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Adult Psychopathology
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ADULT PSYCHOPATHOLOGY
(PSYC 355; Psychopathology II)
Fall 2007
Instructor:
Phone:
E-mail:
Office:
Kelly Rohan, Ph.D.
(802) 656-0798
[email protected]
224 John Dewey Hall
Meeting Time:
Classroom:
Office Hours:
Wednesdays 9:05 – 11:40 am
342 John Dewey Hall
Wed. 11:45 am – 1:15 pm,
by appointment, or any
time the door is open
I. Course Description and Goals
Using a scientific approach to psychopathology, this course will review concepts, theory,
controversies, and research in adult psychopathology. The course will emphasize
descriptive psychopathology (see definition below) and issues of etiology rather than
treatment. The focus is not on memorizing diagnostic criteria. Instead, the content of
this course is designed to foster a sophisticated understanding of adult psychopathology
and an ability to think clearly and critically about contemporary issues in the field.
Students are expected to master ideas and concepts that they will apply now and in the
future to be both educated consumers of psychopathology research and critical readers
of our diagnostic system. Students should also be able to apply what they learn in this
course to how they conceptualize individual clinical cases and to their own research.
Objectives for the course include an increased understanding of and the ability to
critically evaluate:
a. Definitions and diagnostic systems for adult psychological problems.
b. Descriptive psychopathology (e.g. phenomenology, epidemiology, risk factors,
and course of the disorder).
c. Theoretical models for the onset and maintenance etiology of adult psychological
problems.
d. Issues of diversity across gender, culture, and race as they pertain to adult
psychopathology.
e. The empirical literature on adult psychopathology.
II. Required Texts and Selected Readings
American Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental
Disorders (4th Edition Text Revision). Washington, DC: American Psychiatric
Press, Inc. (ISBN 0-89042-061-0)
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Maddux, J. E., & Winstead, B. A. (2005). Psychopathology: Foundations for a
contemporary understanding. Mahwah, NJ: Lawrence Earlbaum Associates,
Publishers. (ISBN 0-8058-4077-X)
(This is the first psychopathology textbook designed specifically for clinical psychology
graduate students. The beginning chapters lay the necessary groundwork on crucial
issues such as the definition of psychopathology, the influences of gender and culture,
and the utility of traditional psychiatric diagnosis. The remaining chapters provide indepth information about common psychological problems and disorders. The chapter
authors, who are active researchers in their respective areas of specialization, highlight
challenges to traditional assumptions and theories for the featured psychological
disorder).
Additional selected readings will be assigned for each topic area. These readings will
supplement the breath of the textbook readings with an in-depth look at recently
published reviews, chapters, meta-analyses, and studies in the literature. The selected
readings will include both theoretical papers and cutting-edge experimental
psychopathology studies. Additional readings for each topic will be made available to
students at least 1 week before the scheduled class meeting. If available, PDF copies
of readings will be emailed to students. Otherwise, a master copy of the readings will
be placed in 208 Dewey for students to photocopy.
III. Course Format
A combination of didactic lecture and seminar formats will be employed during our class
meetings. Accordingly, some of our class time will be devoted to informal lecture (with
questions and comments welcome) and some class time will consist of seminar
discussion. Each student will also have the opportunity to give a formal in-class
presentation, as described below.
IV. Class Participation and Attendance
The course, as a whole, will be interactive, and its success is dependent upon active
preparation, involvement, and discussion by the students. Given that a large portion of
this course will be taught in seminar format, students are expected to complete the
assigned readings and to come to class prepared to discuss them. Students will be
asked to respond to questions that have arisen from the readings. This is your
opportunity to share your reactions and thoughts about the readings. Students are
expected to attend all class meetings and to participate fully.
If a student must miss a class meeting due to an illness, emergency, or Departmentapproved travel; he or she should contact Dr. Rohan in advance. If a student misses a
class meeting, he or she should compose a reflection paper that demonstrates critical
thinking and integration across the various readings assigned for the missed class as
well as a discussion question (see below). Reflection papers should be no more than 3
double-spaced, typed pages in length, and submitted in hard copy to Dr. Rohan by no
later than the next class meeting. Extensions on assignments will be permitted only in
the case of a documented medical or family emergency with the period of extension
determined on a case-by-case basis.
