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Printed in Canada Print Number: 01 Print Year: 2016
To my wife, Kimberlie, and my children, Derek and Claire, for their great patience and support.
—CHRISTOPHER A. K EARNEY
To my wife, Meg, for her love and support.
To Molly, Janey, and Neko for their smiles and laughter.
—TIMOTHY J. TRULL
ABOUT THE AUTHORS
Christopher A. Kearney, Ph.D., is Distinguished Professor of Psychology, Chair of the Department of Psychology, and Director of the UNLV Child School Refusal and Anxiety Disorders Clinic at the University of Nevada, Las Vegas. He is a Fellow of the American Psychological Association, a licensed clinical psychologist, and the author of numerous journal articles, book chapters, and books related to school refusal behavior, social anxiety, shyness, and selective mutism in youth. He has also published a work on general child psychopathology, Casebook in Child Behavior Disorders (Cengage), and is or has been on the editorial boards of Journal of Consulting and Clinical Psychology, Behavior Therapy, Journal of Clinical Child and Adolescent Psychology, Journal of Abnormal Child Psychology, Journal of Psychopathology and Behavioral Assessment, Journal of Anxiety Disorders, and Journal of Gambling Studies. Dr. Kearney has received several awards for his research, teaching, and mentoring, including the Harry Reid Silver State Research Award among others. In addition to his clinical and research endeavors, Dr. Kearney works closely with school districts and mental health agencies to improve strategies for helping children attend school with less distress.
Timothy J. Trull, Ph.D., is Professor of Psychological Sciences at the University of Missouri, Columbia. Dr. Trull received his Ph.D. from the University of Kentucky and completed his internship at New York Hospital–Cornell Medical Center. His research interests are in the areas of diagnosis and classi cation of mental disorders, borderline personality disorder, substance use disorders, clinical assessment, professional issues in clinical psychology, and ambulatory assessment methods. Dr. Trull has received several awards and honors for his teaching and mentoring, including Psi Chi Professor of the Year, the Robert S. Daniels Junior Faculty Teaching Award, and most recently the MU Graduate Faculty Mentor Award. He enjoys teaching Abnormal Psychology and Introduction to Clinical Psychology; his textbook Clinical Psychology (Wadsworth) is used in classes across the United States and internationally. Dr. Trull is a licensed psychologist, and he continues to train future clinical psychologists in the assessment, prevention, and treatment of psychological disorders.
Preface xxvi
1 Abnormal Psychology and Life 3
C Travis / What Do You Think? 4
Introduction to Abnormal Psychology 4
What Is a Mental Disorder? 4
C Treva Throneberry / What Do You Think? 5
Deviance from the Norm 5
Dif culties Adapting to Life Demands 6
Experience of Personal Distress 7
De ning Abnormality 7
Dimensions Underlying Mental Disorders Are Relevant to Everyone 8
INTERIM SUMMARY 11
REVIEW QUESTIONS 11
History of Abnormal Psychology 11
Early Perspectives 12
Early Greek and Roman Thought 12
Middle Ages 12
Renaissance 13
Reform Movement 13
Modern Era 13
INTERIM SUMMARY 14
REVIEW QUESTIONS 14
Abnormal Psychology and Life: Themes 14
Dimensional Perspective 14
Prevention Perspective 14
Consumer Perspective 15
Diversity 16
Stigma 16
INTERIM SUMMARY 17
REVIEW QUESTIONS 18
FINAL COMMENTS 18
KEY TERMS 19
Special Features
• 1.1 FOC US ON DIVERSI T Y: Emotion and Culture 7
CONTINUUM FIGURE 1.2 Continuum of Emotions, Cognitions, and Behaviors 10
• 1.2 FOC US ON L AW AND ETHI C S: Heal Thyself: What the Self-Help Gurus Don’t Tell You 15
Personal Narrative 1.1 Alison Malmon 18
2 Perspectives on Abnormal Psychology 21
C Mariella / What Do You Think? 22
Introduction 22
The Biological Model 23
Genetics 23
Nervous Systems and Neurons 24
Brain 24
Biological Assessment and Treatment 25
Evaluating the Biological Model 25
INTERIM SUMMARY 25
REVIEW QUESTIONS 27
The Psychodynamic Model 28
Brief Overview of the Psychodynamic Model 29
Psychodynamic Assessment and Treatment 30
Evaluating the Psychodynamic Model 32
INTERIM SUMMARY 32
REVIEW QUESTIONS 32
The Humanistic Model 32
Abraham Maslow 33
Carl Rogers 34
Rollo May 34
Humanistic Assessment and Treatment 35
Evaluating the Humanistic Model 35
INTERIM SUMMARY 35
REVIEW QUESTIONS 36
The Cognitive-Behavioral Model 36
Behavioral Perspective 36
Cognitive Perspective 37
A Cognitive-Behavioral Model 38
Cognitive-Behavioral Assessment and Treatment 38
Evaluating the Cognitive-Behavioral Model 40
INTERIM SUMMARY 40
REVIEW QUESTIONS 40
The Sociocultural Model 40
Culture 41
Gender 42
Neighborhoods and Communities 43
Family 43
Sociocultural Assessment and Treatment 44
Evaluating the Sociocultural Model 44
INTERIM SUMMARY 45
REVIEW QUESTIONS 45
FINAL COMMENTS 47
KEY TERMS 47
Special Features
• 2.1 FOC US ON V IO L EN C E: A More Complex Approach 28
• 2.2 FOC US ON L AW AND ETHI C S: Dangerousness and Commitment 33
• 2.3 FOC US ON GEN D ER: A More Complex Approach 41
Personal Narrative 2.1 An Integrative Psychologist: Dr. John C. Norcross 46
3 Risk and Prevention of Mental Disorders 51
C DeShawn / What Do You Think? 52
The Diathesis-Stress Model 52
Diathesis, Stress, and Mental Health 52
Diathesis-Stress: The Big Picture 53
Diathesis-Stress: The Little Picture 53
Implications of the Diathesis-Stress Model 54
INTERIM SUMMARY 54
REVIEW QUESTIONS 54
Epidemiology: How Common Are Mental Disorders? 54
Prevalence of Mental Disorders 55
Treatment Seeking 57
Treatment Cost 58
INTERIM SUMMARY 58
REVIEW QUESTIONS 59
Risk, Protective Factors, and Resilience 59
C Jana / What Do You Think? 59
Risk Factors 59
Protective Factors 61
INTERIM SUMMARY 63
REVIEW QUESTIONS 63
Prevention 63
Prevention on a Continuum 64
Three Types of Prevention 64
Prevention Programs for Mental Disorders 66
INTERIM SUMMARY 69
REVIEW QUESTIONS 69
FINAL COMMENTS 70 KEY TERMS 71
Special Features
• 3.1 JOHN S NOW: A Pioneer in Epidemiology and Prevention 55
3.2 FOC US ON CO LL EG E ST UD EN T S: Suicide 60
3.3 FOC US ON V IO L EN C E: Prevention of Femicide 64
• 3.4 FOC US ON L AW AND ETHI C S: Constructs Related to Insanity 69
Personal Narrative 3.1 Kim Dude and the Wellness Resource Center 70
Monkey Business/Fotolia
4 Diagnosis, Assessment, and Study of Mental Disorders 73
C Professor Smith / What Do You Think? 74
De ning Abnormal Behavior and Mental Disorder 74
Dimensions and Categories 74
DSM 75
Advantages of Diagnosis 75
INTERIM SUMMARY 76
REVIEW QUESTIONS 76
Classifying and Assessing Abnormal Behavior and Mental Disorder 76
Assessing Abnormal Behavior and Mental Disorder 76
Reliability, Validity, and Standardization 77
Interview 80
Intelligence Tests 80
Personality Assessment 81
Behavioral Assessment 85
Biological Assessment 87
Psychophysiological Assessment 88
Neuropsychological Assessment 89
INTERIM SUMMARY 90
REVIEW QUESTIONS 90
Culture and Clinical Assessment 90
Culture and the Development of Mental Disorders 90
Culture and Clinical Assessment 91
INTERIM SUMMARY 92
REVIEW QUESTIONS 92
Studying Abnormal Behavior and Mental Disorder 92
Experiment 92
Correlational Studies 94
Quasi-Experimental Methods 94
Other Alternative Experimental Designs 94
Developmental Designs 96
Case Study 96
Consuming the Media’s Research 96
INTERIM SUMMARY 96
REVIEW QUESTIONS 97
FINAL COMMENTS 97
KEY TERMS 97
Special Features
• 4.1 FOC US ON DIVERSI T Y: Culture and Diagnosis 77
Personal Narrative 4.1 Anonymous 78
• 4.2 FOC US ON L AW AND ETHI C S: Who Should Be Studied in Mental Health Research? 93
5 Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders 99
C Angelina / What Do You Think? 100
Worry, Anxiety, Fear, and Anxiety; ObsessiveCompulsive; and Trauma-Related Disorders: What Are They? 101
Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders: Features and Epidemiology 103
Panic Attack 103
Panic Disorder 104
Social Phobia 105
Speci c Phobia 106
Generalized Anxiety Disorder 106
C Jonathan / What Do You Think? 108
Obsessive-Compulsive Disorder 108
Obsessive-Compulsive-Related Disorders 108
Posttraumatic Stress Disorder and Acute Stress Disorder 109
C Marcus / What Do You Think? 109
Separation Anxiety Disorder and School Refusal Behavior 114
Epidemiology of Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders 114
Stigma Associated with Anxiety, ObsessiveCompulsive, and Trauma-Related Disorders 117
INTERIM SUMMARY 118
REVIEW QUESTIONS 118
Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders: Causes and Prevention 118
Biological Risk Factors for Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders 118
Environmental Risk Factors for Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders 122
Causes of Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders 124
