Monday, April 30, 2012

Religion & Brain: Belief Decreases With Analytical Thinking, Study Shows

Daily Mail
  1. Religion & Brain: Belief Decreases With Analytical Thinking, Study Shows

    Huffington Post‎ - 2 days ago
    Many people with religious convictions feel that their faith is rock solid. But a new study finds that prompting people to engage in analytical ...
  1. Discovery News‎ - 3 days ago
  2. Science AAAS‎ - 3 days ago

With Prison Ministry, Colson Linked Religion and Reform — Beliefs -

With Prison Ministry, Colson Linked Religion and Reform — Beliefs -

April 27, 2012
Fred R. Conrad/The New York Times
Charles W. Colson, the Watergate figure, founded Prison Fellowship, the world’s largest Christian outreach to prisoners.

With Prison Ministry, Colson Linked Religion and Reform

“Since the 1960s, prison reform has been seen as a leftist cause,” Robert Perkinson, a historian and the author of “Texas Tough: The Rise of America’s Prison Empire,” said this week. “But it used to be a Christian cause, and Colson played a big role in bringing prison reform back to Christian conservatism.”
Dr. Perkinson was referring, of course, to Charles W. Colson, the convicted Watergate felon who died last Saturday. In his first act, Mr. Colson was “Nixon’s hatchet man” and “the ugliest of the Watergate thugs, the most shamelessly vicious,” as one historian wrote this week in The New Republic.
But Mr. Colson, who found Jesus shortly before entering prison, remade himself as a free man, in 1976 founding what became Prison Fellowship, the world’s largest Christian outreach to prisoners. In the process, he played an important role in the ever-changing relationship between prisons and religion. Historians of penology — there are many — remembered Mr. Colson as someone who, in a small way, pointed American prisons back toward their roots.
Scholars speak of two rival impulses in American incarceration: one an older, Christian reform impulse and the other a disciplinary and retributive impulse, focused on punitive labor and harsh conditions, which gained strength in the slaveholding South.
“Since the 1790s, religious reformers in some Eastern states successfully lobbied not only for the creation of prisons, but also for reformers’ influence in these institutions’ management,” Jennifer Graber, author of “The Furnace of Affliction: Prisons & Religion in Antebellum America,” wrote in an e-mail. “New York’s first prison, for example, had an operating board composed primarily of Quaker reformers.”
Philadelphia’s earliest prisons were also influenced by Friends, or Quakers. They believed bad environments led people to crime. The theory, according to Joshua Dubler, of the University of Rochester, was that “you separate people out, and because every human being has a divine light inside of them, the divine light will thrive anew.”
In these prisons, those who committed crimes could be penitents — hence the term “penitentiary” — then re-enter society as changed people. Jailers often relied on solitary confinement, which could drive prisoners mad, but the impulse, at least, was toward rehabilitation.
But almost from the beginning that model was opposed by another model, in which the prison was mainly a place of punishment: think of chain gangs and labor farms. Over the centuries, each model has come in and out of vogue.
In the 1960s, “we were at a progressive extreme” in prison theory, according to Dr. Dubler. Prison administrators pursued prisoners’ rehabilitation, while many inmates — including those, like Malcolm X, who joined the Nation of Islam — practiced “revolutionary, politically engaged religion.” Since the 1980s, however, with the trend toward more punitive prisons, prison religion, often supported by volunteers like those from Mr. Colson’s outreach group, has often been more about “adjusting to the system, not about changing the system itself,” Dr. Dubler said.
Yet Mr. Colson advocated more humane, less crowded prisons; more prisoner contact with the outside world; more rehabilitative services; and better services for re-entry to society. Against the conservative and evangelical tides, Mr. Colson was, in a sense, returning to the spirit of the 1960s, or even the 1790s.
A spokesman for Prison Fellowship pointed to studies — by New York Theological Seminary and the University of Pennsylvania, among others — that conclude that prison ministry turns inmates away from crime.
But not all scholars are convinced.
“Criminologists have convincingly shown that inmates involved in religious programming have fewer infractions while inside,” said Dr. Graber. “The data outside is much more difficult to interpret.”
“Nobody knows if this stuff works,” said Winnifred F. Sullivan, a professor at the University at Buffalo and the author of “Prison Religion.” Because prisoners have to request to be part of Mr. Colson’s programs, they may be a more motivated population, Dr. Sullivan said, making it hard to determine the source of any eventual success.
Dr. Sullivan praised Mr. Colson’s ministries for going where other angels fear to tread. “Few people want to do this work,” she said. But she agreed that while Mr. Colson allied with many liberals on prison reform, his brand of evangelical Christianity easily accommodated a conservative vision of society.
The basic goal of Prison Fellowship Ministries “is to train people to be good productive workers in a capitalist society,” Dr. Sullivan said. The ministers want to teach people “to get up every morning and go to work and take care of their families. They say they just happen to use religion.”
Dr. Perkinson, who teaches at the University of Hawaii at Manoa, said that Mr. Colson’s conservative faith may help inmates understand their own failings, but that it does little to help them understand society’s.
“The thing that’s sad is you could have a prison tied to the social gospel or liberation theology, which could connect people to the sins and failings of the larger society,” Dr. Perkinson said. “But that’s not what they have access to.”
Dr. Perkinson once visited the Carol S. Vance Unit, a Texas prison that subcontracts with Prison Fellowship for programming. Inmates can opt into the program, but cannot be forced to participate. He was both discomfited and amazed by what he saw.
“On the one hand, it was flagrantly unconstitutional,” Dr. Perkinson said. “If you didn’t believe God created the earth in seven days, and not just that same-sex relations were a sin but so was masturbation, you couldn’t graduate from this program. It was almost Taliban-style. But it was the only prison of all that I visited in Texas that was permeated with love.”
mark.e.oppenheimer@gmail .com;

