Saturday, May 5, 2012

Study of prison chaplains sheds light on faith behind bars - San Antonio Express-News

Study of prison chaplains sheds light on faith behind bars - San Antonio Express-News

Study of prison chaplains sheds light on faith behind bars

Updated 11:55 p.m., Friday, May 4, 2012


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Movies and television portray hardened criminals cursing God and everyone else.
In reality, many inmates worship God and practice their faith behind bars.
A recent 50-state survey of chaplains by the Pew Research Center's Forum on Religion & Public Life offered a rare look at the worshipers behind bars.
The study said state prisons hold the bulk of the country's convicts (1.4 million), but little has been released to the public on religion in these institutions.
Here are some of the major findings:
Chaplains in state prisons fulfill a range of functions.
Nearly all said they lead worship services, perform religious instruction, do spiritual counseling and organize religious programs. Fifty-seven percent considered the first three their most important functions, but only a third said this is where they spend most of their time.
The chaplains are overwhelmingly Christian (mainly Protestant), male and middle-aged. They also are well-educated, with 62 percent having advanced degrees.
And most like their jobs. Two-thirds said they were very satisfied, and only 6 percent were very or somewhat dissatisfied.
If there seems to be one essential, but challenging, aspect of most prison religion programs, it is in the area of rehabilitating inmates and preparing them for re-entry into society.
More than seven in 10 chaplains considered access to high-quality religion-related prison programs — and support from religious groups after inmates are released — to be “absolutely critical” to successful rehabilitation.
Of chaplains who work in prisons that have rehabilitation or re-entry programs, 57 percent said their quality has improved in the past three years, and 61 percent said participation has increased.
The study gives considerable attention to the topic of religious extremism in prisons.
The researchers explained: “Since the 9/11 terrorism attacks, religious extremism has been a topic of high public interest in the United States. Some experts specifically have raised concerns that prisons could be a breeding ground for home-grown terrorists and have suggested that prison chaplains and other prison administrators need to monitor religious activity more closely.”
Estimates of how common extreme religious views are tend to vary with the security level of the facility and the chaplain's background.
Protestant chaplains were more likely than Catholic or Muslim chaplains to say that religious extremism is either very or somewhat common, and the view was stronger among white evangelical Protestant chaplains than white mainline Protestants.
Nevertheless, 76 percent of chaplains said religious extremism rarely or almost never poses a security threat.
An open-ended question tried to assess what chaplains regarded as extreme. The answers were wide-ranging.
The most common reply was racism disguised as religious dogma, which included racial intolerance or prejudice. This went both ways, as both black and white inmates expressed racial superiority.
Other answers included hostility toward gays and lesbians, negative views of women and intolerance toward sex offenders.
An almost equal number of chaplains said extremism included religious intolerance, such as expressions of religious superiority and attempts to coerce others into their beliefs.
A majority of chaplains said that attempts by inmates to convert other inmates are either very common (31 percent) or somewhat common (43 percent).
It doesn't always work, but the chaplains either said a lot of inmates change religions (26 percent) or some change religion (51 percent). Among those who reported at least some switching, about half said the number of Muslims is growing, followed closely by Protestant Christians and pagan and Earth-based religions.
The chaplains estimated that two-thirds of the inmates in the prisons where they worked were Christians and 5 percent to 9 percent were Muslim, followed by other groups. They said most religious groups have remained relatively stable in size but there was shrinkage of 20 percent among Catholics and 17 percent among the unaffiliated.
However, the researchers cautioned, “Chaplains' perspectives on the religious makeup of inmates may reflect a number of different influences, including their degree of exposure to various groups in the course of their work.”
Requests for religious accommodations, such as religious books or texts and meetings with leaders from inmates' faith, are most always granted. About half of the requests for specific religious diets and religious items or clothing usually are granted but special hairstyles or grooming is mostly denied.
Some chaplains regarded some requests as bogus or extreme, such as seeking raw meat for a Voodoo ritual, said one chaplain. Others said some so-called religious groups were a cover for nonreligious activities, such as gangs that claim to be religious and promote violence.


Read more: http://www.mysanantonio.com/news/local_news/article/Study-of-prison-chaplains-sheds-light-on-faith-3535633.php#ixzz1u01ARX7X

Hebephilia update: DSM-5 workgroup stubbornly clinging to pet diagnosis - by Karen Franklin, Ph.D. on 5/4/12 | Mike Nova's starred items

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via In the news by Karen Franklin PhD by Karen Franklin, Ph.D. on 5/4/12
Salvador Dali*: The Average Bureaucrat
A few weeks ago, I reported on an open letter to the American Psychiatric Association, calling for it to reject three controversial expansions of sexual paraphilia diagnoses that are being promoted by government evaluators in civil commitment cases.

A lot has happened since then. The only one of the three controversial diagnoses still in the running for official status has been altered for the umpteenth time. An esteemed journal is issuing a scathing critique. And the open letter is generating buzz in the blogosphere.

The open letter has garnered more than 100 signatures, many from prominent forensic psychologists and psychiatrists in the U.S. and internationally. If you intend to sign on but haven’t yet, act now because I understand it will be submitted very soon. (Click HERE to review the text; click HERE to email your name and professional title to co-author Richard Wollert.)

