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Child and Adolescent Psychopathology
BOOK REVIEWS
Child and Adolescent Psychopathology. By Irving B. Weiner. New York: John Wiley & Sons. 1982, 529 pp., $23.95 Reviewed by Charles M. Binger, M.D.* In recent years there have been an increasing number of books on child and adolescent psychopathology and child psychiatry. Each has had its strengths and deficits. This reviewer was familiar with Irving B. Weiner’s writing through having read and utilized clinically and in teaching an excellent book he had previously written entitled Psychological Disturbance in Adolescence (1970). According to the author, Child and Adolescent Psychopathology “provides a comprehensive description of the nature, prevalence, causes, course, outcome and treatment of the major forms of psychological disorder and problem behavior occurring in children and adolescents. Along with this emphasis on description, attention is paid throughout the book to the influential concepts, controversial issues and research findings that constitute current thinking and knowledge about developmental psychopathology, and the discussion embraces various theoretical approaches that have contributed to this knowledge” (p. iii). The book is divided into 14 chapters. The first chapter, “The Nature of Normal and Abnormal Development,” presents a broad overview correlating considerable research with definitions of normality, the continuity of normal and abnormal behavior, the prevalence of disturbances in childhood, studies relating to childhood difficulties as predictive of subsequent disturbance in adulthood, and problem behaviors in normal and disturbed adolescents.In the second chapter, the author discusses classification of developmental psychopathology. Again, this is a well written chapter focusing on possible harmful effects of classification along with benefits. He describes various approaches to classification including the more recent DSM-111. The next six chapters address specific kinds of disturbances: Mental Retardation, Minimal Brain Dysfunction or Attention Deficit Disorder, Childhood Psychosis-Infantile Autism and Childhood Schizophrenia, Schizophrenia in Adolescence, Affective Disorders-Depression and Mania, and Neurotic Disorders. Chapter 9 concerns school phobia. The following four chapters discuss problem behaviors, each of which can involve various kinds of specific disturbance: Academic Underachievement, Delinquent Behavior, SUIcidal Behavior, and Alcoliol and Drug Abuse. The final chapter reviews some unifying themes concerning * Dr. Binger is Clinical Professor of Psychiatry, Clinical Coordinator, and Training Director of Child and Adolescent Psychiatry, Department of Psychiatry, University of California,San Francisco.
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the definition, prevalence, causes, course, outcome, prevention and treatment of psychological disorders. Each chapter provides description of the nature of developmental psychopathology through case examples. Contemporary clinical and research findings are cited extensively. The author states that individual topics are presented from a data-based orientation that draws on facts irrespective of whatever theoretical framework generated them. He points out that most of the tables and figures used were prepared especially for this book from recent data. There is a summary at the end of each chapter that can serve as both a study and a handy guide to the topics that are amplified in the text. Overall this reviewer was impressed with the clarity and precision with which Dr. Weiner has integrated a wealth of material based on current research. For instance, an excellent chapter entitled “Schizophrenia in Adolescence” begins with a comprehensive presentation of symptomatologyof adolescent schizophrenia based on research studies along with prognosis and treatment. Another excellent chapter is entitled “Childhood Psychosis-Infantile Autism and Childhood Schizophrenia.”In this chapter the author makes a clear distinction between the nature and course of infantile autism versus the nature and course of childhood schizophrenia. For the practicing child psychiatrist or trainee there are certain limitations to this book. First of all, it is not a comprehensive text of the psychopathology of childhood and adolescence.Major areas such as eating disorders (including anorexia nervosa, bulimia), various psychosomatic disorders, and organic syndromes, are not discussed. Treatment approaches are presented in broad generalities. This reviewer is likewise concerned that the author does not use one particular classification scheme, such as DSM-111, in outlining topics. The author does explain at the onset that the organization of the book‘s content is intended to maximize communication across various classification approaches, as diverse as they may be to reflect our current state of knowledge, as imperfect as it may be. For the most part, the author was successful in this attempt but in certain specific areas his attempts were lacking. For instance, Chapter 8, “Neurotic Disorder,” does not discuss the recent major changes under DMSI11 related to classifying these disorders. Rather the author lumps together phobic disorder, obsessive compulsive disorders, conversion reaction and habit disturbances, such as enuresis and thumb sucking. Under conversion reaction, he discusses Tourette’s syndrome in a very brief and sketchy manner. The chapter is not comprehensive as to psychodynamic understanding of the various psychoneuroses, nor is it up to date regarding related biological research.
