DiCataldo, Frank

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Roger Williams UniversityDOCS@RWUFeinstein College of Arts & Sciences FacultyPublications Feinstein College of Arts and Sciences2007Review of 'Assessing and Managing Violence Riskin Juveniles'Frank DiCataldoRoger Williams University, fdicataldo@rwu.eduFollow this and additional works at: http://docs.rwu.edu/fcas_fpPart of the Psychology CommonsThis Book Review is brought to you for free and open access by the Feinstein College of Arts and Sciences at DOCS@RWU. It has been accepted forinclusion in Feinstein College of Arts & Sciences Faculty Publications by an authorized administrator of DOCS@RWU. For more information, pleasecontact mwu@rwu.edu.Recommended CitationDiCataldo, Frank C. 2007. "Review of 'Assessing and Managing Violence Risk in Juveniles'." Psychiatric Services 58 (7): 1018-1019.PSYCHIATRIC SERVICES ♦ ps.psychiatryonline.org ♦ July 2007   Vol. 58   No. 71018BOOK REVIEWSseems the sort of successful transla-tion from research to behavioral con-structs that might then permit a sec-ond translation from behavioral con-structs to nosologic constructs.Other topics include childhoodmaltreatment, marriage, and ex-pressed emotion—the latter in twoseparate chapters—which are eachexplored with regard to health andpathology. Among the 15 chapters arediscussions of epidemiology, psychol-ogy, biology, and taxonomy. The datadescribed in Relational Processes andDSM-V seem significant. It will benecessary to shape these data intoconceptually coherent concepts in or-der to ensure their eventual inclusioninto a new manual in which, onehopes, neither empiricism nor ideolo-gy alone consistently determine thedefinition of a diagnosis. ♦of the book is congruent with a re-search review of the topic.Overall, I think this volume is wellworth reading. The specific topics areextremely relevant for the practicingpsychiatrist. Though 326 pages long,the book is a relatively quick, easy,and painless read. Given the pub-lished literature reviewed, it is be-coming increasingly clear that whattardive dyskinesia was for the olderantipsychotics, metabolic abnormali-ties are for the atypical antipsy-chotics. This book not only helps usmake sure that we are aware of the is-sues, but it also provides us with prac-tical aids to monitor for these seriousmedical conditions. ♦Managing Metabolic Abnormalities in the Psychiatrically Ill: A Clinical Guide for Psychiatristsedited by Richard A. Bermudes, M.D., Paul E. Keck, M.D., and Susan L. McElroy, M.D.; Arlington, Virginia, American Psychiatric Publishing, Inc., 2006, 326 pages, $49 softcoverBrian B. Sheitman, M.D.This volume addresses an ex-tremely important topic for psy-chiatrists given that many of themedications available for patientswith severe mental illness have con-siderable risk of inducing or worsen-ing weight gain, dyslipidemias, anddiabetes mellitus, all risk factors forcardiovascular disease. Further-more, it is very timely in light of therecent report from the National As-sociation of State Mental HealthProgram Directors that patients withsevere mental illness die, on average,a startling 25 years earlier than pa-tients without these illnesses, withmost of this difference because ofmedical causes.The authors, distinguished re-searchers and experts in their field,divided the book into nine chapters.Chapters 1, 2, and 5 provide an ex-cellent review and update on dia-betes, the metabolic syndrome, andcardiovascular disease, respectively.Chapters 3 and 4 review the litera-ture on the overlap of severe mentalillness and obesity and diabetesmellitus, respectively. Chapters 6,7, and 8 focus on the effects of an-tipsychotic medications on weightgain, glucose metabolism, andserum lipids. Chapter 9, titled“Metabolic Risk Assessment, Moni-toring and Interventions: Translat-ing What We Have Learned IntoClinical Practice,” then attempts tosynthesize this information.The clear strength of this volume isthe very scholarly literature reviewspresented on each of the topics. Atthe end of the chapters I felt that Ihad a good grasp of the relevant liter-ature. Furthermore, the reviews ofobesity, diabetes, and cardiovasculardisease are written in a very readablemanner.Where the book falls somewhatshort of expectations is in not meetingone of the stated objectives, which isto address “the unmet need of thelack of integration of general medicalcare with psychiatric care, and the re-lated problems of barriers to collabo-ration and communication amonghealth care providers.” Although theauthors acknowledge that there issome disagreement among psychia-trists about whose responsibility it isto monitor the general medical condi-tions of people with mental illnesses,there is an absence of discussionabout what the specific issues are andpossible collaborative models. I sus-pect that this may reflect a gap in theresearch literature because the styleDr. Sheitman is director of adult admis-sions at Dorothea Dix Hospital, Raleigh,North Carolina, and clinical professor ofpsychiatry at the University of North Car-olina, Chapel Hill.Assessing and Managing Violence Risk in Juvenilesby Randy Borum and David Verhaagen; New York, GuilfordPress, 226 pages, 2006, $35Frank DiCataldo, Ph.D.It has been a quarter century sinceJohn Monahan (1) first problema-tized the clinical prediction of dan-gerousness, ushering in the paradig-matic shift to a public health model ofviolence risk as a continuum. Theparadox of Monahan’s critique hasbeen the spread—not its demise—ofviolence risk assessment to every cor-ner of mental health practice. Con-cern about violence risk lurks behindevery patient-clinician interaction.The systematization of violence riskassessments for psychiatric patients,thanks in large measure to the recentMacArthur Violence Risk AssessmentStudy (2), is more advanced than it isfor children and adolescents who findthemselves ensnared within the vari-ous systems devised for dealing withyouths in trouble. Assessing and Man-aging Violence