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Rosenberg Kosslyn Cover 2e

Kosslyn
Rosenberg
Abnormal Psychology
Robin S. Rosenberg
Stephen M. Kosslyn

www.wor thpublishers.com
Second
Second
edition edition

Worth
Publishers Abnormal Psychology
FM-CT CONTENTS FM-TOC-i2-T-a

Preface xvii
CHAPTER 2
Understanding Psychological Disorders:
CHAPTER 1 The Neuropsychosocial Approach.................. 29
The History of Abnormal Psychology.............. 3
Neurological Factors in Psychological Disorders 30
The Three Criteria for Determining Brain Structure and Brain Function 30
Psychological Disorders 4 A Quick Tour of the Nervous System 30
Distress 4 Neurons 32
Impairment in Daily Life 5 Chemical Signals 34
Risk of Harm 6 Hormones and the Endocrine System 36
Context and Culture 7 The Genetics of Psychopathology 36
Views of Psychological Disorders Behavioral Genetics 37
Before Science 10 Feedback Loops in Understanding Genes
and the Environment 39
Ancient Views of Psychopathology 10
The Environment Affects the Genes 39
Supernatural Forces 11
The Genes Affect the Environment 40
Imbalance of Substances Within the Body 11
Forces of Evil in the Middle Ages and the Psychological Factors in Psychological Disorders 41
Renaissance 12 Behavior and Learning 41
Rationality and Reason in the 18th and Classical Conditioning 41
19th Centuries 12 Operant Conditioning 42
Asylums 13 Feedback Loops in Understanding Classical
Pinel and Mental Treatment 13 Conditioning and Operant Conditioning 44
Moral Treatment 13 Observational Learning 45
Mental Processes and Mental Contents 45
The Transition to Scientific Accounts of
Mental Processes 45
Psychological Disorders 14
Mental Contents 46
Freud and the Importance of Unconscious Forces 14
Emotion 47
Psychoanalytic Theory 15
Emotions and Behavior 47
Psychosexual Stages 16
Emotions, Mental Processes, and Mental Contents 48
Mental Illness, According to Freud 16
Emotional Regulation and Psychological Disorders 48
Defense Mechanisms 16
Neurological Bases of Emotion 48
Psychoanalytic Theory Beyond Freud 17 Temperament 49
Evaluating the Contributions of Freud and His Followers 17
The Humanist Response 18
Social Factors in Psychological Disorders 50
Family Matters 50
Scientific Accounts of Psychological Disorders 19 Family Interaction Style and Relapse 51
Behaviorism 19 Child Maltreatment 51
The Cognitive Contribution 20 Parental Psychological Disorders 52
Social Forces 21 Community Support 52
Biological Explanations 22 Social Stressors 52
The Modern Synthesis of Explanations of Socioeconomic Status 53
Psychopathology 23 Discrimination, Bullying, and War 54
The Diathesis-Stress Model 23 Culture 54
The Biopsychosocial and Neuropsychosocial Approaches 23
A Neuropsychosocial Last Word on the Beales 56
vi
 Contents vii

CHAPTER 3 Types of Scientific Research 90

Conducting Research with Experiments 90
Clinical Diagnosis and Assessment................. 59
Quasi-Experimental Design 93
Diagnosing Psychological Disorders 61 Correlational Research 93
Why Diagnose? 62 Case Studies 96
A Cautionary Note About Diagnosis 63 Meta-Analysis 97
Reliability and Validity in Classification Systems 64 Ethical Guidelines for Research 98
The Diagnostic and Statistical Manual of Mental
Disorders 65 Research Challenges in Understanding
The Evolution of DSM 65 Abnormality 100

The Evolution of DSM-5 66 Challenges in Researching Neurological Factors 100

The People Who Diagnose Psychological Disorders 70 Challenges in Researching Psychological Factors 101

Clinical Psychologists and Counseling Psychologists 70 Biases in Mental Processes That Affect Assessment 101

Psychiatrists, Psychiatric Nurses, and General Research Challenges with Clinical Interviews 101
Practitioners 71 Research Challenges with Questionnaires 101
Mental Health Professionals with Master’s Degrees 71 Challenges in Researching Social Factors 102
Investigator-Influenced Biases 103
Assessing Psychological Disorders 72
Cultural Differences in Evaluating Symptoms 103
Assessing Neurological and Other Biological Factors 72
Assessing Abnormal Brain Structures with X-Rays, Researching Treatment 104
CT Scans, and MRIs 73 Researching Treatments That Target Neurological
Assessing Brain Function with PET Scans and fMRI 73 Factors 104
Neuropsychological Assessment 74 Drug Effect or Placebo Effect? 105
Assessing Psychological Factors 75 Dropouts 105
Clinical Interview 75 Researching Treatments That Target Psychological
Tests of Psychological Functioning 78 Factors 105

Assessing Social Factors 81 Common Factors and Specific Factors 106

Family Functioning 81 Is Therapy Better Than No Treatment? 107

Community 82 Is One Type of Therapy Generally More Effective

Than Another? 108
Culture 82
The Therapy Dose–Response Relationship 109
Assessment as an Interactive Process 83
Researching Treatments That Target Social Factors 110
Diagnosing and Assessing Rose Mary Gender and Ethnicity of Patient and Therapist 111
and Rex Walls? 84 Culturally Sanctioned Placebo Effects 111
CHAPTER 4 Ethical Research on Experimental Treatments 112
Research Methods.............................................. 87
Using the Scientific Method to Understand
CHAPTER 5
Abnormality 88 Mood Disorders and Suicide........................... 115
The Scientific Method 88 Depressive Disorders 116
Collect Initial Observations 88 Major Depressive Episode 116
Identify a Question 88 Affect: The Mood Symptoms of Depression 116
Develop and Test a Hypothesis 89 Behavioral and Physical Symptoms of Depression 116
Develop a Theory 89 Cognitive Symptoms of Depression 117
Test the Theory 89
viii Contents

Major Depressive Disorder 118

CHAPTER 6
Depression in Children and Adolescents 120
Anxiety Disorders............................................. 155
Persistent Depressive Disorder 120
Current Controversy: Disruptive Mood Common Features of Anxiety Disorders 155
Dysregulation Disorder: Overlabeling of Tantrums? 121 What Is Anxiety? 156
Understanding Depressive Disorders 122 The Fight-or-Flight Response Gone Awry 156
Neurological Factors 122 Comorbidity of Anxiety Disorders 157
Psychological Factors 124
Social Factors 126
Generalized Anxiety Disorder 158

Feedback Loops in Understanding Depressive Disorders 128

What Is Generalized Anxiety Disorder? 158

Treating Depressive Disorders 130 Understanding Generalized Anxiety Disorder 159

Targeting Neurological Factors 130 Neurological Factors 160

Targeting Psychological Factors 132 Psychological Factors: Hypervigilance and the Illusion
of Control 160
Targeting Social Factors 133
Social Factors: Stressors 161
Feedback Loops in Treating Depressive Disorders 135
Feedback Loops in Understanding Generalized
Bipolar Disorders 136 Anxiety Disorder 161
Mood Episodes for Bipolar Disorders 136 Treating Generalized Anxiety Disorder 161
Manic Episode 136 Targeting Neurological Factors: Medication 161
Hypomanic Episode 138 Targeting Psychological Factors 162
The Two Types of Bipolar Disorder 139 Targeting Social Factors 163
Cyclothymic Disorder 140 Feedback Loops in Treating Generalized Anxiety Disorder 164
Understanding Bipolar Disorders 141
Panic Disorder and Agoraphobia 165
Neurological Factors 141
The Panic Attack—A Key Ingredient of Panic Disorder 165
Psychological Factors: Thoughts and Attributions 142
What Is Panic Disorder? 166
Social Factors: Social and Environmental Stressors 143
Feedback Loops in Understanding Bipolar Disorders 143
What Is Agoraphobia? 167

Treating Bipolar Disorders 143 Understanding Panic Disorder and Agoraphobia 168

Targeting Neurological Factors: Medication 144 Neurological Factors 169

Targeting Psychological Factors: Thoughts, Moods, Psychological Factors 170
and Relapse Prevention 144 Social Factors: Stressors, a Sign of the Times,
Targeting Social Factors: Interacting with Others 145 and “Safe People” 170
Feedback Loops in Treating Bipolar Disorder 145 Feedback Loops in Understanding Panic Disorder
and Agoraphobia 171
Suicide 146 Treating Panic Disorder and Agoraphobia 171
Suicidal Thoughts and Suicide Risks 146 Targeting Neurological Factors: Medication 171
Thinking About, Planning, and Attempting Suicide 146 Targeting Psychological Factors 172
Risk and Protective Factors for Suicide 148
Targeting Social Factors: Group and Couples Therapy 174
Understanding Suicide 149
Feedback Loops in Treating Panic Disorder and
Neurological Factors 149 Agoraphobia 174
Psychological Factors: Hopelessness and Impulsivity 150
Social Anxiety Disorder (Social Phobia) 175
Social Factors: Alienation and Cultural Stress 150
What Is Social Anxiety Disorder? 176
Feedback Loops in Understanding Suicide 150
Understanding Social Anxiety Disorder 177
Preventing Suicide 151
Neurological Factors 177
Crisis Intervention 151
Psychological Factors 178
Long-Term Prevention 151
Social Factors 179
 Contents ix

Feedback Loops in Understanding Social Anxiety Treating Obsessive-Compulsive Disorder 205