Hebephilia gets yet another makeover

This week, the Sexual Disorders Workgroup for the upcoming fifth edition of the APA's diagnostic manual toned down its proposal to turn sexual attraction to young teens into a mental disorder. As psychiatrist Allen Frances explains at his DSM5 in Distress blog, hebephilia is still there -- you just have to read the small print to see it:
Dali: Enchanted Beach with Three Fluid Graces





















Confronted by universal opposition from the rest of the field, the DSM 5 group has been forced progressively to whittle down their pet, but they so far have refused to just drop it altogether. 'Hebephilia' first lost its free-standing independence and was cloaked as Pedohebephilia. When this didn't fly, the term was dropped altogether in the title but the concept was slipped into the definition of Pedophilia -- which was expanded out of recognition by having a victim age cut-off of 14 years. No one accepted this outlandish suggestion and now finally the work group comes back with ‘early pubescent children' and tries to keep 'hebephilia' as a term in the subtype. The instability of the criteria sets associated with this concept is additional evidence that the fervor for its adoption stems from emotional loyalty rather than reasoned review of its weak conceptual and research base. How can the group vouch for the reliability of the diagnosis when the concept and criteria are changing every month? This is no way to develop a diagnostic system.
The staunch insistence on this transparent attempt to turn statutory rape into a mental disorder owes in large part to the makeup of the sexual disorders workgroup. As Frances notes, "the most wayward of all the DSM 5 work groups" is "lopsidedly dominated" by psychologists from a sex clinic up in Toronto, whose ambition is "to find a place in DSM 5 for their pet diagnosis."
Although the group's other outlandish proposals, Paraphilic Coercive Disorder and Hypersexuality, have been shelved for the time being, Frances worries that putting them in the appendix "for further study" is still risky:
Recognizing that the jig is up on the grand design, members of the DSM 5 sexual disorders work group have been heard saying they may have to settle for an Appendix placement for their three hothouse creations. This would create forensic dangers. We have learned from the abuse of "Paraphilia Not Otherwise Specified" in Sexually Violent Predator cases that any (even remote) legitimization by DSM 5 is certain to be misconstrued and misused in the courtroom.

Come on guys. This is absolutely absurd just on the face of it…. So back to the drawing board, DSM 5 sexual disorders work group. The grand dream is lost -- now at least make sure you don't mess up on the fine print.
On the professional listservs today, some conspiracy theorists were speculating that the new wording signifies a plot to enhance the standing of physiological testing in sex offender assessment. The latest proposed criteria for "pedophilia, hebephilic type" require "equal or greater sexual arousal from prepubescent or early pubescent children than from physically mature persons." How to determine that fuzzy standard? Enter the penile plethysmographer, a new niche career track, penis cuff at the ready to measure who is aroused by what.

"There is withering criticism already that the DSM is being expanded to sell more drugs," wrote one colleague. "Now it appears that psychiatry and psychology are conspiring to use the DSM to spur PPG tests -- tests which risk leaving patients with traumatic and indelible memory traces. Do most psychiatrists really want to open this door?!"

Orwellian thought police?

The mere idea of allowing the American Psychiatric Association to dictate "normal" sexuality frightens English Professor Christopher Lane. Lane, whose book Shyness: How Normal Behavior Became a Sickness exposed the unscientific inner workings of the DSM-III committee, expressed shock over the first listed criterion for the shelved disorder of hypersexuality: "Excessive time is consumed by sexual fantasies and urges, and by planning for and engaging in sexual behavior." On his Side Effects blog, Lane mused:
Dali: Femme a Tete de Roses
"Excessive time"? What exactly does that mean, and according to whose standards? That's not a small or trivial matter to settle when the APA is talking in vague generalities about the nation’s libido -- how much sex it wants and how much sex the APA thinks it should think about wanting. The APA is talking about how much time Americans can devote to sexual fantasy before it suggests that we’re mentally ill if our preoccupations are stronger than those set by the relevant task force.

Does that initiative seem to overreach a bit, even to the point of sounding almost Orwellian? It does so to me. If we're to have criteria, are quotas next, including for fantasy? It’s as if the East Coast offices of the APA had morphed into those of the Thought Police in Orwell's 1984, warning citizens that they’d overstepped their "sexual thought quota" for the week and must be rationed -- or punished accordingly.
Lane analyzed hebephilia through his characteristic historical lens:
It's an archaism, a throwback literally to 19th-century psychiatry, but refers to practices that were as central to the Classical age -- and thus to Western democracy -- as were Socrates, Plato, and especially Plato’s Symposium, one of the foundational books in the West on eros and love.

The APA is already trying to determine how long normal grief should last before it’s thought pathological. Its brisk, jaw-dropping answer: two weeks. Do we really want the same organization dictating how often we can think about sex? These kinds of proposals can only end badly.
Leading journal tackles the controversy

The good news this week, which should have all of us jumping up and down with joy, is that the APA has caved in under massive public pressure and dropped its plan for a new psychosis risk disorder. This disorder would have put thousands if not millions of youngsters at risk of being dosed up with dangerous antipsychotic drugs based on a suspicion that they might go crazy in the future. Mixed Anxiety Depression has also bit the dust.

Dali: Daddy Longlegs of the Evening Hope
But, as featured in a special issue of the esteemed Journal of Nervous and Mental Diseases due out in June on the raging diagnostic controversies, there are still many battles ahead as the bloated DSM-5 enters the final stretch. The special issue will tackle diagnostic inflation, pharmacological conflicts of interest, controversies with the newly revamped personality disorders, and problems with diagnostic reliability in the recent field trials. Hebephilia, often neglected amidst controversies with wider impact such as psychosis risk syndrome and the pathologization of normal grief, merited an article in this special issue.

In "Hebephilia and the Construction of a Fictitious Diagnosis," forensic psychologists Paul Good and the late Jules Burstein make a strong case for abandoning this faux disorder, which will only make the APA more of a laughingstock in the future.

Good and Burstein catalog an assortment of empirical problems. These range from the difficulty of reliably measuring "recurrent and intense" sexual arousal to problems determining the pubertal status of a young teenage victim. They also challenge the very idea that sexual attraction to pubescent minors is a mental illness, rather than merely illegal.

