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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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Chapter 2 THE DEVELOPMENTAL PSYCHOPATHOLOGY PERSPECTIVE 19

▶ ELIZABETH: No Obvious Explanation 20
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Theories 20
Models 20
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Concept of Development 21
Searching for Causal Factors and Processes 22
◼ ACCENT: A Possible Moderating Influence of Culture 23
Pathways of Development 22
Equifinality and Multifinality 24

ix
x Contents

Risk, Vulnerability, and Resilience 25

Risk and Vulnerability 25
◼ ACCENT: The Timing of Risky Experiences 25
Resilience 27
▶ ANN AND AMY: The “Ordinary Magic” of Resilience 27
Continuity of Disorder 28
Normal Development, Problematic Outcomes 30
Attachment 30
Temperament 31
▶ CARL: A Case of Goodness-of-Fit 32
◼ ACCENT: Sensitivity to Context: For Better or Worse 33
Emotion and Its Regulation 33
Social Cognitive Processing 34
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Chapter 3 BIOLOGICAL AND ENVIRONMENTAL CONTEXTS OF

PSYCHOPATHOLOGY 37
Brain and Nervous System 37
Brain Development: Biology and Experience 37
Structure 38
Neurotransmission 39
Nervous System and Risk for Disordered Functioning 40
Prenatal Influences 40
Perinatal and Postnatal Influences 41
Genetic Context 41
◼ ACCENT: Epigenetics and Gene Expression 42
Single-Gene Inheritance 43
Multiple-Gene Inheritance: Quantitative Methods 43
Searching For Genes and Their Effects: Molecular Methods 44
Gene–Environment Interplay 44
Learning and Cognition 45
Classical Conditioning 45
◼ ACCENT: Albert and Peter: Two Historic Cases 46
Operant Learning 45
Observational Learning 47
Cognitive Processes 47
◼ ACCENT: Thinking About Missteps 48
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Parent Roles, Styles, Psychopathology 49
Maltreatment 50
Changes in Family Structure: Divorce 54
◼ ACCENT: Family Stability 57
 Contents xi

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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Chapter 4 RESEARCH: ITS ROLE AND METHODS 65

Fundamentals of Research 66
Selection of Participants 66
Observation and Measurement 67
Reliability of Research Results 68
Validity of Research Results 68
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Case Studies 69
▶ MAX: Risk for Childhood Schizophrenia 70
Correlational Studies 70
◼ ACCENT: Experiments of Nature 72
Randomized Experiments 72
◼ ACCENT: Translational Research: From Lab to Real-World Settings 73
Single-Case Experimental Designs 74
◼ ACCENT: Epidemiological Research: More than Counting Noses 76
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Cross-Sectional Research 76
Retrospective Longitudinal Research 76
Prospective Longitudinal Research 77
Accelerated Longitudinal Research 77
Qualitative Research 77
Examples of Qualitative Studies 78
Combining Qualitative and Quantitative Methods 78
Ethical Issues 79
Voluntary Informed Consent 79
Confidentiality 79
Balancing It All: Harm and Good 81
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Chapter 5 CLASSIFICATION, ASSESSMENT, AND INTERVENTION 83

Classification and Diagnosis 83
The DSM Approach 84
▶ KEVIN: Seeking a Diagnosis 86
◼ ACCENT: Co-Occurrence: A Common Circumstance 87
▶ SAMUEL: A Case of Co-Occurring Disorders 87
◼ ACCENT: Dimensionality and the DSM 89
xii Contents

Empirical Approaches to Classification 89

Stigmatization and the Impact of Labels 91
◼ ACCENT: The Impact of Stigmatization 92
Assessment 93
▶ ALICIA: An Initial Assessment 93
Conducting a Comprehensive Assessment 94
The Interview 94
Problem Checklists and Self-Report Instruments 95
Observational Assessment 96
Projective Tests 96
Intellectual–Educational Assessment 97
Assessment of Physical Functioning 98
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Prevention 102
Treatment 103
Evidence-Based Interventions 106
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Chapter 6 ANXIETY DISORDERS 109

