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Book Details
Abstract
What does the word 'schizophrenia' mean to you? Perhaps your first thought is of someone with a medical condition that involves some kind of brain disease? But what if you knew that the person in question had been through a traumatic childhood? Would that change how you thought about their mental health? And what impact does this have on how we as a society interact with people with mental distress?
Psychology, Mental Health and Distress is the first mainstream textbook that reconsiders the traditional emphasis on the biological and psychiatric models for what is commonly, but contentiously, known as 'abnormal psychology' or 'psychopathology'. It provides a fully rounded account of mental distress, including social and relationship causes, and challenges your preconceptions about what you think you know about mental health.
Key features:
* Reflects new approaches to mental health and the kinds of psychological interventions (or 'treatments') for those experiencing distress, moving away from a limited diagnostic model
* Offers a wealth of case stories to portray the reality of living with distress, building your empathy to encourage sensitive practice
* Fully informed by current experimental, qualitative and theoretical psychological research including research into hearing voices
* Written by a team of leading clinical and social psychologists with additional contributions by renowned figures including Richard Bentall, a bestselling Penguin author whose Madness Explained won the 2004 BPS Book Award
* Includes a chapter authored by those with first-hand experience of mental health services, ensuring you understand the nuances of this emotionally charged, and often controversial, topic
The authors draw from a range of experience, examples and approaches to present this student-friendly and engaging text: core reading for anyone serious about understanding mental health issues.
This is the book that I have been waiting years to see. Superb, thoroughly researched and intellectually refreshing - a game changer in the field. It should be mandatory reading on every psychology course not just those dealing with mental health issues.' - Ron Roberts, Kingston University, UK
'At last, an undergraduate text that adopts a critical approach to 'Abnormal Psychology'. Psychology, Mental Health and Distress is the first of its kind, providng an accessible, engaging, and refreshing take on the standard material. Assembled by an impressive team of world-class scholars, this text extends the analysis of people's distress beyond biomedical and individualist framings, and toward a deeper exploration of the complext interplay between the body, the psych, and the social and political context. This is an important and revolutionary resource for students and scholars alike.' - Michelle LaFrance, St Thomas University, Canada'I wish this book had been around when I was an undergraduate. Two aspects of the book are especially important. First, recognising the importance of culture in mental health, and secondly, giving a voice to mental health service users.'
- Kate Bennett, University of Liverpool, UK
'In simple langauge and in no ambiguous terms, the authors of this book clearly bring out the limitations of current theory and research in psychiatry, abnormal and clinical psychology. The authors also go a step further to show how we can unshackle oursleves from these limitations. I whole heartedly recommend this book to both the beginning student and seasoned practitioner of mental health who is interested in helping people afflicted by mental distress.'
- David Lackland Sam, University of Bergen, Norway
'An inspiring and ambitious text - a longed-for change to passive acceptances of psychiatric categories. This book is ideal for academics and students wishing to critically probe the limitations of DSM diganoses.'
- Leanne Franklin, Cardiff Metropolitan University
'The book gives an excellent introduction to the field of abnormal psychology and could be read by students, academics, service users and clinical psychologists both to understand the different causes to mental distress, but also how these problems could be best treated.'
- Roger Hagen, Norwegian University of Science and Technology
'This is a book that is long overdue. So many books on psychopathology tend to be overly influenced by a biomedical and cognitive approach to understanding psychological distress, and rarely go further than that. This book takes a refreshing psychological, social and critical approach. It does not discard the importance of biological factors, but it considers in detail the various psychological and social determinants of mental health and distress. I recommend this book as a must-read for clinical psychology trainees, and for students and professionals working in the field of mental health.'- Poul Rohleder, Anglia Ruskin University, UK
'I think it is a brilliant book by what I have read so far - and it has been a long time in coming! I think this book could possible set the trend for the future way of perceiving and thinking about mental health.'
– Dr Fiona McConnochie, School of Social & Health Sciences, University of Abertay Dundee
John Cromby is Senior Lecturer at Loughborough University, UK. Previously, he conducted research and teaching at the Universities of Nottingham and Bradford, and he has experience of working in mental health, drug addiction, and learning disability settings. His work engages with the ways that bodies and social processes come together to produce experience, including experiences of distress. In recent years this has meant exploring topics including paranoia, clinical sadness, emotion and fear of crime, and experimenting with methods of jointly analysing textual data and embodied activity. He is a former editor of the journal Subjectivity.