Sexual abuse in prisons - The Washington Post

Sexual abuse in prisons - The Washington Post

Sexual abuse in prisons

Sexual abuse in prisons
The Justice Department has put off a crackdown for too long.

Sexual abuse in prisons

By Editorial Board, Published: April 29

TENS OF THOUSANDS of men, women and children have been sexually abused behind bars over the past three years while the Obama administration dithered.

The Justice Department was charged with implementing regulations for correctional institutions and detention facilities that would reduce the scourge of sexual violence behind bars. The administration had, by law, until June 2010 to complete the task. That was nearly two years ago.

Congress unanimously approved the Prison Rape Elimination Act (PREA) in 2003 with rare and spectacular bipartisanship. Ideological opposites — Reps. Frank Wolf (R-Va.) and Bobby Scott (D-Va.) and Sens. Jeff Sessions (R-Ala.) and the late Edward M. Kennedy (D-Mass.) — were lead sponsors. The act created a commission that spent six years studying sexual abuse in correctional facilities and crafting thoughtful proposals to decrease such violence.

The commission was led by Judge Reggie B. Walton of the U.S. District Court for the District of Columbia, a judge known for his tough law-and-order approach. It included representatives from academia and the private corrections industry and prisoner advocates. The panel issued recommendations in the summer of 2009; the Obama administration had a year to craft regulations.

Instead, the Justice Department needlessly duplicated the commission’s work, re-interviewing dozens of individuals and groups whose views the panel had considered. It waited while a private consulting firm analyzed the costs of implementing changes, and it blamed the bureaucratic process for delays. It did not, in other words, move with all deliberate speed to protect those in government custody from a form of brutality that leaves psychological scars that can hamper a person’s reintegration into society. Swift and sure action would have been the appropriate response if the administration had been serious about refuting the vile assumption that sexual abuse is an acceptable byproduct of incarceration.

