Rodgers
Guidelines for Term Papers
This is the online version of “guidelines for term papers” for use in my classes.
BRIEF GUIDELINES FOR TERM PAPERS (RODGERS)
SUMMARY:
- At least eleven pages of body( exclusive of title page/references);
- minimum 30 references needed;
- use standard style (APA or MLA) ;
- half of paper should be analysis;
- argue a thesis (don’t just describe your sources);
- choose your topic wisely. Students select their own topics (see below).
- Separate cover page required (with title of paper, student name, class name/number, section).
- Stapled or binder clip only (no paper clips, report covers, folders, plastic covers, etc.)
- Always make a copy of your term paper; ------- just in case !!
Term papers provide an additional/alternative mechanism for demonstrating mastery of course material and the opportunity to explore new fields of study. TOPICS: Students select their own term paper topics. A major function of the paper assignment is for the student to “find” a worthy topic. Problem-finding is a major exercise in creativity (as opposed to problem-solving). Virtually any topic that is related to the subject matter of this course is acceptable. Students do not need to have prior approval unless the topic/method is highly unusual. A good place to start is your text Your text provides a rich source of topics as well as preliminary bibliographic/reference list. Students often take a topic that is only briefly mentioned in the text and expand it into a term paper by reading outside sources. A narrow topic is preferable to a very broad topic. In short, a student should do as narrow/focused a topic as library and time resources permit.
THESIS: Develop and argue a consistent thesis (idea). The thesis argument should be the major organizing principle of the paper. Often the difference between an “A” paper and a “C” paper is the quality of the thesis argument. Analyze and comment on the sources that you are reading; don’t just describe them (This is what is meant by “critical analysis”). METHODOLOGY: The methodology of the paper is open. Any combination of the following may be used: Meta-analysis (library/literature-based)(reporting detailed reading/analysis on a subject), theoretical research papers (presenting critical analysis of existing theory), or research project (reporting original data); such as experimental, quasi-experimental, correlational, field-based, clinical study, archival, interview, case study, questionnaires and/or survey research. FORMAT: A standard style should be used. Any standard style may be used: A.P.A. (American Psychological Association), MLA, MLA2, etc. Papers should be typed for readability although this is not required. Double-space everything. Save a copy of your work. Papers should be in the third person, thus no “I did my paper on . . . .” or “I . . . . “ As this is a term paper, not a theme paper, the focus is on the presentation of a scientific argument and analysis of data/literature not just on one’s own perspective. It is appropriate and required for a student to present his/her own perspective/ ideas/critique of the topic; not as the sole focus. LENGTH: The paper is not judged solely on length. Papers should be at least eleven pages in length (exclusive of title page and references). This is an absolute minimum; feel free to do more. At least half of the paper should be the student’s analysis and critique of the ideas presented as well as the thesis argument.
STRUCTURE: A paper should have: 1. Title page, 2. Introduction, 3. Body, 4. Analytical conclusion and 5. Reference list.
· Title page: All papers are to have a page that specifies the title of the paper, student name, course name/number, section, and instructor’s name. See the example below.
· Introduction: The introduction states the thesis and gives an overview of the paper.
· Body: Presentation of the main points of the paper, documents evidence, presents data, and/or details argument.
· Analytical Conclusion: Presents a summary of the main points of argument and critique. Do not neglect this section as it is very important to give your ideas and to finalize the thesis argument.
·
References: A paper must have references from books,
journals, Internet and other sources. At least 3 references for each page. This is a total count on average. (One page
may have one citation and another 5 citations.) Other’s ideas and words must be
referenced. Only list sources
actually used in the paper (This is not a bibliography). At least 2-3
references should be cited per page. Avoid repeated citations of the same
reference; find parallel references. This is a major grade issue; as the
quality/quantity of your references documents your evidence. It is your
“proof”. Two-thirds of your references should be from scholarly sources. Do not
list references not cited or used. NB:
remember the number of references is a total (for a meta-analytical paper)
and would be references actually used in the paper. This does not mean that all of the references
would be on your specific narrowed topic.
In fact probably only one third would be on the narrowed topic. The
remainder would be in the general topic or comparisons with other related
topics. References/citations are used as evidence as well as to help narrow
your topic. There will be a number of references/citations at the beginning of
the paper to define key words, refine theory, or focus attention. For example,
if your paper were on the use of Ritalin for attention deficit-hyperactivity in
children under the age of three, this is your narrowed topic. Definitions of ADHD, diagnosis, rate,
prevalence, causes, and treatment would be outside your narrowed interest. References/citations allow you to efficiently and
briefly summarize these topics so that you can focus your analysis on children
under three. Likewise, comparisons with
children/persons of different ages may be used and cited as part of the
analytical process. If a different method (experimental, case study,
observation, etc.) is used, then the number of references would be
proportionately adjusted. If ¼ of your
paper is empiricial method, then references/citations
would be reduced ¼ from the 30+ requirement.
The FUNNEL (up to 30-40% of your references)
Please be aware that the paper (regardless of how it is narrowed) will begin in a general manner. The goal of the beginning page is to “funnel” the reader’s attention to your narrowed topic. One important functions of citations/references is to assist in this funneling process. For example, if your topic is ‘the efficacy of facilitation as a treatment for childhood autism”, the beginning topics would be definition of autism, rate/incidence, etiology, etc. The use of references/citations allows you to channel the reader’s attention rapidly.
Avoid common mistakes: Over-broad topic. Weak thesis. Too much description of others’ work. Not enough analysis of reading/literature. Over-reliance on a few references. Not giving one’s own ideas/critiques/views. Failure to cite enough evidence to support the thesis. Failure to give conclusion. Starting paper too late in the term to do an adequate job. In short, start early.
SAMPLE TITLE PAGE FOLLOWS:
Effects of Prior Knowledge on Generative Tasks
Karla Sullivan
Psy 105 Developmental Psychology
MWF 8-9
April 24, 2002
ORIGINAL WORK: The paper/study presented for credit in this course must be your own original work. “By the work, one knows the workman.” No whole or part of a paper presented in another course may be submitted. Very limited inclusion of work for another course may be included, provided: 1. The material is clearly identified; and 2. The material is limited in length to less than half a page Please note the HCC policy on plagiarism.
Hawkeye Academic Integrity and Conduct Policy
The integrity of the academic program and degree rests
on the principle that the grades awarded to students reflect only their own
individual efforts and achievement.
Students are required to perform the work specified by the instructor
and are responsible for the content of work submitted, such as papers, reports,
examinations, and other work.
Violations of academic integrity include various types
of plagiarism and cheating.
Plagiarism:
Representing someone else’s work (written or visual)
as your own without proper
attribution or acknowledgement using academic conventions of
citation is plagiarism.
Plagiarism includes but is not limited to:
- Using
exact words from a source without appropriate crediting
- Cutting
and pasting electronically from any source without appropriate crediting
- Using
wording and/or sentence structure too close to the original in
paraphrasing
- Using
visual images in whole or in part created by someone else
- Buying
a paper and presenting any part of it as one’s own
- Borrowing
a paper in whole or part and presenting any part of it as one’s own
without appropriate crediting
- Falsifying
or inventing any information or citation in an academic exercise
Cheating:
- Obtaining
or giving assistance in any academic work such as on quizzes, tests,
homework, etc., without instructor’s consent
- Taking
an examination or course or turning in work for someone else
- Allowing
someone to take an examination or course or turn in work in your name
- Using
crib notes or electronic devices to get unauthorized assistance on
examinations or other in-class work
Addressing Violations of
Academic Integrity:
Any violations of academic integrity are addressed
first by the instructor within the classroom; the instructor shall have the
discretion to determine the level of severity in setting appropriate penalties.
First Offense:
The individual instructor may reduce the student’s grade in the
assignment or examination and has the discretion to file a report. However, for extreme cases of plagiarism or
cheating, the instructor may assign the student an “F” in the course and will
report this action to the Dean; the report will be placed in the student’s
file.
Second Offense:
Upon confirmation by the Dean of a student’s previous reported offense,
the instructor will have the authority to issue an “F” in the course. A report will be made and placed in the
student’s file.
Third Offense:
Upon confirmation by the Dean of a student’s third offense, the Dean
will determine appropriate penalties ranging from an “F” in the course to
recommending suspension from the college for academic misconduct.
If the student feels that the penalty imposed is
unjust, the student may request a review by the Academic Integrity Review Board
composed of the Director of Student Development/Life (presiding), at least
three faculty representatives selected from the Academic Standards and Issues
Committee, two Student Senate representatives, and the Director of Student
Records and Registration (serving ex officio).
The Review Board shall meet with the student and faculty to review the
case and make recommendations to the Vice President of Academic Affairs, who
shall determine the appropriate penalty.
CITATION AND EVIDENCE: In science, evidence is of two forms: citation of authority and collection of new data. Either/both may be used in your paper. Cite frequently information you gain from other sources. Be scrupulous in giving credit (“A wise man walks with his head bowed.”). Give yourself credit for reading and doing research by citing. Avoid plagiarism. Don’t spend long periods paraphrasing or describing another’s research. Cite the reference and move on. There are two type of citation (quotes): indirect and direct. Indirect citations/quotes refer to non-verbatim and/or paraphrases use of another’s ideas/words. Examples follow: Recent studies (Jones, 1996, 1997; Smith, 1987) have found that . . . . In 1990, Smith compared reaction times . . . . In a recent study (Jones, 1992) . . . Only indirect usage of words/ideas are acceptable. If you wish to quote an author’s words you must use the direct method. Direct citation (quotes) refer to verbatim and/or non-paraphrased use of another’s words/ideas. Direct citations always include a page number reference. Short direct quotes (less than two sentences) are incorporated into the text, enclosed by quotation marks. . . . . .(text). . . he stated, “Placebo effects disappeared . . . . . .” (Smith, 1997, p. 23) Long direct quotes may be set off from the text as a free-standing block without using quotation marks: ____*******start of long direct quote example************
The effect of various neutral substance have been documented in psychology.
The placebo effect disappeared when behaviors were studied in this
manner. It did not matter which behaviors were targeted nor did the
dosage have any significant effect. (Jones, 1992, p. 178).
**************end of
direct quote example***********************************
The FUNNEL (up to 30-40% of your references)
Please be aware that the paper (regardless of how it is narrowed) will begin in a general manner. The goal of the beginning page is to “funnel” the reader’s attention to your narrowed topic. One important function of citations/references is to assist in this funneling process. For example, if your topic is ‘the efficacy of facilitation as a treatment for childhood autism”, the beginning topics would be definition of autism, rate/incidence, etiology, etc. The use of references/citations allows you to channel the reader’s attention rapidly. This should be less than two pages at most.
Research tips:
· Add more words to the search string--- facilitation treatment child autism research efficacy
· Use Google Scholar to search in libraries and articles. http://scholar.google.com/schhp?tab=ws
· Use APA resources. http://www.apa.org/
· Use APA Psycinfo http://www.apa.org/psycinfo/
· Use Psychological Abstracts to find summaries (abstracts) of all the literature by topic. Cite abstract if full article is not available.
· Use ERIC http://www.eric.ed.gov/
· Use Google Translation service or Babelfish (http://babelfish.altavista.com/) for foreign language sources.
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sample term paper topics
Developmental
Sample Topics:
Obsessive
Compulsive Disorder in Children and Adolescents
Psychotherapuetic
drugs for children under 4 years of age
Post-Traumatic Stress Disorder In Children And Adolescents
Postpartum Depression is Not an Excuse for
Murder
|
Trying teenagers in court as adults Does
breastefeeding improve cognitive development? Human
cloning IQ
testing and impact on development High-stakes
testing in schools Can
children adjust from early maltreatment? Homeschooling
and its developmental effects Spanking
(effects of development)—pre-school vs. school Should
children be raised in a gender-neutral environment? Outcomes
for aggressive children - aggressive adults or not? The
media and body image TV
watching and its effect on development |
Tracking in schools HIV-testing
in the workplace Is
personality stable? Mandatory
castration for sexual abuse offenders Mate
selection and nature vs nurture Online
relationships (dev. Issues) Divorce
is "harder" or "easier" now than it ever was before HRT
or not Is
there really a mid-life crisis? Retire
early? Children
can or can't understand death; how does it change? Euthanasia
for late adults Is
there really a cognitive decline in old age? |
Abnormal Psychology
Sample topics = pick a DSM-IV disorder The Narcissistic Personality: collaterals
to diagnosis
Pick a
theorist Necrophilia:
A Violently Dead Issue
Pick a therapy Obsession in “Play Misty for Me”
Obsessive Compulsive Disorder in Children
and Adolescents
Postpartum Depression is Not an Excuse for
Murder
Obsessive-Compulsive & Its Relationship
To Anxiety Disorders
Recovered Memories -- Induced By Therapists ?