Prevention of Anxiety, Obsessive-Compulsive, and TraumaRelated Disorders 126
INTERIM SUMMARY 127
REVIEW QUESTIONS 127
Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders: Assessment and Treatment 127
Assessment of Anxiety, Obsessive-Compulsive, and TraumaRelated Disorders 127
Biological Treatment of Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders 130
Psychological Treatments of Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders 131
What If I Have Anxiety or an Anxiety-Related Disorder? 136
Long-Term Outcome for People with Anxiety, ObsessiveCompulsive, and Trauma-Related Disorders 137
INTERIM SUMMARY 137
REVIEW QUESTIONS 137
FINAL COMMENTS 138
THOUGHT QUESTIONS 138
KEY TERMS 139
Thorsten Futh/laif/Redux
Special Features
CONTINUUM FIGURE 5.1 Worry, Anxiety, and Fear Along a Continuum 102
CONTINUUM FIGURE 5.2 Continuum of Emotions, Cognitions, and Behaviors Regarding Anxiety-Related Disorders 102
• 5.1 FOC US ON CO LL EG E ST UD EN T S: Trauma and PTSD 116
• 5.2 FOC US ON GEN D ER: Are There True Gender Differences in Anxiety-Related Disorders? 116
• 5.3 FOC US ON DIVERSI T Y: Anxiety-Related Disorders and Sociocultural Factors 117
V THE CONTINUUM VIDEO PROJECT Darwin / PTSD 125
Personal Narrative 5.1 Anonymous 128
• 5.4 FOC US ON L AW AND ETHI C S: The Ethics of Encouragement in Exposure-Based Practices 138
6 Somatic Symptom and Dissociative Disorders 141
Somatic Symptom and Dissociative Disorders:
A Historical Introduction 142
Somatization and Somatic Symptom Disorders: What Are They? 142
C Gisela / What Do You Think? 142
Somatic Symptom Disorders: Features and Epidemiology 144
Somatic Symptom Disorder 144
Illness Anxiety Disorder 145
Conversion Disorder 146
Factitious Disorder and Malingering 146
Epidemiology of Somatic Symptom Disorders 147
Stigma Associated with Somatic Symptom Disorders 148
INTERIM SUMMARY 148
REVIEW QUESTIONS 149
Somatic Symptom Disorders: Causes and Prevention 149
Biological Risk Factors for Somatic Symptom Disorders 149
Environmental Risk Factors for Somatic Symptom Disorders 149
Causes of Somatic Symptom Disorders 151
Prevention of Somatic Symptom Disorders 152
INTERIM SUMMARY 152
REVIEW QUESTIONS 153
Somatic Symptom Disorders: Assessment and Treatment 153
Assessment of Somatic Symptom Disorders 153
Biological Treatment of Somatic Symptom Disorders 154
Psychological Treatments of Somatic Symptom Disorders 154
What If I or Someone I Know Has a Somatic Symptom Disorder? 155
Long-Term Outcome for People with Somatic Symptom Disorders 155
INTERIM SUMMARY 155
REVIEW QUESTIONS 155
Dissociative Disorders 156
C Erica / What Do You Think? 156
Normal Dissociation and Dissociative Disorders: What Are They? 157
Dissociative Disorders: Features and Epidemiology 157
Dissociative Amnesia 157
Dissociative Identity Disorder 158
Depersonalization/Derealization Disorder 160
Epidemiology of Dissociative Disorders 161
Stigma Associated with Dissociative Disorders 162
INTERIM SUMMARY 162
REVIEW QUESTIONS 162
Dissociative Disorders: Causes and Prevention 163
Biological Risk Factors for Dissociative Disorders 163
Environmental Risk Factors for Dissociative Disorders 164
Causes of Dissociative Disorders 165
Prevention of Dissociative Disorders 166
INTERIM SUMMARY 166
REVIEW QUESTIONS 167
Dissociative Disorders: Assessment and Treatment 167
Assessment of Dissociative Disorders 167
Biological Treatment of Dissociative Disorders 167
Psychological Treatments of Dissociative Disorders 168
What If I or Someone I Know Has a Dissociative Disorder? 169
Long-Term Outcome for People with Dissociative Disorders 169
INTERIM SUMMARY 169
REVIEW QUESTIONS 169
FINAL COMMENTS 170
THOUGHT QUESTIONS 170
KEY TERMS 170
Special Features
CONTINUUM FIGURE 6.1 Continuum of Somatization and Somatic Symptom Disorders 144
• 6.1 FOC US ON CO LL EG E ST UD EN T S: Somatization 148
• 6.2 FOC US ON V IO L EN C E: Terrorism and Medically Unexplained Symptoms 152
CONTINUUM FIGURE 6.4 Continuum of Dissociation and Dissociative Disorders 158
Personal Narrative 6.1 Heather Pate 160
• 6.3 FOC US ON CO LL EG E ST UD EN T S: Dissociation 161
• 6.4 FOC US ON L AW AND ETHI C S: Recovered Memories and Suggestibility 162
• 6.5 FOC US ON DIVERSI T Y: Dissociation and Culture 163
• 6.6 FOC US ON V IO L EN C E: Dissociative Experiences and Violence Toward Others 166
V THE CONTINUUM VIDEO PROJECT Lani and Jan / Dissociative Identity Disorder 169
7 Depressive and Bipolar Disorders and Suicide 173
C Katey / What Do You Think? 174
Normal Mood Changes and Depression and Mania: What Are They? 174
Depressive and Bipolar Disorders and Suicide:
Features and Epidemiology 175
Major Depressive Episode 175
Major Depressive Disorder 177
Persistent Depressive Disorder (Dysthymia) 178
Other Depressive Disorders 179
Manic and Hypomanic Episodes 179
Bipolar I Disorder 181
Bipolar II Disorder 185
Cyclothymic Disorder 185 Suicide 186
Epidemiology of Depressive and Bipolar Disorders 187 Epidemiology of Suicide 189
Stigma Associated with Depressive and Bipolar Disorders 190
INTERIM SUMMARY 190
REVIEW QUESTIONS 191
Depressive and Bipolar Disorders and Suicide: Causes and Prevention 191
Biological Risk Factors for Depressive and Bipolar Disorders and Suicide 191
Environmental Risk Factors for Depressive and Bipolar Disorders and Suicide 194
Causes of Depressive and Bipolar Disorders and Suicide 198
Prevention of Depressive and Bipolar Disorders and Suicide 199
INTERIM SUMMARY 200
REVIEW QUESTIONS 200
Depressive and Bipolar Disorders and Suicide: Assessment and Treatment 200
Interviews and Clinician Ratings 201
Self-Report Questionnaires 202
Self-Monitoring and Observations from Others 203
Laboratory Assessment 203 Assessment of Suicide 203
Biological Treatment of Depressive and Bipolar Disorders and Suicide 204
Psychological Treatments for Depressive and Bipolar Disorders and Suicide 207
What If I Am Sad or Have a Mood Disorder? 210
Long-Term Outcome for People with Depressive and Bipolar Disorders and Suicide 210
INTERIM SUMMARY 211
REVIEW QUESTIONS 211
FINAL COMMENTS 212
THOUGHT QUESTIONS 212
KEY TERMS 212
Special Features
CONTINUUM FIGURE 7.1 Continuum of Sadness and Depression 176
CONTINUUM FIGURE 7.2 Continuum of Happiness, Euphoria, and Mania 176
Personal Narrative 7.1 Karen Gormandy 180
• 7.1 FOC US ON GEN D ER: Forms of Depression Among Women 182
• 7.2 FOC US ON CO LL EG E ST UD EN T S: Depression 195
VTHE CONTINUUM VIDEO PROJECT Emilie / Bipolar Disorder 200
• 7.3 FOC US ON L AW AND ETHI C S: Ethical Dilemmas in Electroconvulsive Therapy 206
• 7.4 FOC US ON DIVERSI T Y: Depression in the Elderly 208
8 Eating Disorders 215
C Sooki / What Do You Think? 216
Weight Concerns, Body Dissatisfaction, and Eating Disorders: What Are They? 216
Eating Disorders: Features and Epidemiology 217
Anorexia Nervosa 217
Bulimia Nervosa 218
C Lisa / What Do You Think? 218
Binge-Eating Disorder 220
Epidemiology of Eating Disorders 221
Stigma Associated with Eating Disorders 224
INTERIM SUMMARY 225
REVIEW QUESTIONS 225
Eating Disorders: Causes and Prevention 225
Biological Risk Factors for Eating Disorders 225
Environmental Risk Factors for Eating Disorders 227
Causes of Eating Disorders 230 Prevention of Eating Disorders 230
INTERIM SUMMARY 231
REVIEW QUESTIONS 231
Eating Disorders: Assessment and Treatment 231
Assessment of Eating Disorders 231
Treatment of Eating Disorders 234
Biological Treatments of Eating Disorders 234
Psychological Treatments of Eating Disorders 236
What If I Have Weight Concerns or an Eating Disorder? 238
Long-Term Outcome for People with Eating Disorders 238
INTERIM SUMMARY 240
REVIEW QUESTIONS 240
FINAL COMMENTS 240
THOUGHT QUESTIONS 240
KEY TERMS 241
Special Features
CONTINUUM FIGURE 8.1 Continuum of Body Dissatisfaction, Weight Concerns, and Eating Behavior 218
Personal Narrative 8.1 Kitty Westin (Anna’s mother) 220
• 8.1 FOC US ON CO LL EG E ST UD EN T S: Eating Disorders 223
• 8.2 FOC US ON GEN D ER: Why Is There a Gender Difference in Eating Disorders? 223
V THE CONTINUUM VIDEO PROJECT Sara / Bulimia Nervosa 227
Personal Narrative 8.2 Rachel Webb 232
• 8.3 FOC US ON L AW AND ETHI C S: How Ethical Are Pro-Ana (Pro-Anorexia) Websites? 237
9 Substance-Related Disorders 243
C Elon / What Do You Think? 244
Normal Substance Use and Substance-Related Disorders: What Are They? 244
Substance-Related Disorders: Features and Epidemiology 245
Substance Use Disorder 245
Substance Intoxication 246
Substance Withdrawal 246 Types of Substances 247
Epidemiology of Substance-Related Disorders 256
Stigma Associated with Substance-Related Disorders 258
INTERIM SUMMARY 259
REVIEW QUESTIONS 259
Substance-Related Disorders: Causes and Prevention 259
Biological Risk Factors for Substance-Related Disorders 259
Environmental Risk Factors for Substance-Related Disorders 262
Causes of Substance-Related Disorders 266 Prevention of Substance-Related Disorders 267
