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Book Review   |    
Catherine A. Fullerton
Psychiatric Services 2007; doi: 10.1176/appi.ps.58.3.423
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edited by Catherine N. Dulmus, Ph.D., and Lisa A. Rapp-Paglicci, Ph.D.; Somerset, New Jersey, John Wiley and Sons, 2005, 480 pages, $60

Dr. Fullerton is a postdoctoral research fellow in health care policy at Harvard Medical School and staff psychiatrist at Massachusetts General Hospital, Boston.

In the anthology Handbook of Preventive Intervention for Adults, editors Catherine Dulmus and Lisa Rapp-Paglicci have compiled a series of essays that examine a range of adult social, medical, and psychological problems through the lens of prevention. Dr. Dulmus, whose research looks at juvenile violence, is an associate professor of social work at the University of Tennessee. Dr. Rapp-Paglicci is affiliated with the University of South Florida, and her research focuses on juvenile crime and violence, at-risk children and adolescents, and prevention. With this book they have attempted, with mixed results, to extend their traditional focus on childhood prevention to adults.

The book aims to be a one-volume resource for the preventive care of the adult. It is a timely book in an age when the high cost of our technologically focused and disease-centered health care is becoming increasingly difficult to maintain. Prevention and alterations in lifestyle may represent the most effective way to improve the quality of life for adults and manage chronic illness. The book is divided into three sections: emotional and mental problems, health problems, and social problems. The editors incorporate topics ranging from anxiety and suicide to obesity, gambling, and economic instability. Although the wide breadth of topics attempts to be inclusive, it occasionally leaves the reader unclear for whom the book is intended, and the omission of a chapter on tobacco use is surprising. The editors include little in the way of commentary that might have alleviated this confusion. Usually, I find multidisciplinary approaches illuminating; however, in this case, the editors failed to link common themes or situate the disparate topics into facets of a coherent whole.

In an effort to emphasize risk reduction and prevention, the editors reject the traditional public health model of primary, secondary, and tertiary prevention in favor of Gordon's model of preventive practices. As a result each chapter follows a specified layout that includes background, incidence and trends, risk factors, universal preventive practices, selective preventive practices, indicated preventive practices, practice and policy implications, and future directions. The ability of individual authors to mold their topic into this framework varied, and the limitations of Gordon's model are apparent in the often unsuccessful attempts to apply it to specific topics. Nonetheless, many chapters provide solid lists of potential preventive practices that may serve as a starting point for exploring the topic. In addition, I applaud most authors for their focus on evidence-based practice and their acknowledgement when evidence is lacking.

Overall, this book may fill a void in resources aimed at adult prevention. It is not meant to be read straight through. Instead, it is best used as an initial reference for people who want a brief introduction to potential preventive measures on a diverse range of topics.




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