Although the Sexual Disorders Workgroup hides behind a fictive notion of a pure and ethereal "science," Good and Burstein clearly believe that hebephilia, if added to the DSM-5, will be mainly invoked in a partisan manner in forensic proceedings, in order to justify harsher punishment and involuntary civil detention. Because of its power to do harm, they say, its scientific grounding should be especially strong. If it does manage to worm its way into the DSM, they say, it should still be challenged in court:
We believe the admissibility of the proposed revision to DSM-5 that would include Hebephilia as a type of Pedophilia could be challenged in a court of law based on current legal standards. For example, since there is no professional consensus or general acceptance in the scientific community to support the notion of Hebephilia as a mental disorder, it would have difficulty passing the Frye test for admissibility. Similarly, without a widely established body of peer-reviewed, validation research and repeated studies showing inter-rater reliability in the laboratory and among clinicians in the field, Hebephilia would also have difficulty meeting the criteria specified in the Daubert standard.
Indeed, this is just what has been happening to hebephilia in federal court, where at least three civil detention petitions in a row have been thrown out due to the level of controversy in the field over this purported condition.

With all of this tumult, it seems that the DSM-5 excesses are producing a backlash against the American Psychiatric Association and, indeed, fueling disenchantment with the whole enterprise of psychiatric diagnosis.

As Frances writes, the turnaround on psychosis risk syndrome came about due to a combination of:
  • extensive criticism from experts in the field
  • public outrage
  • uniformly negative press coverage
  • abysmal results in DSM-5 field testing
For the first time in its history, DSM 5 has shown some flexibility and capacity to correct itself. Hopefully, this is just the beginning of what will turn out to be a number of other necessary DSM 5 retreats. Today's revisions should be just the first step in a systematic program of reform.… This is certainly no time for complacency. Much of the rest of DSM 5 is still a mess. The reliabilities achieved for many of the other disorders are apparently unbelievably low and the writing of the criteria sets is still unacceptably imprecise.
Who needs reliability?

Frances calls for slowing down the process to allow for additional field testing and, more importantly, an independent scientific review of all the remaining controversial DSM-5 changes. But the DSM-5 folks are taking a different tack. Faced with field trial results showing very poor reliability -- not much better than chance -- for many of their proposed diagnoses, they want to change the definition of what counts as minimally adequate.

Dali: Autumn Cannibalism
It’s pretty ironic: The DSM-III went down in history for elevating the importance of reliability at the expense of validity. Remember, diagnostic reliability just means that similarly trained raters see a certain symptom presentation and call it by the same label. It says nothing about external validity, or whether the label is meaningful in explaining a real-world phenomenon. But reliability is basic. If a diagnostic label cannot be reliably applied, you can't even start talking about its validity. And now, the same psychiatric organization that reified the kappa reliability statistic as the be-all, end-all of science is trying to tell us that traditional kappa levels are unrealistically high for psychiatric research.

Historically, psychiatric reliability studies have adopted the Fleiss standard, in which kappas below 0.4 have been considered poor. In the January issue of the American Journal of Psychiatry, Helena Kraemer and colleagues complained that this standard is unrealistically high, and lobbied for kappas as low as 0.2 -- traditionally considered poor -- to be deemed "acceptable."

Former DSM-III guru Robert Spitzer and colleagues object to this proposal in a letter in the latest issue of the Journal. "Calling for psychiatry to accept kappa values that are characterized as unreliable in other fields of medicine is taking a step backward," they state. "One hopes that the DSM-5 reliability results are at least as good as the DSM-III results, if not better."

Alas, just wishing won't make it so. Despite its grandly stated ambitions, the DSM-5 will likely go down in history as a major gaffe by American psychiatry in its continuing struggle for world dominance.

Remember to check out the open letter
and send in your name, if you are in agreement with it.

Further reading:
*Salvador Dali: "One day it will have to be officially admitted that what we have christened reality is an even greater illusion than the world of dreams."
___________________________________________________________________

See also:


Friday, May 4, 2012
*
Friday, May 4, 2012

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Friday, May 4, 2012

Elsevier Selected as New Publisher of The American Journal of Geriatric Psychiatry - PR Newswire - The Sacramento Bee

Elsevier Selected as New Publisher of The American Journal of Geriatric Psychiatry - PR Newswire - The Sacramento Bee

Elsevier Selected as New Publisher of The American Journal of Geriatric Psychiatry

