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Twin and Triplet Psychology: A Multi- Professional Guide to Working With Multiples

Paul Kymissis, M.D.

Key Words: Books Reviewed

In this volume, contributing authors from various countries including Sweden, the United Kingdom, Australia, and the United States, and from diverse backgrounds and disciplines including medicine, pediatrics, neuropsychiatry, psychotherapy, and research, examine the very interesting subject of twin and triplet psychology.

Although the current technology of in vitro fertilization has dramatically increased the number of multiple births, there is insufficient literature on the psychological aspects of twins and multiples. This book attempts to fill the gap of knowledge, in theory and practice, about psychological issues pertaining to multiple-birth families.

In the first chapter, the author describes the psychology of twin and triplet relationships and gives insights into how it feels to be a twin. Many of the past studies about twins reared apart (and together) showed the importance of genetic factors in the development of human behavior. This author addresses many of the myths about twins, including "telepathy," explaining that these amazing coincidences and synchronicities are related more to genetics than to telepathic experience.

Many twin pregnancies are considered "at risk," a fact that underscores the vulnerabilities of twins. In her chapter about twins in utero, Piontelli brings new and important information about twin research, which, aided by technologies such as ultrasound, is expanding to study prenatal behavior. Monozygotic twins in utero are never behaviorally identical.

Spillman looks at antenatal and postnatal influences on family relationships. If a mother loses a twin fetus, this can deeply wound the mother and surviving twin. Psychological support is important when dealing with the death of a twin. This chapter describes how clubs for parents and multiples can play a supportive role for the family.

Mogford-Bevan discusses language development in twins. Although language development can be initially delayed, as the twins mature this is no longer an issue of concern. Chapters by Bryan and Preedy discuss twins with special needs and stress the development of special programs to meet the educational needs of the preschool twin.

Akerman discusses the psychology of triplets. She notes that quite often when parents are not anticipating multiple births, they are faced with "uncertainty syndrome"—that is, they are unprepared emotionally and may feel fearful and anxious. Since there are no systematic studies of this population, most of the references come from anecdotal case descriptions.

From the epidemiological studies of multiples, it is noted that 1 out of 7,000 births of non–medically assisted conceptions may be triplets. Triplets can be trizygotic, dizygotic, or—rarely—all identical. In terms of psychopathology, attention-deficit/ hyperactivity disorder is more frequent in twins and multiples than in the general population.

Sandbank's chapter on personality, identity, and family relationships is particularly useful. The sense of self in twins balances the tendency to stay the same as one's twin and the desire to become separate.

The book suffers from the usual problem of edited volumes: it lacks conformity among chapters and integration of each aspect of the topic. Such integration could follow issues from basic research to findings, developmental implications, and clinical applications for the everyday clinical practice.

In general, however, the book covers most areas of an important but neglected topic, addressing a phenomenon that is becoming more common with current technological developments in medicine and obstetrics. This book represents an important contribution to the literature on the psychology of multiples and could be useful to clinicians, parents, and teachers.

Footnotes

Dr. Kymissis is Director of the Division of Child and Adolescent Psychiatry, New York Medical Center–Westchester Medical Center, Valhalla, NY.

This Article Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Services Similar articles in this journal Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via Google Scholar Google Scholar Articles by Kymissis, P. Search for Related Content PubMed Articles by Kymissis, P.