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Perspectives on Development Nature versus Nurture Stages and Sequences Internal and External Influences on Development The Ecological Perspective Vulnerability and Resilience CHAPTER Theories of Development Psychoanalytic Theories Cognitive-Developmental Processing Theories Learning Theories Comparing Theories and Information- Finding the Answers: Research Designs and Methods Relating Goals to Methods Studying Age-Related Changes Identifying Relationships between Variables Cross-Cultural (or Cross-Context) Research Research Ethics 12 rowse the shelves lJ Y OU of 1/ -,Olll-/. Summary will find no shortage of ii4 OCil/6 oo~ Key Terms b o oks for parents. v ICe i’o il’let ;,.(> <1~ s.~ q e~ (>~ Titles such as Toilet Tra.ining in a. Day and How to Talk to Your Teenaser abound. Typically, the authors of such books are psychologists, counselors, social workers, educators, or pediatricians. Many are also parents and support their advice with anecdotes from their own parenting experience. In general, though, todays parents regard formal training as a more reliable indicator of expertise on parenting issues than hands-on experience with children (/tulbert, 2003). /tow did this trend-a fairly recent one, by the way-begin? According to many observers, parental preoccupation with “expert” child-rearing advice began in the early years of the 20th century, when popular magazines started pubLishing articles on child-rearing that referred to the theories of Sigmund Freud and other psychologists (Torrey, 1992). Soon, child-rearing books authored by experts became best-sellers. These articles and books recommended ’scientific” approaches to child-rearing. No longer were grandparents or other older adults to be viewed as authorities on bringing up children. Instead, young parents were encouraged to turn to pediatricians and psychologists. One of the first such child-rearing experts was John Watson (1878-1958). /te advocated rigid feeding schedules for infants and an orderly approach to child-rearing. Watson beLieved that American parenting traditions caused children to grow up to be emotionally weak. Accordingly, he advised parents: Never hug and kiss them, never let them sit in your lap. Ifyou must, kiss them once on the forehead when they say good night. shake hands with them in the morning. ~ive them a pat on the head if they have made an extraordinarily good job of a difficult task. (1928, pp. 81-82) Watson’s popularity ebbed as the radically different ideas of Dr. Beryamin spock (1903-1990), author of the classic book Baby and Child Care, became predominant in the 1950s. Spock urged parents to openly display affection toward children. Influenced by Freud’s ideas about the impact of early childhood emotional trauma on later personaLity, spock warned parents against engaging in too much conflict with children over weaning or toilet-training. /te emphasized the need to wait until children were ready to take on such challenges. Today, Watsons ideas are vkwed as emotionally cold and excessively rigid by pediatricians, psychologists, and parents alike. Similarly, many view spocks recommendations as overly indulgent. Yetparents continue to look to experts for help with parenting issues, often turning to the rapidly growing number of Internet sites devoted to child-rearing issues. In one survey, 71 % of mothers reported that they had searched the Internet for help with a parenting issue (Allen & Rainie, 2002). Child-rearing recommendations representing diverse philosophical orientations abound on the World Wide Web. Consequently, there is no single expert”voice” that predominates. /tealth-oriented sites, such as kidshealth.org and askdrsears.com, are very popular. Likewise,sites sponsored by child psychologists receive millions of hits each day. But parents also search for advice on their children’s spiritual development or for nontraditional treatments for conditions such as attention-deficit hyperactivity disorder (Bussing, Zima, ~ary, & ~arvan, 2002). One reason for the diversity and quantity of information available is that, thanks to more than a century of research, we now know a great deal more about the vari- ables that contribute velopment what developmental to human development. Identirying variables that influence delife is scientists develop theories and explaining how they work together to shape an individuals science is all about. Developmental and conduct research aimed at describing, explaining, and predicting age-related changes in behavior, thinking, emotions, and social relationships. H:istorically, developmental science has been associated with the field of psychology, and most of the developmentalists whose work you will read about in this text were or are science also draws from other fields, including biolsociology, and education. scientists want to find ways to help parents, anthropology, psychologists. But developmental ogy, neuroscience, In addition, most developmental teachers, therapists, and others who work with children to do so effectively. In pursuit of these goals, developmental researchers often focus on highly specific issues, such as psychology. We will how many items children of different ages can remember. H:owever, a few ideas are central to every theory and research study in developmental begin our discussion with a brief overview of these ideas. Perspectives on Development enturies before researchers began to use scientific methods to study age-related changes, philosophers proposed explanations of development based on everyday observations. Many of their questions and assertions about the nature of human development continue to be central to modern-day developmental science. C The argument about nature versus nurture, also referred to as heredity versus environment or nativism versus empiricism, is one of the oldest and most central theoretical issues within both psychology and philosophy. For example, have you ever heard someone say that “baby talk” will interfere with a child’s language development? If so, then you have heard an argument for the nurture side of the debate. Such a statement assumes that language development is mostly a matter of imitation: The child must hear language that is properly pronounced and grammatically correct in order to develop linguistic fluency. The nature side would counter that children possess some kind of internal mechanism to ensure that they develop fluent language, no matter how many “goo-goo-ga-gas” they hear from those around them. “Which side is right?” students invariably ask. If there were a simple answer to that question, the debate would have ceased long ago. Instead, the controversy continues today with regard to many developmental processes, including language development. Philosophically, the nature side of the controversy was represented by the idealists and rationalists, principally Plato and Rene Descartes, both of whom believed that at least some knowledge is inborn. On the other side of the argument were a group of British philosophers called empiricists, including John Locke, who insisted that at birth the mind is a blank slate-in Latin, a tabula rasa. All knowledge, the empiricists argued, is created by experience. From this perspective, developmental change is the result of external, environmental factors acting on a child whose only relevant internal characteristic is the capacity to respond. In contrast to both rationalists and empiricists, other philosophers believed that development involved an interaction between internal and external forces. For example, the Christian notion of original sin teaches that children are born with a developmental science The study of age-related changes in behavior, thinking, emotions, and social relationships. CRITICAL T-l INKING- ) See if you can identify one of your own characteristics or behavior patterns that has been strongly affected by “nature” and one that you think is primarily a result of your upbringing. norms Average ages at which developmental events happen. behaviorism The theoretical view that defines development in terms of behavior changes caused by environmental influences. selfish nature and must be spiritually reborn. After rebirth, children have access to the Holy Spirit, which helps them learn to behave morally through parental and churchbased instruction in religious practice. French philosopher Jean-Jacques Rousseau also believed in the idea of interaction between internal and external forces, but he claimed that all human beings are naturally good and seek out experiences that help them grow. For Rousseau, the goal of human development was to achieve one’s inborn potential. “Good” developmental outcomes, such as a willingness to share one’s possessions with others who are less fortunate, resulted from growing up in an environment that didn’t interfere with the child’s expression of his own innate characteristics. In contrast, “bad” outcomes, such as aggressive behavior, were learned from others or arose when a child experienced frustration in his efforts to follow the dictates of the innate goodness with which he was born. The views of two of psychology’s pioneers illustrate the way early psychologists approached the nature-nurture issue. Borrowing an idea from Darwin’s theory of evolution, early childhood researcher G. Stanley Hall (1844-1924) believed that the milestones of childhood were dictated by an inborn developmental plan and were similar to those that had taken place in the development of the human species. He thought that develop mentalists should identify norms, or average ages at which milestones happen. Norms, Hall said, could be used to learn about the evolution of the species as well as to track the development of individual children. So, for Hall, development was mostly about the nature side of the debate. John Watson, whose views you read about at the beginning of the chapter, explained development in a way that was radically different from that of G. Stanley Hall. In fact, Watson coined a new term, behaviorism, to refer to his point of view (Watson, 1913). Behaviorism defines development in terms of behavior changes caused by environmental influences. Watson did not believe in an inborn developmental plan of any sort. Instead, he claimed that, through manipulation of the environment, children could be trained to be or do anything (Jones, 1924; Watson, 1930). As Watson put it, Give me a dozen healthy infants, well-formed, and my own specified world to bring them up in and I’ll guarantee to take anyone at random and train him to become any type of specialist I might select-doctor, lawyer, merchant, chief, and yes, even beggar-man and thief, regardless of his talents, penchants, abilities, vocations, and the race of his ancestors. (1930, p. 104) In a famous study known as the “Little Albert” experiment, Watson conditioned a baby to fear white rats (Watson & Rayner, 1920). As the baby played with the rat, Watson made banging sounds that frightened the child. Over time, the baby came to associate the rat with the noises. He cried and tried to escape from the room whenever the rat was present. Based on the Little Albert study and several others, Watson claimed that all age-related changes are the result of learning (Watson, 1928). John Watson’s pioneering research on emotional learning in infants helped psychologists better understand the role of classicalconditioning in child development. The nature-nurture controversy is not the only “big question” in developmental psychology. An equally central dispute concerns the continuity-discontinuity issue: Is a child’s expanding ability just “more of the same;’ or does it reflect a new kind of activity? For example, a 2-year-old is likely to have no individual friends among her playmates, while an 8-year-old is likely to have several. We could think of this as a quantitative change (a change in amount) from zero friends to some friends, which suggests that the qualitative aspects of friendship are the same at every age-or, as developmentalists would express it, changes in friendships are continuous in nature. Alternatively, we could think of the difference in friendships from one age to another as a qualitative change (a change in kind or type)-from disinterest in peers to interest, or from one sort of peer relationship to another. In other words, in this view, changes in friendships are discontinuous, in that each change represents a change in the quality of a child’s relationships with peers. Thus, friendships at 2 are quite different from friendships at 8 and differ in ways that cannot be captured by describing them solely in terms of the number of friends a child has. Of particular significance is the idea that, if development consists only of additions (quantitative change), then the concept of stages is not needed to explain it. However, if development involves reorganization, or the emergence of wholly new strategies, qualities, or skills (qualitative change), then the concept of stages may be useful. Certainly, we hear a lot of “stagelike” language in everyday conversation about children: “He’s just in the terrible twos” or “It’s only a stage she’s going through.” Although there is not always agreement on just what would constitute evidence for the existence of discrete stages, the usual description is that a stage shift involves not only a change in skills but some discontinuous change in underlying structure (Lerner, Theokas, & Bobek, 2005). The child in a new stage approaches tasks differently, sees the world differently, is preoccupied with different issues. INTERNAL AND EXTERNAL ON DEVELOPMENT INFLUENCES Modern developmental psychologists still debate the nature-nurture and continuitydiscontinuity questions. But most agree that essentially every facet of a child’s development is a product of some pattern of interaction of nature and nurture (Rutter, 2002). Further, most recognize that some aspects of development are continuous and others are more stagelike. Consequently, the discussions have become a bit more complex. Maturation Nature shapes development most clearly through genetic programming that may determine whole sequences of later development. Developmentalist The shift from crawling to walking is a classic example of a maturationaly based universal developmental change. Arnold Gesell (1880-1961) used the term maturation to describe genetically programmed sequential patterns of change, and this term is still uniformly used today (Gesell, 1925; Thelen & Adolph, 1992). Any maturational pattern is marked by three qualities: It is universal, appearing in all children, across cultural boundaries; it is sequential, involving some pattern of unfolding skill or characteristics; and it is relatively impervious to environmental influence. In its purest form, a maturationally determined developmental sequence occurs regardless of practice or training. You don’t have to practice growing pubic hair; you don’t have to be taught how to walk. In fact, only extreme conditions, such as severe malnutrition, prevent such sequences from unfolding. Yet even confirmed maturational theorists agree that experience plays a role. maturation Sequential patterns of change that are governed by instructions contained in the genetic code and shared by all members of a species. critical period Any time period during development when an organism is especially responsive to and learns from a specific type of stimulation. The same stimulation at other points in development has little or no effect. sensitive period A period during which particular experiences can best contribute to proper development. It is similar to a critical period, but the effects of deprivation during a sensitive period are not as severe as during a critical period. The Timing of Experience Modern research tells us that specific experience interacts with maturational patterns in intricate ways. For example, Greenough (1991) notes that one of the proteins required for the development of the visual system is controlled by a gene whose action is triggered only by visual experience. Moreover, experience is required to maintain the neural connections underlying vision (Briones, Klintsova, & Greenough, 2004). So some visual experience is needed for the genetic program to operate. The timing of specific experiences may matter as well. The impact of a particular visual experience may be quite different if it occurs at birth than if it occurs when a baby is older. Developmentalists’ thinking about the importance of timing was stimulated, in part, by research on other species that showed that specific experiences had different or stronger effects at some points in development than at others. The most famous example is that baby ducks will become imprinted on (become attached to and follow) any duck or any other quacking, moving object that happens to be around them 15 hours after they hatch. If nothing is moving or quacking at that critical point, they don’t become imprinted at all (Hess, 1972). So the period just around 15 hours after hatching is a critical period for the duck’s development of a proper following response. In humans, we more often see sensitive periods than true critical periods. The difference is that a sensitive period is a time when a particular experience can be best incorporated into the maturational process, whereas a critical period is a time when an experience must happen or a particular developmental milestone will never occur. For example, infancy and early childhood are sensitive periods for language development. A child who is physically isolated from other humans by an abusive parent during these years will not develop normal language, but she will develop some language function once she is reintegrated into a normal social environment. The study of identic.al twins, like these two girls, is one of the classic.methods of behavior genetics. whenever pairs of identical twins are more like eac.hother in some behavior or quality than are pairs of fraternal twins, a genetic. influenc.e is likely at work. Inborn “Biases and Constraints Another kind of internal influence is described by the concepts of “inborn biases;’ or “constraints” on development. For instance, researchers such as Elizabeth Spelke (1991) have concluded that babies come into the world with certain “preexisting conceptions,” or constraints on their understanding of the behavior of objects. Very young babies already seem to understand that unsupported objects will move downward and that a moving object will continue to move in the same direction unless it encounters an obstacle. Theorists do not propose that these built-in response patterns are the end of the story; rather, they see them as the starting point. Development is a result of experience filtered through these initial biases, but those biases constrain the number of developmental pathways that are possible (Campbell & Bickhard, 1992; Cole, 2005). How Do 8ehavior (i-eneticists Identify (i-enetic Effects? dentical twins share exactly the same genetic pattern, because they develop from the same fertilized ovum. Consequently, develop mentalists have learned a great deal about behavior genetics from studying identical twins who have been raised by different parents. If identical twins are more like each other on some dimension than other kinds of siblings are, despite having grown up in different environments, this is rather compelling evidence of a genetic contribution for that trait. In the case of adopted children, the strategy is to compare the degree of similarity between the adopted child and his birth parents (with whom he shares genes but not environment) with the degree of similarity between the adopted child and his adoptive parents (with whom he shares environment but not genes). If the child turns out to be more similar to his birth parents than to his adoptive parents, or if his behavior or skills are better predicted by the characteristics of his birth parents than by characteristics of his adoptive parents, that evidence would again demonstrate the influence of heredity. Here are two examples, both from studies of intelligence, as measured with standard IQ tests. Bouchard and McGue (1981, p. 1056, Fig. 1) combined the results of dozens of twin studies of the heritability of IQ scores and came up with the results shown in Table 1. The numbers shown in the table are correlations-a statistic explained more fully later in this chapter. For now, you need to know only that a correlation can range from – 1.00 to + 1.00. The closer a correlation is to 1.00, the stronger the relationship it describes. In this case, the numbers reflect how similar the IQs of twins are. You can see from Table 1 that identical twins reared together have IQs I that are highly similar, much more similar than the IQs of fraternal twins reared together. You can also see, though, that environment plays a role, since the IQs of identical twins reared apart are less similar than are those of identical twins reared together. The same conclusion comes from two well-known studies of adopted children-the Texas Adoption Project (Loehlin, Horn, & Willerman, 1994) and the Minnesota Transracial Adoption Study (Scarr, Weinberg, & Waldman, 1993). In both studies, the adopted children were given IQ tests at approximatelyage 18. Their scores on this test were then correlated with the measured IQ scores of their natural mothers and of their adoptive mothers and fathers. These correlations are shown in Table 2. In both cases, the children’s IQs were at least somewhat predicted by their natural mothers’ IQs, but not by the IQs of their adoptive parents, with whom they had spent their entire childhood. Thus, the adoption studies, like the twin studies ofIQ, tell us that there is indeed a substantial genetic component in what is measured by an IQ test. 1. Fraternal twins are no more genetically similar than non-twin siblings, yet the IQs of fraternal twins are more strongly correlated than those of non-twin brothers and sisters. What explanations can you think of to explain this difference? 2. The term environment is extremely broad. What are some of the individual variables that comprise an individual’s environment? Table 2 Texas Minnesota .29 .14 Identical twins reared together Identical twins reared apart Fraternal (nonidentical) twins reared together Siblings (including fraternal twins) reared apart .85 .67 .58 .24 Correlation with the biological mother’s IQ score Correlation with the adoptive mother’s IQ score Correlation with the adoptive father’s IQ score .44 .03 .06 .08 Behavior (1-enetics The concept of maturation and the idea of inborn biases are both designed to account for patterns and sequences of development that are the same for all children. At the same time, nature contributes to variations from one individual to the next. The study of genetic contributions to individual behavior, called behavior genetics, uses two primary research techniques-the study of identical and fraternal twins and the study of adopted children (described more fully in the Research Report). Behavior geneticists have shown that heredity affects a remarkably broad range of behaviors (Posthuma, de Geus, & Boomsma, 2003). Included in the list are not only obvious physical differences such as height, body shape, or a tendency to thinness or obesity, but also cognitive abilities such as general intelligence, more specific cognitive skills such as spatial visualization ability, and problems like reading disability (Rose, 1995). Research has also shown that many aspects of pathological behavior are genetically influenced, including alcoholism, schizophrenia, excessive aggressiveness or antisocial behavior, depression or anxiety, even anorexia (Goldsmith, Gottesman, & Lemery, 1997; Gottesman & Goldsmith, 1994; McGue, 1994). Finally, and importantly, behavior geneticists have found a significant genetic influence on children’s temperament, including such dimensions as emotionality (the tendency to get distressed or upset easily), activity (the tendency toward vigorous, rapid behavior), and sociability (the tendency to prefer the presence of others to being alone) (Saudino, 1998). (iene,Environment Interaction A child’s genetic heritage may also affect his environment (Plomin, 1995), a phenomenon that could occur via either or both of two routes. First, the child inherits his genes from his parents, who also create the environment in which he is growing up. So a child’s genetic heritage may predict something about his environment. For example, parents who themselves have higher IQ scores are not only likely to pass their “good IQ” genes on to their children, they are also likely to create a richer, more stimulating environment for those children. Similarly, children who inherit a tendency toward aggression or hostility from their parents are likely to live in a family environment that is higher in criticism and negativity-because those are expressions of the parents’ own genetic tendencies toward aggressiveness or hostility (Reiss, 1998). Second, each child’s unique pattern of inherited qualities affects the way she behaves with other people, which in turn affects the way adults and other children respond to her. A cranky or temperamentally difficult baby may receive fewer smiles and more scolding than a placid, even-tempered one; a genetically brighter child may demand more personal attention, ask more questions, or seek out more complex toys than would a less bright child (Saudino & Plomin, 1997). Furthermore, children’s interpretations of their experiences are affected by all their inherited tendencies, including not only intelligence but also temperament or pathology (Plomin, Reiss, Hetherington, & Howe, 1994). Internal Models of Experience Although we often associate experience exclusively with external forces, it’s just as important to consider each individual’s view of his or her experiences-in other words, the internal aspect of experience. For instance, suppose a friend says to you, “Your new haircut looks great. I think it’s a lot more becoming when it’s short like that.” Your friend intends it as a compliment, but what determines your reaction is how you hear the comment, not what is intended. If your internal model of your self includes the basic idea “I usually look okay;’ you will likely hear your friend’s comment as a compliment; but if your internal model of self or relationships includes some more negative elements, such as “I usually do things wrong, so other people criticize me,” then you may hear an implied criticism in your friend’s comment (“Your hair used to look awful”). Theorists who emphasize the importance of such meaning systems argue that each child creates a set of internal models of experience-a set of core ideas or assumptions about the world, about himself, and about relationships with others-through which behavior genetics The study of the genetic contributions to behavior or traits such as intelligence or personality. internal models of experience A theoretical concept emphasizing that each child creates a set of core ideas or assumptions about the world, the self, and relationships with others through which all subsequent experience is filtered. all subsequent experience is filtered (Epstein, 1991; Reiss, 1998). Such assumptions are certainly based in part on actual experiences, but once they are formed into an internal model, they generalize beyond the original experience and affect the way the child interprets future experiences. A child who expects adults to be reliable and affectionate will be more likely to interpret the behavior of new adults in this way and will create friendly and affectionate relationships with others outside of the family. A child’s self-concept seems to operate in much the same way, as an internal working model of “who I am” (Bretherton, 1991). This self-model is based on experience, but it also shapes future experience. Low High ~ CII Low Facilitation I I I I ~ High Qj o Aslin’s Model of Environmental > #/’#/’ #/’#/’#/’ Influence Theoretical models are useful for attemptLow ,’ I CII ing to organize ideas about how all these internal and > .h environmental factors interact to influence development. ~ Hlg Attunement One particularly good example of a theoretical approach that attempts to explain environmental influences is a set of models summarized by Richard Aslin (1981), based on earlier work by Gottlieb (1976a, 1976b) and shown schematically in Figure 1.1. In each drawing the dashed line represents the path of development of some skill or behavior that would occur without a particular experience; the solid line represents the path of development if the experience were added. For comparison purposes, the first of the five models shows a maturational pattern with no environmental efOnset