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BRIEF CONTENTS
Chapter 1 Introduction 1
Chapter 2 The Developmental Psychopathology Perspective 19
Chapter 3 Biological and Environmental Contexts of Psychopathology 37
Chapter 4 Research: Its Role and Methods 65
Chapter 5 Classification, Assessment, and Intervention 83
Chapter 6 Anxiety Disorders 109
Chapter 7 Mood Disorders 143
Chapter 8 Conduct Problems 178
Chapter 9 Attention-Deficit Hyperactivity Disorder 219
Chapter 10 Language and Learning Disabilities 251
Chapter 11 Intellectual Disability 281
Chapter 12 Autism Spectrum Disorder and Schizophrenia 313
Chapter 13 Disorders of Basic Physical Functions 346
Chapter 14 Psychological Factors Affecting Medical Conditions 376
Chapter 15 Evolving Concerns for Youth 397
Glossary 411
References 419
Credits 517
Name Index 523
Subject Index 538
vii
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CONTENTS
Preface xxiii
Chapter 1 INTRODUCTION 1
Defining and Identifying Abnormality 2
◼ ACCENT: Some Faces of Problem Behavior 2
Atypical and Harmful Behavior 3
Developmental Standards 3
Culture and Ethnicity 3
Other Standards: Gender and Situations 5
The Role of Others 5
Changing Views of Abnormality 6
How Common are Psychological Problems? 6
◼ ACCENT: Infant Mental Health 7
How are Developmental Level and Disorder Related? 8
How are Gender and Disorder Related? 8
Methodological Issues, True Differences 9
Historical Influences 10
Progress in the Nineteenth Century 10
Sigmund Freud and Psychoanalytic Theory 11
◼ ACCENT: Little Hans: A Classic Psychoanalytic Case 12
Behaviorism and Social Learning Theory 13
Mental Hygiene and Child Guidance Movements 14
Scientific Study of Youth 14
Current Study and Practice 15
◼ ACCENT: Mrs. Hillis: Improving Corn, Hogs, and Children in Iowa 15
Working With Youth and Their Families 16
▶ AARON: Clinical, Legal, and Ethical Considerations 17
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ix
x Contents
Peer Influences 58
Community and Societal Contexts 59
School Influences 59
Socioeconomic Status and Poverty 59
Neighborhoods 61
Culture, Ethnicity, and Minority Status 62
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Suicide 170
Prevalence of Completed Suicides 170
Suicidal Ideation and Attempts 171
▶ PATTY: A Suicide Attempt 172
Suicide and Psychopathology 172
Risk Factors 172
◼ ACCENT: Non-Suicidal Self-Injury 173
Suicide Prevention 174
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Epidemiology 291
Developmental Course and Considerations 291
Etiology 292
▶ JOHNNY: Unknown Cause of MR 292
Pathological Organic Influences 293
Multigenic Influences 293
Psychosocial Influences 293
Multifactor Causation 294
Genetic Syndromes and Behavioral Phenotypes 295
Down Syndrome (DS) 295
◼ ACCENT: The Down Syndrome Advantage 297
Fragile X Syndrome (FXS) 296
▶ SAMMIE: An Example of Fragile X Syndrome 297
Williams Syndrome (WS) 298
▶ ROBERT: An Example of Williams Syndrome 299
Prader–Willi Syndrome (P-WS) 299
Family Accommodations and Experiences 300
◼ ACCENT: Deciding What’s Best for Children with ID 300
Rewards and Satisfactions 301
Assessment 302
Developmental and Intelligence Tests 302
Assessing Adaptive Behavior 303
Intervention 304
Changing Views; Greater Opportunity 304
Prevention 304
◼ ACCENT: Examples of Early Intervention Programs 305
Educational Services 305
▶ JIM: Life in the Mainstream 306
Behavioral Intervention and Support 307
◼ ACCENT: Functional Communication Training 310
Psychopharmacology and Psychotherapy 309
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Definition and Classification: An Overview 362
Classification and Description: DSM Approach 363
▶ ALMA: Like a Walking Skeleton 363
Epidemiology 365
Developmental Course and Prognosis 366
Etiology 366
▶ RILEY: A Combination of Factors Leading to an Eating
Disorder 367
◼ ACCENT: Being Buff: Weight and Shape Concerns in Young
Men 369
▶ IDA: A Sparrow in a Golden Cage 371
Intervention 371
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Glossary 411
References 419
Credits 517
Name Index 523
Subject Index 538
PREFACE
In roughly one hundred years, the study of young people has moved from relative ignorance to considerable knowledge
about human development in general and disordered behavior more specifically. The last few decades arguably have
witnessed unprecedented progress in understanding the problems of children and adolescents and how they and their
families might be assisted. Of course, there is much yet to be learned and the needs of youth are considerable, so the study
of young people is an especially worthwhile enterprise. We hope that this text makes clear the challenge and excitement of
the endeavor.
