Book Reviews

The " problem " with impulse control disorders (ICDs) is that unlike alcohol or other substance abuse, there is no saturation point. One cannot overdose simply by gambling, spending or having too much sex. Perhaps for this reason , ICDs are largely overlooked and poorly understood even today despite increasing attention and research over the last two decades. Nevertheless, anyone who has worked with patients suffering from one or more ICD or who is a sufferer himself will know exactly just how much guilt, shame, and functional disability there is. To support those in need, a comprehensive source about the frequency, evolution, treatment , related public policy, public health, forensic, and medical issues of these disorders is essential. However, to day, there have been limited resources available on both medical and social aspects of ICDs. Impulse control disorders attempts to fill this niche which makes this guide unique of its kind. What do we know about impulse control disorders? What is their impact on society? How do cultural values facilitate and maintain the behaviour? Or, somewhat more practical questions: What are the financial costs of violence to society? How should kleptomania be addressed in court? This book aims to answer these, and many other exciting questions related to the most common impulse control disorders. Perhaps the most obviously modern culture-related ICD of all is compulsive buying. As President Bush concluded after 9/11: " Mrs Bush and I want to encourage Americans to go out shopping ". Nowadays growth is about having more, not being more. It is therefore not surprising that the extent of " shopocalypse " urges attention. The " having more " attitude may well be one of the reasons why theft is a major problem in the United States. The impulsive form of the behaviour, kleptomania, is estimated to account for about 5% of Americans charged with shoplifting annually. In general criminal responsibility is reduced because of the mental illness, however, kleptomans do not stand the cognitive test for insanity as they are very well aware of the illegal nature of their act. The authors report a curious court case from 1997 in Tennessee where a 47-year-old twice-divorced woman was accused of stealing $24.41 worth of merchandise from a store. She was sentenced to 11 months and 29 days in prison. The court argued that her lengthy history of shoplifting was a good-enough reason to protect the …

Did you know that today Americans spend more on gambling than on any other form of entertainment? In the end, society pays the quantifiable costs which are estimated to be around $5 billion annually with an additional $40 billion productivity loss (which equals to Norway's export value in the same year, 1999!). Although gambling has officially become a public health issue, the activity is (un?)intentionally encouraged by many stakeholders across the world. Riverboat cruises, credit card organisations, media and the film industry, professional sports, even fund-raising bingo in schools send the message that it is okay to gamble.
Section II of the book describes the pellicular impulses. From the dermatologist's view there are three types of hair pullers: child, adult with insight and adult without insight hair pullers, all requiring different treatments. Affected hair-bearing areas often have a bizarre pattern with irregular borders and show a decreased density of hairs that are short but of varying length. A similar disorder, "psychodermatoses" or skin picking affects up to 2% of patients in dermatology clinics.
Another "modern addiction", Internet addiction is listed under Section III: Information-seeking impulses. Does playing violent video games lead to violent behaviour? The authors argue that not having an answer to this question may indicate that the question has not been posed correctly in the first place.
Would you ever conduct counselling in the cyberspace? Would you ever accept an e-therapist? Thanks to modern technology, computer programs can be "trained" by recognised experts across a host of situations and nuances, modelling expert responses. Beyond the "perfect" answers, is there any chance we can ever train a computer to display empathy?
The last one, Section IV is about sexual and -perhaps the most problematic of all -aggressive impulses. Hypersexuality is presented from an unusual perspective: the sex industry's hidden victims' point of view. Because of their clients' sexual desires, sex workers are at especially high risk of violence, heroine use, STDS (higher risk than their clients!) and mental health issues. In addition, street sex work is criminalised in almost every part of the world (further victimisation by the authorities) which means added pressure to their already high-risk jobs. Sex work is a dangerous business.
Almost as dangerous as men suffering from intermittent explosive disorder and their violence against women. The United States has been classified as a rape-prone culture that celebrates aggression and eroticizes domination. Over 4.4 million women are physically assaulted each year by their intimate partners, 41% of which result in observable injuries. The National Institute of Justice calculated that costs per victimization episode for rape alone totalled more than $3 million for the year 1990, and the total annual cost of rape has been estimated a staggering $127 billion. This amount equals to the total US export to developing countries in the same year.
Another issue in the United States is intentional fire-setting. According to the statistics, there is a fire somewhere in every 20 seconds. Twenty percent of these fires are intentional fires and arson. In 2005, this resulted in 490 civilian fire deaths and 3 on-duty firefighter fatalities. Furthermore, there is publication to report that intentional fires and arson are likely to increase in bad economic times such as those being experienced in the United States (and around the world) currently. The other issue around arson is that half of all those arrested in the US are juveniles under the age of 18. Arson arrests account for a much larger proportion of arrests for youths under the age of 10 than any other crime that the FBI tracks (3%). Unfortunately, adults who present with fire-setting behaviour are usually directed to the criminal justice system with minimal or no contact with the mental health systems.
With impulse control disorders, overdose and fatalities are somewhat rare. However, their unfavourable effect on the individual's and society's level is more evident than ever. Elias Aboujaoude and Lorrin M. Koran edited a book which is not only informative and interesting to read, it is also eye-opening. They both have extensive experience with these disorders: Dr. Aboujaoude is the Director of the Impulse Disorders Clinic at Stanford University and Prof. Koran is the Director of the Obsessive-Compulsive Disorder Clinic at the same university. Chapters of the book are written by outstanding experts in the field of research and practice to provide first-hand information.
As a result, Impulse control disorders is not only a valuable source of information but also a well-written, interesting guide for researchers, clinicians or anyone who is interested in the personal and societal impact of these disorders beyond the mere symptoms.