of experience fect. The second model, which Aslin calls maintenance, Age describes a pattern in which some environmental input is necessary to sustain a skill or behavior that has already developed maturationally. For example, kittens are born Aslin’s five models of possible relationships between maturation with full binocular vision, but if you cover one of their and environment. The top model shows a purely maturational effect; the bottom model (induction) shows a purely environmental eyes for a period of time, their binocular skill declines. effect. The other three show interactive combinations: maintenance, The third model shows a facilitation effect of the enin which experience prevents the deterioration of a maturationally vironment, in which a skill or behavior develops earlier developed skill; facilitation, in which experience speeds up the dethan it normally would because of some experience. For velopment of some maturational process; and attunement, in which example, children whose parents talk to them more often experience increases the ultimate level of some skill or behavior above the “normal” maturational level. in the first 18 to 24 months of life, using more complex (Source: Aslin, Richard N. “Experiential Influences and Sensitive Periods sentences, appear to develop two-word sentences and in Perceptual Development: Development of perception. Psychobiologiother early grammatical forms somewhat earlier than do cal perspectives: Vol. 2. The visual system (1981), p. 50. Reprinted by children who are talked to less. Yet less-talked-to children permission of Elsevier Science and the author.) do eventually learn to create complex sentences and use most grammatical forms correctly, so the experience of being talked to more provides no permanent gain. When a particular experience does lead to a permanent gain, or an enduringly higher level of performance, Aslin calls the model attunement. For example, children from poverty-level families who attend special enriched day care in infancy and early childhood have consistently higher IQ scores throughout childhood than do children from the same kinds of families who do not have such enriched experience (Ramey & Ramey, 2004). Aslin’s final model, induction, describes a pure environmental effect: In the absence of some experience, a particular behavior does not develop at all. Giving a child tennis lessons or exposing him to a second language falls into this category of experience. o ~ , t Until quite recently, most research on environmental influences focused on a child’s family (frequently only the child’s mother) and on the stimulation available in the child’s home, such as the kinds of toys or books available to the child. If psychologists looked at a larger family context at all, it was usually only in terms of the family’s economic status-its level of wealth or poverty. Since the early 1980s, however, there has been a strong push to widen the scope of research, to consider the ecology, or context, in which each child develops. Urie Bronfenbrenner, one of the key figures in this area of study (1979,1989), emphasizes that each child grows up in a complex social environment (a social ecology) with a distinct cast of characters: brothers, sisters, one or both parents, grandparents, baby-sitters, pets, teachers, friends. And this cast is itself embedded within a larger social system: The parents have jobs that they may like or dislike; they mayor may not have close and supportive friends; they may be living in a safe neighborhood or one full of dangers; the local school may be excellent or poor; and the parents may have good or poor relationships with the school. Bronfenbrenner’s argument is that researchers not only must include descriptions of these more extended aspects of the environment but must also consider the ways in which all the components of this complex system interact with one another to affect the development of an individual child. A particularly impressive example of research that examines such a larger system of influences is Gerald Patterson’s work on the origins of antisocial (highly aggressive) behavior in children (1996; Patterson, DeBarsyshe, & Ramsey, 1989). His studies show that parents who use poor discipline techniques and whose monitoring of their children is poor are more likely to have noncompliant or antisocial children. Once established, however, the child’s antisocial behavior pattern has repercussions in other areas of his life, leading both to rejection by peers and to academic difficulty. These problems, in turn, are likely to push the young person toward a deviant peer group and still further delinquency (Dishion, Patterson, Stoolmiller, & Skinner, 1991; Vuchinich, Bank, & Patterson, 1992). So a pattern that began in the family is maintained and exacerbated by interactions with peers and with the school system. These relationships are of interest in themselves, but Patterson does not stop there. He adds important ecological elements, arguing that the family’s good or poor disciplinary techniques are not random events but are themselves shaped by the larger context in which the family exists. He finds that those parents who were raised with poor disciplinary practices are more likely to use those same poor strategies with their children. He also finds that even parents who possess good child-management skills may fall into poor patterns when the stresses in their own lives are increased. A recent divorce or a period of unemployment increases the likelihood that parents will use poor disciplinary practices and thus increases the likelihood that the child will develop a pattern of antisocial behavior. Figure 1.2 shows Patterson’s conception of how the various components of antisocial behavior fit together. Clearly, taking into account the larger social ecological system in which the family is embedded greatly enhances our understanding of the process. One aspect of such a larger ecology, not emphasized in Patterson’s model but clearly part of Bronfenbrenner’s thinking, is the still broader concept of culture. There is no commonly agreed-on definition for this term, but in essence it describes a system of meanings and customs, including values, attitudes, goals, laws, beliefs, morals, and physical artifacts of various kinds, such as tools and forms of dwellings. The majority U.S. culture, for example, is strongly shaped by the values expressed in the Constitution and the Bill of Rights; it also includes a strong emphasis on “can-do” attitudes and on competition. At a more specific level, U.S. cultural beliefs include, for example, the assumption that the ideal living arrangement is for each family to have a separate house-a belief that contributes to a more spread-out pattern of housing in the United States than what exists in Europe. Family demographics (e.g., income, parent education, quality of neighborhood, ethnic group) Grandparent traits (antisocial behavior and poor family management) — I ••••. …,.. Parent traits (antisocial behavior and susceptibility to stressors) r I _I ••• ••••. …,.. Child conduct problems Rejection by normal peers 11 , Commitment to deviant peer group — I Academic Family stressors (e.g., unemployment, marital conflict, divorce) L I 1,;1,,, I 1+1 – I ••• Patterson’s model describes the many factors that influence the development of antisocial behavior. The core of the process, in this model, is the interaction between the child and the parent (the red box). One might argue that the origin of antisocial behavior lies in that relationship. But Patterson argues that there are larger ecological, or contextual, forces that are also “causes” of the child’s delinquency, some of which are listed in the two blue boxes on the left. (Source: Patterson, G. R., DeBaryshe, B. D., and Ramsey,E., 1989. “A Developmental Perspective on Antisocial Behavior,”American Psychologist, 44, pp. 331 and 332. Copyright © 1989 by the American Psychological Association. Adapted with permission of the American PsychologicalAssociation and B. D. DeBaryshe.) For a system of meanings and customs to be called a culture, it must be shared by some identifiable group, whether that group is the entire population of a country or a subsection of such a population; it must then be transmitted from one generation of that group to the next (Cole, 2005). Families and children are clearly embedded in culture, just as they are located within an ecological niche within the culture. Anthropologists point out that a key dimension on which cultures differ from one another is that of individualism versus collectivism (e.g., Kashima et al., 2005). People in cultures with an individualistic emphasis assume that the world is made up of independent persons whose achievement and responsibility are individual rather than collective. Most European cultures are based on such individualistic assumptions, as is the dominant U.S. culture, created primarily by whites who came to the United States from Europe. In contrast, most of the remainder of the world’s cultures operate with a collectivist belief system in which the emphasis is on collective rather than individual identity, on group solidarity, sharing, duties and obligations, and group decision making (Kashima et al., 2005). A person living in a collectivist system is integrated into a strong, cohesive group that protects and nourishes that individual throughout his life. Collectivism is the dominant theme in most Asian countries, as well as in many African and South American cultures. Strong elements of collectivism are also part of the African American, Hispanic American, Native American, and Asian American subcultures. Greenfield (1995) gives a wonderful example of how the difference between collectivist and individualist cultures can affect actual child-rearing practices as well as people’s judgments of others’ child-rearing. She notes that mothers from the Zinacanteco Maya culture maintain almost constant bodily contact with their young babies and do not feel comfortable when they are separated from their infants. They believe that their babies require this contact to be happy. When these mothers saw a visiting American anthropologist put her own baby down, they were shocked and blamed the baby’s regular crying on the fact that he was separated from his mother so often. Greenfield argues that the constant bodily contact of the Mayan mothers is a logical outgrowth of their collectivist approach, because their basic goal is interdependence rather than independence. The American anthropologist, in contrast, operates with a basic goal of independence for her child and so emphasizes more separation. Each group judges the other’s form of child-rearing to be less optimal or even inadequate. Such differences notwithstanding, researchers note that it is wrong to think of collectivism and individualism in either-or terms, because there are elements of both in every culture (Green, Deschamps, & Paez, 2005). Consequently, when researchers categorize a given culture as collectivist or individualist, they are referring to which of the two sets of values predominates. It is also true that there is a considerable amount of individual variation within cultures. Thus, people who live in individualistic societies may nevertheless, as individuals, develop a collectivist orientation. The same is true for their counterparts in collectivist societies. At this point, it should be clear to you that nature and nurture do not act independently in shaping each child’s development; they interact in complex and fascinating ways. Consequently, the same environment may have quite different effects on children who are born with different characteristics. One influential research approach exploring such an interaction is the study of vulnerable and resilient children. In their long-term study of a group of children born in 1955 on the island of Kauai, Hawaii, Emmy Werner and Ruth Smith (Werner, 1993, 1995; Werner & Smith, 1992, 2001) found that only about two-thirds of the children who grew up in poverty-level, chaotic families turned out to have serious problems themselves as adults. The other third, described as resilient, turned out to be “competent, confident, and caring adults” (Werner, 1995, p. 82). Thus, similar environments were linked to quite different outcomes. Theorists such as Norman Garmezy, Michael Rutter, Ann Masten, and others (Garmezy, 1993; Garmezy & Rutter, 1983; Masten & Coatsworth, 1995; Rutter, 1987, 2005b) argue that the best way to make sense out of results like Werner and Smith’s is to think of each child as born with certain vulnerabilities, such as a difficult temperament, a physical abnormality, allergies, or a genetic tendency toward alcoholism. Each child is also born with some protective factors, such as high intelligence, good coordination, an easy temperament, or a lovely smile, which tend to make her more resilient in the face of stress. These vulnerabilities and protective factors then interact with the child’s environment, and thus the same environment can have quite different effects, depending on the qualities the child brings to the interaction. A more general model describing the interaction between the qualities of the child and the environment Many children who grow up in poverty-stricken comes from Fran Horowitz (1987, 1990), who proposes neighborhoods are high achievers who are well adjusted. that the key ingredients are each child’s vulnerability or Developmentalists use the term resilient to refer to children resilience and the “facilitativeness” of the environment. A who demonstrate positive developmental outcomes despite being raised in high-risk environments. highly facilitative environment is one in which the child has loving and responsive parents and is provided with a rich array of stimulation. If the relationship between vulnerability and facilitativeness were merely additive, the best outcomes would occur for resilient infants reared in optimal environments, and the worst outcomes for vulnerable infants in poor environments, with the two mixed combinations falling halfway between. But that is not what Horowitz proposes, as you can see represented schematically in Figure 1.3. Instead, she is suggesting that a resilient child in a poor environment may do quite well, since such a child can take advantage of all the stimulation and opportunities available. Similarly, she suggests that a vulnerable child may do quite well in a highly facilitative environment. According to this model, it is only the “double whammy”-the vulnerable child in a poor environment-that leads to really poor outcomes. In fact, as you will see throughout the book, a growing body of research shows precisely this pattern. For example, very low IQ scores are most common among children who were low-birth-weight babies and were reared in poverty-level families, while low-birth-weight children reared in middle-class families have essentially Horowitz’s model describes one possible type of interaction benormal IQs, as do normal-weight infants reared in tween the vulnerability of the child and the quality of the environpoverty-level families (Werner, 1986). Further, among lowment. The height of the surface shows the “goodness” of the developmental outcome (such as IQ or skill in social relationbirth-weight children who are reared in poverty-level famships). In this model, only the combination of a vulnerable ilies, those whose families offer “protective” factors (such infant and a nonfacilitative environment will result in a really as greater residential stability, less crowded living condipoor outcome. tions, and more acceptance, more stimulation, and more (Source: Horowitz, F.D., Exploring Developmental Theories: Toward learning materials) achieve higher IQ scores than do a Structural/Behavioral Model of Development, Fig. 1.1, p. 23. © 1987 by Lawrence Erlbaum Associates,Inc. By permission of the equivalently low-birth-weight children reared in the least publisher and author.) optimal poverty-level conditions (Bradley et al., 1994). The key point here is that the same environment can have quite different effects, depending on the qualities or capacities the child brings to Before g0i.rtg ort … the equation. • How did early philosophers and psychologists explain the roles of nature and nurture in age-related change? • What do psychologists mean when they talk about continuity and discontinuity in development? • Explain the roles of the various internal and external influences on development. • What does Bronfenbrenner’s ecological perspective contribute to our understanding of development? • Explain the concepts of vulnerability and resilience. Theories of Deveto ment what they want are the us look at facts from diftheories will help you unpresented in later tudents often say that they dislike reading about theories; facts. However, theories are important, because they help ferent perspectives. A brief introduction to several important derstand some of the more detailed information about them chapters. S The most distinctive and central assumption of the psychoanalytic theories is that behavior is governed by unconscious as well as conscious processes. Psychoanalytic theorists also see development as fundamentally stagelike, with each stage centered on a particular form of tension or a particular task. The child moves through these psychoanalytic theories Developmental theories based on the assumption that age-related change results from maturationally determined conflicts between internal drives and society’s demands. stages, resolving each task or reducing each tension as best he can. This emphasis on the formative role of early experience, particularly early family experience, is a hallmark of psychoanalytic theories. In this view, the first 5 or 6 years of life constitute a kind of sensitive period for the creation of the individual personality. Sigmund Freud (1856-1939) is usually credited with originating the psychoanalytic approach (1905, 1920), and his terminology and many of his concepts have become part of our intellectual culture. Another theorist in this tradition, Erik Erikson (1902-1994), has also had a large impact on the way psychologists think about personality development. when parents divorce, boys are more likely to show disturbed behavior or poorer school performance than are girls. But why? Theories can help to explain facts like this. Freud’s Theory Freud proposed the existence of a basic, unconscious, instinctual sexual drive he called the libido. He argued that this energy is the motive force behind virtually all human behavior. Freud also proposed that unconscious material is created over time through the functioning of the various defense mechanisms, several of which are listed in Table 1.1.We all use defense mechanisms every day, and Freud’s ideas about them continue to be influential among psychologists (Cramer, 2000). A second basic assumption is that personality has a structure, which develops over time. Freud proposed three parts of the personality: the id, which is the source of the libido; the ego, a much more conscious element, the “executive” of the personality; and the superego, which is the center of conscience and morality, since it incorporates the norms and moral strictures of the family and society. In Freud’s theory, these three parts are not all present at birth. The infant and toddler is all id-all instinct, all desire, without the restraining influence of the ego or the superego. The ego begins to develop in the years from age 2 to about 4 or 5, as the child learns to adapt her instantgratification strategies. Finally, the superego begins to develop just before school age, as the child incorporates the parents’ values and cultural mores. Freud thought the stages of personality development were strongly influenced by maturation. In each of Freud’s five psychosexual stages, the libido is centered in that part of the body that is most sensitive at that age. In a newborn, the mouth is the most libido The term used by Freud to describe the basic, unconscious, instinctual sexual energy in each individual. id In Freudian theory, the inborn, primitive portion of the personality, the storehouse of libido, the basic energy that continually pushes for immediate gratification. ego In Freudian theory, the portion of the personality that organizes, plans, and keeps the person in touch with reality. Language and thought are both ego functions. superego In Freudian theory, the “conscience” part of personality, which contains parental and societal values and attitudes incorporated during childhood. psychosexual stages The stages of personality development suggested by Freud: the oral, anal, phallic, latency, and genital stages. TA8lE 1.1 Mechanism Definition Example Denial Behaving as if a problem doesn’t exist Intentionally forgetting something unpleasant Seeing one’s own behavior or beliefs in others whether they are actually present or not Behaving in a way that is inappropriate for one’s age Directing emotion to an object or person other than the one that provoked it Creating an explanation to justify an action or to deal with a disappointment A pregnant woman fails to get prenatal care because she convinces herself she can’t possibly be pregnant even though she has all the symptoms. A child “forgets” about a troublesome bully on the bus as soon as he gets safely home from school every day. A woman complains about her boss to a co-worker and comes away from the conversation believing that the coworker shares her dislike of the boss, even though the co-worker made no comment on what she said. A toilet-trained 2-year-old starts wetting the bed every night after a new baby arrives. An elderly adult suffers a stroke, becomes physically impaired, and expresses her frustration through verbal abuse of the hospital staff. A man stealing money from his employer saysto himself, “They won’t give me a raise. So what if I took $507″ sensitive part of the body, so libidinal energy is focused there. The stage is therefore called the oral stage. As neurological development progresses, the infant has more sensation in the anus (hence the anal stage) and later in the genitalia (the phallic and eventually the genital stages). Erikson’s Theory The stages Erikson proposed, called psychosocial stages, are influenced much less by maturation and much more by common cultural demands for children of a particular age, such as the demand that a child become toilet trained at about age 2 or that the child learn school skills at age 6 or 7. In Erikson’s view, each child moves through a fixed sequence of tasks, each centered on the development of a particular facet of identity. For example, the first task, central to the first 12 to 18 months of life, is to develop a sense of basic trust. If the child’s caregivers are not responsive and loving, however, the child may develop a sense of basic mistrust, which will affect his responses at all the later stages. In both Freud’s and Erikson’s theories, however, the critical point is that the degree of success a child experiences in meeting the demands of these various stages will depend very heavily on the interactions he has with the people and objects in his world. This interactive element in Freud’s and all subsequent psychoanalytic theories is absolutely central. Basic trust cannot be developed unless the parents or other caregivers respond to the infant in a loving, consistent manner. The oral stage cannot be fully completed unless the infant’s desire for oral stimulation is sufficiently gratified. And when a stage is not fully resolved, the old pattern or the unmet need is carried forward, affecting the individual’s ability to handle later tasks or stages. So, for example, a young adult who developed a sense of mistrust in the first years of life may have a more difficult time establishing a secure intimate relationship with a partner or with friends. CO(fNITIVE-DEVELOPMENTAL INFORMATION-PROCESSIN(f AND THEORIES In psychoanalytic theories, the quality and character of a child’s relationships with a few key people are seen as central to the child’s whole development. Cognitivedevelopmental theories, which emphasize primarily cognitive development rather than personality, reverse this order of importance, emphasizing the centrality of the child’s actions on the environment and her cognitive processing of experiences. Piaget’s Theory The central figure in cognitive-developmental theory has been Jean Piaget (1896-1980), a Swiss psychologist whose theories (1952, 1970, 1977; Piaget & Inhelder, 1969) shaped the thinking of several generations of developmental psychologists. Piaget was struck by the great regularities in the development of children’s thinking. He noticed that all children seem to go through the same kinds of sequential discoveries about their world, making the same sorts of mistakes and arriving at the same solutions. For example, all 3- and 4-year-olds seem to think that if you pour water from a short, fat glass into a tall, thin one, there is more water in the thin glass, since the water level is higher there than in the fat glass. In contrast, most 7-year-olds realize that the amount of water is the same in either glass. Piaget’s detailed observations of such systematic shifts in children’s thinking led him to several assumptions, the most central of which is that it is the nature of the human organism to adapt to its environment. This is an active process. In contrast to many theorists, Piaget did not think that the environment shapes the child. Rather, the child (like the adult) actively seeks to understand his environment. In the process, he explores, manipulates, and examines the objects and people in his world. The process of adaptation, in Piaget’s view, is made up of several important subprocesses-assimilation, accommodation, and equilibration-all of which you will learn more about in Chapter 6. What is important to understand at this preliminary point is that Piaget thought that the child develops a series of fairly distinct “understandings,” psychosocial stages The stages of personality development suggested by Erikson, involving basic trust, autonomy, initiative, industry, identity, intimacy, generativity, and ego integrity. cognitive-developmental theories Developmental theories that emphasize children’s actions on the environment and suggest that agerelated changes in reasoning precede and explain changes in other domains. or “theories;’ about the way the world works, based on her active exploration of the environment. Each of these “theories” corresponds to a specific stage. Piaget thought that virtuallyall infants begin with the same skills and built-in strategies and since the environments children encounter are highly similar in important respects, he believed that the stages through which children’s thinking moves are also similar. Piaget proposed a fixed sequence of four major stages, each growing out of the one that preceded it, and each consisting of a more or less complete system or organization of concepts, strategies, and assumptions. Russian psychologist Lev Vygotsky is normally thought of as belonging to the cognitive-developmental camp because he, too, was primarily concerned with understanding the origins of the child’s knowledge (1978/1930). Vygotsky differed from Piaget, however, in one key respect: He was convinced that complex Piaget based many of his ideas on naturalistic observation of forms of thinking have their origins in social interactions children of different ages on playgrounds and in schools. (Duncan, 1995). According to Vygotsky,a child’s learning of new cognitive skills is guided by an adult (or a more skilled child, such as an older sibling), who models and structures the child’s learning experience, a process Jerome Bruner later called scaffolding (Wood, Bruner, & Ross, 1976). Such new learning, Vygotsky suggested, is best achieved in what he called the zone of proximal development-that range of tasks which are too hard for the child to do alone but which she can manage with guidance. As the child becomes more skilled, the zone of proximal development steadily widens, including ever harder tasks. Vygotsky thought the key to this interactive process lay in the language the adult used to describe or frame the task. Later, the child could use this same language to guide her independent attempts to do the same kinds of tasks. (1896-1934) vygotsky’s Theory scaffolding The term used by Bruner to describe the process by which a teacher (or parent, older child, or other person in the role of teacher) structures a learning encounter with a child, so as to lead the child from step to step-a process consistent with Vygotsky’s theory of cognitive development. zone of proximal development In Vygotsky’s theory, the range of tasks that