Sunday, July 22, 2012

Review - 10:28 AM 7/22/2012

Review - 10:28 AM 7/22/2012


Mike Nova's starred items



via BEHAVIOR AND LAW - General, Forensic and Prison Psychiatry News by Mike Nova on 7/1/12

ASA Journals

Section Journals
City & Community (Section on Community and Urban Sociology)
Journal of World Systems Research (Section on Political Economy of the World System)
New in 2011! Society and Mental Health (Section on Sociology of Mental Health)








Recent Selected Articles
Neighborhood Diversity, Metropolitan Constraints, and Household Migration (American Sociological Review, June 2012).
Family Relationships and Troubled Sleep among U.S. Adults: Examining the Influences of Contact Frequency and Relationship Quality (Journal of Health and Social Behavior, June 2012).
Becoming Black Women: Intimate Stories and Intersectional Identities (Social Psychology Quarterly, June 2012).
How Sociology Lost Public Opinion: A Genealogy of a Missing Concept in the Study of the Political (Sociological Theory, June 2012).
Functional Limitations and Psychological Distress: Marital Status as Moderator (Society and Mental Health, March 2012).
Editor's Remarks and Symposium (Contemporary Sociology, May 2012).
India's Reproductive Assembly Line (Contexts, Spring 2012).
Only Here for the Day: The Social Integration of Minority Students at a Majority White High School (Sociology of Education, April 2012).
The Scholarship of Teaching and Learning in Teaching Sociology: 1973-2009 (Teaching Sociology, April 2012).
Lending in the Modern Era: Does Racial Composition of Neighborhoods Matter When Individuals Seek Home Financing? A Pilot Study in New England (City & Community, March 2012).
Special Symposium on the Modern World-System, Vols. I-IV, By Immanuel Wallerstein (Contemporary Sociology, January 2012).
How Not to Lie with Ethnography (Sociological Methodology, 2011).

via BEHAVIOR AND LAW - General, Forensic and Prison Psychiatry News by Mike Nova on 7/2/12

Editorial

Tradition versus empiricism in the current DSM-5 proposal for revising the classification of personality disorders

  1. John Livesley*
Article first published online: 19 MAR 2012
DOI: 10.1002/cbm.1826
Copyright © 2012 John Wiley & Sons, Ltd.
Issue
Criminal Behaviour and Mental Health


First page of article

First page of Tradition versus empiricism in the current DSM‐5 proposal for revising the classification of personality disorders


More content like this

Find more content:

John Livesley, M.D., Ph.D

Dr. John Livesley is Professor Emeritus at the University of British Columbia having previously been Professor and at one time Head of the Department of Psychiatry. He obtained a Ph.D in psychology from the University of Liverpool in 1969 and a medical degree from the same university in 1974. Subsequently, he trained in psychiatry at the University of Edinburgh. He has held academic appointments in psychology at the University of Liverpool and in psychiatry at the Universities of Edinburgh and Calgary.
Dr. Livesley’s research focuses on the classification, assessment, and aetiology of personality disorders and the development of an integrated approach to treatment. He is a Fellow the Royal Society of Canada and editor of the Journal of Personality Disorders. He has served as advisor to the DSM-III-R and DSM-IV and is a member of the DSM-V Working Group on the classification of personality disorder. He has made empirical and theoretical contributions to the literature on personality disorder including several books: Practical Management of Personality Disorder (2003) and three edited books – DSM-IV Personality Disorders (1995), the Handbook of Personality Disorders (2001), and Severe Personality Disorders (2007; co-edited with Bert van Luyn and Solaman Akthar). 		John Livesley, M.D., Ph.D

  • © Specialized Training Services 2009-2012. All Rights Reserved.
http://www.specializedtraining.com/Presenter.aspx?ID=14

john livesley md - GS

via BEHAVIOR AND LAW - General, Forensic and Prison Psychiatry News by Mike Nova on 7/3/12

