Tuesday, May 22, 2012

Mike Nova: Beliefs, their phenomenology, psychopathology, sociopathology and clinical quantitative assessment - working draft

Last Update: 11:41 AM 5/22/2012

 

Mike Nova: Beliefs, their phenomenology, psychopathology, sociopathology and clinical quantitative assessment - working draft

 

Outline


Introduction


Beliefs, their place and assessment in Mental State

Wundt

Affective Component

Jaspers & others

The historical clinical concepts of "paranoia" and "paraphrenia"; Krepelin, Freud, J. Wagner-Jauregg, Schneider and others: 19 - 20 centuries "paradigm"  

Kuhn

Beliefs as paradigms and paradigms as beliefs

 

Phenomenology


Nature and cognitive purpose of beliefs

The Range of Beliefs

Common, religious, scientific, medical, judicial and other beliefs

The Hierarchy of Beliefs and Belief Systems

The elements of normal belief formations

The dynamics of normal belief formations

The "Tree" metaphor and model of normal belief formations

Psychopathology


The hypothesis of "abnormal" ("aberrant, deficient", etc.) "cognitive (including its ideational and affective components) pruning": concepts selection, elimination and confirmation as a psychopathological model of "Delusional Beliefs" formation.

The role of affective factor in "normal" and "abnormal" belief formations


 

Social Pathology


Shared Beliefs and shared Delusions

Societies: "Sane" and "Insane"

Eric Fromm

 

Clinical Quantitative Assessment of Delusional Beliefs


Categorical "cut off" vs. Dimensional approach; Delusional Beliefs as Psychopharmacological Targets

 
Intensity, strength of delusional conviction; the degree of their "incorrigibility

Functional Impairment

Features: Oddity; cultural factors

 Nosology of Delusional Beliefs

Disorder specific Delusional Beliefs
__________________________________________

Sources, References and Links

cognitive pruning: GS


*


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Google Search

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  • OpEdNews - Article: Psychiatrists Seek New Patients At Annual Meeting; Watch For These New Diseases

    Monday, May 21, 2012
    Psychiatrists Seek New Patients At Annual Meeting; Watch For These New Diseases
    (6 comments) Some question the objectivity of a disorder manual written by those who stand to benefit from an enlarged patient pool and new diseases. Furthering the appearance of self-dealing is the revelation that 57 percent of the DSM-5's authors have Pharma links.


    OpEdNews - Article: Psychiatrists Seek New Patients At Annual Meeting; Watch For These New Diseases


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    Psychiatrists Seek New Patients At Annual Meeting; Watch For These New Diseases


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    The first week in May brought a new leader in France and new prospects for same sex couples seeking marriage. But at the American Psychiatric Association's annual meeting in Philadelphia, attended by 11,000 psychiatrists, it was the same old same old. Instead of listening to the public outcry about overmedicated children, soldiers, elderly and everyday people watching too many drug ads, the psychiatry group re-affirmed its resolve to pathologize healthy people and even rolled out new groups to target.
    This is the year the APA puts the finishing touches on DSM-5, the Diagnostic and Statistical Manual of Mental Disorders, a compendium that determines what treatments insurers will cover, what disorders merit funding as "public health" threats and of course, Pharma marketing and profits. Some question the objectivity of a disorder manual written by those who stand to benefit from an enlarged patient pool and new diseases. Furthering the appearance of self-dealing is the revelation that 57 percent of the DSM-5's authors have Pharma links.
    No kidding. Present at this year's meeting were former APA president Alan F. Schatzberg, MD and Charles Nemeroff, MD, both investigatedby Congressfor murky Pharma income. Schatzberg and Nemeroff are co-editors of the APA-published Textbook of Psychopharmacology whose 2009 edition cites the work of Richard Borison, MD former psychiatry chief at the Augusta Veterans Affairs medical center who was sentenced to 15 years in prison for a $10 million clinical trial fraud. Also present was S. Charles Schulz, MD, who was investigated for financial links to AstraZeneca believed to alter his scientific conclusions.
    Even though Assistant Secretary of Defense Jonathan Woodson sent a memo to all branches of the military in February about overprescription of antipsychotic medications like Seroquel and Risperdal for PTSD, military figures closely linked to that overprescription were listed in attendance at the APA meeting.
    Elspeth Ritchie, MD, who told the Denver Post that AstraZeneca's Seroquel was "very useful for the treatment of anxiety and combat-related nightmares," though it was (and is) not approved for such treatment while she was medical director of the army's Strategic Communications Office in 2008, participated in many symposiums. Ritchie, who is now chief clinical officer for the District of Columbia's department of mental health, appeared in an AstraZeneca and Eli Lilly funded webcast for the Massachusetts General Hospital Psychiatry Academy in 2008 in which she lauds the use of "sophisticated" psychiatric medicines "on the battlefield." (see endnote)
    Seroquel earned AstraZeneca nearly $6 billion in revenue last year, reports the Philadelphia Inquirer. "IMS Health, a healthcare information and services company, said that in the 12 months ending in February of this year, 14.1 million Seroquel prescriptions were written, more than any other antipsychotic," it reports.

    Also participating in the military and PTSD content at the APA meeting was Matthew Friedman, MD, Executive Director of the VA's National Center for PTSD who reported, "I received an honorarium from AstraZeneca in the past year," in a 2009 government slide show called "Pharmacological Treatments of PTSD and Comorbid Disorder." Friedman also served as a Pfizer Visiting Professor at the Medical University of South Carolina College of Medicine last year yet is listed in the APA meeting guide as having no "significant relationships to disclose." APA officials have not responded to several requests for comment.
    Of course disorders that Big Pharma has helped monetize like bipolar (which was termed "under diagnosed" and emerging in the elderly at the meeting) and "mood disorders" (once called "life") were well represented. But an alarming amount of attention also went to the apparent new Pharma profit center of alcoholism and drug addiction.
    Addiction specialists have known for more than 70 years that the only "treatment" for drug addiction and alcoholism (after patients are detoxed) are anonymous, self-help programs that are also free. In fact medicine is as powerless to understand or treat drug addiction and alcoholism as alcoholics and drug addicts are over their addiction.
    Still the National Institutes of Health, in conjunction with Big Pharma, continues to spend millions, some say billions, developing "animal models" of addiction and vaccines to "cure" them. Nora D. Volkow, MD director of the National Institute on Drug Abuse, says she seeks a vaccine to treat those at risk of alcoholism and drug addiction on the basis of "biological and environmental factors," before they get sick. (See: treating those "at risk" for psychosis or depression or bipolar disorder on the basis of their family histories with no symptoms or evidence.)

