Childhood Disorders
Resources

 email page    print page

All Topic Reviews
12 and HoldingA Guide to Asperger SyndromeA Lethal InheritanceA Mother's Courage: Talking Back to AutismA Parent's Guide to Asperger Syndrome and High-Functioning AutismA Special EducationA Toss Of The DiceA Tribe ApartA User Guide to the GF/CF Diet for Autism, Asperger Syndrome and AD/HDA Walk in the Rain With a BrainABC of Eating DisordersADD-Friendly Ways to Organize Your LifeADHD Grown UpADHD in the Schools: Assessment and Intervention StrategiesADHD NationAdolescence and Body ImageAdolescent DepressionAggression and Antisocial Behavior in Children and AdolescentsAll Alone in the UniverseAlpha GirlsAmericaAnother PlanetAntisocial Behavior in Children and AdolescentsAsperger Syndrome and Your ChildAsperger Syndrome, Adolescence, and IdentityAsperger's and GirlsAssessment of Childhood DisordersAttention Deficit DisorderAttention-Deficit Hyperactivity DisorderAttention-Deficit/Hyperactivity DisorderAutism - The Eighth Colour of the RainbowAutism and MeAutism's False ProphetsAutistic Spectrum DisordersBad GirlBeen There, Done That? DO THIS!Before I DieBetween Two WorldsBeyond AppearanceBig Mouth & Ugly GirlBipolar ChildrenBipolar Disorder in Childhood and Early AdolescenceBipolar DisordersBipolar KidsBlackwell Handbook of Childhood Cognitive DevelopmentBody Image, Eating Disorders, and ObesityBody Image, Eating Disorders, and Obesity in YouthBoy AloneBrain-Based Therapy with Children and AdolescentsBreaking PointBreathing UnderwaterBringing Up ParentsBullying and TeasingBullying PreventionBut I Love HimCan't Eat, Won't EatCaring for a Child with AutismCatalystChild and Adolescent PsychiatryChild and Adolescent Psychological DisordersChild and Adolescent PsychopathologyChild NeuropsychologyChild Well-BeingChildren and SexualityChildren Changed by TraumaChildren with Emerald EyesChildren with Sexual Behavior ProblemsChildren, Sexuality and SexualizationChildren’s Dreaming and the Development of Consciousness City of OneCommunication Issues In Autism And Asperger SyndromeConcepts of NormalityConcise Guide to Child and Adolescent PsychiatryConquering the Beast WithinConsuming KidsContesting ChildhoodCount Us InCrackedCrossesCutCyber-Safe Kids, Cyber-Savvy TeensDamageDemystifying the Autistic ExperienceDescartes' BabyDilemmas of DesireDirtyDisconnected KidsDoing SchoolDon't Bother Me Mom--I'm Learning!Don't Pick On MeDying to Be ThinEarly Intervention Programs and PoliciesEating an ArtichokeEducating Children With AutismEight Stories UpElijah's CupEmerald City BluesEmotional and Behavioral Problems of Young ChildrenEpilepticEthical Dilemmas in PediatricsEvery Girl Tells a StoryExiting NirvanaExploiting ChildhoodEye ContactFacing BipolarFamily HistoryFast GirlsForever YoungFreaks, Geeks and Asperger SyndromeFreewillFrictionGirl CultureGirl in the MirrorGirlfightingGirlhoodGirlWiseHandbook of Evidence-Based Therapies for Children and AdolescentsHandbook of Preschool Mental HealthHealing ADDHelping Children Cope With Disasters and TerrorismHelping Hyperactive KidsHelping Parents, Youth, and Teachers Understand Medications for Behavioral and Emotional ProblemsHelping Students Overcome Depression and AnxietyHelping Teens Who CutHollow KidsHope's BoyHow Infants Know MindsHow to Keep Your Teenager Out of Trouble and What to Do If You Can'tHurry Down SunshineI Am Not Joey PigzaIdentifying Hyperactive ChildrenIf Your Adolescent Has an Eating DisorderIn the Company of CraziesIncorporating Social Goals in the ClassroomIntegrated YogaIntrusive ParentingIssues for Families, Schools and CommunitiesJake RileyJoey Pigza Loses ControlJoey Pigza Swallowed the KeyJuvenile-Onset SchizophreniaKim: Empty InsideLearning and Behavior Problems in Asperger SyndromeLearning Disorders and Disorders of the Self in Children and AdolescentsLearning Outside the Lines Let Kids Be KidsLiberation's ChildrenLife As We Know ItLisa, Bright and DarkLook Me in the EyeLoserLove and SexLove That DogMad at SchoolMaking ADD WorkMaking American BoysManicMastering Anger and AggressionMaverick