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Book Forum: BUILDING CLINICAL SCIENCE   |    
Personality and Psychopathology: Building a Clinical Science: Selected Papers of Theodore Millon
Russell Eisenman, Ph.D.
Am J Psychiatry 1998;155:990-990.
View Author and Article Information
Lake Charles, La.

New York, John Wiley & Sons, 1995, 331 pp., $59.95.

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This book gives an excellent view of scientific issues in clinical science. The author takes clinically relevant issues and discusses what we do and do not know about them from a scientific standpoint. Often, one learns about problems in method or limitations of what has been done. However, one also learns specifics of findings regarding issues of clinical interest, such as findings about personality disorder, assessment, personality theory, treatment, and other important areas. Millon does an excellent job of showing what we know, what we do not know, and why. The book will be of immense value to anyone interested in important issues in clinical psychology or psychiatry, especially anyone who wants a scientific viewpoint as opposed to clinical speculation.

There are 17 chapters, subsumed under five parts, Introduction, Theory, Taxonomy, Instrumentation, and Intervention. Millon consistently presents important findings and insights. The book seems aimed at practitioners: therapists and researchers. Graduate students would find much of the book understandable, but only the brightest undergraduates who had an excellent background in the topics would profit from all the writings, because much would be beyond their understanding. However, some of the clinical explanations would be understandable to undergraduates, such as what antisocial personalities are like.

There is so much of value in this book that a reviewer can give only brief examples. Consider, for example, the value of distinguishing among signs, symptoms, and traits (pp. 119–121), differences between the MMPI and the Millon Clinical Multiaxial Inventory I and II on item redundancy and scale overlap (pp. 256–257), or ways in which dependent, independent, ambivalent, and detached styles occur with regard to the activity-passivity dimension, yielding 11 coping strategies (pp. 65–67). The author has interesting insights about depression in such areas as borderline personality, narcissistic personality, antisocial personality, and other categories; the big-five-factor model (extraversion, agreeableness, conscientiousness, neuroticism, and openness to experience); and various kinds of tests, including his own but also the Thematic Apperception Test, the Children's Apperception Test, the Make-A-Picture Story, and many others.

I have long been impressed with Millon's writings, and I was impressed with the clinical utility of one of his tests when, while working in a prison treatment program, I dealt with an 18-year-old prisoner who was giving everyone a great deal of trouble. One day, I happened to see one of Millon's tests that this prisoner had previously taken. He scored high on passive-aggressiveness, and this gave me a good insight into some of his dynamics, helping explain many of the things he did.

Millon tells us about his tests and his clinical and theoretical orientations, but he is also very objective, presenting findings on a wide range of topics. The current volume provides excellent insights about a wide variety of clinical issues, especially from a scientific standpoint. As such, it is a very valuable book.

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