INTERIM SUMMARY 268
REVIEW QUESTIONS 269
Substance-Related Disorders: Assessment and Treatment 269
Interviews 269
Psychological Testing 269 Observations from Others 271
Laboratory Testing 272
Biological Treatment of Substance-Related Disorders 273
Psychological Treatment of Substance-Related Disorders 274
What If I or Someone I Know Has a Substance-Related Problem or Disorder? 276
Long-Term Outcome for People with Substance-Related Disorders 276
INTERIM SUMMARY 276
REVIEW QUESTIONS 278
FINAL COMMENTS 278
THOUGHT QUESTIONS 278
KEY TERMS 278
Special Features
CONTINUUM FIGURE 9.1 Continuum of Substance Use and Substance-Related Disorders 246
• 9.1 The Sam Spady Story 252
• 9.2 The “Meth” Epidemic 254
• 9.3 FOC US ON GEN D ER: Date Rape Drugs 256
• 9.4 FOC US ON V IO L EN C E: Alcohol and Violence 264
V THE CONTINUUM VIDEO PROJECT Mark / Substance Use Disorder 264 • 9.5 FOC US ON CO LL EG E ST UD EN T S: Substance Use 268
Personal Narrative 9.1 One Family’s Struggle with SubstanceRelated Disorders 270
• 9.6 FOC US ON L AW AND ETHI C S: Drug Testing 273
David Buf ngton/Photodisc/Jupiter Images
10 Personality Disorders 281
C Michelle / What Do You Think? 282
Personality Traits, Unusual Personality, and Personality Disorder: What Are They? 283
Organization of Personality Disorders 284
Odd or Eccentric Personality Disorders: Features and Epidemiology 285
Paranoid Personality Disorder 285
Schizoid Personality Disorder 285
Schizotypal Personality Disorder 285
C Jackson / What Do You Think? 286
Epidemiology of Odd or Eccentric Personality Disorders 287
INTERIM SUMMARY 288
REVIEW QUESTIONS 288
Dramatic Personality Disorders: Features and Epidemiology 288
C Duane / What Do You Think? 288
Antisocial Personality Disorder 288
Borderline Personality Disorder 289
Histrionic Personality Disorder 289
Narcissistic Personality Disorder 290
Epidemiology of Dramatic Personality Disorders 291
INTERIM SUMMARY 293
REVIEW QUESTIONS 293
Anxious/Fearful Personality Disorders: Features and Epidemiology 293
Avoidant Personality Disorder 293
Dependent Personality Disorder 294
C Betty / What Do You Think? 294
Obsessive-Compulsive Personality Disorder 294
Epidemiology of Anxious/Fearful Personality Disorders 295
Stigma Associated with Personality Disorders 295
INTERIM SUMMARY 296
REVIEW QUESTIONS 296
Personality Disorders: Causes and Prevention 296
Biological Risk Factors for Odd or Eccentric Personality Disorders 297
Environmental Risk Factors for Odd or Eccentric Personality Disorders 297
Causes of Odd or Eccentric Personality Disorders 297
Biological Risk Factors for Dramatic Personality Disorders 298
Environmental Risk Factors for Dramatic Personality Disorders 298
Causes of Dramatic Personality Disorders 299
Biological Risk Factors for Anxious/Fearful Personality Disorders 299
Environmental Risk Factors for Anxious/Fearful Personality Disorders 299
Causes of Anxious/Fearful Personality Disorders 300
Prevention of Personality Disorders 300
INTERIM SUMMARY 301
REVIEW QUESTIONS 302
Personality Disorders: Assessment and Treatment 303
Assessment of Personality Disorders 303
Biological Treatments of Personality Disorders 304
Psychological Treatments of Personality Disorders 304
What If I or Someone I Know Has a Personality Disorder? 307
Long-Term Outcomes for People with Personality Disorders 307
INTERIM SUMMARY 310
REVIEW QUESTIONS 310
FINAL COMMENTS 310
THOUGHT QUESTIONS 310
KEY TERMS 311
Special Features
CONTINUUM FIGURE 10.1 Continuum of Normal Personality and Personality Disorder Traits Related to Impulsivity 282
• 10.1 FOC US ON CO LL EG E ST UD EN T S: Personality Disorders 292
• 10.2 FOC US ON V IO L EN C E: Personality Disorders and Violence 292
• 10.3 FOC US ON GEN D ER: Mirror Images of Personality Disorders? 296
• 10.4 FOC US ON L AW AND ETHI C S: Personality and Insanity 305
V THE CONTINUUM VIDEO PROJECT Tina / Borderline Personality Disorder 307
Personal Narrative 10.1 Anonymous 308
11 Sexual Dysfunctions, Paraphilic Disorders, and Gender Dysphoria 313
Normal Sexual Behavior and Sexual Dysfunctions: What Are They? 314
C Douglas and Stacy / What Do You Think? 314
Sexual Dysfunctions: Features and Epidemiology 315
Male Hypoactive Sexual Desire Disorder 315
Female Sexual Interest/Arousal Disorder 315
Erectile Disorder 316
Female Orgasmic Disorder 316
Delayed Ejaculation 317
Premature (Early) Ejaculation 317
Genito-Pelvic Pain/Penetration Disorder 318
Epidemiology of Sexual Dysfunctions 318
Stigma Associated with Sexual Dysfunctions 321
INTERIM SUMMARY 321
REVIEW QUESTIONS 322
Sexual Dysfunctions: Causes and Prevention 322
Biological Risk Factors for Sexual Dysfunctions 322
Psychological Risk Factors for Sexual Dysfunctions 322
Causes of Sexual Dysfunctions 323
Prevention of Sexual Dysfunctions 323
INTERIM SUMMARY 323
REVIEW QUESTIONS 324
Sexual Dysfunctions: Assessment and Treatment 325
Assessment of Sexual Dysfunctions 325
Biological Treatment of Sexual Dysfunctions 325
Psychological Treatments of Sexual Dysfunctions 326
What If I or Someone I Know Has a Sexual Dysfunction? 327
Long-Term Outcomes for People with Sexual Dysfunctions 328
INTERIM SUMMARY 328
REVIEW QUESTIONS 328
Normal Sexual Desires, Paraphilias, and Paraphilic Disorders: What Are They? 329
Paraphilic Disorders: Features and Epidemiology 329
Exhibitionistic Disorder 330
C Tom / What Do You Think? 330
Fetishistic Disorder 331
Frotteuristic Disorder 331
Pedophilic Disorder 332
Sexual Masochism and Sexual Sadism 333
Transvestic Disorder 333
Voyeuristic Disorder 334
Atypical Paraphilic Disorders 334
Epidemiology of Paraphilic Disorders 334
INTERIM SUMMARY 337
REVIEW QUESTIONS 337
Paraphilic Disorders: Causes and Prevention 337
Biological Risk Factors for Paraphilic Disorders 337
Environmental Risk Factors for Paraphilic Disorders 337
Causes of Paraphilic Disorders 338
Prevention of Paraphilic Disorders 339
INTERIM SUMMARY 339
REVIEW QUESTIONS 339
Paraphilic Disorders: Assessment and Treatment 340
Assessment of Paraphilic Disorders 340
Biological Treatment of Paraphilic Disorders 340
Psychological Treatment of Paraphilic Disorders 341
What If I or Someone I Know Has a Paraphilic Disorder? 342
Long-Term Outcomes for People with Paraphilic Disorders 342
INTERIM SUMMARY 342
REVIEW QUESTIONS 342
Normal Gender Development and Gender Dysphoria: What Are They? 342
C Austin / What Do You Think? 343
Gender Dysphoria: Features and Epidemiology 343
Gender Dysphoria: Causes and Prevention 344
Gender Dysphoria: Assessment and Treatment 345
Assessment of Gender Dysphoria 345
Biological Treatment of Gender Dysphoria 345
Psychological Treatment of Gender Dysphoria 345
What If I or Someone I Know Has Questions About Gender or Gender Dysphoria? 345
Long-Term Outcomes for People with Gender Dysphoria 346
INTERIM SUMMARY 347
REVIEW QUESTIONS 347
FINAL COMMENTS 348
THOUGHT QUESTIONS 348
KEY TERMS 348
Special Features
CONTINUUM FIGURE 11.1 Continuum of Sexual Behavior and Sexual Dysfunctions 314
• 11.1 FOC US ON GEN D ER: Gender Biases in Sexual Dysfunctions and Disorders 319
• 11.2 FOC US ON CO LL EG E ST UD EN T S: Sexual Dysfunctions 322
CONTINUUM FIGURE 11.4 Continuum of Sexual Behavior and Paraphilic Disorders 328
• 11.3 FOC US ON CO LL EG E ST UD EN T S: Sexual Fantasies and Paraphilic Interests 336
• 11.4 FOC US ON V IO L EN C E: Rape 336
• 11.5 FOC US ON L AW AND ETHI C S: Sex Offender Notification and Incarceration 341
Personal Narrative 11.1 Sam 346
V THE CONTINUUM VIDEO PROJECT Dean / Gender Dysphoria 346
12 Schizophrenia and Other Psychotic Disorders 351
C James / What Do You Think? 352
Unusual Emotions, Thoughts, and Behaviors and Psychotic Disorders: What Are They? 352
Psychotic Disorders: Features and Epidemiology 353
Schizophrenia 353
Phases of Schizophrenia 357
Schizophreniform Disorder 359
Schizoaffective Disorder 359
Delusional Disorder 361
C Jody / What Do You Think? 362
Brief Psychotic Disorder 362
Epidemiology of Psychotic Disorders 363
Stigma Associated with Schizophrenia 365
INTERIM SUMMARY 365
REVIEW QUESTIONS 366
Psychotic Disorders: Causes and Prevention 367
Biological Risk Factors for Psychotic Disorders 367
Environmental Risk Factors for Psychotic Disorders 370
Causes of Psychotic Disorders 371
Prevention of Psychotic Disorders 373
INTERIM SUMMARY 373
REVIEW QUESTIONS 374
Psychotic Disorders: Assessment and Treatment 374
Interviews 374
Behavioral Observations 374
Cognitive Assessment 375
Physiological Assessment 375
Biological Treatments of Psychotic Disorders 376
Psychological Treatments of Psychotic Disorders 377
What If I or Someone I Know Has a Psychotic Disorder? 379
Long-Term Outcome for People with Psychotic Disorders 380
INTERIM SUMMARY 380
REVIEW QUESTIONS 380
FINAL COMMENTS 381
THOUGHT QUESTIONS 381
KEY TERMS 381
Special Features
CONTINUUM FIGURE 12.1 Continuum of Unusual Emotions, Cognitions, and Behaviors and Psychotic Disorder 354