An Introduction to Internalizing Disorders 109
Defining and Classifying Anxiety Disorders 110
Normal Fears, Worries, and Anxieties 111
Classification of Anxiety Disorders 111
Epidemiology of Anxiety Disorders 112
◼ ACCENT: Culture, Ethnicity, and Disorder 112
Specific Phobias 113
Diagnostic Criteria 113
Description 113
Epidemiology 113
▶ CARLOS: A Specific Phobia 114
Developmental Course 114
Social Phobia (Social Anxiety Disorder) 114
Diagnostic Criteria 114
Description 114
▶ LOUIS: Social Phobia and Its Consequences 115
Selective Mutism and Social Anxiety 115
▶ BRUCE: Selective Mutism 116
Epidemiology 116
Developmental Course 117
Separation Anxiety 117
Diagnosis and Classification 117
Description 117
Epidemiology 118
 Contents xiii

Developmental Course 118

▶ KENNY: Separation Anxiety 119
School Refusal 119
Definition 119
Description 119
Epidemiology and Developmental Course 120
Generalized Anxiety Disorder 120
Diagnostic Criteria 120
Description 121
▶ JOHN: Generalized Anxiety Disorder 121
Epidemiology 121
Developmental Course 122
Panic Attacks and Panic Disorder 122
Diagnostic Criteria 122
▶ FRANK: Panic Attacks 122
Epidemiology 123
Description and Developmental Pattern 123
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Diagnostic Criteria 124
Description 126
PTSD and Child Abuse 126
Epidemiology 126
◼ ACCENT: Reactions to Mass Violence 128
Developmental Course and Prognosis 129
Obsessive-Compulsive Disorder 129
Diagnostic Criteria 129
▶ STANLEY: The Martian Rituals 129
Description 129
▶ SERGEI: Impairment in Functioning 130
Epidemiology 130
Developmental Course and Prognosis 131
Etiology of Anxiety Disorders 131
Biological Influences 131
Psychosocial Influences 133
Assessment of Anxiety Disorders 135
Interviews and Self-Report Instruments 135
Direct Observations 136
Physiological Recordings 136
Interventions for Anxiety Disorders 136
Psychological Treatments 136
Pharmacological Treatments 139
Treating Obsessive-Compulsive Disorder 139
xiv Contents

Prevention of Anxiety Disorders 140

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Chapter 7 MOOD DISORDERS 143

A Historical Perspective 144
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Definition and Classification of Depression 145
Defining Depression 145
Depressive Disorders: The DSM Approach 146
Depression: Empirical Approaches 146
Description of Depression 147
▶ NICK: The Problems of Depression 147
Epidemiology of Depression 147
Age and Sex 148
Socioeconomic, Ethnic, and Cultural Considerations 149
Co-occurring Difficulties 149
Depression and Development 149
▶ AMY: Preschool Depression 150
Etiology of Depression 151
Biological Influences 151
Temperament 152
Social-Psychological Influences 153
Impact of Parental Depression 155
▶ MARY: Family Interactions and Depression 157
▶ JOE AND FRANK: Different Outcomes 158
Peer Relations and Depression 158
Assessment of Depression 159
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Pharmacological Treatments 160
Psychosocial Treatments 161
Prevention of Depression 164
Bipolar Disorder 164
DSM Classification of Bipolar Disorders 165
▶ SCOTT: Mixed Moods and Aggression 165
Description of Bipolar Disorder 166
Epidemiology of Bipolar Disorder 167
▶ BIPOLAR DISORDER: Families Need Support 168
Developmental Course and Prognosis 168
▶ JOSEPH: Early Bipolar Symptoms 168
Risk Factors and Etiology 169
Assessment of Bipolar Disorder 169
Treatment of Bipolar Disorder 170
 Contents xv

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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Chapter 8 CONDUCT PROBLEMS 178

Classification and Description 179
DSM Approach: Overview 179
DSM Approach: Oppositional Defiant Disorder 179
▶ HENRY: Preschool Oppositional Behavior 180
DSM Approach: Conduct Disorder 181
◼ ACCENT: Are Conduct Problems a Mental Disorder? 183
Empirically Derived Syndromes 183
Gender Differences: Relational Aggression 185
Violence 186
◼ ACCENT: Fire Setting 187
Bullying 188
▶ HENRY: A Victim of Bullying 189
Epidemiology 190
Gender, Age, and Context 190
Patterns of Co-occurrence 191
Developmental Course 192
Stability of Conduct Problems 192
Age of Onset 192
◼ ACCENT: Callous-Unemotional Traits 193
Developmental Paths 194
Etiology 195
The Socioeconomic Context 195
◼ ACCENT: Moving Out of Poverty 196
Aggression as a Learned Behavior 196
Family Influences 197
Peer Relations 201
Cognitive–Emotional Influences 202
Biological Influences 203
Substance Use 205
Classification and Description 205
Epidemiology 206
xvi Contents

