Abstract
Thomas Miller has brought together contributions from multidisciplinary clinician-researchers who are recognised internationally in the child and adolescent health-care field. The contributors, in general, have focused on their particular speciality of research, bringing to the reader exciting and useful information that has implications for clinical practice and raises many questions for further research. This is a book of particular interest to researchers and clinicians who work in child and adolescent psychiatry. However, it may also provide developmental perspectives that will assist the practitioner working with adults.
Duncan Clark and Thomas Miller in the first chapter discuss the stress response and adaptation in children. They look at definitions and factors impinging on the trauma response, including physiological responses, theoretical models and developmental issues.
In the second chapter, Richard McNally addresses current measures of children's reactions to stressful life events. He includes structured interviews relating to DSM criteria, and discusses DSM-IV and new developments in childhood posttraumatic stress disorder (PTSD) assessment.
Roland Summit, Thomas Miller and Lane Veltkamp in the third chapter examine the complex clinical issues and forensic implications of the ‘child abuse accommodation syndrome’. The reader is left to grapple with attitudes towards this and the ‘parental alienation syndrome’ as well as the ‘false memory syndrome’.
Thomas Miller, Lane Veltkamp and Paula Raines address the trauma of family violence. They look at the new diagnostic category of ‘disorders of extreme stress’ raised by the work of Judith Herman. This chapter has models for identifying families with at-risk factors, and a table of indicators for family violence, sexual abuse and neglect. They look at the systemic resources required for the management of family violence.
In the fifth chapter, Anait Azarian and Vitali Skriptchenko-Gregorian study traumatisation and stress in child and adolescent victims of natural disaster, with global information from many disasters as well as case vignettes. This provides a useful backdrop to examining the common stress reactions to a variety of environmental experiences
In the sixth chapter, Philip Saigh, John Fairbank and Anastasia Yasik take the reader away from thinking of adult war veterans to examining the rates of PTSD in child and youth victims in war-related PTSD. They advocate a research agenda for the next decade to better illuminate the impact of war on individuals and communities.
Adolescent pregnancy has not normally been included in the trauma literature. Catherine Martin, Kelly Hill and Richard Welsh, in their chapter, suggest that this phenomenon is a crisis nationally and for families. They also consider the critical concerns in adolescent pregnancy for individuals.
Erik de Wilde and Ineke Kienhorst in their research reveal some fascinating results from their study on the impact of life events and adolescent suicidal behaviour. They compare adolescent suicide attempters with both depressed and non-depressed adolescents, and show links with previous trauma and abuse.
Peter Vik and Sandra Brown then take the reader into the world of life events and substance abuse during adolescence. They describe a bi-directional relationship and the identification of the mechanism that drives this relationship.
In chapter 10, Allan Beane provides the reader with an insight into the trauma of peer victimisation (bullying). The author goes on to outline prevention and intervention strategies for dealing with this widespread form of violence.
This worthwhile book concludes with a chapter from William Yule who informs the reader of the potential of these major stresses to be disabling and last for many years. He makes use of case examples to look at PTSD symptoms and its treatment in children. He considers critical incident stress debriefing, group treatment and individual treatment.
As a child and adolescent mental health clinician working with traumatised children, I found this book of particular interest for the research findings. It will be an invaluable text to those clinicians working with traumatised children. It is not a book addressing how to do the therapy, but it raises a lot of issues that need to be carefully thought about if one is to work in this field and do no further harm. In particular, it will interest those of us who wish to do research because this book raises so many questions for further research.