Disorder 179 Targeting Neurological Factors: Medication 205
Treating Social Anxiety Disorder 180
Targeting Psychological Factors 205
Targeting Neurological Factors: Medication 180
Targeting Social Factors: Family Therapy 206
Targeting Psychological Factors: Exposure and
Feedback Loops in Treating
Cognitive Restructuring 180
Obsessive-Compulsive Disorder 206
Targeting Social Factors: Group Interactions 181
Feedback Loops in Treating Social Anxiety Disorder 181 Trauma-Related Disorders 207
What Are the Trauma-Related Disorders? 208
Specific Phobia 182
What Is Posttraumatic Stress Disorder? 209
What Is Specific Phobia? 182
What Is Acute Stress Disorder? 211
Specifics About Specific Phobia 183
Understanding Specific Phobia 184 Understanding Trauma-Related Disorders: PTSD 213
Neurological Factors 184 Neurological Factors 213
Psychological Factors 185 Psychological Factors: History of Trauma, Comorbidity,
and Conditioning 214
Social Factors: Modeling and Culture 185
Social Factors: Socioeconomic Factors, Social Support,
Feedback Loops in Understanding Specific Phobia 186
and Culture 215
Treating Specific Phobia 186
Feedback Loops in Understanding Posttraumatic
Targeting Neurological Factors: Medication 186 Stress Disorder 215
Targeting Psychological Factors 186
Treating Posttraumatic Stress Disorder 216
Targeting Social Factors: A Limited Role for
Targeting Neurological Factors: Medication 217
Observational Learning 187
Targeting Psychological Factors 217
Feedback Loops in Treating Specific Phobia 187
Current Controversy: Eye Movement
Separation Anxiety Disorder 188 Desensitization and Reprocessing (EMDR)
What Is Separation Anxiety Disorder? 188 Treatment for Posttraumatic Stress Disorder 217
Current Controversy: Separation Anxiety Disorder: Targeting Social Factors: Safety, Support, and Family
Anxiety Disorder or Developmental Difference? 190 Education 218
Understanding and Treating Separation Anxiety Feedback Loops in Treating Posttraumatic Stress
Disorder 191 Disorder 218

Follow-up on Earl Campbell 191 Follow-up on Howard Hughes 220

CHAPTER 7 CHAPTER 8
Obsessive-Compulsive-Related and Dissociative and Somatic Symptom
Trauma-Related Disorders.............................. 195 Disorders............................................................ 223
Obsessive-Compulsive Disorder and Dissociative Disorders 224
Related Disorders 196
Dissociative Disorders: An Overview 224
What Is Obsessive-Compulsive Disorder? 196
Normal Versus Abnormal Dissociation 225
What Is Body Dysmorphic Disorder? 199
Types of Dissociative Disorders 226
Understanding Obsessive-Compulsive Disorder 202
Dissociative Amnesia 226
Neurological Factors 202
What Is Dissociative Amnesia? 226
Psychological Factors 203
Understanding Dissociative Amnesia 228
Social Factors 204
Depersonalization-Derealization Disorder 229
Feedback Loops in Understanding
What Is Depersonalization-Derealization Disorder? 229
Obsessive-Compulsive Disorder 205
Understanding Depersonalization-Derealization Disorder 231
x Contents

Dissociative Identity Disorder 232 Polysubstance Abuse 262

What Is Dissociative Identity Disorder? 232 Prevalence and Costs 262
Criticisms of the DSM-5 Criteria 234 Culture and Context 263
Understanding Dissociative Identity Disorder 234
Stimulants 263
Treating Dissociative Disorders 238
What Are Stimulants? 263
Targeting Neurological Factors: Medication 238
Cocaine and Crack 264
Targeting Psychological and Social Factors: Coping and
Amphetamines 264
Integration 238
Methamphetamine 265
Feedback Loops in Treating Dissociative Disorders 239
Ritalin 265
Somatic Symptom Disorders 240 MDMA (Ecstasy) 265
Somatic Symptom Disorders: An Overview 240 “Bath Salts” 266
Somatic Symptom Disorder 241 Understanding Stimulants 266
What Is Somatic Symptom Disorder? 241 Brain Systems and Neural Communication: Dopamine
Understanding Somatic Symptom Disorder 242 and Abuse 267
Conversion Disorder 244 Psychological Factors: From Learning to Coping 268
What Is Conversion Disorder? 245 Social Factors 269
Criticisms of the DSM-5 Criteria 247
Depressants 271
Understanding Conversion Disorder 247
What Are Depressants? 271
Illness Anxiety Disorder 248
Alcohol 272
Current Controversy: Omission of Hypochondriasis
Sedative-Hypnotic Drugs 274
from DSM-5: Appropriate or Overreaction? 249
Understanding Depressants 275
What Is Illness Anxiety Disorder? 249
Neurological Factors 275
Illness Anxiety Disorder, Anxiety Disorders, and OCD:
Shared Features 250 Psychological Factors 276
Understanding Illness Anxiety Disorder 250 Social Factors 277
Treating Somatic Symptom Disorders 251 Other Abused Substances 278
Targeting Neurological Factors 251 What Are Other Abused Substances? 278
Targeting Psychological Factors: Cognitive-Behavior Opioids: Narcotic Analgesics 278
Therapy 252
Hallucinogens 279
Targeting Social Factors: Support and Family Education 252
Dissociative Anesthetics 280
Feedback Loops in Treating Somatic Symptom
Disorders 253 Understanding Other Abused Substances 281
Neurological Factors 281
Follow-up on Anna O. 254
Psychological Factors 282
Social Factors 282
CHAPTER 9 Feedback Loops in Understanding Substance Use
Substance Use Disorders................................ 257 Disorders 282

Substance Use: When Use Becomes a Disorder 257 Treating Substance Use Disorders 284
Substance Use Versus Intoxication 258 Goals of Treatment 284
Substance Use Disorders 258 Current Controversy: Once an Alcoholic, Always
Substance Use Disorder as a Category or on a an Alcoholic? 285
Continuum? 260 Targeting Neurological Factors 285
Use Becomes a Problem 261 Detoxification 285
Comorbidity 262 Medications 286
 Contents xi

Targeting Psychological Factors 287 Dieting, Restrained Eating, and Disinhibited Eating 313
Motivation 288 Other Psychological Disorders as Risk Factors 313
Cognitive-Behavior Therapy 289 Social Factors: The Body in Context 313
Twelve-Step Facilitation (TSF) 290 The Role of Family and Peers 314
Targeting Social Factors 291 The Role of Culture 314
Residential Treatment 291 Eating Disorders Across Cultures 315
Group-Based Treatment 291 The Power of the Media 315
Family Therapy 292 Objectification Theory: Explaining the Gender Difference 316
Feedback Loops in Treating Substance Use Feedback Loops in Understanding Eating Disorders 317
Disorders 292
Treating Eating Disorders 318

CHAPTER 10 Targeting Neurological and Biological Factors:

Nourishing the Body 319
Eating Disorders................................................ 297 A Focus on Nutrition 319
Anorexia Nervosa 298 Medical Hospitalization 319
What Is Anorexia Nervosa? 298 Medication 319
Anorexia Nervosa According to DSM-5 298 Targeting Psychological Factors:
Cognitive-Behavior Therapy 320
Two Types of Anorexia Nervosa: Restricting and Binge
Eating/Purging 300 CBT for Anorexia 320
Medical, Psychological, and Social Effects of CBT for Bulimia 320
Anorexia Nervosa 300 Efficacy of CBT for Treating Eating Disorders 321
Medical Effects of Anorexia 301 Targeting Social Factors 321
Psychological and Social Effects of Starvation 301 Interpersonal Therapy 321

Bulimia Nervosa 302 Family Therapy 321

What Is Bulimia Nervosa? 302 Psychiatric Hospitalization 322

Medical Effects of Bulimia Nervosa 304 Prevention Programs 323

Is Bulimia Distinct From Anorexia? 305 Feedback Loops in Treating Eating Disorders 323

Binge Eating Disorder and “Other” Eating Follow-up on Marya Hornbacher 324
Disorders 305
What Is Binge Eating Disorder? 305 CHAPTER 11
Current Controversy: Is Binge Eating Disorder Gender and Sexual Disorders......................... 327
Diagnosis a Good Idea? 307
Gender Dysphoria 328
Disordered Eating: “Other” Eating Disorders 307
What Is Gender Dysphoria? 328
Understanding Eating Disorders 308 Understanding Gender Dysphoria 331
Neurological Factors: Setting the Stage 309 Neurological Factors 332
Brain Systems 309 Psychological Factors: A Correlation with Play Activities? 332
Neural Communication: Serotonin 310 Social Factors: Responses From Others 332
Genetics 310 Treating Gender Dysphoria 333
Psychological Factors: Thoughts of and Feelings Targeting Neurological and Other Biological Factors:
About Food 310 Altered Appearance 333
Thinking About Weight, Appearance, and Food 311 Targeting Psychological Factors: Understanding the
Operant Conditioning: Reinforcing Disordered Eating 311 Choices 334
Personality Traits as Risk Factors 312 Targeting Social Factors: Family Support 334
xii Contents

