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Clinical Psychology


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Table of Contents

Notes on Contributors xv

Preface xxiii

1 Research Methods 1
Julian A. Rubel and Wolfgang Lutz

Introduction 1

Research on the Frequency, Cause, and Prevention of Psychological Problems, and Disorders 1

Epidemiology 1

Etiology and Analytical Epidemiology 2

Prevention 3

Evaluating Clinical Interventions and Treatments 3

Does the Intervention Work? 4

External Validity 5

Quantifying the Effects of an Intervention 6

Integrating the Results from Multiple Studies-Meta-analyses 7

Is the Intervention Effective for this Specific Patient? 8

How, for Whom, and under which Conditions do Clinical Interventions Work? 10

Summary 12

2 Classification Systems across the Globe 15
Jan Christopher Cwik and Jurgen Margraf

Introduction 15

Classification Systems in Western Cultures 16

Atheoretical Classification Systems 16

The Diagnostic and Statistical Manual of Mental Disorders (DSM) 16

The International Classification of Diseases, Injuries and Causes of Death (ICD) 17

Theory-based Psychoanalytic and Psychodynamic Classification Systems 18

Classification Systems in Non-Western Cultures 19

The Chinese Classification of Mental Disorders (CCMD) 20

Specific Classification Systems 22

Specific categorical classification systems 22

Specific Noncategorical Classification Systems 23

3 Clinical Interviewing with Adults 29
Christopher C. Conway, Michelle L. Bourgeois, and Timothy A. Brown

Introduction 29

Goals of the Clinical Interview 29

Elements of the Clinical Interview 30

Diagnostic Criteria 30

Risk Assessment 32

Behavioral Observation 33

Psychosocial Assessment 34

Interviewing Techniques 35

Reliability and Validity of Interviews 36

Integrating Cultural Context in Interviews 38

Actuarial Judgment 38

Functional Analysis 39

Differential Diagnosis 40

Summary 40

4 Clinical Interviews with Children and Adolescents 43
Eva Charlotte Merten and Silvia Schneider

Introduction 43

Clinical Interviews with Children and Adolescents 45

Implementation of Clinical Interviews 51

Diagnostics with Children Needs Training! 51

Age, Age, Age . . . 52

Interviews with Preschool Children 52

Are Children Reliable Informants? 53

Difficulties in Daily Practice 56

Difficulties on the Patient's Side 56

Difficulties regarding Taxonomy 57

Difficulties on the Diagnostician's Side 57

Everything Perfect? How Often are Structured Interviews used in Clinical Practice? 58