MindMedicating ChildrenMind FieldsMind to MindMommy I'm Still in HereMore Than a LabelMy Flesh and BloodMyths of ChildhoodNew Hope for Children and Teens with Bipolar DisorderNew Look at ADHD: Inhibition, Time, and Self-ControlNo Child Left DifferentNo Two AlikeNon-Drug Treatments for ADHDNot Much Just Chillin'NurtureShockOdd Girl OutOdd Girl Speaks OutOne Hot SecondOne in ThirteenOphelia SpeaksOphelia's MomOur Journey Through High Functioning Autism and Asperger SyndromeOut of the WoodsOvercoming ADHDOvercoming School AnxietyParenting a Child Who Has Intense EmotionsParenting Children With ADHDParenting Your Out-Of-Control TeenagerPediatric PsychopharmacologyPediatric PsychopharmacologyPediatric PsychopharmacologyPeople with HyperactivityPhobic and Anxiety Disorders in Children and AdolescentsPINSPlease Don't Label My ChildPraising Boys WellPraising Girls WellProblem Child or Quirky Kid?Problem GirlsPsychotherapy for Children and AdolescentsPsychotherapy with Children and AdolescentsPurgeRaising a Moody ChildRaising BlazeRaising Generation RxRaising Resilient ChildrenReady or Not, Here Life ComesReclaiming Our ChildrenRedressing the EmperorReducing Adolescent RiskRemembering Our ChildhoodResilience in ChildrenRethinking ADHDReweaving the Autistic TapestryRitalin is Not the Answer Action GuideRitalin NationRunning on RitalinRunning with ScissorsRutter's Child and Adolescent PsychiatrySeeing EzraSex and the American TeenagerSex, Therapy, and KidsSexting and Young PeopleSexual Teens, Sexual MediaShort Term 12Should I Medicate My Child?SmashedSnapshots of AutismSongs Without WordsSophie Spikey Has a Very Big ProblemSpeakStaying Connected to Your TeenagerStick FigureStraight Talk about Psychiatric Medications for KidsStraight Talk about Psychological Testing for KidsStraight Talk about Your Child's Mental HealthStrange SonStudent DepressionSuicidal Behavior in Children and AdolescentsSurvival Strategies for Parenting Children with Bipolar DisorderSurviving OpheliaTaking Charge of ADHD, Revised EditionTaming the Troublesome ChildTemple GrandinThe American Psychiatric Publishing Textbook Of Child And Adolescent PsychiatryThe Anti-Romantic ChildThe Bipolar ChildThe Boy Who Loved WindowsThe Boy Who Was Raised as a DogThe Buffalo TreeThe Bully Action GuideThe Bully, the Bullied, and the BystanderThe Burn JournalsThe Color of AbsenceThe Curious Incident of the Dog in the Night-TimeThe Depressed ChildThe Developing MindThe Dragons of AutismThe Einstein SyndromeThe EpidemicThe Evolution of ChildhoodThe Explosive ChildThe Eyes of van GoghThe Fasting GirlThe Field of the DogsThe Flight of a DoveThe Hidden Gifts of the Introverted ChildThe Horse BoyThe Identity TrapThe Inner World of a Suicidal YouthThe Inside Story on Teen GirlsThe Kindness of StrangersThe Last Normal ChildThe Little MonsterThe Medicated ChildThe Myth of LazinessThe New Gay TeenagerThe Nurture AssumptionThe OASIS Guide to Asperger SyndromeThe Other ParentThe Perversion of YouthThe Philosophy of AutismThe Psychoanalytic Study of the ChildThe Real Truth About Teens and SexThe Ride TogetherThe Rise and Fall of the American TeenagerThe Science of ADHDThe Sex Lives of TeenagersThe Survival Guide for Kids With LD*The Unhappy ChildThen Again, Maybe I Won'tTherapy with ChildrenThings I Have to Tell YouThings Tom LikesThrough the Glass WallThumbsuckerTotally WiredTouching Spirit BearTrauma in the Lives of ChildrenTreating ADHD and Comorbid DisordersTreatment of Childhood DisordersTwistedUnder the Wolf, Under the DogUnhappy TeenagersUnstrange MindsWastedWe've Got IssuesWeather Reports from the Autism FrontWhat about the KidsWhat in the World Are Your Kids Doing Online?What Works for Whom?What Would Joey Do?What's Happening to My Body? Book for BoysWhat's Happening to My Body? Book for GirlsWhat's Happening to Tom?When Nothing Matters AnymoreWhen Your Child Has an Eating DisorderWhose America?Why Don't Students Like SchoolWill's ChoiceWinnicott On the ChildWorried All the TimeYou Hear MeYoung Minds in Social WorldsYoung People and Mental HealthYour Child, Bully or Victim?