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BOOK REVIEWS
Another concern of this reviewer relates to the chapter on delinquent behavior. Overall this is a well written, comprehensive chapter concerning various forms of delinquency, however, a major concern relates to the author’s insistence on using the term “psychopathic personality.” In the section relating to characterological delinquency, the author argues for the use in older adolescents of the diagnostic label “psychopathic personality” instead of “antisocial personality.” He feels that most clinicians and researchers consider juveniles with a DSM-I11 diagnosis of “undersocialized conduct disorder” as budding psychopaths. This reviewer is distressed by the use of this label with its negative connotations and therapeutic nihilism particulary when focusing on the adolescent. In summary, this is a well written text on selected types of psychopathology in childhood and adolescence. Specific deficits have been discussed in the preceding section. The book should prove useful for the practicing clinician, teacher and student. Reference WEINER,I. B. (1970),Psychological Disturbance in Adolescence. New York: John Wiley & Sons, Inc.
Family Therapy: Major Contributions. By Robert J. Green and James L. Framo. New York: International Universities Press. 1982, 564 pp., $30.00 Reviewed by Ira D. Glick, M.D., and John T. Patten, M.D. * Because there was not a “one-volume collection of the classic papers of family therapy,” two experienced teachers, Robert J. Green, Ph.D., and James L. Framo, Ph.D., have selected 100 papers from the literature. The book is organized in two parts, the first on “theory’) (including contributions by Bateson, Haley, Ferreira, Wynne, Lidz, Stierlin, Vogel and Bell, Satir and Bowen) and the second on “treatment” (including contributions by Ackerman, Framo, Paul, Boszormenyi-Nagy, Whitaker, Minuchin, Pittman et al., Weakland, the MRI group and the Palazzoli group). Preceding the papers, Dr. Green has written a thoughtful distillation of many of the ideas in the field and before each chapter, brief commentaries are provided. As with any attempt at summary, problems develop when lumping the ideas of diverse authors together. However, if one regards the overview not as gospel, or as a cookbook of how to understand the theory and practice of family therapy, then the authors * Ira D. Glick, M.D., is Professor of Psychiatry, Cornell University Medical College, and Associate Medical Director for Inpatient Services, Payne Whitney Clinic, The New York Hospital-Cornell Medical Center, New York. John T. Patten, M.D., is Clinical Instructor of Psychiatry, Comell University Medical College, New York.
do provide us with useful ways of thinking about ways of lumping things together. The systemic epistemologists would be horrified by the authors’ “linear” concretizing of the papers. They would assert that to say there are 12 “major concepts” and 23 “treatment guidelines” would retard rather than advance systems thinking. Yet the authors claim in no way to be providing new insights or theoretical conceptualizations. They feel the “classic papers” chosen will stand the test of time, and in that way they provide us with a well thought out and organized anthology. This book may not be everybody’s cup of tea in learning about family therapy, but compared to the alternatives-a standard textbook (Glick and Kessler, 1980) or a collection of papers by major authors in the field (Gurman and Kniskern, 1981)-any psychotherapist who wishes to pursue the origins of the family field will profit from this book. The papers themselves and the overview evoke far many more questions than they answer. Yet, in a way, that is a metaphor for, and a statement about, the “state-of-the-art” of family therapy. References GLICK, I. D. & KESSLER, D. R. (1980),Marital and Family Therapy, Ed. 2. New York: Grune & Stratton. GURMAN, A. S. & KNISKERN, D. P. (1981),Handbook of Family Therapy. New York: Brunner/Mazel.
The First Birth: A Family Turning Point. By Doris R. Entwisle and Susan G. Doering. Baltimore: The Johns Hopkins University Press. 1981, 321 pp., $25.00 Reviewed by Clarice J. Kestenbaum, M.D.? A sizeable effort has been made during the past 3 decades to examine the ways in which mothers interact with their first born children. In recent years the father’s relationship with the infant has been under scrutiny as well. The First Birth is the first book to deal with the impact of the infant on the couple. No startling revelations are made. The research could be subsumed under the rubric “What Grandmother Always Knew.” Nonetheless, the meticulous gathering of data by two social scientists who provide a combined psychological and sociological approach is, in the authors’ words, “one small step toward a fuller understanding of pregnancy, birth, and early parenting” (p. 266). The authors’ stated aims are to describe and chronicle the family life-cycle of a particular group of cou-
t Dr. Kestenbaum is Director of the Department of Child and Adolescent Psychiatry at the Roosevelt, St. Luke Site Hospital, New York, and Clinical Professor of Psychiatry, College of Physicians and Surgeons,ColumbiaUniversity,New York.