Personal Narrative 12.1 John Cadigan 360
• 12.1 FOC US ON DIVERSI T Y: Ethnicity and Income Level in Schizophrenia 364
• 12.2 FOC US ON CO LL EG E ST UD EN T S: Psychotic Symptoms 365
• 12.3 FOC US ON V IO L EN C E: Are People with Schizophrenia More Violent? 366
VTHE CONTINUUM VIDEO PROJECT Andre / Schizophrenia 373
• 12.4 FOC US ON L AW AND ETHI C S: Making the Choice of Antipsychotic Medication 376
13 Developmental and Disruptive Behavior Disorders 383
Developmental and Disruptive Behavior Disorders 384
C Robert / What Do You Think? 384
Normal Development and Developmental Disorders: What Are They? 385
Developmental Disorders: Features and Epidemiology 385
Stigma Associated with Developmental Disorders 391
INTERIM SUMMARY 392
REVIEW QUESTIONS 392
Developmental Disorders: Causes and Prevention 392
Biological Risk Factors for Developmental Disorders 392
Environmental Risk Factors for Developmental Disorders 396
Causes of Developmental Disorders 396
Prevention of Developmental Disorders 396
INTERIM SUMMARY 398
REVIEW QUESTIONS 398
Developmental Disorders: Assessment and Treatment 398
Cognitive Tests 398
Achievement Tests 399
Interviews 400
Rating Scales 400
Behavioral Observation 400
Biological Treatment for Developmental Disorders 400
Psychological Treatments for Developmental Disorders 401
What If I Think Someone Has a Developmental Disorder? 403
Long-Term Outcome for People with Developmental Disorders 403
INTERIM SUMMARY 403
REVIEW QUESTIONS 404
Normal Rambunctious Behavior and Disruptive Behavior Disorders: What Are They? 404
C Will / What Do You Think? 405
Disruptive Behavior Disorders: Features and Epidemiology 405
Attention-De cit/Hyperactivity Disorder 405
Oppositional De ant Disorder and Conduct Disorder 406
Epidemiology of Disruptive Behavior Disorders 407
Stigma Associated with Disruptive Behavior Disorders 408
INTERIM SUMMARY 409
REVIEW QUESTIONS 410
Disruptive Behavior Disorders: Causes and Prevention 410
Biological Risk Factors for Disruptive Behavior Disorders 410
Environmental Risk Factors for Disruptive Behavior Disorders 411
Causes of Disruptive Behavior Disorders 413
Prevention of Disruptive Behavior Disorders 413
INTERIM SUMMARY 414
REVIEW QUESTIONS 414
Disruptive Behavior Disorders: Assessment
and Treatment 414
Interviews 415
Rating Scales 415
Behavioral Observation 415
Biological Treatments for Disruptive Behavior Disorders 415
Psychological Treatments for Disruptive Behavior Disorders 416
What If I Think a Child Has a Disruptive Behavior Disorder? 417
Long-Term Outcome for Children with Disruptive Behavior Disorders 417
INTERIM SUMMARY 419
REVIEW QUESTIONS 419
FINAL COMMENTS 420
THOUGHT QUESTIONS 420
KEY TERMS 421
Special Features
CONTINUUM FIGURE 13.1 Continuum of Normal Development and Developmental Disorder 384
• 13.1 FOC US ON CO LL EG E ST UD EN T S: Autism 392
• 13.2 FOC US ON L AW AND ETHI C S: Key Ethical Issues and Developmental Disorders 394
• 13.3 FOC US ON DIVERSI T Y: Testing for People with Developmental Disorders 399
V THE CONTINUUM VIDEO PROJECT
Whitney / Autism Spectrum Disorder 401
CONTINUUM FIGURE 13.4 Continuum of Disruptive Behavior and Disruptive Behavior Disorder 406
• 13.4 FOC US ON CO LL EG E ST UD EN T S: ADHD 410
• 13.5 FOC US ON V IO L EN C E: Juvenile Arrests and “Diversion” 417
Personal Narrative 13.1 Toni Wood 418
14 Neurocognitive Disorders 423
C William and Laura / What Do You Think? 424
Normal Changes During Aging and Neurocognitive Disorders: What Are They? 425
Neurocognitive Disorders: Features and Epidemiology 426
Delirium 426
Dementia and Major and Mild Neurocognitive Disorder 428
Alzheimer’s Disease 428
Lewy Bodies 430
Vascular Disease 431
Parkinson’s Disease 432
Pick’s Disease 432
Other Problems 433
Epidemiology of Neurocognitive Disorders 434
Stigma Associated with Neurocognitive Disorders 435
INTERIM SUMMARY 436
REVIEW QUESTIONS 436
Neurocognitive Disorders: Causes and Prevention 437
Biological Risk Factors for Neurocognitive Disorders 437
Environmental Risk Factors for Neurocognitive Disorders 440 Causes of Neurocognitive Disorders 441
Prevention of Neurocognitive Disorders 442
INTERIM SUMMARY 443
REVIEW QUESTIONS 443
Neurocognitive Disorders: Assessment and Treatment 443
Assessment of Neurocognitive Disorders 443
Biological Treatments of Neurocognitive Disorders 445
Psychological Treatments of Neurocognitive Disorders 446
What If Someone I Know Has a Neurocognitive Disorder? 448
Long-Term Outcome for People with Neurocognitive Disorders 449
INTERIM SUMMARY 449
REVIEW QUESTIONS 450
FINAL COMMENTS 450
THOUGHT QUESTIONS 450
KEY TERMS 451
Special Features
CONTINUUM FIGURE 14.1 Continuum of Thinking and Memory Problems and Neurocognitive Disorder 426
• 14.1 FOC US ON CO LL EG E ST UD EN T S: Delirium 434
• 14.2 FOC US ON V IO L EN C E: Maltreatment of the Elderly 436
V THE CONTINUUM VIDEO PROJECT Myriam / Alzheimer’s Disease 437
• 14.3 FOC US ON GEN D ER: Grief in the Spouse Caregiver 448
• 14.4 FOC US ON L AW AND ETHI C S: Ethical Issues and Dementia 449
15 Consumer Guide to Abnormal Psychology 453
Introduction to the Consumer Guide 454
Becoming a Mental Health Professional 454
Types of Therapists and Quali cations 454
Preparing to Be a Mental Health Professional 455
Becoming a Client 458
Treatment at the Individual Level 459
Active Ingredients of Treatment 459
Process Variables in Treatment 460
Does Treatment Work? 462
Prescriptive Treatment 462
INTERIM SUMMARY 463
REVIEW QUESTIONS 463
Treatment at the Community Level 463
Self-Help Groups 463
Aftercare Services for People with Severe Mental Disorders 464
Residential Facilities for People with Developmental Disorders 465
Criminal Justice System 466
Public Policy and Mental Health 466
INTERIM SUMMARY 466
REVIEW QUESTIONS 467
Limitations and Caveats About Treatment 467
Client-Therapist Differences 467
Cultural Differences 467
Managed Care 468
Differences Between Clinicians and Researchers 468
Quick Fixes 468
Misuse of Research 468
Weak Research and How to Judge a Research Article 468
Negative Therapist Characteristics 469
Lack of Access to Treatment 470
Ethics 470
General Principles 470
Assessment 470
Treatment 471
Public Statements 472
Research 472
Resolving Ethical Issues 472
INTERIM SUMMARY 473
REVIEW QUESTIONS 473
FINAL COMMENTS 473
THOUGHT QUESTIONS 473
KEY TERMS 474
Special Features
• 15.1 FOC US ON GEN D ER: Graduate School and Mentors 459
Personal Narrative 15.1 Julia Martinez, Graduate Student in Clinical Psychology 460
Personal Narrative 15.2 Tiffany S. Borst, M.A., L.P.C. 464
• 15.2 FOC US ON L AW AND ETHI C S: Rights of Those Hospitalized for Mental Disorder 466
• 15.3 FOC US ON DIVERSI T Y: Lack of Diversity in Research 467
Personal Narrative 15.3 Christopher A. Kearney, Ph.D. 469
• 15.4 FOC US ON L AW AND ETHI C S: Sexual Intimacy and the Therapeutic Relationship 472
Appendix: Stress-Related Problems 476
Glossary G-0
References R-1
Name Index I-1
Subject Index I-17
PREFACE
Whenwe, the authors, decided to write this textbook, we wanted to create something different for our students. We wanted to create a book that appealed to students by helping them understand that symptoms of psychological problems occur in many people in different ways. We wanted to avoid characterizing mental disorders from a “yes–no” or “us–them” perspective and focus instead on how such problems affect many people to varying degrees in their everyday lives. In essence, we wanted to illustrate how abnormal psychology was really about the struggles that all of us face in our lives to some extent. We represent this approach in our title: Abnormal Psychology and Life.
Abnormal psychology is one of the most popular courses on college campuses. Students are eager to learn about unusual behavior and how such behavior can be explained. Many students who take an abnormal psychology course crave a scienti c perspective that can help prepare them well for graduate school and beyond. Other students take an abnormal psychology course because they are curious about themselves or people they know and thus seek application and relevance of the course information to their daily lives. Our book is designed to appeal to both types of students. The material in the book re ects stateof-the-art thinking and research regarding mental disorders but also emphasizes several key themes that increase personal relevance. These themes include a dimensional and integrative perspective, a consumer-oriented perspective, and emphases on prevention and cultural diversity. Personal relevance is also achieved by providing information to reduce the stigma of mental disorder; by illustrating comprehensive models of mental disorder that include biological, psychological, and other risk factors; and by employing various pedagogical aids, visually appealing material, and technological utilities.