Related Topics
Aggression and Antisocial Behavior in Children and AdolescentsReview - Aggression and Antisocial Behavior in Children and Adolescents
Research and Treatment
by Daniel F. Connor
Guilford Press, 2002
Review by Jack R. Anderson, M.D.
May 14th 2004 (Volume 8, Issue 20)

In the 480 pages of this book, Connor has assembled, organized and discussed an immense treasure-trove of information about a problem that poses an ever-increasing threat to the very foundations of civilization—the problem of violence, aggression and antisocial behavior. Connor addresses this problem at its inception during the developmental periods of childhood and adolescence.

The possibility is raised that early identification of at-risk children and adolescents, followed by appropriate and persistent intervention, might reverse the current trends of increasing adult violence, overwhelmed police forces and over-crowded correctional facilities. Unfortunately, the author notes, a study of health insurance coverage found that more than four million youngsters, aged 10-18 years, had no coverage at all in the United States for the year 1995. "In short, the caveat is that the very youth who need comprehensive, readily available and long-duration mental health care for CD may not have enough (or any) mental health insurance coverage—and that mental health treatment without adequate funding is never satisfactory or effective."

Chapter 1, "Definitions and Subtyping of Aggressive Behavior," differentiates between aggressive behaviors that are adaptive—e.g. for self-preservation or defense of the family or community, and those that are maladaptive—antisocial and criminal behaviors.

Terms currently used to describe maladaptive aggression vary according to their social contexts. For example, the same terms may have different meanings in medical settings than they do in criminal justice studies. It is recommended that common terminology be adopted for all settings so that research can allow for more explicit distinction of various types and sub-types. Such distinction is necessary because of differences in risk factors, etiologies, prognoses and treatments.

Chapter 2, "Prevalence of Aggression, Antisocial Behaviors and Suicide," gives evidence that the current rates of maladaptive aggression in children and adolescents, with resultant injuries and deaths, present a serious public health problem for the United States. Identification and treatment of affected individuals are among the greatest challenges for professionals in juvenile justice, educational, psychiatric and mental health treatment settings.

Chapter 3, "Stability, Impairment and Desistance," discusses the importance of early differentiation of sub-types so that those who will have lifelong antisocial behavior patterns are identified and treated early.

