Research is limited by the instruments that it uses: from the telescope came the solar system: from the microscope came the germ theory. A subtext of these discoveries is “seeing is believing”. For all too long, psychiatric illness has been defined by what could not be seen: a lesion on autopy transformed a psychiatric disorder into a neurologic disorder. The ken of clinical responsibility of psychiatry has, therefore, been delimited to conditions with behavioral and intrapsychic symptoms without visible neuropathology. This situation, of course, has been fertile ground for the persistence of stigma, as psychiatric disorder was equated with moral weakness among the lay public and derided as “functional” by nonpsychiatric clinicians.
Fortunately, the solution for this seeming oxymoron, mental illness, came from technology. Since the mid-1980s increasingly powerful devices have been developed to image the structure, function, neurophysiology, and chemical composition of the living human brain. The impact of these technologies has been informative for brain science but transformative for psychiatry. For example, no longer can schizophrenia be considered a political act or psychologic deviance when one can see the atrophic cortex, hypofunctional frontal lobe, enhanced release of striatal dopamine and reduced levels of N-acetylaspartate.
Functional Neuroimaging in Child Psychiatry, edited by Monique Ernst and Judy Rumsey, takes current imaging opportunities and discusses their applicability to the realm of the child and adolescent subject. The power of this important textbook is that it addresses the critical fact that children are not simply miniature adults.