    (Photo from "Maternal and Fetal C-Cocaine Uptake and Kinetics Measured In Vivo by Combined PET and MRI in Pregnant Nonhuman Primates," Journal of Nuclear Medicine, February 1, 2005 vol. 46 no. 2 312-320)
    It is pretty fair to say Volkow is not an alcoholic or drug addict. Any of them could tell her they don't seek "help" until they're out of options--and even then not from a doctor but from each other. If Pharma, the National Institute on Drug Abuse and the American Psychiatric Association think they can treat a disease caused by drugs with a drug, that's pretty insane. In fact, one of the treatments suggested for alcoholism at the meeting was quetiapine, also known as Seroquel.
    <!--[if !supportEndnotes]-->

    < !--[endif]-->
    <!--[if !supportFootnotes]-->[i]<!--[endif]--> "The Returning Veteran: PTSD and Traumatic Brain Injury," Massachusetts General Hospital Psychiatry Academy, May 28, 2008

    Martha Rosenberg is a health reporter and commentator whose work has appeared in Consumers Digest, the Boston Globe, San Francisco Chronicle, Chicago Tribune, New Orleans Times-Picayune, Los Angeles Times, Providence Journal and Newsday. She serves (more...)
    The views expressed in this article are the sole responsibility of the author
    and do not necessarily reflect those of this website or its editors.

    Blogs de ParaSaber.com » Darlene's blog » Download ebook: Marijuana and Madness: Psychiatry and Neurobiology

    Blogs de ParaSaber.com » Darlene's blog » Download ebook: Marijuana and Madness: Psychiatry and Neurobiology


    Darlene's blog

    20 May 2012
    Escrito por: buvygaty el 20 May 2012 - URL Permanente

    Download ebook: Marijuana and Madness: Psychiatry and Neurobiology


    Marijuana and Madness: Psychiatry and Neurobiology by David Castle, Robin Murray

    Marijuana and Madness: Psychiatry and Neurobiology

    Download Marijuana and Madness: Psychiatry and Neurobiology

    Marijuana and Madness: Psychiatry and Neurobiology David Castle, Robin Murray
    Language: English
    Page: 236
    Format: pdf
    ISBN: 0521819407, 9780511195761
    Publisher:
    Review
    "We congratulate them (the authors) on their accomplishment and recommend this book enthusiastically for all clinicians and researchers interested in substance related issues." Journal of American Medical Association (JAMA), Shahla Modir, MD, UCLA Neuropsychiatric Institute, and John Tsuang, MD, Harbor-UCLA Medical Center

    DSM critique in the New England Journal of Medicine is not what it seems « ALTmentalities

    DSM critique in the New England Journal of Medicine is not what it seems « ALTmentalities

    DSM critique in the New England Journal of Medicine is not what it seems 05/21/2012Posted by ALT in DSM-5, Mental Health Research.
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    I heard the rumors of a fight, and I came a-running.
    Fisticuffs, you say? I’m in!
    This morning, I read [here] that the following inflammatory remarks were published in this week’s New England Journal of Medicine:
    … [Only when psychiatrists address] psychiatric disorders in the same way that internists address physical disorders, explaining the clinical manifestations … by the causal processes and generative mechanisms known to provoke them … will psychiatry come of age as a medical discipline and a field guide [the DSM – Diagnostic and Statistical Manual] cease to be its master work.
    - Paul McHugh, MD and Phillp Slavney, MD in the NEJM [emphasis added]
    Damn, that’s cold. And did I mention it was published in the New England Journal of Medicine (!), which is “one of the world’s most prestigious medical journals… cited in scientific literature more frequently than any other biomedical journal”? All kinds of doctors, clinicians, and practitioners read this thing!
    A big deal.
    Sounds like the authors are saying mental illness is fundamentally NOT like diabetes, that psychiatry as a discipline will continue to suffer from its immaturity and crippling inferiority complex (“we wanna be scientists, too!”) as long as diagnosis doesn’t rest on a firmly established foundation of physical pathology, and that the DSM is a poor substitute for that kind of a foundation.
    Them’s fighting words. Words that might make the NEJM readership think twice before handing out diagnoses and their accompanying pharmacological interventions like the proverbial candy.

    Don’t believe every rumor you hear

    Having matured a bit from my high school days of running directly to join the ring of kids chanting “fight, fight, fight!”, I decided to get a little context. Who are these guys -– researchers? psychiatrists? some other kind of doctors? — and what does the rest of their NEJM editorial say?
    “These guys” are two psychiatrists, professors at the Johns Hopkins School of Medicine. Paul McHugh, the lead author, is a rather famous one. He’s attended Harvard, designed a famous cognitive test often used as a dementia/Alzheimer’s diagnostic tool (a mere 11 questions!), served on the Presidential Council of Bioethics under GW and on a lay panel put together by the Catholic Church to look into the abuse of young boys by priests – none of these things being very high recommendations in my book. The two, together, have written a popular paperback for the general public entitled The Perspectives of Psychiatry which takes the biopsychiatric/disease-based approach to mental health.
    And their editorial? It starts off very nicely with a critique of the DSM-delineated “field guide” method of diagnosis – the main problem being that clinicians no longer think too long or hard about causation. This promotes a “rote-driven” method of treating folks, and as the authors so rightly state “identifying a disorder by its symptoms does not translate into understanding it.” Or treating it effectively, if long-term studies of schizophrenia outcomes are any indication.
    But things go sour real fast as we get to the “what’s to be done about it” part. We simply must establish causation for psychiatric disorders, and – guess what?—the authors have already done that!
    The causes of psychiatric disorders derive from four interrelated but separable families: brain diseases, personality dimensions, motivated behaviors, and life encounters.
    -McHugh et al.
    Good, good.
    They have also helpfully sorted out some common psychiatric disorders into the four families, or “causal perspectives”:
    It’s written in a table so it MUST be true!
    Right there, in the NEJM (remember – prestigious medical journal read by everybody), we’ve got schizophrenia neatly categorized as “brain disease.”
    Oh, dear.