are slightly too difficult for a child to do alone but that can be accomplished successfully with guidance from an adult or more experienced child. information-processing theories A set of theories based on the idea that humans process information in ways that are similar to those used in computers. ‘nformation … Processing Theory Although it is not truly a cognitive-developmental theory, many of the ideas and research studies associated with informationprocessing theory have increased psychologists’ understanding of Piaget’s stages and other age-related changes in thinking. The goal of information-processing theory is to explain how the mind manages information (Klahr, 1992). Information-processing theorists use the computer as a model of human thinking. Consequently, they often use computer terms such as hardware and software to talk about human cognitive processes. Theorizing about and studying memory processes are central to information-processing theory (Birney, Citron-Pousty, Lutz, & Sternberg, 2005). Theorists usually break memory down into subprocesses of encoding, storage, and retrieval. Encoding is organizing information to be stored in memory. For example, you may be encoding the information in this chapter by relating it to your own childhood. Storage is keeping information, and retrieval is getting information out of memory. Most memory research assumes that the memory system is made up of multiple components. The idea is that information moves through these components in an organized way (see Figure 1.4). The process of understanding a spoken word serves as a good example. First, you hear the word when the sounds enter your sensory memory. Your experiences with language allow you to recognize the pattern of sounds as a word. Next, the word moves into your short-term memory, the component of the memory system where all information is processed. Thus, short-term memory is often called working memory. Knowledge of the word’s meaning is then called up out of long-term memory, the component of the system where information is permanently stored, and placed in short-term memory, where it is linked to the word’s sounds to enable you to understand what you have just heard. Information needed to comprehend new information Information selected for processing ~ Sensory information ~ Sensory memory Short-term memory Information to be stored permanently ~ Long-term memory t__ Techniques for processing new information I -! Information-processing research on memory is based on the assumption that information moves into, out of, and through sensory, short-term, and long-term memories in an organized way. Each memory component manages information differently. Information flows through sensory memory as if in a stream. Bits of information that are not attended to drop out quickly. Short-term memory is extremely limited in capacity-an adult’s short-term memory can hold about seven items at a time. However, information can be retained in short-term memory as long as it is processed in some way-for example, when you repeat your grocery list to yourself on the way to the store. Long-term memory is unlimited in capacity, and information is often stored in terms of meaningful associations. For example, suppose you read a sentence such as “Bill wrote a letter to his brother.” When you think about the sentence later, you might mistakenly recall that it contained the word pen. This happens because information about the process of writing and the tools used to do it are stored together in longterm memory. There are both age-related and individual differences in information processing. As you will learn in Chapter 6, the number of items that can be retained in short-term memory at one time is far more limited in young children than in adults and older children. In addition, among children of the same age, some use more efficient strategies for remembering and solving problems. Looking at differences of both kinds and examining children’s thinking from Piaget’s and Vygotsky’s perspectives provide a more complete picture of how children acquire the ability to reason logically. Learning theories represent a theoretical tradition very different from that of either the psychoanalysts or the cognitive-develop mentalists, one in which the emphasis is much more on the way the environment shapes the child than on how the child understands his experiences. Learning theorists do not argue that genetics or built-in biases are unimportant, but they see human behavior as enormously plastic, shaped by predictable processes of learning. Three of the most important learning theories are Pavlov’s classical conditioning model, Skinner’s operant conditioning model, and Bandura’s social cognitive theory. Classical conditioning, made famous by Ivan Pavlov’s (1849-1936) experiments with his salivating dog, involves the acquisition of new signals for existing responses. If you touch a baby on the cheek, she will turn toward the touch and begin to suck. In the technical terminology of classical conditioning, the learning theories Psychological theories that explain development in terms of accumulated learning experiences. classical conditioning One of three major types of learning. An automatic, or unconditioned, response such as an emotion or a reflex comes to be triggered by a new cue, called the conditional stimulus, after having been paired several times with that stimulus. classical Conditioning touch on the cheek is the unconditional stimulus; the turning and sucking are unconditioned responses. The baby is already programmed to do all that; these are automatic reflexes.Learning occurs when some new stimulus is introduced to the system. The general model is that other stimuli that are present just before or at the same time as the unconditional stimulus will eventually trigger the same responses. In the typical home situation, for example, a number of stimuli occur at about the same time as the touch on the baby’s cheek before feeding: the sound of the mother’s footsteps approaching, the kinesthetic cues of being picked up, and the tactile cues of being held in the mother’s arms. All these stimuli may eventually become conditional stimuli and may trigger the infant’s response of turning and sucking, even without any touch on the cheek. Classical conditioning is of special interest in the study of child development because of the role it plays in the development of emotional responses, as Watson’s Little Albert experiment so aptly demonstrated. For example, Laboratory research involving animals things or people present when you feel good will become conditional stimuli was important in the development of for that same sense of well-being; things or people previously associated with skinner’s operant conditioning theory. some uncomfortable feeling may become conditional stimuli for a sense of unease or anxiety. This is especially important in infancy, since a child’s mother or father is present so often when nice things happen-when the child feels warm, comfortable, and cuddled. Thus, mother and father usually come to be conditional stimuli for pleasant feelings, a fact that makes it possible for the parents’ mere presence to reinforce other behaviors as well. A tormenting older sibling might come to be a conditional stimulus for angry feelings, even after the sibling has long since stopped the tormenting. Such classically conditioned emotional responses are remarkably powerful. They begin to be formed very early in life, continue to be created throughout childhood and adulthood, and profoundly affect each individual’s emotional experiences. operant conditioning The type oflearning in which the probability of a person’s performing some behavior is increased or decreased because of the consequences it produces. positive reinforcement The process of strengthening a behavior by the presentation of some pleasurable or positive stimulus. negative reinforcement The process of strengthening a behavior by the removal or cessation of an unpleasant stimulus. Operant Conditioning The second major type of learning is most often called operant conditioning, although you may also see it referred to as instrumental conditioning. Operant conditioning is the process through which the frequency of a behavior increases or decreases because of the consequences the behavior produces. When a behavior increases, it is said to have been reinforced; when it decreases, the behavior is said to have been punished. Psychologist B. F. Skinner (1904-1990) discovered the principles of operant conditioning in a series of animal studies. He believed that these principles strongly influence human development. Reinforcement occurs when a consequence results in an increase in the frequency of a particular behavior. With positive reinforcement, an added stimulus or consequence increases a behavior. Certain kinds of pleasant stimuli-such as praise, a smile, food, a hug, or attention-serve as positive reinforcers for most people most of the time. But strictly speaking, a reinforcer is defined by its effect; we don’t know that something is reinforcing unless we see that its presence increases the probability of some behavior. For example, if a parent gives a child dessert as a reward for good table manners, and the child’s frequency of good table manners increases, then the dessert is a reinforcer. If the frequency does not increase, then the dessert is not a reinforcer. Negative reinforcement increases a behavior because the reinforcement involves the termination or removal of an unpleasant stimulus. Suppose your little boy is whining and begging you to pick him up. At first you ignore him, but finally you do pick him up. What happens? He stops whining. So your picking-up behavior has been negatively reinforced by the cessation of his whining, and you will be more likely to pick him up the next time he whines. At the same time, his whining has probably been positively reinforced by your attention, so he will be more likely to whine on similar occasions. In laboratory situations, experimenters can be sure to reinforce a behavior every time it occurs or to stop reinforcements completely so as to produce extinction of a response. In the real world, however, consistency of reinforcement is the exception rather than the rule. Much more common is a pattern of partial reinforcement, in which a behavior is reinforced on some occasions but not others. Studies of partial reinforcement show that children and adults take longer to learn behaviors under partial reinforcement conditions, but once established, such behaviors are much more resistant to extinction. If you smile at your daughter only every fifth or sixth time she brings a picture to show you (and if she finds your smile reinforcing), she’ll keep on bringing pictures for a very long stretch, even if you quit smiling altogether. Being able to use chopsticks is on)’ one example of the myriad Both positive and negative reinforcements strengthen skills that are learned through modeling. behavior. Punishment, in contrast, weakens behavior. Sometimes punishments involve eliminating nice things (for example, “grounding” a child, taking away TV privileges, or sending her to her room). Often they involve administering unpleasant things such as a scolding or a spanking. What is confusing about such consequences is that they don’t always do what they are intended to do: They do not always suppress the undesired behavior. NKIN(f CRITICAL TH. Say, for example, a parent suspends a teenager’s driving privileges for coming home after curfew in the hope that the penalty will stop the behavior of coming home Think again about your upbringing. What values or attitudes do late. For some teens, this approach will be effective. Others, though, may respond with you think you learned through defiance, by staying out later and later each time their driving privileges are restored. modeling? How were those valTo these teens, the parent’s “punishment” is a form of recognition for the defiant attiues and attitudes displayed tude they hope to project. For them, the “punishment” is actually a positive reinforce(modeled) by your parents or ment. Thus, punishment, like reinforcement, must be defined in terms of its effect on others? behavior; if a consequence doesn’t weaken or stop a behavior, it isn’t a punishment. ‘Bandu.ra’s Social Cognitive Theory Albert Bandura, whose variation of learning theory is by far the most influential among developmental psychologists today, has built on the base of these traditional learning concepts but has added several other key ideas (1977, 1982, 1989,2004). First, he argues that learning does not always require direct reinforcement. Learning may also occur merely as a result of watching someone else perform some action. Learning of this type, called observational learning, or modeling, is involved in a wide range of behaviors. Children learn how to hit from watching other people in real life and on television. They learn how to be generous by watching others donate money or share goods. Bandura also calls attention to another class of reinforcements called intrinsic reinforcements. These are internal reinforcements, such as the pride a child feels when she figures out how to draw a star or the sense of satisfaction you may experience after strenuous exercise. Finally, and perhaps most importantly, Bandura has gone far toward bridging the gap between learning theory and cognitive-developmental theory by emphasizing important cognitive (mental) elements in observational learning. Indeed, he now calls his theory “social cognitive theory” rather than “social learning theory,” as it was originally labeled (Bandura, 1986, 1989). For example, Bandura now stresses the fact that modeling can be the vehicle for learning abstract information as well as concrete skills. In abstract modeling, the observer extracts a rule that may be the basis of the model’s behavior, then learns the rule as well as the specific behavior. A child who sees his parents volunteering one day a month at a food bank may extract a rule about the importance of “helping others,” even if the parents never actually articulate this rule. Thus, through modeling, a child can acquire attitudes, values, ways of solving problems, even standards of self-evaluation. punishment The removal of a desirable stimulus or the administration of an unpleasant consequence after some undesired behavior in order to stop the behavior. Collectively, Bandura’s additions to traditional learning theory make his theory far more flexible and powerful, although it is still not a strongly developmental theory. That is, Bandura has little to say about any changes that may occur with age in what or how a child may learn from modeling. In contrast, both psychoanalytic and cognitivedevelopmental theories are strongly developmental, emphasizing sequential, often stagelike qualitative change that occurs with age. After learning about theories of development, students usually want to know which one is right. However, develop mentalists don’t think of theories in terms of right or wrong but, instead, compare them on the basis of their assumptions and how useful they are to understanding human development. about Development When we say that a theory assumes something to be true, we mean that it begins from a general perspective on development. We can think of a theory’s assumptions in terms of its answers to three questions about development. One question addresses the active or passive issue: Is a person active in shaping her own development, or is she a passive recipient of environmental influences? Theories that claim a person’s actions on the environment are the most important determinants of her development are on the active side of this question. Cognitive-developmental theories, for example, typically view development this way. In contrast, theories on the passive side of the question, such as classical and operant conditioning, maintain that development results from the action of the environment on the individual. As you learned earlier in the chapter, the nature or nurture question is one of the most important issues in developmental psychology. All developmental theories, while admitting that both nature and nurture are involved in development, make assumptions about their relative importance. Theories claiming that biology contributes more to development than environment are on the nature side of the question. Those that view environmental influences as most important are on the nurture side. Other theories assume that nature and nurture are equally important, and that it is impossible to say which contributes more to development. Developmental theories also disagree on the stability versus change issue. Theories that have no stages assert that development is a stable, continuous process. Stage theories, on the other hand, emphasize change more than stability. They claim that development happens in leaps from lower to higher steps. Table 1.2 lists the theories you have read about in this chapter and the assumptions each makes regarding these issues. Because each theory is based on different assumptions, each takes a different approach to studying development. Consequently, research derived from each reveals something different about development. A theory’s assumptions also shape the way it is applied in the real world. For example, a teacher who approached instruction from the cognitive-developmental perspective would create a classroom in which children can experiment to some degree on their own. He would also recognize that children differ in abilities, interests, developmental level, and other internal characteristics. He would believe that structuring the educational environment is important, but that what each student ultimately learns will be determined by his or her own actions on the environment. Alternatively, a teacher who adopted the learning theory perspective would guide and reinforce children’s learning very carefully. Such a teacher would place little importance on ability differences among children. Instead, he would try to accomplish the same instructional goals for all children through proper manipulation of the environment. Usefulness Developmentalists also compare theories with respect to their usefulness. Before reading this section, you should understand that there is a fair amount of dis- Assumptions TABLE 1.2 Comparing Theories Active or Passive? Nature or Nurture? Stages or No Stages? Theory Psychoanalytic Theories Main Ideas Freud’s Psychosexual Theory Erikson’s Psychosocial Theory Cognitive Theories Piaget’s CognitiveDeveloprnental Theory Vygotsky’s Socio-cultural Theory InforrnationProcessing Theory Learning Theories Classical Conditioning Operant Conditioning Bandura’s Social Cognitive Theory Personality develops in five stages from birth to adolescence; in each stage, the need for physical pleasure is focused on a different part of the body. Personality develops through eight life crises across the entire lifespan; a person finishes each crisis with either a good or a poor resolution. Reasoning develops in four universal stages from birth through adolescence; in each stage, the child builds a different kind of scheme. Social interaction is critical to the development of thinking and problem-solving; stages in the development of reasoning reflect internalized language. The cornputer is used as a model for human cognitive functioning; encoding, storage, and retrieval processes change with age, causing changes in memory function. Learning happens when neutral stimuli become so strongly associated with natural stirnuli that they elicit the same responses. Development involves behavior changes that are shaped by reinforcernent and punishment. People learn from models; what they learn frorn a rnodel depends on how they interpret the situation cognitively and ernotionally. Nature Stages Sorne theories have stages; others do not agreement among psychologists on exactly how useful each theory is. Nevertheless, there are a few general criteria most psychologists use to evaluate the usefulness of a theory. One kind of usefulness has to do with a theory’s ability to generate predictions that can be tested with scientific methods. For example, one criticism of Freud’s theory is that many of his claims are difficult to test. In contrast, when Piaget claimed that most children can solve hypothetical problems by age 12 or so, he made an assertion that is easily tested. Thus, Piaget’s theory is viewed by many developmentalists as more useful in this sense than Freud’s. Vygotsky, the learning theorists, and the informationprocessing theorists have also proposed many testable ideas (Thomas, 2000). Another criterion by which psychologists judge the usefulness of theories is their heuristic value, the degree to which they stimulate thinking and research. In terms of heuristic value, we would have to give Freud’s and Piaget’s theories equally high marks. Both are responsible for an enormous amount of theorizing and research on human development, often by psychologists who strongly disagree with them. Yet another way of thinking about a theory’s usefulness is in terms of practical value. In other words, a theory may be deemed useful if it provides solutions to real-life problems. On this criterion, the learning and information-processing theories seem to stand out because they provide tools that can be used to influence behavior. A person who suffers from anxiety attacks, for example, can learn to use biofeedback, a tech- nique derived from classical conditioning theories, to manage them. Similarly, a student who needs to learn to study more effectively can get help from study-skills courses based on information-processing theories. Ultimately, of course, no matter how many testable hypotheses or practical techniques a theory produces, it is of little or no value to develop mentalists if it doesn’t explain the basic facts of development. On this criterion, learning theories, especially those of classical and operant conditioning, are regarded by many developmentalists as somewhat less useful than other perspectives (Thomas, 2000). While they explain how specific behaviors may be learned, the complexity of human development can’t be reduced to connections between stimuli and responses or behaviors and reinforcers. Before goin.g on. … • What ideas do psychoanalytic theorists propose to explain development? • What do Piaget’s and Vygostky’s theories and the informationprocessing theories suggest about cognitive development? • How do learning theories explain age-related change? • What methods do psychologists use to compare theories’ Eclecticism As you can see, the point of comparing theories is not to conclude which one is true. Instead, we compare them to understand the unique contribution each can make to a comprehensive understanding of human development. Consequently, to day’s developmental scientists try to avoid the kind of rigid adherence to a single theoretical perspective that was characteristic of theorists such as Freud, Piaget, and Skinner. Instead, most adopt an approach known as eclecticism, the use of multiple theoretical perspectives to explain and study human development (Parke, 2004). To better understand the eclectic approach, think about how ideas drawn from several theories might help us better understand a child’s disruptive behavior in school. Observations of the child’s behavior and her classmates’ reactions may suggest that her behavior is being rewarded by the other children’s responses (a behavioral explanation). Deeper probing of the child’s family situation may indicate that her acting-out behavior reflects an emotional reaction to a family event such as divorce (a psychoanalytic explanation). The emotional reaction may arise from her inability to understand why her parents are divorcing (a cognitive-developmental explanation). When appropriately applied, each of these perspectives can help us gain insight into developmental issues. Moreover, we can integrate all of them into a more complete explanation than any of the perspectives alone could provide us with. Finding the Answers: Research Designs and Methods he easiest way to understand research methods is to look at a specific question and the alternative ways in which it can be answered. Suppose we wanted to answer the following question: “What causes children’s attention spans to increase as they get older?” How might we go about answering this question? T eclecticism The use of multiple theoretical perspectives to explain and study human development. Developmental psychology uses the scientific method to achieve four goals: to describe, to explain, to predict, and to influence human development from conception to death. To describe development is simply to state what happens. “Children’s attention spans get longer as they get older” is an example of a statement that represents the description goal of developmental psychology. All we would have to do is measure how long children of various ages pay attention to something to meet this objective. Explaining development involves telling why a particular event occurs. As you learned earlier in this chapter, developmentalists rely on theories to generate explanations. Useful theories produce predictions researchers can test, or hypotheses, such as “If changes in the brain cause children’s attention spans to increase, then children whose brain development is ahead of that of their peers should also have longer attention spans.” To test this biological hypothesis, we would have to measure some aspect of brain structure or function as well as attention span. Then we would have to find a way to relate one to the other. We could instead test an experiential explanation of attention-span increase by comparing children of the same age who differ in the amount of practice they get in paying attention. For example, we might hypothesize that the experience of learning to playa musical instrument enhances children’s ability to attend. If we compare instrument-playing and non-instrument-playing children of the same age and find that those who have musical training do better on tests of attention than their age mates who have not had musical training, the experiential perspective gains support. If both the biological and the experiential hypotheses are supported by research, they provide far more insight into age-related attention-span change than would either hypothesis alone. In this way, theories add tremendous depth to psychologists’ understanding of the facts of human development and provide information that can be used to influence development. Let’s say, for example, that a child is diagnosed with a condition that can affect the brain, such as epilepsy. If we know that brain development and attention span are related, we can use tests of attention span to make judgments about how much her medical condition may have already influenced her brain. At the same time, because we know that experience affects memory as well, we may be able to provide her with training that will help her overcome attention-span problems that are likely to arise in the future. CRITICAL ntlNKINCr When researchers set out to study age-related change, they have basically three choices: (1) study different groups of people of different ages, using what is called a crosssectional design; (2) study the same people over a period of time, using a longitudinal design; or (3) combine cross-sectional and longitudinal designs in some fashion in a sequential design. Cross-Sectional Designs To study attention cross-sectionally, we might select groups of participants at each of several ages, such as groups of 2-, 5-, 8-, and ll-yearolds. If we find that each group demonstrates a longer average attention span than all the groups that are younger, we may be tempted to conclude that attention span does increase with age, but we cannot say this conclusively with cross-sectional data, because these children differ not only in age, but in cohort. (A cohort is a group of individuals who share the same historical experiences at the same period in their lives.) The differences in attention might reflect educational differences and not actually be linked to age or development. Furthermore, cross-sectional studies cannot tell us anything about sequences of change over age or about the consistency of individual behavior over time, because each child is tested only once. Still, cross-sectional research is very useful because it is relatively quick to do and can give indications of possible age differences or age changes. Longitudinal designs seem to solve the problems that arise with cross-sectional designs, because they follow the same individuals over a period of time. For example, to examine our attention-span hypothesis, we could test a particular group of children first at age 2, then at age 5, next at age 8, and finally at age 11. Such studies look at sequences of change and at individual consistency or inconsistency over time. And because these studies compare the same people at different ages, they get around the obvious cohort problem. However, longitudinal designs have several major difficulties. One problem is that longitudinal designs typically involve giving each participant the same tests over and over again. Over time, people learn how to In contrast to what happened during the Great Depression, the American economy grew at an unprecedented rate during most of the 1980s and 1990s. Do you think these “boom” times influenced the development of individuals in your cohort to the same extent that the Great Depression influenced people who were children and teenagers during the 1920s and 1930s? Do you think your cohort’s ideas and expectations about financial success are different from those of earlier cohorts because of the era in which you and your peers grew up? cross-sectional design A form of research study in which samples of participants from several different age groups are studied at the same time. longitudinal design A form of research study in which the same participants are observed or assessed repeatedly over a period of months or years. sequential design A form of research study that combines crosssectional and longitudinal designs in some way. longitudinal Designs On!