Summary 59

5 Psychological Tests 65
Robert J. Craig

Introduction 65

Principles and Properties of Psychological Tests 66

Types of Psychological Tests 66

Objective Personality Tests 67

The Minnesota Multiphasic Personality Inventory (MMPI/MMPI-2) 67

Millon Clinical Multiaxial Inventory (MCMI-III) 69

The Personality Assessment Inventory 72

The NEO-PI-R 72

Conclusion 73

Projective Clinical Assessment Instruments 73

Rorschach Inkblot Test 73

Thematic Apperception Test (TAT) 73

Other Instruments 74

Computer Test Interpretation 74

Recent Challenges 75

6 A Global Perspective on Neuropsychological Assessment 81
Rachel N. Casas, Matthew Calamia, and Daniel Tranel

Introduction 81

Overlapping Histories: Neuropsychological Assessment 82

Purposes of Neuropsychological Assessment 83

Classification of Behavior and Cognition in Neuropsychological Assessment 85

Emotionality 86

Executive Functions 87

Neuropsychological Assessment: Approaches and Methods 87

Approaches Emphasizing Qualitative Methods 87

Approaches Emphasizing Quantitative Methods 88

Critical Considerations for Neuropsychological Assessment in a Global Society 89

Interpretation of Neuropsychological Assessment Results 91

Feedback and Recommendations 93

Future Directions for Neuropsychological Assessment: A Global Perspective 94

7 Culturally Informed Neuropsychological Assessment 99
Rosemary Toomey

Introduction 99

The Field of Clinical Neuropsychology 99

Clinical Neuropsychology Assessment 100

Intelligence 101

Achievement 103

Attention 103

Memory 103

Language 104

Executive Functioning 104

Visual Spatial 105

Motor Functioning 105

Crosscultural Considerations in Clinical Neuropsychology 105

Are Nonverbal Tests Culture Free? 106

Bilingualism 106

Translating Tests 107

Literacy 107

Norming by Race or Country 108

Acculturation 108

Interaction of Different Subject Characteristics 109

Child Neuropsychology 109

Reading Disorder: A Lens through which to View Crosscultural Issues 109

Research Study 110

Clinical Case Study 111

Background 111

Test Performance 111

Interpretation 112

Diagnosis and Recommendations 112

Summary 112

8 Evidence-Based Treatments: The Debate 119
Thomas H. Ollendick, Peter Muris, and Cecilia A. Essau

Introduction 119

Defining Evidence-Based Treatments 120

Evidence-Based Treatments: The Debate 121

Conclusions 128

9 Childhood and Adolescent Disorders 135
Amie E. Grills and Melissa K. Holt

Neurodevelopmental Disorders 136

Intellectual Disabilities 136

Autism Spectrum Disorder (ASD) 137

Specific Learning Disorder (SLD) 138

Attention-Deficit/Hyperactivity Disorder (ADHD) 138

Communication Disorders 139

Motor Disorders 141

Disruptive, Impulse-Control, and Conduct Disorders 142

Oppositional Defiant Disorder (ODD) 143

Conduct Disorder (CD) 144

Intermittent Explosive Disorder (IED) 144

Summary 145

10 Mood Disorders 153
Ulrich Stangier and Elisabeth A. Arens

Symptomatology and Classification of Mood Disorders 153

Epidemiology 156

Depressive Disorders 156

Bipolar and Related Disorders 157

Assessment 157

Treatment 158

Basic Strategies 158

Behavioral Activation 160

Cognitive Therapy 161

Interpersonal Approaches 162

Psychological Treatments for Recurrent and Persistent Depression 163

Psychological Treatments for Bipolar Disorder 164

Empirical Evidence for the Efficacy of Psychological Treatments in Mood Disorders 165

Conclusions 166

11 Anxiety and Obsessive-Compulsive Related Disorders 173
Kirstyn L. Krause and Martin M. Antony

Treatment of Anxiety and Obsessive-Compulsive Related Disorders 173

Overview of Anxiety and OC-related Disorders 173

Diagnostic Features 173

Epidemiological Features 174

Treatment of Anxiety and OC-Related Disorders 177

Psychoeducation 177

Motivational Enhancement 177

Self-Monitoring 178

Cognitive Strategies 178

Exposure-Based Strategies 179

Relaxation-Based Strategies 180

Mindfulness and Acceptance-Based Strategies 181

Habit Reversal 181

Social-Skills Training 182

Problem-Solving Training 182

Pharmacotherapy 182

Psychological Treatments for Particular Disorders 183

Cultural Considerations in Treatment 184

Summary 185

12 Posttraumatic Stress Disorder 191
Richard A. Bryant

Definition 191

Prevalence of PTSD 193

The Course of PTSD 193

Comorbidity 194

Theoretical Models of PTSD 194

Risk Factors 195

Treating PTSD 197

Early Intervention for PTSD 198

Complex PTSD 199

Conclusions 200

13 Eating Disorders 209
Brunna Tuschen-Caffier and Jennifer Svaldi

Psychopathology of Eating Disorders 209

Classification of Eating Disorders 209

Epidemiology and Comorbidity 211

Physical Symptoms and Risks 212

Differential Diagnosis 212

Assessment 212

Development, First Onset and Maintenance Factors 213

Treatment 215

Cognitive-affective Preparation for Therapy 215

Nutritional Management 217

Improvement in Body Image Disturbances 218

Enhancement of Stress Management including Interpersonal Conflict Management 219

Cognitive Interventions 219

Maintenance of Therapeutic Gains and Prevention of Relapses 220

Efficacy of Cognitive Behavioral Therapy (CBT) 220

14 Sexual Dysfunctions 225
Pedro J. Nobre

Introduction 225

Classification of Sexual Dysfunctions 225

Prevalence of Sexual Dysfunctions 226

Risk Factors for Sexual Dysfunction 227

Sociodemographic, Relationship and Health Risk Factors 227

Psychological Factors and Sexual Dysfunction 228

Trait Factors 228

Psychological Processing Factors 229

Psychological Models of Sexual Dysfunction 230

Masters and Johnson Psychophysiological Model 230

Barlow's Cognitive-Affective Model 230

Nobre's Cognitive-Emotional Model 231

Treatments for Sexual Dysfunction 231

Review of Treatment Outcome Studies for Sexual Dysfunction 233

Cognitive Behavioral Therapy for Sexual Dysfunction 234

Cognitive Restructuring 235

Brief Summary 235

15 Couple Distress 243
Mehmet Sungur

Introduction 243

What are the Processes that Differentiate Functional Couples from Dysfunctional Ones? 244