    I diagnose thee… Flipfloppers!

    Contrast the NEJM editorial with the polite phrasing the authors used in the aforementioned co-authored The Perspectives of Psychiatry, chapter 6:
    The continuing failure to identify a particular cerebral pathology or pathophysiology in these disorders [manic depression and schizophrenia] undermines attempts to proclaim them as diseases with complete confidence. They remain mysteries in the sense that a confirmation of their essential nature is lacking…
    - authors Paul McHugh, MD and Phillp Slavney, MD in The Perspectives of Psychiatry [emphasis added]
    And yet they feel comfortable, only a few years after these words were published, with proclaiming schizophrenia as a “brain disease,” without providing any citations for new, groundbreaking research whatsoever. Clearly this “DSM critique” is not what it seems.

    Middle way protestors all the way

    As it turns out, these guys are total middle way DSM protestors – the only thing they’d like to fight is the bad public image of the DSM, not the institution of psychiatric diagnoses masquerading as science, and all of the poor treatment that goes along with such posturing (symptom suppression via pharmaceuticals, coercive treatment, et al.).
    According to McHugh and Slavney, “no replacement of the criterion-driven diagnoses of the DSM would be acceptable; clinicians are too accustomed to them.” Rather, the only solution is for everyone [clinicians, researchers, families, patients] to embrace their causation groupings – and for that to be coded and billable, too, one can only presume.
    In no other field would you continue to reach for an admittedly blunt, ineffective tool simply because it’s “what people are used to.” Surely there are some other possiblities?
    I believe that there is another way – instead of fitting people and their “symptoms” into predetermined boxes, we could communicate with each unique individual, offering our support and encouragement (help) when it’s wanted, and offering our respectful non-interventionism and acknowledgement of the humanity of the suffering individual when our “help” is neither helpful nor desired.
    I believe there is life after the DSM – and I’d like, as a society and a community, to live it!

    Psychiatrists identify 'asylum seeker syndrome' - Yahoo!7

    Psychiatrists identify 'asylum seeker syndrome' - Yahoo!7

    A group of Australian psychiatrists has identified a new mental illness syndrome unique to asylum seekers.
    The group is presenting its evidence on Prolonged Asylum Seekers Syndrome at an international psychiatry conference in Hobart.
    It was identified after studying the mental health of asylum seekers and refugees living in Melbourne.
    Major depression was diagnosed in more than 60 per cent of asylum seekers and about 30 per cent of refugees.
    Associate Professor Suresh Sundram, from the University of Melbourne, says asylum seekers who had their applications rejected repeatedly showed clinical symptoms not seen before.
    "It's people who are being subjected to protracted periods of refugee determination, so ones who are not getting quick responses," he said.
    "But maybe even more importantly, it's people who are being repeatedly rejected and have continued to press claims for protection.
    "They seem to be especially vulnerable.
    "We have talked about this syndrome before but it is becoming increasingly clear that it appears to be distinct from anything else that we have been seeing."
    Psychiatrists say the latest evidence shows asylum seekers should be allowed to live in the community to improve their wellbeing.
    "The refugee determination process in Australia seems to contribute to the prevalence of post traumatic stress disorders (PTSD) in asylum seekers insofar as asylum seekers who have had four or more rejections for protection visas, the level of PTSD correlates with the number of rejections that they have had," Associate Professor Sundram said.
    "Those asylum seekers who seem to have a protracted process of refugee determination, they seem to demonstrate clinical features that we haven't seen before and certainly seem to characterise a unique, or distinct, syndrome from other people who have been through similar types of traumas.
    "We've coined the term to best describe this subgroup of asylum seekers who've had this protracted and difficult refugee determination process."
    He says Australia does not have adequate services to deal with the problem because it is not well understood or recognised within the public mental health system.
    An Iranian man who waited for four years to have his refugee status approved has backed the findings.
    Mohsen Sultani was approved in 2004 and says he still suffers mental anguish, as do many people who were in his situation.
    "They don't know anything about (their) future and on top of that the Government accused them of (being) a queue jumper, children overboard, all this stuff...it is absolutely a nightmare," he said.

    Give your psychiatrist a diagnosis of his own: Six disorders to choose from

    Give your psychiatrist a diagnosis of his own: Six disorders to choose from



    af3353b6e9Doctor.jpg Give your psychiatrist a diagnosis of his own: Six disorders to choose from

    (NaturalNews) Given the controversy over the legitimacy of the Diagnostics and Statistics Manual (DSM) used for psychiatric diagnosis, I thought I'd clear things up by submitting the following revisions. These carefully considered and researched new labels should do the trick, as they are intended to make the DSM more balanced by offering the patient an opportunity to diagnose the doctor.

    If you are a doctor and are offended by these proposed DSM additions, then they certainly apply to you. If you are a patient or concerned citizen and are ready to bust one of these onto an unsuspecting doc, you can follow it with the remedy at the end of this article. Here are my six proposed additions to the DSM (others are being researched).