A Dimensional and Integrative Perspective
A focus on how abnormal psychology is a key part of life comes about in this book in different ways. One main way is our focus on a dimensional perspective toward mental disorder. We believe that thoughts, feelings, and behaviors associated with mental disorders are present, to some degree, in all of us. Everyone experiences some level of anxiety, sadness, odd physical symptoms, worry about sexual behavior, and memory problems from time to time, for example. Throughout our chapters we vividly illustrate how different mental disorders can be seen along a continuum of normal, mild, moderate, severe, and very severe emotions, thoughts, and behaviors. We also provide examples along this continuum that parallel common scenarios people face, such as interactions with others and job interviews.
Our dimensional perspective is discussed within the context of an integrative perspective that includes an extensive discussion of risk and protective factors for various mental disorders. Such factors include biological (e.g., genetic, neurochemical, brain changes), personality, psychological (e.g., cognitive, learning, trauma), interpersonal, family, cultural, evolutionary, and other domains. We emphasize a diathesis-stress model and provide sections that integrate risk factors to present comprehensive models of various mental disorders. We also provide an appendix of medical conditions with contributing psychological factors that includes a biopsychosocial perspective to explain the interplay of physical symptoms with stress and other key contributing variables.
A Consumer-Oriented Perspective
Our book is also designed to recognize the fact that today’s student is very consumer-oriented. Students expect textbooks to be relevant to their own lives and to deliver information about diagnostic criteria, epidemiological data, brain changes, and assessment instruments in visually appealing and technologically sophisticated ways. This textbook adopts a consumer approach in several ways. The chapters in this book contain suggestions for those who are concerned that they or someone they know may have symptoms of a speci c mental disorder. These suggestions also come with key questions one could ask to determine whether a problem may be evident. In addition, much of our material is geared toward a consumer approach. In our discussion of neurocognitive disorders such as Alzheimer’s disease, for example, we outline questions one could ask when considering placing a parent in a nursing home.
The consumer orientation of this book is also prominent in the last chapter when we discuss topics such as becoming a mental health professional, becoming a client in therapy, treatments available at the community level such as self-help groups, and how to judge a research article, among other topics. Throughout our chapters, we also focus special attention on issues of gender, ethnicity, law and ethics, and violence in separate boxes. In addition, we have separate sections that speci cally address symptoms of mental disorder in college students. We offer visually appealing examples of a dimensional model for each major mental disorder, brain gures, and engaging tables and charts to more easily convey important information. The book is also linked to many technological resources and contains 15 chapters, which ts nicely into a typical 15-week semester.
We also include several pedagogical aids to assist students during their learning process. The chapters are organized in a
similar fashion throughout, beginning with initial sections on normal and unusual behavior and followed by discussions of features and epidemiology, stigma, causes and prevention, assessment, treatment, and prognosis. The chapters contain interim summaries and review questions at periodic intervals to help students check their understanding of what they just learned. Bold key terms are placed throughout the chapters and corresponding de nitions are placed in the margin. What Do You Think? questions appear after the chapter-opening case study, which help students focus on important aspects of the case. Boxes that direct readers to related videos from the Continuum Video Project are featured in the disorder chapters (Chapters 5–14). More information on the Continuum Video Project, available in MindTap, is on page xxix. Final comments are also provided at the end of each chapter to link material to previous and future chapters. Broad-based thought questions are also at the end of each chapter to challenge students to apply what they have learned to their daily lives. The writing style of the book is designed to be easy to follow and to succinctly convey key information.
Prevention
Another important theme of this book is prevention. Most college students function well in their environment, but everyone has some level of risk for psychological dysfunction or distress. We thus emphasize research-based ways to prevent the onset of psychological problems throughout this textbook. We offer speci c sections on prevention and provide a detailed discussion of risk factors for mental disorder and how these risk factors could be minimized. We also provide a discussion of protective factors and strategies that could be nurtured during one’s life to prevent psychological problems. Examples include anxiety and stress management, emotional regulation, appropriate coping, healthy diet, and adaptive parenting.
Much of our discussion in this area focuses on primary and secondary prevention, which has great appeal for students. Many prevention programs target those who have not developed a mental disorder or who may be at risk due to individual or environmental factors. A focus on prevention helps students understand what they could do to avert problematic symptoms or to seek help before such symptoms become more severe. Prevention material in the book also focuses on tertiary prevention and relapse prevention, so students can understand what steps people can take to continue healthy functioning even after the occurrence of a potentially devastating mental disorder. The prevention material in this book thus has broad appeal, relevance, and utility for students.
Cultural Diversity
Mental health professionals have made a more concerted effort to achieve greater cultural diversity in their research, to apply ndings in laboratory settings to greater numbers of people, and to shine a spotlight on those who are traditionally underserved. We emphasize these greater efforts in this textbook. In addition
to the special boxes on diversity, we provide detailed information about cultural syndromes; how symptoms and epidemiology may differ across cultural groups; how certain cultural factors may serve as risk and protective factors for various disorders; how diagnostic, assessment, and treatment strategies may need to be modi ed for different cultural groups; and how cultural groups may seek treatment or cope differently with symptoms of mental disorder.
Our discussion of cultural diversity applies to various ethnic and racial groups, but diversity across individuals is represented in many other ways as well. We focus heavily on gender differences, sexual orientation, sociocultural factors, migrant populations, and changes in symptoms as people age from childhood to adolescence to adulthood to late adulthood. Our emphasis on cultural and other types of diversity is consistent with our life-based approach for the book: Symptoms of mental disorder can occur in many people in many different ways in many life stages.
Stigma
A focus on a dimensional approach to mental disorder helps us advance another key theme of this book, which is to reduce stigma. Stigma refers to socially discrediting people because of certain behaviors or attributes that may lead to them being seen as undesirable in some way. People with schizophrenia, for example, are often stigmatized as people who cannot function or who may even be dangerous. Adopting a dimensional perspective to mental disorder helps reduce inaccurate stereotypes and the stigma associated with many of these problems. You will also see throughout this book that we emphasize people rst and a mental disorder second to reduce stigma. You will not see us use words or phrases such as schizophrenics or bulimics or the learning disabled. Instead, you will see phrases such as people with schizophrenia, those with bulimia, or children with learning disorder. We also provide special sections on stigma throughout the chapters as well as boxes that contain information to dispel common myths about people with mental disorders that likely lead to negative stereotyping.
Clinical Cases and Narratives
Our dimensional perspective and our drive to reduce stigma is enhanced as well by extensive use of clinical cases and personal narratives throughout the book. Clinical cases are presented in chapters that describe a particular mental disorder and are often geared toward cases to which most college students can relate. These cases then reappear throughout that chapter as we discuss features of that disorder as well as assessment and treatment strategies. We also include personal narratives from people who have an actual mental disorder and who can discuss its symptoms and other features from direct experience. All of these cases reinforce the idea that symptoms of mental disorder are present to some degree in many people, perhaps including those easily recognized by a student as someone in his or her life.
New to the Third Edition
The third edition contains many new and exciting changes. Readers will see that the most obvious change is that ongoing research has adapted to the most recent edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-5. State-of-the-art research and citations are thus presented. The chapters remain aligned as they were previously to enhance teaching in a typical semester and to re ect empirical work that has been done for each set of disorders. DSM-5 criteria and other information are presented to help illuminate symptoms of mental disorders for students and to convey various dimensional aspects as well. Examples include continua based on severity, number of symptoms or behavioral episodes, body mass index, and personality traits, among many others.
The third edition also contains many boxes devoted to gender, diversity, violence, and law and ethics. In addition, separate sections have been added regarding how symptoms of mental disorders often manifest themselves in college students. Updated sections on stigma also illustrate our commitment to this important topic and present fascinating research with respect to others’ views of someone with a mental disorder and treatment and other strategies that have been developed to reduce stigma toward those with mental disorder.
An important process as well has been a thorough review of the material to ensure that students continue to be presented with state-of-the-art research and most current thinking regarding mental disorders, including epidemiology. Many sections of the book have thus been redone or reworked to re ect new data, and hundreds of new citations have been added, most of which are very current. One thing that has not changed, however, is our deep devotion and commitment to this work and to our students and their instructors.
A brief summary of key changes and additions for each chapter in the third edition is provided here. This is not an exhaustive list but provides some general guidance for those familiar with the second edition.
Chapter 1: Abnormal Psychology and Life
• New information regarding worldwide epidemiology of mental disorders.
• Revamped stigma sections to re ect recent ndings.
Chapter 2: Perspectives on Abnormal Psychology
• Updated citations and enhanced clari cation of certain sections.
• Enhanced boxes on violence, law and ethics, and gender, including material on dangerousness and commitment.
Chapter 3: Risk and Prevention of Mental Disorders
• Updated information on epidemiology and a new world map in this regard.
• Revamped sections on demographic risk factors and resilience.
• Updated and new information on prevention, including primary prevention of alcohol use disorders on college campuses and selective prevention of eating disorders in college students.
• Updated information on suicide in college students.
Chapter 4: Diagnosis, Assessment, and Study of Mental Disorders
• Updated information on all assessment information.
• New culture and diagnosis example: ghost oppression.
Chapter 5: Anxiety, Obsessive-Compulsive, and Trauma-Related Disorders
• Updated and enhanced information regarding epidemiology.
• Updated heritability and other etiology information and a revamped gender box.
• Updated assessment and treatment information, such as transdiagnostic treatments.
• New box on anxiety in college students.
Chapter 6: Somatic Symptom and Dissociative Disorders
• Updated information regarding new somatic symptom disorders, including features and epidemiology.
• Updated and revamped sections on risk factors, assessment, and treatment throughout.
• New boxes on somatic symptoms and dissociative experiences in college students.
Chapter 7: Depressive and Bipolar Disorders and Suicide
• Updated information, including features and epidemiology, of the mood disorders.
• Revamped sections on suicide, stigma, genetics, neurochemical features, stressful life events, and interpersonal factors, among other sections.
• New box on depression in college students.
