Cognitive Behavior Therapy of DSM-IV Personality Disorders. Len Sperry. Philadelphia: Brunner/Mazel. (www.taylorandfrancis.com). 1999, 190 pp., $37.95 (hardcover). There have been a number of recent books on cognitive (behavior) therapy for various personality disorders, together or singly. This book is a bit unusual for several reasons. First, it is written by a psychiatrist who brings a medical orientation in addition to a psychological orientation. Second, only certain personality disorders are covered. Third, specific treatment strategies are presented, including group, marital and family, and medication. Part I includes three chapters that provide the theoretical foundation for the treatment chapters to follow. Chapter 1 discusses basic considerations in the treatment of personality disorders. Dr. Sperry makes a clear distinction between character aspects of personality, which include the psychosocial or learned influences, and temperament aspects, which include genetic or biological influences. He bases the latter aspect on Cloninger and associates' (1993) work on the four biological dimensions of temperament; novelty-seeking, harm-avoidance, rewarddependence, and persistence. Unfortunately, this interesting categorization is not treated in much detail and only two Cloninger references appear in the reference section. While I can see why these might be biologically based, I can also see why they might be at least partially psychologically based. This distinction recurs throughout the book and might have warranted a more extended treatment up front. The remainder of the chapter consists of a number of premises about effective treatment of personality disorders, including the necessity of combined and tailored treatment. There is then a section on stages of the treatment process, borrowing explicitly from the work of Prochaska and his colleagues and implicitly from the work of Jeff Young on pattern analysis, pattern change, and pattern maintenance. Chapter 2 discusses character and schema change. Most of it is based explicitly on Young's work on schema change as well as a general overview of the psychodynamic and cognitive-behavioral tradition. Chapter 3 discusses temperament and style change. Although temperament is ostensibly biologically based, the recommended interventions appear to be psychological in nature (e.g. anger and anxiety management training, emotional regulation skill training, problem-solving skills training, and limit setting). I was not sure in what sense these were treatments for biologically based disorders. Part II, which comprises the remainder of the book, includes separate chapters for several or the DSM-IV-identified personality disorders. Specifically, these are the avoidant, borderline, dependent, narcissistic, histrionic, and obsessive-compulsive disorders. These six are described because, as Dr. Sperry says, there is growing opinion that they are considered to be reasonably treatable in outpatient settings. The other four (schizoid, schizotypal, paranoid, and antisocial) are not considered to be treatable, especially in outpatient settings. Each chapter follows the same outline: DSM-IV description, effective treatment strategies (engagement, pattern analysis, pattern change, pattern maintenance & termination), summary, and case example. …