    Learn more: http://www.naturalnews.com/035934_psychiatry_disorders_mental_health.html#ixzz1vb9WAs6a

    CRD: Compassion repression disorder

    Symptoms: When the doc is in the presence of human suffering, he pretends nothing is happening. He could be watching a chess match for all we know. When a patient reaches emotional extremes (as in extraordinarily depressed) he realizes it is time to initiate electro-convulsive therapy and send electric shocks through her brain, possibly wiping out much of her memory. The doc is fine with this and proceeds to go out for a sandwich.

    GNTFY: Got no time for you syndrome

    Symptoms: Due to concerns about making his yacht payment and country club dues, the doc obsessively packs in 4-5 patients every hour. When you ask a question that takes more than 7.5 seconds to answer, the doc quickly regurgitates several medical terms, hands you a brochure and dashes for the door.

    PCSD: Pervasive communication skills disorder

    Symptoms: When the doc holds sensitive information and needs to break the news to the patient, he hits the patient over the head with it in the most dismissive way possible. If the patient has cancer, for example, the doctor might say, "You have cancer. We can't operate. You are going to die. The exit is to your left just down the hall."

    In less severe cases, such as delivering inconclusive test results (most likely from inadequate testing methods or not knowing what to look for) to a patient who had hopes of finding the cause of a symptom, the doctor takes a more compassionate route, such as, "The results are negative. I guess it really is all in your head."

    IAGS: I am God syndrome (also known as "power trip simplex")

    Symptoms: The doc behaves as if he were all-powerful and all-knowing. When confronted with the truth that he is just guessing most of the time and that there are a variety of effective, alternative ways to heal from mental and emotional issues, he recoils in righteous indignation.

    CPWD: Compulsive prescription writing disorder

    Symptoms: Due to repressed feelings of inadequacy and improper toilet training methods used by his parents, the poor doctor compensates by compulsively reaching for the prescription pad every time he hears a symptom. He can't tolerate messes and when patients lives are a bit messy, he has to clean it up as quickly as possible.

    BPDD: Big pharma dependency disorder

    Symptoms: The doc displays little or no ability to actually help people and has no interest human nature anyway, so he is 100% (one HUNDRED percent) dependent upon the pharmaceutical industry to tell him what to do with his patients. Aside from studying which medication matches which symptoms (as can be discerned in 12 minutes or less) the doctor has no other skills. Poor communication skills. No compassion. Little interest in the emotional causes of problems. No taste for nutrition therapy. Nothing!

    There really isn't much there, folks. This guy is a pill-pusher and that's about it! I guess we should show some compassion of our own. After all, once the doc gets a little taste of how easy and lucrative it is to prescribe a pill, he gets sucked right in. Before you know it, he is hooked on the easy money.

    He doesn't have a medical practice that seeks to solve deep problems at the heart of the human condition. He isn't connecting with people in their suffering and helping them work out their emotional problems. He is no teacher or mentor. He is a pill pusher caught up in the drug cartel's deadly game.

    Worst of all, now it is too late. You see, he's got overhead. Bills! Actually helping people takes time he no longer has. You have to get to know people. You need to contemplate their circumstance in life. You can't do it in 15 minutes. You can see one patient per hour at most. There goes that $600,000 annual income. You'd have to cut back to a mere $150,000 annually, or something close to it. So, yeah, it's tough for these guys.

    The remedy to all of the above. A sincere plea to the doctor: Please, please stop. We need good doctors. You have so much opportunity to assist people who put their trust in you. Slow down. Learn to really help people who are suffering with emotional problems. Learn to work with other practitioners of all kinds. The work is rewarding, unlike the pill factory you currently operate. Please consider this request to make a real difference.

    About the author:
    Get the free mini-course taken by more than 10,000 people, Three Soul Stirring Questions That Reveal your Deepest Goals.

    Learn more about Mike's down-to-earth life coaching that comes with a lifetime membership to the iNLP Center online school and receive a free life coaching strategy session.

    Mike Bundrant is the host of Mental Health Exposed, a Natural News Radio program, and the co-founder of the iNLP Center.

    Learn more: http://www.naturalnews.com/035934_psychiatry_disorders_mental_health.html#ixzz1vb9KYRPI

    Monday, May 21, 2012

    Finding Elderly New Yorkers Who Become Lost Outside - NYTimes.com

    Finding Elderly New Yorkers Who Become Lost Outside - NYTimes.com

    Dr. Robert L. Spitzer, Noted Psychiatrist, Apologizes for Study on Gay ‘Cure’ - NYTimes.com

    Dr. Robert L. Spitzer, Noted Psychiatrist, Apologizes for Study on Gay ‘Cure’ - NYTimes.com

    May 18, 2012

    Psychiatry Giant Sorry for Backing Gay ‘Cure’