▶ RODNEY: Alcohol and Nicotine Use 206

Etiology and Developmental Course 207
Assessment 209
Interviews 209
Behavior Rating Scales 209
Behavioral Observations 209
Intervention 210
Parent Training 210
Cognitive Problem-Solving Skills Training 212
Community-Based Programs 213
Multisystemic Therapy 213
▶ MAGGIE: The Need for Multiple Services 214
Pharmacological Intervention 214
Prevention 215
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Chapter 9 ATTENTION-DEFICIT HYPERACTIVITY DISORDER 219

Evolving Ideas About ADHD 220
%4. Classification and Diagnosis 220
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Inattention 222
Hyperactivity and Impulsivity 222
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Motor Skills 223
Intelligence, Academic Achievement 223
Executive Functions 224
Adaptive Behavior 224
Social Behavior and Relationships 224
▶ CORY: Being a “Bad Boy” 225
Health, Sleep, Accidents 226
◼ ACCENT: Autos, Adolescence, and ADHD 226
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▶ JIMMY: Combined Subtype of ADHD 227
▶ TIM: Predominantly Inattentive Subtype of ADHD 228
Co-Occurring Disorders 228
Learning Disabilities 229
Externalizing Disorders 229
Internalizing Disorders 229
Epidemiology 230
Gender 230
Social Class, Race/Ethnicity, and Culture 231
◼ ACCENT: ADHD and African American Youth 231
Developmental Course 232
 Contents xvii

Infancy and the Preschool Years 232

Childhood 232
Adolescence and Adulthood 233
Variation and Prediction of Outcome 233
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Executive Functions and Inhibition 234
Sensitivity to Reward 234
Temporal Processing and Aversion to Delay 235
Multiple Pathways? 235
Neurobiological Abnormalities 235
◼ ACCENT: ADHD: Category or Dimension? 237
Etiology 237
Genetic Influences 237
Prenatal Influences and Birth Complications 238
Diet and Lead 238
Psychosocial Influences 238
A Schema of the Development of ADHD 239
Assessment 239
Interviews 240
Rating Scales 240
Direct Observation 241
Other Procedures 241
Intervention 241
Prevention 241
Pharmacological Treatment 241
◼ ACCENT: Medication Does Not Always Work 242
Behaviorally Oriented Treatment 243
◼ ACCENT: The Summer Treatment Program (STP) 246
Multimodal Treatment 247
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Chapter 10 LANGUAGE AND LEARNING DISABILITIES 251

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▶ THOMAS: So Many Abilities 252
Definitional Concerns 253
Identifying Specific Disabilities 253
◼ ACCENT: Response to Intervention 254
Language Disabilities 255
Normal Language Development 255
DSM Classification and Diagnosis 256
Description 257
▶ RAMON: Phonological Disorder 257
▶ AMY: Problems in Language Expression 258
xviii Contents

▶ TRANG: Problems in Language Reception and Expression 258

Epidemiology and Developmental Course 258
Co-occurring Disorders 259
Cognitive Deficits and Theories 260
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DSM Classification and Diagnosis 261
Reading Disabilities (RD) 261
Disabilities of Written Expression 263
▶ C.J.: Writing, Writing, All Day Long 265
Mathematics Disabilities (MD) 266
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Social Relations and Competence 267
Academic Self-Concept and Motivation 267
Brain Abnormalities In Language and Learning Disabilities 268
Language and Reading: Brain Structure 268
Language and Reading: Brain Function 268
◼ ACCENT: Intervention and Brain Changes 269
Etiology of Language and Learning Disabilities 270
Genetic Influences 270
◼ ACCENT: The FOXP2 Story 271
Psychosocial Influences 271
Assessing Language and Learning Disabilities 272
◼ ACCENT: Clues for Identifying Reading Disorder 272
Intervention for Language and Learning Disabilities 273
Prevention 273
Intervention for Language Disabilities 273
Intervention for Learning Disabilities 274
Special Education Services 275
Inclusion: Benefits and Concerns 277
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Chapter 11 INTELLECTUAL DISABILITY 281