David Harper is Reader in Clinical Psychology at the University of East London (UEL), UK. He trained as a clinical psychologist at the University of Liverpool and worked as a clinical psychologist in National Health Service mental health services in the north-west of the UK for nine years. For a number of years he combined work as a clinician with part-time study for a PhD at Manchester Metropolitan University. He has been at UEL since 2000 and his research interests are in applying critical psychology and social constructionist ideas to the understanding both of distress (particularly paranoia and unusual experiences and beliefs) and the work of mental health professions. He co-authored Deconstructing psychopathology (1995) and co-edited Qualitative research methods in mental health and psychotherapy: An introduction for students and practitioners (2012). He undertakes a small amount of clinical work as a Consultant Clinical Psychologist in Newham as part of the Systemic Consultation Service.
Paula Reavey is Professor of Psychology at London South Bank University, UK, where she delivers a module on the psychology of mental health and distress. She edited the volume Visual Psychologies: Using and Interpreting Images in Qualitative Research (2011) and also co-edited two volumes, New Feminist Stories of Child Sexual Abuse: Sexual Scripts and Dangerous Dialogues (with Sam Warner, 2003) and Memory Matters: Contexts for Understanding Sexual Abuse Recollections (with Janice Haaken, 2009). She is currently working on a co-authored book Vital Memory: Ethics, Affect and Agency (with Steven D. Brown, 2013) and has also published numerous articles on social remembering, child sexual abuse and sexuality, mental distress, and embodiment and space, using a variety of methodologies, including memory work, discourse analysis and visual methods.
Table of Contents
Section Title | Page | Action | Price |
---|---|---|---|
Cover | Cover | ||
Half title | i | ||
Title | iii | ||
Copyight | iv | ||
Brief contents | v | ||
Long contents | vii | ||
List of illustrations | xviii | ||
Tour of the book | xx | ||
About the authors | xxi | ||
A note on authorship | xxii | ||
Additional contributor biographies | xxiii | ||
Foreword | xxiv | ||
Note to lecturers | xxvi | ||
Acknowledgements | xxvii | ||
Dedication | xxix | ||
Part 1 Concepts | 1 | ||
1 From Disorder to Experience | 3 | ||
Introduction | 4 | ||
What is distinctive about this book? | 4 | ||
Terminology | 5 | ||
Stigma and discrimination | 7 | ||
Discrimination | 8 | ||
What is distress? | 9 | ||
Why not abnormal psychology? | 11 | ||
Abnormal psychology is confusing and unclear | 11 | ||
Abnormal psychology is not consistently psychological | 11 | ||
Abnormal psychology is unhelpful | 12 | ||
Isn’t this just anti-psychiatry? | 12 | ||
From disorder to experience | 13 | ||
All in the mind? | 15 | ||
Models of distress | 16 | ||
Overview of this book | 17 | ||
Part 1 | 17 | ||
Part 2 | 17 | ||
How to use this book | 18 | ||
Sequence | 18 | ||
Questions | 18 | ||
Boxes | 18 | ||
Key terms and concepts | 18 | ||
Stories and experiences | 18 | ||
2 History | 19 | ||
Introduction | 20 | ||
History from the patient’s point of view: first person narratives as ‘protest literature’? | 22 | ||
The ancient Greeks: the emergence both of mythic and medical traditions of explanation | 24 | ||
The rise of religious worldviews: Christianity and the Middle Ages | 25 | ||
Increasingly detailed somatogenic models: from humours to nerves | 26 | ||
The ‘Age of Reason’: the birth both of reason and unreason | 26 | ||
The ‘great confinement?’ The madhouse, the asylum and the homogenization of those seen as insane | 28 | ||
Striking off the chains of the insane? The emergence of ‘moral management’ | 29 | ||
The medicalization of madness: the professionalization of asylum management | 30 | ||