    PRINCETON, N.J. — The simple fact was that he had done something wrong, and at the end of a long and revolutionary career it didn’t matter how often he’d been right, how powerful he once was, or what it would mean for his legacy.
    Dr. Robert L. Spitzer, considered by some to be the father of modern psychiatry, lay awake at 4 o’clock on a recent morning knowing he had to do the one thing that comes least naturally to him.
    He pushed himself up and staggered into the dark. His desk seemed impossibly far away; Dr. Spitzer, who turns 80 next week, suffers from Parkinson’s disease and has trouble walking, sitting, even holding his head upright.
    The word he sometimes uses to describe these limitations — pathetic — is the same one that for decades he wielded like an ax to strike down dumb ideas, empty theorizing and junk studies.
    Now here he was at his computer, ready to recant a study he had done himself, a poorly conceived 2003 investigation that supported the use of so-called reparative therapy to “cure” homosexuality for people strongly motivated to change.
    What to say? The issue of gay marriage was rocking national politics yet again. The California State Legislature was debating a bill to ban the therapy outright as being dangerous. A magazine writer who had been through the therapy as a teenager recently visited his house, to explain how miserably disorienting the experience was.
    And he would later learn that a World Health Organization report, released on Thursday, calls the therapy “a serious threat to the health and well-being — even the lives — of affected people.”
    Dr. Spitzer’s fingers jerked over the keys, unreliably, as if choking on the words. And then it was done: a short letter to be published this month, in the same journal where the original study appeared.
    “I believe,” it concludes, “I owe the gay community an apology.”
    Disturber of the Peace
    The idea to study reparative therapy at all was pure Spitzer, say those who know him, an effort to stick a finger in the eye of an orthodoxy that he himself had helped establish.
    In the late 1990s as today, the psychiatric establishment considered the therapy to be a nonstarter. Few therapists thought of homosexuality as a disorder.
    It was not always so. Up into the 1970s, the field’s diagnostic manual classified homosexuality as an illness, calling it a “sociopathic personality disturbance.” Many therapists offered treatment, including Freudian analysts who dominated the field at the time.
    Advocates for gay people objected furiously, and in 1970, one year after the landmark Stonewall protests to stop police raids at a New York bar, a team of gay rights protesters heckled a meeting of behavioral therapists in New York to discuss the topic. The meeting broke up, but not before a young Columbia University professor sat down with the protesters to hear their case.
    “I’ve always been drawn to controversy, and what I was hearing made sense,” said Dr. Spitzer, in an interview at his Princeton home last week. “And I began to think, well, if it is a mental disorder, then what makes it one?”
    He compared homosexuality with other conditions defined as disorders, like depression and alcohol dependence, and saw immediately that the latter caused marked distress or impairment, while homosexuality often did not.
    He also saw an opportunity to do something about it. Dr. Spitzer was then a junior member of on an American Psychiatric Association committee helping to rewrite the field’s diagnostic manual, and he promptly organized a symposium to discuss the place of homosexuality.
    That kicked off a series of bitter debates, pitting Dr. Spitzer against a pair of influential senior psychiatrists who would not budge. In the end, the psychiatric association in 1973 sided with Dr. Spitzer, deciding to drop homosexuality from its manual and replace it with his alternative, “sexual orientation disturbance,” to identify people whose sexual orientation, gay or straight, caused them distress.
    The arcane language notwithstanding, homosexuality was no longer a “disorder.” Dr. Spitzer achieved a civil rights breakthrough in record time.
    “I wouldn’t say that Robert Spitzer became a household name among the broader gay movement, but the declassification of homosexuality was widely celebrated as a victory,” said Ronald Bayer of the Center for the History and Ethics of Public Health at Columbia. “ ‘Sick No More’ was a headline in some gay newspapers.”
    Partly as a result, Dr. Spitzer took charge of the task of updating the diagnostic manual. Together with a colleague, Dr. Janet Williams, now his wife, he set to work. To an extent that is still not widely appreciated, his thinking about this one issue — homosexuality — drove a broader reconsideration of what mental illness is, of where to draw the line between normal and not.
    The new manual, a 567-page doorstop released in 1980, became an unlikely best seller, here and abroad. It instantly set the standard for future psychiatry manuals, and elevated its principal architect, then nearing 50, to the pinnacle of his field.
    He was the keeper of the book, part headmaster, part ambassador, and part ornery cleric, growling over the phone at scientists, journalists, or policy makers he thought were out of order. He took to the role as if born to it, colleagues say, helping to bring order to a historically chaotic corner of science.
    But power was its own kind of confinement. Dr. Spitzer could still disturb the peace, all right, but no longer from the flanks, as a rebel. Now he was the establishment. And in the late 1990s, friends say, he remained restless as ever, eager to challenge common assumptions.
    That’s when he ran into another group of protesters, at the psychiatric association’s annual meeting in 1999: self-described ex-gays. Like the homosexual protesters in 1973, they too were outraged that psychiatry was denying their experience — and any therapy that might help.
    Reparative Therapy
    Reparative therapy, sometimes called “sexual reorientation” or “conversion” therapy, is rooted in Freud’s idea that people are born bisexual and can move along a continuum from one end to the other. Some therapists never let go of the theory, and one of Dr. Spitzer’s main rivals in the 1973 debate, Dr. Charles W. Socarides, founded an organization called the National Association for Research and Therapy of Homosexuality, or Narth, in Southern California, to promote it.
    By 1998, Narth had formed alliances with socially conservative advocacy groups and together they began an aggressive campaign, taking out full-page ads in major newspaper trumpeting success stories.
    “People with a shared worldview basically came together and created their own set of experts to offer alternative policy views,” said Dr. Jack Drescher, a psychiatrist in New York and co-editor of “Ex-Gay Research: Analyzing the Spitzer Study and Its Relation to Science, Religion, Politics, and Culture.”
    To Dr. Spitzer, the scientific question was at least worth asking: What was the effect of the therapy, if any? Previous studies had been biased and inconclusive. “People at the time did say to me, ‘Bob, you’re messing with your career, don’t do it,’ ” Dr. Spitzer said. “But I just didn’t feel vulnerable.”
    He recruited 200 men and women, from the centers that were performing the therapy, including Exodus International, based in Florida, and Narth. He interviewed each in depth over the phone, asking about their sexual urges, feelings and behaviors before and after having the therapy, rating the answers on a scale.
    He then compared the scores on this questionnaire, before and after therapy. “The majority of participants gave reports of change from a predominantly or exclusively homosexual orientation before therapy to a predominantly or exclusively heterosexual orientation in the past year,” his paper concluded.
    The study — presented at a psychiatry meeting in 2001, before publication — immediately created a sensation, and ex-gay groups seized on it as solid evidence for their case. This was Dr. Spitzer, after all, the man who single-handedly removed homosexuality from the manual of mental disorders. No one could accuse him of bias.
    But gay leaders accused him of betrayal, and they had their reasons.
    The study had serious problems. It was based on what people remembered feeling years before — an often fuzzy record. It included some ex-gay advocates, who were politically active. And it did not test any particular therapy; only half of the participants engaged with a therapist at all, while the others worked with pastoral counselors, or in independent Bible study.
    Several colleagues tried to stop the study in its tracks, and urged him not to publish it, Dr. Spitzer said.
    Yet, heavily invested after all the work, he turned to a friend and former collaborator, Dr. Kenneth J. Zucker, psychologist in chief at the Center for Addiction and Mental Health in Toronto and editor of the Archives of Sexual Behavior, another influential journal.
    “I knew Bob and the quality of his work, and I agreed to publish it,” Dr. Zucker said in an interview last week. The paper did not go through the usual peer-review process, in which unnamed experts critique a manuscript before publication. “But I told him I would do it only if I also published commentaries” of response from other scientists to accompany the study, Dr. Zucker said.
    Those commentaries, with a few exceptions, were merciless. One cited the Nuremberg Code of ethics to denounce the study as not only flawed but morally wrong. “We fear the repercussions of this study, including an increase in suffering, prejudice, and discrimination,” concluded a group of 15 researchers at the New York State Psychiatric Institute, where Dr. Spitzer was affiliated.
    Dr. Spitzer in no way implied in the study that being gay was a choice, or that it was possible for anyone who wanted to change to do so in therapy. But that didn’t stop socially conservative groups from citing the paper in support of just those points, according to Wayne Besen, executive director of Truth Wins Out, a nonprofit group that fights antigay bias.
    On one occasion, a politician in Finland held up the study in Parliament to argue against civil unions, according to Dr. Drescher.
    “It needs to be said that when this study was misused for political purposes to say that gays should be cured — as it was, many times — Bob responded immediately, to correct misperceptions,” said Dr. Drescher, who is gay.
    But Dr. Spitzer could not control how his study was interpreted by everyone, and he could not erase the biggest scientific flaw of them all, roundly attacked in many of the commentaries: Simply asking people whether they have changed is no evidence at all of real change. People lie, to themselves and others. They continually change their stories, to suit their needs and moods.
    By almost any measure, in short, the study failed the test of scientific rigor that Dr. Spitzer himself was so instrumental in enforcing for so many years.
    “As I read these commentaries, I knew this was a problem, a big problem, and one I couldn’t answer,” Dr. Spitzer said. “How do you know someone has really changed?”
    Letting Go
    It took 11 years for him to admit it publicly.
    At first he clung to the idea that the study was exploratory, an attempt to prompt scientists to think twice about dismissing the therapy outright. Then he took refuge in the position that the study was focused less on the effectiveness of the therapy and more on how people engaging in it described changes in sexual orientation.
    “Not a very interesting question,” he said. “But for a long time I thought maybe I wouldn’t have to face the bigger problem, about measuring change.”
    After retiring in 2003, he remained active on many fronts, but the reparative study remained a staple of the culture wars and a personal regret that wouldn’t leave him be. The Parkinson’s symptoms have worsened in the past year, exhausting him mentally as well as physically, making it still harder to fight back pangs of remorse.
    And one day in March, Dr. Spitzer entertained a visitor. Gabriel Arana, a journalist at the magazine The American Prospect, interviewed Dr. Spitzer about the reparative therapy study. This was not just any interview; Mr. Arana went through reparative therapy himself as a teenager, and his therapist had recruited the young man for Dr. Spitzer’s study (Mr. Arana did not participate).
    “I asked him about all his critics, and he just came out and said, ‘I think they’re largely correct,’ ” said Mr. Arana, who wrote about his own experience last month. Mr. Arana said that reparative therapy ultimately delayed his self-acceptance as a gay man and induced thoughts of suicide. “But at the time I was recruited for the Spitzer study, I was referred as a success story. I would have said I was making progress.”
    That did it. The study that seemed at the time a mere footnote to a large life was growing into a chapter. And it needed a proper ending — a strong correction, directly from its author, not a journalist or colleague.
    A draft of the letter has already leaked online and has been reported.
    “You know, it’s the only regret I have; the only professional one,” Dr. Spitzer said of the study, near the end of a long interview. “And I think, in the history of psychiatry, I don’t know that I’ve ever seen a scientist write a letter saying that the data were all there but were totally misinterpreted. Who admitted that and who apologized to his readers.”
    He looked away and back again, his big eyes blurring with emotion. “That’s something, don’t you think?”