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V. Discussion Questions
Each student will write at least one thought-provoking discussion question based on the
readings in preparation for each class meeting. Discussion questions should integrate
across various readings for each week (or even across weeks). Each student should
email his or her discussion question to Dr. Rohan and to the rest of the class before
each class meeting.
VI. Examinations
There will be two examinations: a mid-term and a final. Both examinations will consist
of take-home essay questions. The questions will be distributed 1 week before the
exam answers are due. Students will have 1 week to compose short (i.e., no more than
5-6 double-spaced, typed pages using 12-point font for each question) responses to 2-3
essay questions covering the course content. Some questions will require thoughtful
integration across the various reading assignments and seminar discussions. The
exams are open-book, but must be completed alone. Each student should write his or
her student ID number (i.e., full 950#) on the back of the last page of the essays so that
exams can be evaluated blind to identity. The final exam will be cumulative. Submit a
hard copy of your answers, not an email attachment.
VII. In-Class Presentation
Each student will give an in-class presentation and lead a discussion on a disorder or
important construct in adult psychopathology for approximately 60 minutes (45 minutes
of lecture and 15 minutes of seminar discussion). The presenting student should
prepare a Power Point presentation and several questions to stimulate discussion.
Your presentations should cover a description of the condition of interest, symptoms,
epidemiology, diversity issues, risk factors, course, theories of etiology, and important
issues (areas of controversy, recent lines of research), but should not focus on
treatment.
At least 1-week prior to the presentation, the presenting student should provide the
other students and Dr. Rohan with 1-2 representative readings on the topic (e.g., a
chapter or review that summarizes important issues) and a more comprehensive
reference list. At the time of presentation, the presenter should distribute an outline or a
Power Point handout of the presentation material. Potential topics are relatively open,
but should not focus on a major disorder covered in this course. Students should
discuss their topic choices with Dr. Rohan by no later than our second class meeting
and obtain her approval for a specific topic selection. Possible topics include: anxiety
sensitivity construct, trichotillomania, premenstrual dysphoric disorder, postpartum
depression, body dysmorphic disorder, schizoaffective disorder, factitious disorder,
dissociative fugue, one of the sexual disorders, etc. As soon as topics are selected, we
will incorporate the presentations into our class schedule.
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VIII. Student Evaluation
Points earned in each domain will be summed to determine the final course grade. You
will be most satisfied with your grade if you work hard and consistently from week to
week by learning as much as you can from the readings, participating in the class
discussions, composing a thoughtful discussion question, and selecting and presenting
your topic of interest. This method will pay off with systematic accrual of points.
100 - 94 A
93 - 90 A-
89 - 87 B+
86 - 84 B
83 - 80 B-
Component
79 - 77 C+
76 - 74 C
73 - 70 C-
69 - 67 D+
66 - 64 D
63 - 60 D-
59 and below F
Potential Points
Class Participation*
30
In-Class Presentation
20
Examinations
Mid-Term Exam
Final Exam
50
(25)
(25)
Total
100
*Class participation will be based on your contributions to the class discussions and
your written discussion questions.
IX. Feedback
Students will receive written feedback on their performance at specified times
throughout the course. Personalized feedback memorandums will be provided
subsequent to the in-class presentation to comment on the content and style of these
presentations. At mid-term, each student will receive more general feedback regarding
the quality of his or her class participation as well as a summary of grades to date. All
feedback is meant to be constructive and helpful. Students should see Dr. Rohan with
any questions or to review their progress in person.
X. Course Evaluations
Dr. Rohan likes receiving feedback even more than she likes giving it. Completed
course evaluations and informal discussions and/or emails about how her course may
be improved are always welcome and appreciated!
XI. Special Needs
Any student who has a need for accommodation based on the impact of a disability
should contact Dr. Rohan as soon as possible to discuss the specific situation.
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Students who believe that there is something Dr. Rohan needs to know that might
improve his or her learning environment in the classroom should contact her as soon as
possible.
