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Modern perspectives in child psychiatry
B&w.
Rcs. Thu. 1965, Vol. 3, pp. 65 to 68. Per&amon Press Ltd. PrInted in England.
BOOK J. G. HOWELLS (Ed.):
Modem
Perspectives
REVIEWS
itz Child Ps~~hin/r~‘.
Oliver
and Boyd.
105s.
THE recent
months have brought a flurry of textbooks of psychiatry upon us. Most of them deal little or not at all with the psychiatric problems of childhood and adolescence. The chapter on this subject in the currently most popular standard British textbook avowedly borrows considerably from Leo Kanner’s ’ Child Psychiatry, ’ first published thirty years ago in the United States. Kanner’s psychobiological approach remains as valuable as when it was first enunciated. but the emergence of new psychological and sociological theories, together with new albeit unevaluated therapeutic techniques make it appropriate that a new text book devoted entirely to child psychiatry should be published. Because the specialty is one in which national diflerences in clinical approach and available facilities vary considerably, the need for a standard British book is correspondingly greater. To some extent in spite of the editor’s expressed wishes to avoid an attempt at complete coverage, ’ Modern Perspectives in Child Psychiatry ’ goes quite a long way to satisfy this need. The first half of the book entitled ’ Scientific Basis of Child Psychiatry ’ contains contributions of greatly varying depth and breadth, dealing with aspects of child psychology, ethology, and medical genetics. The application of learning theory to child psychiatry is covered clearly and in some detail by Eysenck and Rachman. They cite numerous case histories to support their view of the vnluc of behaviour therapy and discuss underlying concepts. The failure of some neurotic symptoms to show extinction over a prolonged period of time is here explained on the basis of the formation of a secondary instrumental conditioned response superimposed on a classical conditioning situation. There is a need for more controlled studies of therapy in this field. but meanwhile, when reviewing the literature it seems important to mention such trials (for example that reported by Cooper) as have already been carried out. In this section, the formula on page 154 should read X~~IOO(1 _ JO 0.00?38~). Other rewarding chapters in this section include that by Mary Woodward on ’ Piagct’s Theory. ’ Mom space might have been given to Piaget’s view of the moral development of the child as it is here that perhaps his theory is most rclcvant for child psychiatrists, but in general this is a valuable summary of Piaget’s voluminous works. H. Gwynne Jones has written well on ‘ Research Methodology and Child Psychiatry, ’ emphasising the dilferences in role and attitude between the clinician and the research worker. The second half of the book, dealing with clinical aspects, seems to betray some confusion either 01 editorial purpose or direction. Some of the chapters. such as that by Warren on the ‘ Psychiatry of Adolescence ’ are invaluable down-to-earth accounts of practical clinical management. Many of the chapters such as this one would have been more at home in a comprehensive textbook of child psychiatry (which this book makes no prctence to be). Others (and here the section by Peter Scott on ‘ Delinquency ’ is noteworthy for its stimulating readability) provide useful reviews of current research trends. P. H. Connsll has written an interesting clinical account of ‘ Suicide Attempts in Childhood and Adolescence, ’ and IV. J. Blachford Rogers has contributed a detailed account of his in-patient psychiatric unit which would be helpful to anyone involved in the setting up of a similar department. The chapter entitled ‘ The Contribution of Psychological Tests to Child Psychiatry ’ makes a somewhat unorthodox plea for tests of low reliability and emphasises the value of projecttve tests. It is clear however that the author, John R. Lickorish, regards these tests as techniques helpful mainly to elicit clinical information rather than to arrive at diagnoses. The uneven nature of the contributions makes it difhcult to recommend this book wholeheartedly. A number of the clinical chapters contain material which is not available elsewhere. These will be important reading for the psychiatrist-in-training. Educational psychologists will find little new in the chapters dealing with their field, but the clinical psychologist not acquainted with theory and techniques of behaviour therapy will iind this a useful introduction. No practising child psychiatrist should be without this book, representing as it does the views of most of those prominent in British child psychiatry today in the fields in which they have taken particular interest. P. GRAHAM
65
Rcs. Thu. 1965, Vol. 3, pp. 65 to 68. Per&amon Press Ltd. PrInted in England.