Chapter 4, "Categorical Psychiatric Diagnoses and Aggression," points out that aggression in the context of these diagnoses has "multidimensional, diverse and complex etiologies." There is no simple way to explain or understand such aggression.

These first four chapters taken together may be considered as a section intended to acquaint us with the nature and scope of the aggression problem.

 

The next four chapters, chapters 5 through 8, consider the various social and biological factors that are found to be associated with increased maladaptive aggressive behavior.

"Chapter 5, "Risk and Protective Factors in Aggression and Related Behaviors," defines risk factors as "conditions and influences that predispose children and adolescents to the maladaptive expression of aggressive behavior," and protective factors as "contingencies that shield youngsters from the influence of risk factors."

Individual risk factors discussed are: heritable factors; temperament; infant-caregiver attachment; exposure to neurotoxins (prenatal alcohol, fetal cocaine, prenatal and childhood lead); academic underachievement and academic failure; and body size and build.

Family risk factors include: ineffective parenting practices; family functioning; family structure; parental psychopathology; and child abuse and neglect.

Extrafamilial risk factors considered are: peer factors; social deprivation, community factors (collective efficacy, neighborhood violence, availability of firearms and media violence).

Protective factors are presented in tabular form. They include: easy temperament; higher IQ; internal locus of control; high self-esteem; academic competence; social competence; competence in activities; good parent-child relations; external supports; friendships and availability of opportunities.

Chapter 6 discusses psychobiological factors, and chapter 7 neurobiological factors associated with aggressive behaviors. Chapter 8 presents the results of research that attempts to identify and test "multivariable models of the development of early-onset aggression and related behaviors in children and adolescents." 

Throughout this four-chapter section the author expresses disclaimers of any sort of deterministic orientation toward aggressive behaviors. Risk factors are frequently described as "correlative, not causal. In chapter 5 summary, Connor writes: "Most of the associations between these factors and behavioral outcomes are correlational and not causal;" and in chapter 8 summary we find this sentence: "It is important to highlight the idea that this research does not find biological processes to be deterministic for antisocial outcomes (McCord, 1996); rather, the degree to which biological factors determine outcomes varies in relation to environmental conditions, as well as the variability in biological risk factors."

Despite the author's denials, this reviewer finds the orientation of the book to be generally deterministic. There is little said about the child's or adolescent's ability to choose pro-social rather than antisocial behaviors, despite the accumulation of risk factors and lack of protective factors in his developmental history.

 

Chapter 8, "Issues in Female Aggression and Related Behaviors," discusses gender differences in the quality and quantity of aggression and related behaviors. Research is quoted to confirm that "the individual, family and environmental correlates of aggression and antisocial behaviors are generally similar in males and females." The findings of some laboratory studies suggest that testosterone is related to aggression, anger, and violence in adult females, as it is in adult males. However, in adolescent females, studies found no such relationship. In the chapter summary, the author concludes: "Although males tend to be more aggressive than females at all developmental ages throughout the lifespan, female aggression is neither uncommon, trivial, nor unimportant."

 

The last three chapters, 10 through 12, are concerned with planning and carrying out treatment plans for children and adolescents with aggressive and antisocial behaviors.

Chapter 10, "Clinical Assessment, Case Formulation and Treatment Planning," contains a detailed table of goals and specific content areas for the assessment of children and adolescents with conduct disorder. This table considers appropriate goals and content areas for the child; the family; larger systems in the environment; and treatment resources and expertise available in the clinical setting. Some specific assessment techniques discussed are: structured diagnostic interviews, behavior rating scales, and direct behavioral observation. The last section in the chapter presents a plan for conducting a forensic assessment—assessing the risk of harm to others. Although there are risk factors known empirically to be related to future violence, the author warns that "None of these risk factors are powerful enough alone or in combination to produce individual predictions with great accuracy." 