Paraphilic Disorders 335 CHAPTER 12

What Are Paraphilic Disorders? 335
Schizophrenia and Other Psychotic
Paraphilic Disorders Involving Nonconsenting People 336 Disorders............................................................ 365
Sexual Sadism Disorder and Sexual Masochism
Disorder: Pain and Humiliation 340 What Are Schizophrenia and Other
Paraphilic Disorders Involving Nonhuman Objects 341 Psychotic Disorders? 366
Assessing Paraphilic Disorders 343 The Symptoms of Schizophrenia 366
Criticisms of the DSM-5 Paraphilic Disorders 343 Positive Symptoms 366
Understanding Paraphilic Disorders 343 Negative Symptoms 369
Neurological Factors 344 Cognitive Deficits: The Specifics 369
Psychological Factors: Conditioned Arousal 344 Deficits in Attention 369
Social Factors: More Erotica? 344 Deficits in Working Memory 369
Treating Paraphilic Disorders 345 Deficits in Executive Functioning 370
Targeting Neurological and Other Biological Factors: Cognitive Deficits Endure Over Time 370
Medication 345 Limitations of DSM-5 Criteria 370
Current Controversy: Sex Offenders: Is Surgical Deficit/Nondeficit Subtypes 371
Castration an Ethical Solution? 345 Distinguishing Between Schizophrenia and Other
Targeting Psychological Factors: Cognitive-Behavior Disorders 371
Therapy 346 Psychotic Symptoms in Schizophrenia,
Targeting Social Factors 346 Mood Disorders, and Substance-Related Disorders 371
Other Psychotic Disorders 372
Sexual Dysfunctions 346
Current Controversy: Attenuated Psychosis
An Overview of Sexual Functioning and Sexual
Syndrome: The Diagnosis That Wasn’t 375
Dysfunctions 346
Schizophrenia Facts in Detail 376
The Normal Sexual Response Cycle 347
Prevalence 376
Sexual Dysfunctions According to DSM-5 348
Comorbidity 376
Sexual Desire Disorders and Sexual Arousal Disorders 349
Course 377
Orgasmic Disorders 350
Gender Differences 377
Sexual Pain Disorder: Genito-Pelvic Pain/Penetration
Disorder 352 Culture 377
Criticisms of the Sexual Dysfunctions in DSM-5 354 Prognosis 379
Understanding Sexual Dysfunctions 354 Understanding Schizophrenia 380
Neurological and Other Biological Factors 354 Neurological Factors in Schizophrenia 380
Psychological Factors in Sexual Dysfunctions 355 Brain Systems 380
Social Factors 356 Neural Communication 383
Feedback Loops in Understanding Sexual Genetics 384
Dysfunctions 356
Psychological Factors in Schizophrenia 385
Treating Sexual Dysfunctions 358
Mental Processes and Cognitive Difficulties:
Targeting Neurological and Other Biological Factors: Attention, Memory, and Executive Functions 385
Medications 358
Beliefs and Attributions 386
Targeting Psychological Factors: Shifting Thoughts,
Learning Behaviors 359 Emotional Expression 387
Targeting Social Factors: Couples Therapy 360 Social Factors in Schizophrenia 387
Feedback Loops in Treating Sexual Dysfunctions 360 Understanding the Social World 388
Stressful Environments 388
 Contents xiii

Immigration 389 Odd/Eccentric Personality Disorders 410

Economic Factors 390 Paranoid Personality Disorder 411
Cultural Factors: Recovery in Different Countries 390 Schizoid Personality Disorder 413
Feedback Loops in Understanding Schizophrenia 391 Schizotypal Personality Disorder 414

Treating Schizophrenia 392 What Is Schizotypal Personality Disorder? 414

Targeting Neurological Factors in Treating Understanding Schizotypal Personality Disorder 415

Schizophrenia 393 Treating Odd/Eccentric Personality Disorders 417
Medication 393
Dramatic/Erratic Personality Disorders 417
Brain Stimulation: ECT 394
Antisocial Personality Disorder 418
Targeting Psychological Factors in Treating
Schizophrenia 394 Understanding Antisocial Personality Disorder and
Psychopathy 419
Cognitive-Behavior Therapy 394
Treating Antisocial Personality Disorder and Psychopathy 421
Treating Comorbid Substance Abuse: Motivational
Enhancement 395 Current Controversy: Should Psychopaths Receive
Treatment? 422
Targeting Social Factors in Treating Schizophrenia 395
Borderline Personality Disorder 422
Family Education and Therapy 395
Understanding Borderline Personality Disorder 424
Group Therapy: Social Skills Training 395
Treating Borderline Personality Disorder:
Inpatient Treatment 396
New Treatments 427
Minimizing Hospitalizations: Community-Based
Histrionic Personality Disorder 429
Interventions 396
What Is Histrionic Personality Disorder? 430
Feedback Loops in Treating Schizophrenia 397
Distinguishing Between Histrionic Personality
CHAPTER 13 Disorder and Other Disorders 431
Treating Histrionic Personality Disorder 431
Personality Disorders...................................... 401
Narcissistic Personality Disorder 431
Diagnosing Personality Disorders 402 What Is Narcissistic Personality Disorder? 431
What Are Personality Disorders? 403 Treating Narcissistic Personality Disorder 432
Assessing Personality Disorders 404
Fearful/Anxious Personality Disorders 433
DSM-5 Personality Clusters 405
Avoidant Personality Disorder 433
Criticisms of the DSM-5 Category of Personality
Disorders 405 What Is Avoidant Personality Disorder? 433
Understanding Personality Disorders in General 406 Distinguishing Between Avoidant Personality
Disorder and Other Disorders 434
Neurological Factors in Personality Disorders:
Genes and Temperament 407 Dependent Personality Disorder 435
Psychological Factors in Personality Disorders: Obsessive-Compulsive Personality Disorder 436
Temperament and the Consequences of Behavior 408 What Is Obsessive-Compulsive Personality Disorder? 436
Social Factors in Personality Disorders: Insecurely Distinguishing Between Obsessive-Compulsive
Attached 408 Personality Disorder and OCD 438
Feedback Loops in Understanding Personality Understanding Fearful/Anxious Personality Disorders 438
Disorders 408 Treating Fearful/Anxious Personality Disorders 438
Treating Personality Disorders: General Issues 409
Targeting Neurological Factors in Personality Disorders 409
Follow-up on Rachel Reiland 440

Targeting Psychological Factors in Personality Disorders 409

Targeting Social Factors in Personality Disorders 410
xiv Contents

CHAPTER 14 What Is Oppositional Defiant Disorder? 463

What Is Attention-Deficit/Hyperactivity Disorder? 464
Neurodevelopmental and Disruptive
Understanding Disorders of Disruptive Behavior
Behavior Disorders........................................... 443 and Attention 468
Intellectual Disability (Intellectual Neurological Factors 468
Developmental Disorder) 444 Psychological Factors: Recognizing Facial Expressions,
What Is Intellectual Disability? 444 Low Self-Esteem 469
Current Controversy: Changing Mental Retardation Social Factors: Blame and Credit 469
to Intellectual Disability: Will Such a Switch Be Feedback Loops in Understanding Attention-Deficit/
Beneficial? 446 Hyperactivity Disorder 470
Understanding Intellectual Disability 447 Treating Disorders of Disruptive Behavior and
Neurological Factors: Teratogens and Genes 447 Attention: Focus on ADHD 470
Psychological Factors: Problem Behaviors 448 Targeting Neurological Factors: Medication 470
Social Factors: Understimulation 448 Targeting Psychological Factors: Treating Disruptive
Behavior 472
Treating Intellectual Disability 448
Targeting Social Factors: Reinforcement in Relationships 473
Targeting Neurological Factors: Prevention 448
Feedback Loops in Treating Attention-Deficit/
Targeting Psychological and Social Factors:
Hyperactivity Disorder 473
Communication 449
Targeting Social Factors: Accommodation in the
Classroom—It’s the Law 449 CHAPTER 15
Autism Spectrum Disorder 449
Neurocognitive Disorders............................... 477
What Is Autism Spectrum Disorder? 450 Normal Versus Abnormal Aging and
Understanding Autism Spectrum Disorder 453 Cognitive Functioning 478
Neurological Factors 453 Cognitive Functioning in Normal Aging 479
Psychological Factors: Cognitive Deficits 453 Intelligence 479
Social Factors: Communication Problems 454 Memory 480
Treating Autism Spectrum Disorder 454 Processing Speed, Attention, and Working Memory 480
Targeting Neurological Factors 454 Psychological Disorders and Cognition 481
Targeting Psychological Factors: Applied Behavior Analysis 454 Depression 481
Targeting Social Factors: Communication 455 Anxiety Disorders 482
Schizophrenia 482
Specific Learning Disorder: Problems with
Medical Factors That Can Affect Cognition 482
the Three Rs 455
Diseases and Illnesses 482
What Is Specific Learning Disorder? 455
Stroke 483
Understanding Specific Learning Disorder 457
Head Injury 484
Neurological Factors 457
Substance-Induced Changes in Cognition 484
Psychological Factors 458
Social Factors 458 Delirium 484
Treating Dyslexia 458 What Is Delirium? 484
Understanding Delirium: A Side Effect? 487
Disorders of Disruptive Behavior and
Attention 459 Delirium Caused by Substance Use 487
What Is Conduct Disorder? 460 Delirium Caused by a General Medical Condition 487
Adolescent-Onset Type 462 Treating Delirium: Rectify the Cause 487
Childhood-Onset Type 462
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 Contents xv

Dementia (and Mild Versus Major The Insanity Defense: Current Issues 511
Neurocognitive Disorders) 488 Assessing Insanity for the Insanity Defense 512
What Is Dementia? 488 States’ Rights: Doing Away with the Insanity Defense 513
Mild and Major Neurocognitive Disorders 489 Current Controversy: Criminal Behavior:
Current Controversy: Miid and Does Abnormal Neural Functioning Make It
Major Neurocognitive Disorders 490 More Excusable? 513
Dementia and Alzheimer’s Disease 490 With the Insanity Defense, Do People Really
“Get Away with Murder”? 514
Understanding Dementia 492
After Committing the Crime: Competent to
Alzheimer’s Disease 492 Stand Trial? 514
Vascular Dementia 494
Dementia Due to Other Medical Conditions 495
Dangerousness: Legal Consequences 515

