HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS British Journal of Psychiatry Advances in Psychiatric Treatment All RCPsych Journals		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Radley, J. Search for Related Content PubMed Articles by Radley, J.

Challenging Behaviour. Analysis and Intervention in People with Severe Intellectual Disabilities

By Eric Emerson (2nd edn)

Northgate and Prudhoe NHS Trust

Cambridge: Cambridge University Press. 2001. 210 pp. £29.95. ISBN: 0521-7944447.

A substantial minority of people with severe learning disabilities behave in ways that cause problems for themselves, their carers and other members of society. This is frequently a reason for referral to a psychiatrist. Challenging behaviour has become the preferred term in recent years to describe such behaviours because it emphasises the social context. Professor Emerson, a psychologist well-known for his own research in the field of behavioural interventions, has written a comprehensive summary of current thinking about challenging behaviour.

The opening chapter defines challenging behaviour as a social construction and later states that it is not a psychiatric diagnosis, although ‘it may be a secondary feature of a psychiatric disorder’. The second chapter describes the impact of challenging behaviour on the health, safety and quality of life of both the sufferer and his/her carers, which is inevitably significant. A detailed chapter on epidemiology follows, showing that these behaviours are common and tend to be persistent over years or even decades. Theoretical models are discussed in the fourth chapter. The book is concerned primarily with psychological and specifically behavioural approaches but in this second edition Emerson has expanded the section on neurobiological models and psychiatric disorders and this is welcome.

The remaining chapters cover functional analysis, behavioural interventions, psychopharmacological interventions, the effectiveness of community-based supports and the challenges for future research. Although Emerson supports all his comments with references, the number of good case controlled studies to support either pharmacological or behavioural interventions is disappointingly small. The range of methods used by psychologists to measure and influence challenging behaviour are effectively communicated, and the usefulness of the various techniques is helpfully summarised in tables. The ethical implications of each model are considered.

There are some omissions, for example the section on psychiatric disorders does not include consideration of the possible role of psychotic illness, the role of anxiety disorders is given insufficient attention and there is no discussion of the possible usefulness of a psychodynamic understanding and treatment of challenging behaviour. However, the book does succeed in its stated aim of providing a concise introduction to the field and drawing attention to recent advances in applied behaviour analysis. For this reason, and for its extensive references, I commend it to learning disability psychiatrists and other professionals who work with people who have learning disabilities and whose behaviour is challenging.

This Article Submit an eLetter Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via CrossRef Citing Articles via Google Scholar Google Scholar Articles by Radley, J. Search for Related Content PubMed Articles by Radley, J.