dissociative Experiences Scale:
Factor structure, reliability, and relations to demographic
and personality variables. Psychological Assessment, 11,
134–145.
Lecture/Discussion Topic: Psychogenic Versus Organic
Amnesia
Dissociative amnesia is a dissociative disorder that is
not discussed in the text. Students are likely to be aware
that amnesia may be either physically or psychologically based. For example, a blow to the head, alcohol
dependence, stroke, or Alzheimer’s disease may impair
memory, just as marital, financial, or career stress may
do so. Dissociative amnesia is often referred to as psychogenic amnesia and has four characteristics that distinguish it from organic amnesia. First, psychogenic
amnesics lose memory for both the distant and recent
past. For example, they cannot remember the number of
siblings they have. Organic amnesics, on the other hand,
lose memory for the recent past but remember the distant past well. Second, psychogenic amnesics lose their
personal identity—name, address, occupation—but
their store of general knowledge remains intact. For
example, they remember the date, the name of the
President, the capital of Illinois. Organic amnesics,
however, lose both personal and general knowledge.
Third, psychogenic amnesics have no anterograde
amnesia; that is, they remember well events happening
after the amnesia starts. In contrast, organic amnesics
experience severe anterograde amnesia, which is often
their primary symptom; that is, they recall very little
about events after the organic damage. For example,
they may not remember the name of the physician treating them for the head injury. Finally, psychogenic
amnesia often reverses itself very abruptly, ending within a few hours or days of its onset. Within a day, a person may even recall the traumatic event that set off the
memory loss. In the case of organic amnesia, on the
other hand, memory only gradually returns for retrograde memories and hardly ever returns for anterograde
memories following organic treatment. Memory of the
trauma is never revived.
Seligman, M., Walker, E., & Rosenhan, D. L. (2001).
Abnormal psychology (4th ed.). New York: Norton.
Unit 12 Abnormal Psychology 17
A. Dissociative Identity Disorder (p. 578)
Lecture/Discussion Topic: The Dissociative Disorders
Interview Schedule and Dissociative Identity Disorder
Colin Ross and his colleagues developed the Dissociative Disorders Interview Schedule to refine and standardize the diagnosis of dissociative identity disorder
(formerly known as multiple personality). Presenting
some of its key questions in class will provide students
with further insight into the nature of the symptoms
associated with this disorder. “Yes” responses to the following would be rated in the direction of a high dissociative identity disorder score.
1. Have you ever walked in your sleep?
2. Did you have imaginary playmates as a child?
3. Were you physically abused as a child or
adolescent?
4. Were you sexually abused as a child or adolescent?
(Sexual abuse includes rape or any type of unwanted sexual touching or fondling that you may have
experienced.)
5. Have you ever noticed that things are missing from
your personal possessions or where you live?
6. Have you ever noticed that things appear where you
live, but you don’t know where they came from or
how they got there (e.g., clothes, jewelry, books,
furniture)?
7. Do people ever talk to you as if they know you but
you don’t know them, or only know them faintly?
8. Do you ever speak about yourself as “we” or “us”?
9. Do you ever feel that there is another person or
persons inside you?
10. If there is another person inside you, does he or she
ever come out and take control of your body?
The controversy surrounding this disorder led the
authors of the DSM-IV to attempt to increase the precision of diagnosis. Perhaps most important, to fit the
diagnosis of dissociative identity disorder, the person
must have had the experience of amnesia, an inability to
remember important personal information. It is hoped
that more stringent conditions will reduce the number
of false diagnoses.
Ross, C. A., et al. (1990). Structured interview data on
102 cases of multiple personality disorder from four centers. American Journal of Psychiatry, 147, 596–601.
B. Understanding Dissociative Identity Disorder
(pp. 578–579)
VI. Mood Disorders (pp. 579–589)
A. Major Depressive Disorder (p. 580)
Classroom Exercise: Depression Scales
Handout 12–14, a short form of the Center for
Epidemiological Studies—Depression scale (CES-D),
was developed by Jason Cole and his colleagues to be
used as a screening tool in the general population. In
scoring it, students should reverse the numbers placed
in response to statements 3 and 6 (i.e., 0 = 3, 1 = 2,
2 = 1, 3 = 0), then add the numbers in front of all 10
items. Scores can range from 0 to 30, with higher
scores reflecting greater distress. The authors do not
provide specific norms but indicate that “most respondents score in the lower range.” The specific scale items
introduce four important components of depression:
Items 2 and 9 reflect the presence of negative affect;
items 3 and 6 suggest the absence of positive affect;
items 7, 8, and 10 indicate interpersonal difficulty; and
items 1, 4, and 5 assess “somatic” difficulties.
Handout 12–15, the Zung Self-Rating Depression
Scale, is one of the most widely used measures of
depression. In scoring, students should reverse their
responses to items 2, 5, 6, 11, 12, 14, 16, 17, 18, and 20
(1 = 4, 2 = 3, 3 = 2, 4 = 1). They should then add all the
numbers to obtain a total score, which can range from
20 to 80. Scores from 50 to 59 suggest mild to moderate depression, from 60 to 69 indicate moderate to
severe depression, and 70 and above indicate severe
depression.
An adapted version of this scale is published each
year by Parade Magazine prior to National Depression
Screening Day. National Depression Screening Day,
created by Harvard psychiatrist Dr. Douglas G. Jacobs
in 1991, has since been repeated every year in early
October. (A toll-free number, which can be called to
learn the closest screening site, is typically advertised
by the media in late September.) Each year, the number
of sites staffed by mental health professionals has
grown. The free screening includes completion of a
self-rating depression scale; a 20-minute talk on the
causes, symptoms, and treatment of the disorder, during
which participants may ask questions; and 5 minutes
alone with a mental health professional. Based on the
scale scores and the clinician’s probing, participants
learn if they need more evaluation. No diagnosis or
treatment is provided.
Jacobs maintains that the effort has now saved hundreds of lives. He relates the story of a college student
who appeared on the first screening day at McLean
Hospital in Belmont, Massachusetts. “The student had
been putting plastic bags over his head,” Jacobs
recounts, “so his roommate suggested he go to the
screening. He arrived and answered some questions:
‘Do you think of killing yourself?’ He said, ‘Yes.’ In 2
minutes, we had detected that he was at risk. In 10 minutes, he was hospitalized, and treatment was begun. We
saved his life.”
Aaron Beck, a leading investigator of depression,
suggests that college students may be especially prone
to psychological problems because they simultaneously
experience all the transitions that are major stresses in
18 Unit 12 Abnormal Psychology
adulthood. Entering college, they lose family, friends,
and familiar surroundings and are provided no readymade substitutes. Furthermore, while in high school,
they were the most able students; in college they must
compare their own abilities with equally able students.
As the text notes, research indicates that students
who exhibit optimism as they enter college develop
more social support and experience a lowered risk of
depression. Moreover, students’ frequent misperception
of these stresses may be as important a cause of depression as the stresses themselves. While they do not hallucinate their problems of academic or social adjustment,
they often inflate the importance of temporary setbacks
and misjudge the severity of rejections. They may overestimate academic difficulties on the basis of one
mediocre grade. They may grieve over their social isolation, even though they often have at least some caring
and supportive friends. Their pessimism and dissatisfaction may lead to clinical depression that in turn interferes with actual performance. A vicious cycle is created in which misperceptions of academic and social difficulties result in still poorer grades and greater social
isolation.
Beck, A., & Young, J. (1978, September). College blues.
Psychology Today, 80–92.
Cole, J. C., et al. (2004). Development and validation of
a Rasch-Derived CES-D Short Form. Psychological
Assessment, 16, 360–372.
Ubell, E. (1993, September 26). Help for depression.
Parade Magazine, 20.
Ubell, E. (1994, September 18). You can find help for
depression. Parade Magazine, 22.
Classroom Exercise: The Automatic Thoughts
Questionnaire
Philip Kendall and Steven Hollon designed the Automatic Thoughts Questionnaire, Handout 12–16, to
measure the frequency of automatic negative thoughts
associated with depression and to “identify the covert
self-statements reported by depressives as being representative of the kinds of cognitions that depressed persons experience.” Thus the ATQ, which was developed
on a sample of undergraduates, provides a measure of
depression and highlights some of its most important
symptoms. Among the specific facets of depression it
measures are personal maladjustment and desire for
change (e.g., items 14 and 20), negative
expectations (e.g., items 3 and 24), low self-esteem
(e.g., items 17 and 18), and helplessness (e.g., items 29
and 30). Total scores range from 30 (little or no depression) to 150 (maximum depression). Mean scores of
79.6 and 48.6 were obtained for depressed and nondepressed samples, respectively.
Kendall, P., & Hollon, S. (1980). Cognitive self statements in depression: Development of an Automatic
Thoughts Questionnaire. Cognitive Therapy and
Research, 4, 383–395.
Classroom Exercise: Depression and Memory
The text notes that when we are in a bad or sad mood,
we are more likely to remember unpleasant events.
Jerry Burger suggests a simple classroom replication of
D. M. Clark and J. D. Teasdale’s study demonstrating
this effect.
Have students take out a blank piece of paper. Tell
them that you are going to read a series of individual
words and that after you have read each word they will
have a few seconds to think of a past experience they
associate with the word. They are to write down the
experience in a sentence or two. Proceed to read the following list, which Clark and Teasdale used (shorten for
efficiency if you like). Pause between each word, giving
students time to respond: train, ice, wood, letter, house,
race, shoe, window, sign, meeting, travel, reading, road,
machine, rain, roam, water, tunnel.
After students have finished, have them indicate
whether each recalled experience was pleasant or
unpleasant. Finally, have them tally the total number of
pleasant and unpleasant experiences they recalled. Have
them reflect on their level of depression that day and
how it may have affected the degree to which they generated pleasant or unpleasant memories. As noted, when
we are depressed, we remember more unpleasant than
pleasant events. If you prefer to analyze the relationship
between depression and memory more carefully, have
students complete the Zung Self-Rating Depression
Scale (Handout 12–15) before this exercise. Have them
score both the scale and exercise before turning in the
results. Between classes, calculate the correlation
between depression scores and pleasantness ratings and
report the outcome at the next class session.
Burger, J. M. (2007). Instructor’s manual for Burger’s
Personality (7th ed.). Belmont, CA: Wadsworth.
Clark, D. M., & Teasdale, J. D. (1982). Diurnal variations
in clinical depression and accessibility of memories of
positive and negative experiences. Journal of Abnormal
Psychology, 91, 87–95.
Classroom Exercise: Loneliness
You can extend the text discussion of depression and
suicide with Handout 12–17, the Revised UCLA
Loneliness Scale. Scores should be reversed (1 = 4,
2 = 3, 3 = 2, 4 = 1) for items 1, 4, 5, 6, 9, 10, 15, 16,
19, 20. The sum of all 20 items then provides a total
score, which can range from 20 to 80. Mean scores for
males and females enrolled in undergraduate psychology courses were 37.06 and 36.06, respectively.
Unit 12 Abnormal Psychology 19
Correlations ranging from .51 to .62 were found
between loneliness scores and depression, as measured,
for example, by the Beck Depression Inventory.
Loneliness is a common and distressing problem
for many people. In one national survey, 26 percent of
Americans reported having felt “very lonely or remote
from other people” during the previous few weeks. In a
worldwide survey of adults in 18 countries, Italians and
Japanese reported the most frequent feelings of loneliness and Danes reported the least. While we have a
stereotype in our culture of the elderly as being lonely,
research indicates adolescents and young adults are
actually the most lonely. Married people are less lonely
than the unmarried.
The problem of loneliness may be increasing. A
recent study found that, on average, Americans have
only two close friends to confide in, down from an
average of three in 1985. The percentage of people who
reported no confidant rose from 10 percent to almost 25
percent; an additional 19 percent said they had only a
single confidant (often their spouse).
Loneliness has both psychological and physical
consequences. Relatively recent studies at Carnegie
Mellon University suggest that being lonely may make
one physically ill. Students with few friends had a 16
percent weaker immune response to a flu shot than did
their counterparts. Another study found that men who
had the fewest social interactions every week had the
highest levels of an inflammatory marker that seems to
play a role in heart disease. Investigators suggest that
loneliness may depress immune systems by increasing
stress and decreasing the amount of sleep one gets.
Other studies have found that social support and affiliation may serve to protect people from stress and illness
as well as speed recovery from illness or surgery.
While research does not indicate overall sex differences in loneliness, Sharon Brehm and her colleagues
reports that gender interacts with marital status in the
following ways.
1. Married females report greater loneliness than do
married males.
2. Among those never married, males report more
loneliness than do females.
3. Among the separated and divorced, males report
greater loneliness than do females.