Treating Dementia 497

Evaluating Dangerousness 516

Targeting Neurological Factors 498

Actual Dangerousness 516

Targeting Psychological Factors 498

Confidentiality and the Dangerous Patient: Duty to
Warn and Duty to Protect 516
Targeting Social Factors 499
Maintaining Safety: Confining the Dangerously
Diagnosing Mrs. B.’s Problems 499 Mentally Ill Patient 518
Criminal Commitment 518

CHAPTER 16 Civil Commitment 518

Sexual Predator Laws 521
Ethical and Legal Issues................................... 503
Ethical Issues 504
Legal Issues Related to Treatment 521

An Ethical Principle: The Role of Confidentiality 504

Right to Treatment 522

Ambiguities Regarding Confidentiality 505

Right to Refuse Treatment 522

Limits of Confidentiality: HIPAA in Action 505

Competence to Refuse Treatment 522

Legal Restrictions on Confidentiality 506

Mental Health and Drug Courts 523

Privileged Communication 506 The Wheels of Justice: Follow-up on

Informed Consent to Participate in Research on Andrew Goldstein 524
Mental Illness: Can Patients Truly Be Informed? 507

Criminal Actions and Insanity 507 Glossary G-1

While Committing the Crime: Sane or Insane? 508 References R-1
From the M’Naghten Test to the Durham Test 508 Permissions and Attributions P-1
The American Legal Institute Test 509 Name Index N-1
Insanity Defense Reform Acts 509 Subject Index S-1
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FM-CT
PREFACE

T his is an exciting time to study psychopathology. Research on the entire range of

psychological disorders has blossomed during the last several decades, producing
dramatic new insights about psychological disorders and their treatments. However,
the research results are outpacing the popular media’s ability to explain them. We’ve
noticed that when study results are explained in a news report or an online magazine
article, “causes” of mental illness are often reduced to a single factor, such as genes, brain
chemistry, irrational thoughts, or social rejection. But that is not an accurate picture.
Research increasingly reveals that psychopathology arises from a confluence of three
types of factors: neurological (brain and body, including genes), psychological (thoughts,
feelings, and behaviors), and social (relationships, communities, and culture). Moreover,
these three sorts of factors do not exist in isolation, but rather mutually influence each
other. It’s often tempting to seek a single cause of psychopathology, but this effort is
fundamentally misguided.
We are a clinical psychologist (Rosenberg) and a cognitive neuroscientist (Kosslyn)
who have been writing collaboratively for many years. Our observations about the
state of the field of psychopathology—and the problems with how it is sometimes
portrayed—led us to envision an abnormal psychology textbook that is guided by a
central idea, which we call the neuropsychosocial approach. This approach allows us to
conceptualize the ways in which neurological, psychological, and social factors interact
to give rise to mental disorders. These interactions take the form of feedback loops in
which each type of factor affects every other type. Take depression, for instance, which
we discuss in Chapter 5: Someone who attributes the cause of a negative event to his
or her own personal characteristics or behavior (such attributions are a psychological
factor) is more likely to become depressed. But this tendency to attribute the cause of
negative events to oneself is influenced by social experiences, such as being criticized
or abused. In turn, such social factors can alter brain functioning (particularly if one has
certain genes), and abnormalities in brain functioning affect one’s thoughts and social
interactions, and so on—round and round.
The neuropsychosocial approach grew out of the venerable biopsychosocial
approach—but instead of focusing broadly on biology, we take advantage of the
bountiful harvest of findings about the brain that have filled the scientific journals over
the past two decades. Specifically, the name change signals a focus on the brain itself; we
derive much insight from the findings of neuroimaging studies, which reveal how brain
systems function normally and how they have gone awry with mental disorders, and we
also learn an enormous amount from findings regarding neurotransmitters and genetics.
Although mental disorders cannot be fully understood without reference to the
brain, neurological factors alone cannot explain these disorders; rather, mental disorders
develop through the complex interaction of neurological factors with psychological and
social factors. Without question, psychopathology cannot be reduced to “brain disease,”
akin to a problem someone might have with his or her liver or lungs. Instead, we show
that the effects of neurological factors can only be understood in the context of the
other two types of factors addressed within the neuropsychosocial approach. (In fact, an
understanding of a psychological disorder cannot be reduced to any single type of factor,
whether genetics, irrational thoughts, or family interaction patterns.) Thus, we present
cutting-edge neuroscience research results and put them in context, explaining how
they illuminate issues in psychopathology.
Our emphasis on feedback loops among neurological, psychological, and social
factors led us to reconceptualize and incorporate the classic diathesis-stress model
(which posits a precondition that makes a person vulnerable and an environmental
trigger—the diathesis and stress, respectively). In the classic view, the diathesis was almost
always treated as a biological state, and the stress was viewed as a result of environmental
xvii
xviii Preface

events. In contrast, after describing the conventional diathesis-stress model in Chapter 1,

we explain how the neuropsychosocial approach provides a new way to think about the
relationship between diathesis and stress. Specifically, we show how one can view any
of the three sorts of factors as a potential source of either a diathesis or a stressor. For
example, living in a dangerous neighborhood, which is a social factor, creates a diathesis for
which psychological events can serve as the stressor, triggering an episode of depression.
Alternatively, being born with a very sensitive amygdala (a brain structure involved in
fear and other strong emotions) may act as a diathesis for which social events—such as
observing someone else being mugged—can serve as a stressor that triggers an anxiety
disorder.
Thus, the neuropsychosocial approach is not simply a change in terminology (“bio”
to “neuro”), but rather a change in basic orientation: We do not view any one sort of
factor as “privileged” over the others, but regard the interactions among the factors—the
feedback loops—as paramount. In our view, this approach incorporates what was best
about the biopsychosocial approach and the diathesis-stress model.
Our new approach should lead students who use this textbook to think critically
about theories and research on etiology, diagnosis and treatment of mental disorders.
We want students to come away from the course with the knowledge and skills to
understand why no single type of findings alone can explain psychopathology, and to
have compassion for people suffering from psychological disorders. One of our goals is to
put a “human face” on mental illness, which we do by using case studies to illustrate and
make concrete each disorder. These goals are especially important because this course
will be the last psychology course many students take—and this might be the last book
about psychology they read.
The new approach we have adopted led naturally to a set of unique features, as we
outline next.

Unique Coverage
By integrating cutting-edge neuroscience research and more traditional psychosocial
research on psychopathology and its treatment, this textbook provides students with a
sense of the field as a coherent whole, in which different research methods illuminate
different aspects of abnormal psychology. Our integrated neuropsychosocial approach
allows students to learn not only how neurological factors affect mental processes (such
as executive functions) and mental contents (such as distorted beliefs), but also how
neurological factors affect emotions, behavior, social interactions, and responses to
environmental events—and vice versa.
The 16 chapters included in this book span the traditional topics covered in
an abnormal psychology course. The neuropsychosocial theme is reflected in both
the overall organization of the text and the organization of its individual chapters.
We present the material in a decidedly contemporary context that infuses both the
foundational chapters (Chapters 1–4) as well as the chapters that address specific
disorders (Chapters 5–15).
In Chapter 2, we provide an overview of explanations of abnormality and discuss
neurological, psychological, and social factors. Our coverage is not limited merely
to categorizing causes as examples of a given type of factor; rather, we explain how
a given type of factor influences and creates feedback loops with other factors.
Consider depression again: The loss of a relationship (social factor) can affect thoughts
and feelings (psychological factors), which—given a certain genetic predisposition
(neurological factor)—can trigger depression. Using the neuropsychosocial approach,
we show how disparate fields of psychology and psychiatry (such as neuroscience and
 Preface xix

clinical practice) are providing a unified and overarching understanding of abnormal

psychology.
Our chapter on diagnosis and assessment (Chapter 3) uses the neuropsychosocial
framework to organize methods of assessing abnormality. We discuss how abnormality
may be assessed through measures that address the different types of factors: neurological
(e.g., neuroimaging data or certain types of blood tests), psychological (e.g., clinical
interviews or questionnaires), and social (e.g., family interviews or a history of legal
problems).
The research methods chapter (Chapter 4) also provides unique

AP Photo/Winslow Townson
coverage. We explain the general scientific method, but we do so
within the neuropsychosocial framework. Specifically, we consider
methods used to study neurological factors (e.g., neuroimaging),
psychological factors (e.g., self-reports of thoughts and moods),
and social factors (e.g., observational studies of dyads or groups
or of cultural values and expectations). We show how the various
measures themselves reflect the interactions among the different
types of factors. For instance, when researchers ask participants to
report family dynamics, they are relying on psychological factors—
participants’ memories and impressions—to provide measures of
social factors. Similarly, when researchers use the number of items
checked on a stressful-life events scale to infer the actual stress
experienced by a person, social factors provide a proxy measure
of the psychological and neurological consequences of stress. We
also discuss research on treatment from the neuropsychosocial During times of political unrest, violence, or
framework. terrorism, rates of trauma-related disorders
The clinical chapters (Chapters 5–15), which address specific disorders, also are likely to increase.
rely on the neuropsychosocial approach to organize the discussions of both etiology
and treatment of the disorders. Moreover, when we discuss a particular disorder, we
address the three basic questions of psychopathology: What exactly constitutes this
psychological disorder? What neuropsychosocial factors are associated with it? How
is it treated?

Pedagogy
All abnormal psychology textbooks cover a lot of ground: Students must learn many
novel concepts, facts, and theories. We want to make that task easier, to help students
come to a deeper understanding of what they learn and to consolidate that material
effectively. The textbook uses a number of pedagogical tools to achieve this goal.