Now in its eighth edition, Abnormal Child and Adolescent Psychology has enjoyed enormous success. It has been grat-
ifying for us to know that it continues to make a substantial contribution to the field. At the inception of this text (initially
entitled “Behavior Disorders of Children”), relatively few comprehensive books were available in the field. Just as important
was the need for a text that emphasized certain themes that we considered critical to the study of problems of youth. These
themes have stood the test of time, have evolved, and have become more widely and subtly recognized as essential. Indeed,
their early incorporation into the text undoubtedly accounts in part for its ongoing success.
xxiii
xxiv Preface
Lampriscus.
Cott.
Lamp.
Cott.
Mother.
Cott.
Lamp.
Cott.
Lamp.
Mother.
Lamp.
Mother.
Children were not always well behaved in other ways, it seems, and
complaints were made by their parents that the children contradicted them
and did not always rise when their elders came into the room, that they
chattered too much before company, crossed their legs when they sat down,
and completely tyrannized over their pedagogues.
At eighteen, the Athenian youth left school. The state did not give him
the full rights of a citizen until a few years later, and until then he was
required to perform certain military duties, but he was no longer a boy, and
he was considered old enough to understand the meaning of citizenship, and
to know what were its duties and privileges. So it was then, at the time of
leaving his boyhood behind, and entering upon the richer and fuller life
before him, that the youth took the oath of the Ephebi or young men. He was
given the shield and spear of the warrior, and then in the temple, before
Zeus, the Lord of Heaven, and in the presence of the highest Athenian
magistrates, he swore:
"Never to disgrace his holy arms, never to forsake his comrade in the
ranks, but to fight for the holy temples, alone or with others: to leave his
country, not in a worse, but in a better state than he found it; to obey the
magistrates and the laws, and defend them against attack; finally to hold
in honour the religion of his country."
CHAPTER XIV
A Greek drama was in many ways much simpler than a modern drama.
There were fewer characters, and usually only three speaking actors were
allowed on the stage at once. There was only one story told and there was
nothing to take the attention of the audience away from this. The Chorus,
though it no longer told the story, was very important, for it set the
atmosphere of the play, and lyrics of haunting loveliness hinted at the
tragedy that could not be averted, because of terrible deeds done in the past,
or if, indeed, there might be any help, the imagination was carried forward
on wings of hope. The Chorus also served another purpose. In a modern
drama, when the tragedy of a situation becomes almost too great for the
audience to bear, relief is often found in some comic, or partly comic,
episode which is introduced to slacken the tension. Shakespeare does this
constantly. But comic episodes were felt to be out of place in a Greek drama,
and therefore when a tragic scene had taken place, the Chorus followed it by
a song of purest poetry. In one play of Euripides, a terrible scene of tragedy
was followed by a song in which the Chorus prayed for escape from such
sorrows on the wings of a bird to a land where all was peace and beauty.
They sang:
In the great Greek dramas, the Chorus is a constant reminder that, though
they cannot understand or explain them, there are other powers in the world
than the wild passions of men.