Abuses and reforms of the asylums | 31 | ||
Increasing populations and decreasing expectations: the emergence of notions of chronicity | 32 | ||
1900–1945: diagnosis, psychological therapy, eugenics and war | 34 | ||
Classifying the mind: diagnostic classification and the rise of biological psychiatry | 34 | ||
Treating the mind: the birth of the psychological therapies | 37 | ||
Psychoanalysis | 37 | ||
Behaviourism | 37 | ||
Treating the body: new physical treatments | 39 | ||
The participation of German psychiatry in the Nazi genocide | 39 | ||
1945–1970: the Cold War, the pharmacological revolution, de-institutionalization, the DSM, new psychotherapies and anti-psychiatry | 40 | ||
Psychiatry and the Cold War | 40 | ||
Psychiatry and brainwashing | 40 | ||
The political abuse of psychiatry | 40 | ||
New psychological therapies | 42 | ||
From behaviourism to behaviour therapy | 42 | ||
Client-centred therapy | 42 | ||
Family therapy | 42 | ||
Cognitive behavioural therapy | 43 | ||
The birth of psychopharmacology | 43 | ||
The move from asylums to the community | 44 | ||
The post-asylum growth in the ‘psy’ disciplines | 44 | ||
Did community care ‘fail’? | 46 | ||
Attempts to systematize diagnosis | 46 | ||
Anti-psychiatry: five books which challenged psychiatry | 47 | ||
1970–present: new challenges to psychiatry from within and the rise of the service user/survivor movement | 49 | ||
Challenges to psychiatry from within since the 1960s | 49 | ||
Challenges to psychiatry from without since the 1960s: the rise of the psychiatric survivor movement | 50 | ||
The rise of the ‘ex-patients movement’ in the USA | 50 | ||
The history of the service user movement in the UK | 51 | ||
Unite and fight: patients get organized | 51 | ||
3 Culture | 55 | ||
Introduction | 56 | ||
What is culture? | 56 | ||
‘Professional’ cultures | 57 | ||
Studying culture in the context of mental health and distress | 58 | ||
Self and culture | 59 | ||
Emic versus etic distinctions | 61 | ||
Are the boundaries between mental health and normality similar or different across cultures? | 61 | ||
Prevalence rates across cultures | 62 | ||
The World Health Organization studies of schizophrenia | 64 | ||
Cross-cultural differences in the course and outcome of schizophrenia | 64 | ||
Family relationships and expressed emotion | 65 | ||
Employment opportunities and social responses | 65 | ||
Marriage and long-term relationships | 65 | ||
Different cultural emphases, different problems? | 66 | ||
Dissociation: spiritual enlightenment or illness? | 67 | ||
Dissociation and multiple selves: Dissociative Identity Disorder in the US | 67 | ||
Dissociation and religious experiences | 68 | ||
Are the boundaries between madness and sanity similar or different across cultures? | 69 | ||
Body, mind and society | 69 | ||
Somatization | 70 | ||
Culturally specific forms and diagnoses of somatization? | 71 | ||
Migration | 72 | ||
Cultural identification; psychosis and African–Caribbean men | 72 | ||
Ethnic density and parental absence | 72 | ||
4 Biology | 75 | ||
Introduction | 76 | ||
Biology: the primary cause of distress? | 76 | ||
Genetics and distress | 78 | ||
Behavioural genetics | 78 | ||
Molecular genetics | 81 | ||
Biological causation in context | 81 | ||
Culture | 82 | ||
Research funding | 82 | ||
Politics | 83 | ||
Self-interest | 83 | ||
Common sense | 83 | ||
Biology: mostly irrelevant to distress? | 84 | ||
Cannabis and schizophrenia | 85 | ||
Cannabis and schizophrenia: an association | 86 | ||
Association is not causation | 87 | ||
Epidemiological evidence | 87 | ||
The clinical picture | 87 | ||
Conclusion | 88 | ||
Lifelines | 88 | ||
Body, brain and social relations | 92 | ||
Development | 93 | ||
Temporal specificity and distress | 95 | ||
Temporal plasticity and distress | 98 | ||