Chapter 11, "Psychosocial Interventions,"   discusses family interventions, cognitive-behavioral skills training, and prevention programs. In a summary of prevention programs, Connor writes: "The characteristics of successful programs include (1) multimodal interventions that target family supports and early childhood education (interventions with only a single focus are much less effective); (2) interventions of sufficient intensity delivered on a daily to weekly basis; (3) sufficient duration of intervention (at least 2 years and often longer); (4) use of interventions shown to be effective in ameliorating known psychosocial mechanisms that increase risk for CD; (5) interventions that begin early in a child's life (between ages 0 and 6 years); and (6) collaboration among community, school, and mental health professionals. Prevention programs that have these characteristics appear to reduce CD during a child's development."

Under the heading "Treatments That Appear Not To Work," the author includes psychoanalysis and group therapy.

In the final chapter, "Psychopharmacological Treatments," the author warns that "there is a very real risk that nonmethodically conducted medication trials may result in the exposure of aggressive youth to multiple ineffective medications, each with the potential for adverse side effects or drug-drug pharmacological interactions that may impair the youngsters' quality of life." With this caveat, however, he reports studies that demonstrate the effective use of neuroleptics, antipsychotics, mood stabilizers and stimulants in selected cases of childhood and adolescent aggression.

 

Connor writes very clearly. The only suggestion this reviewer can think of to increase the book's readability is to add a glossary of abbreviations. For example, here are some I came across in a few pages: AACAP, ADHD, ADHD-PHI, ANS, ASPD, BAS, BD, BIS, CD, CDC, CPS, CSF, CNS, DA, DSH, DSM, EDA, ECF, ERP, HRL, HRR, MDD, MDI, NE, OCD, ODD, PCL, PCL-R, PFC, PTSD, SC, SCL, SES, SF's, and SUD. A glossary in the form of a bookmark could save the readers—who represent so many different disciplines—a lot of time.

Some idea of the amount and the breadth of material Connor has accumulated, organized and discussed in this book, can be gained by considering the 78-page list of references. There are 17 or 18 references per page, alphabetized by authors, making a total of over 1300 if my arithmetic is correct. If and when the book is re-published, this reviewer would recommend adding a few more. On page 134, there is a section "Body Size and Build," and the terms "endomorphic", "mesomorphic" and "ectomorphic" are used. I believe this section would justify the inclusion of W. Sheldon,'s "Varieties of Delinquent Youth" New York 1949, as well as his two previous volumes, "Varieties of Human Physique" and "Varieties of Human Temperament"; E. Kretschmer's "Physique and Character" Berlin 1948; and P. Schilder's "The Image and Appearance of the Human Body" London 1935.

 

Hopefully, Connor's explanations of the root causes for the constantly increasing violence in our society will come to the attention of politicians, insurance providers, and the health-care industry, so that funding will be provided for the remedial treatment Connor recommends.

    

    

© 2004 Jack R. Anderson

 

 

    Jack R. Anderson, M.D. is a retired psychiatrist living in Lincoln, Nebraska


Share

Welcome to MHN's unique book review site Metapsychology. We feature over 7800 in-depth reviews of a wide range of books and DVDs written by our reviewers from many backgrounds and perspectives. We update our front page weekly and add more than thirty new reviews each month. Our editor is Christian Perring, PhD. To contact him, use one of the forms available here.

Can't remember our URL? Access our reviews directly via 'metapsychology.net'


Metapsychology Online reviewers normally receive gratis review copies of the items they review.
Metapsychology Online receives a commission from Amazon.com for purchases through this site, which helps us send review copies to reviewers. Please support us by making your Amazon.com purchases through our Amazon links. We thank you for your support!


Join our e-mail list!: Metapsychology New Review Announcements: Sent out monthly, these announcements list our recent reviews. To subscribe, click here.

Interested in becoming a book reviewer for Metapsychology? Currently, we especially need thoughtful reviewers for books in fiction, self-help and popular psychology. To apply, write to our editor.

Metapsychology Online Reviews

Promote your Page too

Metapsychology Online Reviews
ISSN 1931-5716