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XI. Class Schedule and Critical Dates
Class Date
Topic
August 29
Course Introduction
September 5
Classification, Conceptual Issues, Role of Theory
*Finalize Presentation Topic
September 12
Anxiety Disorders: Panic Disorder, Specific Phobias
September 19
Anxiety Disorders: Post-Traumatic Stress Disorder and ObsessiveCompulsive Disorder
September 26
Anxiety Disorders: Generalized Anxiety Disorder and Social Anxiety
Disorder
October 3
Mood Disorders: Phenomenology, Subtypes, Course, Epidemiology,
Suicide
October 10
Mood Disorders: Unipolar Depression
October 17
Mood Disorders: Bipolar Disorder and Seasonal Affective Disorder
*Mid-Term Questions Distributed
October 24
Eating Disorders: Anorexia Nervosa, Bulimia Nervosa, Binge Eating
Disorder
*Mid-Term Exam Due (submit hard copy no later than class time)
October 31
Personality Disorders
November 7
Schizophrenia and Psychotic Disorders
November 14
Substance-Related Disorders
November 21
No class—Thanksgiving Recess
November 28
Dissociative Disorders: Amnesia, Dissociative Identity Disorder,
Depersonalization, Fugue
December 5
Somatoform Disorders: Hypochondriasis, Somatization Disorder,
Conversion Disorder, Body Dysmorphic Disorder
Sexual Disorders and Dysfunctions
*Final Exam Questions Distributed
(December 12)
(No Class)
*Final Exam Due (submit hard copy by 4:00 pm to Dr. Rohan’s box)
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Adult Psychopathology
Reading Assignments
Classification, Conceptual Issues, Role of Theory
In DSM-IV-TR: pp. xxiii-xxxvii; 1-37
In Maddux & Winstead (2005):
Chapter 1: Maddux, J. E., Gosselin, J. T., & Winstead, B. A. Conceptions of
psychopathology: A social constructionist perspective. (pp. 3-18).
Chapter 2: Regeser López, S., & Guarnaccia, P. J. Cultural dimensions of
psychopathology: The social world’s impact on mental illness. (pp. 19-37).
Chapter 3: Winstead, B. A., & Sanchez, J. Gender and psychopathology. (pp. 39-61).
Chapter 4: Widiger, T. A. Classification and diagnosis: Historical development and
contemporary issues. (pp. 63-83).
Anxiety Disorders: Panic Disorder, Specific Phobias
In DSM-IV-TR: pp. 429-450.
In Maddux & Winstead (2005): Chapter 7: Lloyd Williams, S. Anxiety disorders. (pp. 127154).
Bouton, M. E., Mineka, S., & Barlow, D. H. (2001). A modern learning theory perspective on
the etiology of panic disorder. Psychological Review, 108, 4-32.
Casey, L. M., Oei, T. P. S., & Newcombe, P. A. (2004). An integrated cognitive model of
panic disorder. Clinical Psychology Review, 24, 529-555.
Craske, M. G., & Waters, A. M. (2005). Panic disorder, phobias, and generalized anxiety
disorder. Annual Review of Clinical Psychology, 1, 97-225.
Merckelbach, H., de Jong, P. J., Muris, P., & van den Hout, M. A. (1996). The etiology of
specific phobias: A review. Clinical Psychology Review, 16, 337-361.
Post-Traumatic Stress Disorder and Obsessive-Compulsive Disorder
In DSM-IV-TR: pp. 456-472.
Brewin, C. R., & Holmes, E. A. (2003). Psychological theories of posttraumatic stress
disorder. Clinical Psychology Review, 23, 339-376.
Doron, G. & Kyrios, M. (2005). Obsessive-compulsive disorder: A review of possible specific
internal representations within a broader cognitive theory. Clinical Psychology Review,
25, 415-432.
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Adult Psychopathology
McKay, D., Abramowitz, J. S., Calamari, J. E., Kyrios, M, Radomsky, A. Sookman, D., Taylor,
S., & Sabine, W. (2004). A critical evaluation of obsessive-compulsive disorder
subtypes: Symptoms versus mechanisms. Clinical Psychology Review, 24, 283-313.
McNally, R. J. (2003). Progress and controversy in the study of posttraumatic stress disorder.
Annual Review of Psychology, 54, 229-252.