5 Diagnosis and Formulation | 101 | ||
Introduction | 102 | ||
A brief history of psychiatric classification and diagnosis | 102 | ||
Medical and psychiatric diagnosis | 103 | ||
What do we mean by medical diagnosis? | 104 | ||
What are the differences between diagnosis in psychiatry and in general medicine? | 105 | ||
Summary | 106 | ||
Problems with psychiatric diagnosis | 106 | ||
Reliability | 106 | ||
Co-morbidity | 106 | ||
Validity | 107 | ||
Cross-cultural perspectives | 108 | ||
Psychiatric diagnosis as a social judgement | 108 | ||
Summary | 109 | ||
Consequences of diagnosis for service users | 109 | ||
Comfort and reassurance | 110 | ||
Access to services | 110 | ||
A sense of community | 110 | ||
Stigma | 110 | ||
Discrimination and social exclusion | 110 | ||
The sick role | 110 | ||
Loss of personal meaning | 110 | ||
Responses to the problems of psychiatric diagnosis | 111 | ||
The present system | 111 | ||
Developing alternative approaches | 112 | ||
Is psychiatric diagnosis fit for purpose? | 112 | ||
Formulation | 114 | ||
What is a formulation? | 114 | ||
Formulation and diagnosis: additions or alternatives? | 115 | ||
Limitations of formulation | 115 | ||
6 Causal Infl uences | 118 | ||
Introduction | 119 | ||
Causal influence, social process | 119 | ||
Causality | 120 | ||
Contingency | 121 | ||
Difficulties | 124 | ||
Researching causality | 124 | ||
Experimental methods | 124 | ||
Survey methods | 126 | ||
Epidemiological studies | 126 | ||
Case studies | 126 | ||
Qualitative research | 127 | ||
Summary | 127 | ||
Recognized causal influences | 127 | ||
Relational influences | 127 | ||
Family relationships | 127 | ||
Early experience | 128 | ||
Trauma and abuse | 129 | ||
Biological influences | 129 | ||
Neurotransmitters | 129 | ||
Brain structure | 130 | ||
Genetics | 130 | ||
Social influences | 131 | ||
Social inequalities | 132 | ||
Gender | 133 | ||
Ethnicity | 133 | ||
Conclusion | 134 | ||
Personal agency and meaning | 135 | ||
Putting this into clinical practice | 136 | ||
Incorporating relationship influences | 136 | ||
Incorporating biological influences | 136 | ||
Incorporating social influences | 136 | ||
Towards integration | 137 | ||
7 Service Users and Survivors | 139 | ||
Service Users/Survivors and Mental Health Services | 139 | ||
Introduction | 139 | ||
The service user/survivor movement – a diverse movement | 140 | ||
The service user/survivor movement – underlying beliefs | 141 | ||
Redefining experience | 142 | ||
Origins and influences | 143 | ||
Range of actions undertaken by the mental health service user/survivor movement | 144 | ||
Actions: consultation and monitoring | 144 | ||
Actions: training and education | 145 | ||
Actions: research | 145 | ||
Actions: alternative understandings | 145 | ||
Actions: service provision | 145 | ||
Actions: anti-discrimination and media work | 146 | ||
Actions: arts and creativity | 146 | ||
What has the survivor movement achieved in the UK? | 146 | ||
Achievements: involvement in care and treatment | 146 | ||
Achievements: independent advocacy | 147 | ||
Achievements: the Mental Health Act and compulsory treatment | 147 | ||
The slowness of change | 148 | ||
The service user/survivor movement: problems and challenges | 148 | ||
Problems and challenges: representation | 148 | ||
Problems and challenges: the process of involvement | 149 | ||
Beyond services: discrimination and social exclusion | 149 | ||
Where are we now? Where are we going? | 150 | ||
The Hearing Voices Network | 151 | ||
What is voice-hearing? | 151 | ||
The hearing voices network | 152 | ||
‘The freedom to hear voices’: the work of Romme and Escher | 152 | ||
An information and support network | 153 | ||
What are hearing voices groups? | 154 | ||
8 Interventions | 158 | ||
Introduction | 159 | ||
Psychiatric Medication | 160 | ||