Published: Wednesday, May. 2, 2012 - 3:56 am
/PRNewswire/ --
Official journal of the American Association for Geriatric Psychiatry
Elsevier, a world-leading provider of scientific, technical and medical information products and services, announces that it has entered into an agreement with the American Association for Geriatric Psychiatry (AAGP) to publish The American Journal of Geriatric Psychiatry (AJGP) beginning in January 2013.
"We are extremely pleased to be entering into this relationship with Elsevier," commented Chris M. deVries, Chief Executive Officer/Executive Vice President of the American Association for Geriatric Psychiatry. "The Journal serves as a primary vehicle for disseminating critical information to our national - and global - community of clinicians, educators, and researchers in the rapidly evolving fields of geriatric psychiatry and mental health. Therefore we are enthusiastic about making our content more readily accessible and discoverable through Elsevier's innovative tools, whether readers are at work, at home, or on the go."
AJGP is the authoritative source of information for the rapidly developing field of geriatric psychiatry. Each monthly issue contains peer-reviewed articles on the diagnosis and classification of psychiatric disorders in later life, epidemiological and biological correlates of mental health of older adults, and psychopharmacology and other somatic treatments. With a 3.566 Impact Factor it ranks in the top third of both the Psychiatry and Geriatrics/Gerontology categories according to Thomson Reuters' Journal Citation Reports®.
The decision to publish with Elsevier was the result of a meticulous review process. According to Editor-in-Chief Dilip V. Jeste, MD, "Key factors driving our decision were the advantages offered by Elsevier's global reach and its expertise in all phases of the publishing process. We anticipate that AJGP's position as the premier journal devoted specifically to geriatric psychiatry will be strengthened through this new association, benefiting our authors, editors, reviewers, and ultimately our readership."
About the Editor-in-Chief
Dilip V. Jeste, MD, Editor-in-Chief, is the Estelle and Edgar Levi Chair in Aging, Distinguished Professor of Psychiatry and Neurosciences, Director of the Sam and Rose Stein Institute for Research on Aging, and Chief of the Geriatric Psychiatry Division at the University of California, San Diego. He serves as Director of NIMH-funded Advanced Center for Innovation in Services and Intervention and Research focusing on psychosis in late-life and Director of the Education Division of the NIH-funded Clinical and Translational Research Institute at UCSD. Dr. Jeste is President-Elect of the American Psychiatric Association.
About The American Association for Geriatric Psychiatry
The American Association for Geriatric Psychiatry is a national association representing and serving its members and the field of geriatric psychiatry. AAGP promotes the mental health and well-being of older people through professional education, public advocacy, and support of career development for clinicians, educators, and researchers in geriatric psychiatry and mental health. http://www.aagponline.org
About Elsevier
Elsevier is a world-leading provider of scientific, technical and medical information products and services. The company works in partnership with the global science and health communities to publish more than 2,000 journals, including The Lancet and Cell, and close to 20,000 book titles, including major reference works from Mosby and Saunders. Elsevier's online solutions include SciVerse ScienceDirect, SciVerse Scopus, Reaxys, MD Consult and Mosby's Nursing Suite, which enhance the productivity of science and health professionals, and the SciVal suite and MEDai's Pinpoint Review, which help research and health care institutions deliver better outcomes more cost-effectively.
A global business headquartered in Amsterdam, Elsevier employs 7,000 people worldwide. The company is part of Reed Elsevier Group PLC, a world-leading publisher and information provider, which is jointly owned by Reed Elsevier PLC and Reed Elsevier NV. The ticker symbols are REN (Euronext Amsterdam), REL (London Stock Exchange), RUK and ENL (New York Stock Exchange).
Media Contact:Rachael Zaleski +1-215-239-3658rachael.zaleski@elsevier.com
SOURCE Elsevier


Read more here: http://www.sacbee.com/2012/05/02/4458981/elsevier-selected-as-new-publisher.html#storylink=cpy

Allen Frances, M.D.: "The grand dream is lost - now at least make sure you don't mess up on the fine print." - DSM 5 Rejects 'Hebephilia' Except for the Fine Print | Psychology Today

DSM 5 Rejects 'Hebephilia' Except for the Fine Print | Psychology Today

DSM5 in Distress
The DSM's impact on mental health practice and research.

DSM 5 Rejects 'Hebephilia' Except for the Fine Print

Now the devil is in the details.
The prize for the most wayward of all the DSM 5 work groups must surely go to the sexual disorders group—creators of three remarkably off-beat proposals. Fortunately, they have gradually been forced to abandon their entire wish list because each of the proposals triggered near universal opposition from forensics experts and sexual disorders researchers. First to go was Hypersexuality (AKA sex addiction); next rape (AKA coercive paraphilia); and this week the work group has finally admitted in all but the fine print that statutory rape (AKA 'hebephilia') is also not a mental disorder. But before rejoicing, we must get down to three errors in the fine print that need to be rectified before the section will be safe from forensic misuse.

1) Defining Pedophilia: Serious forensic mischief still lurks in the recently proposed wording. Here is the problematic DSM 5 criterion:
"A. Over a period of at least 6 months, an equal or greater sexual arousal from prepubescent or early pubescent children than from physically mature persons, as manifested by fantasies, urges, or behaviors."
The phrase 'equal or greater" strikes just the wrong note. The interpretation (or misinterpretation) of these three small words can have huge consequences concerning the constitutionality of involuntary psychiatric commitment as it is applied in Sexually Violent Predator (SVP) cases. SVP statutes explicitly require that mental disorder be distinguished from simple criminality. The sex offender must be mentally disordered to qualify for SVP commitments. In our country, it is never constitutional to force simple criminals into psychiatric hospitals to keep them off the streets as a form of preventative detention.
This crucial distinction (made explicitly by the Supreme Court) seems to be completely lost on the DSM 5 Sexual Disorders work group. An accurate definition of 'Pedophilia' must separate the rarely encountered, mentally disordered 'pedophile' from the much more common run-of-the-mill sex criminal. 'Pedophilia' requires that the offender be intensely and recurrently sexual aroused by prepubescent kids and that they are his preferred or obligatory source of sexual excitement. The contrast is with the simple criminal who preys on kids opportunistically because they are vulnerable or available or perhaps because he is disinhibited by drugs.
This brings us back to the lack of precision in the DSM 5 wording. A drug addled criminal may be attracted 'equally' to just about anything that walks—that doesn't make him a mentally disordered 'Pedophile'. Before diagnosing Pedophilia, there must be an established fixation on prepubescent kids .
The solution is pretty straightforward. The DSM 5 wording should substitute 'preferred or obligatory' for 'equal or greater'. The phrase 'preferred or obligatory' is central to the concept of paraphilia, already appears in the differential diagnosis section in DSM IV, and deserves greater prominence in the DSM 5 criteria set. "Equal or greater" will perpetuate the great confusion about Paraphilia that has plagued the proper application of SVP statutes. And one wonders how "equal or greater" would ever be measured reliably—lets hope this isn't meant as an excuse for expanding phallometric testing beyond its proper competence.

