Abnormal thoughts and afterthoughts

Abnormal Psychology - Abnormal Psychology and Modern Life - Abnormal Psychology - Abnormal Psychology
November 27, 1998

Each of these four books is designed to be the basic textbook for undergraduate student courses in abnormal psychology. They offer surprisingly similar features, down to DSM classification-features displays on the inner folds of the covers. Appropriately, all four include glossaries, references, name index and subject index.

Each book includes case studies, diagrams, tables and an abundance of photographs, featuring celebrities as often as possible: Anthony Hopkins (Davison and Neale); Kurt Cobain (Carson et al ) Oprah Winfrey (Nolen-Hoeksema) and Muhammad Ali (Comer). Each one also offers a "personal" feature, opening each chapter with, for instance, artwork by an artist who may (or may not) have been mentally ill. Summaries, key terms, focus stories and examples are presented in vivid colours and fonts. Clearly the aim is to attract the attention of students in a 30-second-attention-span culture.

Holding this attention and encouraging critical thought appears to be less important. Not one of the texts includes a more problem-based approach by including essay questions or asking students to provide more adequate research designs. Instead, all the texts appear to attempt to fill the student with a plethora of information for completing multiple-choice tests.

Despite this general criticism, some of the books provide a better educational experience than others. Robert Carson et al attempt to address this through a section on "unresolved issues". Susan Nolen-Hoeksema improves on this by including thought-provoking questions directed at students at the ends of sections, and Ronald Comer adds a "thought and afterthought" to each chapter, raising questions that range from the trivial to the profound.

One key area of comparison among the books is the depth of the text, especially in reference to recent research models and evidence. Another is the breadth, with a focus on original topics within the established subjects, or specialised approaches, such as cross-cultural issues. Finally, texts are assessed on the treatment of research. Any main textbook in the human sciences must include an up-to-date description and discussion of the appropriate research methods in the subject. Without this, students cannot learn to assess evidence independently, nor read and digest original research articles referred to in the textbook.

Unfortunately, the international debate concerning evidence-based medicine as applied to psychiatry and psychology is missing from every one of these books. None discusses progressive methods of analysing research data. The two most important breakthroughs in recent years in statistics as applied to abnormal psychology are meta-analysis and causal path analysis, and no textbook aimed at instructing students into the new millennium should omit a description of these methods and specific examples of their use in current research.

Carson et al mention path analysis and explain the relationship with correlations. A relatively old example (S. A. Mednick, 1978) is described. The remaining coverage of research methods is, however, poor. Comer fails to mention either of the statistical procedures, but dedicates a chapter to research methods. The chapter is detailed, but the level of description is appropriate to first-year undergraduate students, but no further. Nolen-Hoeksema also devotes a chapter to research methods at a basic level, introducing sections on ethics as related to research. Surprisingly, although an entire section describes the evaluation of therapy-outcome studies, meta-analysis is not mentioned. Typically, there are instead sections devoted to innovative research "The multiple approach revisited" and to issues in cross-cultural research. The approach throughout this book is to emphasise the less usual and innovative aspects of each topic, making it a useful complementary text. Finally, Davison and Neale provide a description of meta-analysis embedded in the chapter about insight therapies. Their chapter on research methods is the strongest among the books, covering general philosophy of science, epidemiology and experimental methods.

The breadth of the topics included under the heading of abnormal psychology has increased in recent years to include many health-related areas. All four books reflect this: Carson et al devote a chapter to psychological factors and physical illness; Comer includes a shorter and more diffuse section within the chapter on problems of mind and body; Nolen-Hoeksema focuses mainly on stress and its relation to health in the chapter on developmental and health-related disorders, while a section on somatisation and pain disorder appears separately, combined with dissociative disorders; and Davison and Neale describe theories of stress and relate them to cardiovascular disorders and asthma in a chapter on psycho-physiological disorders and health psychology.

Overall, in depth and clarity, Carson et al provide best coverage of health-related issues.

The depth of coverage of specialised issues defines whether a book can be a useful learning tool beyond first-year material. Although textbooks cannot cover every angle of every subject in depth, a good one is expected to raise questions, apply critical analysis to current research and suggest further reading. A random topic, bipolar mood disorder, was chosen for comparison across the books.

Carson et al provide a table defining bipolar mood disorder within other emotional disorders, and a text-heavy, well-referenced section with a critical discussion of aetiological models. Comer's section overflows with case studies to illustrate every angle of manic behaviour and provides an adequate description of explanatory models and treatment. Nolen-Hoeksema provides epidemiological data and mentions some original topics, such as the link with leadership and creativity. However, the discussion of research, and especially research into genetic risk, is poor, with bipolar and unipolar grouped together and contradictory research findings ignored. Davison and Neale provide a much better discussion of genetic aetiology, with a useful table to differentiate bipolar from unipolar mood disorder, but the emphasis throughout the chapter is on unipolar disorder.

Overall, all four textbooks are attractive and adequate for introductory courses. They are all too heavy (literally and in their use of American-based research and examples). Photographs are often over-used and sometimes inappropriate or irrelevant to the text. Of the four, Carson et al is richest in depth, while Davison and Neale are strong on clarity. Either of these would form an appropriate choice of main textbook. Comer is often entertaining and provides discursive anecdotal material, but is weaker on analysis and research evidence. Nolen-Hoeksema is rich in original features and focuses, and would make a good complementary text.

It is difficult to choose between Carson et al and Davison and Neale, but the decision can be made simpler by visiting the associated websites. That of Davison and Neale is adequate, with a clear advantage in the depth of study questions for students. But the Carson et al web-site is fun. Students will enjoy the interactive features and the site is simple to use and maps neatly onto the textbook, giving Carson et al the upper hand.

There are, of course, other textbooks equally worthy. My preference is for three: M. T. Nietzel et al (1998) and T. F. Oltmanns and R. E. Emery (1998, second edition), both of which provide an excellent review of meta-analysis as applied to outcome studies, and the best of the lot, P. C. Kendall and C. Hammen (1998, second edition), which adequately addresses research methods and encourages critical thought by incorporating questions about the future of abnormal psychology at the end of each chapter.

Tamar Pincus is lecturer in abnormal psychology, Royal Holloway, University of London.

Abnormal Psychology

Author - Gerald C. Davison and John M. Neale
ISBN - 0 471 11122 8
Publisher - Wiley
Price - £25.95
Pages - 6

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