Assessment of the Couples 245

Goal Setting in Couple Therapy 246

Couple Therapy: Strategies and Techniques 247

Difficulties with Promoting Change: Difficulties Encountered during Couple Therapy Practice 247

Treatment Issues: Couple Therapy 249

Treatment Approaches for Intervention 249

Behavioral Approaches 250

Cognitive-Behavioral Couple Therapy (CBCT) Approaches 251

Integrative Behavioral Couple Therapy (IBCT) 253

Behavioral Systems Approach to Couple Problems 253

Emotionally Focused Couple Therapy (EFCT) 254

Strategic Approaches and Brief Strategic Couple Therapy (BSCT) 255

Solution-Focused Approaches and Brief Solution-Focused Therapy (BSFT) 255

Psychoanalytical Approaches 256

16 Somatic Symptom Disorders 261
Maria Kleinstauber and Winfried Rief

Introduction 261

Classifying and Diagnosing SSRD 262

Diagnostic Categories According to DSM-5, DSM-IV, and ICD-10 262

Somatic Symptom Disorder (SSD) 262

Illness Anxiety Disorder 264

Other SSRD 264

Critical Reflection on Changes from DSM-IV, and ICD-10 to DSM-5 265

Classifying Specific Functional Somatic Syndromes 266

Specific Cultural Syndromes of Distress 267

Empirically Supported Psychological Interventions for SSRD 267

Cognitive Behavior Therapy (CBT) 267

Other Psychological Interventions for SSRD 273

Psychodynamic Interpersonal Therapy 273

General Practitioner (GP) and Reattribution Training 274

Empirical Evidence for Psychological Interventions in SSRD 274

Transcultural Aspects in Psychological Interventions for SSRD 276

Summary and Conclusion 276

17 Psychotic Disorders 283
Tania Lincoln

Introduction 283

Description of the Disorder 283

Symptoms 284

Diagnostic Criteria 285

Differential Diagnosis 285

Comorbid Disorders and Suicidality 286

Epidemiology, Course of the Disorder and Prognosis 286

Etiology 287

Genetic Risk Factors 287

Prenatal and Perinatal Risk Factors 287

Psychosocial Risk Factors 287

Psychological Models of Explanation: Interplay of Vulnerability, Stressors and Symptoms 288

Neurochemical Models of Explanation: Excess Dopamine 289

Integrative Models: Integrating Genes, Environment, Neurochemistry and Cognitive Schema 290

Assessment 291

Pharmacological Treatment 291

Psychological Interventions 293

Cognitive Behavioral Therapy for Psychosis (CBTp) 293

Empirical Evidence for CBTp in Schizophrenia 298

Family Behavioral Interventions 299

Effectiveness of Psychoeducational Behavioral Family Interventions 301

Other Psychological Approaches and their Effectiveness 301

Summary and Outlook 302

18 Neurobiology and Pharmacological Treatment of Mental Disorders 309
Borwin Bandelow

Introduction 309

Mood Disorders 312

Depression 312

Bipolar Disorders 314

Psychotic Disorders 314

Anxiety Disorders 316

Obsessive-Compulsive Disorder (OCD) 317

Posttraumatic Stress Disorder (PTSD) 317

Somatic Symptom Disorders 318

Substance-Related Disorders 318

Alcohol Addiction 318

Opioid Addiction 319

Dependence on Prescription Drugs 319

Eating Disorders 319

Personality Disorders 320

Borderline Personality Disorder 320

Antisocial Personality Disorder (ASPD) 320

Dementia 321

Sleep Disorders 321

Attention-Deficit/Hyperactivity Disorder (ADHD) 321

Summary 322

19 Mindfulness-Based Interventions 327
Bram Van Bockstaele, Elske Salemink, Brian D. Ostafin, Anne Marie Meijer, and Susan M. Boegels