>’ by studying the same children over time (that is, longitudinal!>,), such as this girl at three ages, can developmentalists identify consistencies (or changes) in behavior across age. take the tests. Such practice effects may distort the measurement of any underlying developmental changes. Another significant problem with longitudinal studies is that not everyone sticks with the program. Some participants drop out; others die or move away. As a general rule, the healthiest and best-educated participants are most likely to stick it out, and that fact biases the results, particularly if the study continues into adulthood. Longitudinal studies also don’t really get around the cohort problem. For example, one famous study, the Oakland Growth Study, followed individuals born between 1918 and 1928 into old age. Consequently, the study’s participants experienced certain major historical events, such as the Great Depression and World War II, that probably influenced their development. So, we don’t know whether the ways in which they changed across these years, when they were children and teenagers, were caused by developmental processes or by the unique historical period in which they were growing up. Age at testing point 1 A B 5 to 8 2 to 5 Sequential Design.s One way to avoid the shortcomings of both cross-sectional and longitudinal designs is to use a sequential design. To study our attention-span question using a sequential design, we would begin with at least two age groups. One group might include 2- to 5-year-olds, and the other might have 5- to 8-year-olds. We would then test each group over a number of years, as illustrated in Figure 1.5. Each testing point beyond the initial one provides two types of comparisons. Age-group comparisons provide the same kind of information as a cross-sectional study would. Comparisons of the scores or behaviors of participants in each group to their own scores or behaviors at an earlier testing point provide longitudinal evidence at the same time. Sequential designs also allow for comparisons of cohorts. Notice in Figure 1.5, for example, that those in Group A are 5 to 8 years old at Testing Point 1, and Age at Age at those in Group Bare 5 to 8 years old at Testing Point testing point testing point 2. Likewise, Group A members are 8 to 11 at Point 2, 2 3 and their counterparts in Group B are this age at 8 to 11 11 to 14 Point 3. If same-age comparisons of the two groups reveal that their average attention spans are different, 5 to 8 8 to 11 the researchers have evidence that, for some reason, the two cohorts differ. Conversely, if the groups perform similarly, the investigators can conclude that their respective performances represent developmental characteristics rather than cohort effects. Moreover, if both groups demonstrate similar age-related patterns of change over time, the researchers can conclude that the developmental pattern is not specific to any particular cohort. Finding the same developmental pattern in two cohorts provides psychologists with stronger evidence than either cross-sectional or longitudinal data alone. After deciding how to treat age, a researcher must decide how to go about finding relationships between variables. Variables are characteristics that vary from person to person, such as physical size, intelligence, and personality. When two or more variables vary together, we say there is a relationship between them. The hypothesis that attention span increases with age involves two variables-attention span and age-and suggests a relationship between them. There are several ways of identifying such relationships. Case Studies and Naturalistic Observation Case studies are in-depth examinations of single individuals. To examine changes in attention span, a researcher could use a case study comparing an individual’s scores on tests of attention at various ages in childhood. Such a study might tell a lot about the stability or instability of attention in the individual studied, but the researcher wouldn’t know if the findings applied to others. Still, case studies are extremely useful in making decisions about individuals. For example, to find out if a child is mentally retarded, a psychologist can do an extensive case study involving tests, interviews of the child’s parents, behavioral observations, and so on. Case studies are also frequently the basis of important hypotheses about unusual developmental events such as head injuries and strokes. When psychologists use naturalistic observation, they observe people in their normal environments. For instance, to find out more about attention span in children of different ages, a researcher could observe them in their homes or day-care centers. Such studies provide developmentalists with information about psychological processes in everyday contexts. The weakness of this method, however, is observer bias. For example, if a researcher observing 2-year-olds is convinced that most of them have very short attention spans, he is likely to ignore any behavior that goes against this view. Because of observer bias, naturalistic observation studies often use “blind” observers who don’t know what the research is about. In most cases, such studies employ two or more observers for the sake of accuracy. This way, the observations of each observer can be checked against those of the other. Like case studies, the results of naturalistic observation studies have limited generalizability. In addition, naturalistic observation studies are very time-consuming. They must be repeated in a variety of settings before researchers can be sure people’s behavior reflects development and not the influences of a specific environment. Correlations A correlation is a number ranging from -1.00 to + 1.00that describes the strength of a relationship between two variables. A zero correlation indicates that there is no relationship between those variables. A positive correlation means that high scores on one variable are usually accompanied by high scores on the other. The closer a positive correlation is to + 1.00,the stronger the relationship between the variables. Two variables that move in opposite directions result in a negative correlation, and the nearer the correlation is to -1.00, the more strongly the two are inversely related. To understand positive and negative correlations, think about the relationship between temperature and the use of air conditioners and heaters. Temperature and air conditioner use are positively correlated. As the temperature climbs, so does the number of air conditioners in use. Conversely, temperature and heater use are negatively correlated. As the temperature decreases, the number of heaters in use goes up. case studies In-depth studies of individuals. naturalistic observation A research method in which participants are observed in their normal environments. correlation A statistic used to describe the strength of a relationshi p between two variables. It can range from -1.00 to +1.00. The closer it is to + 1.00 or -1.00, the stronger the relationship being described. If we want to test the hypothesis that greater attention span is related to increases in age, we can use a correlation. All we would need to do would be to administer attention-span tests to children of varying ages and to calculate the correlation between test scores and ages. If there was a positive correlation between the length of children’s attention spans and age-if older children attended for longer periods of time-then we could say that our hypothesis had been supported. Conversely, if there was a negative correlation-if older children paid attention for shorter periods of time than younger children-then we would have to conclude that our hypothesis had not been supported. Useful as they are, though, correlations have a major limitation: They do not reveal causal relationships. For example, even a high positive correlation between attention span and age would only tell us that attention span and age are connected in some way. It wouldn’t tell us what caused the connection. It might be that older children could understand the test instructions more easily.In order to identify causes, psychologists have to carry out experiments. experiment A research method for testing a causal hypothesis, in which participants are assigned randomly to experimental and control groups and the experimental group is then provided with a particular experience that is expected to alter behavior in some fashion. experimental group A group of participants in an experiment who receive a particular treatment intended to produce some specific effect. control group A group of participants in an experiment who receive either no special treatment or some neutral treatment. independent variable A condition or event that an experimenter varies in some systematic way in order to observe the impact of that variation on participants’ behavior. dependent variable The variable in an experiment that is expected to show the impact of manipulations of the independent variable; also called the outcome variable. Experiments An experiment is a research method that tests a causal hypothesis. Suppose, for example, that we think age differences in attention span are caused by younger children’s failure to use attention-maintaining strategies, such as ignoring distractions. We could test this hypothesis by providing attention training to one group of children and no training to another group. If the trained children got higher scores on attention tests than they did before training, and the no-training group showed no change, we could claim that our hypothesis had been supported. A key feature of an experiment is that participants are assigned randomly to participate in one of several groups. In other words, chance determines the group in which the researcher places each participant. When participants are randomly assigned to groups, the groups have equal averages and equal amounts of variation with respect to variables such as intelligence, personality traits, height, weight, health status, and so on. Consequently, none of these variables can affect the outcome of the experiment. Participants in the experimental group receivethe treatment the experimenter thinks will produce a particular effect,while those in the control group receive either no special treatment or a neutral treatment. The presumed causal element in the experiment is called the independent variable, and the behavior on which the independent variable is expected to show its effect is called a dependent variable (or the outcome variable). Applying these terms to the attention-training experiment may help you better understand them. The group that receives the attention training is the experimental group, while those who receive no instruction form the control group. Attention training is the variable that we, the experimenters, think will cause differences in attention span, so it is the independent variable. Performance on attention tests is the variable we are using to measure the effect of the attention training. Therefore, performance on attention tests is the dependent variable. Experiments are essential for understanding many aspects of development. But two special problems in studying child development limit the use of experiments. First, many of the questions developmentalists want to answer have to do with the effects of unpleasant or stressful experiences-for example, abuse or prenatal exposure to alcohol or tobacco. For obvious ethical reasons, researchers cannot manipulate these variables. For example, they cannot ask one set of pregnant women to have two alcoholic drinks a day and others to have none. To study the effects of such experiences, developmentalists must rely on nonexperimental methods, like correlations. Second, the independent variable developmentalists are often most interested in is age itself, and they cannot assign participants randomly to age groups. Researchers can compare the attention spans of 4-year-olds and 6-year-olds, but the children differ in a host of ways other than their ages.Older children have had more and different experiences.Thus, unlike psychologists studying other aspects of behavior, developmental psychologists cannot systematically manipulate many of the variables they are most interested in. To get around this problem, developmentalists can use any of a number of strategies, sometimes called quasi-experiments, in which they compare groups without assigning the participants randomly. Cross-sectional comparisons are a form of quasi-experiment. So are studies in which researchers select naturally occurring groups that differ in some dimension of interest, such as children whose parents choose to place them in day-care programs compared with children whose parents keep them at home. Such comparisons have built-in problems, because groups that differ in one way are likely to be different in other ways as well. Families who place their children in day care are also likely to be poorer, more likely to have only a single parent, and may have different values or religious backgrounds than those who rear their children at home. If researchers find that the two groups of children differ in some fashion, is it because they have spent their daytime hours in different places or because of these other differences in their families? Such comparisons can be made a bit cleaner if the comparison groups are initially selected so that they are matched on those variables that researchers think might matter, such as income, marital status, or religion. But a quasi-experiment, by its very nature, will always yield more ambiguous results than will a fully controlled experiment. However, as noted in The Real World discussion, media reports of research often do not provide consumers with sufficient information about research methods. Such information is vital to determining the validity of a research finding. Likewise, it can help parents and others who work with children determine the relevance of the research to their own lives. Cross-cultural research, or research comparing cultures or contexts, is becoming increasingly common in developmental psychology. Cross-cultural research is important to developmentalists for two reasons. First, developmentalists want to identify universal changes-that is, predictable events or processes that occur in the lives of individuals in all cultures. Developmentalists don’t want to make a general statement about development-such as “Attention span increases with age” -if the phenomenon in question happens only in Western, industrialized cultures. Without cross-cultural research, it is impossible to know whether studies involving North Americans and Europeans apply to people in other parts of the world. Second, one of the goals of developmental psychology is to produce findings that can be used to improve people’s lives. Cross-cultural research is critical to this goal as well. For example, developmentalists know that children in cultures that emphasize the community more than the individual are more cooperative than children in cultures that are more individualistic. However, to use this information to help all children learn to cooperate, developmentalists need to know exactly how adults in collectivist cultures teach their children to be cooperative. Cross-cultural research helps developmentalists identify specific variables that explain cultural differences. In traditional Kenyan culture, still seen in some rural areas, babies are carried in slings all day and allowed to nurse on demand at night. This cultural pattern, quite different from that in most Western societies, seems to have an effect on the baby’s sleep/wake cycle. Cross-Cultural Methods All of the methods you have learned about are used in cross-cultural research. Cross-cultural researchers borrow methods from other disciplines as well. One such strategy, borrowed from the field of anthropology, is to compile an ethnography-a detailed description of a single culture or context based on extensive observation. Often the observer lives within the culture for a period of time, perhaps as long as several years. Each ethnography is intended to stand alone, although it is sometimes possible to compare several different studies to see whether similar developmental patterns exist in varying contexts. Alternatively, investigators may attempt to compare two or more cultures directly, by testing children or adults in each of several cultures with the same or comparable measures. Sometimes this involves comparisons across different countries. Sometimes the comparisons are between subcultures within the same country, as in the increasingly common research that compares children or adults from different ethnic groups cross-cultural research Any study that involves comparisons of different cultures or contexts. Thinking Critically about Research wo-year-old Jake jumped for joy when his mother, Christina, responded positively to his request to watch his favorite DVD, one that featured the Sesame Street character Elmo. For her part, Christina was thankful for the few minutes of peace she would have as Jake sat enthralled in front of the television. “Besides,”she told herself, “this DVD will help him learn the alphabet.” Nevertheless, a nagging voice in Christina’s head reminded her of a news report she had heard the previous day. The report said that researchers had learned that too much television in the early years could cause children to develop some kind of learning problem, though she couldn’t recall exactly what that problem was. Like most parents, Christina wanted whatever was best for her child, but she was concerned about the meaning of the research report. “How much television is ‘too much’?” she thought. The report had said that some experts recommended that children of Jake’s age watch no television at all. “But isn’t that a bit extreme?” Christina wondered. In today’s information age, parents are bombarded with this kind of information nearly every day. Thinking about such reports can help you understand why it is important to learn about research methods even if you have no intention of ever doing research yourself. For purposes of illustration, let’s take a closer look at a media report like the one that caused Christina to worry about how much time her son spent watching television. In 2004, the news media carried a number of reports warning parents of young children that watching too T much television in the early years might lead to attention deficit hyperactivity disorder (ADHD) later in childhood (e.g., Clayton, 2004). These warnings were based, reporters said, on a scientific study that was published in the prestigious journal Pediatrics. How can a person who isn’t an expert on the subject in question evaluate claims like these? The thinking strategies used by psychologists and other scientists can help us sift through such information. Critical thinking, the foundation of the scientific method, is the process of objectively evaluating claims, propositions, and conclusions to determine whether they follow logically from the evidence presented. When we engage in critical thinking, we exhibit these characteristics: thinking. When thinking critically, we do not automatically accept and believe what we read or hear. • Suspension of judgment. Critical thinking requires gathering relevant and up-to-date information on all sides of an issue before taking a position. • Willingness to modify or abandon prior judgments. Critical thinking involves evaluating new evidence, even when it contradicts pre-existing beliefs. • Independent Applying the first of these three characteristics to the television-ADHD study involves recognizing that the validity of any study isn’t determined by the authority of its source. In other words, prestigious journals-or psychology or communities in the United States, such as African Americans, Hispanic Americans, Asian Americans, and European Americans. Cross-cultural researchers Ann Fernald and Hiromi Morikawa took video and audio recordings of 30 Japanese and 30 American mothers with their infants, playing with the infants’ own toys in the families’ own homes (Fernald & Morikawa, 1993). Ten of the infants in each cultural group were 6 months old, ten were 12 months old, and ten were 19 months old. So, in each culture, Fernald and Morikawa established a cross-sectional study. There were striking similarities in the ways these two groups of mothers spoke to their infants (e.g., Fernald et aI., 1989). Both groups simplified their speech, repeated themselves frequently, used sounds to attract the child’s attention, and spoke in a higher-pitched voice than usual. Yet the mothers from these two cultural groups differed in the kinds of things they said. One such difference, illustrated in Figure 1.6, was in the American mothers’ greater tendency to name toys or parts of toys for their infants. One consequence of this maternal difference appeared to be that the American children knew more words than their Japanese counterparts when they were tested at age 19 months. An Example of a Cross, Cultural Comparison Study textbooks, for that matter-shouldn’t be regarded as sources of fIxed, immutable truths. In fact, learning to question accepted “truths” is important to the scientifIc method itself. The second and third characteristics of critical thinking, suspension of judgment and willingness to change, may require changing some old habits. If you’re like most people, you respond to media reports about research on the basis of your own personal experiences, a type of evidence scientists call anecdotal evidence. For instance, in response to the media report about television-watching and ADHD, a person might say “I agree with that study because my cousin has such severe ADHD that he had to drop out of high school, and he was always glued to the television when he was little.”Another might counter with “I don’t agree with that study because I watched a lot of television when I was a kid, and I don’t have ADHD.” Suspension of judgment requires that you postpone either accepting or rejecting the study’s findings until you have accumulated more evidence. This might involvedetermining what, if any,findings have been reported by other researchers regarding a possible link between television-watching andADHD. Finding out about other relevant studies can help to form a comprehensive picture of what the entire body of research says about the issue. Ultimately, when enough evidence has been gathered, a critical thinker must be willing to abandon preconceived notions and prior beliefs that conflict with it. The quality of the evidence is just as important as the quantity, however. Thus, a critical thinker would evaluate the findings of the television-ADHD study in terms of the methods used to obtain them. Did the researchers randomly assign young children to experimental and control groups who watched different amounts of television and then assess whether experimental and control children differed in ADHD symptoms several years later? If so, then the study was an experiment and media claims that television-watching in early childhood leads to ADHD might be justified. If, however, the researchers simply measured television-watching in early childhood and then correlated this variable with a measure of ADHD later on, then claims of a causal relationship between the two variables wouldn’t be justified. Instead, the appropriate response would be to look for underlying variables, such as parental involvement, that might explain the connection. [The research cited in these reports was correlational in nature, so the strong causal claims implied by many media accounts of the study (Christakis, Zimmerman, Giuseppe, & McCarty, 2004) were inappropriate.] Does a critique of this kind suggest that parents like Christina need not be concerned about how much time their toddlers spend in front of the television? Clearly not. Instead, it confirms a point made at the beginning of the chapter. Development is a complex process involving interactions among many variables. Thus, scientifIc studies can help parents better understand development, but they must be weighed along with other sources of information, including parents’ own priorities and values, in the formulation of parenting decisions. 1. How would you explain the ideas in this discussion to a concerned parent who was not knowledgeable about the principles of critical thinking or about research methods? 2. What variables other than parental involvement might contribute to a relationship between television-watching andADHD? III Qj 50 ..c Research ethics are the guidelines researchers follow to protect the rights of animals and humans who participate in studies. Ethical guidelines are published by professional organizations such as the American Psychological Association, the American Educational Research Association, and the Society for Research in Child Development. Universities, private foundations, and government agencies have review committees that make sure that all research these organizations sponsor is ethical. Guidelines for animal research include the requirement that animals be protected from unnecessary pain and suffering. Further, researchers must demonstrate that the potential benefits of their studies to either human or animal populations are greater than any potential harm to animal subjects. ~ .•. 