The great dramatic festival in Athens was held in the spring in the theatre
of Dionysus, to the south-east of the Acropolis. The theatre in Athens never
became an everyday amusement, as it is today, but was always directly
connected with the worship of Dionysus, and the performances were always
preceded by a sacrifice. The festival was only held once a year, and whilst it
lasted the whole city kept holiday. Originally, admission to the theatre was
free, but the crowds became so great and there was such confusion and
sometimes fighting in the rush for good seats, that the state decided to charge
an admission fee and tickets had to be bought beforehand. But even then
there were no reserved seats, except for certain officials who sat in the front
row. In the time of Pericles, complaints were made that the poorer citizens
could not afford to buy tickets, and so important was the drama then
considered, that it was ordered that tickets should be given free to all who
applied for them.
THEATRE AT EPIDAURUS
The theatre is a great semi-circle on the slope of the Acropolis, with rows
of stone seats on which about eighteen thousand spectators can sit. The front
row consists of marble chairs, the only seats in the theatre which have backs,
and these are reserved for the priests of Dionysus and the chief magistrates.
Beyond the front row, is a circular space called the orchestra, where the
Chorus sings, and in the centre of which stands the altar of Dionysus. Behind
the orchestra, is the stage on which the actors will act, at the back of which is
a building painted to look like the front of a temple or a palace, to which the
actors retire when they are not wanted on the stage or have to change their
costumes. That is the whole theatre and all its stage scenery. Overhead is the
deep blue sky, the Acropolis rises up behind, and the olive-laden hills are
seen in the distance. Much will have to be left to the imagination, but the
very simplicity of the outward surroundings will make the audience give all
their attention to the play and the acting.
When the play begins, there will only be three actors on the stage at once.
They will wear very elaborate costumes, and a strange-looking wooden sole
called a cothurnus or buskin, about six inches high, on their shoes, to make
them look taller and more impressive, and over their faces a curious mask
with a wide mouth, so that everyone in that vast audience will hear them.
There will be no curtain and the play is not divided into different acts. When
there is a pause in the action, the Chorus will fill up the time with their song.
If it is tragedy, we shall not see the final catastrophe on the stage, but a
messenger will appear who will give us an account of what has happened.
All this is very different from the way in which a modern play is given, but
some of the greatest dramas the world possesses were written by Athenian
dramatists and acted on this Athenian stage more than two thousand years
ago.
The legends and traditions from which most of the Greek plays took their
plots were, of course, well known to the Athenians. They were stories
commemorating some great event, or explaining some religious observance,
but naturally these legends were differently treated by different dramatists,
each of whom brought out a different side of the story to enforce some
particular lesson which he wished to bring home to the people, and this is
especially true of the legends like that of Iphigenia connected with the Fall
of Troy.
In the opening speech of this play, Iphigenia very briefly tells her story up
to the moment when the play begins. Just as the Greeks had been ready to
sail for Troy, they were wind-bound at Aulis. The wise men were consulted
as to the meaning of this, and how the gods who must in some way have
been offended, might be appeased, so that fair winds might send them on
their way. Calchas, the seer, told them that Artemis demanded the sacrifice
of Iphigenia, daughter of Agamemnon, King of Argos, the great leader of the
host, and her father sent for her accordingly. The maiden was at home with
her mother, and the messenger who was sent to Argos to bring her was
charged to say that her father desired to wed her to the hero Achilles. She
came and the sacrifice was offered, but at the supreme moment, Artemis
carried Iphigenia away and placed her in the land of the Tauri, a wild and
barbarous tribe, as their priestess. These Tauri had an image of Artemis in a
temple, to which they sacrificed all strangers who were cast on their shores,
and it was the duty of the priestess to consecrate each victim before he was
slain. Here, performing this rite, had Iphigenia lived for more than ten years,
but never yet had a Greek come to this wild land. She knew, of course,
nothing of what had happened at Troy or afterwards; she did not know that
on his return home her father had been slain by Clytemnestra his wife, or
that Orestes, her brother, had avenged that death by slaughtering his own
mother, after which deed he had wandered from place to place pursued by
the relentless torment of the Furies. Bitter against the Greeks for having
willed her sacrifice at Aulis, Iphigenia says of herself that she is "turned to
stone, and has no pity left in her," and she half hopes that the day will come
when a Greek shall be brought to her to be offered in his turn to the goddess.