Child and Adolescent Psychopathology. By Irving B. Weiner. New York: John Wiley & Sons. 1982, 529 pp., $23.95 Reviewed by Charles M. Binger, M.D.* In recent years there have been an increasing number of books on child and adolescent psychopathology and child psychiatry. Each has had its strengths and deficits. This reviewer was familiar with Irving B. Weiner’s writing through having read and utilized clinically and in teaching an excellent book he had previously written entitled Psychological Disturbance in Adolescence (1970). According to the author, Child and Adolescent Psychopathology “provides a comprehensive description of the nature, prevalence, causes, course, outcome and treatment of the major forms of psychological disorder and problem behavior occurring in children and adolescents. Along with this emphasis on description, attention is paid throughout the book to the influential concepts, controversial issues and research findings that constitute current thinking and knowledge about developmental psychopathology, and the discussion embraces various theoretical approaches that have contributed to this knowledge” (p. iii). The book is divided into 14 chapters. The first chapter, “The Nature of Normal and Abnormal Development,” presents a broad overview correlating considerable research with definitions of normality, the continuity of normal and abnormal behavior, the prevalence of disturbances in childhood, studies relating to childhood difficulties as predictive of subsequent disturbance in adulthood, and problem behaviors in normal and disturbed adolescents.In the second chapter, the author discusses classification of developmental psychopathology. Again, this is a well written chapter focusing on possible harmful effects of classification along with benefits. He describes various approaches to classification including the more recent DSM-111. The next six chapters address specific kinds of disturbances: Mental Retardation, Minimal Brain Dysfunction or Attention Deficit Disorder, Childhood Psychosis-Infantile Autism and Childhood Schizophrenia, Schizophrenia in Adolescence, Affective Disorders-Depression and Mania, and Neurotic Disorders. Chapter 9 concerns school phobia. The following four chapters discuss problem behaviors, each of which can involve various kinds of specific disturbance: Academic Underachievement, Delinquent Behavior, SUIcidal Behavior, and Alcoliol and Drug Abuse. The final chapter reviews some unifying themes concerning * Dr. Binger is Clinical Professor of Psychiatry, Clinical Coordinator, and Training Director of Child and Adolescent Psychiatry, Department of Psychiatry, University of California,San Francisco.
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the definition, prevalence, causes, course, outcome, prevention and treatment of psychological disorders. Each chapter provides description of the nature of developmental psychopathology through case examples. Contemporary clinical and research findings are cited extensively. The author states that individual topics are presented from a data-based orientation that draws on facts irrespective of whatever theoretical framework generated them. He points out that most of the tables and figures used were prepared especially for this book from recent data. There is a summary at the end of each chapter that can serve as both a study and a handy guide to the topics that are amplified in the text. Overall this reviewer was impressed with the clarity and precision with which Dr. Weiner has integrated a wealth of material based on current research. For instance, an excellent chapter entitled “Schizophrenia in Adolescence” begins with a comprehensive presentation of symptomatologyof adolescent schizophrenia based on research studies along with prognosis and treatment. Another excellent chapter is entitled “Childhood Psychosis-Infantile Autism and Childhood Schizophrenia.”In this chapter the author makes a clear distinction between the nature and course of infantile autism versus the nature and course of childhood schizophrenia. For the practicing child psychiatrist or trainee there are certain limitations to this book. First of all, it is not a comprehensive text of the psychopathology of childhood and adolescence.Major areas such as eating disorders (including anorexia nervosa, bulimia), various psychosomatic disorders, and organic syndromes, are not discussed. Treatment approaches are presented in broad generalities. This reviewer is likewise concerned that the author does not use one particular classification scheme, such as DSM-111, in outlining topics. The author does explain at the onset that the organization of the book‘s content is intended to maximize communication across various classification approaches, as diverse as they may be to reflect our current state of knowledge, as imperfect as it may be. For the most part, the author was successful in this attempt but in certain specific areas his attempts were lacking. For instance, Chapter 8, “Neurotic Disorder,” does not discuss the recent major changes under DMSI11 related to classifying these disorders. Rather the author lumps together phobic disorder, obsessive compulsive disorders, conversion reaction and habit disturbances, such as enuresis and thumb sucking. Under conversion reaction, he discusses Tourette’s syndrome in a very brief and sketchy manner. The chapter is not comprehensive as to psychodynamic understanding of the various psychoneuroses, nor is it up to date regarding related biological research.