0 •.. l: 40 :J 0 l: 30 QI ..c 20 E III QI :J l: l: 10 ::i!: 6 mo. 12 mo. 19 mo. 6 mo. 12 mo. 19 mo. Age of infant Cultural ifferenceswere evidentin Fernaldand Morikawa’s d (1993) studyof how mothersspeak to their infants. Before gotng on … • Discuss the pros and cons of cross-sectional, longitudinal, and sequential research designs. • How do developmentalists use case studies, naturalistic observation, correlations, and experiments to identify relationships between variables? .Why is cross-cultural research important? • Listthe ethical principles researchers follow to protect the rights of participants. • How does learning about research methods help you be a more criticalthinker? Ethical standards for research involving human participants are based on the following major themes: Protection from Harm. It is unethical to do research that may cause permanent physical or psychological harm to participants. Moreover, if there is a possibility of temporary harm, researchers must provide participants with some way of repairing the damage. For example, if the study will remind participants of unpleasant experiences, like rape, researchers must provide them with counseling. Informed Consent. Researchers must inform participants of any possible harm and require them to sign a consent form stating that they are aware of the risks involved in participating. In order for children to participate in studies, their parents must give permission after the researcher has informed them of possible risks. If children are older than 7, they must also give consent themselves. If the research takes place in a school or day-care center, an administrator representing the institution must also consent. In addition, human participants, whether children or adults, have the right to discontinue participation in a study at any time. Researchers are obligated to explain this right to children in language they can understand. Confidentiality. Participants have the right to confidentiality. Researchers must keep the identities of participants confidential and must report data in such a way that no particular piece of information can be associated with any specific participant. The exception to confidentiality is when children reveal to researchers that they are being abused or have been abused in any way by an adult. In most states, all citizens are required to report suspected cases of child abuse. Knowledge of Results. Participants, their parents (if they are children), and administrators of institutions in which research takes place have a right to a written summary of a study’s results. Protection from Deception. If deception has been a necessary part of a study, participants have the right to be informed about the deception as soon as the study is over. Summary Perspectives on Development as high IQ, prevent some children from being negatively influenced by risk factors. • The question of the degree to which development is influenced by nature and by nurture has been central to the study of development for thousands of years. Philosophers and early psychologists thought of the nature-nurture issue as an either-or question. • Psychologists have also debated the question of whether development is continuous or discontinuous. Those who favor continuity emphasize the quantitative aspects of development, while those who view development as discontinuous often propose stage models to explain developmental change. • One group of influences on development includes internal factors such as maturation, critical and sensitive periods, inborn biases, individual genetic variations, and internal models of experience. Theoretical models try to explain how internal and external factors interact. • The ecological perspective attempts to explain how external factors such as family and culture influence development. • Developmental psychologists often discuss development in terms of vulnerability and resilience. The idea is that certain risk factors, such as poverty, predispose children to develop in undesirable ways. However, protective factors, such Theories of Development • Psychoanalytic theories suggest that internal drives strongly influence development. Both Freud and Erikson proposed stages to explain the process of personality people age. development as • Cognitive-developmental theories propose that basic cognitive processes influence development in all other areas. Piaget’s theory has been especially influential, but interest in Vygotsky’s ideas has grown in recent years. Informationprocessing theory also explains development in terms of cognitive processes. • Learning theories emphasize the influence of the environment on children’s behavior. Classical and operant conditioning principles explain learning in terms of links between stimuli and responses. Bandura’s social cognitive theory gives more weight to children’s cognitive processing of learning experiences and attempts to explain how modeling influences development. • Psychologists don’t think of theories as “true” or “false.” Instead, they compare theories on the bases of assumptions and usefulness. Finding the Answers: Research Designs and Methods • The goals of developmental psychology are to describe, to explain, to predict, and to influence age-related change. Developmental psychologists use various methods to meet these goals. • In cross-sectional studies, separate age groups are each tested once. In longitudinal designs, the same individuals are tested repeatedly over time. Sequential designs combine cross-sectional with longitudinal comparisons. • Case studies and naturalistic observation provide a lot of important information, but it usually is not generalizable. Correlational studies measure relations between variables. They can be done quickly and yield information that is more generalizable than information from case studies or naturalistic observation. To test causal hypotheses, it is necessary to use experimental designs in which participants are assigned randomly to experimental or control groups . • Cross-cultural (cross-context) research helps developmentalists identify universal patterns and cultural variables that affect development. • Ethical principles that guide psychological research include protection from harm, informed consent, confidentiality, knowledge of results, and protection from deception. Key Terms behavior genetics (p. behaviorism (p. 4) case studies (p. 25) classical conditioning (p. 17) cognitive-developmental theories (p. 15) control group (p. 26) correlation (p. 25) critical period (p. 6) cross-cultural research (p. 27) cross-sectional design (p. 23) dependent variable (p. 26) developmental science (p. 3) eclecticism (p. 22) ego (p. 14) experiment (p. 26) experimental group (p. 26) id (p. 14) independent variable (p. 26) information-processing theories (p. 16) internal models of experience (p. learning theories (p. 17) libido (p. 14) longitudinal design (p. 23) maturation (p. 6) naturalistic observation (p. 25) negative reinforcement (p. 18) norms (p. 4) operant conditioning (p. 18) positive reinforcement (p. 18) psychoanalytic theories (p. 13) psychosexual stages (p. 14) psychosocial stages (p. 15) punishment (p. 19) scaffolding (p. 16) sensitive period (p. 6) sequential design (p. 23) superego (p. 14) zone of proximal development (p. 16) See for “ou~ ‘. l. ! Culture and Informal Theories of Development Researchers have found that the development of psychological theories is a basic component of human thinking. In other words, we observe human behavior and develop ideas that we think explain our observations. These ideas are often strongly influenced by culture. You can find out about the relationship between culture and informal theories of development by presenting people from different backgrounds with the statement attributed to John Watson at the beginning of the chapter. Next, ask them to explain why they agree or disagree with the statement. Write down or record their responses and analyze them to see how much emphasis each person places on internal (e.g., intelligence) and external (e.g., education) variables. One way of measuring this would be to give each person an “internal” score and an “external” score by assigning 1 point for each internal and each external variable men- tioned. Average the scores within each cultural group represented by the people included in your study, and then compare the results across cultures. Research Design Almost all the important findings in developmental psychology have resulted from studies employing all of the methods you have learned about in this chapter. For instance, Piaget’s theory was built on naturalistic observation, case studies, correlational studies, and experiments. Moreover, many crosscultural studies have replicated his original results. Think of a question about development that you find intriguing or personally meaningfuL How would you look for an answer to that question with each of the methods described in this chapter? Conception and G-enetlcs The Process of Conception Genotypes, Phenotypes, and Patterns of Genetic Inheritance CHAPTER Development from Conception to Birth The Stages of Prenatal Development Sex Differences in Prenatal Development Prenatal Behavior Problems in Prenatal Development Genetic Disorders Chromosomal Errors Teratogens: Maternal Diseases Teratogens: Drugs Other Teratogens and Maternal Factors Summary Key Terms

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Abnormal Psychology: An Overview WHAT DO WE MEAN BY ABNORMAL BEHAVIOR? Why Do We Need to Classify Mental Disorders? What Are the Disadvantages of Classification? The DSM -IV Definition of Mental Disorder How Does Culture Affect What Is Considered Abnormal? Culture-Specific Disorders HOW COMMON ARE MENTAL DISORDERS? Prevalence and Incidence Prevalence Estimates for Mental Disorders Treatment The Mental Health “Team” RESEARCH APPROACHES IN ABNORMAL PSYCHOLOGY Forming Hypotheses about Behavior Sampling and Generalization Criterion and Comparison Groups Studying the World as It Is: Observational Research Designs Retrospective versus Prospective Strategies Manipulating Variables: The Experimental Method in Abnormal Psychology Studying the Efficacy of Therapy Single-Case Experimental Designs Animal Research UNRESOLVED ISSUES: Are We All Becoming Mentally Ill? Sources of Information he topics and problems central to abnormal psychology surround us every day. You have only to pick up a newspaper, read a magazine, watch TV, or go to a movie to be exposed to some of the issues that clinicians and researchers deal with on a day-to-day basis. Almost weekly, it seems, some celebrity is in the news because of a drug or alcohol problem, an eating disorder, or some other psychological difficulty. Bookstore shelves are lined with personal accounts of struggles with schizophrenia, depression, phobias, and panic attacks. Films such as A Beautiful Mind portray aspects of psychopathology with varying degrees of accuracy. And then there are the tragic news stories of mothers who kill their children, where problems with depression, schizophrenia, or postpartum difficulties seem to be implicated. Abnormal psychology also exists much closer to home. Walk around any college campus, and you will see notices about peer support groups for people with eating disorders, depression, and a variety of other problems. You may even know someone who has experienced a clinical problem. It may be a cousin with a cocaine habit, a roommate with bulimia, or a grandparent who is developing Alzheimer’s disease. It may be a co-worker of your mother’s who is hospitalized for depression, a neighbor who is afraid to leave the house, or someone at your gym who works out intensely while looking worrisomely thin. It may even be the disheveled man in the aluminum foil hat who shouts, “Leave me alone!” to voices only he can hear. The issues of abnormal psychology capture our interest, demand our attention, and trigger our concern. They also compel us to ask questions. To illustrate further, let’s consider two clinical cases. Monique is a 24-year-old law school student. She is attractive, neatly dressed, and clearly very bright. If you were to meet her, you would think that she had few problems in her life. But Monique has been drinking alcohol since she was 14, and she smokes marijuana every day. Although she describes herself as “just a social drinker,” she drinks four or five glasses of wine when she goes out with friends and also drinks a couple of glasses of wine a night when she is alone in her apartment watching TV in the evening. She frequently misses early morning classes because she feels too hungover to get out of bed, and on several occasions her drinking has caused her to black out. Although she denies having any problems with alcohol, Monique admits that her friends and family have started to get very concerned about her and have suggested that she seek help. Monique, however, says, “I don’t think I am an alcoholic because I never drink in the mornings.” The previous week she decided to stop smoking marijuana entirely because she was concerned that she might have a drug problem. However, she found it impossible to stop and is now smoking regularlyagain. Donald is 33 years old. Although Donald is of relatively high intelligence, he has never been employed for more than a few days at a time, and he currently lives in a sheltered community setting. Donald has brief but frequent periods when he needs to be hospitalized. His hospitalizations are triggered by episodes of great agitation during which Donald hears voices. These voices heap insulting and abusive comments on him. In most social situations, Donald appears awkward and painfully unsure of himself, as well as rather socially inappropriate. In his mid-teens Donald began to withdraw socially from his friends and family. When he was 17, he suddenly, and without any obvious trigger, began to hear voices. At that time he was stubbornly insistent that the voices were coming, with malicious intent, from within a neighbor’s house and were being transmitted electronically to the speakers of the family television. More recently he has begun to consider the possibility that he somehow produces them within himself. During periods of deterioration, Donald can be heard arguing vehemently with the voices. The rest of the time he appears to be reasonably able to ignore them, although his voices are never entirely absent for sustained periods. Prior to his breakdown, Donald lived a relatively normal middle-class life. He was reasonably popular among peers and showed considerable athletic prowess. He earned passing grades in school, although his parents and teachers often complained that he seemed inattentive and preoccupied. There was no evidence of his ever having abused drugs. Perhaps you found yourself asking questions as you read about Monique and Donald. For example, because Monique doesn’t drink in the mornings, you might have wondered whether she could really have a serious alcohol problem. She does. This is a question that concerns the criteria that someone has to meet before getting a particular diagnosis. Or perhaps you wondered whether other people in Monique’s family also have drinking problems. They do. This is a question about what we call family aggregation, or whether a disorder runs in families. No doubt you were also curious about what is wrong with Donald and why he is hearing voices. Donald suffers from schizophrenia. Also, as Donald’s case illustrates, it is not unusual for someone who develops schizophrenia to be apparently perfectly normal before suddenly becoming ill. These cases give some indication of how profoundly lives can be derailed because of mental disorders. Although the names of the people have been changed to protect their identities, these cases describe real people with real problems. It is hard to read about difficulties such as these without feel- ing compassion for the people who are struggling. But in addition to compassion, clinicians and researchers who want to help people like Monique and Donald must have other skills. If we are to understand mental disorders, we must learn to ask the kinds of questions that will enable us to help the patients and the families who suffer from mental disorders. These questions are at the very heart of a research-based approach that looks to use scientific inquiry and careful observation to understand abnormal psychology. Asking questions is an important aspect of being a psychologist. Psychology is a fascinating field, and (although we are undoubtedly biased) abnormal psychology is one of the most interesting areas of psychology. Psychologists are trained to ask questions and to conduct research. Though not all people who are trained in abnormal psychology (sometimes called “psychopathology”) conduct research, they still rely heavily on their scientific skills and ability both to ask questions and to put information together in coherent and logical ways. For example, when a clinician first sees a new client or patient, he or she asks a lot of questions to try and understand the issues or problems related to that person. The clinician will also rely on current research to choose the most effective treatment. The “best treatments” of 20, 10, or even 5 years ago are not invariably the best treatments of today. Knowledge progresses, and advances are made. And research is the engine that drives all of these developments. In this chapter, we will outline the field of abnormal psychology and the varied training and activities of the people who work in it. First we describe the ways in which abnormal behavior is defined and classified so that researchers and mental health professionals can communicate with each other about the people they see. Some of the issues here are probably more complex and controversial than you might expect. We also outline basic information about the extent of behavioral abnormalities in the population at large. You will notice that a large section of this chapter is devoted to research. We make every effort to convey how abnormal behavior is studied. Research is at the heart of progress and knowledge in abnormal psychology. The more you know and understand about how research is conducted, the more educated and aware you will be about what research findings mean and what they do not mean. For example, read Developments in Research 1.1 before you buy a magnet to help you with a repetitive-stress injury caused by typing too many term papers! WHAT Do WE MEAN By ABNORMAL BEHAVIOR? Just under 50 percent of people will suffer from a mental disorder at some point in their lives, with anxiety disorders being especially common. It may come as a surprise to you that there is still no universal agreement about what we mean by abnormality or disorder. This is not to say we do not have definitions; we 1.1 here is a growing trend for people to use alternative medical therapies when they experience problems (Eisenberg et aI., 1998). One form of “energy healing” therapy that is growing in popularity is the use of magnets. Many companies now sell therapeutic magnets, and there are many testimonials that can be found on the Internet that extol their healing powers. Magnets are often marketed to people who have chronic hand or wrist pain. This type of problem is known as repetitive-stress injury (RSI).A common source of such problems is extensive computer use. But do magnets really relieve the chronic pain that is associated with repetitivestress injury? Testimonials notwithstanding, the only way to answer this question is by controlled research. To investigate this issue, Pope and McNally (2002) randomly assigned college students with RSIto one of three groups. One group was asked to wear wristbands containing magnets for a 30-minute period (magnet group). Asecond group was also given apparently identical bracelets to wear. In this case, however, and unknown both to the participants and to the assistant running the study, the magnets had been removed from the wristsbands (sham group). A third group of subjects did not receive any magnets (no-treatment group). You should note here that this study is an example of what we call a double-blind study. In other words, neither the subjects nor the experimenter who was working with the subjects knew who got the genuine magnets. The use of the wristbands with the magnets removed is called a placebo treatment condition (the word placebo comes from the Latin meaning “I shall please”). Placebo treatment conditions enable experimenters to control for the possibility that simply believing one is getting an effective type of treatment produces a therapeutic benefit. Finally,the notreatment control group enables the experimenters to see what happens when they don’t provide any treatment (or expectation of treatment) at all. At the start of the study, all of the student participants completed a 4-minute typing test. This provided a measure of how many words they could type in this time. Then, 30 Do Magnets Help with Repetitive-Stress Injury? T minutes after wearing the magnets or fake wristbands (or, for the no-treatment subjects, after waiting 30 minutes), all participants completed another 4-minute typing test. In addition, those who had been assigned to either the genuine or the placebo magnet group were asked to rate their degree of pain relief (from no improvement to complete relief) using an 8-point scale. What were the results? As might be expected, those people who had been assigned to the no-treatment group did not report that their level of pain changed in any appreciable way. This is hardly surprising, because nothing had been done to them at all. They typed an average of about four more words on the second test (the post-test) than on the first (the pretest). Did the people who wore the magnets do better than this? The answer is yes. Those who wore the genuine magnets reported that their pain was diminished. They also typed an average of 19 more words on the second typing test than they did on the first! In other words, with respect to both their self-report data (their pain improvement ratings) and their behavioral data (how rapidly they could type), they clearly did better than the no-treatment group. Before you rush out to buy magnetic bracelets, however, let us look at the performance of the people who received the fake bracelets. Likethe subjects who wore the genuine magnets, these participants also reported that their pain had improved. And, in fact, on the behavioral typing test, subjects in the placebo treatment group typed even more words on the second test (an average of 26 words more) than subjects who wore the real magnets did! With respect to their self-reports and their behavioral data, therefore, the group who wore the fake bracelets improved just as much as the group who wore the real magnets! Judging on the basis of this study, then, we must conclude that magnet therapy works via the placebo effect, not because there is any genuine clinical benefit that comes from the magnets themselves. Ifyou believe that the magnet will help your RSI,you don’t actually need a magnet to bring about any clinical improvement. And this, in a nutshell, is why we need controlled research trials. do. However, every definition provided so far has proved problematic (Maddux, Gosselin, & Winstead, 2005). What is perhaps more remarkable is that even though we lack consensus on a definition, there is still a lot of agreement about which conditions are disorders and which are not (Spitzer, 1999). How do we manage this? In part, the answer lies in the fact that there are some clear elements of abnormality (Lilienfeld & Marino, 1999; Seligman et al., 2001). No one element of abnormality is sufficient in and of itself to define or determine abnormality, but the greater the similarity between a given person’s behavior and the elements of abnormality described in The World Around Us 1.2, the more likely it is that the person is abnormal or mentally disordered in some way. In other words, we adopt a “prototype” kind of model of abnormality and assess the degree to which a given person 1.2 T Although here is no one behavior that makes someone of menHowever, there are The more in the following reflect abnormality. abnormality, is statistically than something This tells us that in defining If something (as is mental retarrare and highly that is unde- abnormal. This has made the definition we make value judgments. rare and undesirable that is statistically tal disorders problematic. certainly elements of abnormality. dation), we are more likely to consider it abnormal desirable (such as genius) or something sirable but statistically If. Violation that someone has difficulties areas, the more likely it is that he or she has some form of mental disorder. common (such as rudeness). of the Standards of Society: All cultures have 1. Suffering: If people suffer psychologically, we are rules. Some of these are formalized as laws. Others form the norms and moral standards that we are taught to follow. Although many social rules are arbitrary to some extent, when people fail to follow the conventional social and moral rules, we may consider and on how commonly their behavior abnormal. Of course, much depends on the magnitude of the violation it is violated by others. For example, most of us have parked illegally at some time or other. This failure to follow the rules is so statistically common that we tend inclined to consider this as indicative anxiety disorders. of abnormality. Depressed people clearly suffer, as do people with But what about the patient who is because they You may have manic? He or she may not be suffering (indeed, many such patients dislike taking medications don’t want to lose their manic “highs”). a test tomorrow and be suffering because of that. But in (all that we would hardly label your suffering abnormal. suffering is an element of abnormality condition many cases, it is neither a sufficient cases of abnormality something not to think of it as abnormal. On the other hand, when a mother drowns her children, there is instant recognition that this is abnormal behavior. is needed) nor even a necessary condition as abnormal. Maladaptive (that all must show) for us to consider 5. Social Discomfort: When someone violates a social behavior is often an to the point where she may withdraw from rule, those around him or her may experience a sense of discomfort or unease. For example, imagine you are traveling home on the bus, and there is no one else on the bus except the driver. Then the bus stops and someone else gets on. Even though there are rows and rows of empty seats, this person sits down next to you. How do you feel? In a related vein, how do you feel when someone you met only 4 minutes before starts to tell you of her suicide attempt? Unless you are a therapist working in a crisis intervention center, you would probably consider this an example of abnormal behavior. and Unpredictability: As we have already may add some For The person with anorexia 2. Maladaptiveness: indicator of abnormality. may restrict her intake offood becomes so emaciated that she needs to be hospitalized. The person with depression weeks or months. Maladaptive with our well-being involve maladaptive personality work and our relationships. friends and family and may be unable to work for behavior interferes and with our ability to enjoy our But not all disorders behavior. Consider the con artist and the contract killer, both of whom have antisocial disorder (see Chapter 11). One may be able glibly to talk people out of their life savings, the other to take someone’s life in return for payment. Is this behavior maladaptive? sider them abnormal, ior is maladaptive Not for them, because it is the way they make their respective livings. We conhowever, because their behavfor society. 6. Irrationality noted, we expect people to behave in certain ways. Although a little unconventionality consider a given unorthodox scream and yell obscenities be unpredictable, The disordered often irrational. most important spice to life, there is a point at which we are likely to behavior abnormal. at nothing, you would It would behavior example, if the person next to you suddenly started to 3. Deviancy: The word abnormal literally means “away from the normaL” But simply considering statistically rare behavior to be abnormal does not provide us with a solution to our problem of defining abnormality. Genius is statistically rare, as is perfect pitch. However, we do not consider people with such uncommon talents to be abnormal in any way. On the other hand, mental retardation (which is also statistically rare and represents a deviation from normal) is considered to probably regard that behavior as abnormal. speech and the disorganized and it would make no sense to you. (see Chapter 14) are of patients with schizophrenia Such behaviors are also a hallmark of factor, however, is our evaluation of the manic phases of bipolar disorder. Perhaps the whether the person can control his or her behavior. (continued) Fewof us would consider a roommate who began to recite speeches fromKing Learto be abnormal ifwe knew that he was playing Learin the next campus Shakespeare production-or even if he was a dramatic person givento extravagant outbursts. Onthe other hand, ifwe discovered our roommate lyingon the floor,flailingwildly,and reciting Shakespeare, we might consider callingfor assistance ifthis was entirely out of character and we knew of no reason why it should be happening. resembles it. Using the elements of abnormality described in The World Around Us 1.2, consider the case in The World Around Us 1.3 on the following page. Finally, we should note the additional problem of changing values and expectations in society at large. Because society is constantly evolving and becoming more or less tolerant of certain behaviors, what is considered abnormal or deviant in one decade may not be considered deviant or abnormal a decade or two later. For example, at one time, homosexuality was classified as a mental disorder. It is no longer viewed as such today (see Chapter 13). And 20 years ago, pierced noses, lips, and navels were regarded as highly deviant and prompted questions about a person’s mental health. Now, however, such adornments are quite commonplace, are considered fashionable by many, and generally attract little attention. What other behaviors can you think of that are considered normal by today’s standards but were regarded as deviant in the past? As with most accomplished athletes, Venus and Serena Williams’ physical ability is “abnormal” in a literal and statistical sense. Yet their behavior would not be labeled as being “abnormal” by psychologists. Why not? Why Do We Need to Classify Mental Disorders? If defining abnormality is so difficult, why do we do it? One simple reason is that most sciences rely on classification (e.g., the periodic table in chemistry and the classification of living organisms into kingdoms, phyla, classes, and so on in biology). At the most fundamental level, classification systems provide us with a nomenclature (a naming system) and enable us to structure information in a more helpful manner. Organizing information within a classification system also allows us to study the different disorders that we classify and therefore to learn more, not only about what causes them but also how they might best be treated. For example, thinking back to the cases you read about, Monique has alcohol and drug dependence, and Donald suffers from schizophrenia. Knowing what disorder each of them has is clearly very helpful, as Donald’s treatment would likely not work for Monique. A final effect of classification system usage is somewhat more mundane. As others have pointed out, the classification of mental disorders has social and political implications (see Blashfield & Livesley, 1999; Kirk & Kutchins, 1992). Simply put, defining the domain of what is considered to be pathological establishes the range of problems that the mental health profession can address. Twenty years ago, pierced noses, lips, and navels were regarded as highly deviant. Now, such adornments are considered fashionable by many, and attract little attention. 