IPHIGENIA.
ORESTES, her brother.
PYLADES, friend to Orestes.
THOAS, King of Tauris.
A HERDSMAN.
A MESSENGER.
Voice.
Another Voice.
(Enter Orestes and Pylades. Their dress shows they are travellers.
Orestes is shaken and distraught.)
Orestes.
Pylades.
Orestes.
Orestes.
Pylades.
Danger gleams
Like sunshine to a brave man's eyes, and fear
Of what may be is no help anywhere.
Orestes.
After they are gone, enter gradually the women of the Chorus. These are
Greek women who have been taken captive in war by King Thoas, and so
they are friendly to the exiled and lonely Iphigenia, for they are just as
homesick as she is. They come now in obedience to a call from her to assist
in mourning for Orestes, who, she is convinced by her dream, is dead.
Chorus.
****
Leader.
Iphigenia.
Iphigenia and the Chorus then lament together over the ruin and loss that has
befallen the House of Agamemnon. Suddenly the Leader of the Chorus stops
them.
Leader.
Herdsman.
Iphigenia.
Herdsman.
(She rises.)
Make all the speed ye may;
'Tis not too much. The blood-bowl and the spray!
Iphigenia.
Herdsman.
Iphigenia.
Herdsman.
Iphigenia.
Herdsman.
Iphigenia.
Herdsman.
Iphigenia.
Herdsman.
We came to wash our cattle in the brine.
Iphigenia.
The herdsman tells his tale of how the men were taken prisoners. Iphigenia
hears in silence and at the end of it says:
'Tis well. Let thy hand bring them, and mine own
Shall falter not till here God's will be done.
(Exit Herdsman.)
Iphigenia then gives way to her feelings. There are strangers to be sacrificed;
to that she is accustomed, but these men are Greeks. Yet she herself suffered
bitter things at the hands of the Greeks; should she not avenge these? By
degrees, however, as she thinks of her youth, of her home, she melts, and at
length withdraws into the Temple, raging against the cruel deed that she
must do, and not at all sure that she can nerve herself to do it.
The coming of these Greeks has brought Greece vividly back to the thoughts
of the Chorus. All Greeks loved the sea and were seafarers, and the arrival of
these two adventurous men reminds these exiled women of their home, and
in their imagination they see the ship cross the sea, until it touches the
Friendless and cruel shore.
Chorus.
*****
Leader.
Iphigenia.
So be it.
My foremost care must be that nothing harms
The temple's holy rule.—Untie their arms.
That which is hallowed may no more be bound.
You, to the shrine within! Let all be found
As the law bids, and as we need this day.
(Orestes and Pylades are set free; some Attendants go into the
Temple.)
Ah me!
What mother then was yours, O strangers, say,
And father? And your sister, if you have
A sister: both at once, so young and brave
To leave her brotherless! Who knows when heaven
May send that fortune? For to none is given
To know the coming nor the end of woe;
So dark is God, and to great darkness go
His paths, by blind chance mazed from our ken.
Whence are ye come, O most unhappy men?
From some far home, methinks, ye have found this shore
And far shall stay from home for evermore.
Orestes asks Iphigenia not to make their fate worse by dwelling on it, nor to
pity them. They know where they are and the cruel custom of the land.
Iphigenia.
Orestes.
Iphigenia.
Orestes.
Iphigenia.
Are ye two brothers of one mother born?
Orestes.
Iphigenia.
Orestes.
Iphigenia.
Orestes.
Iphigenia.
Orestes.
Iphigenia.
Orestes.
Iphigenia.
Nay: why shouldst thou deny so small a grace?
Orestes.
Iphigenia.
Orestes.
Iphigenia.
Orestes.
Iphigenia.
Orestes.
Iphigenia.
Orestes.
Iphigenia.