Feedback Loops Within the Neuropsychosocial Approach

This textbook highlights and reinforces the theme of feedback loops among neurological,
psychological, and social factors in several ways:
• In each clinical chapter, we include a section on “Feedback Loops in Understanding,”
which specifically explores how disorders result from interactions among the
neuropsychosocial factors. We also include a section on “Feedback Loops in Treating,”
which specifically explores how successful treatment results from interactions among
the neuropsychosocial factors.
• We include neuropsychosocial “Feedback Loop” diagrams as part of these sections.
For example, in Chapter 7 we provide a Feedback Loop diagram for understanding
posttraumatic stress disorder and another for treating posttraumatic stress disorder.
xx Preface

NeuroPsychoSocial
Brain Systems
Hippocampus

Neural Communication Genetics

Norepinephrine Inherited tendency to seek
Serotonin out situations that may have
a higher likelihood of trauma

NeuroPsychoSocial NeuroPsychoSocial
Mental Processes and
Mental Contents
Dissociation during
trauma
Stressful Life Events Family
Beliefs that one is unable
to control stressors and Socioeconomic stress No known major
that the world is a Lack of social support contribution
dangerous place
Specific characteristics
Affect Behavior of the traumatic event

Anxiety Conditioned emotional

Fear response to stimuli
associated with trauma
Negative reinforcement Gender/Culture
of avoidance Cultural influences on
symptom expression

FIGURE 7.2 • Feedback Loops in Understanding PTSD

These diagrams illustrate the feedback loops among the neurological, psychological,
and social factors. Additional feedback loop diagrams can be found on the book’s
website at: www.worthpublishers.com/launchpad/rkabpsych2e.
• The Feedback Loops in Understanding diagrams serve several purposes: (1) they
provide a visual summary of the most important neuropsychosocial factors that
contribute to various disorders; (2) they illustrate the interactive nature of the factors;
(3) because their overall structure is the same for each disorder, students can compare
and contrast the specifics of the feedback loops across disorders.
 Preface xxi

Treatments Targeting
Neurological Factors
Medication: SSRIs

Changes neural
activity

Decreases isolation
and shame
Changes thoughts, Increases social
feelings, and support
behaviors
Improves
relationships

Treatments Targeting Treatments Targeting

Psychological Factors Social Factors
CBT: Breathing, Group therapy
relaxation, exposure, Couples or family
cognitive restructuring, therapy
psychoeducation
EMDR

FIGURE 7.3 • Feedback Loops in Treating PTSD

• Like the Feedback Loops in Understanding diagrams, the Feedback Loops in Treating
diagrams serve several purposes: (1) they provide a visual summary of the treatments for
various disorders; (2) they illustrate the interactive nature of successful treatment (the
fact that a treatment may directly target one type of factor, but changes in that factor in
turn affect other factors); (3) because their overall structure is the same for each disorder,
students can compare and contrast the specifics of the feedback loops across disorders.

Clinical Material
Abnormal psychology is a fascinating topic, but we want students to go beyond
fascination; we want them to understand the human toll of psychological disorders—
what it’s like to suffer from and cope with such disorders.To do this, we’ve incorporated
several pedagogical elements. The textbook includes three types of clinical material:
chapter stories—each chapter has a story woven through, traditional third-person cases
(From the Outside), and first-person accounts (From the Inside).

Chapter Stories: Illustration and Integration

Each chapter opens with a story about a person (or, in some cases, several people) who
has symptoms of psychological distress or dysfunction. Observations about the person
or people are then woven throughout the chapter. These chapter stories illustrate the
common threads that run throughout the chapter (and thereby integrate the material),
serve as retrieval cues for later recall of the material, and show students how the theories
and research presented in each chapter apply to real people in the real world; the stories
 xxii Preface

humanize the clinical descriptions and discussions of research presented

Tom Wargacki/WireImage/Getty Images

in the chapters.
The chapter stories present people as clinicians and researchers often
find them—with sets of symptoms in context. It is up to the clinician or
researcher to make sense of the symptoms, determining which of them may
meet the criteria for a particular disorder, which may indicate an atypical
presentation, and which may arise from a comorbid disorder. Thus, we
ask the student to see situations from the point of view of clinicians and
researchers, who must sift through the available information to develop
hypotheses about possible diagnoses and then obtain more information to
confirm or disconfirm these hypotheses.
In the first two chapters, the opening story is about a mother and
daughter—Big Edie and Little Edie Beale—who were the subject of a
famous documentary in the 1970s and whose lives have been portrayed
more recently in the play and HBO film Grey Gardens. In these initial
chapters, we offer a description of the Beales’ lives and examples of their
very eccentric behavior to address two questions central to psychopathology:
How is abnormality defined? Why do psychological disorders arise?
The stories in subsequent chapters focus on different examples
of symptoms of psychological disorders, drawn from the lives of other
people. For example, in Chapter 6 we discuss football star Earl Campbell
(who suffered from symptoms of anxiety); in Chapter 7 we discuss the
reclusive billionaire Howard Hughes (who suffered from symptoms of
obsessive-compulsive disorder and who experienced multiple traumatic
events); and in Chapter 12 we discuss the Genain quadruplets—all four
of whom were diagnosed with schizophrenia.
We return often to these stories throughout each chapter in an effort
to illustrate the complexity of mental disorders and to show the human
side of mental illness, how it can affect people throughout a lifetime,
Using this book’s definition of a psychological rather than merely a moment in time.
disorder, did either of the Beales have a
disorder? Big Edie exhibited distress that
was inappropriate to her situation; both From the Outside
women appeared to have an impaired ability The feature called From the Outside provides third-person accounts (typically case
to function. The risk of harm to the women,
however, is less clear-cut. presentations by mental health clinicians) of disorders or particular symptoms of
disorders. These accounts provide an additional opportunity for memory consolidation
of the material (because they mention symptoms the person experienced), an additional
set of retrieval cues, and a further sense of how symptoms and disorders affect real
people; these cases also serve to expose students to professional case material. The From
the Outside feature covers an array of disorders, such as cyclothymic disorder, panic
disorder, transvestic disorder, and separation anxiety disorder. Often several From the
Outside cases are included in a chapter.

From the Inside

In every chapter in which we address a disorder in depth, we present at least one first-
person account of what it is like to live with that disorder or particular symptoms of it.
In addition to providing high-interest personal narratives, these From the Inside cases help
students to consolidate memory of the material, provide additional retrieval cues, and are
another way to link the descriptions of disorders and research findings to real people’s
experiences. The From the Inside cases illuminate what it is like to live with disorders
such as agoraphobia, obsessive-compulsive disorder, illness anxiety disorder, alcohol use
disorder, gender dysphoria, and schizophrenia, among others.
 Preface xxiii

Learning About Disorders:

Consolidated Tables to
Consolidate Learning
In the clinical chapters, we provide two types of tables to help students organize and
consolidate information related to diagnosis: DSM-5 diagnostic criteria tables, and Facts
at a Glance tables.

DSM-5 Diagnostic Criteria Tables

The American Psychiatric Association’s manual of psychiatric disorders—the Diagnostic
and Statistical Manual of Mental Disorders, 5th edition (DSM-5)—provides tables of the
diagnostic criteria for each of the listed disorders. For each disorder that we discuss at
length, we present the DSM-5 diagnostic criteria table; we also explain and discuss the
criteria—and criticisms of them—in the body of the chapters themselves.

Facts at a Glance Tables for Disorders

Another important innovation is our summary tables for each disorder, which provide
key facts about prevalence, comorbidity, onset, course, and gender and cultural factors.
These tables are clearly titled with the name of the disorder, which is followed by the
term “Facts at a Glance” (for instance, Obsessive-Compulsive Disorder Facts at a Glance).
These tables give students the opportunity to access this relevant information in one
place and to compare and contrast the facts for different disorders.

New Features
This edition has two new features: Current Controversy boxes and Getting the Picture
critical thinking photo sets.

Current Controversies
New to this edition, each clinical chapter includes a brief discussion about a current
controversy related to a disorder—its diagnosis or its treatment. Examples include
whether the new diagnoses in DSM-5 of mild and major neurocognitive disorders
are net positive or negative changes from DSM-IV, and whether eye movement
desensitization and reprocessing (EMDR) provides additional benefit beyond that
of other treatments for posttraumatic stress disorder. These discussions help students
understand the iterative and sometimes controversial nature of classifying “problems”
and symptoms as disorders, and whether and when treatments might be appropriate.
Many of these discussions were contributed by instructors who teach Abnormal
Psychology—including: Ken Abrams, Carleton College; Randy Arnau, University of
Southern Mississippi; Glenn Callaghan, San Jose State University; Richard Conti, Kean
University; Patrice Dow-Nelson, New Jersey City University; James Foley, College
of Wooster; Rick Fry, Youngstown State University; Farrah Hughes, Francis Marion
University; Meghana Karnik-Henry, Green Mountain College; Kevin Meehan, Long
Island University; Jan Mendoza, Golden West College; Meera Rastogi, University of
Cincinnati, Clermont College; Harold Rosenberg, Bowling Green State University;
Anthony Smith, Baybath College; and Janet Todaro, Salem State University.