2) Restricting Pedophilia to prepubescent children: Adding 'early pubescent' youngsters is an unwarranted and radical change from the standard definition of Pedophilia. It reflects the fact that the DSM 5 work group is lopsidedly dominated by researchers connected to one center. They have displayed a stubborn ambition to find a place in DSM 5 for their pet diagnosis: 'hebephilia' supported by the unproven suggestion that men attracted to pubescent kids have a mental disorder. Aside from its deep conceptual flaws and extremely thin research base, the proposal ignores the fact that statutory rape is committed for a whole variety of other much more common reasons (eg opportunistic crime, a vulnerable victim, unavailability of other partners, immaturity, substance disinhibition, date rape, etc.). Paraphilia would explain only a vanishingly small proportion of the sexual crimes committed with pubescent victims who are under the age of consent. And we already know that 'hebephilia' has been much abused in SVP hearings by evaluators who casually pin the mental disorder label on simple criminals to end run the constitutional protections against preventive detention.
Confronted by universal opposition from the rest of the field, the DSM 5 group has been forced progressively to whittle down their pet, but they so far have refused to just drop it altogether. 'Hebephilia' first lost its free standing independence and was cloaked as Pedohebephilia. When this didn't fly, the term was dropped altogether in the title but the concept was slipped into the definition of Pedophilia—which was expanded out of recognition by having a victim age cut-off of 14 years. No one accepted this outlandish suggestion and now finally the work group comes back with 'early pubescent children' and tries to keep 'hebephilia' as a term in the subtype. The instability of the criteria sets associated with this concept is additional evidence that the fervor for its adoption stems from emotional loyalty rather than reasoned review of its weak conceptual and research base. How can the group vouch for the reliability of the diagnosis when the concept and criteria are changing every month? This is no way to develop a diagnostic system.
The work group may try to justify inserting 'early pubescent children' on the grounds that it is mentioned in ICD-10. This is misleading in three ways: first, ICD-10 is inconsistent- its research criteria include only prepubescent children; only its clinical description mentions 'early pubertal children'; second, the goal of DSM-5 is to achieve compatibility with ICD-11 (not ICD-10) and my understanding is that the ICD-11 workgroup has already identified the phrase 'early pubertal children' as an error that will be corrected ; and third, ICD is much freer to be loose in its language because it not much used for forensic purposes (let alone in SVP commitment hearings that bear so consequentially on the proper application of our constitution and the proper uses of psychiatry in our society.

3) Drop the subtype: "Hebephillic Type—sexually attracted to early pubescent children (Tanner Stage 2-3)".
Come on guys. This is absolutely absurd just on the face of it. Do clinicians really know what the Tanner stages are? Even if you did, how would you possibly ever determine the Tanner stage of the victim. And how reliably can the different Tanner stages be diagnosed? One waggish critic scorned the Tanner stages as a futile exercise in 'splitting pubic hairs'. Putting Tanner stages in DSM 5 is really that silly. So back to the drawing board, DSM 5 sexual disorders work group. The grand dream is lost- now at least make sure you don't mess up on the fine print.
And one more thing. Recognizing that the jig is up on the grand design, members of the DSM 5 sexual disorders work group have been heard saying they may have to settle for an Appendix placement for their 3 hothouse creations. This would create forensic dangers. We have learned from the abuse of ' Paraphilia Not Otherwise Specified' in SVP cases that any (even remote) legitimization by DSM 5 is certain to be misconstrued and misused in the courtroom.
I commend you to an excellent discussion of this and many other issues pertaining to the DSM 5 Paraphilia section in an Open Letter authored by Richard Wollert and Thomas Zander. Mental health professionals concerned with these issues can sign on in an effort to improve the DSM 5 paraphilia so that it doesn't continue or greatly worsen the confusion we caused by the poorly written section in DSM IV. .
See: http://bit.ly/LetterDSM

In the news by Karen Franklin PhD: Open letter opposing DSM-5 paraphilias expansion

In the news by Karen Franklin PhD: Open letter opposing DSM-5 paraphilias expansion

Tuesday, April 10, 2012


Open letter opposing DSM-5 paraphilias expansion

Photo credit: Dr. Joanne Cacciatore
As readers of this blog are aware, proposals to expand the sexual disorders in the American Psychiatric Association's upcoming DSM-5 have generated significant controversy among forensic psychologists and psychiatrists. Now, forensic psychologists are banding together to urge APA President John Oldham to reject the proposed diagnoses of pedohebephilia, paraphilic coercive disorder and hypersexual disorder. The text of an open letter drafted by Richard Wollert, an Oregon psychologist with extensive experience in sex offender treatment and evaluation, follows. If, after reading it, you would like to become a signator, just click on the indicated link, and provide Dr. Wollert with your name and professional credentials. Don't delay, as I understand that this important letter is being submitted very soon.
 