Chapter 8: Eating Disorders
• Updated information, including features and epidemiology, of eating disorders.
• Revamped stigma and family sections, among others, on eating disorders.
• New box on eating disorder symptoms in college students.
Chapter 9: Substance-Related Disorders
• Updated information throughout and especially with respect to recent gures regarding substance use.
• Revamped sections on stigma, prevention, and long-term outcome of substance use disorders, among other sections.
• New box on treatment of substance use disorders in college students.
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"Answer my question. I'm not chaffing you, I'm in deadly earnest. Have you ever had a vision of Duke Aubrey?"
Master Ambrose moved uneasily in his chair He was far from proud of that vision of his. "Well," he said, gruffly, "I suppose one might call it that. It was at the Academy—the day that wretched girl of mine ran away. And I was so upset that there was some excuse for what you call visions."
"And did you tell anyone about it?"
"Not I!" said Master Ambrose emphatically; then he caught himself up and added, "Oh! yes I believe I did though. I mentioned it to that spiteful little quack, Endymion Leer. I'm sure I wish I hadn't. Toasted Cheese! What's the matter now, Nat?"
For Master Nathaniel was actually cutting a caper of triumph and glee.
"I was right! I was right!" he cried joyfully, so elated by his own acumen that for the moment his anxiety was forgotten.
"Read that, Ambrose," and he eagerly thrust into his hands Luke Hempen's letter
"Humph!" said Master Ambrose when he had finished it. "Well, what are you so pleased about?"
"Don't you see, Ambrose!" cried Master Nathaniel impatiently. "That mysterious fellow in the cloak must be Endymion Leer nobody else knows about your vision."
"Oh, yes, Nat, blunt though my wits may be I see that. But I fail to see how the knowledge helps us in any way." Then Master Nathaniel told him about Dame Marigold's theories and discoveries.
Master Ambrose hummed and hawed, and talked about women's reasoning, and rash conclusions. But perhaps he was more impressed, really, than he chose to let Master Nathaniel see. At any rate he grudgingly agreed to go with him by night to the Guildhall and investigate the hollow panel. And, from Master Ambrose, this was a great concession; for it was not the sort of escapade that suited his dignity.
"Hurrah, Ambrose!" shouted Master Nathaniel. "And I'm ready to bet a Moongrass cheese against a flask of your best flower-in-amber that we'll find that rascally quack at the bottom of it all!"
"You'd always a wonderful eye for a bargain, Nat," said Master Ambrose with a grim chuckle. "Do you remember, when we were youngsters, how you got my pedigree pup out of me for a stuffed pheasant, so moth-eaten that it had scarcely a feather to its name, and, let me see, what else? I think there was a half a packet of mouldy sugar-candy...."
"And I threw in a broken musical-box whose works used to go queer in the middle of 'To War, Bold Sons of Dorimare,' and burr and buzz like a drunk cockchafer," put in Master Nathaniel proudly. "It was quite fair—quantity for quality."
CHAPTER XIII
WHAT
MASTER NATHANIEL
AND MASTER AMBROSE FOUND IN THE GUILDHALL
Master Nathaniel was much too restless and anxious to explore the Guildhall until the groom returned whom he had sent with the letter to Luke Hempen.
But he must have taken the order to ride night and day literally—in so short a time was he back again in Lud. Master Nathaniel was, of course, enchanted by his despatch, though he was unable to elicit from him any detailed answers to his eager questions about Ranulph. But it was everything to know that the boy was well and happy, and it was but natural that the fellow should be bashful and tongue-tied in the presence of his master
But the groom had not, as a matter of fact, come within twenty miles of the widow Gibberty's farm.
In a road-side tavern he had fallen in with a red-haired youth, who had treated him to glass upon glass of an extremely intoxicating wine; and, in consequence, he had spent the night and a considerable portion of the following morning sound asleep on the floor of the tavern.
When he awoke, he was horrified to discover how much time he had wasted. But his mind was set at rest on the innkeeper's giving him a letter from the red-haired youth, to say that he deeply regretted having been the indirect cause of delaying a messenger sent on pressing business by the High Seneschal (in his cup the groom had boasted of the importance of his errand), and had, in consequence, ventured to possess himself of the letter, which he guaranteed to deliver at the address on the wrapper as soon, or sooner, as the messenger could have done himself.
The groom was greatly relieved. He had not been long in Master Nathaniel's service. It was after Yule-tide he had entered it.
So it was with a heart relieved from all fears for Ranulph and free to throb like a schoolboy's with the lust of adventure that Master Nathaniel met Master Ambrose on the night of the full moon at the splendid carved doors of the Guildhall.
"I say, Ambrose," he whispered, "I feel as if we were lads again, and off to rob an orchard!"
Master Ambrose snorted. He was determined, at all costs, to do his duty, but it annoyed him that his duty should be regarded in the light of a boyish escapade.
The great doors creaked back on their hinges. Shutting them as quietly as they could, they tip-toed up the spiral staircase and along the corridor described by Dame Marigold: whenever a board creaked under their heavy steps, one inwardly cursing the other for daring to be so stout and unwieldy.
All round them was darkness, except for the little trickles of light cast before them by their two lanthorns.
A house with old furniture has no need of guests to be haunted. As we have seen, Master Nathaniel was very sensitive to the silent things—stars, houses, trees; and often in his pipe-room, after the candles had been lit, he would sit staring at the bookshelves, the chairs, his father's portrait—even at his red umbrella standing up in the corner, with as great a sense of awe as if he had been a stargazer.
But that night, the brooding invisible presences of the carved panels, the storied tapestries, affected even the hard-headed Master Ambrose. It was as if that silent population was drawing him, by an irresistible magnetism, into the zone of its influence.
If only they would speak, or begin to move about—those silent rooted things! It was like walking through a wood by moonlight.
Then Master Nathaniel stood still.
"This, I think, must roughly be the spot where Marigold found the hollow panel," he whispered, and began tapping cautiously along the wainscotting.
A few minutes later, he said in an excited whisper, "Ambrose! Ambrose! I've got it. Hark! You can hear, can't you? It's as hollow as a drum."
"Suffering Cats! I believe you're right," whispered back Master Ambrose, beginning, in spite of himself, to be a little infected with Nat's absurd excitement.
And then, yielding to pressure, the panel slid back, and by the light of their lanthorns they could see a twisting staircase.
For a few seconds they gazed at each other in silent triumph. Then Master Nathaniel chuckled, and said, "Well, here goes—down with our buckets into the well! And may we draw up something better than an old shoe or a rotten walnut!" and straightway he began to descend the stairs, Master Ambrose valiantly following him.
The stairs went twisting down, down—into the very bowels of the earth, it seemed. But at long last they found themselves in what looked like a long tunnel.
"Tally ho! Tally ho!" whispered Master Nathaniel, laughing for sheer joy of adventure, "take it at a gallop, Brosie; it may lead to an open glade ... and the deer at bay!"
And digging him in the ribs, he added, "Better sport than moth hunting, eh?" which showed the completeness of their reconciliation.
Nevertheless, it was very slowly, and feeling each step, that they groped their way along the tunnel.
After what seemed a very long time Master Nathaniel halted, and whispered over his shoulder, "Here we are. There's a door ... oh, thunder and confusion on it for ever! It's locked."
And, beside himself with irritation at this unlooked-for obstacle, he began to batter and kick at the door, like one demented.
He paused a minute for breath, and from the inside could be heard a shrill female voice demanding the pass-word.
"Pass-word?" bellowed back Master Nathaniel, "by the Sun, Moon and Stars and the Golden Apples of the West, what...."
But before he could finish his sentence, the door was opened from the other side, and they marched into a low, square room, which was lit by one lamp swinging by a chain from the ceiling—for which there seemed but little need, for a light more brilliant than that of any lamp, and yet as soft as moonlight, seemed to issue from the marvelous tapestries that hung on the walls.
They were dumb with amazement. This was as different from all the other tapestry they had ever seen as is an apple-tree in full blossom against a turquoise sky in May to the same tree in November, when only a few red leaves still cling to its branches, and the sky is leaden. Oh, those blues, and pinks, and brilliant greens! In what miraculous dyes had the silks been dipped?
As to the subjects, they were those familiar to every Dorimarite— hunting scenes, fugitives chased by the moon, shepherds and shepherdesses tending their azure sheep. But, depicted in these brilliant hues, they were like the ashes of the past, suddenly, under one's very eyes, breaking into flame. Heigh-presto! The men and women of a vanished age, noisy, gaudy, dominant, are flooding the streets, and driving the living before them like dead leaves.
And what was this lying in heaps on the floor? Pearls and sapphires, and monstrous rubies? Or windfalls of fruit, marvellous fruit, fallen from the trees depicted on the tapestry?
Then, as their eyes grew accustomed to all the brilliance, the two friends began to get their bearings; there could be no doubt as to the nature of that fruit lying on the floor. It was fairy fruit, or their names were not respectively Chanticleer and Honeysuckle.
And, to their amazement, the guardian of this strange treasure was none other than their old acquaintance Mother Tibbs.
Her clear, child-like eyes that shone like lamps out of her seared weather-beaten face, were gazing at them in a sort of mild surprise. "If it isn't Master Hyacinth and Master Josiah!" she exclaimed, adding, with her gay, young laugh, "to think of their knowing the pass-word!"
Then she peered anxiously into their faces: "Are your stockings wearing well yonder? The last pair I washed for you didn't take the soap as they should. Marching down the Milky Way, and tripping it beyond the moon, is hard on stockings."
Clearly she took them for their own fathers.
Meanwhile, Master Ambrose was drawing in his breath, with a noise as if he were eating soup, and creasing his double chins—sure signs, to anyone who had seen him on the Bench, that he was getting ready to hector
But Master Nathaniel gave him a little warning nudge, and said cordially to their hostess, "Why, our stockings, and boots too, are doing very nicely, thank you. So you didn't expect us to know the pass-word, eh? Well, well, perhaps we know more than you think," then, under his breath to Master Ambrose, "By my Great-aunt's Rump, Ambrose, what was the pass-word?"
Then turning again to Mother Tibbs, who was slightly swaying from her hips, as if in time to some jig, which she alone could hear, he said, "You've got some fine tapestry. I don't believe I've ever seen finer!"