Salkovskis, P. M., Thorpe, S. J., Wahl, K., Wroe, A. L., & Forrester, E. (2003). Neutralizing
increases discomfort associated with obsessional thoughts: An experimental study
with obsessional patients. Journal of Abnormal Psychology, 112, 709-715.
Shalev, A. Y., & Freedman, S. (2005). PTSD following terrorist attacks: A prospective
evaluation. American Journal of Psychiatry 162, 1188-1191.
Generalized Anxiety Disorder and Social Anxiety Disorder
In DSM-IV-TR: pp. 450-456; 472-484.
Borkovec, T. D., Alcaine, O. M., & Behar, E. (2004). Avoidance theory of worry and
generalized anxiety disorder. (pp. 77-108). In R. G. Heimberg, C. L. Turk, & D. S.
Mennin (Eds.), Generalized anxiety disorder: Advances in research and practice. New
York: Guilford.
Hofmann, S. G, Heinrichs, N., & Moscovitch, D. A. (2004). The nature and expression of
social phobia: Towards a new classification. Clinical Psychology Review, 24, 769-797.
Turk, C. L., Heimberg, R. G., & Luterek, J. A. (2005). Emotional dysregulation in generalized
anxiety disorder: A comparison with social anxiety disorder. Cognitive Therapy and
Research, 29, 89-106.
Turk, C. L., Lerner, J., Heimberg, R. G., & Rapee, R. M. (2001). An integrated cognitivebehavioral model of social anxiety. (pp. 281-303). In S. G. Hofman & P. M. Bibartolo
(Eds.), From social anxiety to social phobia: Multiple perspectives. Needham Heights,
MA: Allyn & Bacon.
Wells, A., & Carter, K. (2001). Further tests of a cognitive model of generalized anxiety
disorder: Metacognitions and worry in GAD, panic disorder, social phobia, depression,
and nonpatients. Behavior Therapy, 32, 85-102.
Mood Disorders: Phenomenology, Subtypes, Course, Epidemiology, Suicide
In DSM-IV-TR: pp. 345-428.
In Maddux & Winstead (2005): Chapter 8: Ingram, R., & Trenary, L. Mood disorders. (pp.
155-177).
Bouland, R. J. & Keller, M. B. (2002). Course and outcome of depression. (pp. 43-60). In I. H.
Gotlib & C. L. Hammen (Eds.), Handbook of depression. New York: Guilford Press.
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Adult Psychopathology
McCullough, J. P., Klein, D. N., Borian, F. E., Howland, R. H., Riso, L. P., Keller, M. B., &
Banks, P. L. C. (2003). Group comparisons of DSM-IV subtypes of chronic depression:
Validity of the distinctions, part 2. Journal of Abnormal Psychology, 112, 614-622.
Shankman, S. A., & Klein, D. N. (2003). The relation between depression and anxiety: An
evaluation of the tripartite, approach-withdrawal, and valence-arousal models. Clinical
Psychology Review, 23, 605-637.
Sprock, J., & Yoder, C.Y. (1997). Women and depression: An update on the report of the
APA task force. Sex Roles, 36, 269-303.
The following epidemiological report is provided for your reference only (do not expect you to
read for class):
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Koretz, D., Merikangas, K. R., Rush, A. J.,
Walters, E. E., Wang, P. S. (2003). The epidemiology of Major Depressive Disorder:
Results from the National Comorbidity Survey Replication (NCS-R). JAMA, 289, 30953105.
Mood Disorders: Unipolar Depression
Beck, A. T., Rush, A. J., Shaw, B. F., & Emery, B. (1979). An overview. (pp. 8-20). Cognitive
therapy of depression. New York: Guilford Press. (NOTE: The specified pages
present an overview of the cognitive model of depression).
Hammen, C. (2005). Stress and depression. Annual Review of Clinical Psychology, 1, 293319.
Ferster, C. B. (1973). A functional analysis of depression. American Psychologist, 28, 857870.