The administration deserves credit for endorsing some provisions that did not sit well with the corrections industry at large, including a prohibition on cross-gender pat-downs and strip searches of juveniles and the conclusion that PREA covers not just rape but a broader category of sexual abuse. It should apply these policies to federal immigration detention centers. Everyone in custody — regardless of the type of institution — should be able to know that the government is doing everything in its power to ensure humane and safe conditions. And juveniles should enjoy the strongest protections.

Some with direct knowledge of the status of the regulations say they are in the last stages of review by the Office of Management and Budget and could be out within weeks. We certainly hope so.

Sunday, April 29, 2012

Sometimes Church-State Separation Is Better for the Church | Almost Diamonds

Sometimes Church-State Separation Is Better for the Church | Almost Diamonds

International Academy of Law and Mental Health

International Academy of Law and Mental Health

XXXIIIrd Congress of the International Academy of Law and Mental Health
Amsterdam, Netherlands
July 14th-19th, 2013

The Dark Side of Personality | Psychology Today

The Dark Side of Personality | Psychology Today

The Dark Side of Personality

Is there a psychopath in your neighborhood, boardroom, or (egad) bedroom? Maybe it's more common than we want to think.


Psychopathy is among the most difficult disorders to spot. The psychopath can appear normal, even charming. Underneath, they lack conscience and empathy, making them manipulative, volatile and often (but by no means always) criminal. They are an object of popular fascination and clinical anguish: psychopathy is impervious to treatment.

Personality Disorders

Personality disorders are deeply ingrained ways of thinking and behaving that are inflexible and generally lead to impaired relationships with others. Mental health professionals formally recognize ten disorders that fall into three "clusters," although there is now known to be much overlap between the disorders, each of which exists on a spectrum.


Questions of personality have vexed mankind from the dawn of personhood: can people change? How do others perceive me? What is the difference between normal and pathological behavior? One's personality is so pervasive and all-important that it presents a clinical paradox of sorts: it is hard to assess our own personality, impossible to overlook that of others.

Crime and Punishment | Psychology Today

Crime and Punishment | Psychology Today

Crime and Punishment

Knowing what punishment to mete out is no simple feat. Some forms of punishment may send the wrong message. For example, is it okay to solve problems with more violence? Here are some thoughts on this tough topic.

Law and Crime

Psychology and the law intersect in the field of forensic science. Legal practitioners require a grasp of human motivation at its most basic and most debased in order to render fair judgment.


For a topic as subjective as morality, people sure have strong beliefs about what's right and wrong. Yet even though morals can vary from person to person and culture to culture, many are practically universal, as they result from basic human emotions. We may think of moralizing as an intellectual exercise, but more frequently it's an attempt to make sense of our gut instincts.

In Hopeful Sign, Health Spending Is Flattening Out

The New York Times - Breaking News, World News & Multimedia

In Hopeful Sign, Health Spending Is Flattening Out
The slowing of the growth rate is partly explained by the recession, but evidence suggests that changing behavior of health care providers and consumers also partly accounts for it.

Doctor Panels Urge Fewer Routine Tests -

Doctor Panels Urge Fewer Routine Tests -

Doctor Panels Recommend Fewer Tests for Patients

In a move likely to alter treatment standards in hospitals and doctors’ offices nationwide, a group of nine medical specialty boards plans to recommend on Wednesday that doctors perform 45 common tests and procedures less often, and to urge patients to question these services if they are offered. Eight other specialty boards are preparing to follow suit with additional lists of procedures their members should perform far less often.
Universal Images Group, via Getty Images
A doctor reading the results of a patient’s exercise stress test.