Popular Mindfulness-Based Interventions 327

Mindfulness-Based Stress Reduction 327

Mindfulness-Based Cognitive Therapy 328

Application of Mindfulness in Mental Health Care 328

Psychoeducation Example 329

Meditation Practice Example 329

Inquiry Example 330

Homework Example 330

Effects of Mindfulness-based Interventions on Psychological Disorders 330

Neurodevelopmental Disorders 330

Schizophrenia Spectrum and Other Psychotic Disorders 331

Bipolar and Related Disorders 332

Depressive Disorders 332

Anxiety Disorders 333

Obsessive-Compulsive and Related Disorders 334

Trauma- and Stressor-Related Disorders 334

Feeding and Eating Disorders 335

Sleep-Wake Disorders 336

Substance-Related and Addictive Disorders 336

Neurocognitive Disorders 337

Discussion 338

Acknowledgements 340

20 Internet-Based Treatments 347
Gerhard Andersson and Thomas Berger

Introduction 347

Are Internet Treatments Effective? 348

The "How" Question 349

A Research Agenda for the World? 350

Challenges for the Future 351

Summary 353

21 Virtual Reality 361
Cristina Botella, Rosa M. Banos, Azucena Garcia-Palacios, and Soledad Quero

Introduction 361

Virtual Reality for the Treatment of Different Psychological Disorders and Health Problems 362

Virtual Reality as an Ecological Context for Assessing Human Behavior 363

Virtual Reality as a Realistic Laboratory Setting for Psychopathology 365

Mood-Induction Procedures 365

Study of Cognitive Biases 365

Study of Psychotic Phenomena 366

Study of the Self and Embodiment Processes 367

Virual Reality Developments for the Treatment of Different Mental and Health Conditions 367

Specific Phobias 368

Social Anxiety Disorder 369

Panic Disorder and Agoraphobia 369

Generalized Anxiety Disorder 370

Stress-Related Disorders 370

Virtual Reality in the Treatment of Health Conditions 372

Future Perspectives and Ethical Implications of VR 373

Summary 374

22 Working Alliance 383
Nicole Everitt, Brad Cini, and Nikolaos Kazantzis

Measurement 384

California Psychotherapy Alliance Scales (CALPAS; Marmar & Gaston, 1988) 384

Penn Helping Alliance Questionnaire (HAq; Luborsky, 1976) 384

Vanderbilt Therapeutic Alliance Scale (VTAS; Hartley & Strupp, 1983) 384

Working Alliance Inventory (WAI) 384

Evidence for Relations with Outcome 384

Temporal Precedence 386

Impact of Alliance Rater and Time of Assessment 386

Adapting Working Alliance Based on Patient Characteristics 387

Evidence for Patient Characteristics in Alliance Research 388

Further Critique 388

Patient Matching 389

The Therapeutic Relationship is More Than the Working Alliance: The Case of Cognitive Behavior Therapy 389

Collaboration 390

Conclusion 391

23 Culture in Clinical Psychology: Adapting Treatments 399
Anushka Patel and Devon E. Hinton

Culture in Clinical Psychology: Adapting Treatments 399

Why do we Need Culturally Adapted Treatments? 400

How to Adapt: Develop New Treatments or Modify what Works? 401

Evidence for Efficacy of Cultural Adaptation: What to Adapt 402

A Model of Anxiety Generation across Cultural Contexts 403

How to Culturally Adapt Treatment? 405

Key Treatment Targets 405

Psychoeducation and Treatment Engagement 406

Teaching Emotion Regulation in a Culturally Appropriate Way 408

Culturally Appropriate Exposure 409

Summary 411

Index 419

About the Author

STEFAN G. HOFMANN, PHD, is Professor of Psychology in the Department of Psychological and Brain Sciences at Boston University, where he directs the Psychotherapy and Emotion Research Laboratory. His main research focuses on the mechanism of treatment change, translating discoveries from neuroscience into clinical applications, emotion regulation strategies, and cultural expressions of psychopathology. He is the author of more than three hundred scientific publications and twenty books. He is a Highly Cited Researcher by Thomson Reuters, and has many other awards.

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