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Doody's Review ServiceReviewer: Michael Joel Schrift, D.O., M.A.(University of Illinois at Chicago College of Medicine)
Description: This book focuses on the influence of relational processes to psychopathology. The theme throughout is that relational processes must be part of any empirically based plan for revising nosology in the future DSM-V. Unfortunately, the current psychiatric nosology has yet to be empirically based! I cannot understand the logic of adding more unvalidated diagnoses to the DSM — why not validate and biologically delineate the "disorders" we already have? The current DSM diagnostic groupings based on psychopathology, on groupings of symptoms, theories of etiology, and precipitating events, are not empirically based but are definitions generated by committee consensus and are not necessarily related to how the brain is biologically organized. It seems to me that this book is a proposal to expand this inherently flawed method of nosologic generation. Although the book is written and edited by respected clinician-researchers and several of the chapters are quite interesting, I do not believe the proposal that this book emphasizes will be helpful to the field.
Purpose: The purpose "is to develop a shared commitment on the part of clinicians, researchers, psychopathologists, consumers, and advocates who have an interest in the revision of the DSM to take seriously the issue of relational processes as they relate to the diagnoses within the DSM."
Audience: The targeted audience includes clinical psychiatrists, psychologists, social workers, and psychiatric researchers.
Features: The book is divided into four parts. Part 1, which is quite good, summarizes the biological aspects of social behavior with excellent chapters on topics such as the neurobiology of the social brain and the role of animal models. Part 2 focuses on assessment and includes chapters on childhood maltreatment and adult psychopathology (genetics didn't seem to be accounted for), relational diagnoses and their connection to axis I and II. Part 3 covers prevention and treatment, and part 4 is a summary. Each chapter ends with relevant citations of the literature.
Assessment: The DSM-IV task force determined that there was not enough of an empirical base to include relational disorders in the DSM-IV. I hope a similar task force for the DSM-V repeats that conclusion. Unfortunately, this book did not convince me to change that hope.