Opler's
Cultural Symptoms Of Schizophrenia
Techniques in Forensic Psychology
The Debate About
Excluding Homosexuality From The DSM
Savant Intelligence And
Precognition
Misdiagnosis of Pervasive Developmental
Disorders (PDD)
Psychotherapuetic
drugs for children under 4 years of age
Post Traumatic Stress Disorder And Treatment As A Form Of Depression
Post-Traumatic Stress Disorder In Children And Adolescents
The Link Between Learning
Disability and Delinquency
Transient Global Amnesia
Panic Disorder / Etiology
& Treatment
Psychological Theories & Therapeutic
Interventions in the Narcissistic Disorders
GENERAL
PSYCHOLOGY
Sample paper topics
Maternal Depression And
Child Development
Psychological Criminal Profiling
Predicting Antisocial Behavior
Panic Disorder / Etiology & Treatment
Schizophrenia In
Urban Black & Hispanic Populations
The Effects of Culturally Sanctioned
Beliefs on Psychological Disorders
Savant Intelligence And
Precognition
Mental Health For
The Homeless
Mental Retardation / "Cloak of
Competence"
Mild Mental Retardation / Public Debate
& Current Classification Terminology
Munchausen by Proxy: Nursing Interventions
Obsessive Compulsive Disorder in Children
and Adolescents
1. What is consciousness? Is it possible to explain this phenomenon in terms of basic physiology? If so, how? Is representation consciousness? Is sensation consciousness?
2. Emotional abnormalities have been correlated with aggressive and maladaptive behavior in animals (non-human and human). What [convincing] evidence exists that a treatment regimen should focus on these abnormalities? What of the ethical issues that arise?
3. Emoting involves a range of feelings, thoughts, reaction times, and obviously varies from individual to individual. In the search for the anatomical correlates of emotion, the emerging evidence points not only to autonomic function, but also endocrine system, how would you define the construct “emotion”? Is this a definition that holds across species?
4. Understanding physiological phenomena is not distinct from other aims of psychological research. Similar goals include describing the particular behavior(s) of humans, what leads to these behaviors, how they are initiated, maintained and terminated. Can physiological findings offer an understanding of such constructs as motivation and reward?
5. What therapies are in practice for certain drug addiction disorder(s)? How do they compare - for instance pharmacological treatment versus behavior therapy (i.e., conditioning / exposure)? Is there research regarding the benefits of combined therapies?
6. Gene therapy is the target of much research. What is it? Choose a disease that is currently being targeted for gene therapy. What has been identified in animal (non-human) research? What of human research - what clinical trials (if any) has the therapy undergone? successes? failures? ethical concerns?
7. There is evidence in many species of varying degree of communication as well as language. In a
paper on language across the animal kingdom, you may focus on evidence of language ability in the African gray, in non-human primates (sign language) or other animals. In your paper, you may choose to address any of the following questions. What is the overwhelming evidence? Do these forms of communication and "taught" language indicate a level of cognition not previously recognized? Is it anthropomorphic to consider language and cognition in lower animals?
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APA Style examples
from or based on the 4th edition of the Publication Manual of
the American Psychological Association
REFERENCE LIST
EXAMPLES
BOOK - SINGLE AUTHOR
Bernstein, T.M. (1965). The careful
writer: A modern guide to English usage.
BOOK - TWO AUTHORS
Strunk, W., Jr., & White, E. B.
(1979). The elements of style (3rd ed.).
BOOK - MORE THAN TWO AUTHORS
Flanagan, J. C., Dailey, J., Shaycroft, M., Gorham, W., Orr, D., & Goldberg, I. (1962). Design for a study of
American youth. Boston: Houghton Mifflin.
BOOK - CORPORATE AUTHOR
American Psychiatric Association. (1980). Diagnostic and statistical manual of mental disorders. (3rd ed.).
Washington, DC: Author.
ARTICLE or CHAPTER FROM BOOK
Hartley, J. T., Harker, J. O., & Walsh, D. A. (1980). Contemporary issues and new directions in adult development
of learning and memory. In L. W. Poon (Ed.), Aging in the 1980's: Psychological issues (pp. 239-252). Washington,
DC: American Psychological Association.
ARTICLE FROM JOURNAL (continuous pagination in volume)
Paivio, A. (1975). Perceptual comparisons through the mind's eye. Memory & Cognition, 3, 635-647.
ARTICLE FROM JOURNAL (paginated by issue)
Becker, L. J., & Seligman, C. (1981). Welcome to the energy crisis. Journal of Social Issues, 37(2), 1-7.
ARTICLE FROM MAGAZINE
Gardner, H. (1981, December). Do babies sing a universal song? Psychology Today, pp. 70-76.
ARTICLE FROM NEWSPAPER
Lublin, J. S. (1980, December 5). On idle: The unemployed shun much mundane work, at least for a while. The
Wall Street Journal, pp. 1, 25.
ENCYCLOPEDIA ARTICLE - SIGNED
Brislin, R. W. (1984). Cross-cultural psychology. In Corsini, R. J. (Ed.), Encyclopedia of psychology (Vol. 1, pp.
319-327).
Citation
of non-standard media (including personal conversations)—
·
if anonymous,
then see anonymous guidelines under web-based
Movie/video
Johson, C.(producer)(2005). Title of video. Date of broadcast.
Television
Johson, C.
(producer) (2004). Ttile
of program, Broadcast sponsor(NBC, PBS), date of broadcast (
Personal
conversation
Your name (2003). Personal conversation with
Albert Einstein.
WORLD WIDE WEB
BASED RESOURCE
Beckleheimer, J. (1994). How do you cite a URL in a bibliography? [On-line]. Available:
http://www.nrlssc.navy.mil/meta/bibliography.html.
NOTE: The APA has revised their recommendations for citing electronic documents since the publication of the 4th edition of the Publication Manual. The most recent version of the Electronic Reference Formats Recommended by the American Psychological Association is available at: http://www.apa.org/journals/webref.html
This source provides the following example:
Electronic reference formats recommended by the American Psychological
Association. (1999, November 19). Washington, DC: American Psychological
Association. Retrieved November 19, 1999 from the World Wide Web:
http://www.apa.org/journals/webref.html
ANONYMOUS CITATION. If possible find the author of the web page or web article, If not; try to find the sponsoring organization (APA, 2005 or American Red Cross, 2004).
If no author or organization can be found then cite as Anonymous (2005) (or Anonymous, 2004a versus Anonymous, 2004b, etc.)
The reference list appears at the end of your work. It contains only those materials made reference to in the text of your work. It is not a bibliography.
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MORE
SAMPLE PAPERS ARE BELOW
SAMPLE TERM PAPER (abridged
and used with author’s permission)
Creativity 1
Effects of Prior Knowledge on Generative Tasks
Karla Sullivan
Psy 105 Developmental Psychology
MWF 8-9
April 24, 2002
Creativity 2
The creation of new ideas plays an important role in the growth of any society. Inventions
such as the telephone and automobile have provided the tools for increased levels of
communication and widened the access to information. While the modern generation may view
these inventions as staples of our society, at the time of their conception they were viewed as
revolutionary new concepts. Yet, were they truly revolutionary or were they an extension of
prior knowledge? Large proportions of new ideas are based on the properties of an existing
concept (Marsh, Ward, & Landau, 1999). Without the concept of the phonograph, for example,
we may never have had the benefit of 8-tracks, audio cassettes, or compact discs. These
creations, while separate in their levels of advancement, are all based on the initial notion of
recorded sound.
Researchers recognize the benefits of prior knowledge as adaptive to survival. The fact that
humans are able to learn and apply information from previous experience assists in reasoning,
problem solving, and comprehension of our environment (Smith, Ward, & Schumacher, 1993).
Without the use of prior knowledge it would be impossible to advance cognitively. The benefits
notwithstanding, the use of prior knowledge also has the potential of limiting, or constraining,
the creative process (Marsh, Bink, & Hicks, 1999; Marsh, Landau, & Hicks, 1996; Marsh, Ward,
et al., 1999; Smith, et al., 1993). The theoretical construct of structured imagination proposes
that new ideas are seldom, if ever, truly "new." It contends that, when faced with the intention of
a novel creation, humans search their memory base for a previous, similar experience and then
expand or alter that prior solution to fit the current need (Marsh, et al., 1996; Marsh, Ward, et al.,
1999). Whether this retrieval is intentional or not, the features of prior solutions then become a
part of the "new" creation, thereby limiting its originality. The purpose of this paper is to
provide evidence that the notion of structured
imagination is accurate and that the use of prior
Creativity 3
knowledge plays a role in the production of novel ideas by inducing constrains on an individual’s
creative process.
In 1993, Smith, Ward, & Schumacher conducted a series of experiments to test the effect of
previous knowledge on creativity by presenting participants, just prior to a generative drawing
task, with examples of others’ creations. Specifically, participants were asked to create creatures
that might be expected to live on other planets, but that the creatures must not represent those
found on earth. They hypothesized that those who were shown examples of possible creatures
just prior to the task would incorporate more features of the examples into their own creative
product than those who were not presented with any prior example. This hypothesis was
confirmed. Of the three critical features (antennae, tail, and four legs) represented in all of the
provided examples, two of the three features (antennae and tail) were significantly more common
proportionately (p<.05) in the experimental group than in the control group who were not shown
these examples. Likewise, overall conformity ? calculated as the mean of the three proportions
of the critical features ? was also significantly higher in the experimental group, indicating that
those who were shown examples prior to the task relied more heavily on properties shown in the
examples, thereby constraining their own creativity (Smith, et al., 1993). Smith and his fellow
researchers also tested this same hypothesis using the creation of novel toys instead of space
creatures and nearly identical results were obtained on all levels.
Smith, et al. (1993) concluded that structured imagination, or the conformity hypothesis as it
was labeled, did exist and hampered
creativity. To further bolster this claim, another team of
researchers replicated the 1993 study and then added a further hypothesis that not only does the
presentation of examples constrain creativity, but that the more examples that are shown, the
more creativity will be stifled (Marsh, et al.,
1996). Five groups were shown a specified number
Creativity 4
of examples, either 1, 3, 6, or 9. The control group was not provided any examples prior to the
task. Of the examples shown to the four experimental groups, all had the three common
attributes as in the Smith study, namely, antennae, a tail, and four legs. The results substantiated
Smith’s claim that conformity in a creative task increases when examples are presented and also
confirmed their hypothesis regarding the quantity of examples shown. Not only was there a
significant linear trend (p<.01) for the proportion of critical features present as the number of
examples increased, there was also a significant linear trend (p<.01) in overall conformity,
suggesting that those provided with more examples are more likely to incorporate the three
critical attributes of the examples into their creations.
In 1999, Marsh, Bink, & Hicks took a similar approach to validating the notion of structured
imagination in the form of conceptual priming, or conceptual conformity. The theory of
conceptual conformity states, "If the shared features of examples are conceptually related to one
another, that fact should influence overall levels of conformity" (p. 356). This means that it
isn’t necessarily the particular attributes themselves that will lead to conformity, but rather the
concept that those attributes characterize. In this study, example features were created reflecting
characteristics of the concept hostility. As in the aforementioned studies, participants were asked
to generate space creatures and were shown (except in the control group) a series of examples
just prior to the task. Likewise, as in the aforementioned studies, each example contained three
critical features. However, to signify the concept of hostility, the three critical features were
fangs, spikes, and weapons.
The analysis of this study focused on two measures of conformity ? target conformity and
conceptual conformity. Target conformity represents the proportion of the three critical features
in the generated creations, whereas conceptual conformity represents the proportion of other
Creativity 5
features concluded by the researchers to also indicate hostility (e.g., horns, claws, and body
armor). The results supported the hypothesis. Subjects who were shown examples with a hostile
"tone" had significantly higher target conformity effects and conceptual conformity effects than
those in the control group (Marsh, Bink, et al., 1999). Interestingly, the conceptual conformity
effect was higher than the target conformity effect, indicating that while participants shown
examples were likely to include the initial critical features into their designs, they were even
more likely to add other features representing hostility than those not shown examples. The
reason these results are particularly important to recognize lies within a follow-up questionnaire
that participants in the experimental group were asked to fill out regarding the examples they
were shown. The purpose of the questionnaire was to ascertain whether participants recognized
the concept of hostility within the examples, which, if it was detected, could mean that there was
conscious effort on their part to include attributes of hostility in their creations. However, of the
44 participants in the study, not one person made reference to the hostile nature of the examples
(Marsh, Bink, et al., 1999). Therefore, based on the data of the study, although participants may
not have been explicitly aware of the hostility in the examples, a significant number still
incorporated features related to the concept, indicating that a hostile mindset may have been
induced through conceptual priming.
The results of the previous three experiments demonstrate that, in a generative drawing task,
participants are more likely to have limited
creative capacity if simply presented with examples
prior to the task. In 1999, Marsh, Ward, & Landau generalized these results to generative word
tasks as well. They hypothesized that participants given word examples containing common
orthographic qualities would conform to these orthographic features when creating new non-
words.
