Handbook of Infant Mental Health, Second Edition, edited by Charles H. Zeanah, Jr., New York, NY, The Guilford Press, 2000, 588 pp, $60.00.
In spite of some popular controversy about what exactly infant mental health is, this book starts with the premise that the reader believes that such a discipline exists. The initial chapter of this book opens with the fundamental controversy of infant mental health: those who believe that a child's future is determined by early behavior and experience and those who believe that infancy is a passing period that will have little relation to what follows. The remainder of the book is filled with evidence to support the first stand and does an excellent job in illustrating the complexity of the early years. The book is written from a perspective that is primarily based on the Transactional Model. Because of the crucial importance of the primary caregiving relationship for infant mental health, this relational and transactional model dominates most of the chapters in the text.
The book is divided into six sections: (1) Context of Infant Mental Health, (2) Risk and Protective Factors, (3) Assessment, (4) Psychopathology, (5) Intervention, and (6) Applications of Infant Mental Health. The first section, on the discipline of infant mental health, consists of five chapters and summarizes the transactional framework that the remainder of the book will follow. Since the first edition, three new chapters have been added, with an increased emphasis on brain development and pregnancy, as well as a succinct discussion of cultural context.
The second section, Risk and Protective Factors, consists of six chapters, with two new strong additions on poverty and early childhood trauma, which update the perspective on these issues. This section in particular brings a broader perspective, beyond the early years of life, to examine lifelong implications of infant mental health issues.
Section 3, Assessment, although a short section with only four chapters, is new to this edition and is highly relevant to the practicing developmental and behavioral pediatrician. In particular, Chapters 14 and 15 are succinct and practical summaries of concepts in the assessment of young children.
The fourth section, Psychopathology, is the longest, consisting of 12 chapters, with 3 new chapters on depression, aggression, and gender identity disorder, all of which are very well written and clinically useful. They provide a comprehensive reference for the practicing clinician in generating a differential diagnosis and constructing a treatment plan. In particular, the chapters on communication problems and disturbances of attachment offer fresh vantage points to think about in diagnosis and treatment. All 12 chapters have comprehensive and up to date reference lists that may guide the reader to further exploration of these broad topics.
Section 5, with five chapters and two new topics to this edition-early intervention with infants and toddlers with disabilities and infant massage therapy-provides a very nice blend of practical and theoretical material. The first two chapters, on prevention programs and early intervention, take a public health and policy perspective that is compelling. The final three chapters, on psychotherapy, interaction guidance, and massage, are more practical and didactic in conveying practical information.
The final section addresses applications of infant mental health with four chapters, one of which is a new addition on training in infant mental health. This addresses for the first time how the field may continue to create new professionals who are adequately trained to address the issues of this new field, namely, multidisciplinary nature, developmental orientation, multigenerational perspective, and prevention emphasis.
In summary, this book is a comprehensive reference that is a valuable addition to a developmentally oriented clinician who interacts with young children and families. The significant changes between the first and second edition make it a stronger and more current text than the first edition, while it continues to maintain a strong focus on the transactional model as it relates to infant mental health.
Marilyn Augustyn, M.D.
Division of Developmental and Behavioral Pediatrics; Boston University School of Medicine; Boston, Massachusetts