Risk in Juveniles willundoubtedly help close that gap. It isthe best resource presently availableDr. DiCataldo is assistant professor ofpsychology at Roger Williams University,Bristol, Rhode Island.books.qxd  6/18/2007  10:03 AM  Page 1018PSYCHIATRIC SERVICES ♦ ps.psychiatryonline.org ♦ July 2007   Vol. 58   No. 7 1019BOOK REVIEWSfor the mental health professionalfaced with the complex task of havingto provide empirically anchored as-sessments of the risk of violenceamong young people.Randy Borum and David Verhaagenhave done a masterful job of distillingthe expansive theoretical and empiri-cal literature from developmentalcriminology, adolescent psychopathol-ogy, and research on youth violence.They translate this vast store into aconcise and clearly presented practicemanual to guide the clinician fromdata collection, to the synthesis offindings, and to the construction of acomprehensive and relevant report re-garding violence risk and its manage-ment and reduction. It will be an in-dispensable resource for the clinicianworking within any of the numerous“at-risk-youth” sites, where risk assess-ments are routinely produced.Although the book will likely be a fa-vorite among the clinicians who con-duct risk assessments as a regular partof their clinical practice, it will likelyfail to satisfy scholars concerned aboutthe media-fueled panic about youth vi-olence, which is behind the recent le-gal trends calling for the criminaliza-tion of delinquency and the ever-grow-ing overrepresentation of youths fromminority groups within the criminaljustice system. Concern about violencerisk among youths is everywhere thesedays. The adolescent in our midst hasbecome a figure to be regarded withfear, and our fears are no longer con-fined to youths within the halls of juve-nile court. They have spread to ourschools and are reaching down toyounger and younger children. Thebook sidesteps these larger problemsthat have more to do with our systemsof thought about youths than with theyouths themselves.The assessment process pre-scribed within the book will un-doubtedly result in better assess-ments. Let’s hope that it doesn’t alsopromote the idea that more assess-ments are necessarily better. Betterquality and less quantity could be amore valuable outcome. ♦References1. Monahan J: Predicting Violent Behavior:An Assessment of Clinical Techniques.Beverly Hills, Calif, Sage, 19812. Monahan J, Steadman H, Silver E, et al:Rethinking Risk Assessment: TheMacArthur Study of Mental Disorder andViolence. New York, Oxford UniversityPress, 2001er than a symptom to Bruno Bettel-heim’s blaming mothers in The Emp-ty Fortress. Psychoanalysis was grad-ually replaced with the DSM’s at-tempts at standardized psychiatric di-agnosis. Autism was not included inthe DSM-II as a distinct disorder,whereas DSM-III, called autism a“pervasive developmental disorder”and no longer a psychosis.Gradually, we arrived at where weare at today, with broad diagnosticcriteria including pervasive develop-mental disorder not otherwise statedand Asperger’s disorder, which nowmakes up as many as 75 percent ofnew cases in the spectrum. Grinkercriticizes the comparison betweenprevalence studies in the past andpresent, arguing that the diagnosticcriteria have changed so much thatthis comparison is not reliable: “Diag-nosing a mental disorder in a child islike describing a moving target.” Epi-demiological methods used today aremuch more aggressive, and publicawareness as well as earlier detectionis leading to increased numbers.In the book’s second part, we areintroduced to captivating and uplift-ing personal stories of families aroundthe world living with autism. Fromthe suburbs of Washington, D.C., toFrance, India, South Africa, andSouth Korea, these tales shed lightnot only on this illness but on hu-mankind. The parents of childrenwith autism, no matter how remoteand impoverished, seek a diagnosisand treatment for their children andare helping autism in “becoming visi-ble.” They fight for awareness andbetter education, form advocacygroups, and change beliefs. AsGrinker says in the introduction to hisbook, “We should stop, step back andtake a closer look at our fears aboutautism.”Unstrange Minds is a well-written,carefully presented work of scientificresearch, looking at the cultural im-plications of autism. It manages to ad-dress key points about autism today,both internationally and very person-ally. I believe that anyone touched byautism, whether physician, psycholo-gist, teacher, or parent, should readthis book. ♦Unstrange Minds: Remapping the World of Autismby Roy Richard Grinker; New York, Basic Books, 2006, 340 pages, $26.95Yael Dvir, M.D.Unstrange,” a neologism coined bythe poet E. E. Cummings, isvery appropriately used in the title ofthis book. As Roy Richard Grinkerstates in his introduction, “theprocess of understanding autism itselfparallels the work that anthropolo-gists do, since the minds of peoplewith autism are sometimes as hard tounderstand as foreign cultures.”Grinker is a professor of anthropologyat George Washington University andis interested in the intersection be-tween culture and illness. He is alsothe father of a daughter with autism.In this beautifully written, captivat-ing book, Grinker looks at autismfrom a cultural viewpoint and ob-serves how culture dictates the waywe view autism. He examines the his-torical events leading to the currentrise in the prevalence of autism andcritically inspects the available evi-dence. “Is there really more autism,or are we just seeing it more?” heasks. Grinker argues for the latter.In the book’s first part, Grinker re-views the significant changes that psy-chiatry has undergone leading to the“tipping point” in this “epidemic,”from Leo Kanner’s first description ofautism as a biological syndrome rath-Dr. Dvir is affiliated with the Departmentof Psychiatry, University of Massachu-setts Medical School, Worcester.books.qxd  6/18/2007  10:03 AM  Page 1019

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