◼ ACCENT: Sticks and Stones and Stigma 282
Definition and Classification 282
The AAIDD Approach 282
The DSM and Past Approaches 284
Nature of Intelligence and Adaptive Behavior 284
Measured Intelligence 284
◼ ACCENT: Measured Intelligence: A History of Abusive Ideas 286
Adaptive Functioning 287
Description 288
▶ ANNALISE: Profound Intellectual Disability 289
Co-Occurring Disorders 290
 Contents xix

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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Chapter 12 AUTISM SPECTRUM DISORDER AND SCHIZOPHRENIA 313

A Bit of History 313
Autistic Disorder (Autism) 314
DSM Classification and Diagnosis 314
▶ PAUL: Autistic Aloneness 314
Description: Primary Features 315
Description: Secondary Features 317
Co-occurring Disorders 320
Epidemiology 321
◼ ACCENT: An Epidemic of Autism? 322
xx Contents

Developmental Course 322

Neurobiological Abnormalities 323
Etiology 324
Autism Spectrum Disorder and Other PDDs 326
▶ LESLIE: PDD-NOS 328
Assessment of ASD 328
▶ NICHOLAS: Childhood Disintegrative Disorder 329
Prevention of ASD 330
Intervention for ASD 330
◼ ACCENT: The Early Start Denver Model (ESDM) 331
Schizophrenia 335
DSM Classification and Diagnosis 335
Description: Primary and Secondary Features 336
Epidemiology 337
Developmental Course 337
▶ MARY: A Tragic Course of Childhood Schizophrenia 339
Neurobiological Abnormalities 338
Etiology 340
Assessment 342
Prevention 342
Intervention 343
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Chapter 13 DISORDERS OF BASIC PHYSICAL

FUNCTIONS 346
Problems of Elimination 347
Typical Elimination Training 347
Enuresis 347
▶ JAY: Enuresis and Its Consequences 347
Encopresis 349
▶ SUSAN: Encopresis and Its Consequences 349
Sleep Problems 350
Sleep Development 350
Common Sleep Problems 351
Sleep Disorders 352
Treating Sleep Problems 354
▶ MATTHEW: Recurrent Nightmares 355
◼ ACCENT: Sleep Apnea 356
Problems of Feeding, Eating, and Nutrition 357
Common Eating and Feeding Problems 357
Early Feeding and Eating Disorders 357
Obesity 359
▶ SEAN: Obesity and Family Environment 361
 Contents xxi

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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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Chapter 14 PSYCHOLOGICAL FACTORS AFFECTING MEDICAL

CONDITIONS 376
Historical Context 376
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Asthma 377
▶ LOREN: Managing Asthma 377
Consequences of Chronic Conditions 379
Adjustment and Chronic Illness 380
▶ LISA: Diabetes Management and Family Context 383
Cancer: Adapting to Chronic Illness 384
◼ ACCENT: The Impact of HIV/AIDS in Children and Adolescents 385
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Adherence to Medical Regimens 386
Psychological Modification of Chronic Pain 389
▶ CINDY: Chronic Headache Pain 390
Reducing Procedure-Related Pain and Distress 390
◼ ACCENT: Preventing Childhood Injury 393
Preparation for Hospitalization 394
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Chapter 15 EVOLVING CONCERNS FOR YOUTH 397

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Maternal Employment and Child Care 398
Adoptive Families 400
Foster Care 402
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Fragmentation, Utilization, Evaluation 404
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xxii Contents

Third World Poverty and Health 406

Exposure to Armed or Sociopolitical Conflict 407
Diversity and International Cooperation 409
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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.

THEME 1: DEVELOPMENTAL PSYCHOPATHOLOGY

At the heart of the text is the partnership of the developmental psychopathology perspective and the more traditional
(usual) clinical/disorder approach. The latter underscores description of the symptoms, causes, and treatments of disorders
of young people. The developmental psychopathology perspective assumes that problems of youth must be viewed within
a developmental context. The developmental psychopathology perspective is articulated in early chapters of the book and
guides discussion of specific disorders in subsequent chapters.
A primary assumption of developmental psychopathology is the belief that normal and disturbed behavior are related
and are best viewed as occurring along a dynamic pathway of growth and experience, with connections to the past and to
the future. This proposition is reflected in the text in several ways. Consideration is given to the timing and processes of
normal development and how these may go awry in psychopathology. We also take seriously the assumption that behav-
ioral development cannot be readily parsed by age, and thus we employ a broad time frame for discussing psychological
problems in childhood and adolescence. Understanding these problems is enhanced by anchoring them in the early years
of life and linking them to outcomes in adulthood.