Getting the Picture

Also new to this edition are brief visual features that help to consolidate learning, which
we call Getting the Picture: We offer two photos and ask students to decide which one
Other documents randomly have
different content
from an alcove in his direction. Before he could avoid her she spoke
to him.
However unwelcome the meeting might have been to Shelby—
and his face showed plainly that it was so—there could be no doubt
of Paquita’s eagerness to see him. As I looked at her I could only
wonder at the strangeness of life. She whom men had pursued and
had found elusive, even when they thought they had her captured,
was now herself in the anomalous rôle of pursuer. And the man
whom she pursued cared no more for her than she for those who
pursued her. Nay more, he was openly, hopelessly in love with
another woman, in every respect the antithesis of herself. Much as I
disliked Paquita’s type, though realizing her fascination as a study, I
could not help seeing the potential tragedy and pathos of the
situation.
She did not accuse or upbraid. On the contrary, she was using
every art of which she was a past mistress to fascinate and attract. I
did not need prompting from Kennedy to see the strange romance of
the situation. The little dancer was subtly matching all the charm and
all the knowledge of men and the world which she possessed
against the appeal that Winifred had made to a hitherto latent side of
Shelby’s nature. The struggle between the two women was no less
enthralling than the unraveling of the mystery of Marshall Maddox’s
death.
“By Heaven!” I heard Kennedy mutter under his breath, as we
watched Paquita and Shelby, “I wonder whether it is right to let
events take their course. Yes—it must be. If he cannot go through it
now, he’ll never be able to. Yes, Shelby Maddox must fight that out
for himself. He shall not ruin the life of Winifred Walcott.”
His remark set me thinking of the responsibility Craig had had
thrust on him. It was far more than merely running down the
murderer of Marshall Maddox, now.
Shelby himself evidently appreciated what faced him. I could see
that he was talking very bluntly and pointedly to her, almost rudely.
Now and then she flashed a glance at him which, with her flushed
face and the emotion expressed in her very being, could not have
failed only three days ago. Shelby seemed to feel it, and took refuge
in what looked to be an almost harshness of manner with her.
Kennedy jogged my arm and I followed his eyes. In the alcove
from which she had come I was not surprised to see Sanchez,
standing and looking at them. His dark eyes seemed riveted on the
man as though he hated him with a supernal hate. What would he
himself not have given to be where Shelby was? I wondered whether
his blinded eyes saw the truth about Shelby’s position. I doubted it,
for it was with difficulty that he restrained himself. Black and ominous
were the looks that he darted at the younger man. Indeed, I did not
envy him.
As I turned to say something to Kennedy I saw that Sanchez and
ourselves were not the only ones interested. Frances Maddox had
just come out of the dining room, had seen her brother and Paquita,
and had drawn back into the shadow of a doorway leading to the
porch, where she could see them better without being seen by them.
Yet she betrayed nothing of her feelings toward either.
Meanwhile Shelby had been getting more and more vehement as
he talked. I could not hear, but it was quite evident now that he was
repeating and enforcing the remarks he had made to Paquita the
night before during their secret stroll down the beach. And she,
instead of getting angry, as he no doubt hoped she would, was
keeping her temper and her control of herself in a most dangerous
manner.
There was so much to think about that it was not until now that I
noticed that the face we had seen in the alcove was gone. Sanchez
had disappeared. Had the thing been too much for him? Was it that
he could not trust himself to stay? At any rate, he was gone.
Just then Shelby turned on his heel, almost brutally, and
deliberately walked away. It was as though he felt it his only escape
from temptation.
Paquita took an involuntary step after him, then stopped short. I
followed her quick glance to see what it might be that had deterred
her. She had caught sight of Frances Walcott, whose interest had
betrayed her into letting the light stream through the doorway on her
face. Instantly Paquita covered the vexation that was on her face.
Least of all would she let this man’s sister see it. Consummate
actress that she was, she turned and walked across the lobby, and a
moment later was in gay conversation with another of her numerous
admirers. But it did not take an eye more trained than mine to see
the gaiety was forced, the animation of quite a different character
from that she had showed to Shelby.
“Of one thing we can be sure,” remarked Craig. “Miss Walcott will
hear all about this. I hope she hears the truth. I’m almost tempted to
tell her myself.” He paused, debating. “No,” he decided, finally, “the
time hasn’t come yet.”
Shelby had retreated to the porch, where now he was pacing up
and down, alone. As he came past the door his abstracted glance
fell with a start on his sister. He drew himself together and spoke to
her. Evidently he was debating whether she had seen anything, and,
if so, how much and how she had interpreted it. At any rate, he was
at pains to speak now, hoping that she might carry a message which
he dared not send. What was going on in their minds I could not
guess, but to outward appearance they were more like brother and
sister than I had seen them ever before.
They parted finally and Shelby continued his measured tread
about the porch, as though trying to make up his mind on a course of
action. For about a quarter of an hour he walked, then, his face set in
determined lines, entered the Lodge and went deliberately over to a
florist’s stand. There, oblivious to anything else, he selected the
handsomest bunch of violets on the stand. He was about to drop his
card into their fragrant and reconciling depths when he paused,
replaced the card in his case, and directed the man to deliver them
anonymously. There was no need for us to inquire where they were
sent.
Still oblivious to the gay life of the Lodge and Casino, he strode
out into the night and down to the dock, paying no attention to
Craig’s student as he passed. He stepped into the tender which was
still waiting and we saw him head straight for the Sybarite. Ten
minutes later the lights in the main saloon flashed up. Shelby was
evidently at work over some problem, wrestling it out himself. Was it
his relations with Winifred or his stock-market schemes—or both?
“Well, I’ve been looking all over for you. Where have you been?”
sounded Burke’s voice back of us, as Kennedy and I were silently
looking out over the dark waters at the yacht.
Without waiting for us to reply Burke hurried on. “You remember
that operator, Steel, that was here from Seaville?”
“Yes,” encouraged Kennedy. “What of him?”
“He went back to the station and has done his trick. He has just
crossed over again with a message to me. That wireless power,
whatever it is, is jamming the air again. I thought you’d like to know
of it.”
For just a second Kennedy looked at Burke in silence, then
without further inquiry turned and almost ran down the length of the
dock to the float at the end.
There Watkins had already set up on the float a large affair which
looked for all the world like a mortar. We watched as Craig fussed
with it to make sure that everything was all right. Meanwhile the
student continued adjusting something else that had been let down
over the edge of the float into the water. It seemed to be a peculiar
disk, heavy and suspended by a stout wire which allowed it to be
submerged eight or ten feet.
“What’s this thing?” inquired Burke, looking at the mortar over
which Craig was bending. “Fireworks, or are you going to bombard
somebody?”
“It’s a light-weight rocket mortar,” explained Kennedy, ramming
something into it. “You’ll see in a moment. Stand back, all of you—off
the float—on the dock.”
Suddenly there came a deep detonation from the mortar and a
rocket shot out and up in a long, low parabola. Kennedy rushed
forward, and another detonation sent a second far out in a different
angle.
 “What is it?” gasped Burke, in amazement.
“Look!” called Kennedy, elated.
Another instant, and from every quarter of the harbor there
seemed to rise, as if from the waves, huge balls of fire, a brilliant and
luminous series of flames literally from the water itself. It was a
moonless night but these fires seemed literally to roll back the
Cimmerian darkness.
“A recent invention,” explained Craig, “light-bombs, for use at
night against torpedo-boat and aeroplane attacks.”
“Light-bombs!” Burke repeated.
“Yes, made of phosphide of calcium. The mortar hurls them out,
and they are so constructed that they float after a short plunge in the
water. You see, the action of the salt water automatically ignites them
merely by contact and the chemical action of the phosphide and the
salt water keeps them phosphorescing for several minutes.”
As he talked he shot off some more.
“Kennedy, you’re a genius,” gasped Burke. “You’re always ready
for anything.”
The sight before us was indeed a beautiful pyrotechnic display.
The bombs lighted up the shores and the low-lying hills, making
everything stand forth and cast long spectral shadows. Cottages
hidden among trees or in coves along the wide sweep of the shore
line stood out as if in an unearthly flare.
What people on the shore thought we had no time even to
wonder. They crowded out on the porches, in consternation. The
music at the Casino stopped. No one had ever seen anything like it
before. It was fire on water!
As yet none of us had even an inkling of what it was that Kennedy
expected to discover. But every craft in the harbor now stood out
distinct—in the glare of a miniature sun. We could see that, naturally,
excitement on the boats was greater than it was on shore, for they
were closer to the flares and therefore it seemed more amazing.
 Craig was scanning the water carefully, seeking any sign of
something suspicious.
“There it is!” he exclaimed, bending forward and pointing.
We strained our eyes. A mile or two out I could distinguish a
power-boat of good size, moving swiftly away, as though trying to
round the shelter of a point of land, out of the light. With a glass
some one made out a stubby wireless mast on her.
Kennedy’s surmise when we had first studied the wireless
interference had proved correct.
Sure enough, in the blackness of the night, there was a fast
express cruiser, of the new scout type, not large, almost possible for
one man to control, the latest thing in small power-boats and a
perfect demon for speed!
Was that the source of the strange wireless impulses? Whose
was it, and why was it there?
 XXI