Death Penalty Climate Changing - Mike Nova's starred items

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 Mike Nova's starred items

via Death Penalty Information Center by edeleon on 4/25/12
On April 25, Connecticut Governor Dannel Malloy (pictured) signed into law a bill that replaces the death penalty with life without parole. Connecticut is the fifth state in five years, and the 17th overall, to do away with capital punishment. Governor Malloy, who once supported the death penalty, offered the following statement: “My position on the appropriateness of the death penalty in our criminal justice system evolved over a long period of time. As a young man, I was a death penalty supporter. Then I spent years as a prosecutor and pursued dangerous felons in court, including murderers. In the trenches of a criminal courtroom, I learned firsthand that our system of justice is very imperfect. While it’s a good system designed with the highest ideals of our democratic society in mind, like most of human experience, it is subject to the fallibility of those who participate in it. I saw people who were poorly served by their counsel. I saw people wrongly accused or mistakenly identified. I saw discrimination. In bearing witness to those things, I came to believe that doing away with the death penalty was the only way to ensure it would not be unfairly imposed." See more of the governor's statement below.
Connecticut's repeal of capital punishment is in line with a growing national trend toward alternatives to the death penalty and an increased awareness that it is not serving murder victims' families. The bill gained the support of over 179 victims’ families and friends, who believe the state’s capital punishment statute does not provide the promised “closure” after the loss of a loved one. Since 1976, the state has carried out only one execution. The death penalty repeal bill is prospective and will not affect the sentences of the 11 inmates currently on the state’s death row.
("No More Death Penalty in CT," NBC News, April 25, 2012; "Gov. Malloy on Signing Bill to Repeal Capital Punishment," April 25, 2012). See New Voices.
Governor Malloy's Statement following his signing of the repeal bill:
“This afternoon I signed legislation that will, effective today, replace the death penalty with life in prison without the possibility of release as the highest form of legal punishment in Connecticut. Although it is an historic moment – Connecticut joins 16 other states and the rest of the industrialized world by taking this action – it is a moment for sober reflection, not celebration.
“Many of us who have advocated for this position over the years have said there is a moral component to our opposition to the death penalty. For me, that is certainly the case. But that does not mean – nor should it mean – that we question the morality of those who favor capital punishment. I certainly don’t. I know many people whom I deeply respect, including friends and family, that believe the death penalty is just. In fact, the issue knows no boundaries: not political party, not gender, age, race, or any other demographic. It is, at once, one of the most compelling and vexing issues of our time.
“My position on the appropriateness of the death penalty in our criminal justice system evolved over a long period of time. As a young man, I was a death penalty supporter. Then I spent years as a prosecutor and pursued dangerous felons in court, including murderers. In the trenches of a criminal courtroom, I learned firsthand that our system of justice is very imperfect. While it’s a good system designed with the highest ideals of our democratic society in mind, like most of human experience, it is subject to the fallibility of those who participate in it. I saw people who were poorly served by their counsel. I saw people wrongly accused or mistakenly identified. I saw discrimination. In bearing witness to those things, I came to believe that doing away with the death penalty was the only way to ensure it would not be unfairly imposed.
“Another factor that led me to today is the ‘unworkability’ of Connecticut’s death penalty law. In the last 52 years, only 2 people have been put to death in Connecticut – and both of them volunteered for it. Instead, the people of this state pay for appeal after appeal, and then watch time and again as defendants are marched in front of the cameras, giving them a platform of public attention they don’t deserve. It is sordid attention that rips open never-quite-healed wounds. The 11 men currently on death row in Connecticut are far more likely to die of old age than they are to be put to death.
“As in past years, the campaign to abolish the death penalty in Connecticut has been led by dozens of family members of murder victims, and some of them were present as I signed this legislation today. In the words of one such survivor: ‘Now is the time to start the process of healing, a process that could have been started decades earlier with the finality of a life sentence. We cannot afford to put on hold the lives of these secondary victims. We need to allow them to find a way as early as possible to begin to live again.’ Perhaps that is the most compelling message of all.
“As our state moves beyond this divisive debate, I hope we can all redouble our efforts and common work to improve the fairness and integrity of our criminal justice system, and to minimize its fallibility.”
(Hartford Courant, April 25, 2012).

via Death Penalty Information Center by edeleon on 4/27/12
A new book published in electronic format, The Death Penalty Failed Experiment: From Gary Graham to Troy Davis in Context by Diann Rust-Tierney, examines the problem of arbitrariness in the death penalty since its reinstatement in 1976. Through an analysis of the cases of Gary Graham and Troy Davis, the author argues that race, wealth and geography play a more significant role in determining who faces capital punishment than the facts of the crime itself. Both defendants had significant claims of innocence; both were black defendants who were ultimately executed in the South; in both cases, the victim in the underlying murder was white. Graham was executed in Texas in 2000 and Davis was executed in Georgia in 2011. Rust-Tierney writes, “How do you administer the most severe punishment imaginable in a manner that is accurate, free from bias and demonstrably fair? Until we are all seen and treated as equal, we cannot afford to keep capital punishment.” Ms. Rust-Tierney is an attorney and Executive Director of the National Coalition to Abolish the Death Penalty. Download a copy of the ebook here.
(D. Rust-Tierney, "The Death Penalty Failed Experiment: From Gary Graham to Troy Davis in Context," McKinney & Associates, April 2012). The Death Penalty Failed Experiment is the second publication in McKinney & Associates’ Voice Matters: An eBook Series on Public Relations with a Conscience. See Arbitrariness and Race. Read more Books on the death penalty. Listen to DPIC's Podcast on Arbitrariness.