Anikó Maráz Doctoral School of Psychology Department of Clinical Psychology and Addiction
Eötvös Loránd University Budapest, Hungary

Cyber-safe kids, cyber-savvy teens. Helping young people learn to use the Internet safely and responsibly
Jossay On 324 pages the book discusses many topics such as privacy protection, the decision-making abilities of children and adolescents, online sexual behavior, cyberbullying, self-harm communities, online gaming and plagiarism. In each chapter there are examples of possible harm, some empirical results, technology-based advice and communication techniques. As a possible solution, Willard recommends the use of explicit rules. She suggests creating an agreement between parents and their children, one similar to the terms of agreements used by online sites. The appendix contains a template for "Parent-teen Internet use of agreement." The agreement has to be made collectively and has to be accepted both by parents and their children. This contract -signed by both sides -must contain family values and standards regarding Internet use. Willard notes that important family values have to be reflected in Internet usage as well, in the same way as in any other offline habits. The book provides additional information that helps parents cooperate with their children to establish healthy Internet use, instead of making general restrictions.
As the title of the book suggests, Internet safety issues have to be discussed in a way which depends on the age of the user. Willard created five distinct groups differing in age: under 8, 8-10, 11-12, 13-15, 16-18, acknowl-edging that risks and concerns increase with the age of the user. This division is beneficial and practical, but perhaps it would have been even more fruitful if the reader received some more insight in the psychosocial features of the age clusters. Different methods, parental styles, and level of control are needed within the different age clusters to help the children and teens make safe choices in an online environment. It is only possible based on a trustworthy parental relationship to teach children and teens how to play safely and responsibly. The mutual reliance between parents and chil-dren creates ground for the gradual progress in which children become more autonomous, responsible and are in need of less adult control and monitoring.
The content of the book is divided into five chapters: 1) Internet parenting strategies, 2) Fundamental issues, 3) Influences on online decision making, 4) Specific risks and concerns, and 5) Accenting the positive.
The first chapter, Internet parenting strategies introduces the risks and concerns of Internet usage. Some of these are technical (hacking, copyright infringement, security concerns, etc.), while others are social problems (hate groups, sexual harassment, unsafe online communities, etc.) and the problem of addiction is also discussed (gambling, gaming, etc.). There is a short section about how parenting styles (authoritarian, permissive, authoritative) foster online and offline behavior. Perhaps it would have been a little more gainful if there was a wider empirical background about the mechanisms of different parenting styles and their effects in the family. This chapter introduces the interaction between age differences and methods, and the potential of a parent-teen contract which is a recurrent topic in many other chapters. One of the main goals of this chapter is to engage the reader to take responsibility for children and teens in the online environment. Willard shed light on the problems of technology based defense systems: softwares which over-or underblock certain webpages and weakness of the monitoring softwares. She concludes, however, that none of the protection softwares could replace a parent who takes responsibility for his or her child. Parents have to cooperate with children and teens by building knowledge, skills, and values which allow them to make consistently good choices on their own. Parents also have to cooperate with other parents and teachers to observe the rules laid down in the agreement at every place their children are able to use the Internet. The more adults are involved in the supervision of Internet usage, the less harm there may be. Last but not least, Willard sums up the potential warning signs of unsafe usage such as disturbed relationships, emotional upset and bullying.