1.3 Extreme Generosity or Pathological Behavior? Z completing in literature. ell Kravinsky grew up in a working-class neighborhood in Philadelphia. A brilliant stu- dent, he won prizes at school and began investing in the stock market when he was 12. Despite his abilities, his Russian immigrant in parents were, in the words of a family friend, “steadfast denying him any praise.” Kravinsky went to Dartmouth, where he majored in Asian studies, and, after graduation, he took a job at an insurance company. Later he became a teacher, working with children who had social and emotional problems. Eventually he returned to school himself, first in education, the second this time, he also indulged his to two Ph.D.s-the Throughout growing interest in real estate. By the time he was 45, he was married with children, and his assets amounted almost $45 million. Although Kravinsky had a talent for making money, he found it difficult to spend it. He drove an old car, did not give his children pocket money, and lived with his family in a modest home. As his fortune grew, however, he began to talk to his friends about his plans to give all of his assets to charity. His philanthropy began in earnest when he and his $6.2 million, to the Centers for someone in need was almost unbearable. coordinator. chiatrist. He called the wife gave two gifts, totalling Albert Einstein Medical Center and spoke to a transplant He met with a surgeon, and then with a psythat he suffered and that his wife did not support his that he did not have Kravinsky told the psychiatrist Disease Control Foundation. They also donated an apartment building to a school for the disabled in Philadelphia. The following year the Kravinskys gave gifts of real estate for his giving was to help oththat were worth around $30 million to Ohio State University. Kravinsky’s motivation ers. According to one of his friends, “He gave away the money because he had it and there were people who needed it. But it changed his way of looking at himself. He decided the purpose of his life was to give away things.” After he had put some money aside in trust for his wife and his children, Kravinsky’s personal assets were reduced to a house (on which he had a substantial essentially mortgage), two minivans, and around $80,000 in stocks and cash. He had given away his entire fortune. with the Kravinsky’s giving did not end when his financial assets were gone. He began to be preoccupied idea of nondirected organ donations, in which an altruistic from depression desire to donate one of his kidneys. When the psychiatrist told him that he was doing something to do, Kravinsky’s response was, “I do have to do it. You’re missing the whole point. It’s as much a necessity as food, water, and air.” Three months tater, Kravinsky left his home in the early hours of the morning and drove to the hospital. operation In an that took 3 hours, he gave his right kidney to Donnell Reid, a 29-year-old single black woman who was studying social work and who had been on dialysis for the previous 8 years. The day after the operation, wife to tell her what he had done. In spite of the turmoil that his kidney donation created within his family, Kravinsky’s mind turned back to philanthropy almost immediately. “I lay there in the hospital, and I thought about all my other good organs. When I do something good, I feel that I can do more. I burn to do more. It’s a heady feeling.” By the time he was discharged, he was wondering about giving away his one remaining kidney. In the months after the operation, enced a loss of his sense of direction. his life as a continuing donation. Kravinsky experiHe had come to view he called his person gives an organ to a total stranger. When he learned that he could live quite normally with only one kidney, Kravinsky decided that the personal costs of giving away one of his kidneys were minimal compared to the benefits that someone with kidney disease would receive from being given a matching kidney. His wife, however, did not share his view. Although she had consented to giving away large sums of money to good causes, when it came to her husband giving away his kidney, she could not agree. For Kravinsky, however, the burden of not being able to do something that would help alleviate the suffering of But now that his financial assets and his kidney were gone, what could be next? His current dilemma is how he can continue to give in the way that matters most to him, and how he can continue to live if (continued) he carries out the organ donations he envisions. Sometimes he imagines offering his entire body for donation. “My organs could save several people if I gave my whole body away.” He also acknowledges that he feels unable to do that to his family. At the present time, Kravinsky is involved in a real estate partnership with the goal of giving his shares in the business endeavor to charity. Peter Singer, a Princeton philosopher, has called Kravinsky “a remarkable person who has taken very seri- ously questions about the nature of our moral obligations to assist people.” Others who hear Kravinsky’s story may think that he is quite mad. What do you think? Is Kravinsky’s behavior abnormal? Or is this a man of profound moral commitment who possesses a degree of courage that allows him to act on his personal convictions? (Taken from Parker, 2004) And on a purely types of problems pragmatic warrant level, it also delineates insurance reimbursement, which and so ill that I was unable to work, my marriage ended, I lost my business, and I became homeless. At this point I had my most powerful experience with stigma. I was 38 years old. I had recently been discharged after a psychiatric hospitalization for a suicide attempt, I had no place to live, my savings were exhausted, and my only possession was a 4-year-old car. I contacted the mental health authorities in the state where I then lived and asked for assistance in dealing with my mental illness. I was told that to qualify for assistance I would need to sell my car and spend down the proceeds. I asked how I was supposed to get to work when I recovered enough to find a job. I was told, “Don’t worry about going back to work. People like you don’t go back to work” (McNulty, 2004). how much reimbursement. What Are the Disadvantages of Classification? Of course, there are also some drawbacks fication system. Classification, in a shorthand inevitably information of shorthand to having a classiprovides by its very nature, form. However, using any form leads to a loss of information. For type tells you is suffer- example, learning about a person who has a particular of disorder (e.g., by reading a case summary) much more than just being told that the person ing from “schizophrenia:’ In other words, as we simplify through classification, we inevitably lose an array of personal details about the actual person who has the disorder. Moreover, a psychiatric although diagnosis. things are changing, attached there can The another experiences component of James of stigma, McNulty which also illustrate of is the problem also still be some stigma (or disgrace) to receiving People who would readily disclose that they have an illness such as diabetes are much more likely to be silent if the diagnosis involves a mental disorder. In part, this is because talking candidly have unwanted of a fear (real or imagined) that about having psychological social or occupational the following example. problems will consequences. disorder for are automatic beliefs that people have about other people based on knowing one (often trivial) thing about them (e.g., people who wear glasses are more intelligent; New Yorkers are rude; everyone in the South has a gun). Because we may have heard about certain behaviors that can accompany mental disorders, we may automatically and incorrectly infer that this will also be true for any person we meet who has a psychiatric diagnosis. This is reflected in the comment, “People like you don’t go back to work.” Take a moment to consider honestly your own stereotypes orders. What assumptions view people irresponsible, about people with mental disdo you tend to make? Do you stereotyping. Stereotypes James McNulty, who has suffered from bipolar many years, provides with mental illness as less competent, more more dangerous, and more unpredictable? I have lived with bipolar disorder for more than 35 yearsall of my adult life. The first 15 years were relatively conventional, at least on the surface. I graduated from an Ivy League university, started my own business, and began a career in local politics. I was married, the father of two sons. I experienced mood swings during these years, and as I got older the swings worsened. Eventually, I became Research has shown that such attitudes are not uncommon (see Watson et al., 2004). Finally, stigma can be perpetuated by the problem of labeling. A person’s self-concept may be directly affected by being given a diagnosis of schizophrenia, depression, or some other form of mental illness. How might you react if you were told something like this? Also, once a group of symptoms (see Table 1.1) is given a name and identified by Symptom: A symptom is a single indicator of a problem. It can involve affect (e.g., sad mood, anxiousness), behavior (problems sleeping, lethargy), or cognition (excessive worry, suicidal thoughts). Syndrome: A syndrome is a group or cluster of symptoms that all occur together. For example, sad or depressed mood, problems sleeping, concentration problems, weight loss, and suicidal thinking are all symptoms that reflect the syndrome of depression. Note that in the case of depression, depression can be a symptom (when it refers to depressed mood). It is also the name of the syndrome (when it refers to the cluster of symptoms). ~ A clinically significant behavioral or psychological syndrome or pattern ~ Associated with distress or disability (i.e., impairment in one or more important areas of functioning) Not simply a predictable and culturally sanctioned response to a particular event (e.g., the death of a loved one) Considered to reflect behavioral, psychological, or biological dysfunction in the individual (adapted from American Psychiatric Association, DSMIV, 2000, p. xxi) ~ ~ means of a diagnosis, this “diagnostic label” can be hard to shake, even if the person later makes a full recovery. It is important to keep in mind, however, that diagnostic classification systems do not classify people. Rather, they classify the disorders that people have. In other words, it is essential to note that a person has an illness, but is not defined by that illness. Language is therefore very important. At one time it was quite common for mental health professionals to describe a given patient as “a schizophrenic” or “a manic-depressive.” Now, however, it is widely acknowledged that it is more accurate (not to mention more respectful) to say,”a person with schizophrenia” or”a person who suffers from manic depression.” Simply put, the person is not the diagnosis. The DSM-IV Definition of Mental Disorder In the United States, the gold standard for defining various types of mental disorders is the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders, commonly known as “the DSM.” The DSM is currently in its fourth edition (hence, DSM-IV). DSM-IV was first published in 1994 and then was revised slightly in 2000. This most recent edition of the DSM is known as “DSM-IV-TR” (the TR stands for text revision). Table 1.2 summarizes the current DSM-IV definition of a mental disorder. This DSM definition does not refer to the causes of mental disorder. In other words, the DSM attempts to be “atheoretical.” It also carefully rules out, among other things, behaviors that are culturally sanctioned, such as (depressive) grief following the death of a significant other. The text of the DSM is also careful to assert that mental dis- orders are always the product of “dysfunctions;’ dysfunctions that in turn always reside in individuals, not in groups. Though widely accepted, the DSM definition of mental disorder still has problems. For example, what exactly is meant by the term “clinically significant” and how should this be measured? Also, how much distress or disability should someone experience before he or she can be considered to be suffering from a mental disorder? Who determines what is “culturally sanctioned”? And what exactly constitutes a “behavioral, psychological, or biological dysfunction”? Obviously, the problematic behavior cannot itself be the “dysfunction;’ for that would be like saying mental disorders are due to mental disorders. If a dysfunction is caused by a dysfunction, we have a definition that is based on circular reasoning. Identifying this flaw in the DSM definition, Jerome Wakefield (l992a, 1992b, 1997) has proposed the idea of mental disorder as “harmful dysfunction.” In his own definition (see Table 1.3), Wakefield classifies “harm” in ~ ~ ~ causes significant distress or disability, is not merely an expectable response to a particular event, and is a manifestation of a mental dysfunction. (Wakefield, 1992b, p. 235) terms of social values (e.g., suffering, being unable to work, etc.), and “dysfunction” refers to some underlying mechanism that fails to perform according to its (presumably evolutionary) “design” (see Clark, 1999). One merit of Wakefield’s approach is that he acknowledges the role played by social values in the definition of a mental disorder. He also tries to use scientific theory (the theory of evolution) in his conception of mental disorder. Nonetheless, there are still various logical and philosophical problems with this proposed solution (e.g., Lilienfeld & Marino, 1999; Maddux et aI., 2005). How are we to know if a problematic behavior is caused by a dysfunction? Evolutionary theory does not provide us with a convenient list of what is functional and what is not. Rather, we are left to base these evaluations on social norms, not on scientific observations. Moreover, to imagine that we might someday be able to pinpoint a distinct underlying and presumably biological dysfunction for each of the nearly 300 DSM diagnoses seems rather an impossible task. As you can see, the term mental disorder defies simple, straightforward definition. Despite the frustrations in trying to pin down such notions as distress and dysfunction, and in developing a consensus definition of mental disorder, clinical research and patient care must continue. We cannot wait until the experts have worked out all the details before we explore the nature, origins, and best forms of treatment for a wide range of disorders. Therefore, the “prototype” model of abnormality discussed earlier is the best attempt we have to identify and help those suffering from mental disorders. Any definition of abnormality or mental disorder must be somewhat arbitrary, and the DSM-IV definition is no exception. The DSM is a work in progress. Much thought is now being given to issues that will need to be dealt with as we begin to move toward DSM-V (e.g., Widiger & Clark, 2000). As our understanding of differe~t disorders changes and as our thinking evolves, so too WIll the DSM and its definition of mental disorder. “four” is similar to the sound of the word for “death” (see Tseng, 2001, pp. 105-6). There is also considerable variation in the way different cultures describe psychological distress. For example, there is no word for “depressed” in the languages of certain Native Americans, Alaska Natives, and some Southeast Asian groups (Manson, 1995). Of course, this does not mean that people from such cultural groups do not experience clinically significant depression. As the accompanying case illustrates, however, the way some disorders present themselves may depend on culturally sanctioned ways of describing distress. How Does Culture Affect What Is Considered Abnormal? It is difficult to consider the concepts of normal and abnormal without reference to culture. Within a given culture, there are many shared beliefs and behaviors that are widely accepted and that form part of customary pr~ctice. For example, many people in Christian countnes believe that the number 13 is unlucky. The origins of this may be linked to the Last Supper, when 13 people ,:ere present. Many of us try to be especially careful on Fnday the 13th. Some hotels and apartment buildings do not have a thirteenth floor, and there is often no bed number 13 in hospitals. The Japanese, in contrast, do no.t care about the number 13 but try to avoid the number 4 If they can. This is because in Japanese, the sound of the word for JGHis a 71-year-old member of a southwestern tribe who has been brought to a local Indian Health Service hospital by one of his granddaughters and is seen in the general medical outpatient clinic for multiple complaints. Most of Mr. GH’s complaints involve nonlocalized pain. When asked to point to where he hurts, Mr.GH indicates his chest, then his abdomen, his knees, and finally moves his hands “all over.” Barely whispering, he mentions a phrase in his native language that translates as “whole body sickness.” His granddaughter notes that he “has not been himself” recently. Specifically, Mr. GH, during the past 3-4 months, has stopped attending or participating in many events previously important to him and central to his role in a large extended family and clan. He is reluctant to discuss this change in behavior as well as his feelings. When questioned more directly, Mr. GH acknowledges that he has had difficulty falling asleep, sleeps intermittently through the night, and almost always awakens at dawn’s first light. He admits that he has not felt like eating in recent months, but denies weight loss, although his clothes hang loosely in many folds. Trouble concentrating and remembering are eventually disclosed as well. Asked why he has not participated in family and clan events in the last several months, Mr.GHdescribes himself as “too tired and full of pain” and “afraid of disappointing people.” Further pressing by the clinician is met with silence. Suddenly the patient states, “Youknow, my sheep haven’t been doing well lately. Their coats are ragged; they’re thinner. They just wander aimlessly; even the ewes don’t seem to care about the little ones.” Physical examination and laboratory tests are normal. Mr.GHcontinues to take two tablets of acetaminophen daily for mild arthritic pain. Although he describes himself as a “recovering alcoholic,” Mr. GH reports not having consumed alcohol during the last 23 years. He denies any prior episodes of depression or other psychiatric problems (Manson, 1995, P·488). As is apparent in the case of JGH, culture can shape the clinical presentation of disorders like depression, which are found all over the world (see Draguns & TanakaMatsumi, 2003). In China, for example, people who are suffering from depression most typically focus on physical concerns (fatigue, dizziness, headaches) rather than saying that they feel sad or down (Kleinman, 1986; Parker et al., 2001). This focus on physical pain rather than emotional pain is also noteworthy in Mr. GH’s case. Although things are slowly improving, we still Some African tribe members know relatively little inflict painful and permanent scars (a process called about the cultural aspects scarification) on their faces and of abnormal psychology torsos in an effort to beautify (Arrindell, 2003). The vast themselves. Such a practice majority of the psychiatric might be viewed as “abnormal” literature originates from by Western European cultures but it is quite cammon among Euro-American countries African tribes. (Western Europe, North America, and Australia/ New Zealand). Astonishingly, of the papers submitted to and published in the six leading psychiatric journals between 1996 and 1998, only 6 percent came from areas of the world where 90 percent of the world’s population actually lives (Patel & Sumathipala, 2001)! Moreover, when research is published in languages other than English, it tends to get disregarded (Draguns, 2001). There is no word for “depressed” in the languages of certain Native American tribes. Peaple from this culture tend to describe their symptoms of depression in physical rather than emotional terms. Culture-Specific Disorders Certain forms of psychopathology seem to be highly culture-specific. In other words, they are found only in certain areas of the world and appear to be highly linked to culturally bound concerns. One example is taijin kyofusho. This syndrome, which is a form of anxiety disorder (see Chapter 6), is quite prevalent in Japan. It involves a marked fear that one’s body, body parts, or body functions may offend or embarrass others or make them feel uncomfortable. Often, people with this disorder are afraid of blushing or fear upsetting others by their gaze, facial expression, or body odor (Levine & Gaw, 1995). Another culturally based way of showing distress that is found in Latinos, especially those from the Caribbean, is ataque de nervios (Lopez & Guarnaccia, 2005). The symptoms of an ataque de nervios, which is often triggered by a stressful event like divorce or loss of a loved one, include crying, trembling, uncontrollable screaming, and a general feeling of being out of control. Sometimes the person may become aggressive physically or verbally. In other cases, the person may faint or experience something that looks like a seizure. Once the ataque is over, the person may quickly return to normal and have no memory of what happened. As we can see from these examples, abnormal behavior is behavior that deviates from the norms of the society in which it is enacted (e.g., see Gorenstein, 1992; Scheff, 1984). Experiences such as hearing the voice of a dead relative might be regarded as normative in one culture (e.g., in many Native American tribes) but as abnormal in another. Nonetheless, certain unconventional actions and behaviors are almost universally considered to be the product of mental disorder. For example, many years ago the anthropologist Jane Murphy (1976) studied what was regarded as abnormal behavior by the Yoruba of Africa and also by Yupik-speaking Eskimos living on an island in the Bering Sea. Both societies had words that were used to denote abnormality or “craziness.” In addition, the clusters of behaviors that were considered to reflect abnormality in these cultures were behaviors that most of us would also Some disorders are highly culture-specific. For example, taijin kyofusho is a disorder that is prevalent in japan and is characterized by a fear that one may upset others by one’s gaze, facial expression, or body odor. Mental health planners need to have a clear picture of the nature and extent of psychological problems within a given area, state, or country so that they can determine how resources, such as funding of research projects or services provided by community mental health centers, can be most effectively allocated. For example, it would obviously be foolish to have a treatment center filled with many experts able to treat anorexia nervosa (a very severe but rare clinical problem) while at the same time providing few treatment resources for people suffering from anxiety or depression, which are much more common. Estimates of the frequency of mental disorders in different groups of people may provide valuable clues about their causes. For example, it is generally found that women with depression outnumber men with depression by a ratio of about 2:1 (Culbertson, 1997). This suggests that gender is an important factor to consider in any efforts to understand depression. What is also very interesting, however, is that among Jews, the genders are affected about equally (Levav et al., 1997). This is not true for other religious groups. Looking more closely at this ratio, it becomes apparent that Jewish males have a higher risk for depression than do men of non-Jewish descent. Why should this be? Although we do not yet know for sure, there are some interesting leads that we will discuss later in this chapter. regard as abnormal, such as hearing voices, laughing at nothing, defecating in public, drinking urine, and believing things that no one else believes. Why do you think these behaviors are universally considered to be abnormal? In ReVIew ~ Why is abnormality so difficult to define? What characteristics help us recognize abnormality? ~ Explain the differences between a symptom and a syndrome. Is depression a symptom or a syndrome? In what ways can culture shape the clinical presentation of mental disorders? ~ __ COMMON ARE MENTAL DISORDERS? How many and what kind of people actually have diagnosable psychological disorders today? This is an important question for a number of reasons. First, this kind of information is essential for planning mental health services. How Before we can discuss the extent of mental disorders in society, we must clarify how psychological problems are counted. Epidemiology is the study of the distribution of diseases, disorders, or health-related behaviors in a given population. Mental health epidemiology is the study of the distribution of mental disorders. A key component of an epidemiological survey is determining the frequencies of mental disorders. There are several ways of doing this. The term prevalence refers to the number of active cases in a population during any given period of time. Prevalence figures are typically expressed as percentages (i.e., the percentage of the population that has the disorder). There are several different types of prevalence estimates that can be made. Point prevalence refers to the estimated proportion of actual, active cases of the disorder in a given population at any instant in time. For example, if we were to conduct a study and count the number of people who are suffering from major depression (see Chapter 7) on January 1 of next year, this would provide us with a point prevalence estimate of active cases of depression. Anyone who was suffering from depression during November and December but who managed to recover by January 1 would not be included in our point prevalence figure. The same is true of someone whose depression didn’t begin until January 2. If, on the other hand, we wanted to get a I-year prevalence figure, we would count everyone who suffered from depression at any time during the whole year. As you might imagine, this prevalence figure would be higher than the point prevalence figure, because it would cover a much longer time. It would also include people who had recovered before the point prevalence assessment and people whose disorders did not begin until after the point prevalence estimate was made. Finally, we might also wish to get an estimate of how many people had suffered from a particular disorder at any time in their lives (even if they are now recovered). This would provide us with a lifetime prevalence estimate. Because they cover full life spans and include both currently ill people and recovered people who have had the disorder, lifetime prevalence estimates tend to be higher than other kinds of prevalence estimates. The other important term you should be familiar with is incidence. This refers to the number of new cases that occur over a given period of time (typically 1 year). Incidence figures are typically lower than prevalence figures because they exclude already existing cases. In other words, if we were assessing the I-year incidence of schizophrenia, we would not count people whose schizophrenia began before our January 1 starting date (even if they were still ill), because theirs would not be “new” cases of schizophrenia. On the other hand, someone who was quite well previously but who then developed schizophrenia during our I-year window would be included in our incidence estimate. Prevalence Estimates for Mental Disorders Now that you understand some basic terms, let’s look at the I-year prevalence rates for several important disorders. Three major national mental health epidemiology studies, with direct and formal diagnostic assessment of participants, have been carried out in the United States in recent years. One, the Epidemiologic Catchment Area (ECA) study, concentrated on sampling the citizens of five communities: Baltimore, New Haven, St. Louis, Durham (NC), and Los Angeles (Myers et aI., 1984; Regier et aI., 1988; Regier et aI., 1993). Another, the National Comorbidity Survey (NCS), was more extensive. It sampled the entire U.S. population and had a number of improvements as well sophisticated methodological (Kessler et aI., 1994). A replication of the NCS (the NCS-R) has recently been completed (Kessler et aI., 2004; Kessler, Berglund, et aI., 2005; Kessler & Merikangas, 2004). The most current I-year and lifetime prevalence estimates (based on NCS-R survey data) of different types of DSMIV mental disorders are shown in Table 104. The lifetime prevalence of having any DSM-IV disorder is 4604 percent. This means that almost half of the Americans who were questioned had been affected by mental illness at some point in their lives (Kessler, Berglund, et aI., 2005). Although this figure may seem very high, it may well be an underestimate because the NCS studies did not assess for eating disorders (see Chapter 9), schizophrenia, (see Chapter 14), or autism (see Chapter 16) or include measures of most personality disorders (see Chapter 11). As you can see from Table lA, the most prevalent kind of psychological disorders are anxiety disorders. The most common individual disorders are major depression, alcohol abuse, and specific phobias (e.g., fear of small animals, insects, flying, heights, etc.). Social phobias (e.g., fear of public speaking) are also very common (see Table 1.5). Although lifetime rates of mental disorders appear to be quite high, it is important to remember that, in some cases, the duration of the disorder may be relatively brief (e.g., depression that lasts for a few weeks after the :: f–~~-:~ ~ {“”l/”r/ _’ -, , •..