via Death Penalty Information Center by edeleon on 4/30/12
In a recent op-ed in the Atlanta Journal-Constitution, former U.S. President Jimmy Carter called for the end of the death penalty. President Carter cited the risk of wrongful executions, the lack of evidence of deterrence, and the costs of prosecution as reasons to abolish capital punishment. He wrote, “[T]here has never been any evidence that the death penalty reduces capital crimes or that crimes increased when executions stopped. Tragic mistakes are prevalent. DNA testing and other factors have caused 138 death sentences to be reversed since I left the governor’s office. The cost for prosecuting executed criminals is astronomical. Since 1973, California has spent roughly $4 billion in capital cases leading to only 13 executions, amounting to about $307 million each.” President Carter also cited the unfair application of the death penalty as an especially compelling reason for repeal: “Perhaps the strongest argument against the death penalty is extreme bias against the poor, minorities or those with diminished mental capacity. Although homicide victims are six times more likely to be black rather than white, 77 percent of death penalty cases involve white victims. Also, it is hard to imagine a rich white person going to the death chamber after being defended by expensive lawyers. This demonstrates a higher value placed on the lives of white Americans.” Read full op-ed below.
Show death penalty the door
By Jimmy Carter
For many reasons, it is time for Georgia and other states to abolish the death penalty. A recent poll showed that 61 percent of Americans would choose a punishment other than the death penalty for murder.
Also, just 1 percent of police chiefs think that expanding the death penalty would reduce violent crime. This change in public opinion is steadily restricting capital punishment, both in state legislatures and in the federal courts.
As Georgia’s chief executive, I competed with other governors to reduce our prison populations. We classified all new inmates to prepare them for a productive time in prison, followed by carefully monitored early-release and work-release programs. We recruited volunteers from service clubs who acted as probation officers and “adopted” one prospective parolee for whom they found a job when parole was granted. At that time, in the 1970s, only one in 1,000 Americans was in prison.
Our nation’s focus is now on punishment, not rehabilitation. Although violent crimes have not increased, the United States has the highest incarceration rate in the world, with more than 7.43 per 1,000 adults imprisoned at the end of 2010. Our country is almost alone in our fascination with the death penalty. Ninety percent of all executions are carried out in China, Iran, Saudi Arabia and the United States.
One argument for the death penalty is that it is a strong deterrent to murder and other violent crimes. In fact, evidence shows just the opposite. The homicide rate is at least five times greater in the United States than in any Western European country, all without the death penalty.
Southern states carry out more than 80 percent of the executions but have a higher murder rate than any other region. Texas has by far the most executions, but its homicide rate is twice that of Wisconsin, the first state to abolish the death penalty. Look at similar adjacent states: There are more capital crimes in South Dakota, Connecticut and Virginia (with death sentences) than neighboring North Dakota, Massachusetts and West Virginia (without death penalties). Furthermore, there has never been any evidence that the death penalty reduces capital crimes or that crimes increased when executions stopped. Tragic mistakes are prevalent. DNA testing and other factors have caused 138 death sentences to be reversed since I left the governor’s office.
The cost for prosecuting executed criminals is astronomical. Since 1973, California has spent roughly $4 billion in capital cases leading to only 13 executions, amounting to about $307 million each.
Some devout Christians are among the most fervent advocates of the death penalty, contradicting Jesus Christ and misinterpreting Holy Scriptures and numerous examples of mercy. We remember God’s forgiveness of Cain, who killed Abel, and the adulterer King David, who had Bathsheba’s husband killed. Jesus forgave an adulterous woman sentenced to be stoned to death and explained away the “eye for an eye” scripture.
There is a stark difference between Protestant and Catholic believers. Many Protestant leaders are in the forefront of demanding ultimate punishment. Official Catholic policy condemns the death penalty. Perhaps the strongest argument against the death penalty is extreme bias against the poor, minorities or those with diminished mental capacity. Although homicide victims are six times more likely to be black rather than white, 77 percent of death penalty cases involve white victims. Also, it is hard to imagine a rich white person going to the death chamber after being defended by expensive lawyers. This demonstrates a higher value placed on the lives of white Americans.
It is clear that there are overwhelming ethical, financial, and religious reasons to abolish the death penalty.
Jimmy Carter was the 39th president and is founder of The Carter Center in Atlanta.
(J. Carter, "Show death penalty the door," Atlanta Journal-Constitution, April 25, 2012). Read more New Voices on the death penalty. Listen to DPIC's podcast on Deterrence.

via Death Penalty Information Center by edeleon on 5/2/12
Commentary from nationally syndicated columnist E.J. Dionne (pictured) and the New York Times reflected on the changing state of the death penalty in the U.S. in light of recent developments. Dionne cited the repeal of the death penalty in Connecticut as an example of a "remarkable pivot in the politics of the death penalty, the premier issue on which an overwhelming consensus favoring what’s taken to be the conservative side has begun to crumble." He observed that "significant groups of libertarian Republicans and opponents of abortion have crossed to the repeal side." In an editorial titled "The Myth of Deterrence," the New York Times noted that "a distinguished committee of scholars working for the National Research Council has now reached the striking and convincing conclusion that all of the research about deterrence and the death penalty done in the past generation . . . should be ignored." The Times concluded that other states should follow Connecticut’s lead in repealing the death penalty. Read full texts below.
Little Connecticut’s big message on the death penalty
By E.J. Dionne Jr., April 29, 2012
Since the 2010 elections, newly empowered conservative and Republican state legislatures have gained national attention with their wars on public employee unions, additional restrictions on abortion and new barriers to voting.
Against this backdrop, the little state of Connecticut has loomed as a large progressive exception. Last year, it became the first state to require employers to grant paid sick leave. It also enacted a law granting in-state tuition to students whose parents brought them to the United States illegally as young children.
And last week, Connecticut Gov. Dan Malloy signed a law repealing the state’s death penalty. There are now 17 states without capital punishment, Illinois having joined the ranks last year. What happened in Connecticut brings home the flaw in seeing everything that has happened in the states since the midterm vote as embodying a steady shift rightward.
Where they hold power, progressives have also been using their states as laboratories, and Malloy is part of an impressive group of mostly smaller-state Democratic governors who have combined a moderate, business-friendly style with progressive policymaking. Their ranks include, among others, Govs. Jack Markell in Delaware, Martin O’Malley in Maryland, John Hickenlooper in Colorado, Deval Patrick in Massachusetts and outgoing Gov. John Lynch in New Hampshire.
After the 2012 election, a key front in the battle for America’s political future will involve how the various left and right experiments in the states are judged. Aggressive conservatives such as Govs. Scott Walker in Wisconsin and John Kasich in Ohio are in the headlines now, and the recall Walker faces will keep him there for a while. But there will be a quieter and more comprehensive reckoning down the road.
Part of this reckoning will be a remarkable pivot in the politics of the death penalty, the premier issue on which an overwhelming consensus favoring what’s taken to be the conservative side has begun to crumble.
In the 1980s and ‘90s, capital punishment was a staple of Republican campaigns against a handful of liberals who bravely stuck with their opposition to the ultimate punishment. George H.W. Bush used the issue effectively against Democrat Mike Dukakis in the 1988 presidential campaign. Republicans also used it in their 1994 electoral sweep, notably in defeating three-term Democratic Gov. Mario Cuomo in New York. And no wonder: In 1994, support for the death penalty hit its peak of 80 percent nationwide.
But a Gallup survey last fall showed how much things have changed: Support for capital punishment was down to 61 percent. Among the many reasons for the drop are a decline in crime rates, which has increased public confidence in the criminal justice system, and a stream of reports casting doubt on the guilt of some who were executed. In addition, significant groups of libertarian Republicans and opponents of abortion have crossed to the repeal side. An important test of the new politics of capital punishment will come this November in a California death penalty referendum.
For all this, it still takes political courage to end capital punishment. A Quinnipiac University poll released last week as Malloy signed the death penalty repeal found 62 percent of Connecticut voters still favoring executions of those convicted of murder, with only 30 percent opposed. Just 29 percent of those queried approved of the legislature’s handling of the issue, while 51 percent disapproved.
But (and it’s a very important but) support for the death penalty, in Connecticut and elsewhere, is not as robust as it looks. When Quinnipiac posed a different question — “Which punishment do you prefer for people convicted of murder, the death penalty, or life in prison with no chance of parole?” — only 46 percent favored the death penalty. An equal number chose life without parole. Death penalty opponents have an opening they haven’t had for some time.
Moreover, voters aren’t as agitated by the issue as they once were. Only 37 percent of Connecticut voters told Quinnipiac that the issue would be “extremely” or “very” important to how they cast their ballots in legislative elections.
Malloy is under no illusions about the strong residual opposition to repeal. When he signed the repeal bill last Wednesday, he did so with little ceremony, carefully observing that “many people whom I deeply respect, including friends and family ... believe the death penalty is just.”
Nonetheless, what Malloy did was historic, and it was a sign that despite the dreary polarization that characterizes our debates, American politics is still capable of springing surprises.

