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Book Forum: Psychopathology   |    
Neurodevelopmental Mechanisms in Psychopathology
MARK H. FLEISHER, M.D.
Am J Psychiatry 2005;162:829-830. doi:10.1176/appi.ajp.162.4.829
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Edited by Dante Cicchetti and Elaine Walker. Cambridge, U.K., Cambridge University Press, 2003, 558 pp., $100.00; $34.99 (paper).

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Dante Cicchetti from the University of Rochester and Elaine Walker of Emory University provide an extensive collection of chapters that present established as well as hypothetical ideas on the ultimate biological view of human behavior and psychopathology. This book is an ambitious effort to explain and weave together the many different disciplines of neuroscience, neural development, and psychopathology to create an understanding of the intimate relationships among these complex areas. The editors are successful in this effort, in my opinion.

As one would expect, this is not a quick read, and it is not going to be an essential text on the shelves of many clinicians. In fact, its real-life clinical utility will probably be minimal at best. However, for those with a serious interest in understanding the proposed biological views of normal and aberrant development of the nervous system and its intimate connections to other integrated systems of the body and to the ultimate expression of what is diagnosed behaviorally, this can be a fascinating book.

The book itself developed out of a series of papers from conferences on neurodevelopment, neurosciences, and developmental psychopathology. Fifty international experts in their fields have contributed 21 chapters divided into four sections. Part 1 discusses human neurodevelopmental processes in the prenatal, perinatal, and postnatal periods and the attendant risks for adult mental disorders. Part 2 focuses on animal models of development of the nervous system as they relate to psychopathology. Part 3 includes 16 chapters involving developmental models of genetic and environmental affects relevant to psychopathology, including areas such as childhood disruptive disorders, aggression, antisocial behavior, substance abuse, and schizophrenia. Part 4 deals with the neurodevelopmental processes that illustrate high-risk conditions and mental disorders, including personality disorders, the neurobiology of mood disorders in children and adolescents, traumatic stress disorders, and psychotic disorders.

Briefly looking at three of the chapters will help to understand the broader focus of the book. The first chapter, "Principles of Neurobehavioral Teratology," presents a brief overview of current teratology and 10 basic principles of research in this area. These principles include possible mechanisms of effect, likely agents, exposure, dose-response relationships, and timing effects. The chapter ends, as many do, with a section titled Future Directions. Chapter 9, "Early Orbitofrontal-Limbic Dysfunction and Autism," discusses aspects of social and other behaviors, links them to neural structures and circuits, and proposes related deficits in autistiform behaviors. Finally, chapter 21, "Neurohormonal Aspects of the Development of Psychotic Disorders," is a broadly written chapter that includes, among other topics, important background information, behavioral and biological risk indicators, and a view on the synthesis of the early developmental course of psychosis. Again, this chapter finishes with perspectives on future research topics.

The chapter authors write about what is known and what is hypothesized in their areas of expertise. The editors have made an important contribution to these complex topics by creating a work based on scientific accomplishment. Some readers may find it to be too biologically oriented at the expense of a more psychological point of view. Nevertheless, those whose interests rely primarily in understanding the nature of human behavior by examining the neuroscience building blocks will find this a very engaging and satisfying book.

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