BOOK REVIEWS 257

to the field, as well as taking it a good deal further. It should certainly be familiar to behaviour therapists using the concept of learned helplessness in their theoretical considerations of their practical therapeutic work.

H.J EYSENCK

T. WALSH (Ed.): Euting Beharior and Earing Disorders. American Psychiatric Press, Washington, D.C. (1988). xviii + 232 pp. f22.50.

Why do clinicians and researchers buy edited collections of papers on a special topic? Either because such books provide a useful review of areas related to their own special interest, or because they wish to see a considered attempt to bring together and relate divergent approaches to a single problem. This requires the editor to ensure that contributions are cross-referenced. and the key points in the chapters are brought together and discussed in some overall review. Alas, this collection is the usual tired grouping of chapters assembled after a symposium held in 1987, and with little attempt to integrate the findings.

Of the 14 chapters in the book. 4 are predominantly animal based, and only 7 chapters actually deal with eating disordered patients. A number describe laboratory attempts to examine the eating behaviour of bulimic and anorexic patients. some (Walsh) using very small samples without reference to normal controls, and others (Hetherington and Rolls) with carefully designed studies comparing eating disordered patients with normal weight controls. This last chapter contains the important observation that sensory specific satiety is lacking in bulimic and highly restrained normal weight subjects. In none of the accounts of bulimia was the problem of how laboratory attempts to simulate the conditions which allow bingeing to occur deal with the usual features of secrecy and the diurnal pattern of bingeing. Kaufman and Kanarek provide a useful account of the role of endogenous opioids in sweet tastes and overeating in one of the remaining non-clinical chapters. This book will be rapidly submerged in the sea of similar titles currently dealing with the overdescribed issue of eating disorders in women.

PETER WRIGHT

K. M. PIRKE. W. VANDEREYCKEN and D. PL~~G (Eds): The Psychobiology of Bulimia Mervosa. Springer, Berlin (1988). viii + 181 pp. DM 79,

Bulimia nervosa celebrates its tenth birthday as a diagnosis in 1989. And this book reflects some of the current theories of its aetiology as well as approaches to treatment. The biological theorists propose that bulimic patterns of eating result from deficiencies of serotonin, and the link is made with seasonal affective disorder (SAD) in which overeating of carbohydrate may result in an increase in endogenous serotonin release and improvement of mood. One weakness in the theoretical link between SAD and bulimia nervosa is that bulimic patients generally feel worse after episodes of bulimia. There is some evidence, however, that patients with bulimia nervosa have low central serotonin sensitivity from studies of prolactin release following L-tryptophan administration, so the idea may have some validity. A disagreement rages between the chapters in the book on the relevance of the association between bulimia nervosa and depression. One point of view is that the two are linked by biological antecedents, supported apparently by organic changes in bulimia nervosa similar to those found in depression. Back comes the retort: these biological changes are all found in simple food restriction, the depression in bulimia nervosa is most likely a psychologically mediated reaction to the disordered diet, The debate continues.

Psychological theories of aetiology are addressed by Booth, Herman and Polivy. Sadly, there is no discussion of the cultural factors which must contribute substantially to the explanation of the preponderance of eating disorders in Western women. Organic enthusiasts will also be thrilled by the study of CT brain scanning in anorexia and bulimia nervosa showing increased cerebra-spinal fluid spaces in the former as well as, to a lesser degree, the latter. The cause of this and whether it has any psychological implications have not been established. Of greater interest to psychologists will be chapters on treatment approaches to bulimia nervosa and on body image disturbance including an interesting account of the use of video to confront anorexic patients with their own body image. Cognitive behavioural treatment appears to be a successful approach to bulimia nervosa but whether it is superior to other intensive therapies is still a matter for debate. Antidepressants. although effective. do not seem to have an advantage over psychological approaches.

In general. a useful book giving an indication of the state of knowledge in an area replete in theories but short on data.

PAUL ROBINSON

E. CIPANI (Ed.): The Treatment of Severe Behavior Disorders-Behavior Analysis Approaches. American Association of Mental Retardation, Washington. D.C. (1989). xv + 190 pp. $21.00.

This book is part of the series entitled “Monographs of the American Association on Mental Retardation” edited by M. J. Begab. It is divided into three sections. The first covers treatment approaches and includes chapters on self-management, punishment. positive programming and behavioural diagnostics. The second examines severe problems: aggressive and disruptive behaviours and self-stimulation. The final section looks at training concerns and covers both parent training and staff management.