Creativity 6
Subjects were placed into one of three conditions ? consistent, inconsistent, and control. The
consistent group was given a word from a particular category such as "fruit" and then a matching
non-word that contained a particular orthographic quality. For example, one pair of items might
be apple (representing category) and opfing (a non-word representing the orthographic quality of
words ending in ?ing). All non-words were similar in three critical areas in that they contained
the same orthographic quality, number of syllables, and number of letters. Those in the
inconsistent condition also saw matched items, however the orthographic qualities, number of
syllables, and number of letters were varied each time. Those in the control condition were not
given pairs of items prior to the generation of new non-words. Data analysis showed that those
in the consistent condition conformed significantly more (p<.05) to each of the three critical
features than those in either the inconsistent or control conditions. Overall conformity was also
significantly higher in the consistent condition than in the other two (Marsh, Ward, et al., 1999).
Therefore, the evidence suggests that those who were presented with a strict set of word structure
retained that structure in their creation of new words. These results appear to mirror those of
other experiments testing the effects of examples and constraints on creativity.
While the constraining effects on creativity when provided examples just prior to the
generative task appear well-documented, a concern of the researchers was whether this constraint
was consistent or whether it diminished over time. To answer this question, Smith et al. (1993)
altered their initial experiment so that a 23-minute delay occurred between the presentation of
examples and the creation of either toy or space creature designs. The results indicated that
although conformity for the three critical features (as previously mentioned) as well as overall
conformity declined due to delay, the decrease was not enough to be significant.
Creativity 7
In response to this finding, Marsh, et al. (1996) included in their research a one-day delay
between the presentation of examples containing three critical features and the generation of
creature designs. Two groups were used; the immediate condition which simply replicated the
previous research, and a delay condition, which consisted of the aforementioned one-day waiting
period. Unlike the results of Smith, et al. (1993), overall conformity did not decline. In fact, it
was significantly higher in the delay condition than in the immediate condition. This would
suggest that levels of conformity actually rise after a delay in time.
This increase in conformity after a delay in time is explained by the theory of cryptomnesia.
Cryptomnesia is the unintentional plagiarism or inadvertent use of prior knowledge (Smith, et al.,
1993; Marsh, et al., 1996; Marsh, Ward, et al., 1999). It manifests itself as a result of structured
imagination. The theory is that "…when creating something novel, people bring to mind (either
consciously or unconsciously) existing categories and concepts, thereby causing the features of
those categories to become incorporated into their creations" (p. 669). As time increases
between prior knowledge and a task, the information initially presented may become stored with
other prior knowledge. This mixing of information may make it indecipherable to the individual
as to whether that information is a novel creation designed by the person him/herself or another
person’s idea. Therefore, people may assume that their designs are truly of their own creation.
The implications of this misuse of information are that people often do not monitor where their
ideas come from, thus, whether the information comes from an experimenter or is self-generated,
the use of this information increases conformity and decreases creativity (Marsh, et al., 1996).
While all of this information supports the hypothesis that humans inadvertently use prior
knowledge in generative tasks, the extent of this finding is partially limited. For example, not all
forms of creativity are affected by the use of examples and prior knowledge. In the previously
Creativity 8
mentioned generative drawing experiments testing whether presenting examples influences
creativity, in not one study was there a significant difference between the number of designs
created between the control and experimental groups. Similarly, there were no significant
changes in number or type of noncritical features created nor in the total number of features.
Consequently, providing examples and using prior knowledge doesn’t appear to affect the
quantity of creations produced but rather the quality of creations produced. However, these non-
significant findings may be of less concern than the reality of the total findings because creativity
is less often judged on quantity than quality.
Another concern regarding this data lies within the research itself. The first concern is that
none of the studies used validated features in their experiments. Features were chosen based on
what the researchers thought would make acceptable attributes. For example, in the study
measuring conceptual conformity (Marsh, Bink, et al., 1999) the attributes of hostility were
designated solely by the researchers with no mention of whether they were valid for the
construct. Other concepts, such as survival, would share similar attributes; therefore those
features may have been measuring something other than hostility.
A second problem concerns the samples of participants for the studies. Often it either was not
stated how many persons were in each condition or, when it was stated, the sample sizes were
small or drastically unequal. For instance, in Smith, et al., 1999, one experiment had 25
participants in the control condition while the experimental condition contained 66. This type of
inconsistency may hinder the generalizability of the results.
Finally, creativity in and of itself is a highly subjective construct. Accordingly, creating
accurate measurements for a subjective construct is no simple task. While the methods presented
Creativity 9
in this review seem sufficient, more research should be conducted to test this perceived
effectiveness.
It has been stated that novel creations are seldom novel at all. The theoretical construct of
structured imagination substantiates this claim by arguing that during the generation of creative
designs, persons rely on prior knowledge on which to base solutions. The evidence presented
corroborates this sentiment. The most heavily documented data does indeed indicate that the
presence of examples introduces a biasing effect by increasing conformity to the features
embedded within the presented material. This information has implications for nearly every
industry in business that expects creative results from its associates. Society may believe an
invention is truly revolutionary when, in fact, the creation is most likely a mere extension of a
previous thought.
Creativity 10
References
Marsh, R. L., Bink, M. L., & Hicks, J. L. (1999). Conceptual priming in a generative
problem-solving task. Memory & Cognition, 27 (2), 355-363.
Marsh, R. L., Landau, J. D., & Hicks, J. L. (1996). How examples may (and may not)
constrain creativity. Memory & Cognition, 24 (3), 669-680.
Marsh, R. L., Ward, T. B., & Landau, J. D. (1999). The inadvertent use of prior knowledge
in a generative cognitive task. Memory & Cognition, 27 (1), 94-105.
Smith, S. M., Ward, T. B., & Schumacher, J. S. (1993). Constraining effects of examples in a
creative generation task. Memory & Cognition, 21 (6), 837-845.
More
more
**********END OF SAMPLE PAPER****************** MORE SAMPLE PAPERS BELOW***************
_______________________________________________________________________
How to write a
great research paper
This outlines the logical steps to writing a good research paper. To achieve supreme excellence or perfection in anything you do, you need more than just the knowledge. Like the Olympic athlete aiming for the gold medal, you must have a positive attitude and the belief that you have the ability to achieve it. That is the real start to writing an A+ research paper.
CONTENTS:
STEP 1. CHOOSE A TOPIC
STEP 2. FIND
INFORMATION
STEP 3.
STATE YOUR THESIS
STEP 4. MAKE
A TENTATIVE OUTLINE
STEP 5.
ORGANIZE YOUR NOTES
STEP 6.
WRITE YOUR FIRST DRAFT
STEP 7.
REVISE YOUR OUTLINE AND DRAFT
Checklist
One Checklist
Two
STEP 8. TYPE FINAL PAPER
STEP 1. CHOOSE A TOPIC
Choose a topic which interests and challenges you. Your attitude towards the topic may well determine the amount of effort and enthusiasm you put into your research.
Focus on a limited aspect, e.g. narrow it down from "Religion" to "World Religion" to "Buddhism". Obtain teacher approval for your topic before embarking on full scale research. If you are uncertain as to what is expected of you in completing the assignment or project, re-read your assignment sheet carefully or ASK your teacher.
Select a subject you can manage. Avoid subjects that are too technical, learned, or specialized. Avoid topics that have only a very narrow range of source materials.
STEP 2. FIND INFORMATION
Surf the Net.
For general or background information, check out useful URLs, general information online, almanacs or encyclopedias online such as Britannica, or Encarta, etc. Use Search Engines and other search tools as a starting point.
Pay attention to domains, e.g., .edu (educational institution), .gov (government), or .org (non-profit organization). These sites represent institutions and tend to be more reliable, but be watchful of possible political bias in some government sites. Be selective of .com (commercial) sites. Many .com sites are excellent; however, a large number of them contain advertisements for products and nothing else. Be wary of the millions of personal home pages on the Net. The quality of these personal homepages vary greatly. Learning how to evaluate Web sites critically and to search effectively on the Internet can help you eliminate irrelevant sites and waste less of your time.
The recent arrival of a variety of domain names such as .biz, .pro, .info, .name, .ws (WebSite), .cc (from Cocos Island) or .sh (from St. Helena) or .tv (from Tuvalu) may create some confusion as you would not be able to tell whether a .cc or .sh or .tv site is in reality a .com, a .edu, a .gov, a .net, or a .org site. The new extensions are available to anyone who wishes to register a distinct domain name that has not already been taken. For instance, if Books.com is unavailable, you can register as Books.ws or Books.info via a service agent such as Register.com
Depending on the information you are searching, the Internet is not always the easiest nor the first place you should try especially if you don't have ready access to a computer. Some students unnecessarily line up for a computer to find the meaning of a word when they should be using their common sense, i.e. a simple dictionary. Often the traditional printed resource, such as a dictionary, an almanac, or a directory, can provide you with the needed information much faster. This situation may change, however, as more libraries begin subscribing to online resources and buying fewer printed material.
To find books in the Library use the OPAC (Online Public Access
Catalog).
Check out other print materials available in the Library:
- Almanacs, Atlases, AV Catalogs
- Encyclopedias and Dictionaries
- Government Publications, Guides, Reports
- Magazines, Newspapers
- Vertical Files
- Yellow Pages, Zip or Postal Code and Telephone Directories
Check out online resources, Web based information services, or resource materials on CD-ROMs:
- Online reference materials (e.g. ELECTRIC LIBRARY, EBSCO HOST, etc.)
- Index to Periodicals and Newspapers (e.g., RESOURCE ONE, MAS, etc.)
- Encyclopedias (e.g., ENCARTA, BRITANNICA, WORLD BOOK, CANADIAN ENCYCLOPEDIA, etc.)
- Magazines and Journals in full text and/or full image (e.g., TIME, MACLEAN'S, NEWSWEEK, etc.)
- Newspapers
(e.g.,
- Social Issues (e.g. SIRS, ISSUEQUEST, etc.)
- Subject Specific CD-ROMs (e.g. DISCOVERING AUTHORS, EXPLORING SHAKESPEARE, etc.)
Check out Public and University Libraries, businesses, government
agencies, as well as contact knowledgeable people in your community.
Read and evaluate. Bookmark your favorite Internet sites. Printout, photocopy, and take notes of relevant information.
As you gather your resources, jot down full bibliographical information
(author, title, place of publication, publisher, date of publication, page
numbers, URLs, creation or modification dates on Web pages, and your date of
access) on your work sheet, printout, or enter the information on your laptop
for later retrieval. If printing from the Internet, it is wise to use a browser
that provides you with the URL and date of access on every printed page.
Remember that an article without bibliographical information is useless since
you cannot cite its source.
STEP 3. STATE YOUR THESIS
Do some critical thinking and write your thesis statement down in one sentence. Your thesis statement is like a declaration of your belief. The main portion of your essay will consist of arguments to support and defend this belief.
STEP 4. MAKE A TENTATIVE OUTLINE
All points must relate to the same major topic that you first mentioned in your capital Roman numeral.
Example of an outline:
I. Shakespeare's life A. Early life in Stratford 1. Shakespeare's family a. Shakespeare's father b. Shakespeare's mother 2. Shakespeare's marriage B. The Elizabethan Theater 1. The Globe Theater a. History of the Globe b. Owners of the Globe c. Structure of the Globe 2. Acting companies a. Men and boys b. Sponsorships II. Shakespeare's plays A. Hamlet B. Romeo and Juliet
The purpose of an outline is to help you think through your topic carefully and organize it logically before you start writing. A good outline is the most important step in writing a good paper. Check your outline to make sure that the points covered flow logically from one to the other. Include in your outline an INTRODUCTION, a BODY, and a CONCLUSION. Make the first outline tentative.
INTRODUCTION - State your thesis and the purpose of your research paper clearly. What is the chief reason you are writing the paper? State also how you plan to approach your topic. Is this a factual report, a book review, a comparison, or an analysis of a problem? Explain briefly the major points you plan to cover in your paper and why readers should be interested in your topic.
BODY - This is where you present your arguments to support your thesis statement. Remember the RULE OF 3, i.e. find 3 supporting arguments for each position you take. Begin with a strong argument, then use a stronger one, and end with the strongest argument for your final point.
CONCLUSION - Restate your thesis. Summarize your arguments. Explain why you have come to this particular conclusion.
STEP 5. ORGANIZE YOUR NOTES
Organize all the information you have gathered according to your outline. Do not include any information that is not relevant to your topic. Make sure the information you have gathered is accurately recorded. Devise your own method to organize your notes.
One method may be to mark with a different color ink or use a hi-liter to identify sections in your outline, e.g., IA3b - meaning that the item "Accessing WWW" belongs in the following location of your outline:
I. Understanding the Internet A. What is the Internet 3. How to "Surf the Net" b. Accessing WWW
Group your notes following the outline codes you have assigned to your notes, e.g., IA2, IA3, IA4, etc. This method will enable you to quickly put all your resources in the right place as you organize your notes according to your outline.