Models of psychiatric drug action | 160 | ||
Psychoactive drugs | 161 | ||
Evidence on psychiatric drugs | 162 | ||
Randomized controlled trials | 162 | ||
Problems with randomized controlled trials | 163 | ||
Evidence for disease-centred effects | 164 | ||
Characteristics of different psychiatric drugs | 164 | ||
Antipsychotics | 164 | ||
Antidepressants | 166 | ||
Drugs used for people with a diagnosis of manic depression | 167 | ||
Stimulants | 167 | ||
Benzodiazepines | 168 | ||
Conclusions | 168 | ||
Compulsory Psychiatric Treatment | 168 | ||
Why give treatment compulsorily? | 168 | ||
Is it ever ethical to treat someone compulsorily? | 169 | ||
What is the Mental Health Act? | 169 | ||
What is meant by risk of harm to self or others? | 169 | ||
Who is most likely to receive compulsory treatment? | 170 | ||
The rise in the use of compulsory treatment in England and Wales | 171 | ||
Electro-convulsive Therapy | 171 | ||
What is ECT? | 171 | ||
What are the origins of ECT? | 171 | ||
How often is it used? | 172 | ||
When is it used? | 172 | ||
What are its side-effects? | 172 | ||
Is ECT effective? | 172 | ||
Psychological Therapies | 173 | ||
What is psychotherapy? | 173 | ||
Psychoanalysis | 173 | ||
Cognitive–behavioural therapy | 174 | ||
The humanistic and existential therapies | 174 | ||
Does psychotherapy work? | 174 | ||
Our currency, your problem: the question of power in psychotherapy | 177 | ||
Implications for clinical practice | 178 | ||
Feminist approaches | 178 | ||
Narrative approaches | 178 | ||
Systemic approaches | 179 | ||
Community Psychology | 179 | ||
Definitions and origins of community psychology | 180 | ||
Theoretical frameworks informing community psychology | 181 | ||
Community psychology and effectiveness | 182 | ||
Community psychology interventions | 184 | ||
Space to Write | 184 | ||
Psychology in the Real World | 184 | ||
Women, men, empowerment and learning disability: the WELD and MELD groups | 186 | ||
Social action therapy: The White City project | 187 | ||
Conclusion | 188 | ||
Part 2 Forms of Distress | 191 | ||
9 Sadness and Worry | 193 | ||
Introduction | 194 | ||
History and culture | 195 | ||
History | 195 | ||
Culture | 196 | ||
Contemporary Western forms of sadness and worry | 198 | ||
Psychiatric diagnoses | 200 | ||
Prevalence and distribution | 200 | ||
Causal influences | 201 | ||
Social inequality | 201 | ||
Gender | 203 | ||
Family and childhood influences | 203 | ||
Life events | 204 | ||
Childhood abuse | 205 | ||
Psychological processes | 205 | ||
Sadness | 205 | ||
Worry | 206 | ||
Biological processes | 208 | ||
Sadness | 209 | ||
Worry | 210 | ||
Lifelines, plasticity and specificity | 211 | ||
Specificity | 211 | ||
Plasticity | 212 | ||
Interventions | 212 | ||
Pharmaceutical interventions | 212 | ||
Physical interventions | 214 | ||
ECT | 214 | ||
Psychosurgery | 215 | ||
Psychological interventions | 215 | ||
Cognitive and cognitive–behavioural | 215 | ||
Behavioural | 216 | ||
10 Sexuality and Gender: Diversity, Deviance and Disorder? | 219 | ||
Introduction | 220 | ||
What’s ‘normal’, sex-wise? | 220 | ||
Topics covered in this chapter | 221 | ||
Historical considerations | 221 | ||
Culture, sexuality and the body | 222 | ||
Sex and gender | 222 | ||
Discrimination regarding sexual and gender identity, and its relationship to mental distress | 223 | ||
Defining ‘problems’ | 224 | ||
Causing distress | 224 | ||
Non-consensual or illegal behaviour | 224 | ||
Problems with having sex | 225 | ||
General prevalence rates and issues concerning problems with having sex | 225 | ||
Psychiatric diagnoses | 225 | ||
Diagnostic issues for Alice | 226 | ||
Diagnostic issues for Sajid | 227 | ||
Causes, maintenance and risk | 227 | ||
Culture | 227 | ||
Age | 228 | ||
Gender | 228 | ||
Relationships and childhood | 228 | ||
Life events | 229 | ||
