This book is the result of an effort of more than
forty years, at the University of Oregon, to identify causes and treatments of
antisocial behavior in children and adolescents. It is a rather dry book, and will receive little acknowledgment
apart from professionals in the field who read it, but it is, in fact, a
fantastic accomplishment. For one
thing, few research projects continue over this sort of time span, and the data
are voluminous and very helpful. For another,
the findings in this book, if applied at all rigorously, could significantly
decrease antisocial behavior in young people. 
It is sad that the data probably will not be systematically applied
across the country.

The studies reported in this book began in the
1960’s, with the aim of developing approaches to help antisocial children and
adolescents. Most of the studies
reported have been prospective, and some have gone on for many years. The authors and contributors take the view
that antisocial actions are shaped largely by social phenomena – especially
within the family – and they have excellent data to back up this approach. They propose a developmental model of
conduct that is very useful and interesting, albeit incomplete.

The book begins with a history of the “Oregon model”
of the development of antisocial behavior in children and adolescents, going
back to the 1960’s. In contrast to
several modern views that look for the origins of this behavior within the
child herself or himself, this model examines the environment of the child –
especially the family, and the way that the environment reinforces maladaptive,
antisocial behavior. Although the
theory may be old-fashioned, the authors argue successfully that theirs is “a
theory of aggression that works.” There
is, indeed, abundant evidence in support of it that is presented in the rest of
the multi-authored book.

The
next section of the book examines “coercion theory”, the way that antisocial
behavior develops in the context of the type of coercive environment that the
child grows up in. I would argue
against the use of the term coercive
because of its connotations. The
authors would maintain, I believe, that all childhood environments are
inherently coercive, and that it is the style of coercion that is problematic. The authors have good data for dispositions
by caregivers and styles of coercive environments during the first year of life
as being linked to antisocial behavior. 
Different authors next address the concept of “competence” (and mastery)
in early development. This is highly
linked, in a robust research study, with the quality of attachment, which is a
predictor of future positive peer interactions. In addition, children with early, positive peer interactions are
unlikely to become antisocial later. 
The next chapter in this section examines the family’s role in
reinforcing the development of antisocial behavior. Lack of familial problem-solving and inconsistent or mean
discipline are associated with an increased risk of antisocial behavior, in
long-term, well-designed studies, although much remains to be learned about
this phenomenon. A subsequent chapter
examines the role of the peer group – which is very powerful – in reinforcing
antisocial behavior. Contextual factors
such as parental unemployemnt, family income, parental depression, and lower
academic achievement by parents also play a role, and this situation carries
into the next generation and beyond, unfortunately. In another chapter, Patterson and others present data suggesting
that early-onset antisocial behavior is of much more significance than
late-onset (adolescent) antisocial behavior and should be prioritized in the
social/criminal justice systems.

After an interesting chapter on depression and its
role, Reid and Eddy write an overview of interventions, which is very
good. They view microsocial processes
as the target of interventiion and have an admirable rationale for doing
this. They argue strongly for a
family-based treatment model. This is
followed by an excellent chapter on treatment interventions in foster care
situations, with a major research agenda over the next two decades, a chapter
on prevention during the elementary school years (the well known LIFT project),
shown to at least delay onset of serious antisocial behavior, a chapter on
social interventions with families of divorce, also quite promising, and,
finally, an excellent chapter on a family-centered prevention strategy based in
schools.

Patterson then adds a final chapter speculating
about extension of the models depicted in the book, with excellent graphics.

The book concludes with a very lengthy and useful
list of references and a fine index.

This book has many positives. It presents lengthy research by a committed
group over many years, with interesting and heuristic results and ideas for
further research. The findings are
incomplete but compelling, as far as they go.

There are negatives. The social view presented is too restrictive. There are many biological correlates and
perhaps precipitants of antisocial behavior, well researched but largely
ignored in the book. The psychological
vantage point is also very limited. The
writing style is, for the most part, decent, but no more than that, and some of
the chapters require rather careful reading because of intricate research
design.

For philosophers and philosophically inclined
psychiatrists, psychologists and social workers, there are unstated but
fascinating questions:

1)       
Why
should we take a social phenomenon (coercive parenting) and insist that it is
an individual syndrome (conduct disorder, oppositional-defiant disorder)?

2)       
Given
the data on adolescent antisocial behavior as a multigenerational and largely
social phenomenon, what is the individual responsibility of the individual
delinquent?

I
recommend the book!

© 2002 Lloyd A. Wells

Lloyd
A. Wells, Ph.D., M.D., is a child and adolescent psychiatrist at the Mayo Clinic in Minnesota. He has a
particular interest in philosophical issues related to psychiatry and in the
logic used in psychiatric discourse.

Categories: ChildhoodDisorders, Personality