STEP 6. WRITE YOUR FIRST DRAFT
Start with the first topic in your outline. Read all the relevant notes you have gathered that have been marked, e.g. with the capital Roman numeral I.
Summarize, paraphrase or quote directly for each idea you plan to use in your essay. Use a technique that suits you, e.g. write summaries, paraphrases or quotations on note cards, or separate sheets of lined paper. Mark each card or sheet of paper clearly with your outline code or reference, e.g., IB2a or IIC, etc.
Put all your note cards or paper in the order of your outline, e.g. IA, IB, IC. If using a word processor on a computer, create filenames which match your outline codes for easy cut and paste as you type up your final paper.
STEP 7. REVISE YOUR OUTLINE AND DRAFT
Read your paper for any errors in content. Arrange and rearrange ideas to follow your outline. Reorganize your outline if necessary, but always keep the purpose of your paper and your readers in mind.
CHECKLIST ONE:
1. Is my thesis statement concise and clear? 2. Did I follow my outline? Did I miss anything?3. Are my arguments presented in a logical sequence?4. Are all sources cited to ensure that I am not plagiarizing?5. Have I proved my thesis with strong supporting arguments?6. Have I made my intentions and points clear in the essay?
Re-read your paper for grammatical errors. Use a dictionary or a thesaurus as needed. Do a spell check if using a word processor. Correct all errors that you can spot and improve the overall quality of the paper to the best of your ability. Get someone else to read it over. Sometimes a second pair of eyes can see mistakes that you cannot.
CHECKLIST TWO:
1. Did I begin each paragraph with a proper topic sentence?2. Have I supported my arguments with documented proof or examples?3. Any run-on or unfinished sentences?4. Any unnecessary or repetitious words?5. Varying lengths of sentences?6. Does one paragraph or idea flow smoothly into the next?7. Any spelling or grammatical errors?8. Quotes accurate in source, spelling, and punctuation? 9. Are all my citations accurate and in correct format?10. Did I avoid using contractions? Use "cannot" instead of "can't", "do not" instead of "don't"?11. Did I use third person as much as possible? Avoid using phrases such as "I think", "I guess", "I suppose", "I believe", etc.12. Have I made my points clear and interesting but remained objective?13. Did I leave a sense of completion for my reader(s) at the end of the paper?
For an excellent source, check out Elements of Style by William Strunk, Jr.
STEP 8. TYPE FINAL PAPER
All formal reports or essays should be typewritten using a word processor (or a typewriter - hard to find nowadays in this part of the world).
Read the assignment sheet again to be sure that you understand fully what is expected of you, and that your essay meets the requirements as specified by your teacher. Know how your essay will be evaluated.
Proofread final paper carefully for spelling, punctuation, missing or duplicated words. Make the effort to ensure that your final paper is clean, tidy, neat, and attractive.
Aim to have your final paper ready a day or two before the deadline. This gives you peace of mind and a chance to triple check. Before handing in your assignment for marking, ask yourself: "Is this the VERY BEST that I can do?"
P.S. A note on correct grammar and spelling:
The
usage of high technology in the Media and particularly on the Internet has
changed some of the traditionally accepted rules in the use of the English
language. People today seem to be less concerned with correct grammar,
spelling, and the use of capital letters while quick and concise e-mails are
being rushed out with a click of the mouse, often with no way of retrieving the
sent messages. Even when spelling or grammatical errors in e-mail messages are
later discovered, unless the errors are serious, few people would bother
correcting the mistakes and re-sending the messages.
It
may be a good idea to type the SEND TO e-mail address last, after you have had
a chance to read over your e-mail message and check for errors before clicking
the SEND button.
The
English language is a living thing and nowhere can we witness its change more
rapidly than in the Internet community and in the Media today.
The
power of software and Web developers in changing the English language worldwide
cannot be underestimated. Organizations which determine the HTML and XML
standards for the world, for instance, have more power to alter the course of
the English language than they realize. Notice the change of spacing in the
1999 MLA
handbook for Writers of Research Papers from the Modern Language
Association. For bibliographical citations, it is now officially correct to
type one space after any punctuation mark as opposed to one space after a comma
or a colon, and two spaces after a period at the end of a statement. And, if
you are using HTML to create your Web page, even if you have typed in two or
more spaces between words or after punctuations, almost all browsers will read
and display only one space. Under normal circumstances, you have no choice in
the matter.
What
a generation ago would have been considered an unthinkable grammatical error is
now quite acceptable. A full-page advertisement appeared in the prestigious
award-winning North American newspaper, the Toronto Financial Post, on
October 23, 1999, D4, which read: "Who do you trust to create shareholder
value?" Should the correct answer be: "I trust he," "I
trust she," or "I trust they" to correspond with the
"who" being asked? Of course not, at least not yet, anyway. In this
particular case, what was traditionally considered a correct usage of grammar
is no longer a requirement.
Until
the arrival of such times when new editions of dictionaries change to conform
and comply with societal norms, students must strive for the highest standards
possible and use current dictionaries as the ultimate standard of what is
correct. For now, "whom" is still the objective case of
"who", and the phrase "For whom the bell tolls" is still
perfectly correct.
*************
Sample Paper #2
*****************************
Alcoholism as a predictor of dissociation
John Q. Student
PY 201 Abnormal Psychology
Fall 2007
This paper attempts to provide the reader with a better understanding of the disease of alcoholism. In addition to reviewing the health consequences and social implications of the disease, this review examines the development of the disease theory of alcoholism, the paradigm shift in Western culture’s understanding and treatment of the disease, and highlights the treatment and recovery options available today to the alcoholic seeking help. Section One generally describes the disease of alcoholism, the physical effects of alcohol, the development and progression of alcohol dependence, suggested causes of alcoholism, and health consequences associated with heavy drinking. Section Two discusses the prevalence of alcoholism and its social effects. Section Three describes the development of the disease theory of alcoholism and discusses the change over time in social attitudes and perspectives towards this disease. Section Four describes genetic research currently being conducted in the field of alcoholism study and considers the implications of the findings that this research provides. Section Five discusses different treatment approaches to the disease of alcoholism and various recovery options that are available to an alcoholic seeking help.
Alcohol dependence as a
predictor of dissociation
John Q.
Student
PY
201 Abnormal Psychology
Fall 2007
Alcoholism
is a common, chronic, often progressive disorder that has serious negative
consequences not only for the affected individual, but also for society. Alcoholism has serious health consequences
and is responsible annually for a large number of deaths from alcohol-related
diseases, accidents, and homicides.
Current research suggests that nearly 100,000 Americans die annually as
a result of alcohol abuse (Vogin, 2002). Alcohol abuse is also a significant factor in
a number of social problems including criminal behavior. Estimates indicate
alcohol as a factor in more than half of the country’s traffic accidents,
homicides and suicides (Vogin). People who suffer from this illness are known
as alcoholics. They cannot control their
drinking even when it becomes the underlying cause of serious harm, including
medical disorders, marital difficulties, job loss, or automobile crashes. Medical science has yet to identify the exact
cause of alcoholism, but research suggests that it has a genetic basis and that
psychological, social, and environmental factors influence its development (Vogin). Alcoholism
cannot be cured yet, but various treatment options can help an alcoholic avoid
drinking and regain a healthy life.
Alcohol
dependence develops differently in each individual, but is characterized by
certain common symptoms that separate alcoholics from “normal drinkers,”
according to the National Institute on Alcohol Abuse and Alcoholism (NIAAA), a
Physical
Effects of Alcohol
Ethyl
alcohol, or ethanol, is present in varying amounts in different alcoholic
beverages from beer or wine to distilled liquors such as whiskey, gin, and
rum. When a person consumes alcohol, it
is rapidly absorbed into the bloodstream, travels throughout the entire body,
and affects nearly every tissue.
Moderate and high doses of alcohol impair the functions of the central
nervous system. The higher the alcohol
level is in the blood, the greater the impairment. As the blood passes through the liver,
enzymes break down the alcohol into harmless byproducts, which are eliminated
from the body six to eight hours later.
In alcoholics, oftentimes the rate of ingestion exceeds the rate of
elimination, thus raising the blood alcohol level and resulting in intoxication
(Hewitt & Gordis, 2001).
While small
amounts of alcohol may relieve tension or fatigue, increase appetite, or
produce an anesthetic effect, larger quantities inhibit or impair higher
thought processes, often producing euphoria, and reducing inhibition, anxiety,
and guilt. As a person becomes
intoxicated, their inhibitions become lessened and, as drinking progresses,
their speech may become loud and slurred.
Impaired judgment may lead to incautious behavior, and physical reflexes
and muscular coordination may become noticeably affected. Non-alcoholics may experience dysphoria (i.e., unpleasant feelings) and stop drinking at
this point. Alcoholic individuals,
however, may continue to drink in spite of such feelings (Peele, in D.A. Ward
(Ed.), 1990). If drinking continues,
complete loss of physical control follows, ending in stupor, and possibly
death. One paradox with an alcoholic’s
drinking patterns as a response to relieve anxiety, depression or other
emotional distress is that they continue to show these problems after drinking,
often in quite severe form. Studies have
indicated that alcoholics who drink in response to depression and anxiety
actually show greater anxiety and depression after drinking (Peele, 1990). Here we see that while drinking to relieve
emotional stress may provide acute relief for the drinker, it may also result
in the possible development of more severe emotional disabilities that
perpetuate the individual’s alcohol dependence.
It seems that drinking creates a vicious cycle for these alcoholics,
which reinforces and potentially exacerbates their drinking and emotional
problems (Peele, 1990).
The
Development of Alcohol Dependence
Once begun,
alcoholism typically progresses over 10-20 years (Blondelle,
Frierson & Lippmann, 1996). Health professionals typically describe three
general stages to characterize this progression. Each stage is defined by a set of symptoms
that can be used by the treating physician in early diagnosis and treatment of
alcoholism. These stages are: (1) social
drinking, (2) problem drinking and (3) alcohol dependence. Most individuals who drink alcohol never
progress beyond Stage One, and are commonly known as “social drinkers.” In this stage, individuals drink alcohol
primarily as an accompaniment to social situations and alcohol consumption is not
the central focus of their activities (Hewitt & Gordis,
2001).
A small
percentage of social drinkers may progress to Stage Two. During this stage, drinking begins to cause
problems that may increase in severity over time with continued heavy drinking,
although they may not show any signs of physical illness. Signs of Stage Two progression usually
include an increase in alcohol consumption that begins to interfere with other
activities. As problem drinking
progresses, the alcoholic's intoxicated behavior may become disagreeable and
antisocial. Such a person may resort to
drinking to relieve the physical discomfort of withdrawal symptoms. During this phase, one may take up “morning
drinking” in an attempt to offset uncomfortable symptoms of a “hangover” that
may have developed after heavy drinking the night before (Hewitt & Gordis, 2001).
During
Stage Two, one may or may not be alcohol dependent, as dependence is subtle,
slow and progressive. As alcohol
dependence develops, the person is often unable to acknowledge that drinking
and intoxication have become goals in and of themselves. Drinking may become a coping mechanism for
dealing with problems, and hence, justifiable to the user (although many of
such problems may have been brought about by the heavy alcohol use in the first
place). In addition, these heavy
drinkers may neglect familial responsibilities and decline in their
productivity at work. Many alcoholics
develop a psychological condition known as denial, where they are unable to
acknowledge that alcohol use lies at the root of many of their problems, which
furthers the progression of the disease.
Denial was long thought to be a personality trait shared by all persons
who suffer from alcohol-use disorders.
Despite their claim that they can quit drinking at their own discretion,
in actuality, many problem drinkers find it increasingly difficult to moderate
their alcohol consumption as time progresses, despite their illusion of control
(Hewitt & Gordis, 2001).
These
factors over time lead to stage three, the ultimate stage of alcohol
dependence. In addition to suffering fro
Causes
The
etiology of alcoholism is unknown, but strong evidence exists for a genetic
origin (Devor & Cloninger,
1989), although clearly psychological, social, and environmental factors
influence its expression and may perpetuate its development as well (Hewitt
& Gordis, 2001).
Environmental factors and social factors that may affect the development
of the disease include personal behavioral skills, peer influences early in
life, parental behavior, social and cultural attitudes toward alcohol use,
stress, and availability of alcoholic beverages. Once a person has established a drinking
pattern, social and environmental factors combined with physical and
psychological changes induced by heavy drinking may perpetuate the continued
use of alcohol among alcoholic individuals (Hewitt & Gordis,
2001).
Health
Consequences
While some
studies have found that moderate use of alcohol has beneficial health effects,
including protection from coronary heart disease, heavy and prolonged intake of
alcohol can seriously disturb body chemistry.
Heavy drinkers lose their appetite and tend to obtain calories from
alcohol rather than from ordinary foods.
While alcohol is rich in calories and can provide substantial amounts of
energy, if it constitutes the primary source of calories in place of food, the
body will lack vitamins, minerals, and other essential nutrients (Hewitt & Gordis, 2001).
