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Child Psychiatry and the General Practitioner
Book Reviews CHILD PSYCHIATRY AND THE GENERAL PRACTITIONER. Edited by Adam J. Karowski, M.D. and Dante A. Santora. Springfield, Ill.: Cilarles C Tilomas. This book was written to provide an understanding of the types of prohlems that face the physician in the daily practice of medicine. It stresses the need for an awareness of the dynamic relationship existing between the child and the parents; parents often experience feelings of guilt when their child becomes emotionally ill and prefer an organic explanation for the difficulties. A chapter on "Psychosomatic Disorders" indicates the role of conRict in these situations in which feelings are expressed through the language of the body. Psychodynamics, throughout the book, is expressed in a clear and concise manner. The orientation is predominantly Freudian with some of the modifications suggested by Rado in his theory of adaptational psychodynamics. The difficulties in the diagnosis of depression and conversion reactions are underscored, especially in the presence of somatic complaints and/or somatic illness. The need to evaluate the soma as well as the psyche is constantly stressed. A description of the schizophrenic child is presented through a case study, in which the complexities of the prohlem are vividly portrayed. The effects of hospitalization on a child as well as its family are studied in detail. ~Iethods of prevention of emotional upheavals as well as detailed instructions as to management are provided. Drug therapy receives adequate coverage. This book will adequately meet the needs of physicians who seek an understanding of their role in the management of emotional problems of children. It will not only make for better therapeutic handling but will aid in the recognition of limitations and the need for psychiatric referral. W.D.
MULTIPLE SCLEROSIS-P R 0 G NOS I SAND TREATMENT. By Leo Alexander, M.D., Austin W. Berkeley, PlI.D., and Alene M. Alexander. 188 pages. Springfield, Illinois: Cilarles C Tilomas, 1961. $7.50. The authors provide a study of the quantitative aspects of the disease in order to "provide order and predictability." By measuring the facts of age, duration of illness and of specific attacks and correlating these with a quantitative measure of severity of neurological involvement and disability, they provide guides to prognosis and treatment. This book is based on a study of 554 cases in which a positive diagnosis was made. It was found that the greater the degree of recovery from a preceding attack or attacks, the more likely is the patient January-February, 1963
to achieve recovery from subsequent ones. The worst cases are those in which there is no recovery between attacks, the disease progressing without interruption. Evidence is presented that two kinds of the disease exist: an inexorably progressive one and a mild form. The earliest time at which the difference can be ascertained is five years. Evaluation of treatment by blood transfusions pointed to a beneficial effect, especially in those cases whose natural recovery potential was the poorest. The use of ACTH and steroid hormones was evaluated in 39 patients who received intensive treatment as compared to matched controls and pointed to the effectiveness of the therapy. The book will be of value to both the general physician and neurologist. It offers an excellent review of the disease and a stimulating attempt to sharpen the clinician's prognostic and therapeutic ability.
w.o.
PSYCHOLOGICAL EVALUATION OF THE CEREBRAL PALSIED PERSON. By R. B. AUen and T. W. Jefferson. 86 pages. Springfield, IUin0i8: Cilarles C Thomas, 1962. This is another monograph in the American Lectures in Psychology. Although the authors emphasize the individuality of response among the victims of cerebral palsy, they present practical guide-lines for the selection of psychological tests, the administration, interpretation and use of assessment findings. The authors emphasize the multiple-handicapped modalitics of the cerebral palsy individuals and the high incidence of speech impairment, mental retardation, hearing impairment and convulsive disorders. They suggest two batteries of tests for the assessment of intellectual status. One is utilized with subjects who are capable of following oral instructions on test items that do not require motor factors for performance. The second is designed for those subjects who are unable to take tests due to a serious handicap. Conclusions on the latter group are inferential. Some valuable check lists are supplied to the reader for the survey of physical handicaps, the physical abilities necessary for the use of the Stanford-Binet Form L-M, the Wechsler Intelligence Scale for Chilelren and The Wechsler Adult Intelligence Scale. An earthy picture of the role of personality tests as tapping the effects of the handicap is painstakingly outlined. The authors conclude this little volume with a discussion of the limitations of standardized aptitude test batteries for the physically handicapped. Here the clinician must call upon "experience and ingenuity" in the choice of tests and/or the adaptation of standardized tests. A number of research projects are currently exploring work samples to determine work potential.
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MULTIPLE SCLEROSIS-P R 0 G NOS I SAND TREATMENT. By Leo Alexander, M.D., Austin W. Berkeley, PlI.D., and Alene M. Alexander. 188 pages. Springfield, Illinois: Cilarles C Tilomas, 1961. $7.50. The authors provide a study of the quantitative aspects of the disease in order to "provide order and predictability." By measuring the facts of age, duration of illness and of specific attacks and correlating these with a quantitative measure of severity of neurological involvement and disability, they provide guides to prognosis and treatment. This book is based on a study of 554 cases in which a positive diagnosis was made. It was found that the greater the degree of recovery from a preceding attack or attacks, the more likely is the patient January-February, 1963
to achieve recovery from subsequent ones. The worst cases are those in which there is no recovery between attacks, the disease progressing without interruption. Evidence is presented that two kinds of the disease exist: an inexorably progressive one and a mild form. The earliest time at which the difference can be ascertained is five years. Evaluation of treatment by blood transfusions pointed to a beneficial effect, especially in those cases whose natural recovery potential was the poorest. The use of ACTH and steroid hormones was evaluated in 39 patients who received intensive treatment as compared to matched controls and pointed to the effectiveness of the therapy. The book will be of value to both the general physician and neurologist. It offers an excellent review of the disease and a stimulating attempt to sharpen the clinician's prognostic and therapeutic ability.
w.o.
PSYCHOLOGICAL EVALUATION OF THE CEREBRAL PALSIED PERSON. By R. B. AUen and T. W. Jefferson. 86 pages. Springfield, IUin0i8: Cilarles C Thomas, 1962. This is another monograph in the American Lectures in Psychology. Although the authors emphasize the individuality of response among the victims of cerebral palsy, they present practical guide-lines for the selection of psychological tests, the administration, interpretation and use of assessment findings. The authors emphasize the multiple-handicapped modalitics of the cerebral palsy individuals and the high incidence of speech impairment, mental retardation, hearing impairment and convulsive disorders. They suggest two batteries of tests for the assessment of intellectual status. One is utilized with subjects who are capable of following oral instructions on test items that do not require motor factors for performance. The second is designed for those subjects who are unable to take tests due to a serious handicap. Conclusions on the latter group are inferential. Some valuable check lists are supplied to the reader for the survey of physical handicaps, the physical abilities necessary for the use of the Stanford-Binet Form L-M, the Wechsler Intelligence Scale for Chilelren and The Wechsler Adult Intelligence Scale. An earthy picture of the role of personality tests as tapping the effects of the handicap is painstakingly outlined. The authors conclude this little volume with a discussion of the limitations of standardized aptitude test batteries for the physically handicapped. Here the clinician must call upon "experience and ingenuity" in the choice of tests and/or the adaptation of standardized tests. A number of research projects are currently exploring work samples to determine work potential.
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