THEME 2: MULTIPLE TRANSACTIONAL INFLUENCES

A second theme woven throughout the text is the view that behavioral problems result from transactions among variables.
With few—if any—exceptions, behavior stems from multiple influences and their continuous interactions. Biological struc-
ture and function, genetic transmission, cognition, emotion, social interaction, and numerous aspects of the immediate
and broader environment play complex roles in generating and maintaining psychological and behavioral functioning.
Developmental psychopathologists are committed to the difficult task of understanding and integrating these multiple
influences—efforts that are addressed throughout the text.

THEME 3: THE INDIVIDUAL IN CONTEXT

Following from this, a third theme emphasizes that the problems of the young are intricately tied to the social and cultural
contexts in which they experience life. Children and adolescents are embedded in a circle of social and environmental
influences involving family, peer, school, neighborhood, societal, and cultural circumstances. At any one time, youths bring
their personal attributes to these circumstances, are affected by them, and in turn, influence other people and situations.
Meaningful analysis of psychological problems thus requires that the individual be considered in developmental context.
Such aspects as family interactions, friendships, gender, educational opportunity, poverty, ethnicity and race, and cultural
values all come into play.

xxiii
xxiv Preface

THEME 4: THE EMPIRICAL APPROACH

A fourth major theme is a bias toward the empirical approach. Prudent and insightful thinking is required in both figuring
out the puzzles of behavioral problems and applying acquired knowledge. We believe that empirical approaches and the
theoretical frameworks that rely on scientific method provide the best avenue for understanding the complexity of human
behavior. Research findings thus are a central component of the book and inform our understanding of the problems expe-
rienced by youth and how the lives of young people might be improved.

THEME 5: THE PERSON AT THE CENTER

Concern for the optimal development of the child or adolescent is given important emphasis throughout this text. While
there is no doubt that empirical studies further our understanding of development, it is helpful to examine problems from
a more personal viewpoint. Thus, by also viewing problems through the lens of the experience of troubled youths and their
families, students better come to understand how psychopathology is manifested, what needs a youth may have, how inter-
vention can help a child, and a plethora of other factors. The many case descriptions in the text are vital in bringing forth
the personal. So also are the several other individual accounts, quotations, and photographs. Real-life is singularly captured
by the hyperactive child who realizes that he is considered a “bad boy,” the sister who believes she has become a better per-
son through caring for her intellectually challenged brother, and the parents who report being “jolted” by a TV description
of a youth whose problems were similar to those of their undiagnosed child.

ORGANIZATION OF THE TEXT

As a relatively comprehensive introduction to the field, Abnormal Child and Adolescent Psychology includes theoretical
and methodological foundations of the field and devotes most discussion to specific problems of youth—that is, to the
characteristics, epidemiology, developmental course, etiology, assessment, treatment, and prevention of psychopathology.
Although we have not formally divided the chapters into broader sections, they are conceptualized as three units.
UNIT I, consisting of Chapters 1 through 5, presents the foundation for subsequent discussion. A broad overview
of the field is presented, including basic concepts, historical context, developmental influences, theoretical perspectives,
research methodology, classification and diagnosis, assessment, prevention, and treatment approaches. These chapters
draw heavily on the psychological literature and also recognize the multidisciplinary nature of the study and treatment of
youth. We assume that readers have some background in psychology, but we have made an effort to serve those with rela-
tively limited background or experience.
UNIT II, consisting of Chapters 6 through 14, addresses major disorders. There is considerable organizational con-
sistency across these chapters. For most disorders, classification, clinical description, epidemiology, developmental course,
etiology, assessment, and prevention/treatment are discussed in that order. At the same time, flexible organization is a guid-
ing principle so that the complexity inherent in specific chapter topics is not sacrificed.
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problems.
UNIT III consists of Chapter 15, which rounds out and extends what has gone before. The chapter examines evolving
concerns regarding the development of youth. The focus is on selected critical family issues, mental health services, and
briefly on youth living in countries other than the United States.