    A New Attack on Alzheimer’s - NYTimes.com

    A New Attack on Alzheimer’s - NYTimes.com

    May 20, 2012

    A New Attack on Alzheimer’s

    The Obama administration has announced a bold research program to test whether a drug can prevent the onset of Alzheimer’s disease well before any symptoms appear. It is a long shot, but the payoff could be huge.
    Currently, there is no cure for Alzheimer’s, which steadily robs patients of their memory, followed by full-blown dementia. There is also no diagnostic test to identify who has it, and no treatment to slow patients’ deterioration for more than a few months.
    While work continues on those fronts, the new clinical trial will test whether the drug, Crenezumab, made by Genentech, can prevent the disease in a group of people whose genetic heritage guarantees that they will develop it. If the drug successfully prevents the loss of mental capacities as measured by a sensitive new cognitive test there is hope — but no guarantee — that it could do the same for members of the general public. As Pam Belluck described in The Times last week, the trial will focus on members of an extended family in Colombia who carry a rare genetic mutation that causes them to develop Alzheimer’s early in life. They typically experience cognitive impairment at about age 45 and dementia by 51. The trial will also include a smaller number of individuals in the United States with the same genetic mutation.
    Instead of recruiting thousands of volunteers and following them for an extended period as in a customary prevention trial, the researchers in Colombia will give the drug to only 100 people with the early-onset genetic mutation. They will give placebos to another 100 people with the mutation and to 100 family members who do not carry the deadly gene.
    The study will cost more than $100 million and is being financed mostly by Genentech, buttressed by $16 million from the National Institutes of Health and $15 million raised by the Banner Alzheimer’s Institute in Phoenix, which is leading the study.
    The prevailing, but not universally accepted, hypothesis is that amyloid plaques in the brain play a major role in causing Alzheimer’s. Crenezumab attacks the formation of such plaques, apparently by binding to amyloid proteins and clearing them from the brain. If the drug fails to work, the trial will probably demolish the amyloid hypothesis and set researchers scrambling to find other targets to attack.
    A prevention trial of a different drug that was also intended to slow formation of amyloid plaques actually made patients’ symptoms worse, possibly because it interfered with various other proteins needed by the brain. Researchers believe that Crenezumab will be safer and more effective, but again there are no guarantees. The risk is justified given that without the treatment the recipients will inevitably get Alzheimer’s in the prime of their lives. The truly big payoff will come if the drug succeeds in this group and lays the groundwork for preventing or slowing the progress of Alzheimer’s that appears late in life. The researchers will be gathering data on a variety of biomarkers — glucose activity in the brain, shrinkage of the brain, certain proteins in cerebral spinal fluid, for example — to see which if any are related to preventing amyloid plaques and the loss of mental abilities.
    If the drug prevents the deterioration of particular biomarkers and ultimately sustains mental capacity, then the same markers might be useful in identifying and treating older people likely to develop the disease. And federal regulators might be willing to approve other prevention drugs based on their short-term effects on biomarkers, speeding the conduct of clinical trials.
    More than five million Americans currently have Alzheimer’s. Without an effective preventive, the number will rise steadily as the population ages.