Thoughts and feelings | 229 | ||
Chemical substances | 230 | ||
Substance use | 230 | ||
Prescribed psychiatric medications | 230 | ||
Biological factors | 230 | ||
Medical conditions | 230 | ||
Hormones | 231 | ||
Lifelines, plasticity and specificity | 231 | ||
The problem with diagnosis | 233 | ||
Summary | 233 | ||
Interventions for people who have problems having sex | 234 | ||
The basic structure of sex therapy | 235 | ||
Interventions | 235 | ||
Developing communication and sexual skills | 236 | ||
Medical treatments | 236 | ||
Summary of treatments and interventions | 237 | ||
Variation in sexual arousal | 237 | ||
Problems with diagnosis | 238 | ||
Impairment or social judgment? | 238 | ||
Specific paraphiliac characteristics? | 239 | ||
Distress | 241 | ||
Discrimination | 241 | ||
Summary | 241 | ||
Gender, Variance and Distress | 242 | ||
Definitions | 242 | ||
Gender, bodies and science | 243 | ||
Gender and the DSM | 244 | ||
Prescribing gender | 244 | ||
Debates about diagnosis | 245 | ||
Possibilities | 246 | ||
Interventions | 246 | ||
Section summary | 247 | ||
11 Madness | 249 | ||
Introduction: attempting to define madness | 250 | ||
History and culture | 251 | ||
History: the invention of schizophrenia | 251 | ||
Symptoms | 253 | ||
Causes | 253 | ||
Outcomes | 253 | ||
Clinical psychology and schizophrenia | 253 | ||
Cultural influences on how madness is seen: stigma and prejudice | 255 | ||
Public opinion about the causes of distress | 256 | ||
The relationship of causal beliefs to attitudes | 256 | ||
Contemporary Western forms of distress | 257 | ||
Prevalence | 257 | ||
The DSM | 258 | ||
Problems with the traditional psychiatric account | 259 | ||
Reliability | 259 | ||
Validity | 259 | ||
a) Symptoms | 259 | ||
b) Outcomes | 260 | ||
An alternative approach to researching psychotic experiences | 260 | ||
Researching reliable constructs | 260 | ||
Causal processes | 262 | ||
The stress-vulnerability or bio-psychosocial model | 262 | ||
A genetic predisposition to schizophrenia? | 262 | ||
Family studies | 262 | ||
The search for a schizophrenic gene | 263 | ||
Schizophrenia is a brain disease? | 263 | ||
Biochemistry | 264 | ||
Neuroanatomy | 265 | ||
Uniform prevalence? | 265 | ||
Psychosocial causes | 265 | ||
Poverty | 266 | ||
Ethnicity | 267 | ||
Adverse events in childhood and adolescence | 267 | ||
Loss of parents | 267 | ||
Problematic parenting | 267 | ||
Child abuse and neglect | 268 | ||
Substance abuse | 269 | ||
Adverse events in adulthood | 270 | ||
Physical assault and rape | 270 | ||
War | 270 | ||
Explanatory models explaining how adversity leads to psychosis | 271 | ||
The traumagenic neurodevelopmental model | 271 | ||
Psychodynamic theory | 271 | ||
Attachment theory | 272 | ||
Dissociation | 272 | ||
Cognitive research | 272 | ||
Hallucinations | 272 | ||
Paranoid delusions | 273 | ||
Lifelines, plasticity and specificity | 274 | ||
The perspective of experience-based experts | 274 | ||
Interventions | 274 | ||
From rotating chairs to lobotomies | 274 | ||
Shock therapy | 275 | ||
Antipsychotic drugs | 276 | ||
a) First generation, ‘conventional’ antipsychotics | 276 | ||
b) Second-generation atypical antipsychotics | 276 | ||
Psychosocial treatments | 277 | ||
The Soteria model | 277 | ||
Cognitive therapy | 278 | ||
Early intervention | 279 | ||
Initiatives by experience-based experts | 279 | ||
The recovery approach | 280 | ||
Asking about adverse life events | 280 | ||
Prevention | 281 | ||
12 Distressing Bodies and Eating | 283 | ||
Introduction | 284 | ||
Topics covered in this chapter | 285 | ||
What’s normal? Contemporary Western forms of eating problems and weight concerns | 285 | ||
History and culture | 286 | ||
Historical considerations | 286 | ||
Culture | 287 | ||
The universal rise of eating problems? | 287 | ||