CONTENT: HIGHLIGHTS AND UPDATES

It almost goes without saying that the study of the psychopathology of youth, as it catapults ahead, must include judicious
consideration of recent research and issues. Such consideration is reflected by the provision of new information through-
out the text. The updated content not only points to new findings and issues but, importantly, it also confirms or extends
Another random document with
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 By the Muses, Sir,—Not with the stinger.

Lampriscus.

Then you shouldn't be so naughty.

Cott.

O how many will you give me?

Lamp.

Your mother fixes that.

Cott.

How many, mother?

Mother.

As many as your wicked hide can bear

(They proceed with the flogging).

Cott.

Stop!—That's enough! Stop!

Lamp.

You should stop your ways.

Cott.

I'll never do it more, I promise you.

Lamp.

Don't talk so much, or else I'll bring a gag.

Cott.

I won't talk,—only do not kill me,—please.

Lamp. (at length relenting).

Let him down, boys.

Mother.

No, leather him till sunset.

Lamp.

Why, he's as mottled as a water snake.

Mother.

Well, when he's done his reading, good or bad,

Give him a trifle more, say twenty strokes.[8]

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.

But in spite of all his misdemeanours and punishments, in letters, music

and gymnastics, the Athenian boy was educated until he was eighteen years
old. The stories of the ancient heroes who had fought at Troy, and those of
more recent times who had defeated the Persians filled him with enthusiasm
for his race and a love of freedom for his city. Having to learn many things
without the aid of books, his mind grew quick, alert and observant, and his
music and gymnastics taught him the beauty of self-control and dignified
restraint.
 MUSIC SCHOOL SCENES.
From a Hydria in the British Museum. (E 171.)

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."

[1] From The Schools of Hellas, by Kenneth J. Freeman.

[2] Lucian, translated by Kenneth J. Freeman, in The Schools of Hellas.

[3] Plato: Protagoras, translated by Jowett.

[4] Xenophon: Banquet.

[5] See p. 312.

[6] Plato: Laws.

[7] Plato: Republic, translated by Davies and Vaughan.

[8] Herodas: Mime, III, translated by Kenneth J. Freeman in The Schools

of Hellas.

CHAPTER XIV

THE GREEK THEATRE

The Greek drama began as a religious observance in honour of Dionysus.

To the Greeks this god personified both the spring and the vintage, the latter
a very important time of year in a vine-growing country, and he was a
symbol to them of that power there is in man of rising out of himself, of
being impelled onwards by a joy within him that he cannot explain, but
which makes him go forward, walking, as it were, on the wings of the wind,
of the spirit that fills him with a deep sense of worship. We call this power
enthusiasm, a Greek word which simply means the god within us.
 From very early times, stories of his life were recited at the religious
festivals held in honour of Dionysus, and then stories of the other gods and
of the ancient heroes were told as well. It was from these beginnings that the
drama came. Originally, the story was told in the form of a song, chanted at
first by everyone taking part in the festival, and later by a chorus of about
fifty performers, and at intervals in the song the leader would recite part of
the story by himself. By degrees the recitation became of greater importance
than the song; it grew longer, and after a time two people took part in it and
then three; at the same time the chorus became smaller and of less
importance in the action of the drama, until at last it could consist of only
fifteen performers.

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:

Could I take me to some cavern for mine hiding,

In the hill-tops where the Sun scarce hath trod;
Or a cloud make the home of mine abiding,
As a bird among the bird-droves of God.

And the song goes on to carry the imagination to a spot

 Where a voice of living waters never ceaseth
In God's quiet garden by the sea,
And Earth, the ancient life-giver, increaseth
Joy among the meadows, like a tree.[1]

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

An Athenian audience was very critical, and shouts and applause, or

groans and hisses showed its approval or disapproval of the play being acted.
Several plays were given in one day, and a prize was awarded to the best, so
the audience was obliged to start at dawn and would probably remain in the
theatre until sunset. Let us go with an Athenian audience and see a play
which was first performed in the latter half of the fifth century B.C.

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.

On this occasion the play we are to see is "Iphigenia in Tauris," written

by Euripides, one of the greatest of the Athenian dramatists.