Joiner, T. E. Jr. (2002). Depression in its interpersonal context. (pp. 295-313). In I. H. Gotlib &
C. L. Hammen (Eds.), Handbook of depression. New York: Guilford Press.
Scher, C. D., Ingram, R. E., & Segal, Z. V. (2005). Cognitive reactivity and vulnerability:
Empirical evaluation of construct activation and cognitive diathesis in unipolar
depression. Clinical Psychology Review, 25, 487-510.
Thase, M. E. (2002). Biological aspects of depression. (pp. 192-218). In I. H. Gotlib & C. L.
Hammen (Eds.), Handbook of depression. New York: Guilford Press.
Mood Disorders: Bipolar Disorder and Seasonal Affective Disorder
Alloy, L. B., Abramson, L. Y., Urosevic, S., Walshaw, P. D., Nusslock, R., & Neeren, A. M.
(2005). The psychosocial context of bipolar disorder: Environmental, cognitive, and
developmental risk factors. Clinical Psychology Review, 25, 1043-1075.
Cueller, A. K., Johnson, S. L., & Winters, R. (2005). Distinctions between unipolar and bipolar
depression. Clinical Psychology Review, 25, 307-339.
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Adult Psychopathology
Newman, C. F., Leahy, R. L., Beck, A. T., Reilly-Harrington, N. A., & Gyulai, L. (2002).
Chapter 1: Bipolar disorder: Diagnostic, epidemiologic, etiologic, and prognostic issues
(pp. 3-23). Bipolar disorder. Washington, DC: American Psychological Association.
Partonen, T., & Lönnqvist, J. (1998). Seasonal affective disorder. The Lancet, 352, 13691374.
Rohan, K. J., Sigmon, S. T., & Dorhofer, D. M. (2003). Cognitive-behavioral factors in
seasonal affective disorder. Journal of Consulting and Clinical Psychology, 71, 22-30.
Eating Disorders: Anorexia Nervosa, Bulimia Nervosa, Binge Eating Disorder
In DSM-IV-TR: pp. 583-595; 785-787.
In Maddux & Winstead (2005): Chapter 11: Polivy, J., Herman, C. P., & Boivin, M. Eating
disorders. (pp. 229-254).
Fairburn, C. G., Cooper, Z., & Shafran, R. (2003). Cognitive behaviour therapy for eating
disorders: A “transdiagnostic” theory and treatment. Behaviour Research and Therapy,
41, 509-528.
Keel, P. K., & Klump, K. L. (2003). Are eating disorders culture-bound syndromes?:
Implications for conceptualizing their etiology. Psychological Bulletin, 129, 747-769.
Polivy, J., & Herman, C. P. (2002). Causes of eating disorders. Annual Review of
Psychology, 53, 187-213.
Stice, E. (2002). Risk and maintenance factors for eating pathology: A meta-analytic review.
Psychological Bulletin, 128, 825-848.
Personality Disorders
In DSM-IV-TR: pp. 685-; 785-729.
In Maddux & Winstead (2005): Chapter 10: Coker, L. A., & Widiger, T. A. Personality
disorders. (pp. 201-227).
Cale, E. M., & Lilienfield, S. O. (2002). Sex differences in psychopathy and antisocial
personality disorder: A review and integration. Clinical Psychology Review, 22, 11791207.
Haslam, N. (2003). The dimensional view of personality disorders: A review of the taxometric
evidence. Clinical Psychology Review, 23, 75-93.
Lieb, K., Zanarini, M. C., Schmahl, C., Linehan, M. M., & Bohus, M. (2004). Borderline
personality disorder. The Lancet, 364, 453-461.
Skodol, A. E. et al. (2005). Dimensional representations of DSM-IV personality disorders:
Relationships to functional impairment. American Journal of Psychiatry, 162, 19191925.
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Adult Psychopathology
Trull, T. J., & Durrett, C. A. (2005). Categorical and dimensional models of personality
disorder. Annual Review of Clinical Psychology, 1, 355-380.
The following epidemiological report is provided for your reference only (do not expect you to
read for class):
Grant, B. F., Hasin, D. S., Stinson, F. S., Dawson, D. A., Chou, S. P., Ruan, W. J., &
Pickering, R. (2004). Prevalence, correlates, and disability of personality disorders in
the United States: Results from the National Epidemiologic Survey on Alcohol and
Related Conditions. Journal of Clinical Psychiatry, 65, 948-958.
