Language in Psychiatry: A Handbook of Clinical Practice

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Language in Psychiatry: A Handbook of Clinical PracticeFine, Jonathan (2006) London: Equinox Publishing. (Distributor: The Davis Brown Book Company, CT). ISBN 1-904768-12-1. 1 + 344 pp. $100.00.This volume was written by a professor of linguistics who credits 2 key sources of information for his work, Michael Halladay's An Introduction to Functional Grammar (second edition, London: Arnold, 1994) and the Diagnostic and Statistical Manual of Mental Disorders (DSM = IV; American Psychiatric Association, 1994). It presents an approach to listening in psychiatry. Because much of clinical practice is dependent on information and impressions gained from interactions with patients, the clinical picture that emerges from this interaction leads to a neuropsychiatric diagnosis and, to some extent, suggestions for psychiatric treatment. The author argues that if the diagnostician's approach in psychiatric disorders is centrally concerned with meanings, and because atypical communications at these meetings may be clearly a primary phenomena in these disorders, it is through language use and other contexts that the diagnosis and treatment are mainly affected.The book includes 10 chapters, the first 4 chapters being essentially preparatory to help the reader understand the author's conceptions of neuropsychiatric phenomenology from the linguistic point of view. These chapters carefully and in great detail describe the peculiar and abnormal aspects of language use, verbal and nonverbal, that typify neuropsychiatric disorders. The author provides clear-cut examples derived from patients to illustrate the linguistic features that he describes.In chapter 5, he focuses on pervasive developmental disorders, specifically, on autistic and Asperger's disorder. The description of these disorders and their clinical features are clearly and in considerable detail amplified. Chapter 6 focuses on attention deficit hyperactivity disorder. Here the author describes the inattention, hyperactivity, and the impulsivity of patients who have this disorder, and he thoroughly elaborates how these verbal and nonverbal behaviors characterize this psychiatric classification.Chapter 7 deals with psychotic disorders. A section is provided titled “Synopsis of schizophrenia in language: Approaches to schizophrenia and language, and schizophrenia in functional linguistic terms.” Then there is provided evidence of disconnections from social reality, disconnections in ideation, expressed interpersonally and in channels of communication. Finally, there is a section on negative symptoms through language, such as blocking, poverty of speech, poverty of content in speech, and flattening of affect.Chapter 8 discusses mood disorders. The author covers both mania and depression and the characteristics these disorders exhibit in language. In mood disorders, these features of language tend to appear in various contexts and in various social processes. Chapter 9 deals with personality disorders, and a table is provided—well elaborated on in the text—summarizing the relations between personality disorders and language features.Chapter 10 is titled “The partnership of language and psychiatry.” It discusses the methods of studying psychiatric disorders and the problems that must still be investigated both clinically and in terms of research in language.On the whole, this book is interesting and stimulating, especially for those psychiatric practitioners who pay attention to and are fascinated by the ever-challenging connections between verbal and nonverbal communications as these characterize and help identify neuropsychiatric disorders. This book is not designed for those basic and clinical neuroscientists who are investigating the neurochemical, neurocerebral, and neuropsychopharmacological connections involved in mental disorders, as well as in mental health.Louis A.

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