4. Among those whose spouse has died, males report
greater loneliness than do females.
ly to reduce a woman’s social network than a man’s. For
example, men are more likely to remain employed and
seem to establish closer relationships with their relatives
after marriage than they had before. Married women
may forgo outside employment and also leave their relatives to be with their husbands. As a result, they suffer
greater social isolation.
In contrast, women, married or single, are more
likely to maintain some intimate ties with their friends.
Men tend to have close emotional relationships only
with their female partners. Hence, unmarried or romantically unattached males are likely to be emotionally
isolated despite regular contact with people at work and
during leisure activities.
What reasons do people give for being lonely? One
survey sorted them into five major categories.
Brehm and her colleagues suggest that these findings indicate that men and women may differ in their
vulnerability to two types of loneliness: social and emotional isolation. In social isolation, people are dissatisfied and lonely because they lack a social network of
friends and acquaintances. In emotional isolation, they
are dissatisfied because they lack a single intense relationship. Research has found that marriage is more like-
Lecture/Discussion Topic: Bipolar Disorder
To give students some idea of the manic state of a bipolar disorder, read the following account.
1. Being unattached: Having no spouse or romantic
partner, particularly breaking up with a spouse or
partner.
2. Alienation: Being misunderstood and feeling different; not being needed and having no close friends.
3. Being alone: Coming home to an empty house.
4. Forced isolation: Being hospitalized or housebound; having no transportation.
5. Dislocation: Being away from home; starting a new
job or school; traveling often.
How do people cope with loneliness? Rubenstein
and Shaver have found four major strategies. “Sad passivity” includes sleeping, drinking, overeating, and
watching TV. “Social contact” may involve calling a
friend or visiting someone. “Active solitude” takes the
form of studying, reading, exercising, or going to a
movie. “Distractions” include spending money and
going shopping.
Comer, R. (2007). Abnormal psychology (6th ed.). New
York: Worth.
McPherson, M., Smith-Lovin, L., & Brashears, M. E.
(2006). Social isolation in America: Changes in core discussion networks over two decades. American
Sociological Review, 71, 353–375.
Miller, R., Perlman, D., & Brehm, S. (2007). Intimate
relationships (4th ed.). New York: McGraw-Hill.
Rubenstein, C. M., & Shaver, P. (1982). In search of intimacy. New York: Delacorte Press.
B. Bipolar Disorder (p. 581)
When I start going into a high, I no longer feel like an
ordinary housewife. Instead, I feel organized and accomplished, and I begin to feel I am my most creative self. I
can write poetry easily. I can compose melodies without
20 Unit 12 Abnormal Psychology
effort. I can paint. My mind feels facile and absorbs
everything. I have countless ideas about improving the
conditions of mentally retarded children, how a hospital
for these children should be run, what they should have
around them to keep them happy and calm and unafraid.
I see myself as being able to accomplish a great deal for
the good of people. I have countless ideas about how the
environmental problem could inspire a crusade for the
health and betterment of everyone. I feel able to accomplish a great deal for the good of my family and others. I
feel pleasure, a sense of euphoria or elation. I want it to
last forever. I don’t seem to need much sleep. I’ve lost
weight and feel healthy, and I like myself. I’ve just
bought six new dresses, in fact, and they look quite good
on me. I feel sexy and men stare at me. Maybe I’ll have
an affair, or perhaps several. I feel capable of speaking
and doing good in politics. I would like to help people
with problems similar to mine so they won’t feel hopeless. (Fieve, 1975, p. 17)
David Rosenhan and Martin Seligman identify the
following symptoms of mania.
1. Mood or emotional symptoms The mood is typically euphoric, expansive, and elevated. In some cases,
the dominant mood is irritability, particularly if the
manic person is thwarted. Even when euphoric,
manic people are close to tears and if frustrated
burst out crying. This suggests that a strong depressive element coexists with mania.
2. Grandiose cognition Manic people believe they
have no limits to their abilities and, what’s worse,
do not recognize the painful consequences of trying
to carry out their plans. They may have a flight of
ideas in which ideas race through their mind faster
than can be related or written down. Sometimes
manic people have delusional thoughts about themselves—for example, that they are special messengers of God or are intimate friends with celebrities.
3. Motivational symptoms The manic person’s
hyperactivity has an intrusive, dominating, and
domineering quality. In the manic state, some
engage in compulsive gambling, reckless driving,
or poor financial investment.
4. Physical symptoms With the hyperactivity comes a
greatly lessened need for sleep. After a few days,
however, exhaustion settles in, and the mania slows
down.
Between 0.6 and 1.1 percent of the U.S. population
will have bipolar disorder in their lifetime. It affects
both sexes equally. Onset is sudden and, typically, no
precipitating event is obvious. The first episode is usually manic and occurs between ages 20 and 30. Bipolar
illness tends to recur but surprisingly not many episodes
occur more than 20 years after the initial onset.
Fieve, R. R. (1975). Mood swing. New York: Morrow.
Seligman, M., Walker, E., & Rosenhan, D. L. (2001).
Abnormal psychology (4th ed.). New York: Norton.
C. Understanding Mood Disorders (pp. 582–586)
Lecture/Discussion Topic: The Sadder-but-Wiser Effect
A number of studies have shown that depressed persons
may see certain events more accurately than do those
who are happy and optimistic. Lauren Alloy and Lyn
Abrahamson, among the first to report this finding in
1979, initially labeled it the sadder-but-wiser effect.
Today it is also known as depressive realism.
In testing the learned helplessness theory of depression, Alloy and Abrahamson recruited groups of depressives and nondepressives. Research participants were
individually placed behind a special arrangement of
lights and buttons and periodically were given a choice
whether or not to push one of the buttons. A light was
programmed to come on every other time the choice
was presented, regardless of the participant’s choice.
Afterwards, the experimenter asked participants to estimate how much control they had over the lights. From
helplessness theory, Alloy and Abrahamson predicted
that depressed subjects would underestimate their control. In fact, however, the depressed participants were
very accurate in their estimates, while those who were
not depressed made mistakes by drastically exaggerating the degree of control they thought they exercised.
Alloy and Abrahamson replicated this finding in
other experiments. Nondepressives consistently
overestimated their control over positive events and
underestimated their control over negative events. Other
researchers reported similar results. For example, Peter
Lewinsohn had participants interact with one other person or with a group and then asked them to rate their
own social skills. In evaluating themselves, they noted
the clarity of their communication, their friendliness,
and their ability to understand others. Observers on the
opposite side of a one-way mirror also rated the participants. While nondepressives perceived themselves more
positively than did the observers, depressed participants
gave themselves ratings that were very close to those of
the observers.
What does all of this have to say about helping the
depressed to see things more clearly? Alloy reports that
one patient, after hearing these results, quit therapy on
the basis that there was nothing wrong with him. In
reflecting later on her patient’s decision, the therapist
states, “If I had been able to talk to him, I would have
pointed out that to be realistic is not necessarily the
same as being adaptive.”
Fred Hapgood suggests that depressed persons may
feel as they do, not because of low ego defenses or
learned helplessness, but because they see themselves
as “lost in a society of cockeyed optimists who barge
Unit 12 Abnormal Psychology 21
through life with little grasp of the consequences of
their actions or words.” A depressing thought? Yes, suggests Hapgood, and possibly one more likely to be
correct.
Hapgood, F. (1985, August). The sadder-but-wiser effect.
Science, 85, 86–88.
Lecture/Discussion Topic: Cognitive Errors in
Depression
Aaron Beck’s work with depressed patients convinced
him that depression is primarily a disorder of thinking
rather than of mood. He argued that depression can best
be described as a cognitive triad of negative thoughts
about oneself, the situation, and the future. The
depressed person misinterprets facts in a negative way,
focuses on the negative aspects of any situation, and
also has pessimistic expectations about the future. The
cognitive errors of depressed people include the
following.
1. Overgeneralizing: Drawing global conclusions
about worth, ability, or performance on the basis of
a single fact.
2. Selective abstraction: Focusing on one insignificant
detail while ignoring the more important features
of a situation.
3. Personalization: Incorrectly taking responsibility
for bad events in the world.
4. Magnification and minimization: Gross evaluations
of a situation in which small, bad events are magnified and large, good events are minimized.
5. Arbitrary inference: Drawing conclusions in the
absence of sufficient evidence or of any evidence at
all.
6. Dichotomous thinking: Seeing everything in one
extreme or its opposite (black or white, good or
bad).
Beck and others have noted that the thoughts of
depressed people differ from those with anxiety disorders. Those suffering from anxiety typically focus on
uncertainty and worry about the future. In contrast,
depressed people focus on negative aspects of the past
or reflect a negative outlook on what the future will
bring. Whereas anxious people worry about what may
happen and whether they will be able to deal with it,
depressed people think about how terrible the future
will be and how they will be unable to deal with it or
improve it.
Sarason, I., & Sarason, B. (2005). Abnormal psychology
(11th ed.). Upper Saddle River, NJ: Prentice Hall.
Classroom Exercise: Attributions for an Overdrawn
Checking Account
The text reports that depressed people are more likely
to explain bad events in terms of causes that are stable,
global, and internal. More specifically, experiments
have shown that either stable or global attributions can
produce depression, but internal attributions seem to
produce depression only when they are combined with
stable and global components. Given the present popularity of the social-cognitive perspective, you may want
to offer a specific illustration of the attributions most
likely to be associated with depression.
Ask students to imagine that they have just been
notified by their bank that their checking account is
overdrawn. After reflecting a bit on the possible reasons
for the notification, have them write down in a sentence
or two what they believe to be the single most important cause. Then, in thinking about what they have written, have them answer the following questions.
1. Does the cause you describe reflect more about you
or something more about other people or circumstances (internal or external)?
2. Is the cause something that is permanent or temporary; that is, is the cause likely to be present in the
future (stable or unstable)?
3. Is the cause something that influences other areas
of your life or only your checking account balance
(global or specific)?
Ask for volunteers to share some of their answers
and reiterate that attributions for events that are internal, stable, and global are most likely to be associated
with depression. Christopher Peterson and Martin
Seligman give the examples on the next page of attributions for the overdrawn checking account.
22 Unit 12 Abnormal Psychology
Examples of Causal Explanations for the Event
“My Checking Account Is Overdrawn”
Explanation
Style
Stable
Global
Specific
Unstable
Global
Specific
Internal
External
“I’m incapable of doing
anything right.”
“I always have trouble
figuring my balance.”
“All institutions chronically
make mistakes.”
“This bank has always used
antiquated techniques.”
“I’ve had the flu for a week,
and I’ve let everything
slide.”
“The one time I didn’t
enter a check is the one
time my account gets
overdrawn.”
“Holiday shopping demands
that one throw oneself
into it.”
“I’m surprised—my bank has
never made an error before.”
Source: Peterson et al. (1984). Casual explanations as a risk factor for depression: Theory and evidence. Psychological Review,
91. Copyright © 1984 by the American Psychological Association. Adapted by permission.
Classroom Exercise: The Body Investment Scale and
Self-Mutilation
You can extend the text Close-Up on suicide with
Handout 12–18, the Body Investment Scale designed by
Israel Orbach and Mario Mikulincer. To obtain a total
score, respondents need to reverse the numbers (1 = 5,
2 = 4, 4 = 2, 5 = 1) they place in front of items 2, 3, 5,
7, 9, 11, 13, 17, and 22 and then add up the numbers in
front of all 24 statements. Scores can range from 24 to
120, with higher scores reflecting a more positive emotional investment in one’s body. Orbach and Mikulincer
identified four separate aspects of the bodily self measured by their scale. Items 5, 10, 13, 16, 17, and 21
assess body image feelings and attitudes, items 2, 6, 9,
11, 20, and 23 measure comfort in physical contact with
others, items 1, 4, 8, 12, 14, and 19 reflect concern for
body care, and items 3, 7, 15, 18, 22, and 24 assess
investment in body protection.
Working primarily with adolescents and young
adults between 13 and 19, the authors found their scale
to be predictive of self-destructive behaviors, including
suicidal tendencies. Those with higher scores reported
higher self-esteem as well as having experienced greater
maternal care. Moreover, they were more likely to indicate a capacity to enjoy sensual and bodily pleasures
and were less likely to state that their parents had been
overprotective.
You may want to extend the discussion of suicide
to a consideration of research on self-mutilation. One
survey of undergraduate students reported that 9.8 percent of the students indicated that they had purposefully
cut or burned themselves on at least one occasion in the
past. A 2003 study found a high prevalence of self-
injury among 428 homeless and runaway youth (ages
16 to 19) with 72 percent of males and 66 percent of
females reporting a past history of self-mutilation.