Schizophrenia
In DSM-IV-TR: pp. 297-343.
In Maddux & Winstead (2005): Chapter 9: Walker, E., Bollini, A., Hochman, K., & Kestler, L.
Schizophrenia. (pp. 179-200).
Beck, A. T., & Rector, N. A. (2005). Cognitive approaches to schizophrenia: Theory and
therapy. Annual Review of Clinical Psychology, 1, 577-606.
López, S. R., Hipke, K. N., Polo, A. J., Jenkins, J. H., Karno, M., Vaughn, C., & Snyder, K. S.
(2004). Ethnicity, expressed emotions, attributions, and course of schizophrenia:
Family warmth matters. Journal of Abnormal Psychology, 113, 428-439.
Reichenberg, A., Rieckmann, N., & Harvey, P. D. (2005). Stability in schizophrenia symptoms
over time: Findings from the Mount Sinai Pilgrim Psychiatric Center Longitudinal
Study. Journal of Abnormal Psychology, 114, 363-372.
Rosenfarb, I. S., Bellack, A. S., Aziz, N., Kratz, K. M., & Sayers, S. (2004). Race, family
interactions, and patient stabilization in schizophrenia. Journal of Abnormal
Psychology, 113, 109-115.
Substance-Related Disorders
In DSM-IV-TR: pp. 191-295.
In Maddux & Winstead (2005): Chapter 14: Fals-Stewart, W. Substance use disorders. (pp.
301-324).
Chassin, L., Flora, D. B., & King, K. M. (2004). Trajectories of alcohol and drug use and
dependence from adolescence to adulthood: The effects of familial alcoholism and
personality. Journal of Abnormal Psychology,113, 483-498.
Higgins, S. T., Heil, S. H., & Lussier, J. P. (2004). Clinical implications of reinforcement as a
determinant of substance use disorders. Annual Review of Psychology, 55, 431-461.
Holahan, C. J., Moos, R. H., Holahan, C. K., Cronkite, R. C., Randall, P. K. (2003). Drinking
to cope and alcohol use and abuse in unipolar depression: A 10-year model. Journal
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Adult Psychopathology
of Abnormal Psychology, 112, 159-165.
Nolen-Hoeksema, S. (2004). Gender differences in risk factors and consequences for alcohol
use and problems. Clinical Psychology Review, 981-1010.
Sher, K. J., Grekin, E. R., & Williams, N. A. (2005). The development of alcohol use
disorders. Annual Review of Clinical Psychology. 1, 493-523.
Dissociative Disorders
In DSM-IV-TR: pp. 519-533.
Elzinga, B. M., Phaf, R. H., Ardon, A. M., & van Dyck, R. (2003). Directed forgetting between,
but not within, dissociative personality states. Journal of Abnormal Psychology, 112,
237-243.
Gleaves, D. H., & May, M. C. (2001). An examination of the diagnostic validity of dissociative
identity disorder. Clinical Psychology Review, 21, 577-608.
Huntjens, R. J. C., Postma, A., Peters, M. L., Woertman, L., & van der Hart, O. (2003).
Interidentity amnesia for neutral, episodic information in dissociative identity disorder.
Journal of Abnormal Psychology, 112, 290-297.
Kihlstrom, J. F. (2005). Dissociative disorders. Annual Review of Clinical Psychology, 1, 227253.
Merckelbach, H., Devilly, G. J., & Rassin, E. (2002). Alters in dissociative identity disorder:
Metaphors or genuine entities? Clinical Psychology Review, 22, 481-497.
Somatoform Disorders
Sexual Disorders and Dysfunctions
In DSM-IV-TR: pp. 485-517 and pp. 535-582.
In Maddux & Winstead (2005): Chapter 12: McConaghy, N. Sexual dysfunctions and
disorders. (pp. 255-280).
In Maddux & Winstead (2005): Chapter 13: Eifert, G. H., & Zvolensky, M. J. Somatoform
disorders. (pp. 281-300).
Brown, R. J. (2004). Psychological mechanisms of medically unexplained symptoms: An
integrative conceptual model. Psychological Bulletin, 130, 793-812.
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