212
BOOK REVIEWS
Another concern of this reviewer relates to the chapter on delinquent behavior. Overall this is a well written, comprehensive chapter concerning various forms of delinquency, however, a major concern relates to the author’s insistence on using the term “psychopathic personality.” In the section relating to characterological delinquency, the author argues for the use in older adolescents of the diagnostic label “psychopathic personality” instead of “antisocial personality.” He feels that most clinicians and researchers consider juveniles with a DSM-I11 diagnosis of “undersocialized conduct disorder” as budding psychopaths. This reviewer is distressed by the use of this label with its negative connotations and therapeutic nihilism particulary when focusing on the adolescent. In summary, this is a well written text on selected types of psychopathology in childhood and adolescence. Specific deficits have been discussed in the preceding section. The book should prove useful for the practicing clinician, teacher and student. Reference WEINER,I. B. (1970),Psychological Disturbance in Adolescence. New York: John Wiley & Sons, Inc.
Family Therapy: Major Contributions. By Robert J. Green and James L. Framo. New York: International Universities Press. 1982, 564 pp., $30.00 Reviewed by Ira D. Glick, M.D., and John T. Patten, M.D. * Because there was not a “one-volume collection of the classic papers of family therapy,” two experienced teachers, Robert J. Green, Ph.D., and James L. Framo, Ph.D., have selected 100 papers from the literature. The book is organized in two parts, the first on “theory’) (including contributions by Bateson, Haley, Ferreira, Wynne, Lidz, Stierlin, Vogel and Bell, Satir and Bowen) and the second on “treatment” (including contributions by Ackerman, Framo, Paul, Boszormenyi-Nagy, Whitaker, Minuchin, Pittman et al., Weakland, the MRI group and the Palazzoli group). Preceding the papers, Dr. Green has written a thoughtful distillation of many of the ideas in the field and before each chapter, brief commentaries are provided. As with any attempt at summary, problems develop when lumping the ideas of diverse authors together. However, if one regards the overview not as gospel, or as a cookbook of how to understand the theory and practice of family therapy, then the authors * Ira D. Glick, M.D., is Professor of Psychiatry, Cornell University Medical College, and Associate Medical Director for Inpatient Services, Payne Whitney Clinic, The New York Hospital-Cornell Medical Center, New York. John T. Patten, M.D., is Clinical Instructor of Psychiatry, Comell University Medical College, New York.
do provide us with useful ways of thinking about ways of lumping things together. The systemic epistemologists would be horrified by the authors’ “linear” concretizing of the papers. They would assert that to say there are 12 “major concepts” and 23 “treatment guidelines” would retard rather than advance systems thinking. Yet the authors claim in no way to be providing new insights or theoretical conceptualizations. They feel the “classic papers” chosen will stand the test of time, and in that way they provide us with a well thought out and organized anthology. This book may not be everybody’s cup of tea in learning about family therapy, but compared to the alternatives-a standard textbook (Glick and Kessler, 1980) or a collection of papers by major authors in the field (Gurman and Kniskern, 1981)-any psychotherapist who wishes to pursue the origins of the family field will profit from this book. The papers themselves and the overview evoke far many more questions than they answer. Yet, in a way, that is a metaphor for, and a statement about, the “state-of-the-art” of family therapy. References GLICK, I. D. & KESSLER, D. R. (1980),Marital and Family Therapy, Ed. 2. New York: Grune & Stratton. GURMAN, A. S. & KNISKERN, D. P. (1981),Handbook of Family Therapy. New York: Brunner/Mazel.
The First Birth: A Family Turning Point. By Doris R. Entwisle and Susan G. Doering. Baltimore: The Johns Hopkins University Press. 1981, 321 pp., $25.00 Reviewed by Clarice J. Kestenbaum, M.D.? A sizeable effort has been made during the past 3 decades to examine the ways in which mothers interact with their first born children. In recent years the father’s relationship with the infant has been under scrutiny as well. The First Birth is the first book to deal with the impact of the infant on the couple. No startling revelations are made. The research could be subsumed under the rubric “What Grandmother Always Knew.” Nonetheless, the meticulous gathering of data by two social scientists who provide a combined psychological and sociological approach is, in the authors’ words, “one small step toward a fuller understanding of pregnancy, birth, and early parenting” (p. 266). The authors’ stated aims are to describe and chronicle the family life-cycle of a particular group of cou-
t Dr. Kestenbaum is Director of the Department of Child and Adolescent Psychiatry at the Roosevelt, St. Luke Site Hospital, New York, and Clinical Professor of Psychiatry, College of Physicians and Surgeons,ColumbiaUniversity,New York.