Readers’ Comments

"I order what I consider unnecessary tests all the time because of malpractice fears. The art of medicine died when the lawyers got involved."
john credico, Toledo
The recommendations represent an unusually frank acknowledgment by physicians that many profitable tests and procedures are performed unnecessarily and may harm patients. By some estimates, unnecessary treatment constitutes one-third of medical spending in the United States.
“Overuse is one of the most serious crises in American medicine,” said Dr. Lawrence Smith, physician-in-chief at North Shore-LIJ Health System and dean of the Hofstra North Shore-LIJ School of Medicine, who was not involved in the initiative. “Many people have thought that the organizations most resistant to this idea would be the specialty organizations, so this is a very powerful message.”
Many previous attempts to rein in unnecessary care have faltered, but guidance coming from respected physician groups is likely to exert more influence than directives from other quarters. But their change of heart also reflects recent changes in the health care marketplace.
Insurers and other payers are seeking to shift more of their financial pain to providers like hospitals and physician practices, and efforts are being made to reduce financial incentives for doctors to run more tests.
The specialty groups are announcing the educational initiative called Choosing Wisely, directed at both patients and physicians, under the auspices of the American Board of Internal Medicine Foundation and in partnership with Consumer Reports.
The list of tests and procedures they advise against includes EKGs done routinely during a physical, even when there is no sign of heart trouble, M.R.I.’s ordered whenever a patient complains of back pain, and antibiotics prescribed for mild sinusitis — all quite common.
The American College of Cardiology is urging heart specialists not to perform routine stress cardiac imaging in asymptomatic patients, and the American College of Radiology is telling radiologists not to run imaging scans on patients suffering from simple headaches. The American Gastroenterological Association is urging its physicians to prescribe the lowest doses of medication needed to control acid reflux disease.
Even oncologists are being urged to cut back on scans for patients with early stage breast and prostate cancers that are not likely to spread, and kidney disease doctors are urged not to start chronic dialysis before having a serious discussion with the patient and family.
Other efforts to limit testing for patients have provoked backlashes. In November 2009, new mammography guidelines issued by the U.S. Preventive Services Task Force advised women to be screened less frequently for breast cancer, stoking fear among patients about increasing government control over personal health care decisions and the rationing of treatment.
“Any information that can help inform medical decisions is good — the concern is when the information starts to be used not just to inform decisions, but by payers to limit decisions that a patient can make,” said Kathryn Nix, health care policy analyst for the Heritage Foundation a conservative research group. “With health care reform, changes in Medicare and the advent of accountable care organizations, there has been a strong push for using this information to limit patients’ ability to make decisions themselves.”
Dr. Christine K. Cassel, president and chief executive officer of the American Board of Internal Medicine Foundation, disagreed, saying the United States can pay for all Americans’ health care needs as long as care is appropriate: “In fact, rationing is not necessary if you just don’t do the things that don’t help.”
Some experts estimate that up to one-third of the $2 trillion of annual health care costs in the United States each year is spent on unnecessary hospitalizations and tests, unproven treatments, ineffective new drugs and medical devices, and futile care at the end of life.
Some of the tests being discouraged — like CT scans for someone who fainted but has no other neurological problems — are largely motivated by concerns over a malpractice lawsuits, experts said. Clear, evidence-based guidelines like the ones to be issued Wednesday will go far both to reassure physicians and to shield them from litigation.
Still, many specialists and patient advocates expressed caution, warning that the directives could be misinterpreted and applied too broadly at the expense of patients.
“These all sound reasonable, but don’t forget that every person you’re looking after is unique,” said Dr. Eric Topol, chief academic officer of Scripps Health, a health system based in San Diego, adding that he worried that the group’s advice would make tailoring care to individual patients harder. “This kind of one-size-fits-all approach can be a real detriment to good care.”
Cancer patients also expressed concern that discouraging the use of experimental treatments could diminish their chances at finding the right drug to quash their disease.
“I was diagnosed with Stage IV breast cancer right out the gate, and I did very well — I was what they call a ‘super responder,’ and now I have no evidence of disease,” said Kristy Larch, a 44-year-old mother of two from Seattle, who was treated with Avastin, a drug that the F.D.A. no longer approves for breast cancer treatment. “Doctors can’t practice good medicine if we tie their hands.”
Many commended the specialty groups for their bold action, saying the initiative could alienate their own members, since doing fewer diagnostic tests and procedures can cut into a physician’s income under fee-for-service payment schemes that pay for each patient encounter separately.
“It’s courageous that these societies are stepping up,” said Dr. John Santa, director of the health ratings center of Consumer Reports. “I am a primary care internist myself, and I’m anticipating running into some of my colleagues who will say, ‘Y’ know, John, we all know we’ve done EKGs that weren’t necessary and bone density tests that weren’t necessary, but, you know, that was a little bit of extra money for us.’ ”
This article has been revised to reflect the following correction:
Correction: April 5, 2012