THE SUBMARINE EAR

Almost before we knew it the speed demon had disappeared
beyond the circle of the flares.
“Suspiciously near the Sybarite,” remarked Kennedy, under his
breath, watching the scout cruiser to the last moment as she ran
away.
I wondered whether he meant that the swift little motor-boat might
have some connection with Shelby Maddox and his new activities,
but I said nothing, for Kennedy’s attention was riveted on the wake
left by the boat. I looked, too, and could have sworn that there was
something moving in the opposite direction to that taken by the boat.
What could it be?
On the end of the dock was an incandescent lamp. Craig
unscrewed the bulb and inserted another connection in the bulb
socket, an insulated cable that led down to the apparatus on the float
over which his assistant was still working.
By this time quite a crowd had collected on the dock, and on the
float, watching us.
“Burke,” ordered Kennedy, “will you and Jameson make the
people stand back? We can’t do anything with so many around.”
As we pressed the new-comers back I saw that among them was
Paquita. Though I looked, I could not discover Sanchez, but thought
nothing of it, for there were so many about that it would have been
hard to find any particular person.
“If you will please stand back,” I implored, trying to keep the
curious from almost swamping the float, “you will all be able to see
what is going on just as well and, besides, it will be a great deal safer
—providing there is an explosion,” I added as a happy afterthought,
although I had almost as vague an idea what Kennedy was up to as
any of them.
The words had the effect I intended. The crowd gave way, not
only willing, but almost in panic.
As they pressed back, however, Paquita pressed forward until she
was standing beside me.
“Is—Mr. Maddox—out there?” she asked, pointing out at the
Sybarite anxiously.
“Why?” I demanded, hoping in her anxiety to catch her off guard.
She shot a quick glance at me. There was no denying that the
woman was clever and quick of perception.
“Oh, I just wondered,” she murmured. “I wanted to see him, so
much—that is all. And it’s very urgent.”
She glanced about, as though hoping to discover some means of
communicating with the yacht, even of getting out to it. But there did
not seem to be any offered.
I determined to watch her, and for that reason did not insist that
she get back as far as the rest of the crowd. All the time I saw that
she was looking constantly out at the Sybarite. Did she know
something about Shelby Maddox that we did not know? I wondered
if, indeed, there might be some valid reason why she should get out
there. What did she suspect?
Again she came forward, inquiring whether there was not some
way of communicating with the Sybarite, and again, when I tried to
question her, she refused to give me any satisfaction. However, I
could not help noticing that in spite of the cold manner in which
Shelby had treated her, she seemed now to be actuated more by the
most intense fear for him than by any malice against him.
What it meant I had the greatest curiosity to know, especially
when I noticed that Paquita was glancing nervously about as though
in great fear that some one might be present and see her. Nor did
she seem to be deterred from showing her feelings by the fact that
she knew that I, Kennedy’s closest friend, was watching and would
undoubtedly report to him. It was as though she had abandoned
discretion and cast fear to the winds.
As the minutes passed and nothing happened, Paquita became a
trifle calmer and managed to take refuge in the crowd.
I took the opportunity again to run my eye over them. Nowhere in
the crowd could I discover Winifred, or, in fact, any of the Maddox
family. They seemed to be studiously avoiding appearance in public
just now, and I could not blame them, for in a summer colony like
that at Westport facts never troubled gossipers.
“What do you suppose Kennedy is afraid of?” whispered Hastings
in my ear, nervously. “Your friend is positively uncanny, and I can
almost feel that he fears something.”
“I’m sure I don’t know,” I confessed, “but I’ve seen enough of him
to be sure that no one is going to catch him napping. Here’s Riley.
Perhaps he has some news.”
The Secret Service operative had shouldered his way through the
throng, looking for Burke, who was right behind me.
“What’s the matter,” demanded his chief.
“There’s another message, by telephone from the Seaville
Station,” Riley reported. “They say they are having the same trouble
again—only more of it.”
“That operator, Steel, came back again,” considered Burke.
“Where is he?”
“As soon as I got the message, I hunted him up and took the
liberty of sending him up to Mr. Kennedy’s room to look at that
arrangement there. I couldn’t make anything out of it myself, I knew,
and I thought that he could.”
“Did he?” inquired Burke.
“Yes. Of course he hadn’t seen it work before. But I told him as
nearly as I could what you had told me, and it didn’t take him very
long to catch on to the thing. After that he said that what was being
recorded now must be just the same as it had been before when Mr.
Kennedy was there—not messages, but just impulses.”
“Where is he—down here?”
“No, I left him up there. I thought it might be best to have some
one there. Did you want to speak to him? There’s a telephone down
here in the boat-house up to the switchboard at the Lodge.”
Riley jerked his thumb back over his shoulder at a little shelter
built on the end of the dock.
“N-no,” considered Burke. “I wouldn’t know what to tell him.”
“But I think you ought to tell Kennedy that,” I interrupted. “He
might know what to do.”
Together Riley and I walked across the float to where Craig was
at work, and briefly I told him what had happened.
He looked grave, but did not pause in his adjustment of the
machine, whatever it was.
“That’s all right,” he approved. “Yes, get the operator on the wire.
Tell him to stay up there. And—yes—tell him to detach that
phonograph recording device and go back to straight wireless. He
might try to wake up the operator on the Sybarite, if he can. I guess
he must know the call. Have him do that and then have that
telephone girl keep the line clear and connected from the boat-house
up to my room. I want to keep in touch with Steel.”
Riley and I pushed through the crowd and finally managed to
deliver Kennedy’s message, in spite of the excitement at the Lodge,
which had extended by this time to the switchboard operator. I left
Riley in the boat-house to hold the wire up to our room, and rejoined
Burke and Hastings on the float.
Kennedy had been working with redoubled energy, now that the
light bombs had gone out after serving their purpose. We stood apart
now as he made a final inspection of the apparatus which he and his
assistant had installed.
 Finally Craig pressed down a key which seemed to close a circuit
including the connection in the electric-light socket and the
arrangement that had been let over the edge of the float. Standing
where we were we could feel a sort of dull metallic vibration under
our feet, as it were.
“What are you doing?” inquired Hastings, looking curiously at a
headgear which Kennedy had over his ears.
“It works!” exclaimed Craig, more to Watkins than to us.
“What does?” persisted Hastings.
“This Fessenden oscillator,” he cried, apparently for the first time
recognizing that Hastings had been addressing him.
“What is it?” we asked crowding about. “What does it do?”
“It’s a system for the employment of sound for submarine signals,”
he explained, hurriedly. “I am using it to detect moving objects in the
water—under the water, perhaps. It’s really a submarine ear.”
In our excitement we could only watch him in wonder.
“People don’t realize the great advance that has been made in the
use of water instead of air as a medium for transmitting sounds,” he
continued, after a pause, during which he seemed to be listening,
observing a stop watch, and figuring rapidly on a piece of paper, all
at once. “I can’t stop to explain this apparatus, but, roughly, it is
composed of a ring magnet, a copper tube which lies in an air gap of
a magnetic field, and a stationary central armature. The magnetic
field is much stronger than that in an ordinary dynamo of this size.”
Again he listened, as he pressed the key, and we felt the peculiar
vibration, while he figured on the paper.
“The copper tube,” he resumed mechanically to us, though his
real attention was on something else, “has an alternating current
induced in it. It is attached to solid disks of steel, which in turn are
attached to a steel diaphragm an inch thick. Surrounding the
oscillator is a large watertight drum.”
 “Then it makes use of sound-waves in the water?” queried
Hastings, almost incredulously.
“Exactly,” returned Craig. “I use the same instrument for sending
and receiving—only I’m not doing any real sending. You see, like the
ordinary electric motor, it is capable of acting as a generator, too and
a very efficient one. All I have to do is to throw a switch in one
direction when I want to telegraph or telephone under water, and in
the other direction when I want to listen.”
“Talking through water!” exclaimed Burke, awestruck by the very
idea, as though it were scarcely believable.
“That’s not exactly what I’m doing now,” returned Kennedy,
indulgently, “although I could do it if there was any one around this
part of the country equipped to receive and reply. I rather suspect,
though, that whoever it is is not only not equipped, but wouldn’t want
to reply, anyhow.”
“Then what are you doing?” asked Burke, rather mystified.
“Well, you see I can send out signals and listen for their reflection
—really the echo under water. More than that, I can get the sounds
direct from any source that is making them. If there was a big
steamer out there I could hear her engines and propellers, even if I
couldn’t see her around the point. Light travels in straight lines, but
you can get sounds around a corner, as it were.”
“Oh,” I exclaimed, “I think I see. Even if that little scout cruiser did
disappear around the point, you can still hear her through the water.
Is that it?”
“Partly,” nodded Kennedy. “You know, sound travels through water
at a velocity of about four thousand feet a second. For instance, I
find I can get an echo from somewhere practically instantaneously.
That’s the bottom of the bay—here. Another echo comes back to me
in about a twentieth of a second. That, I take it, is reflected from the
sea wall on the shore, back of us, at high tide. It must be roughly a
hundred feet—you see, that corresponds. It is a matter of
calculation.”
“Is that all?” I prompted, as he paused again.
 “No, I’ve located the echo from the Sybarite and some others.
But,” he added slowly, “there’s one I can’t account for. There’s a
sound that is coming to me direct from somewhere. I can’t just place
it, for there isn’t a moving craft visible and it doesn’t give the same
note as that little cruiser. It’s sharper. Just now I tried to send out my
own impulses in the hope of getting an echo from it, and I
succeeded. The echo comes back to me in something more than five
seconds. You see, that would make twenty thousand-odd feet. Half
of that would be nearly two miles, and that roughly corresponds with
the position where we saw the scout cruiser at first, before it fled.
There’s something out there.”
“Then I was right,” I exclaimed excitedly. “I thought I saw
something in the wake of the cruiser.”
Kennedy shook his head gravely. “I’m afraid you were,” he
muttered. “There’s something there, all right. That wireless operator
is up in our room and you have a wire from the boathouse to him?”
“Yes,” I returned. “Riley’s holding it open.”
Anxiously Kennedy listened again in silence, as though to verify
some growing suspicion. What was it he heard?
Quickly he pulled the headgear off and before I knew it had
clapped it on my own head.
“Tell me what it sounds like,” he asked, tensely.
I listened eagerly, though I was no electrical or mechanical
engineer, and such things were usually to me a sealed book. Still, I
was able to describe a peculiar metallic throbbing.
“Record the time for the echo from it,” ordered Kennedy, thrusting
the stop watch into my hands. “Press it the instant you hear the
return sound after I push down the key. I want to be sure of it and
eliminate my own personal equation from the calculation. Are you
ready?”
I nodded and an instant later, as he noted the time, I heard
through the oscillator the peculiar vibration I had felt when the key
was depressed. On the qui vive I waited for the return echo. Sure
enough, there it was and I mechanically registered it on the watch.
“Five and thirty-hundredths seconds,” muttered Kennedy. “I had
five and thirty-five hundredths. It’s coming nearer—you hear the
sound direct again?”
I did, just a trifle more distinctly, and I said so.
Confirmed in his own judgment, Craig hastily turned to the
student. “Run up there to the boat-house,” he directed. “Have Riley
call that wireless operator on the telephone and tell him to get the
Sybarite on the wireless—if he hasn’t done it already. Then have him
tell them not to try to move the yacht under any circumstance—but
for God’s sake to get off it themselves—as quick as they can!”
“What’s the matter?” I asked, breathlessly. “What was that
humming in the oscillator?”
“The wireless destroyer—the telautomaton model—has been
launched full at the Sybarite,” Craig exclaimed. “You remember it
was large enough, even if it was only a model, to destroy a good-
sized craft if it carried a charge of high explosive. It has been
launched and is being directed from that fast cruiser back of the
point.”
We looked at one another aghast. What could we do? There was
a sickening feeling of helplessness in the face of this new terror of
the seas.
“It—it has really been launched?” cried an agitated voice of a girl
behind us.
Paquita had pushed her way altogether through the crowd while
we were engrossed in listening through the submarine ear. She had
heard what Kennedy had just said and now stood before us, staring
wildly.
“Oh,” she cried, frantically clasping her hands, “isn’t there
anything—anything that can stop it—that can save him?”
She was not acting now. There could be no doubt of the
genuineness of her anxiety, nor of whom the “him” meant. I
wondered whether she might have been directly or indirectly
responsible, whether she was not now repentant for whatever part
she had played. At least she must be, as far as Shelby Maddox was
involved. Then I recollected the black looks that Sanchez had given
Shelby earlier in the evening. Was jealousy playing a part as well as
cupidity?
Kennedy had been busy, while the rest of us had been standing
stunned. Suddenly another light-bomb ricocheted over the water.
“Keep on sending them, one by one,” he ordered the student, who
had returned. “We’ll need all the light we can get.”
Over the shadowy waves we could now see the fine line of foam
left by the destroyer as it shot ahead swiftly.
Events were now moving faster than I can tell them. Kennedy
glanced about. On the opposite side of the float some one of the
visitors from the cottages to the dance at the Casino had left a trim
hardwood speedboat. Without waiting to inquire whose it was, Craig
leaped into it and spun the engine.
“The submarine ear has warned us,” he shouted, beckoning to
Burke and myself. “Even if we cannot save the yacht, we may save
their lives! Come on!”
We were off in an instant and the race was on—one of the most
exciting I have ever been in—a race between this speedy motor-boat
and a telautomatic torpedo to see which might get to the yacht first.
Though we knew that the telautomaton had had such a start before it
was discovered that we could not beat it, still there was always the
hope that its mechanism might slow down or break down.
Failing to get there first, there was always a chance of our being
in at the rescue.
In the penetrating light of the flare-bombs, as we approached
closer the spot in which Watkins was now dropping them regularly,
we could see the telautomaton, speeding ahead on its mission of
death, its wake like the path of a great man-eating fish. What would
happen if it struck I could well imagine.
 Each of us did what he could to speed the motor. For this was a
race with the most terrible engine yet devised by American inventive
genius.
 XXII

