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November 28, 1990

Treating Suicidelike Behavior in a Preschooler

Author Affiliations

Thomas Jefferson University Philadephia, Pa

Thomas Jefferson University Philadephia, Pa


by Paul V. Trad, 476 pp, $45, ISBN 0-8236-6649-2, Madison, Conn, International Universities Press Inc, 1990.

JAMA. 1990;264(20):2683-2684. doi:10.1001/jama.1990.03450200091042

This article is only available in the PDF format. Download the PDF to view the article, as well as its associated figures and tables.


This book records the case of Alexi, a very emotionally disturbed boy, seen from age three years and four months as a patient at the clinic where the author is a child psychiatrist.

Alexi attends a preschool program where he has often behaved disruptively and aggressively and had withdrawn episodes. Trad, understandably quite concerned by Alexi's self-destructive fantasies and behavior, worries about Alexi's safety should he become more preoccupied with his destructive fantasies. Moreover, Alexi comes from a chaotic, unstable, disrupted, abusive environment, peopled with insensitive, psychologically immature, aggressive and depriving relatives. Recognizing that Alexi's parents were probably deprived, not very well—nurtured individuals during their own childhoods, Trad clearly assesses their difficulties and inabilities to parent adequately. Showing that events affecting Alexi and his family are probably multifaceted, and that Alexi's behavior is obviously multi-determined, Trad wisely elects not only to work with Alexi, but also to involve his parents