An article on Wednesday about a move to recommend that doctors curb the use of 45 common and often unnecessary medical tests and procedures misidentified the organization that was issuing the advisory. It is the American Board of Internal Medicine Foundation, an organization that promotes physician professionalism — not the American Board of Internal Medicine, the specialty board with which it is affiliated.


Share your thoughts.

The DSM's impact on mental health practice and research.

Medical Specialists Will Try to Reduce Excessive Diagnostic Testing

A caution against preventive psychiatry
An article in the New York Times on April 4 describes a wonderful new initiative that may substantially improve the quality of US health care, while simultaneously also cutting its costs. Nine medical specialties have joined forces in a concerted and long overdue effort to reduce unneeded diagnostic testing and treatment. Although the US spends much more per capita on medical diagnosis and treatment than any other country in the world, we don't come close to getting our money's worth. Because unnecessary testing and treatment eat up a whopping one-third of all medical expenditures, we wind up spending a fortune for poor results on most national health outcome measures.
The new initiative by the medical specialty groups recognizes that many medical tests and procedures are not only wasteful, but also cause more harm than good. The American Board of Internal Medicine and Consumer Reports will jointly sponsor an educational program called 'Choosing Wisely', aimed at changing the attitudes and habits of physicians and patients. Among the commonly overused tests that will be the target of re-education are: EKG's, mammograms, prostate studies, and MRI, CT, and stress cardiac imaging.
Education is a much needed first step. When it comes to medical care, people too often people think that more is necessarily better. They fail to appreciate the harm that follows when promiscuous screening leads to unneeded and aggressive treatment. But education won't be enough. Things have gotten so far out of hand because of perverse financial incentives that make unnecessary procedures very profitable and also because of pervasive physician fears that leaving any test undone will invite a malpractice suit. We need to change the incentives in the system, not just the attitudes of the participants.
How does this initiative from other medical specialties apply to psychiatry? The dis-infatuation with ubiquitous screening in the rest of medicine should provide a needed check on the premature and unrealistic DSM-5 ambition to achieve a 'paradigm shift' toward psychiatric prevention. DSM-5 plans to introduce many new diagnoses that straddle the heavily populated boundary with normality. The DSM-5 rationale (consciously borrowed from what has been tried with such mixed success in the rest of medicine) is to screen early and treat expectantly in order to reduce the lifetime burden of illness. This would be a wonderful goal if only there were available tools to realize it. Truth be told, psychiatry does not now have any method to allow for accurate early diagnosis and we also have no preventive treatments of proven efficacy. If DSM-5 doesn't come to its senses, millions of people will be misidentified, over-diagnosed, and over-treated with medicines that can cause very harmful complications.
It is sadly ironic that DSM-5 has caught the early screening, prevention bug precisely when other specialties were already discovering its risks and dangerous unintended consequences. We should learn from, not copy, painfully earned experiences in the rest of medicine and avoid expanding our boundaries before we can safely do so.
And, on another note, cautions about overuse of existing laboratory testing should also be applied to the long awaited and much hyped biological testing for Alzheimer's dementia. An Alzheimer's profile is still only a research tool, at least a few years away from being ready for clinical practice. But even when ready, the risk/benefit and cost/benefit analysis of widespread Alzheimer's testing should be given the kind of searching scrutiny that is only now revealing the risks and limitations of excessive screening. The lesson learned- it is not always a good idea to screen for something just because we have a test that lets us do so.