Within cultural differences? | 288 | ||
Psychiatric diagnoses | 289 | ||
Prevalence and distribution | 289 | ||
Risks and maintaining factors | 290 | ||
Socio-cultural factors: body image and weight concerns | 290 | ||
The impact of the media | 291 | ||
Body image distortion and body dissatisfaction | 291 | ||
Gender identity | 292 | ||
Control and confusion: female development and maturation | 292 | ||
Control through dieting | 292 | ||
Conflicting roles and expectations that young girls and women face in a changing society | 293 | ||
The complex relationship between mothers and daughters and gender transmission | 293 | ||
Family and childhood influences | 294 | ||
Systems theory | 294 | ||
Life events | 295 | ||
Childhood abuse | 295 | ||
Thoughts and feelings | 295 | ||
Cognitions | 295 | ||
Intrapersonal and interpersonal factors | 296 | ||
Cognition and bingeing | 296 | ||
Emotions | 296 | ||
Biological factors | 297 | ||
Genetic factors | 297 | ||
Neurotransmitter functioning in the hypothalamic region | 298 | ||
Endogenous opioids | 298 | ||
Neuroendocrine functioning | 298 | ||
Lifelines, plasticity and specificity | 298 | ||
Summary | 299 | ||
Interventions | 300 | ||
Weight gain | 300 | ||
Cognitive–behaviour therapy | 301 | ||
Stage 1: Engaging the patient | 301 | ||
Stage 2: A review and revision (if necessary) of the original formulation | 301 | ||
Stage 3: Addressing the major maintaining factors | 301 | ||
Stage 4: Looking to the future: how to maintain positive change and prevent relapse | 302 | ||
How effective is cognitive–behaviour therapy (CBT)? | 302 | ||
Family therapy | 303 | ||
How effective is family therapy? | 304 | ||
How effective are drug treatments? | 304 | ||
Antipsychotics | 306 | ||
13 Disordered Personalities? | 308 | ||
Introduction | 309 | ||
History and culture | 309 | ||
History | 309 | ||
A brief history of personality theory and its problems | 310 | ||
Culture and personality | 312 | ||
Contemporary Western forms of distress | 313 | ||
Prevalence | 313 | ||
Psychiatric diagnosis | 314 | ||
The history of diagnosing personality disorder | 314 | ||
Problems with prevalence | 314 | ||
Service users’ views and experiences | 316 | ||
Disordered personalities or problems in relationships? | 317 | ||
The reliability of personality disorder diagnoses | 318 | ||
Diagnostic instability over time | 320 | ||
Co-morbidity | 320 | ||
Personality disorder not otherwise specified | 321 | ||
Personality disorder: whither or wither? | 321 | ||
Categorical versus continuum models | 321 | ||
Causal influences | 323 | ||
Culture and personality disorder | 323 | ||
Cultural bias in the diagnosis of personality disorders? | 324 | ||
Psychopaths in suits? The search for the ‘successful psychopath’ | 325 | ||
Gender and personality disorder | 326 | ||
Gender bias in the diagnosis of personality disorders? | 327 | ||
Social inequality | 328 | ||
Family and childhood influences | 328 | ||
Life events | 330 | ||
Psychological processes | 330 | ||
Biological processes | 331 | ||
Lifelines, plasticity and specificity | 332 | ||
Interventions | 333 | ||
Therapeutic pessimism and negative attitudes towards those with a diagnosis of personality disorder | 333 | ||
Interventions: borderline personality disorder | 333 | ||
Preventative interventions | 334 | ||
Psychological interventions | 334 | ||
Family interventions | 335 | ||
Social interventions | 335 | ||
Service-level interventions | 336 | ||
Medication | 336 | ||
Interventions: antisocial personality disorder | 336 | ||
Preventative interventions | 336 | ||
Psychological interventions | 337 | ||
Antisocial personality disorder, dangerousness and treatability | 337 | ||
Social interventions | 337 | ||
Medication | 337 | ||
Appendix: Mental Health Professions in the UK | 339 | ||
Glossary | 341 | ||
References | 358 | ||
Index | 409 |