Concise oxford textbook of psychiatry

Behav. Res. Ther. Vol. 33, No. 5, pp. 613-617, 1995

Pergamon

Elsevier Science Ltd. Printed in Great Britain 0005-7967(94)00097-2

BOOK REVIEWS HANS OLAV FEKJAER: Alcohol and Illicit drugs: Myths and Realities, IOGT Alcohol and Drug Information Centre, Colombo, Sri Lanka (1993). 149 pp. $22.00 This is an interesting book which challenges some widely accepted beliefs about the nature of alcohol and drug intoxication. It is divided into two main sections, unconscious and conscious motives for alcohol use. Although the section titles refer only to alcohol, other drugs are also mentioned. Chapter l discusses the social and symbolic role of intoxicants in society. Chapter 2 deals with self-handicapping through intoxication, one of the unconscious motivations behind drinking. In order to maintain a self concept of a competent and intelligent individual, patients may choose to handicap themselves through the use of alcohol or drugs. The author rejects the explanation that patients drink alcohol so as to relieve anxiety about performance. He believes that the individual chooses drug use as this leads society to attribute any failure to intoxication rather than to qualities of the individual. This argument is extended in Chapter 3 where alcohol is seen as an alibi for behaviour. Alcohol is blamed for the patient's violence and this is likened to giving one's conscience a holiday. The second section deals with the physical and psychological effects of substance misuse highlighting discrepancies between the user's subjective accounts of the effects of drugs or alcohol and the findings that have been derived from research studies. The author emphasises that it is the socially derived interpretation of drug effects that determines whether or not the individual gets 'high' from drug or alcohol use. He then goes on to discuss how education to separate intoxication from disinhibition may be a potential therapeutic intervention to modify the subject's substance misuse. Those readers treating patients with substance abuse problems are likely to find this book of interest although I feel this is more a book to browse through in the library rather than to buy. JANE TILLER

G. C. DAVISON and J. M. NEALE: Abnormal Psychology, 6th edn. Wiley, New York (1994). x x i v + 7 8 2 p p . £21.00 Davison and Neale's textbook on abnormal psychology has been a leading work in the field for twenty years. It has, once again, been revised, keeping to the four-year interval between editions. Most readers of this journal would be familiar with earlier editions of this volume. As an introduction to abnormal psychology, the book tries to answer two questions: What causes psychological problems? and; What treatments are most effective for these problems? The approach is scientific, but with a strong clinical flavour. The discussion of models and conceptualisations encourages critical examination by the reader. What is new in this latest edition? Several features may be listed. The DMS-IV draft categories and criteria are used. There are more clinical case vignettes at the beginning of chapters. Cultural diversity is discussed more fully. New empirical and theoretical materials are provided in most areas, especially post traumatic stress disorder, HIV/AIDS, and sexual abuse. The book also attempts more at integration of different approaches, in various content areas. The book is well presented, geared towards the convenience of the student, with focus boxes, illustrations, diagrams and summaries. There is a lot of colour, pleasingly used. Apart from its obvious value as a student text, does this new edition have any relevance to therapists? In the reviewer's view, its up-to-date summaries of many areas are useful quick reading for anyone. Also, some topics and issues are very well covered--e.g., ethical and legal issues in therapy and research, and some innovative therapeutic strategies. So, all in all, this latest version of an old favourite is to be highly recommended. A. READ

M. GELDER, D. GATHand R. MAYOU: Concise Oxford Textbook of Psychiatry. Oxford University Press, Oxford (1994). viii + 467 pp. £14.95 This is a shortened version of a well established and widely used textbook on psychiatry, the Oxford Textbook of Psychiatry. The aim has been to provide a short, practical guide for practitioners who are not specialists in mental health, and for clinical medical students. Thus it is relatively brief in its discussion of topics, somewhat didactic, and lacking in references. It is an introduction only, and the authors make this very clear. The most relevant chapter, from the point of view of the readers of this journal, is that on psychological treatment (Chapter 18). This offers a simple classification of psychological therapies into four, based on aim: Relief of distress, readjustment, restoration of function and reconstruction. A parallel classification of techniques gives us: Counselling, cognitive-behavioural and psychodynamic. These are sensible, a n d - - f o r the beginner--useful. However, the identification of 'treatment aimed at reconstruction' exclusively with psychodynamic therapy will be disputed by many. Recent work in cognitive therapy aims to do just that. Although the book does not have references, it does give titles for further reading. These are, on the whole, well selected. 613