In
addition, prolonged use of large amounts of alcohol may cause serious liver
damage. In the first stage of liver
disease, usually caused by excessive alcohol consumption, fat accumulates in
the liver (also known as “fatty liver”) whereby complications leading to
hepatitis or cirrhosis may develop. Such
heavy drinking may also damage heart muscle as nearly half of all cases of cardiomyopathy, a potentially fatal heart disease, are
caused by alcohol abuse. Alcoholics also
tend to have higher levels of the hormone epinephrine in the blood along with
deficiencies of the mineral magnesium. This
combination produces severe arrhythmias, or heartbeat irregularities, a common
cause of sudden death in heavy drinkers.
In addition, chronic drinkers typically develop hypertension, a leading
cause of stroke. A particularly common
feature of alcoholism is “blackout” drinking, where the person cannot
consciously recall events or his behavior during such a blackout state of
intoxication. Some such blackouts may
last for a period of several hours or up to several days (Hewitt & Gordis, 2001).
Clinical
psychologist J.R. Milam (1992) suggests, three phases of progressive brain
impairments that participate in personal and character transformation in the
alcoholic that augment the strength of their emotions and of their
addiction. These phases are briefly
described as follows: (1) Between drinking episodes, all brain cells are in a toxic,
malnourished state. Their detoxification
and stabilization takes several weeks of total abstinence from alcohol and all
other drugs. If heavy drinking
continues, (2) billions of brain cells are damaged, such that repair and
healing takes several months of abstinence.
Chronic alcoholics often reach the point where (3) many millions of
brain cells die. The loss is permanent,
but during a period of some four years of total abstinence, surviving brain
cells compensate for those that are lost (Milam).
The strong
physical component of alcohol addiction becomes even more evident when the
alcoholic tries to stop drinking. In
some cases, alcohol withdrawal may lead to delirium tremens (DTs), which
produce confusion, sleeplessness, depression, and terrifying
hallucinations. As the delirium
progresses, a persistent and uncontrollable shaking develop, beginning with the
hands that may extend to the head and body (Hewitt & Gordis,
2001).
PREVALENCE
OF ALCOHOLISM AND ITS SOCIAL EFFECTS
Alcohol
dependence affects a broad cross section of society around the world.
Scientists have not identified a typical alcoholic personality, and they cannot
predict with absolute certainty which drinkers will progress to alcohol
dependence. While alcohol use disorders
develop in a predictable pattern, some studies show that alcohol problems and
their solutions differ significantly according to the age, sex and ethnicity of
the individual (Seale & Muramoto, 1993). The prevalence of the illness varies in
different countries. At a cultural
level, addiction to a substance such as alcohol varies according to historical
events and social attitudes (Blum & Blum, 1969; McClelland et al., 1972; Zinberg & Harding, 1979). Cultural variations in alcoholism rates are
related to the way in which drinking is perceived of in different cultural
settings. In some cultures, problem
drinking is practically unknown. In
rural Mediterranean societies, for example, drinking does not lead to the
destructive and antisocial behavior (such as fighting, reckless driving,
blackout, sexual aggression) that seems to define alcoholism in American
culture (Blum & Blum). Moderate
drinking is notable in ethnic and cultural groups such as the Chinese (Barnett,
1955), the Greeks (Blum & Blum), the Jews (Glassner
& Berg, 1980), and the Italians (Lolli, Serianni, Golder & Luzzato-Fegiz, 1958).
The WHO
estimates that nearly 62 million people worldwide suffer from alcohol
dependence, and studies estimate there are more than 15 million alcoholics in
Today
experts characterize alcohol-use disorders as forms of illness that are so
widespread that they constitute a major public health problem. According to the WHO, alcohol dependence and
other alcohol-use disorders undermine global health, and account for 3.5
percent of the total cases of disease worldwide. In the
There are
costly links between addiction/alcoholism and our criminal justice system as
well. The vast majority of all prison
inmates are incarcerated for crimes secondary to drug and alcohol
addiction. The annual cost to society of
tending to the multiple effects of alcoholism and addiction, including rampant
“psychiatric” problems, family neglect and abuse, poverty, violence, and other
crimes, illness, and organ and system failures, accidental injuries and deaths,
is in the hundreds of billions of dollars (Milam, 1992). Clearly, the disease of alcoholism is not
only a problem for the individual, but a problem with enormous consequences for
society as well.
THE
DEVELOPMENT OF DISEASE THEORY AND CHANGE IN SOCIAL ATTITUDES
Complications
from heavy alcohol consumption have been recorded throughout history around the
world. Physicians have played a role in the
treatment of alcoholism since the age of Antiquity. A large amount of treatment by physicians has
been well meaning, but misinformed and characterizes the complexity of
understanding the disease of alcoholism.
With the exception of a few physicians ahead of their time, most of
society has viewed people who drink excessively as irresponsible, immoral, and
of weak character. The commonplace view
for centuries (and still among many of the uninformed today) held that taking
or rejecting a drink was a matter of personal decision, thus all excessive
drinking was considered a voluntary act and the individual, therefore, should
be held responsible for his or her behavior.
Thus, punishment and incarceration of drunkards was considered necessary
to protect the community, an issue that we are still grappling with today. It is only within the last two centuries that
research findings have determined that alcoholism is, indeed, a disease with
real, neurophysiological components; these effects
may render the alcoholic incapable of exercising discretion or control
regarding alcohol or drug ingestion.
One of the
earliest versions of the disease theory of alcoholism originated with physician
Benjamin Rush, who published An Inquiry into the Effects of Ardent Spirits on
the Human Mind and Body in 1784. Therein
he chronicles the progression of alcoholism with the same level of
understanding that we maintain today:
“Drunkenness
is the result of a loss of willpower.
Initially drinking is purely a matter of choice. It becomes a habit, and then a
necessity.” He also identified
alcoholism as a primary disease and not a symptom of some other malady. Rush considered cold baths and total
abstinence necessary treatments to effect a cure for
alcoholism, but found that such treatment methods yielded disappointing
results. Since it proved almost
impossible for Rush to impose his radical therapy in everyday surroundings, he
proposed the construction of detoxification establishments, and asylums to
provide sober housing for chronic abusers until cured (Levine, 1978).
Perhaps the
greatest advances in our understanding of alcoholism as a disease came about in
the 19th and 20th Centuries. At the turn
of the 19th Century, English physician, Dr. Thomas Trotter was one of the first
medical professionals to relate alcoholism to the increasing numbers of
patients in the emerging, specialized mental hospitals, and among the first
medical professionals to articulate a conception of alcoholism similar to the
disease theory we have today. He wrote,
“drunkenness is an illness of unknown cause which
upsets the healthy equilibrium of the body.”
His deduction quickly caught on.
In 1841, the first English life assurance company offered lower premiums
to those who abstain from alcohol, thus we see the emergence of a growing
awareness of the link between longevity and alcohol consumption. Doctors in English sanitariums were also
quick to draw such links. In 1850,
Forbes Wilson mentioned that 4 out of 5 inmates were in the asylum through
overindulgence in distilled liquor (Sournia, 2000).
Throughout
other parts of
Concurrently,
in
Medical
Doctor Thomas L. Haynes (1988) suggests that the most notable treatments for
alcoholism developed in the 19th and 20th Centuries beginning with Sigmund
Freud. Although Freudian psychoanalytic
theories about why people drink uncontrollably were insightful, his therapies
seemed unable to keep people sober for long.
Against the setting of temperance movements gaining swift momentum, he
and other physicians were just becoming aware of chemical dependency as a
disease and were gradually discovering more about various physical and mental
complications related to heavy drinking (Haynes).
Dr. Carl
Jung, one of Freud’s students, is said to be instrumental in our current
understanding of alcohol dependence as a disease. He concluded, after working with many
alcoholics, that alcoholism was a hopeless condition from which one could not
recover without some type of spiritual conversion experience. Dr. William Silkworth
coined the description of alcoholism that was adopted by Alcoholics Anonymous
in 1935 as “an obsession of the mind that condemns one to drink and an allergy
of the body that condemns one to die.”
He estimated that his success rate with alcoholics was approximately 2%
before the recovery of Bill Wilson and the founding of Alcoholics Anonymous
(Haynes, 1988).
Dr. E.M. Jellinek is recognized as the premier researcher in the
field of alcoholism and was strongly influential of the disease model of
alcoholism that we maintain today. Dr.
Haynes maintains that Jellinek’s writings and
descriptions “did more for the acceptance of the disease concept of alcoholism
and of A.A. as a respectable therapeutic modality than any other medical force
of the time” (Haynes, 1988).
Up until
these advances mid-20th century, social attitudes about alcoholism were
ambivalent, as there was no strong correlative evidence that alcoholic drinking
and behaviors (and all of the consequences entailed) were not just a matter of
personal choice. As noted earlier, the
typical picture of the alcoholic was of someone without steady employment,
unable to sustain family relationships and most likely in desperate financial
straits, because of poor choices and hedonistic indulgences in alcohol. This stereotype was slowly dispelled as new
medical findings emerged and as highly respected people publicly admitted their
alcohol dependence and shared their successful (although often more apparent
than real) recovery stories.
Particularly critical in changing the way Americans view alcohol-use
disorders were
The
American Medial Association is widely believed to have first accepted
alcoholism as a disease in 1956, although the original resolution was not
officially ratified until ten years later.
In February of 1987, Dr. Smith introduced a motion that the AMA include
all mood-altering drugs in the disease of chemical dependence, and the American
Medical Society on Alcoholism and Other Drug Dependencies introduced the same
motion in June of 1987. The AMA then
passed a resolution that all drug addictions are one disease (Haynes, 1988).
During the
early 1980s, the National Institute on Alcohol Abuse and Alcoholism and the
National Institute on Drug Abuse shifted their funding emphasis to support
research in the biology of addiction. In
1986, Harvard,
GENETIC
RESEARCH
The
biological or “disease theory” model as it is articulated today recognizes that
alcoholism is a primary addictive response to alcohol in a biologically susceptible
drinker, regardless of character personality.
Both animal and human studies have shown repeatedly that alcohol
addiction is hereditary and indicate a number of in-born, pre-drinking
biological differences in alcoholics – such as initial and progressive
differences in their biological responses to alcohol, including alcohol
metabolism, and in the effect of alcohol on performance, mood, and mental
abilities (Milam, 1992). Despite the
opposing belief that alcoholism is not a disease, but rather a conditioned
response to psychosocial stress, the majority of the medical community today
accepts the disease theory and focuses their research efforts on this model and
its implications (Hewitt & Gordis, 2001).
Most of the
support for the popularity of the disease model of alcoholism is based on
genetic research that gives scientists positive indicators that alcoholism is
inherited. Studies in the 1970’s have
shown that alcoholism runs in families—alcoholics are six times more likely
than non-alcoholics to have blood relatives who are alcohol dependent (Goodwin
et al., 1974; Cotton, 1979). Researchers
have long sought to determine whether these familial patterns result from
genetics, from a common home environment (which often includes alcoholic parents),
or both. In their research, scientists
investigate the possible genetic components of alcoholism by studying
populations and families as well as genetic, biochemical and neurobehavioral
characteristics (Cloninger & Begleiter,
1990).
Proponents
of the biological model or “disease” approach to understanding alcoholism,
support genetic research because the discovery of a specific genetic effect on
the development of alcoholism would be beneficial for three general reasons:
1.) It could lead to the identification of some
people at risk who could act to avoid developing alcohol related problems
(Goodwin, 1989. Goodwin, in WM Cox (Ed.), 1990).
2.) Genetic research may help us to understand
the role of environmental factors that are critical in the development of
alcoholism (Cloninger et al., 1981).
3.) Genetic research may lead to better
treatments, based on new understandings of the physiological mechanisms of
alcoholism (Crabbe & Harris, 1991).
Three
general research methods that scientists employ to learn more about the
genetics of alcoholism include genetic marker studies, animal studies and
twin/adoption studies. Each will be
briefly described herein.
Genetic
Marker Studies
Different models
for the way in which alcoholism runs in families have been suggested by a
limited number of family studies.
Interpretation of these studies has been complicated by the likelihood
that alcoholism is a heterogeneous condition (i.e., a collection of different
conditions that look similar, but whose mechanisms and modes of inheritance may
differ). Additional studies are needed
to sort out the mechanisms of transmission (Hill, 1992; Gilligan, Reich & Cloninger, 1987).
To search
the human genome for specific genes related to alcoholism, researchers may
employ different methods of experimentation.
These methods include DNA scanning, the candidate gene approach, and
genetic marker studies. In DNA scanning,
scientists scan the human genome which involves characterizing the entire
length of DNA and finding genes that relate to alcoholism without proposing
candidate genes (genes that are hypothesized to be connected with the
expression of alcoholism). Genetic marker
studies and the candidate gene approach test particular genes that are
hypothesized to be related to the physiology of alcoholism. If certain genes are related to alcoholism,
then genes lying close to them on the same chromosome – and the traits they determine
– may be inherited at the same time that the risk of alcoholism is
inherited. This phenomenon is called
linkage. Assortments of genes
hypothesized to be linked to alcoholism have been examined, but none have
passed a rigorous test for linkage (Cook & Gurling
in Cloninger & Begleiter,
1990; Goldman in Galanter, 1988).