More generally, research indicates self-injury is more
frequent among women than men and typically begins
in the teen years. Those who injure themselves are not
usually seeking to end their lives but rather seem to use
self-injury as a coping effort to relieve emotional pain.
Before her tragic death, Princess Diana brought global
attention to the disorder when she admitted in a television interview that she had intentionally injured her
arms and legs: “You have so much pain inside yourself
that you try to hurt yourself on the outside because you
want help.”
Although some self-mutilators are suicidal, most
cut themselves not to die but to cope with the stresses
of staying alive. Many were sexually abused as children
and learned to shield themselves from the trauma by
dissociating themselves from their emotions. Some
claim that cutting snaps them back into consciousness.
One victim writes, “It proves I’m alive, I’m human, I
have blood coursing through my veins.” Others who
suffer from anorexia or bulimia apparently self-mutilate
to gain control over their bodies or to express their feelings about being abused. “They’re wearing a visible
symbol of the violation imposed on them,” claims
Joseph Shrand, director of the Child and Adolescent
Outpatient Clinic at McLean Hospital in Belmont,
Massachusetts.
Whatever their childhood experience, almost all
self-mutilators, according to experts, grew up in homes
with poor communication between parent and child.
Cutting often seems to be a replacement for absent lan-
Unit 12 Abnormal Psychology 23
guage. Self-mutilators may have lived through a bitter
divorce or were verbally demeaned as fat or lazy. As a
result, they suffer self-loathing, not merely lower selfesteem. “Cutting is literally like letting out bad blood,”
claims Marilee Strong, author of A Bright Red Scream,
a book on self-mutilation.
Treatments include antidepressants and even the
drug Naltrexone, commonly used to treat heroin
addicts. Although traditional psychotherapy is often
ineffective, some therapists report success using Marsha
Linehan’s dialectical behavior therapy, which teaches
skill in tolerating distress and controlling behavior. War,
poverty, and unemployment may also be contributing
factors.
Some therapeutic efforts have successfully generated alternative coping behaviors for sufferers who otherwise would engage in self-injury. For example, clients
may be encouraged to journal, to participate in sports or
exercise, or to seek social support in curbing the urge to
harm themselves. Even safer methods of self-harm that
do not lead to permanent injury— for example, the
snapping of a rubber band on the wrist—may help calm
the urge to engage in self-injury.
Kalb, C. (1998, November 9). An armful of agony.
Newsweek, 82.
Orbach, I., & Mikulincer, M. (1998). The body investment scale: Construction and validation of a body experience scale. Psychological Assessment, 10, 415–425.
Tyler, K. A., et al. (2003). Self-mutilation and homeless
youth: The role of family abuse, street experiences, and
mental disorders. Journal of Research on Adolescence,
13, 457–474.
Vanderhoff, H., & Lynn, S. J. (2001). The assessment of
self-mutilation: Issues and clinical considerations.
Journal of Threat Assessment, 1, 91–109
Classroom Exercise: Understanding Suicide
Laura Madson and Corey J. Vas designed Handout
12–19 to help students understand the risk factors for
suicide. You may want to use the exercise before students have read the text material on mood disorders and
the Close-Up on suicide. Distribute a copy of the handout to each student. As the instructions indicate, have
students read the descriptions of the four fictional persons and, using their best judgment, rank them in terms
of their risk for attempting or committing suicide.
After students have completed the rankings, engage
the full class in a discussion of the “correct” rankings
(initially, you could form small groups). The discussion
will make it clear that these rankings are somewhat
arbitrary and will highlight the uncertainty that surrounds suicide risk. The same event may have no effect
on one person but may dramatically increase the risk for
suicide in another person. In addition, the overwhelming majority of people who experience various risk factors do not become suicidal. As Madson and Vas conclude, “Predicting suicide is far more complex than
compiling a laundry list of a person’s risk factors.”
In surveying the literature, Madson and Vas identify a number of risk factors that are correlated with suicidal ideation and behavior. Some, but not all, of these
are also identified in the text. For example, suicidal
behavior varies by gender, age, and marital status. Easy
accessibility to firearms, mood disorders, substance
abuse, and feelings of loneliness and hopelessness are
also predictive.
Perhaps the strongest single predictor of suicidal
behavior, particularly in adolescents, is previous suicide
attempts. Among adolescents and young adults (under
age 30), interpersonal loss; poor social adjustment; and
problems surrounding love relationships, dating, and
friends also act as precipitating factors. Rejection by
a potential partner or loss of a romantic relationship
may be a powerful predisposing event for undergraduates.
In terms of the rankings, Madson and Vas suggest
that Person 2 is at greatest risk because she presents two
of the strongest predictors of suicide (i.e., a previous
suicide attempt and the breakup of a long-term relationship). Person 4 may be second in terms of risk because
he presents other leading predictors (i.e., he has a substance abuse problem, ready access to firearms, and
recently began giving away his possessions). The last
two persons present both risk factors (i.e., a young
woman who is depressed and ostracized by her family
because she is lesbian, and a father who recently lost
his job), but they also show protective factors that
decrease risk (i.e., she is currently in treatment for her
depression, and he has his family to provide social support). The article authors rank persons 3 and 1 in positions 3 and 4, respectively.
Finally, the brevity of the descriptions represents a
challenge. Clinicians who do careful evaluations of
clients have much greater detail about the person’s current mental state and his or her past behavior. You might
ask students what additional information they would
want in order to make more informed judgments. For
example, the person at most risk has “taken a few pills”
in her past, so therapists would certainly want more
information including the type of medication and quantity. If you like, you can expand the fictional accounts
as well as vary the risk factors across cases. Madson
and Vas note that students find the exercise valuable
and those who participate do perform better on questions testing knowledge of the suicide literature, particularly of risk factors. They also observe that, because
suicide is an unsettling topic, you should be ready to
provide support in helping students process any
24 Unit 12 Abnormal Psychology
negative emotions. At a minimum, they suggest being
ready to provide referral to your institution’s counseling
center.
Madson, L., & Vas, C. J. (2003). Learning risk factors for
suicide: A scenario-based activity. Teaching of
Psychology, 30, 123–126.
Classroom Exercise: The Expanded Revised Facts on
Suicide Quiz
Handout 12–20, the Expanded Revised Facts on Suicide
Quiz, designed by John McIntosh and Richard Hubbard,
is a useful tool for introducing class discussion of
research on suicide. The information communicated in
the answers to the questions goes well beyond that presented in the text, so the quiz is useful, even if students
have already completed the unit. The quiz contains 25
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
F (40.9%)
T (45.5%)
T (27.3%)
F (70.5%)
F (95.5%)
F (77.3%)
T (52.3%)
F (50.0%)
T (18.2%)
F (84.1%)
F (59.1%)
T (31.8%)
F (25.0%)
T (54.5%)
F (70.5%)
F (18.2%)
T (61.4%)
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
T (36.4%)
F (11.4%)
F (29.5%)
T (88.6%)
T (27.3%)
T (40.9%)
T (29.5%)
F (38.6%)
a (38.6%)
c (6.8%)
b (47.7%)
a (18.2%)
b (70.5%)
a (84.1%)
b (25.0%)
c (6.8%)
a (50.0%)
The mean score for all students was 24.1, and no
sex differences were found.
Earlier, Richard Hubbard and John McIntosh had
noted that students’ increasing interest in the topic of
suicide may in part be due to its personal relevance.
Studies suggest that perhaps 40 to 50 percent of students have suicidal thoughts at one time or another and
that as many as 15 percent may have actually attempted
suicide.
Depending on time, you may want to present
Edwin Schneidman’s 10 common characteristics of suicidal people. Schneidman presents the following in the
belief that knowledge of these characteristics may help
the general public and mental health professionals
reduce suicide rates.
1. Unendurable psychological pain. Suicide is not an
act of hostility or revenge but a way of switching
off unendurable and inescapable pain. If you reduce
their level of suffering, even just a little, suicidal
people will choose to live.
true–false and 25 multiple-choice items. Besides basic
demographic questions about suicide (e.g., age, sex,
race/ethnicity, methods), the quiz touches on a number
of clinically relevant issues. For those who used an earlier version of the instrument, this expanded revised
version includes new items selected to represent emerging issues in suicidology, including questions on suicide
in later life. The correct answers are provided below;
beside each is the percentage of 373 undergraduates in
general or abnormal psychology classes who correctly
answered that question. [Note: In a personal communication, John McIntosh stated, “The only question that
still remains tenuous is #37 related to suicide rates and
specific race/ethnicity. Although at the time we presented and collected data for ERFOS rates were highest for
Native Americans (slightly higher than for Whites),
more recent data has been the opposite again.”]
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
c (56.8%)
a (47.7%)
c (11.4%)
c (81.8%)
b (18.2%)
b (56.8%)
a (68.2%)
b (68.2%)
c (20.5%)
c (54.5%)
b (36.4%)
b (31.8%)
a (72.7%)
c (56.8%)
a (63.6%)
b (27.3%)
2. Frustrated psychological needs. Needs for security,
achievement, trust, and friendship are among the
important ones not being met. Address these psychological needs and the suicide will not occur.
Although there are pointless deaths, there is never a
“needless” suicide.
3. The search for a solution. Suicide is never done
without purpose. It is a way out of a problem or
crisis and seems to be the only answer to the question: “How do I get out of this?”
4. An attempt to end consciousness. Suicide is both a
movement away from pain and a movement to end
consciousness. The goal is to stop awareness of a
painful existence.
5. Helplessness and hopelessness. Underneath all the
shame, guilt, and loss of effectiveness is a sense of
powerlessness. There is the feeling that no one can
help and nothing can be done except to commit
suicide.
Unit 12 Abnormal Psychology 25
6. Constriction of options. Instead of looking for a
variety of answers, suicidal people see only two
alternatives: a total solution or a total cessation. All
other options have been driven out by pain. The
goal of the rescuer should be to broaden the suicidal person’s perspective.
7. Ambivalence. Some ambivalence is normal, but for
the suicidal person ambivalence is only between
life and death. In the typical case, a person cuts his
or her own throat and calls for help simultaneously.
The rescuer can use this ambivalence to shift the
inner debate to the side of life.
8. Communication of intent. About 80 percent of suicidal people give family and friends clear clues
about their intention to kill themselves.
9. Departure. Quitting a job, running away from
home, leaving a spouse are all departures, but suicide is the ultimate escape. It is a plan for a radical,
permanent change of scene.
10. Lifelong coping patterns. To spot potential suicides,
one must look to earlier episodes of disturbance, to
the person’s style of enduring pain, and to a general
tendency toward “either/or” thinking. Often, there
has been a style of problem solving that might be
characterized as “cut and run.”
Hubbard, R. W., & McIntosh, J. L. (2003, April 25). The
Expanded Revised Facts on Suicide Quiz. Paper presentation at the annual meeting of the American Association
of Suicidology, Santa Fe, NM.
Hubbard, R., & McIntosh, J. (1992). Integrating suicidology into abnormal psychology classes: The Revised Facts
on Suicide Quiz. Teaching of Psychology, 19, 163–166.
McIntosh, J. L., & Hubbard, R. W. (2004, April 16). A
Facts on Suicide Quiz: Reliability and Validity. Paper
presentation at the annual meeting of the American
Association of Suicidology, Santa Fe, NM.
Schneidman, E. (1987, March). At the point of no return.
Psychology Today, 54–58.
Lecture/Discussion Topic: Commitment to the Common
Good
Martin Seligman argues that the present epidemic of
depression stems in part from a rise in individualism
and a decline in commitment to religion and family,
and, more generally, to a decline in commitment to
close-knit relationships and the common good. While
Seligman believes that depression follows from a pessimistic way of thinking about failure, and that learning
to think more optimistically provides one strategy for
short-circuiting depression, he does not believe that
learned optimism alone will stop the tide of depression
on a societal basis. It has to be coupled with a renewed
commitment to the common good. Seligman observes,
“Optimism is a tool to help the individual achieve the
goals he has set for himself. It is in the choice of the
goals themselves that meaning—or emptiness—resides.
When learned optimism is coupled with a renewed
commitment to the common good, our epidemic of
depression and meaninglessness may end.”
Seligman suggests that we begin thinking of this
renewed commitment to the common good as a kind of
moral jogging in which a little daily self-denial is
exchanged for long-term self-enhancement. In our own
self-interest, we must begin to reduce our investment in
ourselves and heighten our investment in the common
good. Some of his specific suggestions follow:
—Give 5 percent of last year’s income away. Do it
personally, not through a charity. Advertise among
potential recipients in a charitable field of interest
that you are giving, say, $2000 away. Interview
applicants, give out the money, and follow its use
to a successful conclusion.