She smiled, and then coming close up to him, said in a low voice, "Does your Worship know what makes it so fine? No? Why, it's the fairy fruit!" and she nodded her head mysteriously, several times.
Master Ambrose gave a sort of low growl of rage, but again Master Nathaniel shot him a warning look, and said in a voice of polite interest, "Indeed! Indeed! And where, may I ask, does the ... er ... fruit come from?"
She laughed merrily, "Why, the gentlemen bring it! All the pretty gentlemen, dressed in green, with their knots of ribands, crowding
down in the sunrise from their ships with the scarlet sails to suck the golden apricocks, when all in Lud are fast asleep! And then the cock says Cockadoodledoo! Cockadoodledooooo!" and her voice trailed off, far-away and lonely, suggesting, somehow, the first glimmer of dawn on ghostly hayricks.
"And I'll tell you something, Master Nat Cock o' the Roost," she went on, smiling mysteriously, and coming close up to him, "you'll soon be dead!"
Then she stepped back, smiling and nodding encouragingly, as if to say, "There's a pretty present I've given you! Take care of it."
"And as for Mother Tibbs," she went on triumphantly, "she'll soon be a fine lady, like the wives of the Senators, dancing all night under the moon! The gentlemen have promised."
Master Ambrose gave a snort of impatience, but Master Nathaniel said with a good-humoured laugh, "So that's how you think the wives of the Senators spend their time, eh? I'm afraid they've other things to do. And as to yourself, aren't you getting too old for dancing?"
A slight shadow passed across her clear eyes. Then she tossed her head with the noble gesture of a wild creature, and cried, "No! No! As long as my heart dances my feet will too. And nobody will grow old when the Duke comes back."
But Master Ambrose could contain himself no longer. He knew only too well Nat's love of listening to long rambling talk—especially when there happened to be some serious business on hand.
"Come, come," he cried in a stern voice, "in spite of being crackbrained, my good woman, you may soon find yourself dancing to another tune. Unless you tell us in double quick time who exactly these gentlemen are, and who it was that put you on guard here, and who brings that filthy fruit, and who takes it away, we will ... why, we will cut the fiddle strings that you dance to!"
This threat was a subconscious echo of the last words he had heard spoken by Moonlove. Its effect was instantaneous.
"Cut the fiddle strings! Cut the fiddle strings!" she wailed; adding coaxingly, "No, no, pretty master, you would never do that! Would he now?" and she turned appealingly to Master Nathaniel. "It would be like taking away the poor man's strawberries. The Senator has peaches and roasted swans and peacock's hearts, and a fine coach to drive in, and a feather bed to lie late in of a morning. And the poor man has black bread and baked haws, and work ... but in the summer he has strawberries and tunes to dance to. No, no, you would never cut the fiddle strings!"
Master Nathaniel felt a lump in his throat. But Master Ambrose was inexorable: "Yes, of course I would!" he blustered; "I'd cut the strings of every fiddle in Lud. And I will, too, unless you tell us what we want to know. Come, Mother Tibbs, speak out—I'm a man of my word."
She gazed at him beseechingly, and then a look of innocent cunning crept into her candid eyes and she placed a finger on her lips, then nodded her head several times and said in a mysterious whisper, "If you'll promise not to cut the fiddle strings I'll show you the prettiest sight in the world—the sturdy dead lads in the Fields of Grammary hoisting their own coffins on their shoulders, and tripping it over the daisies. Come!" and she darted to the side of the wall, drew aside the tapestry and revealed to them another secret door. She pressed some spring, it flew open disclosing another dark tunnel.
"Follow me, pretty masters," she cried.
"There's nothing to be done," whispered Master Nathaniel, "but to humour her. She may have something of real value to show us."
Master Ambrose muttered something about a couple of lunatics and not having left his fireside to waste the night in indulging their fantasies; but all the same he followed Master Nathaniel, and the second secret door shut behind them with a sharp click.
"Phew!" said Master Nathaniel: "Phew!" puffed Master Ambrose, as they pounded laboriously along the passage behind their light-footed guide.
Then they began to ascend a flight of stairs, which seemed interminable, and finally fell forward with a lurch on to their knees,
and again there was a click of something shutting behind them.
They groaned and cursed and rubbed their knees and demanded angrily to what unholy place she had been pleased to lead them.
But she clapped her hands gleefully, "Don't you know, pretty masters? Why, you're where the dead cocks roost! You've come back to your own snug cottage, Master Josiah Chanticleer. Take your lanthorn and look round you."
This Master Nathaniel proceeded to do, and slowly it dawned on him where they were.
"By the Golden Apples of the West, Ambrose!" he exclaimed, "if we're not in my own chapel!"
And, sure enough, the rays of the lanthorn revealed the shelves lined with porphyry coffins, the richly wrought marble ceiling, and the mosaic floor of the home of the dead Chanticleers.
"Toasted Cheese!" muttered Master Ambrose in amazement.
"It must have two doors, though I never knew it," said Master Nathaniel. "A secret door opening on to that hidden flight of steps. There are evidently people who know more about my chapel than I do myself," and suddenly he remembered how the other day he had found its door ajar.
Mother Tibbs laughed gleefully at their surprise, and then, placing one finger on her lips, she beckoned them to follow her; and they tiptoed after her out into the moonlit Fields of Grammary, where she signed to them to hide themselves from view behind the big trunk of a sycamore.
The dew, like lunar daisies, lay thickly on the grassy graves. The marble statues of the departed seemed to flicker into smiles under the rays of the full moon; and, not far from the sycamore, two men were digging up a newly-made grave. One of them was a brawny fellow with the gold rings in his ears worn by sailors, the other was— Endymion Leer.
Master Nathaniel shot a look of triumph at Master Ambrose, and whispered, "A cask of flower-in-amber, Brosie!"
For some time the two men dug on in silence, and then they pulled out three large coffins and laid them on the grass.
"We'd better have a peep, Sebastian," said Endymion Leer, "to see that the goods have been delivered all right. We're dealing with tricky customers."
The young man, addressed as Sebastian, grinned, and taking a clasp knife from his belt, began to prise open one of the coffins.
As he inserted the blade into the lid, our two friends behind the sycamore could not help shuddering; nor was their horror lessened by the demeanor of Mother Tibbs, for she half closed her eyes, and drew the air in sharply through her nostrils, as if in expectation of some delicious perfume.
But when the lid was finally opened and the contents of the coffin exposed to view, they proved not to be cere cloths and hideousness, but—closely packed fairy fruit.
"Yes, that's the goods all right," said Endymion Leer, "and we'll take the other two on trust. Shut it up again, and help to hoist it on to my shoulder, and do you follow with the other two—we'll take them right away to the tapestry-room. We're having a council there at midnight, and it's getting on for that now."
Choosing a moment when the backs of the two smugglers were turned, Mother Tibbs darted out from behind the sycamore, and shot back into the chapel, evidently afraid of not being found at her post. And she was shortly followed by Endymion Leer and his companion.
At first, the sensations of Master Nathaniel and Master Ambrose were too complicated to be expressed in words, and they merely stared at each other, with round eyes. Then a slow smile broke over Master Nathaniel's face, "No Moongrass cheese for you this time, Brosie," he said. "Who was right, you or me?"
"By the Milky Way, it was you, Nat!" cried Master Ambrose, for once, in a voice of real excitement. "The rascal! The unmitigated rogue! So
it's him, is it, we parents have to thank for what has happened! But he'll hang for it, he'll hang for it—though we have to change the whole constitution of Dorimare! The blackguard!"
"Into the town probably as a hearse," Master Nathaniel was saying thoughtfully, "then buried here, then down through my chapel into the secret room in the Guildhall, whence, I suppose, they distribute it by degrees. It's quite clear now how the stuff gets into Lud. All that remains to clear up is how it gets past our Yeomen on the border ... but what's taken you, Ambrose?"
For Master Ambrose was simply shaking with laughter; and he did not laugh easily.
"Do the dead bleed?" he was repeating between his guffaws; "why, Nat, it's the best joke I've heard these twenty years!"
And when he had sufficiently recovered he told Master Nathaniel about the red juice oozing out of the coffin, which he had taken for blood, and how he had frightened Endymion Leer out of his wits by asking him about it.
"When, of course, it was a bogus funeral, and what I had seen was the juice of that damned fruit!" and again he was seized with paroxysms of laughter.
But Master Nathaniel merely gave an absent smile; there was something vaguely reminiscent in that idea of the dead bleeding— something he had recently read or heard; but, for the moment, he could not remember where.
In the meantime, Master Ambrose had recovered his gravity "Come, come," he cried briskly, "we've not a moment to lose. We must be off at once to Mumchance, rouse him and a couple of his men, and be back in a twinkling to that tapestry-room, to take them red-handed."
"You're right, Ambrose! You're right!" cried Master Nathaniel. And off they went at a sharp jog trot, out at the gate, down the hill, and into the sleeping town.
They had no difficulty in rousing Mumchance and in firing him with their own enthusiasm. As they told him in a few hurried words what
they had discovered, his respect for the Senate went up in leaps and bounds—though he could scarcely credit his ears when he learned of the part played in the evening's transactions by Endymion Leer.
"To think of that! To think of that!" he kept repeating, "and me who's always been so friendly with the Doctor, too!"
As a matter of fact, Endymion Leer had for some months been the recipient of Mumchance's complaints with regard to the slackness and inefficiency of the Senate; and, in his turn, had succeeded in infecting the good Captain's mind with sinister suspicions against Master Nathaniel. And there was a twinge of conscience for disloyalty to his master, the Mayor, behind the respectful heartiness of his tones as he cried, "Very good, your Worship. It's Green and Juniper what are on duty tonight. I'll go and fetch them from the guard-room, and we should be able to settle the rascals nicely."
As the clocks in Lud-in-the-Mist were striking midnight the five of them were stepping cautiously along the corridors of the Guildhall. They had no difficulty in finding the hollow panel, and having pressed the spring, they made their way along the secret passage.
"Ambrose!" whispered Master Nathaniel flurriedly, "what was it exactly that I said that turned out to be the pass-word? What with the excitement and all I've clean forgotten it."