Animal
Studies
Another research method used in
studying the genetics of alcoholism includes using animal models. These models have several advantages over
human subjects insofar as researchers can study larger numbers and more
generations of subjects, can arrange informative matings,
can better manipulate the environment, and can make measurements that would not
be possible on humans. Using the
powerful genetic methods available through animal studies, investigators are
beginning to map genes that may be responsible for some of the animals'
alcohol-related behaviors (Nadeau, 1990).
The main limitation of using
animal research methods to study alcoholism is that there is no animal model of
alcoholism that encompasses the whole spectrum of alcoholic behaviors in
humans. Researchers have, nevertheless,
studied alcohol-related behaviors in animals that are believed to resemble
aspects of human alcoholism, and have succeeded in breeding lines of rodents
with high or low measures of most of these traits. This success demonstrates that such traits
are substantially genetically determined in rodents and could be genetically
determined in humans as well (Phillips & Crabbe, in Crabbe & Harris,
1991).
Twin
Studies and Adoption Studies
Two major
methods of investigating the inheritance of alcoholism involving humans are
studies of twins and adoptees. Further
support for the idea of genetic transmission of alcoholism has been confirmed
by such studies. Research findings
indicate greater concordance rates in alcoholism for identical versus fraternal
twins, and on the greater influence of the biologic versus the adoptive family
in the development of alcoholism among adoptees. Pickens and co-workers (1991) studied 169
same-sex pairs of twins, both males and females, at least one of which sought
treatment for alcoholism. They found a
greater concordance of alcohol dependence in identical twins than in fraternal twins. In studying 902 male Finnish twins, Partanen and co-workers (1966) found that less severe
drinking patterns were less heritable and more severe drinking patterns were
more heritable.
Goodwin et
al. (1973) found that male adoptees with alcoholic parents were four times more
likely to become alcoholics than those without, although there was no alcohol
abuse in the sets of adoptive parents. Cloninger and his fellow researchers subsequently performed
a series of much larger studies of adoptees, which also revealed these trends (Cloninger, Bohman & Sigvardsson, 1981).
Studies conducted by Schuckit et al. (1972)
discovered that half-siblings with at least one alcoholic-biologic parent were
far more likely to develop alcoholism than those without such a parent, no
matter by whom they were raised.
There is
still some debate within the medical community as to what sort of a role genetic influences have on a person’s
susceptibility to inheriting and expressing traits of alcoholism. Genes might play a direct role in the
development of alcoholism, as in affecting the body’s metabolism of alcohol; or
they might play a less direct role, such as influencing a person’s temperament
or personality in such a way that the person becomes vulnerable to
alcoholism. The extent of the influence
of genetic factors on the development of alcoholism is still pending further
research, but enough studies seem to have confirmed that there is a genetic
link (Hewitt & Gordis, 2001).
PREVENTION,
TREATMENT APPROACHES AND RECOVERY
Physicians can
play an important role in treatment by educating patients to prevent the
addictive cycle from starting, by being alert to risk factors, recognizing
signs of alcoholism (particularly during its early stages), and initiating
interventions designed to halt progression of this disease. The physician’s prominent role in
preventative treatment for alcohol dependency can be roughly divided into three
categories: primary, secondary and tertiary prevention. Each phase of treatment entails an assessment
of different factors, which will be briefly discussed herein.
Primary
Prevention
The goal of
primary prevention is to identify those patients at risk for alcohol abuse and
to educate them in order to stop the disease before it starts. The intensity of the steps taken during
primary prevention will depend on whether the patient is considered a high-risk
candidate for alcoholism or a low-risk candidate. Low-risk candidates who drink at all should
be told to drink only in moderation (meaning no more than two standard-sized
drinks per day) and never at work, before driving or when operating
machinery. High-risk candidates (e.g.,
those with a strong family history of alcohol problems) are recommended to
consider total abstinence as the best way to prevent alcoholism. They should also be encouraged to learn more
about alcoholism by attending AA meetings as an observer and by reading AA
literature or similar publications.
Similarly, total abstinence is recommended for adolescents, persons with
alcohol-sensitive conditions, recovering alcoholics, and patients with past
alcohol-related problems (Blondell, Frierson & Lippman,
1996).
Secondary
Prevention
Secondary
prevention aims to identify patients with early signs of the disease and halt
its further progression. In its early
stages, alcoholism has few specific signs or symptoms, but clinicians can
prevent its further progression if they recognize them and intervene. Combinations of certain conditions may be
suggestive of alcoholism. They include
the following four general categories: (1) Recognition by the patient of
excessive consumption of alcohol or the need to “control” their drinking. (2) Negative effects on others when or
because of drinking (or lack of drinking).
(3) Adverse personal consequences when or because of drinking (or lack
of drinking). (4) Evidence of tolerance,
actual chemical dependence or the need to manage a withdrawal syndrome. More specific symptoms may include anxiety,
depressed mood, drunk driving arrests, blackouts, dysphoria, dyspepsia, gastritis, elevated liver enzyme
levels, hypertension, vague abdominal complaints, sleep disturbance, frequent
job changes, marital/family problems, and myriad of other possible physical and
psychological manifestations of this disease. During secondary prevention, the patient must
be confronted, as decisive action is necessary to overcome any onset of denial,
the main defense mechanism against recognition of the problem and acceptance of
treatment (Blondell, Frierson
& Lippman, 1996).
A treatment
strategy is also recommended at this phase of prevention (i.e., attendance at
Alcoholics Anonymous meetings, attempts at controlled drinking, etc.). If these measures show no improvement,
further steps such as formal intervention, counseling, or commitment to an
inpatient treatment center may be necessary (Blondell,
Frierson & Lippman,
1996).
Tertiary
Prevention
The goal of
tertiary prevention is to treat and rehabilitate patients with chronic alcoholism
to prevent a potentially fatal disease progression. Typically, 10 to 20 years of active drinking
are needed to reach this stage, although in some individuals alcoholism
proceeds more rapidly. Patients often
require hospitalization for an acute medical problem, related or unrelated to
alcohol. Tertiary prevention includes
the following measures: (1) The assessment of risk for
a withdrawal syndrome by obtaining information about the quantity and frequency
of alcohol consumption. (2) Treating withdrawal
syndrome and detoxification, as well as other possible complications (e.g.,
malnutrition), pharmacologically as needed.
(3) Planning for rehabilitation after the patient stabilizes (Blondell, Frierson & Lippman, 1996).
Treatment
Approaches
A positive,
public health approach that integrates medical, psychological, and social
therapies can lead to improved outcomes for patients who are addicted to
alcohol and/or other substances. There
have been several recent changes in the areas of treatment and recovery for
alcoholism. Private treatment for
alcoholism and drug abuse greatly expanded beginning in the late 1970’s. Federal financing for the treatment shifted
to service contracts and third-party payments, and as a result, the primary
locus for treatment changed from public institutions to private facilities and
contractors (Peele, 1984). Between 1978
and 1984, the number of beds in private alcoholism treatment centers more than
quadrupled. In the 80’s hospitalization
of adolescents in private psychiatric facilities mainly for drug and alcohol
abuse, jumped 450% (Peele, 1991). Some
research indicates that treatment does indeed have a dramatic impact in
positively changing an individual’s behavior.
A recently completed 5-year study by the Center for Substance Abuse
Treatment (CSAT) which involved thousands of clients in hundreds of alcohol and
drug treatment centers, indicated that treatment dramatically reduces criminal
behavior, reduces arrests by nearly 60%, and cut illicit, violent and risky
sexual behaviors in half (Lucas, 1999).
There are,
however, skeptics as to whether or not treatment centers are efficacious in and
of their own right. One prominent
skeptic is Enoch Gordis, M.D., the director of the
National Institute on Alcohol Abuse and Alcoholism (NIAA). After studying a large hospital program that
he himself administered, Gordis concluded,
“contemporary alcoholism treatment is, at best, of limited effectiveness”
(Peele, 1991). George Vaillant, a supporter of the disease theory of alcoholism,
recently completed a research study of methods of treating alcoholism that
included hospital detoxification, compulsory AA attendance, and a counseling
program. Contrary to what one might
expect, his findings indicated that his patients, who participated in the
treatment programs fared no better after 8 years than alcoholics who did not
participate in such recovery programs.
He reflected that perhaps the best that can be said concerning the current
methods of treatment is, at least, that they do not interfere with the natural
recovery process (Vaillant, 1983).
Another
important factor to acknowledge when considering whether or not people succeed
in overcoming an addiction may not only be determined by the type of treatment
they receive. Based on his research
findings, Vaillant remarked, “the
most important single prognostic variable associated with remission among
alcoholics who attend alcohol clinics is having something to lose if they
continue to abuse alcohol.” Among Vaillant’s own patients at an urban municipal hospital,
many had little to lose, as 95% relapsed at some point after treatment (Peele,
1991). A study of an inner-city hospital
alcoholism ward by John Helzer and his colleagues
found that 93% of the patients were either dead or still abusing alcohol 5-7
years after treatment. It has been
suggested that private treatment centers ordinarily show better outcomes,
partly because their clients are more likely to have families, jobs, and
incomes (Peele, 1991).
Treatment
Methods
Treatment
methods of alcohol dependency vary depending upon an individual's medical and
personal needs. Some heavy drinkers who
recognize their problem appear to recover on their own. Others recover through participation in the programs
of Alcoholics Anonymous or other self-help groups. Some alcoholics require long-term individual
or group therapy, which may include hospitalization (Hewitt & Gordis, 2001).
Numerous
studies indicate that simple, brief interventions can be effective in changing
drinking behavior in those who are not severely alcohol dependent. In brief interventions, a problem drinker
meets with a health professional for one to four sessions, with each session
lasting from a few minutes to an hour.
During these meetings, the health professional makes the person aware
that his or her current drinking patterns or medical problems are related to
alcohol abuse and could progress to alcohol dependence (Hewitt & Gordis, 2001).
For some
alcoholics, treatment begins with detoxification, which normally requires less
than a week, during which time patients usually stay in a specialized
residential treatment facility or a separate unit within a general or
psychiatric hospital. These facilities
also offer extended treatment programs to help alcoholics in their recovery
(Hewitt & Gordis, 2001).
Treatment
may also involve individual counseling and group therapy to help a person who
is alcohol dependent adapt to a new way of life that is not driven by
alcohol. Throughout the
Physicians
may prescribe medications to help prevent alcoholics from returning to drinking
once they have stopped. The drug disulfiram (sold under the trade name Antabuse),
interferes with the way the body processes alcohol, producing extremely
unpleasant reactions when alcohol is ingested, but shows no noticeable effect
unless a person drinks alcohol (Fuller et al., 1986). Naltrexone (ReVia) is a narcotic approved for use in alcohol treatment
in 1995. Although scientists are not certain
how this medication works in the brain, it reduces an alcoholic's craving for
alcohol, most likely by blocking the positive effects the individual gets from
drinking alcohol. Indications are that Naltrexone is most effective when it is used in combination
with counseling programs such as individual and social therapies (Voipicelli et al., 1992; O’Malley, 1995).
Recovery
Since there
is no cure for alcoholism, even sober alcoholics are said to be “in recovery,”
a lifelong process. Total abstinence
from alcohol and other sedatives (including prescription drugs) is said to be
the cornerstone of managing recovery.
Relapses are a common part of the recovery process as well and should be
expected and planned for. Discussion of
temptations, means of coping, support systems and a non-drinking, healthful
lifestyle (i.e., diet and exercise) is often helpful. Follow-up aftercare programs may assist in
helping a recovering alcoholic maintain sobriety. Such programs may include group therapy,
individual psychotherapy, employer-mandated monitoring programs, and self-help
groups such as Alcoholics Anonymous (Blondell, Frierson & Lippmann, 1996).
Alcoholics
Anonymous
Until the mid-1930s,
alcohol-dependent individuals who could not afford a private sanitarium or
psychiatrist could find help only at state hospitals, in jails, or through
street ministries. The formation of Alcoholics Anonymous (A.A.) in 1935 marked
the first non-medical approach that made sustained recovery from alcohol
dependence possible for many individuals.
Today nearly 2 million people worldwide clai
The A.A.
program promotes psychological principles that help people live a healthy,
stress-free lifestyle where the individual learns that he or she suffers from a
disease and gains support and encouragement to stay sober through group
interaction and help from his or her own conception of a “higher power.” The organization functions through local
groups that have no constitutions, officers, or dues. Anyone who has a drinking proble
Other
Recovery Approaches
While
Alcoholics Anonymous is widely recognized as an effective source of support,
not everyone responds to the group's spiritual bent. Other recovery approaches include Rational
Recovery, an organization that promotes lifelong abstinence from alcohol and
teaches people how to recognize psychological “triggers” to combat the urge to
drink. Another non-A.A. organization is
the Secular Organizations for Sobriety/Save Our Selves (SOS), which endorses a
program that separates recovery from spirituality whereby individuals are
encouraged to rely on themselves and others in the group – not a spiritual
power – to gain sobriety (Hewitt & Gordis,
2001).