—Give up eating out once a week, shopping for new
shoes, watching a rented movie on Tuesday night,
and spend the time promoting the well-being of
others. Help in a soup kitchen, visit AIDS
patients, clean the public park, raise funds for your
alma mater.
—Visit areas where you will encounter the homeless.
Talk to beggars and judge as well as you can
whether they will use the money for nondestructive purposes. Spend three hours a week doing
this.
—When you read of particularly virtuous or evil
acts, write letters. Compose fan letters to people
who could use your praise, “mend-your-ways” letters to people and organizations you dislike.
Follow up with letters to elected officials who can
act directly. Again, spend three hours weekly in
this activity.
—Teach your children to give things away. Suggest
they set aside one-fourth of their allowance to give
to a needy person or project. Further suggest that
they do this personally.
Some items on the list are likely to generate a lively discussion. Ask students to consider alternatives that
might produce similar results without putting the person
“in the hole” financially.
You might also ask your class to reflect on the psychological benefits of bipartisan efforts to promote the
common good through volunteer service. And what
might be the psychological payoff for those who participate in community-sponsored “random acts of kindness” days or weeks?
Seligman, M. (1990). Learned optimism. New York:
Knopf.
26 Unit 12 Abnormal Psychology
VII. Schizophrenia (pp. 589–596)
A. Symptoms of Schizophrenia (pp. 590–591)
PsychSim 5: Losing Touch With Reality
This activity explains the symptoms of schizophrenia
and the brain changes that accompany schizophrenia.
Students learn about the types of schizophrenia and the
main symptoms, view video clips of individuals with
schizophrenia, and are asked to identify the symptoms
displayed by each individual.
Student Project: The Eden Express and Schizophrenia
Michael Gorman reports a highly successful student
project in which students were asked to read Mark
Vonnegut’s The Eden Express and relate it to the psychological literature on schizophrenia. The book is an
autobiographical account of the author’s schizophrenic
breakdown and eventual recovery. Vonnegut describes
his thoughts and feelings while hallucinating, his
attempts to commit suicide, and his struggle to recover.
He himself attributes his cure primarily to the use of
Thorazine, but certainly other factors contributed to his
recovery. The book is also relevant to the discussion of
therapy in Unit 13.
While Gorman had students write papers discussing how different theoretical perspectives would
account for the cause and cure of Vonnegut’s schizophrenia, you might simply assign the book as outside
reading; this in itself will provide students with new
insight into the nature of schizophrenia.
Gorman, M. (1984). Using The Eden Express to teach
introductory psychology. Teaching of Psychology, 11(1),
39–40.
Classroom Exercise: Magical Ideation Scale
Handout 12–21 is Mark Eckblad and Loren Chapman’s
30-item true-false scale to assess “magical thinking.”
The scale is based on the idea that schizophrenia-prone
people often show a belief in magical influences. Most
of the items inquire about respondents’ interpretations
of their own experiences rather than their belief in the
theoretical possibility of magical forms of causation. Of
more than 1500 college students who completed the
scale, males and females had mean scores of 8.56 and
9.69, respectively. The scoring key appears at the top of
the next column.
The scale is part of a larger project aimed at developing “measures of deviant functioning to identify
young adults who may be psychosis prone.” Participants
who scored very high on the Magical Ideation Scale
were interviewed extensively. Compared to a control
group, they did report “more schizotypical experiences,
more affective symptoms, and more difficulties in
concentration.”
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
T
T
T
T
T
T
F
T
T
T
T
F
F
T
T
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
F
T
F
T
T
T
F
F
T
T
T
T
T
T
T
Eckblad, M., & Chapman, L. (1983). Magical ideation as
an indicator of schizotypy. Journal of Consulting and
Clinical Psychology, 51, 215–225.
Lecture/Discussion Topic: Infantile Autism
You can extend the text discussion of schizophrenia to
include a consideration of infantile autism (see also text
Unit 9). The autistic condition appears similar to schizophrenia, in that social withdrawal is a prominent characteristic of both. There are, however, important differences. For example, autism is usually diagnosed at an
early age, sometimes within the first 6 months after
birth, and always by age 3. The usual age for diagnosis
of schizophrenia is between 15 and 30 years. Although
the incidence of schizophrenia in males and females is
about equal, autism occurs mostly in males. Finally,
schizophrenia tends to run in families, whereas autism
does not.
James Kalat identifies nine characteristic behaviors
of the autistic child.
1. Social isolation. The child ignores others, even parents, and retreats into a world of his (or her) own.
2. Stereotyped behaviors. The child rocks back and
forth, bites his hands, stares at some object,
engages in repetitive behaviors.
3. Resistance to any change in routine.
4. Abnormal responses to sensory stimuli. Sometimes
the child ignores visual and auditory stimuli; at
other times, he shows a “startle reaction” to very
mild stimuli.
5. Insensitivity to pain. The child is remarkably insensitive to cuts, burns, and other sources of pain.
6. Inappropriate emotional expression. Sometimes the
child may have sudden bouts of fear without obvious reason. In other cases, he may show absolute
fearlessness and unprovoked laughter.
7. Disturbances of movement. These vary from hyperactivity to prolonged inactivity.
Unit 12 Abnormal Psychology 27
8. Poor development of speech. Some never develop
any spoken language, whereas others begin to
develop it and then lose it.
9. Specific, limited intellectual problems. Many autistic children do well on some intellectual tasks but
very poorly on others. It is nearly impossible to
estimate their general intelligence because they fail
to follow the directions of a standard IQ test.
Prognosis for the autistic child is not good. Many
drugs have been tried but none has proved to be reliably
helpful. Therapy involving operant conditioning techniques (see Unit 13) has occasionally been useful. More
recently, some encouraging results have been reported
for large doses of vitamins and minerals, including vitamin B and magnesium.
Some theorists have suggested that parental lack of
emotional warmth is the cause of autism, but others
reject the bad-parent theory. They point to the fact that
in most cases, siblings are completely normal. It also
seems impossible to alleviate autism by merely providing a great deal of emotional warmth and love.
One puzzling characteristic of some autistic children is that they tend to huddle around radiators and
other heat sources, as if they felt cold. Even more surprising, some autistic children behave almost normally
when they have a fever, showing better attention to their
surroundings and improved communication with other
people.
James Kalat and others have speculated on the possible biological basis of autism. Insensitivity to pain,
which characterizes the autistic child, can also be produced by morphine or other opiate drugs. The brain
uses some peptide synaptic transmitters, called endorphins and enkephalins, with effects similar to those of
morphine. If for some unknown reason the brain sometimes produced huge amounts of enkephalins and at
other times small amounts, the behavioral effect would
resemble that of a child who occasionally took morphine, and would be very much like that of a child with
autism.
Eric Courchesne and Rachel Yeung-Courchesne
have linked autism to underdevelopment of the cerebellum. They have used an advanced imaging technique to
show precisely where autism-linked damage may occur.
The location of the damage suggests that it occurs during the fetal stage or during the first 2 years of life and
may be caused by genetic abnormality or exposure to a
virus or harmful chemicals.
Elias, M. (1988, May 26). Autism may be caused by
brain damage. USA Today, p. 10.
Kalat, J. (2007). Biological psychology (9th ed.). Pacific
Grove, CA: Wadsworth.
Courchesne, E., et al. (1988). Hypoplasia of cerebellar
vermal lobules VI and VII in autism. New England
Journal of Medicine, 318, 1349–1354.
B. Onset and Development of Schizophrenia
(pp. 591–592)
C. Understanding Schizophrenia (pp. 592–596)
VIII. Personality Disorders (pp. 596–599)
Lecture/Discussion Topic: Narcissistic Personality
Disorder
Narcissistic personality disorder provides a good extension of the brief review of personality disorders in the
text. Ask your students whether they agree with the following statements:
1.
2.
3.
4.
I think I am a special person.
I expect a great deal from other people.
I am envious of other people’s good fortune.
I will never be satisfied until I get all that I
deserve.
5. I really like to be the center of attention.
All the statements are drawn from Robert Raskin and
Calvin Hall’s Narcissistic Personality Inventory and
reflect some of the disorder’s primary features. The narcissistic personality has a strong need to be admired,
has a grandiose sense of self-importance, and demonstrates a lack of insight into other people’s feelings.
This sense of superiority is accompanied by feelings of entitlement. That is, narcissists believe they
should receive special privileges and respect—get the
best job, obtain admission to the best university—
although they have done nothing to earn such favorable
treatment. Moreover, the world should be their fan club.
When they come to a party, they expect to be welcomed
with great fanfare. Many narcissists prefer friends who
are weak or unpopular, so they will not compete for
attention.
Randy Larsen and David Buss identify the narcissistic paradox—narcissists appear to have high selfesteem, but it is actually quite fragile. They appear selfconfident but are in desperate and continuing need for
others to verify their worth. Ironically, without others,
they are nothing; at the same time, they disdain others.
In an interview with Gear magazine in October 2000,
entertainer Roseanne Barr stated (hopefully tongue-incheek): “I hate every human being on earth. I feel
everyone is beneath me, and I feel they should all worship me.”
Narcissists have difficulty in their interpersonal
relations because of an inability to recognize the needs
28 Unit 12 Abnormal Psychology
or desires of others. They talk mostly about themselves.
In fact, research finds that they tend to use first-person
pronouns in everyday conversation significantly more
often than does the average person. Narcissists are also
prone to envy. They tend to disparage the success and
accomplishments of others. Appearing snobbish, they
may attempt to hide their strong feelings of envy and
rage over the success of others. Their fragile sense of
self-worth becomes apparent when others are critical of
them. They either fly into a rage or experience a period
of depression, shame, and self-doubt.
Larsen, R. J., & Buss, D. M. (2008). Personality psychology: Domains of knowledge about human nature (3rd
ed.). Boston: McGraw-Hill.
Raskin, R., & Hall, C. S. (1979). A narcissistic personality inventory. Psychological Reports, 45, 590.
Sedikes, C., et al. (2002). Do others bring out the worst
in narcissists? The “others exist for me” illusion. In
Y. Kashima, M. Foddy, & M. Platow (Eds.), Self and
identity (pp. 103–124). Mahwah, NJ: Erlbaum.
Classroom Exercise: Schizotypal Personality
Questionnaire
You can extend the text discussion of personality disorders with Handout 12–22, Adrian Raine’s schizotypal
personality questionnaire. It will introduce the key characteristics of a fascinating personality disorder that is
closely tied to the study of schizophrenia. Students
score their responses by adding all their “yes” responses. Total mean score for 220 male and female undergraduates was 9.6.
Three subscales help to describe the essential characteristics of this disorder. The cognitive-perceptual factor is assessed by items 2, 4, 5, 9, 10, 12, 16, and 17.
The mean score for undergraduates was 3.6. The items
suggest that the disorder is often marked by unusual
perceptual experiences, magical thinking, and odd
beliefs and ideas of reference. The interpersonal factor
is measured by items 1, 7, 11, 14, 15, 18, 21, and 22.
The mean undergraduate score was also 3.6.
Schizotypical personality is marked by social anxiety,
few close friends, and constricted affect. The “disorganized” factor is assessed by items 3, 6, 8, 13, 19, and
20, and the mean score for undergraduates was 2.5.
The personality disorder is marked by odd behavior,
including odd speech.
Schizoptypal personality disorder falls within the
“eccentric” cluster of personality disorders (the other
clusters include the “erratic” cluster, which covers antisocial, borderline, histrionic, and narcissistic disorders,
and the “anxious” cluster, which covers avoidant,
dependent, and obsessive-compulsive personality
disorders.)
Those suffering schizoptypal personality disorder
report unusual perceptions that border on hallucina-
tions. They may feel that other people are looking at
them or hear murmurs that sound like their names. It is
not unusual for them to hold many superstitious beliefs,
including an acceptance of ESP and other psychic phenomena. They may believe in magic such as in their
own ability to control others with their thoughts.
Schizotypal people are very uncomfortable in
social situations, especially those that involve strangers.
They feel that they are different from others and simply
don’t fit in. Importantly, they become more, rather than
less, anxious as they interact. They are suspicious of
others and thus unable to invest trust in them.
Schizotypal persons have disorganized thoughts
that are expressed in difficulty communicating, vague
speech, and odd nonverbal behavior. They often fail to
make eye contact in conversation and are viewed as
eccentric. They often wear clothes that are unkempt or
that clash.
Raine, A., & Benishay, D. (1995). The SPQ-B: A brief
screening instrument for schizotypal personality disorder.
Journal of Personality Disorders, 9, 346–355.
A. Antisocial Personality Disorder (p. 597)
Classroom Exercise: Antisocial Personality Disorder
Many regard Hervey Cleckley’s The Mask of Sanity to
be the classic work on antisocial personality disorder.