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.

In the meantime, Orestes, tormented beyond endurance by the Furies, had

gone to the Oracle of Apollo, to ask how he might be purified from his sin,
and Apollo had told him to go to the land of the Tauri and bring back to
Attica the image of Artemis his sister, so that it might no longer be stained
by the blood of the human sacrifices. And so it comes about that Orestes is
the first Greek who will be brought to Iphigenia for sacrifice to Artemis. It is
at this moment that the play opens.[2]

CHARACTERS OF THE PLAY

IPHIGENIA.
ORESTES, her brother.
PYLADES, friend to Orestes.
THOAS, King of Tauris.
A HERDSMAN.
A MESSENGER.

CHORUS of captive Greek Women, handmaids to Iphigenia.

THE GODDESS, PALLAS ATHENA.

The scene shows a great and barbaric Temple on a desolate sea-coast. An

altar is visible stained with blood. There are spoils of slain men hanging
from the roof. Iphigenia, in the dress of a priestess, comes out of the Temple,
and in a speech that serves really as a Prologue to the play, she tells her
story. At the end of her speech, which is haunted throughout by a sense of
exile and homesickness, she describes a strange dream she has just had,
which she interprets as meaning that Orestes, her brother, is dead. She then
goes into the Temple.

Voice.

Did some one cross the pathway? Guard thee well.

Another Voice.

I am watching. Every side I turn my eye.

(Enter Orestes and Pylades. Their dress shows they are travellers.
Orestes is shaken and distraught.)

Orestes.

How, brother? And is this the sanctuary

At last, for which we sailed from Argos?

Pylades.

For sure, Orestes. Seest thou not it is?

Orestes.

The altar, too, where Hellene blood is shed.

Pylades.

How like long hair those blood-stains, tawny red!

Orestes.

And spoils of slaughtered men—there by the thatch.

Pylades.

Aye, first-fruits of the harvest, when they catch

Their strangers!—'Tis a place to search with care.

(He searches while Orestes sits.)

During this search, Orestes, in a speech addressed to Apollo, explains why

they are there, and expresses hopelessness at their ever accomplishing the
will of the god, and even suggests their turning back. But Pylades
encourages him and bids him take courage, for, he says,

Danger gleams
Like sunshine to a brave man's eyes, and fear
Of what may be is no help anywhere.

Orestes.

Aye, we have never braved these leagues of way

To falter at the end. See, I obey
Thy words. They are ever wise. Let us go mark
Some cavern, to lie hid till fall of dark.
God will not suffer that bad things be stirred
To mar us now, and bring to naught the word
Himself hath spoke. Aye, and no peril brings
Pardon for turning back to sons of kings.

(They go out towards the shore.)

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.

Peace! Peace upon all who dwell

By the Sister Rocks that clash in the swell
Of the Friendless Seas.

****

From Hellas that once was ours,

We come before thy gate,
From the land of the western seas,
The horses and the towers,
The wells and the garden trees,
And the seats where our fathers sate.

Leader.

What tidings, ho? With what intent

Hast called me to thy shrine and thee,
O child of him who crossed the sea
To Troy with that great armament,
The thousand prows, the myriad swords?
I come, O child of Atreid Lords.

(Iphigenia, followed by attendants, comes from the Temple.)

Iphigenia.

Alas! O maidens mine,

I am filled full of tears:
My heart filled with the beat
Of tears, as of dancing feet,
A lyreless, joyless line,
And music meet for the dead.
 For a whisper is in mine ears,
By visions borne on the breath
Of the Night that now is fled,
Of a brother gone to death.
Oh sorrow and weeping sore,
For the house that no more is,
For the dead that were kings of yore
And the labour of Argolis!

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.

Stay, yonder from some headland of the sea

There comes, methinks a herdsman, seeking thee.

(Enter a Herdsman. Iphigenia is still on her knees.)

Herdsman.

Daughter of Clytemnestra and her King,

Give ear! I bear news of a wondrous thing.

Iphigenia.

What news, that so should mar my obsequies?

Herdsman.

A ship hath passed the blue Symplegades,

And here upon our coast two men are thrown,
Young, bold, good slaughter for the altar-stone
Of Artemis.

(She rises.)
 Make all the speed ye may;
'Tis not too much. The blood-bowl and the spray!

