BOOK REVIEWS 377

F. K. GOODWIN and K. R. JAMISON: Manic-Depressive Illness. Oxford University Press, Oxford (1990). xii + 938 pp. L65.00.

With the exception of an excellent chapter on genetic factors by Elliot Gershon, this massive volume is the result of a IO-yr collaboration by Goodwin, who deals for the most part with biological issues of etiology and treatment, and Jamison, who focusses on the psychological aspects of manic-depressive illness. This by itself is unusual and impressive, but the result is also a thorough (over 4000 references) and up-to-date integrative review of all facets of the disorder that is well-nigh indispensable for clinicians and researchers. The authors view manic-depressive disorder as a biological illness which is genetically based and environmentally influenced and, accordingly, do not deal with etiological and treatment issues (e.g. cognitive and behavioural approaches) which may more properly apply to a different subset of mood disorders. Their concept of manic-depressive illness includes not only the unnecessarily restrictive subset of manifestly bipolar cases (as currently advocated in the DSM-III), but also the serious recurrent cases of unipolar illness. This Kraepelinian approach is not without its difficulties: as the authors take pains to point out, the research literature is often unclear about the boundaries of the disorder. Yet, despite their efforts, there remain some probably unavoidable occasions when it is unclear if the conclusions are based on data from bipolar (DSM-III), manic-depressive (Goodwin & Jamison), or strictly unipolar major depressions. Not unexpectedly, given their broader concept, Goodwin and Jamison conclude that bipolar illness is underdiagnosed. They also make a strong case that the age of onset is probably earlier and that single-episode cases are rarer than assumed. Both polarity and cyclicity of the disorder are emphasized throughout. The only weak link may be Jamison’s chapter on creativity and manic-depressive illness which begins with a detailed critical analysis of the methodological problems but then engages in rather unwarranted and sometimes misleading claims (e.g. the evidence for Robert Schumann’s ‘manic-depressive’ illness is not as clear-cut as it is made to appear) which, given the cautious and measured approach adopted elsewhere in the volume, seems out of place. Nonetheless, this is a small and peripheral drawback to what is a truly outstanding achievement by the authors and the publisher. One hopes that frequent updated editions will follow in the future.

D. PAPAGEORGIS

S. J. MEISELS and J. P. SHONKOFF (Eds): Handbook of Early Childhood Intervention. Cambridge University Press, Cambridge (1990). f40.00 Hardback; f15.00 Paperback.

This book is the product of the period of growth and development within the area of early childhood intervention which has taken place over the last 10 yr. The implementation of the Education for All Handicapped Children Act Amendments of 1986 (Public Law 99457) in the U.S.A., and the Children’s Act 1981 in the U.K. has brought early intervention into the limelight, making this a timely addition for the wide variety of professionals involved with young children and their families. The book aims to integrate the theory, research and practical knowledge which currently guide clinical practice, as well as to facilitate further growth in the field of early intervention for children from birth to 3 yr.

The book is divided into seven sections. The first consists of an introductory chapter that places the concept of early intervention in historical context and identifies potential research challenges. The second section examines sources of developmental vulnerability (biological, familial and social) that can have a deleterious effect on development, as well as the protective factors which may form a buffer to such influences. The next section explores four theoretical bases of early intervention. These are: (1) the transactional model, a perspective that explains behaviour as the mutual effect of context on child and child on context; (2) the psychodynamic and developmental model, which considers the emotional milestones of the young child and family; (3) the behavioural-ecological model, which places the behavioural approach to intervention in an ecological framework-that is, the child viewed in the context of the family and the family, in turn, viewed in the context of the larger social system; and (4) the neurological model, which looks at the link between psychological processes and neurological functioning in the context of understanding child development.

The fourth section of the book is a comprehensive review of assessment within early childhood intervention. The six chapters cover traditional models of multidisciplinary approaches as well as alternatives to assessing young children and approaches to evaluating parent-child interaction, families and social support. Clinicians will find this section particularly enlightening, although many of the assessment instruments mentioned are not widely available in the U.K. The fifth section covers models of service delivery (i.e. actual intervention) from various vantage points: child, caregiver, family, hospital and community. Where such a handbook as this should come into its own, this section disappointingly is of more use as a description of research than a clinical tool. It does, however, provide a useful overview of current and potential ideas in intervention.

The sixth section identifies four specific areas of research for closer scrutiny, providing: a review of what is known about the effects of early intervention on the child; the use of the family as a focus for intervention; the economic costs and benefits of early intervention (a factor of increasing relevance to British policy makers); and a critique of efficacy research. The book’s final section is devoted to a broad range of policy issues and programme planning and direction.

One needs to adjust to both American terminology and ideology before appreciating this comprehensive (and at times overwhelming) review of the field of early childhood intervention. Contributors to the handbook have shown a sensitivity to the diverse nature and complexity of early childhood problems. It is therefore a book which will be relevant to the vast array of those professionals who provide services to young children and their familes.

MICHELLE NEW

M. HERSEN, R. M. EISLER and P. M. MILLER (Eds): Progress in Behavior Modification, Vol25. Sage, Newbury Park (1990). 216 pp. f37.50.

This edition of Progress in Behavior Modzfication contains six chapters which are well organized, easy to read and of current interest. The topics covered are: insomnia (Lillie and Rosenberg), cigarette smoking (Hall, Hall and Ginsberg), childhood