Recasting Cleckley’s clinical criteria for the disorder in
the form of self-referential or opinion statements,
Michael Levenson designed Handout 12–23 to assess
this antisocial posture. He attempted to remove the negative connotations of the original criteria so that the
items would suggest to antisocial persons that antisocial
traits are not necessarily undesirable. A point is scored
for each “true” response. If you use the scale, it would
be wise to note that the items have been employed
strictly for research, not for diagnostic purposes, and
that you are using the scale to introduce Cleckley’s portrayal of the antisocial personality. When Levenson
included the scale in a study of risk taking and personality, he obtained a mean score of 8.33 for residents in a
long-term drug treatment facility, a mean of 6.06 for
skilled rock climbers, and a mean of 5.15 for police
officers/fire fighters who had been commended for
bravery in the line of duty. All participants were male.
Cleckley identifies the following characteristics of
antisocial personality.
1.
2.
3.
4.
Superficial charm and good intelligence.
Poise, rationality, absence of neurotic anxiety.
Lack of a sense of personal responsibility.
Untruthfulness, insincerity, callousness,
manipulativeness.
5. Antisocial behavior without regret or shame.
6. Poor judgment and failure to learn from
experience.
Unit 12 Abnormal Psychology 29
7. Inability to establish lasting, close relationships
with others.
8. Lack of insight into personal motivations.
Cleckley, H. (1976). The mask of sanity (5th ed.). St.
Louis: Mosby.
Levenson, M. (1990). Risk taking and personality.
Journal of Personality and Social Psychology, 58,
1073–1080.
Feature Film: In Cold Blood
In Cold Blood provides an excellent introduction to personality disorders. Based on Truman Capote’s bestseller, it relates the true story of the personalities and
events surrounding the murder of the Herbert Clutter
family. Perry Smith and Richard Hickock, two former
prison inmates, travel to Holcomb, Kansas, with the
intent of robbing the Clutter farm. When they find no
money, they systematically shoot the four defenseless
family members. The film focuses on the personality
and motives of Perry Smith. Through flashbacks, the
viewer observes the role of early experience in the
development of his aggressive behavior. After showing
the film, you can discuss the possible factors that contribute to the antisocial personality.
You can also use this film to introduce a discussion
of the insanity defense. As Capote relates in his book,
the defendants’ attorneys entered an insanity plea, but
under the M’Naghten rule (in criminal trials, an insanity
defense is valid only if the defendant is shown not to
have known what he or she was doing or did not know
right from wrong). Smith and Hickock were convicted
and sentenced to hang. While Richard Hickock’s criminal conduct might be attributed to an earlier head
injury, a psychiatrist testified that Hickock knew the
difference between right and wrong. Tests to determine
whether brain damage was in fact present were never
conducted.
You might ask students if they think the insanity
plea is ever appropriate, and if so, what should be the
criteria. In the 1950s, the Durham rule replaced
M’Naghten in some courts. The Durham rule states that
the “accused is not criminally responsible if his unlawful act is the product of mental disease or defect.”
David Bazelon, the presiding judge at the trial that first
applied this criterion, believed that use of the general
term “mental disease” would leave the profession of
psychiatry free to apply its full knowledge. Forcing the
jury to rely on expert but often conflicting testimony
has not proved workable, however, so the Durham rule
is no longer used in most jurisdictions.
Other alternatives to the insanity defense have been
proposed, and in some cases adopted. For example, several states have adopted the verdict “guilty but mentally
ill.” While the person is held legally accountable for his
action, his sentence involves psychotherapeutic treat-
ment in a hospital or in jail. Treatment may focus on
helping the convict take responsibility for his or her
own actions. Another proposal has been the plea of
diminished capacity, or diminished responsibility,
whereby a defendant may be tried for a lesser crime if
there is reason to suspect psychological disorder. Its
advantage is that it does not create a separate category
of prisoners (or patients). Moreover, it recognizes that
responsibility exists along a continuum, with some people more responsible than others for their actions.
B. Understanding Antisocial Personality Disorder
(pp. 597–598)
IX. Rates of Psychological Disorders
(pp. 599–600)
Lecture/Discussion Topic: The Commonality of
Psychological Disorders
The results of a federally funded study headed by
Ronald Kessler of the University of Michigan’s Institute
for Social Research and released in early 1994 suggested that nearly half of people ages 15 to 54 have experienced at least one bout with a psychiatric disorder, and
about one in three have had such an episode over the
last year. Psychological disorder peaks between the ages
of 25 and 34. Affluent, well-educated people seem to
suffer less anxiety than others, perhaps, Kessler suggests, because “they’re not as scared about their future,
and can afford to buy psychological help.” Despite the
high lifetime rates of emotional problems, only one out
of four people have ever received help. Kessler notes
that many mental disorders are mild, and people recover
from them without help.
The study found that the most common disorders
were these:
1. Major depressive episode, which constitutes at least
two weeks of symptoms such as low mood and loss
of pleasure. More than 17 percent have suffered an
episode in their lives, more than 10 percent in the
last year.
2. Alcohol dependence, with more than 14 percent
experiencing it in their lifetime, 7.2 percent in the
last year.
3. Social phobia, a persistent fear of feeling scrutinized or embarrassed in social situations, with 13
percent experiencing it, almost 8 percent in the last
year.
4. Simple phobia, or a persistent fear of objects such
as animals, insects, or blood, or of situations such
as closed spaces, heights, or air travel, with more
than 11 percent experiencing it in their lifetime,
almost 9 percent in the last year.
Kessler and his colleagues have released another
report based on a nationally representative face-to-face
30 Unit 12 Abnormal Psychology
household survey conducted between February 2001
and April 2003. It extends earlier findings. The
researchers used the fully structured World Health
Organization World Mental Health Survey version of
the Composite International Diagnostic Interview in
assessing 9282 English-speaking respondents. Perhaps
of greatest interest is that one-quarter of all Americans
met the criteria for having a mental illness within the
prior year, and fully a quarter of those had a “serious”
disorder that significantly disrupted their ability to
function day to day. Although comparable studies in 27
other countries are not yet complete, the researchers
conclude that these new numbers suggest that the
United States is poised to rank No. 1 globally for
mental illness. Other important findings include the
following:
• About half of Americans will meet the criteria for a
DSM-IV disorder sometime in their lifetime.
• By age 75, the lifetime probability of an anxiety
disorder (including phobias) is 32 percent, of mood
disorders (including depression) is 28 percent, of
impulse control disorders is 25 percent, of alcohol
abuse is 15 percent, and of drug abuse is 9 percent.
• Median age of onset is much earlier for anxiety (11
years) and impulse-control (11 years) disorders
than for substance abuse (20 years) and mood disorders (30 years). Half of all cases start by 14
years and three-fourths by 24 years.
• Rates of mental illness have flattened in the past 15
years after steadily rising from the 1950s.
• 41 percent of those having a disorder went for
treatment in the prior year which is up from 25 percent a decade ago. Younger adults are more likely
to seek prompt care, so the stigma of mental illness
may be waning.
• Because schizophrenia, autism, and some other
severe disorders were not surveyed, the researchers
conclude that the prevalence of psychological disorders is even higher than their statistics suggest.
Elias, M. (1994, January 14). Many adults have glitches
in mental health. USA Today, p. 4D.
Kessler, R. C., et al. (2005) Lifetime prevalence and ageof-onset distributions of DSM-IV Disorders in the
National Comorbidity Survey Replication. Archives of
General Psychiatry, 62, 593–602.
Unit 12 Abnormal Psychology 31
Name
Period
Date
HANDOUT 12–1
Fact or Falsehood?
T F
1. In some cultures, depression and schizophrenia are nonexistent.
T F
2. The more contact people have with individuals with disorders, the less accepting
their attitudes are.
T F
3. About 30 percent of psychologically disordered people are dangerous; that is, they
are more likely than other people to commit a crime.
T F
4. Research indicates that in the United States there are more prison inmates with
severe mental disorders than there are psychiatric inpatients in all the country’s
hospitals.
T F
5. Identical twins who have been raised separately sometimes develop similar phobias.
T F
6. Dissociative identity disorder is a type of schizophrenia.
T F
7. In North America, today’s young adults are three times more likely than their
grandparents to report having suffered depression.
T F
8. White Americans commit suicide nearly twice as often as Black Americans do.
T F
9. There is strong evidence for a genetic predisposition to schizophrenia.
T F
10. Twenty-six percent of adult Americans suffer from a diagnosable mental dissorder in
a given year.
32 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–2
Defining Psychological Disorders
Instructions: Read through the case studies that follow. After you read each one, decide whether you think that the
individual described is displaying a psychological disorder. Go with your initial “gut” instinct for now.
Andrew has led a turbulent life. As a young child, he skipped school more often than he attended. When he did attend,
he was a frequent behavior problem, often getting into fights with other boys. He was finally expelled from school
altogether after stabbing another student in his high school class. Since then he has not held a job for any length of
time. Soon after his expulsion, he began supplementing his income by breaking into homes and stealing whatever he
could get his hands on. However, he appears to feel no guilt about this behavior. Although he has never been in a committed relationship, he has several children, whom he never sees, due partly to the fact that he frequently moves from
town to town. Despite these characteristics, Andrew is a colorful and entertaining person and has a certain charm. If
asked, he will tell you that he is quite happy with his current life-style.
Has a Psychological Disorder
Does not have a Psychological Disorder
Barbara was generally a happy child and had many friends in high school. She made very good grades and decided to
go on to college and then to law school. After her first year of law school, she began to notice periods of “feeling
down.” At first she ignored this, but after a year or so, these episodes began to get worse. When she started paying
more attention, she noticed that the episodes usually began about a week before her period and ended a few days after
her period began. In addition to feeling depressed during that time, she also was overly sensitive to criticism. Often,
her appetite would increase, and she would especially crave sweets. Sometimes she found it difficult to concentrate on
her studies during this time, and she often lacked the energy to do much of anything except watch television.
Has a Psychological Disorder
Does not have a Psychological Disorder
Charles is the third of seven children. He attended school in the suburbs of a large city, where he made average
grades. He dated a bit in high school and had several close friends. During vacations, he worked in his father’s garage,
learning all he could about automobiles. After high school, Charles took a job as a mechanic in the garage. However,
Charles was beginning to feel different from his co-workers. He began to realize that he was attracted to one of his
customers, a man with whom he had gone to school. When Charles realized this, he became very confused and felt
angry with himself for having such feelings. Although he tried to convince himself that the feelings would go away
over time, they did not, and Charles finally admitted to himself that he was a homosexual. Currently, he is in a
monogamous relationship with another man but is afraid to admit his sexual orientation to friends or family, for fear
of their reaction. He often finds himself preoccupied with trying to find ways to hide his orientation from them.
Has a Psychological Disorder
Does not have a Psychological Disorder
Unit 12 Abnormal Psychology 33
HANDOUT 12–2 (continued )
Diane is the only child of two professional parents. She did well in high school and had several close friends.
However, her grades suffered when she got to college, and she spent one semester on probation before she graduated. While in college, she met Don, and the two married soon after graduation and had two children of their
own. Diane and Don decided that she would stay home until the children were in school, since his job with a
prestigious accounting firm would allow him to support the family. Three months ago, however, Don came home
from work and announced that he had met another woman and was having an affair and that he had decided to
leave Diane. The divorce proceeded quickly, and, while Diane retained custody of the children, she had to move to
a smaller apartment. She began looking for work but found that it was difficult to find a job, and eventually took
a job she disliked. Diane often finds herself thinking about how quickly her life has changed in the last few
months. She becomes very sad and will sometimes lie in bed crying after the children are asleep. She finds herself eating a lot more than she used to, and sometimes, she has difficulty getting to sleep at night.
Has a Psychological Disorder
Does not have a Psychological Disorder
Eric was born in a rural town in the midwest. He made average grades in school and decided after graduation to
purchase a farm in the area and raise corn. He very much enjoyed this lifestyle and did quite well. One day, while
working in the field, an accident with a combine caused Eric to be rushed to the hospital. While doctors were able
to save his life, they were not able to save his legs. Eric is now confined to a wheelchair. It has been a year since
the accident and he is in a great deal of pain, which is partially controlled by morphine, which his doctor has prescribed. However, his thinking remains quite rational, and he has been able to do some work helping with the
books at his parents’ store. He does not enjoy this work and misses his previous activity. Recently, he confided in
his doctor that he does not feel that his new life is worth living, and he has decided that he would like to end it
all.
Has a Psychological Disorder
Does not have a Psychological Disorder
Source: Davis, S. M. (2003, January). Utilizing contradictions in students’ implicit definitions of “mental disorder” in an
introductory psychology course. Poster presented at the 25th Annual National Institute on the Teaching of Psychology, St.