The Myth of Deterrence
Editorial, N.Y. Times - April 28, 2012
One of the most frequently made claims about the death penalty is that it deters potential murderers. That was the claim when the Supreme Court reinstated capital punishment in 1976. It is the claim today after a revival of research about the topic in the last decade.
But a distinguished committee of scholars working for the National Research Council has now reached the striking and convincing conclusion that all of the research about deterrence and the death penalty done in the past generation, including by some first-rank scholars at the most prestigious universities, should be ignored.
The committee found that the research “is not informative about whether capital punishment increases, decreases, or has no effect on homicide rates.” No study looks at what really matters, by comparing the deterrent effects of capital punishment with other penalties, like life without parole. A lot of the research assumes that “potential murderers respond to the objective risk of execution,” but only one in six of the people sentenced to death in the last 35 years have been executed and no study properly took that diminished risk into account.
“Nothing is known about how potential murderers actually perceive their risk of punishment,” said the criminologist Daniel Nagin, chairman of the committee.
The committee was careful to say what it did not examine, including the proven risk that an innocent person could be sentenced to death and the fact that the administration of capital punishment could well be discriminatory.
On Wednesday when Connecticut’s governor, Dannel Malloy, signed the state’s new law abolishing the death penalty, these problems were on his mind. As a former supporter of capital punishment, he said that he “came to believe that doing away with the death penalty was the only way to ensure it would not be unfairly imposed.”
The 33 states that retain the death penalty should follow that lead.
(E.J. Dionne, "Little Connecticut’s big message on the death penalty," Washington Post, April 29, 2012; "The Myth of Deterrence," New York Times, editorial, April 28, 2012). See Deterrence and Public Opinion. Read more Editorials. Listen to DPIC's podcast on Deterrence.

Honduras - Neglect Cited in Prison Fire - NYTimes.com

Honduras - Neglect Cited in Prison Fire - NYTimes.com

Honduras: Neglect Cited in Prison Fire

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The Inter-American Commission on Human Rights said Wednesday that the conditions that led to the Feb. 14 fire that killed 361 people at the Comayagua national prison were the result of decades of neglect of Honduras’s prisons and iron-fisted anticrime policies. A commission delegation that visited the prison and two others late last month concluded that the “most worrisome” problem in Honduras’s prisons was that the authorities had effectively ceded control to the prisoners themselves, in part because guards were not properly trained. This “has led to high levels of violence and corruption, in a context of absolute impunity,” the commission said. The delegation also found severe overcrowding, as well as unsafe housing and inadequate food, water and medical care.

Psychiatric News Alert: APA Invites Third Round of Public Comment on DSM-5

Psychiatric News Alert: APA Invites Third Round of Public Comment on DSM-5

Thursday, May 3, 2012

APA Invites Third Round of Public Comment on DSM-5

For a third and final time, the American Psychiatric Association is inviting public comment on the proposed criteria for the upcoming fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5).

The public comment period began May 2 and will continue until June 15. Key changes posted for this round of public review include, among others, proposals to place attenuated psychosis syndrome and mixed anxiety depressive disorder in Section III of the manual, covering conditions that require further research before their consideration as formal disorders. Also proposed is adding language to major depressive disorder criteria to help differentiate between normal bereavement associated with a significant loss and symptoms that indicate a mental disorder.

Feedback to the proposed criteria can be submitted online at http://www.dsm5.org/ until the comment period ends June 15. Nearly 10,800 comments from health care professionals, mental health advocates, families, and consumers were submitted in the first two public comment periods in 2010 and 2011.

For more information about DSM-5 see Psychiatric News here.
 

APA TV Annual Meeting 2012 | psychiatry.org

APA TV Annual Meeting 2012 | psychiatry.org

APA TV Annual Meeting 2012
Watch APA TV, the 2012 Annual Meeting video highlights from the Pennsylvania Convention Center, Philadelphia, PA, May 4 - 9. Each daily APA TV program includes “Thought Leadership” and “Conference News” segments.

The five-minute Thought Leadership segments showcase case studies and best practices from the psychiatry departments of 17 academic institutions.

Conference News is a daily program of Annual Meeting highlights, featuring “behind the scenes” interviews, coverage of special events, and reactions to the day from attending delegates. Upcoming interviews include APA President John Oldham, M.D., APA President-elect Dilip Jeste, M.D., Retired General Peter Chiarelli, award-winning author Kay Redfield Jamison, Ph.D., Director of the National Institute on Drug Abuse (NIDA) Nora Volkow, M.D., actor Dan Butler of NIDA’s Addiction Performance Project. If you can’t make it to Philly for the 165th APA Annual Meeting, be sure to check back here each day to watch APA TV.