Concluding
Remarks
The disease
of alcoholism is vast and all encompassing, and affects many, if not all areas
of the alcoholic’s life. The effect of
this disease on social institutions and its impact upon the medical field has
been magnanimous. Research efforts
regarding the biological components of this disease have just begun, and are
far from being exhausted. While there is
much left to be resolved regarding our understanding of the nature of this
disease and its various implications on both the individual and societal level
as well, this paper is expected to have been successful in at least
establishing the following summary points with respect to our current
understanding of alcoholism:
1.) That alcoholism is a progressive, often
fatal disease having genetic origin, influenced by social, psychological and
environmental factors, and should be distinguished from heavy drinking.
2.) The disease of alcoholism has a drastic
negative impact on both the individual and on society.
3.) Genetic research is discovering more and
more evidence in support of the disease theory of alcoholism, although many advancements have yet to be made.
4.) Physicians can take active steps in
preventative treatment of alcoholism.
5.) Treatment approaches may or may not be
effective, but do not seem to be interfering with the recovery process.
6.) There are a variety of treatment approaches
and recovery options available to the individual seeking help.
Clearly, we
are still lacking scientific answers to many key questions about alcoholism;
including: why alcoholism is transmitted, how it affects complex
neurobehavioral systems, whether or not such genetic transmission can be
prevented, and whether or not we can design medication to stop the addictive
cycle before it becomes destructive, if one is found to have such a genetic
susceptibility. Only time and scientific
efforts will provide such answers. In
the meantime, the paradigmatic shift from understanding alcoholism as a
psychological response to our current understanding of alcoholism as a
biological response has greatly affected treatment programs, research methods
and social attitudes regarding our perception of alcoholism and of alcoholic
individuals. We can only hope that as
scientific research methods are refined and as we learn more about the human
genome, that we will be able to discover more about this genetic susceptibility
that is expressed in multitude of aspects that differentiate the alcoholic from
the non-alcoholic. Such findings would
not only provide us with a better understanding of the disease of alcoholism
and the alcoholic, but a better understanding of ourselves as well.
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Sournia, J (1986). L’histoire de l’ Alcoolisme.
Vogin M.D.,
Voipicelli, J.R., Alterman, A.I., & Hayashida,
M., et al. (1992). Naltrexone in the treatment of alcohol dependence. Archives of General
Psychiatry, 49, 11, 876-880.
Zinberg, N.E.,
& Harding, W.M. (1979). Control and
intoxicant use: A theoretical and practical overview” Journal of Drug Issues,
9, 121-143.
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The Relationship of Child
Victimization to
Dissociative
Identity Disorder
John Q. Student
PY 100 General Psychology
Fall 2007
The history of dissociative identity
disorder (DID), previously known as multiple personality disorder (MPD), is
complex and vague. DID can be traced back four thousand years
to the ancient civilizations of Greece and Egypt with the beginning
documentation of hysteria. DID has as its
principal characteristic, dissociation, whose history begins with Franz Anto Mesmer, induced somnambulism, and hypnotism. Interest in MPD peaked in the late 19th
century and then declined early in the 20th century (Ross, 1996) and many
factors influenced DID’s unique progression. Controversy surrounds the
diagnosis; some researchers and clinicians accept its validity while others
question its existence. The disorder also has similar symptoms to many other
disorders and therefore a correct diagnosis is crucial. Today DID is a valid
diagnosis and it’s history can be seen in the progression of diagnoses in the
Diagnostic and Statistics Manual for Mental Disorders from hysteria to DID (DSM
I through DSM IV-TR, 1952-2000).
Felida, a Belgian teenager living
in the late nineteenth century, often passed from her “first state” to her
“second state” and would return to her normal “first state” later in the day
(Hacking, 1992). Her “first state” consisted of the standard hysterical
symptoms of the time: defective tactile sensations, no sense of taste,
diminished sense of smell, depression, partial anaesthesia,
[and] occasional convulsions when under stress (Hacking, 1992). In the second
state she was more lively and cheerful, yet her second state was not able to
remember what happened during her first-state (Hacking, 1992). This is the life
of a person with dissociative identity disorder (DID).
Dissociative
identity disorder, previously known as multiple personality disorder (MPD), is
a complex mental illness that affects one in every hundred people (Haddock,
2001).
At present the DSM IV-TR, created by the American Psychiatric Association (APA,
2000), classifies a person as having dissociative identity disorder if they
meet the following criteria: (a) the presence of two or more distinct
identities or personality states (each with its own relatively enduring pattern
of perceiving, relating to, and thinking about the environment and self); (b)
at least two of these identities or personality states recurrently take control
of the person’s behavior; (c) inability to recall important personal
information that is too extensive to be explained by ordinary forgetfulness;
(d) the disturbance is not due to the direct physiological effects of a
substance (e.g. blackouts or chaotic behavior during Alcohol Intoxication) or a
general medical condition (e.g., complex partial seizures) and in children the
symptoms are not attributable to imaginary playmates or other fantasy play
(APA, 2000).
DID, has as its principle
characteristic - dissociation. When people dissociate they may feel
disconnected from themselves or disconnected from the world around them; this
disconnection can become so enveloping that the person may distort time and may
not be able to recall what happened during the dissociated state (Haddock,
2001). Many humans engage in defense mechanisms when faced with overwhelming
stress; dissociation is one example of a defense mechanism. It “can be thought
of as both a neurobiological response to threat and a psychological defense to
protect one from an overwhelming experience” (Haddock, 2001, p.14). A
psychological disorder may result when this dissociation interferes with life
functioning after the trauma when there is no longer a threat to the person
(Haddock, 2001); this is when a person may develop DID.
The history of dissociative
identity disorder is complex and vague, much like the illness itself. Even
today, doctors have trouble diagnosing people with DID. Therefore, the history,
the development in the Diagnostic and Statistics Manual (APA, 1952, 1963, 1980,
1984, 1994, 2000), and the causes of dissociative identity disorder will be
presented so as to view DID in the context of its time and to shed light on the
complexity of the illness.
DID Debate
Throughout history, there has been
controversy as to whether or not DID can be considered an actual disorder.
Opinions about DID range from believing the diagnosis to be a fiction
co-created by patient and clinician, to accepting the validity of the diagnosis
(Cardena and Spiegel, 1996). Those in opposition to
the clinical diagnosis hold that ‘personality states’ or alter personalities
are created by therapists or psychoanalysts as a result of suggestion and therefore
do not truly exist (Hacking, 1992). Horevitz (1994)
identifies two interesting questions relating to the controversy surrounding
DID - have clinicians become so fascinated with the possibility of multiplicity
in patients that they covertly elicit it during therapy? Or, have clinicians
become better diagnosticians of the secret inner worlds of childhood trauma
survivors? (Horevitz, 1994) This skepticism exists in
the minds of many researchers and clinicians.
However, the American Psychiatric
Association recognizes dissociative identity disorder as a significant and
actual mental illness, which gives validity to the illness itself. Another
controversy surrounding dissociative identity disorder is the concern with what
exact terms are sufficient and necessary to diagnose a patient as having DID.
Continuous revisions of the DSM show the chronological development of a
dissociative identity disorder diagnosis through the first DSM (1952) to the
present DSM IV-TR (2000). This development shows the struggle for a clear and
precise diagnosis of a complex and controversial disease. It also shows the
main problem with the history of dissociative identity disorder – the degree to
which naming and defining an illness helps to arrive at a correct diagnosis and
treatment.
Differential Diagnosis
The multiple personality
literature has reported cases of people with DID that have as many as 100
distinct personalities (or alters) (Hacking, 1992); differences between
personalities can range fro
Some of the major indicators of
DID include symptoms such as hearing inner voices, nightmares, panic attacks,
depression, eating disorders, chemical dependency, loss of time, handwriting
differences, difference in appearance, and severe headaches that are associated
with the switching of personalities (Haddock, 2001). Most psychiatric patients
are comorbid, they fit the diagnostic criteria for
more than one disorder and the average DID patient meets the criteria for three
to four other psychological disorders (Acocella,
1999). A person may not be initially diagnosed with DID because of the distinct
personality controlling them at that moment and that specific ‘person’s’
behavior. For example, if one alter is highly depressed and that alter is in
control of the person when visiting a therapist for the first time, that person
would at the start of therapy be diagnosed as depressed. Therefore, care must be
taken when diagnosing patients and clinicians must be aware of DID’s specific
characteristics so as to not incorrectly diagnose.
DID must be distinguished from a
variety of other disorders because several other diagnoses are often confused with
DID (Kahn and Fawcett, 1993). First it must be differentiated from symptoms
that are caused by the direct physiological effects of a general medical
condition (APA, 2000). Second, it must also be distinguished from dissociative
symptoms due to complex, partial seizures (although they can co-occur). And DID
must not result from the physiological effects of a substance (APA, 2000). A
diagnosis of DID takes precedence over other dissociative disorders and
individuals should be differentiated from people with trance or possession
symptoms (who would be diagnosed as Dissociative Disorder Not Otherwise
Specified) (APA, 2000). Most importantly DID must be distinguished from other
disorders with overlapping symptoms: including Schizophrenia and other Psychotic
disorders, Bipolar disorder (with rapid cycling), Anxiety disorders, Somatization disorders, and Personality disorders (APA,
2000).
The Etiology of DID
DID, previously thought of as Multiple
Personality Disorder, has often been linked with hysteria, somnambulism (i.e.,
mesmerism/hypnosis), demonic possession (Flora, 1988; Veith,
1965), and trance states (Ross, 1996). The most important and direct historical
link to DID is the mental illness, hysteria, which has been documented and
discussed since the earliest recordings of medicine (Veith,
1965). Hysteria is the manifestation of physical symptoms (i.e., convulsions,
paralyses, strangulation, breathing problems, numbness, pain) or psychological
symptoms (i.e., anxiety, emotional outbursts, ‘spells’) or both, in the absence
of any clear natural cause (Acocella, 1999). Hysteria
dates back four thousand years in to the ancient civilizations of
“Hysteria” is derived from the Greek word hystera, which means “uterus” and traditionally hysteria
has been identified as a disease of women. The word to describe this illness
sheds light on the first understanding of its causes. It was believed to be a
disorder that only affected women and was caused by alterations in the womb;
this association between the illness and a woman’s womb expressed the effect
that disordered sexual activity could have on emotional stability (Veith, 1965). Today, the most widely accepted cause of DID
is childhood sexual abuse; in a survey done by The National Institute of Mental
Health on 100 MPD cases, 97% of the patients reported experiencing significant
trauma in childhood (Hacking, 1992). Perhaps the women in ancient times were
also dissociating because of traumatic reasons, which may parallel childhood
sexual abuse in the present. Some cases of hysteria could have in fact been DID
because of the similarity in causes (sexual) as has been demonstrated with DID.
Veith (1970) argues that much of what has been called
hysteria at different periods would now be described by other names and how we
would describe hysteria now would have been attributed to other diseases in
earlier times.
In the medieval era social
attitudes toward hysteria changed; the preoccupation with demonology and
witchcraft altered societal perceptions of a hysteric from that of a sick human
being to that of someone who was possessed on purpose and “in cahoots” with the
devil (Veith, 1965). With the rise of Christianity
organic theories of hysteria were replaced by supernatural explanations and
unusual female complaints were seen to be the work of the devil (Acocella, 1999). DID is diagnosed three to nine times more
frequently in adult females than in males (APA, 2000) and in earlier times the
majority of people accused of being witches, possessed, or hysterical were also
women.
During the seventeenth
century, Thomas Willis (considered to be the father of neurology) introduced
the notion that hysteria stemmed from the brain, primarily the nervous system,
instead of from alterations in the womb. He believed hysterical fits were
caused by “spirits inhabiting the brain, being now prepared for explosions” and
seldom admitted to the uterus as the starting point of the disorder (Veith, 1965, p. 131). From his own experiences Willis was
convinced that hysteria was not limited to women, and therefore could not be a
problem of the uterus. Yet, he did believe that women were more susceptible to
hysteria than men, because “Women, from any sudden terror and great sadness,
fall into mighty disorder of spirits, where men from the same occasion are
scarcely disturb’d at all” (Veith,
1965, p. 133). Thomas Willis went on to publish a book on nervous disorders,
which included hysteria, and popularized the term “nervous”. Several books were
published after Willis to clarify what the term “nervous” applied to and to
explain specific nervous disorders. Even Philippe Pinel’s
Nosographie (1798) contained a reference to nervous –
one of his five classes of diseases was titled neuroses. This fourth class of
disease included hysteria and was discussed under the title of “Genital
Neuroses of Women”, suggesting that Pinel also
recognized hysterical symptoms only in women. Yet, he described similar
symptoms in men under different titles (Veith, 1965).