Petersburg, FL, January 2003.
34 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–3
Adult ADHD Self-Report Scale Symptom Checklist
Please answer the questions below, rating yourself on each of the criteria using the following scale. As you answer
each question, describe how you have felt and conducted yourself over the past 6 months.
0 = never
1 = rarely
2 = sometimes
3 = often
4 = very often
1. How often do you have trouble wrapping up the final details of a project, once the challenging parts have
been done?
2. How often do you have difficulty getting things in order when you have to do a task that requires
organization?
3. How often do you have problems remembering appointments or obligations?
4. When you have a task that requires a lot of thought, how often do you avoid or delay getting started?
5. How often do you fidget or squirm with your hands or feet when you have to sit down for a long time?
6. How often do you feel overly active and compelled to do things, like you were driven by a motor?
Source: Reprinted by permission of the World Health Organization.
Unit 12 Abnormal Psychology 35
Name
Period
Date
HANDOUT 12–4
The Healthy Adult
Circle the five characteristics that best describe a mature, healthy, and socially competent adult male.
1.
2.
3.
4.
5.
ambitious
tactful
adventurous
aware of others’ feelings
need for security
6.
7.
8.
9.
10.
self-confident
logical
gentle
independent
expresses tender feelings
Circle the five characteristics that best describe a mature, healthy, and socially competent adult female.
1.
2.
3.
4.
5.
ambitious
tactful
adventurous
aware of others’ feelings
need for security
6.
7.
8.
9.
10.
self-confident
logical
gentle
independent
expresses tender feelings
Circle the five characteristics that best describe a mature, healthy, and socially competent adult person.
1.
2.
3.
4.
5.
ambitious
tactful
adventurous
aware of others’ feelings
need for security
6.
7.
8.
9.
10.
self-confident
logical
gentle
independent
expresses tender feelings
Source: Broverman et al. (1970). Sex role stereotypes and clinical judgments of mental health. Journal of Consulting and
Clinical Psychology, 34. Copyright © 1970 by the American Psychological Association. Adapted by permission.
36 Unit 12 Abnormal Psychology
HANDOUT 12–5
Suppose, without your knowledge, just before you came to class today, someone put a drug into your drink that soon
will make you behave as though you were psychotic. This afternoon, a classmate finds you wandering the halls muttering nonsense and takes you to the Principal’s office. The Principal notifies your parents of your “illness” and they
send you to a psychiatric clinic where you fill out a questionnaire that asks about events in your past that might have
caused your “breakdown.” Take some time now, during a short break, to think about it. Can you remember happenings
in your own life that might explain your “psychopathological” condition? Jot down anything that comes to mind.
Don’t sign them but be prepared to hand in your notes when class resumes.
Source: Kimble, G. A. (1996, August). Secondary school psychology: The challenge and the hope (table 2). Paper presented
at the 104th Annual Convention of the American Psychological Association, Toronto.
Unit 12 Abnormal Psychology 37
Name
Period
Date
HANDOUT 12–6
Pretend the following description of Tom W. was written by a clinical psychologist 5 years ago, when Tom was a senior in high school. Please read it carefully before responding to the question below.
Tom W. is of high intelligence, although lacking in true creativity. He has a need for order and clarity, and
for neat and tidy systems in which every detail finds its appropriate place. His writing is rather dull and
mechanical, occasionally enlivened by somewhat corny puns and flashes of imagination of the sci-fi type.
He has a strong drive for competence. He seems to have little feeling and little sympathy for other people
and does not enjoy interacting with others. Self-centered, he nonetheless has a deep moral sense.
Today, Tom is a mental patient in a state hospital. Might that outcome have been predicted when Tom was a senior in
high school? On what basis?
Source: Bolt, M. (1999). Instructor’s Manual to accompany Social Psychology (6th ed., p. 478). Copyright © 1996 by
McGraw-Hill. Reproduced by permission of The McGraw-Hill Companies. Adapted from Kahneman, D., & Tversky, A.
(1973). On the psychology of predictions. Psychological Review, 80, 237–251. Copyright © 1973 by the American
Psychological Association. Reprinted with permission.
Unit 12 Abnormal Psychology 37
Name
Period
Date
HANDOUT 12–6
Pretend the following description of Tom W. was written by a clinical psychologist 5 years ago, when Tom was a senior in high school. Please read it carefully before responding to the question below.
Tom W. is of high intelligence, although lacking in true creativity. He has a need for order and clarity, and
for neat and tidy systems in which every detail finds its appropriate place. His writing is rather dull and
mechanical, occasionally enlivened by somewhat corny puns and flashes of imagination of the sci-fi type.
He has a strong drive for competence. He seems to have little feeling and little sympathy for other people
and does not enjoy interacting with others. Self-centered, he nonetheless has a deep moral sense.
Today, Tom is a graduate student in the School of Education in a state university and hopes to work eventually with
handicapped children. Might that outcome have been predicted when Tom was a senior in high school? On what
basis?
Source: Bolt, M. (1999). Instructor’s Manual to accompany Social Psychology (6th ed., p. 478). Copyright © 1996 by
McGraw-Hill. Reproduced by permission of The McGraw-Hill Companies. Adapted from Kahneman, D., & Tversky, A.
(1973). On the psychology of predictions. Psychological Review, 80, 237–251. Copyright © 1973 by the American
Psychological Association. Reprinted with permission.
38 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–7
Penn State Worry Questionnaire
Using a scale from 1 = “not at all typical of me” to 5 = “very typical of me” respond to each of the following items:
1. If I do not have enough time to do everything, I do not worry about it.
2. My worries overwhelm me.
3. I do not tend to worry about things.
4. Many situations make me worry.
5. I know I should not worry about things, but I just cannot help it.
6. When I am under pressure I worry a lot.
7. I am always worrying about something.
8. I find it easy to dismiss worrisome thoughts.
9. As soon as I finish one task, I start to worry about everything else I have to do.
10. I never worry about anything.
11. When there is nothing more I can do about a concern, I do not worry about it any more.
12. I have been a worrier all my life.
13. I notice that I have been worrying about things.
14. Once I start worrying, I cannot stop.
15. I worry all the time.
16. I worry about projects until they are all done.
Source: Meyer et. al. Development and validation of the Penn State Worry Questionnaire. Behavior Research and Therapy,
28, 487–495. Copyright 1990. Reprinted by permission of Elsevier in the format Text via Copyright Clearance Center.
Unit 12 Abnormal Psychology 39
Name
Period
Date
HANDOUT 12–8
Taylor Manifest Anxiety Scale
Circle the items that are true of you.
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
I do not tire quickly.
I am troubled by attacks of nausea.
I believe I am no more nervous than most others.
I have very few headaches.
I work under a great deal of tension.
I cannot keep my mind on one thing.
I worry over money and business.
I frequently notice my hand shakes when I try to do something.
I blush no more often than others.
I have diarrhea once a month or more.
I worry quite a bit over possible misfortunes.
I practically never blush.
I am often afraid that I am going to blush.
I have nightmares every few nights.
My hands and feet are usually warm.
I sweat very easily even on cool days.
Sometimes when embarrassed, I break out in a sweat.
I hardly ever notice my heart pounding and I am seldom short of breath.
I feel hungry almost all the time.
I am very seldom troubled by constipation.
I have a great deal of stomach trouble.
I have had periods in which I lost sleep over worry.
My sleep is fitful and disturbed.
I dream frequently about things that are best kept to myself.
I am easily embarrassed.
I am more sensitive than most other people.
I frequently find myself worrying about something.
I wish I could be as happy as others seem to be.
I am usually calm and not easily upset.
I cry easily.
I feel anxiety about something or someone almost all the time.
I am happy most of the time.
It makes me nervous to have to wait.
I have periods of such great restlessness that I cannot sit long in a chair.
Sometimes I become so excited that I find it hard to get to sleep.
I have sometimes felt that difficulties were piling up so high that I could not overcome them.
I must admit that I have at times been worried beyond reason over something that really did not matter.
I have very few fears compared to my friends.
I have been afraid of things or people that I know could not hurt me.
I certainly feel useless at times.
I find it hard to keep my mind on a task or job.
I am usually self-conscious.
I am inclined to take things hard.
I am a high-strung person.
Life is a trial for me much of the time.
At times I think I am no good at all.
I am certainly lacking in self-confidence.
I sometimes feel that I am about to go to pieces.
I shrink from facing a crisis of difficulty.
I am entirely self-confident.
Source: Janet T. Spence .Taylor Manifest Anxiety Scale in A personality scale of manifest anxiety. Journal of Abnormal and
Social Psychology. Copyright © 1953. Reprinted by permission of the author.
40 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–9
Psychological Disorder
We are interested in the kinds of thoughts you may have had after a traumatic experience. Below are a number of
statements that may or may not be representative of your thinking. Please read each statement carefully and tell us
how much you AGREE or DISAGREE with each statement. People react to traumatic events in many different ways.
There are no right or wrong answers to these statements.
1 = Totally disagree
2 = Disagree very much
3 = Disagree slightly
4 = Neutral
5 = Agree slightly
6 = Agree very much
7 = Totally agree
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
The event happened because of the way I acted.
I can’t trust that I will do the right thing.
I am a weak person.
I will not be able to control my anger and will do something terrible.
I can’t deal with even the slightest upset.
I used to be a happy person but now I am always miserable.
People can’t be trusted.
I have to be on guard all the time.
I feel dead inside.
You can never know who will harm you.
I have to be especially careful because you never know what can happen next.
I am inadequate.
I will not be able to control my emotions, and something terrible will happen.
If I think about the event, I will not be able to handle it.
The event happened to me because of the sort of person I am.
My reactions since the event mean that I am going crazy.
I will never be able to feel normal emotions again.
The world is a dangerous place.
Somebody else would have stopped the event from happening.
I have permanently changed for the worse.
I feel like an object, not like a person.
Somebody else would not have gotten into this situation.
I can’t rely on other people.
I feel isolated and set apart from others.
I have no future.
I can’t stop bad things from happening to me.
People are not what they seem.
My life has been destroyed by the trauma.
There is something wrong with me as a person.
Unit 12 Abnormal Psychology 41
HANDOUT 12–9 (continued )
30.
31.
32.
33.
34.
35.
36.
My reactions since the event show that I am a lousy coper.
There is something about me that made the event happen.
I will not be able to tolerate my thoughts about the event, and I will fall apart.
I feel like I don’t know myself anymore.
You never know when something terrible will happen.
I can’t rely on myself.
Nothing good can happen to me anymore.
Scoring Key for the Posttraumatic Cognitions Inventory (PTCI)
Negative Cognitions
about Self
Negative Cognitions
about the World
Self-Blame
2 ______
7 ______
3 ______
8 ______
15 ______
4 ______
10 ______
19 ______
5 ______
11 ______
22 ______
6 ______
18 ______
31 ______
9 ______
23 ______
12 ______
27 ______
14 ______
1 ______
Sum C ______
divided by 5 = ______ (Score)
16 ______
Sum B ______
17 ______
divided by 7 = _______ (Score)
20 ______
21 ______
24 ______
25 ______
26 ______
Total Score
28 ______
Sum A ______
29 ______
Sum B ______
30 ______
Sum C ______
33 ______
35 ______
Sum of A, B, C = _______ (Score)
36 ______
Sum A ______
divided by 21 = ______ (Score)
Note. Items 13, 32, and 34 are experimental and therefore not included in subscales.
Source: Foa et al. (1999). The Posttraumatic Cognitions Inventory: Development and validation. Psychological Assessment, 11.
Copyright © 1999 by the American Psychological Association and the authors. Adapted by permission.
42 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–10
Measuring Fear
Using the key below, rate each item on the intensity of fear you associate with that object or event.
1
no fear
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
2
very little
fear
3
a little
fear
4
some
fear
Sharp objects
Being a passenger in a car
Dead bodies
Suffocating
Failing a test
Looking foolish
Being a passenger in an airplane
Worms
Arguing with parents
Rats and mice
Life after death
Hypodermic needles
Being criticized
Meeting someone for the first time
Roller coasters
Being alone
Making mistakes
Being misunderstood
Death
Being in a fight
Crowded places
Blood
Heights
Being a leader
Swimming alone
Illness
5
much
fear
27.
28.
29.
30.
31.
32.
33.
34.
35.
36.
37.
38.
39.
40.
41.
42.
43.
44.
45.
46.
47.
48.
49.
50.
51.