• if”A-”~ ••• – ~ • r ~ .;’ Prevalence of DSM:-IV Disorders,,”‘! . ~~.~.d~lts:” ” :,. .’.’ One-Year (%) Any mood disorder Any anxiety disorder Any substance-abuse Any disorder 9.5 18.1 r’ , Lifetime (%) 20.8 28.8 14.6 4604 disorder 3.8 26.2 Disorder Major depressive disorder Alcohol abuse Specific phobia Social phobia Conduct disorder One-Year Prevalence (%) 6.7 3.1 8.7 6.8 1.0 Lifetime Prevalence (%) 16.6 13.2 12.5 12.1 9.5 breakup of a romantic relationship). Also, many people who meet criteria for a given disorder will not be seriously affected by it. For example, in the NCS-R study, almost half (48 percent) of the people diagnosed with a specific phobia had disorders that were rated as mild in severity, and only 22 percent of phobias were regarded as severe Disorders do not always Occur in isolation. A person (Kessler, Chiu, et aI., 2005). who abuses alcohol may Meeting diagnostic criteria also be depressed or have for a particular disorder and an anxiety disorder. being seriously impaired by it are not always the same thing. A final finding from the NCS-R study was the widespread occurrence of comorbidity among diagnosed disorders (Kessler, Chiu, et aI., 2005). Comorbidity is the term used to describe the presence of two or more disorders in the same person. Comorbidity seems to be especially high in people who have severe forms of mental disorders. In the NCS-R study, half of the people with a disorder that was rated as serious on a scale of severity (mild, moderate, serious) also had two or more additional disorders (for example, a person who drinks excessively may also be depressed and have an anxiety disorder). In contrast, only 7 percent of the people who had a mild form of a disorder also had two or more other diagnosable conditions. What this tells us is that comorbidity is much more likely to occur in people who have the most serious forms of mental disorders. When the condition is mild, comorbidity is the exception and not the rule. health facility or mental health practitioner, but the patient does ~ot have. to be admitted to the hospital or stay there overnIght. PatIents may attend a community mental health center, see .aprivate therapist, or receive treatment through the outpatlent department of a hospital. . Hospitalization and inpatient care are the preferred optIOns for people who need more intensive treatment than can be provided on an outpatient basis. Various surveys indicate that admission to mental hospitals has decreased substantially over the past 45 years. The development of medications that control the symptoms of the most severe disorders is one reason for this change. Budget cuts have ~lso forced many large state or county facilities to clos~. Patlents who need inpatient care are now typically admItted to the psychiatric units of general hospitals (Nara.I.,1993) or to private psychiatric hospitals that speCIalIze III mental disorders (Kiesler & Simpkins, 1993). Because of their high cost, stays in private inpatient facilities now tend to be much shorter than they were in the past, with patients receiving additional treatment on an outpatient basis. This trend away from the use of traditional hospitalization, a trend often referred to as “deinstitutionalization,” will be discussed more extensively in Chapters 2 and 18. r?~et Not all people with psychological disorders receive treatment. In some cases, people deny or minimize their problems. Others try to cope on their own with their problems and may manage to recover without ever seeing a mental health professional. Even when they recognize that they have a problem, it is typical for people to wait a long time before they decide to seek help. Half of the people who suffer from depression delay seeking treatment for more than 6-8 years. For anxiety disorders, the delay ranges from 9 to 23 years (Wang, Berglund, et aI., 2005)! When people with mental disorders do seek help, they are often treated by their family physician rather than a mental health specialist (Wang, Lane, et aI., 2005). It is also the case that the vast majority of mental health treatment is now done on an outpatient (as opposed to an inpatient) basis (Narrow et aI., 1993; O’Donnell et aI., 2000). Outpatient treatment requires that patients visit a mental In many clinical settings, diagnosis and assessment may involve a number of participants who play differing roles in the process and who gather data germane to a comprehensive evaluation of the patient’s (or client’s) situation. These professionals gather information from several perspectives and sources. The latter may include family members, friends, school officials (if the client is a child or adolescent), and any mental health professionals and social agencies with which the patient may have had contact. All these contributors then meet to process and integrate all the available information, arrive at a consensus diagnosis, and plan the initial phase of treatment. The World Around Us 1.4 briefly summarizes the training and professional identities of the mental health personnel likely to be found on such treatment teams. In ReVIew ~ What is epidemiology? ~ What is the difference between prevalence and incidence? ~ ~ What are the most common mental disorders? How is illness severity associated comorbidity? with 1.4 PSYCHIATRIC CLINICAL PSYCHOLOGIST NURSE R.N. certification plus specialized trainclients. Nurses nursing. therapy plus hand- Ph.D. in psychology, with both One-year internhospital or mental health center. Or, degree with more cliniin a ing in the care and treatment of psychiatric research and clinical skill specialization. ship in a psychiatric Psy.D. in psychology (a professional cal than research specialization) clinical psychologists like psychiatrists, COUNSELING can attain M.A. and Ph.D. in psychiatric OCCUPATIONAL THERAPIST B.S. in occupational plus t-year internship internship resources. training with physically or psychologically psychiatric hospital or mental health center. In some states, with additional training are permitted, to patients. plus internproblems to prescribe medications icapped individuals, helping them make the most of their PASTORAL COUNSELOR Ministerial background plus training PSYCHOLOGIST Ph.D. in psychology deals with adjustment in psychology. Internship chaplain. in mental health facility as a ship in a marital- or student-counseling counseling psychologist not involving severe mental disorder. SCHOOL PSYCHOLOGIST setting; normally, a Paraprofessional COMMUNITY MENTAL HEALTH WORKER Ideally, a person having doctoral psychology, with additional train- Person with limited direc- training in child-clinical professional training who works under professional ing and experience in academic and learning problems. At present, many school systems lack the resources to maintain an adequate school psychology PSYCHIATRIST tion; usually involved in crisis intervention. ALCOHOL- OR DRUG-ABUSE COUNSELOR program. (usually 3 Limited professional and management of training but trained in the evaluation M.D. with residency training alcohol- and drug-abuse problems. years) in a psychiatric PSYCHOANALYST hospital or mental health facility. In both mental health clinics and hospitals, personnel a from several fields may function as an interdisciplinary team-for psychiatric example, a psychiatrist, a clinical psychologist, nurse, and an occusocial worker, a psychiatric may work together. M.D. or Ph.D. plus intensive training in the theory and practice of psychoanalysis. CLINICAL SOCIAL WORKER M.S.W. or Ph.D. with specialized pational therapist clinical training in mental health settings. RESEARCH ApPROACHES IN ABNORMAL PSYCHOLOGY As is apparent from the NCS- R study, the lives oflarge numbers of people are affected by mental disorders. To learn all that we can about these conditions, we need research. Through research we can study the nature of disorderswhat their symptoms are, how acute (short in duration) or chronic (more long-lasting) they are, what kinds of deficits they are associated with, and so forth. Research also helps us understand the etiology (or causes) of disorders. Finally, we need research so that we can provide the best care for the patients who come to us for help. All of the authors of this book are practicing clinicians. As such, we turn to the research literature to help us provide the most effective and up-to-date care for the patients we see. Students new to the field of abnormal psychology often assume that all the answers we need can come solely from studying individual cases. But when we study individual cases and make inferences from them, we are likely to have errors in our thinking. One such error is that we often attend only to data that confirm our view of how things are. For example, Dr. Smart might believe that drinking milk causes schizophrenia. When we ask Dr. Smart why he holds this view, he might say it is because every patient he has ever treated who has schizophrenia has drunk milk at some time in his or her life. Given that Dr. Smart has treated a lot of patients with schizophrenia and clearly has a great deal of experience with the disorder, we might be persuaded that he is right. Then along comes Dr. Notsofast. Dr. Notsofast decides to conduct a research study. He studies two groups of people. One group has schizophrenia. The other group does not have schizophrenia. Dr. Notsofast asks all of them about their milkdrinking habits. He finds that everyone has drunk milk at some point in his or her life and that there are no differences between the two groups. As this simple example illustrates, research prevents us from being misled by natural errors in thinking. In short, research protects investigators from their own biases in perception and inference (Raulin & Lilienfeld, 1999). Not all research is done in a laboratory. Abnormal psychology research can be conducted in clinics, hospitals, schools, prisons, and even highly unstructured situations such as with the homeless on the streets. It is not the setting that determines whether research can be done. As Kazdin aptly points out (1998c, p. x), “methodology is not merely a compilation of practices and procedures. Rather it is an approach toward problem solving, thinking, and acquiring knowledge.” As such, research methodology is constantly evolving. As new techniques become available (for example, brain-imaging techniques and new statistical procedures), methodology evolves. In the sections that follow, we introduce some fundamental research concepts so that you can start to think like a clinical scientist. To further help you, we sometimes use a Research Close-Up highlight to draw your attention to some key terms that are important to know and understand. Sources of Information As humans, we typically pay a lot of attention to the people around us. If you were asked to describe your best friend, your father, or even the professor teaching your abnormal psychology class, you would undoubtedly have plenty to say. As in virtually all other sciences, the foundation of psychological knowledge comes from observation. Indeed, much early knowledge about a wide range of psychopathological disorders came from case studies in which specific individuals were described in great detail. Astute clinicians such as the German psychiatrist Emil Kraepelin (1856-1926) and the Swiss psychiatrist Eugen Bleuler (1857-1939) provided us with detailed accounts of Abnormol psychology research can be conducted in a variety of settings outside the research laboratory, including clinics, hospitals, schools, or, as shown in this photo, prisons. patients whom a modern-day reader would easily recognize as suffering from disorders such as schizophrenia and manic depression. Alois Alzheimer (1864-1915) described a patient with an unusual clinical picture that subsequently became known as Alzheimer’s disease (see Chapter 15). Sigmund Freud (1856-1939), the founder of psychoanalysis, published many interesting clinical cases describing what we now recognize as phobia (the case of “Little Hans”) and obsessive-compulsive disorder (“the Rat Man”). Such cases make for interesting reading, even today. Much can be learned when skilled clinicians use the case study method, and case studies are a wonderful source of research ideas. But the information acquired is often relevant only to the individual being described and may be flawed, especially if we seek to apply it to other cases involving an apparently similar abnormality. When there is only one observer and one subject, and when the observations are made in a relatively uncontrolled context and are anecdotal and impressionistic in nature, the conclusions we can draw are very narrow and may be mistaken. If we wish to study behavior in a more rigorous manner, how do we go about doing it? Much depends on what we want to know. For example, if we are studying aggressive children, we might wish to have trained observers count how many times children who are classified as being aggressive hit, bite, push, punch, or kick other children they play with. This would involve direct observation of the children’s behavior. But there are also other behaviors we can study. For example, we might collect information about biological variables (such as heart rate) in our sample of aggressive children. Alternatively, we could collect information about stress hormones, such as cortisol, by asking them to spit into a plastic container (saliva contains cortisol) and then sending the saliva sample to the lab for analysis. This too is a form of observational data; it tells us something that we want to know using a variable that is relevant to our interests. In addition to observing people’s behavior directly, researchers can also collect self-report data from the research participants themselves. We could, for example, collect information from the children by asking them to fill out age-appropriate questionnaires. Or we could interview them and ask them how many friends they have. In other words, we can ask our research participants to report on their subjective experiences. Although this might seem like a good way to get information, it is not without its limitations. Self-report data can sometimes be misleading. One child might say that he has 20 “best friends” and yet, when we observe him, he may always be playing alone. Another child might say she has only one best friend and yet is always surrounded by peers who are soliciting her attention. Because people sometimes deliberately lie, misinterpret the question, or want to present themselves in a particularly favorable (or unfavorable) light, self-report data, although valuable and widely used in abnormal psychology research, cannot always be Pulsed-magnetic field Observing behavior really means studying what people (e.g., healthy people, depressed people, anxious people, people with schizophrenia) do and what they do not do. We may study social behavior in a sample of depressed patients by getting trained observers to rate how often they smile or make eye contact, or we may ask the patients themselves to fill out self-report questionnaires that assess social skills. If we think that sociability in depressed patients might be related to (or correlated with) how depressed they are, we might also ask patients to complete self-report measures designed to assess the severity of depression, and we might even measure levels of certain substances in patients’ blood, urine, or cerebrospinal fluid (the clear fluid that bathes the brain and that can be obtained by performing a lumbar puncture; see Chapter 14). We could possibly even study our depressed patients’ brains directly via brain-imaging approaches. All of these sources of information provide us with potentially valuable data that are the basis of scientific inquiry. Forming Hypotheses about Behavior To make sense of behavior, researchers generate hypotheses. Hypotheses are efforts to explain, predict, or explore something-in this case, behavior. What distinguishes scientific hypotheses from the speculation we all experience in response to the question “Why?”? The difference is that scientists attempt to test their hypotheses. In other words, they try to design research studies that will help them get closer to a full understanding of how and why things happen. Anecdotal accounts such as case studies can be very valuable in helping us develop hypotheses, although case studies are not well suited for testing them. Other sources of hypotheses are unusual or unexpected research findings. For example, earlier you learned that although men generally have lower rates of depression than women, this is not the case for Jewish men. This is clearly an observation in search of an explanation. Why should Jewish men be more at risk for depression than non-Jewish men? One hypothesis is that there may be an interesting (and inverse) relationship between depression and alcohol use (Levav et al., 1997). Jewish men have lower rates of alcohol abuse and alcohol dependence than do non-Jewish men. Consistent with this idea, a study of members of Orthodox synagogues in London found no alcoholism and similar rates of depression in females and males (i.e., a 1:1 gender ratio instead of the typical 2:1 ratio; Loewenthal et al., 1995). Although much more remains to be learned, the hypothesis that the higher rates of depression in Jewish men may have something to do with their lower rates of alcohol abuse appears to have some value for further study (see Loewenthal et al., 2003). Hypotheses are also important because they frequently determine the therapeutic approaches used to treat a particular clinical problem. For example, suppose we are confronted with someone who washes his or her hands 60 to 100 times a day, causing serious injury to the Researchers use technology, such as transcranial magnetic stimulation (TMS), to study how the brain works. This TMS technique generates a magnetic field on the surface of the head, through which underlying brain tissue is stimulated. Researchers can evaluate and measure behavioral consequences of this noninvasive and painless brain stimulation. regarded as highly accurate and truthful. This is something that anyone who has ever answered a personal ad knows only too well! Technology has advanced, and we are now developing ways to study behaviors, moods, and cognitions that have long been considered inaccessible. For example, as illustrated in Figure 1.1, we can now use brain-imaging techniques to study people’s brains at work. We can study blood flow to various parts of the brain during memory tasks. We can look at which brain areas influence imagination. With techniques such as transcranial magnetic stimulation (TMS), which generates a magnetic field on the surface of the head, we can stimulate underlying brain tissue (for an overview, see Fitzgerald et aI., 2002). This can be done painlessly and noninvasively while the person receiving the TMS sits in an armchair. Using TMS, we can even take a particular area of the brain “off-line” for a few seconds and measure the behavioral consequences. In short, we can collect behavioral data that would have been impossible to obtain even a few years ago. Essentially, when we talk about observing behavior, we mean much more than simply watching people. Although men generally have lower rates of depression than women, the rate of depression for Jewish men and women is equal. Why would this be so? A correlation between higher rates of depression and lower rates of alcohol abuse in Jewish men provides interesting ground for further study. skin and underlying tissues (this is an example of obsessive-compulsive disorder). If we believe that this behavior is a result of subtle problems in certain neural circuits, we might try to identify which circuits are dysfunctional in the hope of eventually finding a way to correct them (probably by medication). On the other hand, if we view the excessive hand washing as reflecting a symbolic cleansing of sinful and unacceptable thoughts, we might try to unearth and address the sources of the person’s excessive concern with morals and scruples. Finally, if we regard the hand washing as merely the product of unfortunate conditioning or learning, we might devise a means to extinguish the problematic behavior. In other words, our working hypotheses about the causes of different disorders very much shape what kinds of approaches we adopt both when we study disorders and when we try to treat them. Sampling and Generalization As we have already noted, single-case studies can be very valuable because they help us to generate ideas and working hypotheses. But although we can occasionally get important leads from the intensive observation of a single case, such a strategy rarely yields enough information to allow us to reach firm conclusions. Research in abnormal psychology is concerned with gaining enhanced understanding and, where possible, control of abnormal behavior (that is, the ability to alter it in predictable ways). Ed may accost women in supermarkets and try to lick their feet because his mother always gave him attention when, as a child, he tried on her shoes. But George may engage in the same behavior for an entirely different reason. We need to study a larger group of people with the same problem in order to discover which of our observations or hypotheses have scientific credibility. The more people we study, the more confident we can be about our findings. Whom should we include in our research study? In general we want to study groups of individuals who have similar abnormalities of behavior. If we wanted to study people with major depression, for example, a first step would be to determine criteria such as those provided in DSM-IV- TR for identifying people affected with this clinical disorder. We would then need to find people who fit our criteria. Ideally, we would study everyone in the world who met our criteria, because these people constitute our population of interest. This, of course, is impossible to do, so instead we would try to get a representative sample of people who are drawn from this underlying population. To do this, we would use a technique called sampling. What this means is that we would try to select people who are representative of the much larger group of individuals having major depressive disorders. Ideally, we would like our smaller sample (our study group) to mirror the larger group (the underlying population) in all important ways (e.g., in severity and duration of disorder and in demographics such as age, gender, and marital status). If we could do everything perfectly, our research sample would be randomly selected from the larger population of people with depression, which is tantamount to ensuring that every person in that population would have an equal chance of being included in our study. Such a procedure would automatically adjust for potential biases in sample selection. In practice, however, this does not happen, and researchers must simply do the best they can given real-world constraints (which include the fact that some people just don’t want to be in a research study!). From a research perspective, the more representative our sample is, the better able we are to generalize, to the larger group, the findings derived from our work with the sample. A sample that involves depressed men and women of all ages, income groups, and education levels is more representative of the underlying population of depressed people than is a sample of depressed kindergarten teachers who are all female, unmarried, and aged 23-25. In addition, when we study a group of people who have something important in common (e.g., depression), we can then infer that anything else they turn out to have in common, such as a family history of depression or low levels of certain neurotransmitters, may be related to the behavioral disorder itself. Of course, this assumes that the characteristic in question is not widely shared by people who do not have the abnormality. Criterion and Comparison Groups To explain the idea of criterion and comparison groups let’s go back to our example about schizophrenia and milk. Dr. Smart’s hypothesis was that milk drinking causes schizophrenia. However, when a group of patients with schizophrenia (the criterion group, or group of interest) was compared with a group of patients who did not have schizophrenia (the comparison group), it was clear that there were no differences in milk drinking between the two groups. To test their hypotheses, researchers use a comparison group (sometimes called a control group). This is a group of people who do not exhibit the disorder being studied but who are comparable in all other major respects to the criterion group (i.e., people with the disorder). By”comparable” we might mean that the two groups are similar in age, number of males and females in each group, education level, and similar demographic kinds of variables. Typically, the comparison group is psychologically healthy, or “normal,” according to certain specified criteria. We can then compare the two groups on the variables we are interested in. Using the controlled research approaches we have just described, researchers have discovered many things about large numbers of psychological disorders. We can also use extensions of this kind of approach not only to compare one group of patients with healthy controls, but also to compare groups of patients who have different disorders. For example, Cutting and Murphy (1990) studied how well (1) patients with schizophrenia, (2) patients with depression or mania, and (3) healthy controls did on a test of social knowledge. This involved a series of multiple-choice questions that presented a social problem (e.g., “How would you tell a friend politely that he had stayed too long?”). Answer choices included responses such as, “There’s no more coffee left” and “You’d better go. I’m fed up with you staying too long.” (In case you are wondering, both of these are incorrect choices; the preferred answer for this example was, “Excuse me. I’ve got an appointment with a friend.”) Consistent with the literature showing social deficits associated with schizophrenia, the