Master Ambrose shook his head. "I haven't the slightest idea," he whispered back. "To tell you the truth, I couldn't make out what she meant about your having used a pass-word. All I can remember your saying was 'Toasted Cheese!' or 'Busty Bridget!'—or something equally elegant."
Now they had got to the door, locked from the inside as before.
"Look here, Mumchance," said Master Nathaniel, ruefully, "we can't remember the pass-word, and they won't open without it."
Mumchance smiled indulgently, "Your Worship need not worry about the pass-word," he said. "I expect we'll be able to find another that will do as well ... eh, Green and Juniper? But perhaps first—just to be in order—your Worship would knock and command them to open."
Master Nathaniel felt absurdly disappointed. For one thing, it shocked his sense of dramatic economy that they should have to resort to violence when the same result could have been obtained by a minimum expenditure of energy. Besides, he had so looked forward to showing off his new little trick!
So it was with a rueful sigh that he gave a loud rat-a-tat-tat on the door, calling out, "Open in the name of the Law!"
These words, of course, produced no response, and Mumchance, with the help of the other four, proceeded to put into effect his own pass-word, which was to shove with all their might against the door, two of the hinges of which he had noticed looked rusty.
It began to creak, and then to crack, and finally they burst into ... an empty room. No strange fruit lay heaped on the floor; nothing hung on the walls but a few pieces of faded moth-eaten tapestry. It looked like a room that had not been entered for centuries.
When they had recovered from their first surprise, Master Nathaniel cried fiercely, "They must have got wind that we were after them, and given us the slip, taking their loads of filthy fruits with them, I'll...."
"There's been no fruit here, your Worship," said Mumchance in a voice that he was trying hard to keep respectful; "it always leaves stains, and there ain't any stains here."
And he couldn't resist adding, with a wink to Juniper and Green, "I daresay it's your Worship's having forgotten the pass-word that's done it!" And Juniper and Green grinned from ear to ear.
Master Nathaniel was too chagrined to heed this insolence; but Master Ambrose—ever the champion of dignity in distress—gave Mumchance such a look that he hung his head and humbly hoped that his Worship would forgive his little joke.
CHAPTER XIV
DEAD IN THE EYE OF THE
LAW
The following morning Master Nathaniel woke late, and got up on the wrong side of his bed, which, in view of the humiliation and disappointment of the previous night, was, perhaps, pardonable.
His temper was not improved by Dame Marigold's coming in while he was dressing to complain of his having smoked green shag elsewhere than in the pipe-room: "And you know how it always upsets me, Nat. I'm feeling quite squeamish this morning, the whole house reeks of it ... Nat! you know you are an old blackguard!" and she dimpled and shook her finger at him, as an emollient to the slight shrewishness of her tone.
"Well, you're wrong for once," snapped Master Nathaniel; "I haven't smoked shag even in the pipe-room for at least a week—so there! Upon my word, Marigold, your nose is a nuisance—you should keep it in a bag, like a horse!"
But though Master Nathaniel might be in a bad temper he was far from being daunted by what had happened the night before.
He shut himself into the pipe-room and wrote busily for about a quarter of an hour; then he paced up and down committing what he had written to memory. Then he set out for the daily meeting of the Senate. And so absorbed was he with the speech he had been preparing that he was impervious, in the Senators' tiring-room, to the peculiar glances cast at him by his colleagues.
Once the Senators had donned their robes of office and taken their places in the magnificent room reserved for their councils, their whole personality was wont suddenly to alter, and they would cease to be genial, easy-going merchants who had known each other all their lives and become grave, formal—even hierophantic, in manner;
while abandoning the careless colloquial diction of every day, they would adopt the language of their forefathers, forged in more strenuous and poetic days than the present.
In consequence, the stern look in Master Nathaniel's eye that morning, when he rose to address his colleagues, the stern tone in which he said "Senators of Dorimare!" might have heralded nothing more serious than a suggestion that they should, that year, have geese instead of turkeys at their public dinner.
But his opening words showed that this was to be no usual speech. "Senators of Dorimare!" he began, "I am going to ask you this morning to awake. We have been asleep for many centuries, and the Law has sung us lullabies. But many of us here have received the accolade of a very heavy affliction. Has that wakened us? I fear not. The time has come when it behooves us to look facts in the face— even if those facts bear a strange likeness to dreams and fancies.
"My friends, the ancient foes of our country are abroad. Tradition says that the Fairies" (he brought out boldly the horrid word) "fear iron; and we, the descendants of the merchant-heroes, must still have left in us some veins of that metal. The time has come to prove it. We stand to lose everything that makes life pleasant and secure— laughter, sound sleep, the merriment of fire-sides, the peacefulness of gardens. And if we cannot bequeath the certainty of these things to our children, what will boot them their inheritance? It is for us, then, as fathers as well as citizens, once and for all to uproot this menace, the roots of which are in the past, the branches of which cast their shadow on the future.
"I and another of your colleagues have discovered at last who it was that brought this recent grief and shame upon so many of us. It will be hard, I fear, to prove his guilt, for he is subtle, stealthy, and mocking, and, like his invisible allies, his chief weapon is delusion. I ask you all, then, to parry that weapon with faith and loyalty, which will make you take the word of old and trusty friends as the only touchstone of truth. And, after that—I have sometimes thought that less blame attaches to deluding others than to deluding oneself. Away, then, with flimsy legal fictions! Let us call things by their
names—not grograine or tuftaffity, but fairy fruit. And if it be proved that any man has brought such merchandise into Dorimare, let him hang by his neck till he be dead."
Then Master Nathaniel sat down.
But where was the storm of applause he had expected would greet his words? Where were the tears, the eager questions, the tokens of deeply stirred feelings?
Except for Master Ambrose's defiant "Bravos!" his speech was received in profound silence. The faces all round him were grim and frigid, with compressed lips and frowning brows—except the portrait of Duke Aubrey—he, as usual, was faintly smiling.
Then Master Polydore Vigil rose to his feet, and broke the grim silence.
"Senators of Dorimare!" he began, "the eloquent words we have just listened to from his Worship the Mayor can, strangely enough, serve as a prelude—a golden prelude to my poor, leaden words. I, too, came here this morning resolved to bring your attention to legal fictions—which, sometimes, it may be, have their uses. But perhaps before I say my say, his Worship will allow the clerk to read us the oldest legal fiction in our Code. It is to be found in the first volume of the Acts of the twenty-fifth year of the Republic, Statute 5, chapter 9."
Master Polydore Vigil sat down, and a slow grim smile circulated round the hall, and then seemed to vanish and subside in the mocking eyes of Duke Aubrey's portrait.
Master Nathaniel exchanged puzzled glances with Master Ambrose; but there was nothing for it but to order the clerk to comply with the wishes of Master Polydore.
So, in a small, high, expressionless voice, which might have been the voice of the Law herself, the clerk read as follows:
"Further, we ordain that nothing but death alone shall have power to dismiss the Mayor of Lud-in-the-Mist and High Seneschal of Dorimare before the five years of his term of office shall fully have
expired. But, the dead, being dumb, feeble, treacherous and given to vanities, if any Mayor at a time of menace to the safety of the Dorimarites be held by his colleagues to be any of these things, then let him be accounted dead in the eye of the Law, and let another be elected in his stead."
CHAPTER XV
"HO, HO, HOH!"
The clerk shut the great tome, bowed low, and withdrew to his place; and an ominous silence reigned in the hall.
Master Nathaniel sat watching the scene with an eye so cold and aloof that the Eye of the Law itself could surely not have been colder. What power had delusion or legal fictions against the mysterious impetus propelling him along the straight white road that led he knew not whither?
But Master Ambrose sprang up and demanded fiercely that the honourable Senator would oblige them by an explanation of his offensive insinuations.
Nothing loth, Master Polydore again rose to his feet, and, pointing a menacing finger at Master Nathaniel, he said: "His worship the Mayor has told us of a man stealthy, mocking, and subtle, who has brought this recent grief and shame upon us. That man is none other than his Worship the Mayor himself."
Master Ambrose again sprung to his feet, and began angrily to protest, but Master Nathaniel, ex cathedra, sternly ordered him to be silent and to sit down.
Master Polydore continued: "He has been dumb, when it was the time to speak, feeble, when it was the time to act, treacherous, as the desolate homes of his friends can testify, and given to vanities. Aye, given to vanities, for what," and he smiled ironically, "but vanity in a man is too great a love for grograines and tuftaffities and other costly silks? Therefore, I move that in the eye of the Law he be accounted dead."
A low murmur of approval surged over the hall.
"Will he deny that he is over fond of silk?"
Master Nathaniel bowed, in token that he did deny it.
Master Polydore asked if he would then be willing to have his house searched; again Master Nathaniel bowed. There and then?
And Master Nathaniel bowed again.
So the Senate rose and twenty of the Senators, without removing their robes, filed out of the Guildhall and marched two and two towards Master Nathaniel's house.
On the way who should tag himself on to the procession but Endymion Leer. At this, Master Ambrose completely lost his temper. He would like to know why this double-dyed villain, this shameless Son of a Fairy, was putting his rancid nose into the private concerns of the Senate! But Master Nathaniel cried impatiently, "Oh, let him come, Ambrose, if he wants to. The more the merrier!"
You can picture the consternation of Dame Marigold when, a few minutes later, her brother—with a crowd of Senators pressing up behind him—bade her, with a face of grave compassion, to bring him all the keys of the house.
They proceeded to make a thorough search, ransacking every cupboard, chest and bureau. But nowhere did they find so much as an incriminating pip, so much as a stain of dubious colour
"Well," began Master Polydore, in a voice of mingled relief and disappointment, "it seems that our search has been a...."
"Fruitless one, eh?" prompted Endymion Leer, rubbing his hands, and darting his bright eyes over the assembled faces. "Well, perhaps it has. Perhaps it has."
They were standing in the hall, quite close to the grandfather's clock, which was ticking away, as innocent and foolish-looking as a newlyborn lamb.
Endymion Leer walked up to it and gazed at it quizzically, with his head on one side. Then he tapped its mahogany case—making