6
great
fear
7
terror
Being with drunks
Illness or injury to loved one
Being self-conscious
Driving a car
Meeting authority
Mental illness
Closed places
Boating
Spiders
Thunderstorms
Not being a success
God
Snakes
Cemeteries
Speaking before a group
Seeing a fight
Death of a loved one
Dark places
Strange dogs
Deep water
Being with a member of the opposite sex
Stinging insects
Untimely or early death
Losing a job
Auto accidents
Source: Geer. The development of a scale to measure fear. Behavior Research and Therapy. Copyright 1965. Reprinted by
permission of Elsevier.
Unit 12 Abnormal Psychology 43
Name
Period
Date
HANDOUT 12–11
Rate the degree to which the thoughts or beliefs below are typical of your thinking when anticipating or participating
in a social encounter. Use the following scale:
1 = never characteristic
2 = rarely characteristic
3 = sometimes characteristic
4 = often characteristic
5 = always characteristic
1. When I am in a social situation, I appear clumsy to other people.
2. If I am with a group of people and I have an opinion, I am likely to chicken out and not say what I think.
3. I feel as if other people sound more intelligent than I do.
4. When I am with other people, I am not good at standing up for myself.
5. I am a coward when it comes to interacting with other people.
6. I feel unattractive when I am with other people.
7. I would never be able to make a speech in public.
8. Other people are more comfortable in social situations than I am.
9. Other people are more socially capable than I am.
10. No matter what I do, I will always be uncomfortable in social situations.
11. My mind is very likely to go blank when I am talking in a social situation.
12. I am not good at small talk.
13. Other people are bored when they are around me.
14. When speaking in a group, others will think what I am saying is stupid.
15. If I am around someone I am interested in, I am likely to get panicky or do something to embarrass
myself.
16. I do not know how to behave when I am in the company of others.
17. If something went wrong in a social situation, I would not be able to smooth it over.
18. When I am with other people they usually don’t think I am very smart.
19. When other people laugh it feels as if they are laughing at me.
20. People can easily see when I am nervous.
21. If there is a pause during a conversation, I feel as if I have done something wrong.
Source: S. Turner and D. Beidel. (2003). the social thoughts and beliefs scale: A new inventory for assessing cognitions in
social phobia. Psychological Assessment 15, 391. Copyright © 2003 Reprinted by permission.
44 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–12
The following statements refer to experiences that many people have in their everyday lives. Circle the number that
best describes HOW MUCH that experience has DISTRESSED or BOTHERED you during the PAST MONTH. The
numbers refer to the following verbal labels:
0
Not at all
1
A little
2
Moderately
3
A lot
4
Extremely
1. I have saved up so many things that they get in the way.
0 1 2 3 4
2. I check things more often than necessary.
0 1 2 3 4
3. I get upset if objects are not arranged properly.
0 1 2 3 4
4. I feel compelled to count while I am doing things.
0 1 2 3 4
5. I find it difficult to touch an object when I know it has been touched
by strangers or certain people.
0 1 2 3 4
6. I find it difficult to control my own thoughts.
0 1 2 3 4
7. I collect things I don’t need.
0 1 2 3 4
8. I repeatedly check doors, windows, drawers, etc.
0 1 2 3 4
9. I get upset if others change the way I have arranged things.
0 1 2 3 4
10. I feel I have to repeat certain numbers.
0 1 2 3 4
11. I sometimes have to wash or clean myself simply because I feel contaminated.
0 1 2 3 4
12. I am upset by unpleasant thoughts that come into my mind against my will.
0 1 2 3 4
13. I avoid throwing things away because I am afraid I might need them later.
0 1 2 3 4
14. I repeatedly check gas and water taps and light switches after turning them off.
0 1 2 3 4
15. I need things to be arranged in a particular order.
0 1 2 3 4
16. I feel that there are good and bad numbers.
0 1 2 3 4
17. I wash my hands more often and longer than necessary.
0 1 2 3 4
18. I frequently get nasty thoughts and have difficulty getting rid of them.
0 1 2 3 4
Source: Foa, E. F., et al. (2002). The obsessive-compulsive inventory: Development and validation of a short version.
Psychological Assessment, 14, 485–496. Scale appears in the Appendix, p. 486. Reprinted by permission of the author.
Unit 12 Abnormal Psychology 45
Name
Period
Date
HANDOUT 12–13
The Curious Experiences Survey
Here are some experiences that people have in their daily lives. We are interested in how often you have these
experiences (when you are not under the influence of alcohol or drugs). Please use the following scale for your
responses.
1 = This never happens to me.
2 = This occasionally happens to me.
3 = This sometimes happens to me.
4 = This frequently happens to me.
5 = This is almost always happening to me.
1. Had the experience of feeling as though I was standing next to myself, or watching myself as if I
were looking at a different person.
2. Had the experience of looking in a mirror and not recognizing myself.
3. Had the experience of feeling that other people, objects, and the world around me were not real.
4. Had the experience of feeling that my body did not belong to me.
5. Had the experience of remembering a past event so vividly that it felt like I was reliving that
event.
6. Had the experience of not being sure whether things I remember happening really did happen or
whether I just dreamed them.
7. Had the experience of being in a familiar place but finding it strange and unfamiliar.
8. Feeling that I became so involved in a fantasy or daydream that it felt like it was really happening
to me.
9. Find that I sometimes sit staring off in space, thinking of nothing, and am not aware of the passage of time.
10. Find that in one situation I act so differently from when I’m in another situation that I felt almost
as if I were two different people.
11. Find that in certain situations I am able to do things with amazing ease and spontaneity that would
usually be difficult for me.
12. Found that I could not remember whether I had done something or had just thought about doing
that thing.
13. Found evidence that I had done things that I did not remember doing.
14. Found that I hear voices inside my head that told me to do things or that commented on things
that I was doing.
15. Felt as though I was looking at the world through a fog so that people or objects appeared far
away or unclear.
16. Felt like I was dreaming when I was awake.
17. Felt like I was disconnected from my body.
Source: Goldberg, L. R. (1999). The Curious Experiences Survey, a revised version of the Dissociative Experiences
Scale: Factor structure, reliability, and relations to demographic and personality variables. Psychological Assessment, 11.
Copyright © 1999 by the American Psychological Association. Adapted by permission.
46 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–14
Depression Scale
Using a scale from: 0 = rarely/none to 3 = most of the time, indicate how often the following were true for you over
the past 2 weeks:
1. I was bothered by things that usually don’t bother me.
2. I felt that I could not shake off the blues even with the help from my friends or family.
3. I felt that I was just as good as other people.
4. I had trouble keeping my mind on what I was doing.
5. I felt that everything I did was an effort.
6. I felt hopeful about the future.
7. I felt my life had been a failure.
8. I felt fearful.
9. I felt lonely.
10. People were unfriendly.
Source: Cole et al. (2004). Development and validation of a Rasch-Derived CES-D Short Form. Psychological
Assessment, 16 Table 1, page 363. Copyright © 2004 by the American Psychological Association. Adapted by permission.
Unit 12 Abnormal Psychology 47
Name
Period
Date
HANDOUT 12–15
Instructions: Read each statement carefully. Use the following scale to indicate how often you have felt that way during the past two weeks. (If you are on a diet, respond to statements 5 and 7 as though you were not on a diet.)
1 = none or a little of the time
2 = some of the time
3 = good part of the time
4 = most or all of the time
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
I feel down-hearted, blue, and sad.
Morning is when I feel the best.
I have crying spells or feel like it.
I have trouble sleeping through the night.
I eat as much as I used to.
I enjoy looking at, talking to, and being with attractive women/men.
I notice that I am losing weight.
I have trouble with constipation.
My heart beats faster than usual.
I get tired for no reason.
My mind is as clear as it used to be.
I find it easy to do the things I used to do.
I am restless and can’t keep still.
I feel hopeful about the future.
I am more irritable than usual.
I find it easy to make decisions.
I feel that I am useful and needed.
My life is pretty full.
I feel that others would be better off if I were dead.
I still enjoy the things I used to do.
Source: Zung, W. K. A self-rating depression scale. Archives of General Psychiatry, 12, 63–70. Copyright © 1965
American Medical Association. Reprinted by permission of the American Medical Association in the format Text via
Copyright Clearance Center.
48 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–16
Automatic Thoughts Questionnaire
Listed below are a variety of thoughts that pop into people’s heads. Please read each thought and indicate how frequently, if at all, the thought occurred to you over the last week. Please read each item carefully and fill in the blank
with the appropriate number, using the following scale:
1 = not at all
2 = sometimes
3 = moderately often
4 = often
5 = all the time
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
25.
26.
27.
28.
29.
30.
I feel like I’m up against the world.
I’m no good.
Why can’t I ever succeed?
No one understands me.
I’ve let people down.
I don’t think I can go on.
I wish I were a better person.
I’m so weak.
My life’s not going the way I want it to.
I’m so disappointed in myself.
Nothing feels good anymore.
I can’t stand this anymore.
I can’t get started.
What’s wrong with me?
I wish I were somewhere else.
I can’t get things together.
I hate myself.
I’m worthless.
Wish I could just disappear.
What’s the matter with me?
I’m a loser.
My life is a mess.
I’m a failure.
I’ll never make it.
I feel so helpless.
Something has to change.
There must be something wrong with me.
My future is bleak.
It’s just not worth it.
I can’t finish anything.
Source: Kendall, P., & Hollon, S. (1980). Cognitive self statements in depression: Development of an Automatic
Thoughts Questionnaire. Cognitive Therapy and Research, 4, 383–395. Copyright © 1989 Philip C. Kendall. Reprinted
by permission.
Unit 12 Abnormal Psychology 49
Name
Period
Date
HANDOUT 12–17
The Revised UCLA Loneliness Scale
Directions: Indicate how often you feel the way described in each of the following statements. Circle one number for
each.
Statement
Never
Rarely
Sometimes
Often
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
_________________________________________________________________________________________________________________________________________________________
1. I feel in tune with the people around me
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
I lack companionship
There is no one I can turn to
I do not feel alone
I feel part of a group of friends
I have a lot in common with the people around me
I am no longer close to anyone
My interests and ideas are not shared by those around me
I am an outgoing person
There are people I feel close to
I feel left out
My social relationships are superficial
No one really knows me well
I feel isolated from others
I can find companionship when I want it
There are people who really understand me
I am unhappy being so withdrawn
People are around me but not with me
There are people I can talk to
There are people I can turn to
_________________________________________________________________________________________________________________________________________________________
Source: Russell et al. (1980). The revised UCLA Loneliness Scale: Concurrent and discriminant validity evidence. Journal
of Personality and Social Psychology, 39. Copyright © 1980 by the American Psychological Association. Adapted by
permission.
50 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–18
The Body Investment Scale (BIS)
Instructions for Participants: The following is a list of statements about one’s experience, feelings, and attitudes of
his/her body. There are no right or wrong answers. We would like to know what your experience, feelings, and attitudes of your body are. Please read each statement carefully and evaluate how it relates to you by checking the degree
to which you agree or disagree with it. If you do not agree at all: circle (1). If you do not agree: circle (2). If you are
undecided: circle (3). If you agree: circle (4). If you strongly agree: circle (5). Try to be as honest as you can.
1. I believe that caring for my body will improve my well-being. 1
2.
3.
4.
5.
6.
7.
8.
9.
10.
11.
12.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
24.
I don’t like it when people touch me.
It makes me feel good to do something dangerous.
I pay attention to my appearance.
I am frustrated with my physical appearance.
I enjoy physical contact with other people.
I am not afraid to engage in dangerous activities.
I like to pamper my body.
I tend to keep a distance from the person with
whom I am talking.
I am satisfied with my appearance.
I feel uncomfortable when people get too close
to me physically.
I enjoy taking a bath.
I hate my body.
In my opinion it is very important to take care of the body.
When I am injured, I immediately take care of the wound.
I feel comfortable with my body.
I feel anger toward my body.
I look in both directions before crossing the street.
I use body care products regularly.
I like to touch people who are close to me.
I like my appearance in spite of its imperfections.
Sometimes I purposely injure myself.
Being hugged by a person close to me can comfort me.
I take care of myself whenever I feel a sign of illness.
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
4
5
5
5
5
5
5
5
5
1
1
2
2
3
3
4
4
5
5
1
1
1
1
1
1
1
1
1
1
1
1
1
1
2
2
2
2
2
2
2
2
2
2
2
2
2
2
3
3
3
3
3
3
3
3
3
3
3
3
3
3
4
4
4
4
4
4
4
4
4
4
4
4
4
4
5
5
5
5
5
5
5
5
5
5
5
5
5
5
Source: I. Orbach & M. Mikulincer (1998). The body investment scale: construction and validation of a body experience
scale Psychological Assessment, 10, 425. Copyright © 1998 Israel Orbach. Reprinted by permission.