Chapter 2 is about Fundamental issues. Willard provides further insight in the risks and dangers of specific Internetrelated topics, such as commercials, privacy, Internet addiction, multitasking, information literacy, stranger literacy and the problematic features of social networking. Most of these issues are generated by the attributes of the online context. Teachers and parents have to be familiar with this new environment to prevent harmful impacts, and help improve children's skills to be able to make wise choices on their own. Willard guides the reader through the topic of social networking, e-commercials, privacy protection, Internet addiction, information and online stranger literacy as fundamental issues. Willard's most notable concern with social networking sites is the overrated social status of online relationships. The limitless and confusing online commercials and the undeveloped privacy protection strategies are also fundamental issues. Willard discusses Internet addiction and multitasking in one topic, after which she lists their indicators and suggests practical strategies to handle these problems. The last two fundamental issues in the chapter are information and online stranger literacy. These look familiar to traditional parenting patterns, but the online environment adds many new risk factors.
The next chapter discusses the background and the Influences on online decision making. Willard explains the basics of brain development which is responsible for decision making. By explaining that the age-based deficits (underdeveloped frontal lobe) of the brain regions is responsible for diminished decision making could help children understand that there are situations where they just have to ask for adult help. In addition to brain developmental difficulties, the online environment provides different context for making decisions. Willard mentions the problem of anonymity, the lower chance of detection and punishment, the lack of confrontation with actions in personal life, the possibility of social influence, and heavy social pressure from peers. These effects help rationalize decisions and have significant influence on online actions.
Chapter 4, called Specific risks and concerns, provides an in-depth discussion of each of the specific risks and concerns: 1) online pornography, 2) cyberbullying, 3) cyberthreats, 4) violent gaming, 5) gambling, 6) hate groups, 7) sites that support self-harm, 8) computer security concerns. Each of these topics starts with fictional stories about children and teens revealing how Internet-related problems effect their everyday life, or cause serious harm. After the illustrations, Willard defines the risks and concerns regarding the age difference of users, and the nature and frequency of the problems. She also gives parents recommendations for handling the emerging situations and talks about constructive ways of giving the knowledge, skills, and values to the children that can empower them to make the right choices online. Willard emphasizes the importance of a dialogue and the establishment of trust between parent and child. To handle the above-mentioned Internet-related problems, Willard gives practical advice on how to monitor, guide and effectively communicate with the child. It is worth noting, however, that most of these pieces of advice have not been empirically tested.
The last chapter of the book is about Accenting the positive. Even though the book highlights the negative aspects of the Internet, the last short chapter approaches the cyberworld as a potentially beneficial phenomenon. Willard notes that besides mindless surfing, endless gaming, or inane gambling, using the Internet can be very beneficial. The main advantages of Internet use according to Willard are: 1) fostering the communication within the family, 2) conducting research for school projects, 3) exploring subjects of personal interest, 4) creating own websites, 5) organizing teams and clubs, 6) discussing and proposing solutions to local issues, 6) organizing social servicing projects. Despite this summary of the positive possibilities, Willard has a quite negative judgment towards children's and teens' Internet use.
Willard's comprehensive book serves as a helping hand for parents and teachers who are in need of knowledge in the fields of online environments. Even though the methods and pieces of advice have not been empirically tested, they are likely to work. The main advantage of the book is that each chapter highlights the importance of making trustworthy relationship between parent and child. Establishing an honest relationship could be the most effective way to teach young people how to act safely and responsibly on their own, and make them feel responsible for themselves and others.

Árpád Mihalik Doctoral School of Psychology
Eötvös Loránd University Budapest, Hungary