Later, in the eighteenth
century Franz Anto Mesmer, for his dissertation, drew
upon Richard Mead’s argument that “gravity produced ‘tides’ in the atmosphere
as well as in the water and that the planets could therefore affect the fluidal
balance of the human body. Mesmer associated this ‘animal gravitation’ with
health” and introduced his theory of “animal magnetism” (Gillispie,
1974). His findings took on new life when he “began treating his own patients…[applying] magnets to his patients bodies…” which “produced
dramatic results, especially in the case of a young woman suffering from
hysteria.” (Gillispie, 1974, p. 326) Mesmer
popularized “induced somnambulism” and in “1784 his followers, led by the Chastenet de Puysegur brothers,
extended mesmeric ‘rapport’ into something new: mesmeric induced hypnosis.” (Gillispie, 1974, p. 327) This was the beginning of medical
and public methods of getting people into an altered consciousness. It brought
about the possibility of a conscious and subconscious life – a strange new
phenomena for the people of the eighteenth century (Gillispie,
1974).
In 1843 James Braid changed the name “induced
somnambulism” to hypnotism, derived from the Greek word “hypotikos”,
which means sleep inducing (Flora, 1988; Veith,
1965). Morton Prince, a physician, states his thoughts on hypnotism and how it
relates to personality.
…hypnotism has always been
treated as if it were something bizarre, a mental condition that stood apart as
something distinctly different from all other conditions; whereas it is only
one of a large category of conditions characterized by alteration of the
personality. In this category are to be found various clinical types of
alteration, some normal some abnormal, all due to the same processes and
mechanisms…states of hypnosis are as varied and multiform as there are possible
combinations of the psychological and physiological components of personality.
Even in the same person several different states may develop, each exhibiting
different memories, traits, and other personality characteristics (Prince,
p.145, 1929).
Today, a relationship is found
between hypnotism and DID, based on a person’s ability to dissociate (in other
words to be in a hypnotic state). Some researchers presently believe that most
people suffering from DID are more easily hypnotized (able to dissociate easier)
than other people without the disorder. The DSM-IV-TR reports that individuals
with DID score toward the upper end of the distribution on measures of hypnotizability and dissociative capacity (APA, 2000). Yet,
other researchers call in to question this link between hypnotizability
and dissociation. Whalen and Nash (1996) report that there is not compelling
evidence to support the notion that hypnotizability
and dissociativity are overlapping traits – and in
fact they believe that the two exist independently of one another.
Later, in the nineteenth
century the first apparent classification of multiple personality disorder was
called “double consciousness” (Hacking, 1992). During this time the physician
Robert Brudenell Carter (1828-1918) came up with the
first theory of repression as a cause of hysteria. Carter developed three main
factors as the cause of hysteria: “[1] the temperament of the individual, [2]
the event or situations which trigger the initial attack, and [3] the degree to
which the affected person is compelled to conceal or ‘repress’ the exciting
causes” (Veith, 1965, p.211). Further, he believed
that sexual passion was the most frequent and important determinant causing
hysteria. A relationship concurrent with contemporary thought about DID is
seen. Current causal evidence and the understanding of dissociation in a DID
patient mirrors Carter’s first two factors in his theory of repression, which
he believed caused hysteria. In Breuer and Freud’s Studies on Hysteria (1957),
many of the cases presented would meet current DSM-IV criteria for dissociative
identity disorder. And childhood sexual trauma is reported in several of these
case histories (Ross, 1996).
In
DID is also associated with
trance and possession; the actual history of dissociation begins with the
experiences of shamans. The psychological basis of DID and other dissociative
disorders can be seen in trance and possession states found in most cultures
throughout history (Ross, 1996). Flora (1988) describes the relationship
between possession and multiple personalities by stating:
There is a strong possibility that
MPD existed along with possession for thousands of years, only to go
undetected. By definition, possession could be considered a type of multiple
personality. It was only after the decline of the phenomenon known as
possession, during the nineteenth century, that multiple personality case
histories started turning up in the mesmerist literature and later in the
medical reports (p.5).
Still, the question persists of
whether or not possession (in this case spirit possession) is actually DID
(Fiske,
Alan Fiske, an
anthropologist, poses the question, “Is it a psychological disorder? Or is it
culturally, socially relevant part of society that has disappeared in the
present Western world?” (Fiske,
The Rise and Fall of Dissociation in the 20th Century
During the late nineteenth
and early 20th century, interest in dissociation was unique in the psychiatric
world. Interest in multiple personality disorder peaked in the late nineteenth
century and then dropped off to nearly zero early in the 20th century (Ross,
1996). Many factors influenced why dissociation became so unpopular in the
early 20th century. The first are the theories of Sigmund Freud. Freud’s
seduction theory (Miller, 2000), a repression model of psychopathology,
explained away any childhood sexual abuse and did not allow treatment of
dissociative symptoms. As a result of Freud’s influence, dissociative diagnoses
became irrelevant to mainstream psychology at that time (Ross, 1996).
The second influence on the
severe decline in interest in dissociation is the creation of the term and the
recognition of the disorder, schizophrenia. Bleuler
coined the phrase schizophrenia, which means split mind in Greek. He stated
that “it is not alone in hysteria that one finds an arrangement of different
personalities one succeeding the other: through similar mechanisms
schizophrenia produces different personalities existing side by side” (quoted
in Ross, 1996, p. 5). It seems that Bleuler may have
chosen the term schizophrenia because many of his descriptions of
schizophrenics are actually descriptions of what we now call DID (Ross, 1996).
The problem lies in the similar symptoms of both diseases. One of the main
characteristics of schizophrenia is hearing voices. Yet, a patient with DID may
think they are hearing voices because of semi-consciousness of their other
personalities. Evidence shows this problem: even after DID had been well
established, two studies show that undiagnosed DID patients received incorrect
diagnoses of schizophrenia in 25% and 40% of the cases in the two series (Ross,
1996). This is the trouble with dissociative identity disorder: it is extremely
hard to diagnose and can often be mistaken for a number of other disorders. Further, many experts question whether or not the disease even
exists.
During the mid 20th century
(1920 to 1950) academic interest in MPD and dissociation diminished and only a
few papers were published on the subject, per year, worldwide; no other
disorder has ever disappeared fro
Another factor that
influenced the resurgence in popularity of MPD is the way it was displayed in
the mass media. Two books, The Three Faces of Eve and Sybil were published in
1957 and 1973 respectively, which depicted the lives of a person with multiple
personality disorder. Both were later made into successful
The Evolution of DID in the
DSM
In 1952, in the first
edition of the DSM, hysteria was not included as an illness. Similar symptoms
were described in terms of a “conversion symptom” (Veith,
1965), which alluded to hysteria. But there was a disorder listed in the first
DSM that refers to hysteria – dissociative reaction. Dissociative reaction
(which was formerly classified as a type of conversion hysteria) includes
dissociated states such as depersonalization, dissociated personalities,
stupor, fugue, amnesia, dream states, and somnambulism. The DSM-I specifically
states:
This reaction represents a type of
gross personality disorganization, the basis of which is a neurotic
disturbance…The repressed impulse giving rise to the anxiety may be discharged
by, or deflected into, various symptomatic expressions, such as…dissociated
personality, etc (APA, 1952, p. 32)
It is in the DSM-II (1963) where
we see the first mention of ‘multiple personality’, which falls under the
category of “Neuroses”, specifically “Hysterical Neuroses” “Dissociative Type”.
The DSM-II defines this disorder as: “In the dissociative type, alterations may
occur in the patient’s state of consciousness or in his identity, to produce
such symptoms as amnesia, somnambulism, fugue, and multiple personality” (APA,
1963, p. 40). In 1980, with the release of the next volume of the DSM, DSM III,
dissociative disorders were finally recognized as a type of mental illness and
specific diagnostic criteria for multiple personality disorder was included.
The DSM-III presented the following three criteria for multiple personality
disorder: the existence within the individual of two or more distinct
personalities, each of which is dominant at a particular time; the personality
that is dominant at any particular time determines the individual’s behavior;
and each individual personality is complex and integrated with its own unique behaviour patterns and social relationships (APA, 1980).
The DSM-III went on to discuss associated features of the disorder itself such
as age of onset, course, impairment, complications, predisposing factors,
prevalence, sex ratio, and familial pattern.
In 1987 a revised edition of
the DSM-III came out, the DSM-III-R, which contained interesting changes in its
MPD classification. The major heading of “Dissociative Disorders” was expanded
to include (in parenthesis) “or Hysterical Neuroses, Dissociative Type” (APA,
1987, p. 269) which shows a small return to the DSM-II position (Flora, 1988).
It also contains a subclassification for “conversion
type” (APA, 1987, p. 257), which is described much like symptoms of hysteria in
the past. This is an important historical change because at this time, in 1987,
doctors again realized that symptoms of hysteria were part of MPD. The
DSM-III-R makes slight changes to the actual diagnostic criteria for MPD as
follows. The existence within the person of two or more distinct personalities
or personality states each with its own relatively enduring pattern of
perceiving, relating to, and thinking about the environment and self; and at
least two of these personalities or personality states recurrently take full
control of the persons behavior (APA, 1987, p. 272). With these changes, the
link to the next and most recent DSM (IV) is visible.
It is very interesting that the
first three DSMs (and the third revised edition) do not include any mention of
amnesia or loss of time in the diagnostic criteria for MPD, because it was
considered a dissociative disorder at the time – and dissociation itself has
always been thought to contribute to memory loss. Finally, with the fourth DSM
(1994) there is a connection with amnesia and memory loss and it is evident in
the re-labeling of MPD to DID in the diagnostic criteria section C.
Summary
Multiple personality
disorder is an interesting phenomenon with an equally interesting history. Hacking
accurately describes the problems and intricacies concerning multiple
personality disorder. He states, “The history of multiple personality disorder
(MPD) cruelly illustrates our vast reservoir of confusions about the mind and
its maladies….Its past and present put on display the wobbly relations between
behavior, diagnosis, therapy, surrounding culture and madness” (Hacking, 1992,
p. 4). Multiple personality disorder is
representative of the history of psychiatry in general; mental illness is extremely
complicated and it seems we may never fully understand the human mind and the
way it works. Many discrepancies and controversies concerning DID and MPD exist
in the literature. Much research and clarification on the subject is needed.
Only time will further our understanding of this illness, just as time has
allowed us to better understand the complex human psyche.
References
Acocella, J. (1999). Creating hysteria: Women and Multiple Personality Disorder.
Breuer, J. & Freud, S.
(1957). Studies on Hysteria. Translated from the
German and edited by
Cardena, E. & Spiegel, D. (1996). Diagnostic
issues, criteria, and comorbidity of dissociative
disorders. In L. K. Michelson and W. J. Ray (Ed), Handbook of
Dissociation: Theoretical, Empirical, and Clinical Perspectives (227-239).
American
Psychiatric Association (1952). Diagnostic and Statistical Manual: Mental Disorders.
American
Psychiatric Association (1963). Diagnostic and Statistical Manual
of Mental Disorders II.
American
Psychiatric Association (1980). Diagnostic and Statistical Manual
of Mental Disorders III.
American
Psychiatric Association (1994). Diagnostic and Statistical Manual
of Mental Disorders IV.
American
Psychiatric Association (2000). Diagnostic and Statistical Manual of Mental
Disorders IV-TR.
Fiske, Alan. Culture and Psychopathology.
Flora, E. W. (1988). Tracing
the Historical Development Of The Diagnosis and
Treatment of Multiple Personality Disorder in 19th and 20th Century
Gillispie, C. C. (1974). Dictionary
of Scientific Biography IX: Macrobius to Naumann.
Hacking,
Haddock,
D. B. (2001). The Dissociative Identity Disorder Sourcebook.
Horevitz, R. (1994). Dissociation
and multiple personality: Conflicts and Controversies. In S. J. Lynn and J. W. Rhue (Ed.), Dissociation: Clinical and Theoretical
Perspectives (434-453).
Kahn, A.
P. & Fawcett, J. (1993). The Encyclopedia of Mental
Health.
Miller, N. K. (2000). The
Seduction Theory: A Misunderstanding of Freud. US: University Microfilms
International.
Prince, M.
(1929). Clinical and Experimental Studies in Personality.
Ross, C. A. (1996). History, phenomenology, and epidemiology of dissociation. In
L. K. Michelson and W. J. Ray (Ed), Handbook of Dissociation: Theoretical,
Empirical, and Clinical Perspectives (3-24).
Veith,
Whalen, J.
E. & Nash, M. R. (1996). Hypnosis and dissociation: Theoretical, empirical,
and clinical perspectives. In L. K. Michelson and W. J. Ray (Ed), Handbook of
Dissociation: Theoretical, Empirical, and Clinical Perspectives (191-204).
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