$0.00
Unit 12 Abnormal Psychology 51
Name
Period
Date
HANDOUT 12–19
Suicide
Read each of the scenarios below and indicate which person you think is at greatest risk for attempting/committing
suicide by writing a “1” in the space. Indicate which person you think is at the next greatest risk by writing a “2” in
the space, and so on. In short, rank the descriptions with 1 being the person at the greatest risk and 4 being the person at the least risk.
Person 1:
Joe is a 35-year-old man who just found out that he has been laid off from his job as a computer programmer after working at the same company for 7 years. He has no idea how he is going to tell his wife
and their 5-year-old girl that daddy just lost his job. Money is tight and looks to be getting even tighter.
Joe finds himself thinking that his family would be better off if he were dead and they could collect on
the insurance money.
Person 2:
Maria is a 22-year-old college student who just broke up with her boyfriend of 2 years. Much of Maria’s
self-concept was based on her idea of a future with her boyfriend primarily because she had such a difficult time adjusting to her parents’ divorce. At age 13, following her parents’ first separation, Maria
took “a few pills” but nothing serious happened and she never told anyone about it.
Person 3:
Amy is a 19-year-old female who just told her family that she is a lesbian. Disowned by her father and
ostracized by the rest of her family, Amy now finds herself on her own trying to pay for school. Amy’s
counselor has noted disturbing changes in her behavior, especially that she isn’t sleeping or eating, she
can’t concentrate on schoolwork, and she has stopped doing things with her friends. Amy reluctantly
followed her counselor’s advice and saw a doctor about beginning medication.
Person 4:
Alex is a 57-year-old man who has been divorced three times, the last divorce costing him his house
and his status in the community. As if that weren’t enough, the economy has led to poor commissions at
his high-pressure sales job so he hasn’t made his alimony and child support payments for the last few
months. After work, he often goes to the shooting club to shoot a few rounds with his favorite gun as a
way to blow off steam and then has a few beers “to help him relax.” The other day, after shooting and
drinking several rounds, he unexpectedly gave his favorite gun to his best friend.
Source: L. Madson et al. Learning risk factors for suicide: A scenario-based activity. Teaching of Psychology, 30.
Copyright © 2003 by Lawrence Erlbaum Associates in the format Textbook via Copyright Clearance Center.
52 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–20
Expanded Revised Facts on Suicide Quiz
Circle the answer you feel is most correct for each question. “T” (true), “F” (false), or “?” (don’t know)
T F ?
1. People who talk about suicide rarely commit suicide.
T F ?
2. No tendency toward suicide is genetically (i.e., biologically) inherited and passed on
from one generation to another.
T F ?
3. The suicidal person neither wants to die nor is fully intent on dying.
T F ?
4. If they were assessed by a psychiatrist, everyone who commits suicide would be diagnosed as depressed.
T F ?
5. If you ask someone directly "Do you feel like killing yourself?" it will likely lead them
to make a suicide attempt.
T F ?
6. A suicidal person will always be suicidal and entertain thoughts of suicide.
T F ?
7. Suicide rarely happens without warning.
T F ?
8. A person who commits suicide is mentally ill.
T F ?
9. A time of high suicide risk in depression is at the time when the person begins to
improve.
T F ?
10. Nothing can be done to stop a person from making the attempt once they have made up
their mind to kill themself.
T F ?
11. Motives and causes of suicide are readily established.
T F ?
12. Women’s suicide rates are generally highest in midlife.
T F ?
13. Suicide is among the top 4 causes of death in the U.S.
T F ?
14. Most people who attempt suicide fail to kill themselves.
T F ?
15. Those who attempt suicide do so only to manipulate others and attract attention to
themselves.
T F ?
16. Oppressive weather (e.g., rain, etc.) has been found to be very related to suicidal
behavior.
T F ?
17. There is a strong correlation between alcoholism and suicide.
T F ?
18. Suicide seems unrelated to moon phases.
T F ?
19. Special treatment techniques are needed in dealing with the depressed/suicidal elderly.
T F ?
20. On average each year more people die from homicides than suicides.
T F ?
21. More teenagers die from suicide than from AIDS.
T F ?
22. Elderly suicide rates have declined for several decades.
T F ?
23. Suicide rates for young African American Males significantly increased over the last two
decades.
T F ?
24. By age, race, and sex, the grouping at highest risk for death by suicide is elderly white
males.
T F ?
25. Older adults are much less likely than younger adults to use firearms as a method of
suicide.
Unit 12 Abnormal Psychology 53
HANDOUT 12–20 (continued )
For questions 26–50, select your single answer from among choices a, b, or c.:
26.
What percent of suicides leaves a suicide note?
a. 15–25%
b. 40–50%
c. 65–75%
27.
Suicide rates for the U.S. as a whole are
for the young.
a. lower than
b. higher than
c. the same as
28.
With respect to sex differences in suicide attempts:
a. Males and females attempt at similar levels.
b. Females attempt more often than males.
c. Males attempt more often than females.
29.
Suicide rates among the young are
those for the old.
a. lower than
b. higher than
c. the same as
30.
Men kill themselves in numbers
those for women.
a. similar to
b. higher than
c. lower than
Suicide rates for the young since the 1950s have:
a. increased
b. decreased
c. changed little
31.
32.
The most common method employed to kill oneself in the U.S. is:
a. hanging
b. firearms
c. drugs and poisons
33.
The season of highest suicide risk is:
a. Winter
b. Fall
c. Spring
The day of the week on which the most suicides occur is:
a. Monday
b. Wednesday
c. Saturday
Suicide rates for nonwhites are
those for whites.
a. higher than
b. similar to
c. lower than
34.
35.
36.
Which marital status category has the lowest rates of suicide?
a. married
b. widowed
c. single, never married
37.
The ethnic/racial group with the highest suicide rate is:
a. Whites
b. African American
c. Native Americans
38.
The risk of death by suicide for a person who has attempted suicide in the past is
has never attempted.
a. lower than
b. similar to
c. higher than
39.
Compared to other Western nations, the U.S. suicide rate is:
a. among the highest
b. moderate
c. among the lowest
40.
The most common method in attempted suicide is:
a. firearms
b. drugs and poisons
someone who
c. cutting ones wrists
41.
On the average, when a young person makes a suicide attempt they are
to die compared to an
elderly person.
a. less likely
b. just as likely
c. more likely
42.
If we place the ways people die in rank order for young people and for the nation as a whole, suicide
ranks ____ for the young when compared to the nation as a whole.
a. the same
b. higher
c. lower
54 Unit 12 Abnormal Psychology
HANDOUT 12–20 (continued )
43.
The region of the U.S. with the highest suicide rates is:
a. Eastern
b. Midwestern
c. Western
44.
Most older adults who complete suicide:
a. did not have a physician at the time of their death.
b. have not seen a physician in the year before their death.
c. have seen a physician in the month before their death
45.
Currently, ____ states have legalized physician assisted suicides.
a. 0
b. 1
c. 3
46.
According to government surveys of American high school students (grades 9 to 12),
they had made a suicide attempt in the past year.
a. 1 in 5
b. 1 in 12
c. 1 in 25
47.
Individuals with HIV or AIDS appear to have a
populations.
a. higher
b. lower
48.
reported
suicide risk compared to undiagnosed
The risk of suicide is highest among:
a. alcoholics/substance abusers
b. schizophrenics
c. similar
c. depressed individuals
49.
The age group most likely to make a non fatal suicide attempt is:
a. young
b. middle aged
c. old
50.
On average approximately
a. 40–50
Americans die from suicide each day:
b. 80–90
c. 120–130
Source: R. W. Hubbard and John McIntosh. The expanded revised facts on suicide quiz. Paper presented at the
annual meeting of the American Association of Suicidology, Santa Fe, NM. Copyright © 2003. Reprinted by
permission.
Unit 12 Abnormal Psychology 55
Name
Period
Date
HANDOUT 12–21
True–False Scale
Circle the items with which you agree, that is, those you consider “true.”
1. Some people can make me aware of them just by thinking about me.
2. I have had the momentary feeling that I might not be human.
3. I have sometimes been fearful of stepping on sidewalk cracks.
4. I think I could learn to read others’ minds if I wanted to.
5. Horoscopes are right too often for it to be a coincidence.
6. Things sometimes seem to be in different places when I get home, even though no one has been there.
7. Numbers like 13 and 7 have no special powers.
8. I have occasionally had the silly feeling that a TV or radio broadcaster knew I was listening to him.
9. I have worried that people on other planets may be influencing what happens on earth.
10. The government refuses to tell us the truth about flying saucers.
11. I have felt that there were messages for me in the way things were arranged, like in a store window.
12. I have never doubted that my dreams are the products of my own mind.
13. Good luck charms don’t work.
14. I have noticed sounds in my albums that are not there at other times.
15. The hand motions that strangers make seem to influence me at times.
16. I almost never dream about things before they happen.
17. I have had the momentary feeling that someone’s place has been taken by a look-alike.
18. It is not possible to harm others merely by thinking bad thoughts about them.
19. I have sometimes sensed an evil presence around me, although I could not see it.
20. I sometimes have a feeling of gaining or losing energy when certain people look at me or touch me.
21. I have sometimes had the passing thought that strangers are in love with me.
22. I have never had the feeling that certain thoughts of mine really belong to someone else.
23. When introduced to strangers, I rarely wonder whether I have known them before.
24. If reincarnation were true, it would explain some unusual experiences I have had.
25. People often behave so strangely that one wonders if they are part of an experiment.
26. At times, I perform certain little rituals to ward off negative influences.
27. I have felt that I might cause something to happen just by thinking too much about it.
28. I have wondered whether the spirits of the dead can influence the living.
29. At times I have felt that a teacher’s lecture was meant especially for me.
30. I have sometimes felt that strangers were reading my mind.
Source: Eckblad et al. (1983). Magical ideation as an indicator of schizotypy. Journal of Consulting and Clinical Psychology,
51. Copyright © 1983 by the American Psychological Association. Reprinted by permission.
56 Unit 12 Abnormal Psychology
Name
Period
Date
HANDOUT 12–22
Please answer each item by checking Yes or No. Answer all items even if you’re unsure of your answer.
Yes
No
1. People sometimes find me aloof and distant.
2. Have you ever had the sense that some person or force is around you, even though you cannot see
anyone?
3. People sometimes comment on my unusual mannerisms and habits.
4. Are you sometimes sure that other people can tell what you are thinking?
5. Have you ever noticed a common event or object that seemed to be a special sign for you?
6. Some people think that I am a very bizarre person.
7. I feel I have to be on my guard even with friends.
8. Some people find me a bit vague and elusive during a conversation.
9. Do you often pick up hidden threats or put-downs from what people say or do?
10. When shopping do you get the feeling that other people are taking notice of you?
11. I feel very uncomfortable in social situations involving unfamiliar people.
12. Have you had experiences with astrology, seeing the future, UFOs, ESP or a sixth sense?
13. I sometimes use words in unusual ways.
14. Have you found that it is best not to let other people know too much about you?
15. I tend to keep in the background on social occasions.
16. Do you ever suddenly feel distracted by distant sounds that you are not normally aware of?
17. Do you often have to keep an eye out to stop people from taking advantage of you?
18. Do you feel that you are unable to get “close” to people?
19. I am an odd, unusual person.
20. I find it hard to communicate clearly what I want to say to people.
21. I feel very uneasy talking to people I do not know well.
22. I tend to keep my feelings to myself.
Source: JOURNAL OF SOCIAL AND CLINICAL PSYCHOLOGY by Rainer. Copyright 1995 by GUILFORD PUBLICATIONS, INC. Reproduced with permission of GUILFORD PUBLICATIONS, INC. in the format Textbook via
Copyright Clearance Center.
Unit 12 Abnormal Psychology 57
Name
Period
Date
HANDOUT 12–23
Personality Inventory
Indicate your agreement or disagreement with each of the following items by circling T (True) or F (False).
T
F
Love is just a four-letter word.
T
F
People find me very charming.
T
F
About the only thing that ever makes me nervous is being cooped up.
T
F
People who never lie are suckers.
T
F
Feeling guilty is a waste of time.
T
F
If I don’t feel like doing something, I just don’t do it.
T
F
I often do things just for the hell of it.
T
F
I’ve fallen in and out of love dozens of times.
T
F
Most of my problems are due to the fact that people just don’t understand me.
T
F
As far as people go, I can take them or leave them.
T
F
One of my chief amusements is pulling people’s strings.
T
F
I have never been able to understand how anyone could pursue one goal for a long time.
T
F
I keep finding myself in the same difficulties time after time.
Source: Levenson (1990). Risk taking and personality. Journal of Personality and Social Psychology, 58. Copyright ©
1990 by the American Psychological Association. Adapted by permission.