    Sunday, May 20, 2012

    MISSION BEHIND BARS AND BEYOND - Home Page

    Home Page

    Behind the Bars . . .

    SUPPORT, MODEL, MENTOR
    In 2009, one in every 31 adults in the United States was either in prison, in jail, or on supervised release. That translates to 7.3 million people. State corrections costs now top $52 billion annually and consume one in every 15 discretionary dollars. Nationally, 43 percent of prisoners released in 2004 were reincarcerated within three years. In Kentucky, 43 percent of those released in 2007 were reincarcerated within three years. It is estimated over 60% of those released from prison find themselves in prison again. Within the first year, 44% return to prison. This figure increases to 70% after three years.
    COST TO INCARCERATE
    The cost of incarcerating an inmate in Kentucky is close to $19,000 per inmate per year. There are approximately 21,000 men and women incarcerated in Kentucky prisons and jails. Kentucky spends about $450 million annually on corrections. Spending on corrections has quadrupled over the past two decades. Over the course of time, 95% of those who are incarcerated will be released and will return to our communities. Unfortunately, support systems that prepare ex-offenders to return and to live healthy, productive, crime-free lives are limited.

    Prison Psychiatry News Review - 5/20/2012 | “If you are going to put them in prison, you have to keep them safe.”: US Issues Far-Reaching Rules to Stem Prison Rape - New York Times | Mentally ill inmates sue to get out of solitary - Boston.com - 8:49 AM 5/20/2012 - Mike Nova's starred items

    Google Reader - Mike Nova's starred items

    Prison Psychiatry News Review - 5/20/2012

    8:49 AM 5/20/2012 - Mike Nova's starred items

    “If you are going to put them in prison, you have to keep them safe.”

    US Issues Far-Reaching Rules to Stem Prison Rape - New York Times

    via prisons - Google News on 5/17/12

    New York Daily News









    US Issues Far-Reaching Rules to Stem Prison Rape
    New York Times
    WASHINGTON — The Justice Department on Thursday issued the first comprehensive federal rules aimed at “zero tolerance” for sexual assaults against inmates in prisons, jails and other houses of detention. The regulations, issued after years of ...

    Justice: Prisons to step up anti-rape effortsWashington Post




    “Sexual violence, against any victim, is an assault on human dignity and an affront to American values,” President Obama said.

    Obama announced that the Prison Rape Elimination Act would apply to all federal confinement facilities, and all other agencies with such facilities had to have protocols within a year to fight prison rape.  — Associated Press



    Crimes in prisonWatertownDailyTimes.com

    all 344 news articles »

    via prisons - Google News on 5/19/12









    New rules aim to reduce prison rapes
    Lawrence Journal World
    By Shaun Hittle New regulations issued by the Obama administration Thursday could affect how Kansas prisons handle sexual assaults. The new regulations — under development since the passage of the 2003 Prison Rape Elimination Act, or PREA — include ...

    and more »

    via prisons - Google News on 5/17/12









    Justice: Prisons to step up anti-rape efforts
    KSRO
    WASHINGTON (AP) — The Obama administration ordered federal, state and local officials Thursday to adopt zero tolerance for prison rape as it issued mandatory screening, enforcement and prevention regulations designed to reduce the number of inmates ...

    via Prison News on 5/18/12
    The Obama administration ordered federal, state and local officials Thursday to adopt zero tolerance for prison rape as it issued mandatory screening, enforcement and prevention regulations designed to reduce the number of inmates who suffer sexual victimization at the hands of other prisoners and prison staff.

    via prisons - Google News on 5/19/12

    MLive.com









    Law Talk: How President Obama plans to reduce prison rape
    MLive.com
    By Barton Deiters | bdeiters@mlive.com AP File Photo This week, the US Department of Justice announced it was stepping up efforts under the 2003 Prison Rape Elimination Act to end prison rape. The Justice Department recognized that prison rape is a ...
    Feds: Prisons to step up anti-rape effortsLongview News-Journal
    Crimes in prisonWatertownDailyTimes.com
    Rape trial: Obama forces prisons to get tough on assaultsPittsburgh Post Gazette

    all 344 news articles »

    via prisons - Google News on 5/20/12


    "The “war on drugs” cost billions of dollars and has been a failure. There is the same number of people addicted to drugs now as when this war began. The consequence of this war has been an ever-increasing rise in incarceration with a disproportionate number of people of color being arrested and incarcerated. For a sobering and startling examination of this phenomenon, please read Michelle Alexander’s book, “The New Jim Crow: Mass Incarceration in an Age of Colorblindness.”

    There is hope, however.