THE TELAUTOMATON
Devilishly, while the light-bombs flared, the telautomaton sped
relentlessly toward its mark.
We strained our eyes at the Sybarite. Would they never awake to
their danger? Was the wireless operator asleep or off duty? Would
our own operator be unable to warn them in time?
Then we looked back to the deadly new weapon of modern war
science. Nothing now could stop it.
Kennedy was putting every inch of speed into the boat which he
had commandeered.
“As a race it’s hopeless,” he gritted, bending ahead over the
wheel as if the boat were a thing that could be urged on. “What they
are doing is to use the Hertzian waves to actuate relays on the
torpedo. The wireless carries impulses so tuned that they release
power carried by the machine itself. The thing that has kept the
telautomaton back while wireless telegraphy has gone ahead so fast
is that in wireless we have been able to discard coherers and relays
and use detectors and microphones in their places. But in
telautomatics you have to keep the coherer. That has been the
barrier. The coherer until recently has been spasmodic, until we got
the mercury steel disk coherer—and now this one. See how she
works—if only it could be working for us instead of against us!”
On sped the destroyer. It was now only a matter of seconds when
it would be directed squarely at the yacht. In our excitement we
shouted, forgetting that it was of no use, that they would neither hear
nor, most likely, know what it was we meant.
 Paquita’s words rang in my ears. Was there nothing that could be
done?
Just then we saw a sailor rush frantically and haul in a boat that
was fastened to a boom extending from the yacht’s side.
Then another and another ran toward the first. They had realized
at last our warning was intended for them. The deck was now alive
and faintly over the water we could hear them shouting in frantic
excitement, as they worked to escape destruction coming at them
now at express train speed.
Suddenly there came a spurt of water, a cloud of spray, like a
geyser rising from the harbor. The Sybarite seemed to be lifted
bodily out of the water and broken. Then she fell back and settled,
bow foremost, heeling over, as she sank down to the mud and ooze
of the bottom. The water closed over her and she was gone, nothing
left but fragments of spars and woodwork which had been flung far
and wide.
Through my mind ran the terrible details I had read of ships
torpedoed without warning and the death and destruction of
passengers. At least there were no women and children to add to
this horror.
Kennedy slowed down his engine as we approached the floating
wreckage, for there was not only the danger of our own frail little
craft hitting something and losing rudder or propeller, but we could
not tell what moment we might run across some of those on the
yacht, if any had survived.
Other boats had followed us by this time, and we bent all our
energies to the search, for pursuit of the scout cruiser was useless.
There was not a craft in the harbor capable of overtaking one of her
type, even in daylight. At night she was doubly safe from pursuit.
There was only one thing that we might accomplish—rescue.
Would we be in time, would we be able to find Shelby? As my mind
worked automatically over the entire swift succession of events of
the past few days I recalled every moment we had been observing
him, every action. I actually hated myself now for the unspoken
suspicion of him that I had entertained. I could see that, though
Kennedy had been able to promise him nothing openly, he had in
reality been working in Shelby’s real interests.
There flashed through my mind a picture of Winifred. And at the
same time the thought of what this all meant to her brought to me
forcibly the events of the night before. One attack after another had
been leveled against us, starting with the following and shooting at
Hastings at our very laboratory door. Burke had been attacked. Then
had come the attack on Kennedy, which had miscarried and struck
me. Death had been leveled even at Mito, as though he had
possessed some great secret. Next had come the attempted
abduction of Winifred Walcott. And at last it had culminated in the
most spectacular attack of all, on Shelby himself.
Try as I could by a process of elimination, I was unable to fix the
guilt on any one in particular, even yet. Fixing guilt, however, was not
what was needed now.
We had come into the area of the floating debris, and the
possibility of saving life was all that need concern us. In the darkness
I could make out cries, but they were hard to locate.
We groped about, trying hard to cover as much area as possible,
but at the same time fearful of defeating our own purposes by
striking some one with bow or propeller of our speed boat. Every
now and then a piece of the wreckage would float by and we would
scan it anxiously in mingled fear and hope that it would assume a
human form as it became more clearly outlined. Each time that we
failed we resumed the search with desperate determination.
“Look!” cried Burke, pointing at a wooden skylight that seemed to
have been lifted from the deck and cast but into the waves, the glass
broken, but the frame nearly intact. “What’s that on it?”
Kennedy swung the boat to port and we came alongside the dark,
bobbing object.
It was the body of a man.
With a boat-hook Craig hauled the thing nearer and we leaned
over the side and together pulled the limp form into our boat.
 As we laid him on some cushions on the flooring, our boat drifted
clear and swung around so that the flare shone in his face. He stirred
and groaned, but did not relax the grip of his fingers still clenched
after we had torn them loose from the skylight grating.
It was Shelby Maddox—terribly wounded, but alive.
Others of the crew were floating about, and we set to work to get
them, now aided by the volunteer fleet that had followed us out.
When it was all over we found that all had been accounted for so far,
except the engineer and one sailor.
Just at present we had only one thought in mind. Shelby Maddox
must be saved, and to be saved he must be rushed where there was
medical assistance.
Shouting orders to those who had come up to continue the
search, Kennedy headed back toward the town of Westport.
The nearest landing was the town dock at the foot of the main
street, and toward this Craig steered.
There was no emergency hospital, but one of the bystanders
volunteered to fetch a doctor, and it was not long before Shelby was
receiving the attention he needed so badly.
He had been badly cut about the head by flying glass, and the
explosion had injured him internally, how serious could not be
determined, although two of his ribs had been broken. Only his iron
will and athletic training had saved him, for he was weak, not only
from the loss of blood, but from water which he had been unable to
avoid swallowing.
The doctor shook his head gravely over him, but something had
to be done, even though it was painful to move him. He could not lie
there in an open boat.
Kennedy settled the matter quickly. From a tenant who lived over
a store near the waterfront he found where a delivery wagon could
be borrowed. Using a pair of long oars and some canvas, we
improvised a stretcher which we slung from the top of the wagon and
so managed to transport Shelby to the Harbor House, avoiding the