Stella Chess and Alexander Thomas (editors) ANNUAL PROGRESS IN CHILD PSYCHIATRY AND CHILD DEVELOPMENT New York: Brunner/Mazel, Inc., 1981, 682 pp., $30.00
The appearance of each volume of Annual Progress has become a notable and welcome yearly event in child psychiatry and pediatrics. Drs. Chess and Thomas have served their constituency well over the past 12 years and continue lodoso. Each year they select from the current psychiatric, pediatrie, psychologic, neurologic, and child development literature those publications which are significant for indicating new trends and knowledge, bringing new knowledge to bear on old problems, dealing with contemporary social issues, or evaluating current research methodologies. The papers are grouped by topic and an orienting introduction to each section offers the editors' own trenchant comments and brings to bear their own special wisdom distilled from first-hand clinical and research experience.
In this short space justice cannot be done to the richness and diversity of the material, but a sampling of the contents will provide an introduction to what the reader can expect. The first section, devoted to research on the newborn and young infant, amply demonstrates that infant psychological studies are beginning to come of age, approaching the level of sophistication that has for many years characterized studies of the older child. As one example, Bakeman and Brown, studying the later effects of early interaction between prematures and their mothers, find that developmental outcome at age three years depends upon what aspect of development is being evaluated: socialization is found to be related to early interaction but cognitive development is not. Another example is Homer's review of recent studies of infant responses to strangers and evaluation of the methodologies used to explore this behavior. He points out that the finding of stranger anxiety depends upon whether it is the baby or the stranger who controls the encounter. When the baby is in control, the results suggest that fear is "a comparatively minor phenomenon of infancy and, possibly, not part of any natural developmental course at all." Another study of the same behavior finds that infants' wariness reflects mothers' wariness of strangers and is not "a unique infantile phenomenon."
This same increasing level of sophistication is evidenced in the papers selected for the section on child abuse. Belsky views child abuse as an interactional process of multifactorial etiology. He draws from an ecological analogy to conceptualize child abuse in terms of the interrelational effects of individual characteristics of child and of parents operating in their own microsystem. This system in turn interacts with the social structure of the community (exosystem), which then interacts with the larger cultural matrix (macrosystem). An examination of the elements and underlying assumptions of each system illuminates the whole and dwarfs the significance of single causes. Egeland, Breitenbucher, and Rosenberg from Minnesota report a prospective study undertaken to discover if there is a correlation between stressful life events of mothers and child abuse. The authors conclude that maternal stress alone is not a sufficient cause, and make a case for studying what maternal personality characteristics protect against as well as predispose to abuse.
From the perspective of the pediatrician, virtually all of the contributions are of compelling interest. To cite a few of the more specifically pediatrically oriented issues: the relationship between school structure and academic achievement; infant and child temperament; the psychological impact of the menarche; race bias in the diagnosis and disposition of the violent adolescent; psychosocial factors in juvenile dia betes; personality of deaf children; psychological adjustment of children with hypopituitarism and short stature.
Chess and Thomas again demonstrate their ability to choose from among the vast yearly output those publications that are significant, wellconceived, thoughtful, and thoughtprovoking. In addition to the wisdom of their selection, they offer the reader their own valuable commentary on each topic. The pediatrie as well as the child psychiatry community is in their debt for providing a point of view which is balanced, critical, and responsive to changing needs and perceptions.