BOOK J. G. HOWELLS (Ed.):
Modem
Perspectives
REVIEWS
itz Child Ps~~hin/r~‘.
Oliver
and Boyd.
105s.
THE recent
months have brought a flurry of textbooks of psychiatry upon us. Most of them deal little or not at all with the psychiatric problems of childhood and adolescence. The chapter on this subject in the currently most popular standard British textbook avowedly borrows considerably from Leo Kanner’s ’ Child Psychiatry, ’ first published thirty years ago in the United States. Kanner’s psychobiological approach remains as valuable as when it was first enunciated. but the emergence of new psychological and sociological theories, together with new albeit unevaluated therapeutic techniques make it appropriate that a new text book devoted entirely to child psychiatry should be published. Because the specialty is one in which national diflerences in clinical approach and available facilities vary considerably, the need for a standard British book is correspondingly greater. To some extent in spite of the editor’s expressed wishes to avoid an attempt at complete coverage, ’ Modern Perspectives in Child Psychiatry ’ goes quite a long way to satisfy this need. The first half of the book entitled ’ Scientific Basis of Child Psychiatry ’ contains contributions of greatly varying depth and breadth, dealing with aspects of child psychology, ethology, and medical genetics. The application of learning theory to child psychiatry is covered clearly and in some detail by Eysenck and Rachman. They cite numerous case histories to support their view of the vnluc of behaviour therapy and discuss underlying concepts. The failure of some neurotic symptoms to show extinction over a prolonged period of time is here explained on the basis of the formation of a secondary instrumental conditioned response superimposed on a classical conditioning situation. There is a need for more controlled studies of therapy in this field. but meanwhile, when reviewing the literature it seems important to mention such trials (for example that reported by Cooper) as have already been carried out. In this section, the formula on page 154 should read X~~IOO(1 _ JO 0.00?38~). Other rewarding chapters in this section include that by Mary Woodward on ’ Piagct’s Theory. ’ Mom space might have been given to Piaget’s view of the moral development of the child as it is here that perhaps his theory is most rclcvant for child psychiatrists, but in general this is a valuable summary of Piaget’s voluminous works. H. Gwynne Jones has written well on ‘ Research Methodology and Child Psychiatry, ’ emphasising the dilferences in role and attitude between the clinician and the research worker. The second half of the book, dealing with clinical aspects, seems to betray some confusion either 01 editorial purpose or direction. Some of the chapters. such as that by Warren on the ‘ Psychiatry of Adolescence ’ are invaluable down-to-earth accounts of practical clinical management. Many of the chapters such as this one would have been more at home in a comprehensive textbook of child psychiatry (which this book makes no prctence to be). Others (and here the section by Peter Scott on ‘ Delinquency ’ is noteworthy for its stimulating readability) provide useful reviews of current research trends. P. H. Connsll has written an interesting clinical account of ‘ Suicide Attempts in Childhood and Adolescence, ’ and IV. J. Blachford Rogers has contributed a detailed account of his in-patient psychiatric unit which would be helpful to anyone involved in the setting up of a similar department. The chapter entitled ‘ The Contribution of Psychological Tests to Child Psychiatry ’ makes a somewhat unorthodox plea for tests of low reliability and emphasises the value of projecttve tests. It is clear however that the author, John R. Lickorish, regards these tests as techniques helpful mainly to elicit clinical information rather than to arrive at diagnoses. The uneven nature of the contributions makes it difhcult to recommend this book wholeheartedly. A number of the clinical chapters contain material which is not available elsewhere. These will be important reading for the psychiatrist-in-training. Educational psychologists will find little new in the chapters dealing with their field, but the clinical psychologist not acquainted with theory and techniques of behaviour therapy will iind this a useful introduction. No practising child psychiatrist should be without this book, representing as it does the views of most of those prominent in British child psychiatry today in the fields in which they have taken particular interest. P. GRAHAM
65