Iphigenia.

Men of what nation? Doth their habit show?

Herdsman.

Hellenes for sure, but that is all we know.

Iphigenia.

No name? No other clue thine ear could seize?

Herdsman.

We heard one call his comrade "Pylades."

Iphigenia.

Yes. And the man who spoke—his name was what?

Herdsman.

None of us heard. I think they spoke it not.

Iphigenia.

How did ye see them first, how make them fast?

Herdsman.

Down by the sea, just where the surge is cast,—

Iphigenia.

The sea? What is the sea to thee and thine?

Herdsman.
 We came to wash our cattle in the brine.

Iphigenia.

Go back, and tell how they were taken; show

The fashion of it, for I fain would know
All.—'Tis so long a time, and never yet,
Never, hath Greek blood made this altar wet.

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.

But who be these, from where the rushes blow

On pale Eurotas, from pure Dirces,
That turn not neither falter,
Seeking Her land, where no man breaketh bread,
Her without pity, round whose virgin head
Blood on the pillars rusts from long ago,
Blood on the ancient altar.
A flash of the foam, a flash of the foam,
A wave on the oar-blade welling,
And out they passed to the heart of the blue;
A chariot shell that the wild waves drew.
Is it for passion of gold they come,
Or pride to make great their dwelling?

*****

Through the Clashing Rocks they burst:

They passed by the Cape unsleeping
Of Phineus' sons accurst:
They ran by the star-lit bay
Upon magic surges sweeping,
Where folk on the waves astray
Have seen, through the gleaming grey,
Ring behind ring, men say,
The dance of the old Sea's daughters.

The guiding oar abaft

It rippled and it dinned,
And now the west wind laughed
And now the south west wind;
And the sail was full in flight,
And they passed by the Island White:

Birds, birds, everywhere,

White as the foam, light as the air;
And ghostly Achilles raceth there,
Far in the Friendless Waters.
 A sail, a sail from Greece,
Fearless to cross the sea,
With ransom and with peace
To my sick captivity.
O home, to see thee still,
And the old walls on the hill!

Dreams, dreams, gather to me!

Bear me on wings over the sea;
O joy of the night, to slave and free,
One good thing that abideth!

Leader.

But lo, the twain whom Thoas sends,

Their arms in bondage grasped sore
Strange offering this, to lay before
The Goddess! Hold your peace, O friends.

Onward, still onward to this shrine

They lead the first-fruits of the Greek.
'Twas true, the tale he came to speak,
That watcher of the mountain kine.

O holy one, if it afford

Thee joy, what these men bring to thee,
Take thou their sacrifice, which we,
By law of Hellas, hold abhorred.

(Enter Orestes and Pylades, bound, and guarded by Taurians. Re-

enter Iphigenia.)

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.

Say first—which is it men call Pylades?

Orestes.

'Tis this man's name, if that will give thee ease.

Iphigenia.

From what walled town of Hellas cometh he?

Orestes.

Enough!—How would the knowledge profit thee?

Iphigenia.
 Are ye two brothers of one mother born?

Orestes.

No, not in blood. In love we are brothers sworn.

Iphigenia.

Thou also hast a name: tell me thereof.

Orestes.

Call me Unfortunate. 'Tis name enough.

Iphigenia.

I asked not that. Let that with Fortune lie.

Orestes.

Fools cannot laugh at them that nameless die.

Iphigenia.

Why grudge me this? Hast thou such mighty fame?

Orestes.

My body, if thou wilt, but not my name.

Iphigenia.

Nor yet the land of Greece where thou wast bred?

Orestes.

What gain to have told it thee, when I am dead?

Iphigenia.
 Nay: why shouldst thou deny so small a grace?

Orestes.

Know then, great Argos was my native place.

Iphigenia.

Stranger! The truth!—From Argos art thou come?

Orestes.

Mycenae, once a rich land, was my home.

Iphigenia.

'Tis banishment that brings thee here—or what?

Orestes.

A kind of banishment, half forced, half sought.

Iphigenia.

Wouldst thou but tell me all I need of thee!

Orestes.

'Twere not much added to my misery.

Iphigenia.

From Argos!—Oh, how sweet to see thee here!

Orestes.

Enjoy it then. To me 'tis sorry cheer.

Iphigenia.