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Book Reviews

In sum, a very good basic introduction to psychiatry, better than most of its rivals. It should be particularly good for medical students in their clinical years. For practitioners, it is a good starting point, but--as I am sure the authors would agree--they would need to read more before they actually attempt to practice psychiatry. P. DE SILVA

P. FELDMAN: The Psychology of Crime--A Social Science Textbook. Cambridge University Press, Cambridge (1993). xxiii + 526 pp. £37.50 This book is presented as an overview of current theory and research in criminology, where the emphasis is intended to be largely psychological but with some integration of sociological perspectives. The title indicates that the book is marketed as a 'social sciences textbook'. It is intended to be especially valuable to undergraduate and postgraduate courses across the field of social sciences. The book is in four parts. Part I, "Description', deals with the definitions and classifications of criminal offences, as well as discussing offenders, their victims, the police and the courts. Part II, 'Explanation', consists of six chapters, which focus on the causes of crime. Part III, 'Control', discusses the penal system, therapeutic interventions and crime prevention. In Part IV, 'Summary', the main conclusions from the individual chapters are summarised. The greatest value of this book lies in the author's ability to give a very clear, detailed and interesting overview of the changing trends in criminological thinking. It provides the reader with a valuable insight into how ideas about crime and criminals change through succeeding generations. The main problem with this book is that the author consistently fails to present up-to-date literature. Indeed, the book fails in its aims to present 'current' theory and research. As an example, out of the 58 pages of references, there are only 10 references from 1990 onwards and 7 of those are from articles in the Economist. In some areas, the literature is over 10 yrs out of date. Secondly, the material presented is quite selective. For example, in Chapter 4 Feldman focuses exclusively on the American Court System which is of little interest or relevance to British readers. Thirdly, there are some serious inaccuracies in the book. For example, Feldman repeatedly confuses the EPQ with the EPI. On page 88, Feldman wrongly attributes the work of Irving and Hilgendorf for the Royal Commission on Criminal Procedure to David Farrington. Fourthly, even though the book contains a chapter on individual differences, the author fails to discuss the relevance of individual differences to specific offences. Finally, the spelling used in the book alternates between English and American, even on the same page, which may irritate some readers. Overall, this is a somewhat disappointing book which presents a great deal of interesting material, but fails to keep up-to-date with the current literature. GISLI GUDJONSSON

NATHANIEL McCONAGHY: Sexual Behavior--Problems and Management. Plenum Press, New York (1993). xii + 414 pp. $60.00 Many books have appeared in recent years on sexuality and sexual problems. Given the increasing public discussion of sex and sexual behaviour, and the increasing availability of therapeutic services for sexual difficulties, this is not surprising. Not all of these books, however, are written by authors who have made a major, genuine contribution to the study of sex through solid, empirical work. The present volume is one which has just that kind of author. Nathaniel McConaghy's work in the field of sex and sexual problems spans over a quarter of a century, and has been widely recognized as a major contribution. This book, which is an ambitious, full-length text which attempts an overview of the whole range of sexual behaviours and sexual problems, bears the hallmark of the author's experience and first hand knowledge. The book consists of eight substantial chapters, covering the following areas: assessment of sexual activity; biological influences; homosexuality/heterosexuality; transvestism and transsexualism; sexual dysfunctions and difficulties; child-adult sexual activity; sexual coercion and assault; and sexual deviations. The chapters give some detailed discussions of the topics. Much of the book is clinically relevant, and practitioners will find many sections to be excellent sources of information on major topics of clinical concern. For example, McConaghy gives excellent discussions of penile plethysmography, of the management of sexual offences and deviations and of the aetiology of homosexuality/heterosexuality. A particular strength of the book is the author's wholly laudable attempt to examine critically what is believed concerning sexual behaviour. Many of these beliefs reflect entrenched political positions, and it is no easy task to de-politicise the field. McConaghy's balanced, authoritative book should go a long way towards liberating the field of sex, as an academic and clinical discipline, from these political positions. On the whole, this is an excellent, original book which will surely be greatly appreciated by researchers and clinicians alike. OLWEN McGREGOR

HOWARD RACHLIN: Behavior and Mind: The Roots o f Modern Psychology. Oxford University Press, New York (1994). viii + 163 pp. In this book, the author, an acknowledged authority on behaviourist psychology, introduces a new doctrine which he calls 'teleological behaviorism'. This is a post-Skinnerian development which stresses the consequences of our actions for an