patients with schizophrenia did worse on this test than the healthy controls and the depressed/manic patients. The finding that the patients with schizophrenia did worse than the depressed/manic patients also allowed the researchers to rule out the possibility that simply being a psychiatric patient is linked to poor social knowledge. Studying the World as It Is: Observational Research Designs A major goal of researchers in abnormal psychology is to learn about the causes of different disorders. But for obvious ethical and practical reasons, we often cannot do this directly. Perhaps we want to know what causes depression. We may hypothesize that factors such as stress or losing a parent early in life might contribute to the development of depression. Most certainly, however, we cannot create such situations and then see what happens! Instead, the researcher uses what is known as an observational or cor- relational research design. Unlike a true experimental design (described below), observational research does not involve any manipulation of variables. Instead, the researcher selects groups of interest (people who have recently been exposed to a great deal of stress or people who lost a parent when they were growing up) and then compares the groups on a variety of different characteristics (including, in this example, measures of depression). Any time we study differences between people who have a particular disorder and people who do not (i.e., whenever we have a comparison group of some kind), we are using this kind of observational or correlational research design. Essentially, we are capitalizing on the fact that the world works in ways to create natural groupings of people (people with specific disorders, people who have had traumatic experiences, people who win lotteries, etc.) whom we can then study. Using these kinds of research designs, we can then identify factors that seem to go along with being depressed, having alcohol problems, binge eating, and the like (for a more comprehensive description of this kind of research approach, see Kazdin, 1998c). But mere correlation, or association, between two or more variables can never by itself be taken as evidence of causation-that is, a relationship in which one of the associated variables (e.g., stress) causes the other (e.g., depression). This is an important caveat to bear in mind. Many studies in abnormal psychology show that two (or more) things regularly occur together, such as poverty and retarded intellectual development, or depression and reported prior stressors. For example, even as late as the 1940s, it was thought that masturbation caused insanity. As we discuss in Chapter 13, this hypothesis no doubt arose from the fact that historically, patients in mental asylums could often be seen masturbating in full view of others. Of course, we now know that masturbation and insanity were correlated not because masturbation caused insanity but because sane people are much more likely to masturbate in private than in public. In other words, the key factor was one of social awareness. Even though correlational studies may not be able to pin down causal relationships, they can be a powerful and rich source of inference. They often suggest causal hypotheses and occasionally provide crucial data that confirm or refute these hypotheses. Much of what we know about mental disorders comes from correlational studies. The fact that we cannot manipulate many of the variables we study does not mean that we cannot find out a great deal. Retrospective versus Prospective Strategies Observational research designs can be used to study different groups of patients as they are now (that is, concurrently). For example, if we used brain imaging to look at the size of certain brain structures in patients with schizophrenia and in healthy controls, we would be using this type of approach. But if we wanted to try to learn what our patients were like before they developed a specific mental disorder like schizophrenia, we might adopt a retrospective research approach. In other words, we would try to collect information about how the patients behaved early in their lives in the hope of identifying factors that might have been associated with what went wrong later. In some cases, our source material might be limited to patients’ recollections or the recollections of family members, or material from diaries or other records. A challenge with this kind of research design is that memories can be both faulty and selective. There are certain difficulties in attempting to reconstruct the pasts of people already experiencing a disorder. Apart from the fact that a person who is currently suffering from a mental disorder may not be the most accurate or objective source of information, such a strategy invites investigators to discover what they already expect to discover about the background factors theoretically linked to a disorder. For example, reports of a link between early sexual abuse and various forms of psychopathology (e.g., see Chapters 8 and 11) started to emerge in the 1980s. After this, many therapists began to suggest to their patients who had these conditions that perhaps they too had been abused. For some overzealous therapists, the fact that many patients had no memories of any abuse was taken as evidence that the painful memories had simply been “repressed.” In other cases, simply having such common problems as difficulty sleeping or being easily startled was taken as evidence of past abuse. Over time, many patients became as convinced as their therapists that they must have been abused and that this accounted for all their current difficulties and problems. But for many patients, it simply wasn’t true that they had been abused. There are pitfalls in trying to reinterpret a person’s past (or past behavior) in light of his or her present problems. Adherence to good scientific principles is as important in the clinical domain as it is in the research laboratory. Another approach is to use prospective (as opposed to retrospective) strategies. Here the idea is to identify individuals who have a higher-than-average likelihood of becoming psychologically disordered and to focus on them before the disorder develops. We can have much more confidence in our hypotheses about the causes of a disorder if we have been tracking various influences and measuring them ahead of time. When our hypotheses correctly predict the behavior that a group of individuals will develop, we are much closer to establishing a causal relationship. In a typical instance, children who share a risk factor known to be associated with relatively high rates of subsequent breakdown (such as having been born to a mother with schizophrenia) are studied over the course of many years. Those who do break down are compared with those who do not in the hope that important differentiating factors will be discovered. Manipulating Variables: The Experimental Method in Abnormal Psychology Correlational research takes things as they are and determines covariations among observed phenomena. Do things vary together in a direct, corresponding manner (known as a positive correlation-see Figure 1.2) such as in the case of female gender and increased risk of depression? Or is there an inverse correlation, or negative correlation, between our variables of interest (such as high socioeconomic status and generally less risk of mental disorder)? Or are the variables in question entirely independent of one another, or uncorrelated, such that a given state or level of one variable fails to predict reliably anything about that of another, as in our earlier example of milk and schizophrenia? Even when we find strong positive or negative associations between variables, however, correlational research does not allow us to conclude anything about directionality (i.e., does variable A cause B, or does B cause A?). However, correlational studies often provide crucial information that cannot be obtained in any other way and that might suggest certain causal influences. Scientific research is most rigorous, however, and its findings most compelling and reliable, when it employs the full power of the experimental method. In such cases, scientists control all factors except one-one that could have an effect on a variable or outcome of interest; then they actively manipulate that one factor. This factor is referred to as the independent variable. If the outcome of interest, called the dependent variable, is observed to change as the manipulated factor is changed, that variable can be regarded as a cause of the outcome (see Figure 1.3 on p. 22). For example, if a proposed treatment is provided to a given group of patients but withheld from an otherwise completely comparable one (giving or not giving the treatment is the experimental manipulation), and if the former group experiences positive changes significantly in excess of those experienced by the latter group, then a causal inference can be made regarding the treatment’s efficacy. Studying the Efficacy of Therapy Used in the context of treatment research, the experimental method has proved indispensable. It is a relatively simple and straightforward matter to set up a study in which a proposed treatment is given to a designated group of patients and withheld from a similar group of patients. Should the treated group show significantly more improvement than the untreated group, we can have confidence in the treatment’s efficacy. We may not, however, know why the treatment works, although investigators are becoming increasingly sophisticated in fine-tuning their experiments to tease out the mechanisms through which • • • • • • • • • • • • • • • • • • • • • • • • r= r=+1.00 r = -1.00 a “‘” //. –……\ , • I •I / I. I \ ,. …. _-.”",/ / I \ \. /. –….. , ,._ …•. / .•.. ..’ ., \ \ r = weak positive —’ / 1·/ / I. / -../ .. /. “‘” .\ I ‘-”‘” Scatterplots of data illustrating positive, negative, and no correlation between variables. therapeutic change is induced (e.g., Jacobson et al., 1996; Hollon, DeRubeis, & Evans, 1987; Kazdin & Nock, 2003). In treatment research it is important that the two groups (treated and untreated) be as comparable as possible except for the presence or absence of the proposed active treatment. To facilitate this, patients are typically randomly assigned to the treatment condition or the notreatment condition. Once a treatment has been established as effective, it can then be provided for members of the original control (untreated) group, leading to improved functioning for everyone. Sometimes, however, this “waiting list” control group strategy is deemed inadvisable for ethical or other reasons. For example, withholding a treatment that has already been established as beneficial just to evaluate some new type of treatment may deprive control subjects of valuable clinical help for longer than would be considered ethical. For this reason, there need to be stringent safeguards regarding the potential costs versus benefits of conducting the particular research project. In some cases, an alternative research design may be called for, in which two (or more) treatments are compared in different equivalent groups. This type of study is called a standard treatment comparison study. Typically, the efficacy of the treatment that is used as the control condition has already been established, so patients who are assigned to this condition are not disadvantaged. The issue then is whether patients who get the new treatment do even better than those getting the control (established) treatment. Such comparative-outcome research has much to recommend it and is being increasingly employed (Barlow & Kazdin, 1998; Kendall et al., 2004). Single-Case Experimental Designs Does experimental research always involve testing hypotheses by manipulating variables across groups? The simple answer is no. We have already noted the importance of case studies as a source of ideas and hypotheses. In addition, case studies can be used to develop and test therapy techniques within a scientific framework. Such approaches are called single-case research designs (Hayes, 1998; Kazdin, 1998b, 1998c). A central feature of these designs is that the same subject is -, _…I I I FIGURE 1.3 Compare responses between two groups Observational and Experimental Research Designs (A) In observational research, data are collected from two different samples or groups and then compared. (8) In experimental research, participants are assessed at baseline and then randomly assigned to different groups (e.g., a treatment and a control condition). After the experiment or treatment is completed, data collected from the two different groups are then compared. (Adapted from Petrie and Sabin, 2000.) r– I I Random assignment Administer treatment Compare responses between two groups Random assignment studied over time. Behavior or performance at one point in time can then be compared to behavior or performance at a later time, after a specific intervention or treatment has been introduced. One of the most basic experimental designs in singlecase research is called the ABAB design. The different letters refer to different phases of the intervention. The first A phase serves as a baseline condition. Here we simply collect data on or from the subject. Then, in the first B phase, we introduce our treatment. Perhaps the subject’s behavior changes in some way. But even if there is a change, we are not justified in concluding that it was the introduction of our treatment that caused the change in the subject’s behavior. Something else could have happened that coincided with our introducing the treatment, so any association between the treatment and the behavior change might be spurious. The way we can establish whether it really was what we did in the first B phase that was important is to withdraw the treatment and see what happens. This is the reasoning behind the second A phase (i.e., at the ABA point). Then, to demonstrate that we can again get the behavior to change back to how it was in the first B phase, we reintroduce our treatment and observe what happens. To illustrate this, let’s consider the case of Kris (see Rapp et aI., 2000). f_1 Kris Kriswas a 19-year-old female who was severely retarded. Since the age of 3 she had pulled her hair out. This disorder is called trichotillomania (pronounced tricko-tillomania). Kris’s hair pulling was so severe that she had a bald area on her scalp that was about 2.5 in. in diameter. The researchers used an ABAB experimental design (see Figure 1.4) to test a treatment for reducing Kris’s hair pulling. In each phase, they used a video camera to observe Kris while she was alone in her room watching TV.During the baseline phase (phase A), observers mea- Phase A Baseline B A B 2.5 lb Base- 2.5 lb weights line weights ‘iij .c c ; till a- 100 Hair manipulation 80 ~ :; Q. ‘c ~ E ell 60 j An ABAB Experimental Design: Kris’s Treatment \; ; 0 E 40 … C ell aell ell till ~ 20 c.. 0 20 Treatment sessions In the A phase baseline data are collected. In the B phase a treatment is introduced. This treatment is then withdrawn (second A phase) and then reinstated (second B phase). In this example, hair manipulation declines with use of wrist weights, goes back to pretreatment (baseline) levels when they are withdrawn, and declines again when they are reintroduced. (Data adapted from Rapp et al., 2000.) sured the percentage of time that Kris either touched or manipulated her hair (42.5 percent of the time) and how much hair pulling she did (7.6 percent of the time). In the treatment phase (B), a 2.5·lb weight was put around Kris’s wrist when she settled down to watch TV.When she was wearing the wrist weight, Kris’s hair manipulation and hair pulling went down to zero. This, of course, sug· gested that Kris’s behavior had changed because she was wearing a weight on her wrist. To verify this, the wrist weight was withdrawn in the second A phase (i.e., ABA). Kris immediately started to touch and manipulate her hair again (55.9 percent). She also showed an increase in hair pulling (4 percent of the time). When the wrist weight was reintroduced in the second B phase (ABAB), Kris’s hair manipulation and hair pulling once again decreased, at least for a while. Although additional treatments were necessary (see Rapp et aI., 2000), Kris’s hair pulling was eventually totally eliminated. Most important for our purposes, the ABAB design allowed the researchers to explore systematically the treatment approaches that might be beneficial for patients with trichotillomania, using experimental techniques and methods. ings from animal studies will apply (that is, can be generalized) to humans. Experiments of this kind are generally known as analogue studies (in which we study not the real thing but some approximation to it). Analogue studies can also involve humans (for example, when we try to study depression by studying normal individuals whom we have made mildly and transiently sad using one technique or another). One current model of depression, called “hopelessness depression” (see Chapter 7), has its roots in some early research that was done with animals (Seligman, 1975). Laboratory experiments with dogs had demonstrated that, Yet another way in which we can use the experimental method is to conduct research with animals. Although ethical considerations are still important in animal research, we can perform studies using animal subjects (e.g., giving them experimental drugs, implanting electrodes to record brain activity, etc.) that it would not be possible to do with humans. Of course, one major assumption is that the find- Animal research allows behavioral scientists to manipulate and study behavior under controlled conditions that would not be possible to replicate using humans as subjects. However, results of this research may not hold up when extended to humans outside the laboratory in a “real-world” setting. when subjected to repeated experiences of painful, unpredictable, and inescapable electric shock, the dogs lost their ability to learn a simple escape response to avoid further shock in a different situation later on. They just sat and endured the pain. This observation led Seligman and his colleagues to argue that human depression (which he believed was analogous to the reaction of the helpless dogs) is a reaction to the experience of uncontrollable stressful events where one’s behavior has no effect on one’s environment, leading him or her to become helpless, passive, and depressed. In other words, the findings from these animal studies provided the impetus for what first became known as “the learned helplessness theory of depression” (Abramson, Seligman, & Teasdale, 1978; Seligman, 1975) and is now called “the hopelessness theory of depression” (Abramson et aI., 1989). These theories of depression are not without their own problems, but it is important to remain aware of the broader issue: Although problems can arise when we generalize too readily from animal to human models of psychopathology, the learned helplessness analogy has generated much research and has helped us refine and develop our ideas about depression. As we have already mentioned, all the authors of this book are both researchers and practicing clinicians with differing research backgrounds and preferred treatment strategies. One of our main purposes with this book is to educate you in an approach to abnormal behavior that is respectful both of scientific principles and of patients and clients who suffer from psychopathological conditions. At a more specific level, we hope to provide you with a thoughtful examination of abnormal behavior and its place in contemporary society. We will focus on all the major types of mental disorders and acquaint you with the current state of scientific knowledge for each. Because we wish never to lose sight of the person, however, we also provide as much case material as we can in each chapter. Behind each disorder, and in each scientific study, there are people first-people who have much in common with all of us. Throughout this text we assume that a sound and comprehensive study of abnormal behavior should be based on the following principles: 1. A SCIENTIFIC APPROACH TO ABNORMAL BEHAVIOR. Any comprehensive view of human behavior must draw on concepts and research findings from a variety of scientific fields. Of particular relevance are genetics, neuroanatomy, neurochemistry, sociology, anthropology, and, of course, psychology. Because we believe an understanding of the scientific approach to acquiring knowledge in abnormal psychology rests on an understanding of research principles, we hope this book will help you develop your ability to think like a research scientist. It is our belief that the benefits of acquiring such skills will persist long after your course in abnormal psychology has ended and will make it possible for you to understand and have a sophisticated appreciation of the research the field generates in the future. 2. OPENNESS TO NEW IDEAS. Science is progressive and cumulative. Knowledge builds upon knowledge. But science is also creative. And as scientists, we owe it to ourselves and to the field to be willing to consider new ideas-even if they contradict our favorite theories. This does not mean that we should ever blindly accept something just because it is different and new. But we believe that if something that is different and new is supported by credible scientific data, all of us should be willing to consider developing a fresh perspective. Scientists who are closed-minded and dogmatic are not true scientists at all. 3. RESPECT FOR THE DIGNITY, INTEGRITY, AND GROWTH POTENTIAL OF ALL PERSONS. In attempting to provide a broad perspective on abnormal behavior, we will focus not only on how maladaptive patterns are perceived by clinical psychologists and other mental health personnel, but also on how such disorders are perceived by those experiencing them, as well as by their families and friends. Historically, many of the disorders described in this book were conceptualized in In ReVIew ~ ~ How is experimental research different from observational (correlational) research? Explain what an ABAB design is. Why are such designs helpful to clinicians and researchers? If two variables are correlated, does this mean that one variable causes the other? If so, why? If not, why not? ~ THE Focus OF THIS BOOK To provide consistency, when we discuss disorders we will try to focus on three significant aspects: (1) the clinical picture, in which we will describe what is going on with the disorder; (2) the possible causal factors; and (3) treatments. In each case, we will examine the evidence for biological, psychosocial (i.e., psychological and interpersonal), and sociocultural (the broader social environment of culture and subculture) influences. In short, we will strive to give you a sophisticated appreciation of the total context in which abnormalities of behavior occur. extremely pessimistic terms. This is not an attitude we share. As our understanding of abnormal psychology grows, we become better able to help patients previously considered to be hopeless cases. New developments will only provide us with more of what we need to help our patients. In short, we are optimistic about the current state of the field and about what the future holds. In ReVIew ~ Why do we need a research-based approach in order to learn about psychopathology? Are We All Becoming Mentally Ill? The Expanding Horizons of Mental Disorder CJ3 ing committee ecause the concept of mental disorder, as we have seen, lacks a truly objective means of settling on its limits, and because it is in the economic and other interests of mental health professionals to designate larger and larger tiona I diagnoses beyond those that appeared in the previous stringent criteria for incluthis promises to be an uphill battle. Menlike the members of other of phenomena related to their own of ser- edition (DSM-III-R) by adopting sion. Nevertheless, professions, expertise. tal health professionals, enhances the importance is a prerequisite vices rendered. tend to view the world through a lens that of a disorder in the DSM reimbursement segments of human behavior as within the purview of “mentally disordered,” there is constant pressure to include in the behavior. in the DSM more and more kinds of socially undesirable at other drivers) as a newly discovered And, of course, inclusion for health insurers’ For example, one proposal was to include “road rage” (anger mental disorder DSM-IV (Sharkey, 1997). However, anger at other drivers is so common that almost all of us would be at risk of being diagnosed with this new disorder if it had been added to the DSM. There is considerable responsible informal evidence that the steerof DSM-IV profor the production It is thus in the interests of the public at large to keep a wary eye on proposed expansions eventually lead to a situation of the “mentally disordered” domain. It is conceivable that failure to do so might where almost anything but the behavior could be as to lose most bland, conformist, declared a manifestation most of its scientifically and conventional of mental disorder. By that point, productive meaning. worked hard to fend off a large number of such frivolous the concept would have become so indiscriminate posals, and in fact they largely succeeded in avoiding addi- ~ Encountering common surprising, of mental instances of abnormal behavior is a ~ Culture appear shapes the presentation to be highly culture-specific. a category clinical of clinical disorders that experience disorder. for all of us. This is not of many forms ~ in some cases. There are also certain disorders given the high prevalence ~ A precise definition something standards, of “abnormality” is still elusive. whether The DSM employs system regarded clinical similar type of classification Disorders are entities, though not all Elements that can be helpful is abnormal maladaptiveness, and unpredictability. ~ Wakefield’s helpful adequate nonetheless notion definition of “harmful of mental in considering to that used in medicine. may be best considered problems, include suffering, of society’s ~ in others, irrationality, as discrete disorders deviancy, violations in this way. the DSM and with causing discomfort Even though provides it is not without to identify product.” us with working problems criteria that help clinicians lives. It is far dysfunction” disorder. definition. It is is a a fully and researchers important from a “finished and study specific However, familiarity step forward but still fails to provide that affect people’s to serious a good working the DSM is essential study in the field. ~ To avoid misconception and error, we must adopt a scientific approach to the study of abnormal behavior. This requires a focus on research and research methods, including an appreciation of the distinction between what is observable and what is hypothetical or inferred. To produce valid results, research must be done on people who are truly representative of the diagnostic groups to which they purportedly belong. Research in abnormal psychology may be observational or experimental. Observational research studies things as they are. Experimental research involves manipulating one variable (the independent variable) and seeing what effect this has on another variable (the dependent variable). ~ Mere correlation between variables does not enable us to conclude that there is a causal relationship between them. Simply put, correlation does not equal causation. Although most experiments involve studies of groups, single-case experimental designs (e.g., ABAB designs) can also be used to make causal inferences in individual cases. Analogue studies (e.g., animal that provide an approximation disorders of interest. Although be a problem, animal research very informative. research) are studies to the human generalizability can in particular has been ~ ~ ~ ~ ABAB design (P. 22) abnormal behavior (P. 11) acute (P. 15) analogue studies (P. 23) case study (P. 16) chronic (P. 15) comorbidity (P. 14) comparison or control group (P. 19) criterion group (P. 19) dependent variable (P. 20) direct observation (P. 16) double-blind study (P. 4) epidemiology (P. 12) experimental research (P. 21) family aggregation (P. 3) incidence (P. 13) independent variable (P. 20) labeling (P. lifetime prevalence (P. 13) negative correlation (P. 20) nomenclature (P. 6) observational research (P. 19) 1-year prevalence (P. 12) placebo (P. 4) point prevalence (P. 12) positive correlation (P. 20) prevalence (P. 12) prospective strategy (P. 20) retrospective strategy (P. 20) sampling (P. 18) self-report data (P. 16) single-case research design (P. 21) stereotyping (P. stigma (P. symptom (P. 9) syndrome (P. 9)