    The Kentucky General Assembly passed a bill last year that will begin relieving our overburdened corrections system. This will move those who need treatment for addiction into recovery and rehabilitation programs where they belong. This is only one small part of the solution."





    For prisoners, hope and help behind bars and beyond
    The Courier-Journal
    Serving as pastor of Luther Luckett Christian Church (Disciples of Christ), the only prison congregation in Kentucky, I am faced with incarcerated men like Russell, the man in Mr. Pitts' column, who ask the very same question as he did: “What are you ...


    "Grounded in the principles of restorative justice that hold people accountable for their actions as they seek to find healing and wholeness in their lives, we train small, faith-based groups of six to eight volunteers to work with men released from prison. These groups meet with one ex-offender weekly and contact him daily. They help him set goals, develop action plans and hold him accountable to the actions he takes. The groups listen, support and provide mentoring. In addition, the groups direct the ex-offender to helpful resources in the community. The goal is to equip, not enable.
    It is working.
    Each of us grows and matures through healthy relationships and with good role models. Many who have been incarcerated have never been blessed with either. One missing link in reducing recidivism and ending the cycle that has been sadly named “the school-to-prison pipeline,” is a compassionate community willing to work with those who have paid their debt to society. To expect them to turn their lives around without outside community support is na├»ve."

    and more »

    Comprehensive interdisciplinary collection of links to news and journal articles on General, Forensic and Prison Psychiatry and Psychology and the issues of Behavior and Law with occasional notes and comments by Michael Novakhov, M.D. ( Mike Nova). .... Psychiatric Mislabeling Is Bad For Your Mental Hea... Introduction to this Issue: International Perspect... Psychopathic traits and change on indicators of dy... A Kindler, Gentler Psychiatrist « candidaabrahamso.

    via prisons - Google Blog Search by Bert Useem on 5/19/12
    U.S. Prisons and the Myth of Islamic Terrorism. by Bert Useem. There is a great deal of concern that U.S. prisons are generating high levels of Islamic extremism. Sociologist Bert Useem argues that the evidence fails to support this fear.

    via Behavior and Law by Mike Nova on 5/19/12
    Punishment Outside Prison - NYTimes.com

    May 19, 2012

    Punishment Outside Prison


    By LINCOLN CAPLAN

    Probation and parole for convicted offenders are complex and growing problems in criminal justice. Scholars and others with the American Law Institute, meeting in Washington this week, are to present draft proposals on ways to reform laws about offenders who serve these out-of-custody sentences.
    The draft recommends fewer such community-based sentences, with shorter terms and fewer conditions imposed so that supervision is better defined. When finalized, the plan will be a model for state penal codes.
    In 2010, more than 2.3 million people were behind bars in the United States. More than twice that number, 4.9 million, were under probation or parole. Such sentences — imposed either for lesser offenses like shoplifting, or after release from prison for more serious offenses — are considered easy time compared with incarceration and a first step toward a fresh start. But often, that turns out to be wrong.
    Increasingly, these offenders are not reintegrated into society. Often, so many conditions are imposed on their probation or parole — like not being allowed to drink alcohol after being convicted of passing a bad check — that it is easy to violate just one and end up in custody. And the consequences of community sentences even for those never imprisoned — like not being permitted to vote or to qualify for, say, a beautician’s license — make it difficult to find a job. Under a sound justice system, most offenders should do their time and get a second chance. For many, probation and parole lead to prison, not back to a normal life.


    Mike Nova's starred items

    Relationship between comorbidity and violence risk assessment in forensic psychiatry – the implication of neuroimaging studies. (Link). • Relationship of IQ to suicide and homicide rate: an international perspective. (Link) ...

    via prisons - Google News on 5/17/12

    abc13.com









    Prisons system ordered to release details on execution drugs
    Austin American-Statesman
    By Mike Ward In a victory for open government, Texas prison officials on Thursday lost their latest attempt to keep secret details about its stock and suppliers of lethal injection drugs. In an opinion dated Monday, Attorney General Greg Abbott ...
    Texas prisons must disclose execution drug detailsKIII TV3
    State Prisons Must Disclose Execution Drug InfoCBS Local

    all 39 news articles »

    via prisons - Google News on 5/17/12

    Boston.com









    Mentally ill inmates sue to get out of solitary
    Boston.com
    Prison officials defend the practice, saying administrative segregation, which can include up to 23 hours a day alone in a concrete cell, is a fundamental part of security. Art Leonardo, executive director of the North American Association of Wardens ...

    and more »










    Army launches review of PTSD diagnoses
    U.S. News & World Report
    The latest reviews were triggered by revelations that the forensic psychiatry unit at Madigan Army Medical Center at Joint Base Lewis-McChord in Washington state may have reversed diagnoses based on the expense of providing care and benefits to members ...

    They are glad not to be in a state prison, where there is more violence and where their mental health problems would go mostly untreated. Their fondest hope is to be transferred to a lower security facility, or, even better, to a ...

    via forensic psychiatry - Google Blog Search by unknown on 5/17/12
    The latest reviews were triggered by revelations that the forensic psychiatry unit at Madigan Army Medical Center at Joint Base Lewis-McChord in Washington state may have reversed diagnoses based on the expense of ...

    via prisons - Google News on 5/17/12

    BBC News









    Inmate killed in fight inside Honduran prison
    The Associated Press
    TEGUCIGALPA, Honduras (AP) — Inmates at a violence-prone Honduran prison seized hostages and battled among themselves, leaving at least one inmate dead and 11 wounded, authorities said Thursday. Prison director Orlando Leyva said some women were held ...
    Women held hostage in Honduran prison riotsNew Zealand Herald

    all 89 news articles »










    Mental health an issue near end of stabbings trial
    WSET
    Brewer, who works at the state-run Center for Forensic Psychiatry, said whatever demons Abuelazam had two years ago shouldn't absolve him of responsibility in Minor's death. Abuelazam is accused of faking car trouble or seeking directions before he ...

    and more »