Exploring the Reasoning that the United States Holds the Highest Prison Rate

12:25 AMElizabeth HallNo comments

Introduction
Prison 2
Prison 2 (Photo credit: planetschwa)
Since 1980, there has been a huge growth in the incarcerated population in the United
States according to Seiter (2008). There are several legal issues, which have directly contributed if not caused entirely the explosion of people doing time in correctional facilities in this country. Besides the mindset that confinement is the most effective means of dealing with crime, it seems that the decision in Rhodes v. Chapman by the United States Supreme Court in 1981 was the beginning of this problem. The decision, which stated it was not unconstitutional to house prisoners in housing that is overcrowded, gave the green light to this issue. Other reasons include but are not limited to the increased use of confinement as penal policy, increasing sentence lengths, truth in sentencing, new penology, the war on drugs, and the sentencing reform act of 1984.
Rhodes v. Chapman
Justia (n.d.), reports that in 1981 inmates from an Ohio maximum security correctional institution filed a class action lawsuit which claimed that housing two men in a cell was against their eighth amendment rights against cruel and unusual punishment. The court held that because the inmates are out of their cells most of the day that this did not constitute cruel and unusual punishment. This ruling allowed administrations of prisons to double cell inmates which is a good thing because over the next twenty five years the population grew in the correctional system by at least 500 percent as noted by Seitel (2008). This is attributed to several factors that have changed penal policy from the medical model that focused on rehabilitation and reducing recidivism to the model of confinement that we use today.

Increased Use of Confinement as Policy
In the United States, the American people have changed how they view crime. Since 1980 we are more afraid of crime, the media reports violent crime almost daily. We have also become less tolerant of the criminal element in society, and would just as soon lock them up and keep them confined notes Seitel (2008). Some of this is because the public does not generally follow the statistics that show that our crime rates are dropping, and with the media showing the worst of the violent crime daily we tend to believe the worst. When it is time to tell our policy makers what we want, because of this influence and our lack of looking for the facts on our own, we tell them that we want them confined and for longer periods of time (Seitel, 2008).
The Federal Bureau of Prisons (n.d.) reports that the Sentencing Reform Act of 1984 was used to toughen the sentencing guidelines for criminals. This legislation was used to establish determinate sentencing, abolish parole at the federal level and reduced the amounts of good time that was given for following the rules in prison. In addition to these guidelines, there were addendums in 1986, 1988, and 1990 as illegal immigration and illicit drug use and sale increased conviction rates in the court system (Federal Bureau of Prisons, n.d.). This type of legislation also established the truth in sentencing guidelines.
Truth in sentencing guidelines maintains that an inmate in prison for a violent crime must serve out 85% of the time given at sentencing holds Chen (2000). Three strike laws maintain that habitual offenders receive longer sentences for their crimes. If the offender’s crime was violent, the standard sentence becomes 25 to life on the third strike. What this has managed to cause according to Chen (2000) is more older offenders in prisons past the age of 50, more lifers, and an increase in other types of offenders in intermediate sanction punishments, due to the overcrowding that these laws have caused.
In addition to the stance on tougher sentencing, reduction of good time, and truth in sentencing and three strike legislation, at the same time in the early 1980’s Ronald Reagan’s Presidency was the time that we as a nation declared a “war on drugs” campaign (Seitel, 2008). The idea is that society’s stance on illicit drugs holds that the problems caused by the use, production, and sale of these substances are not good for our society, communities or families. They bring unnecessary crime along with these factions of the narcotics industry. Seitel (2008) also maintains that according to the Department of Justice, research correlates a compelling relationship between crime and substance use. As drug crimes became more pronounced more federal statutes and mandatory sentencing guidelines were set regarding them. When the mandatory statute for federal narcotics crimes became five or ten year mandatory sentences, the prison population grew to the increased sentencing time.
Conclusion
Since the 1980’s, we have watched our prison population in the United States quadruple in size. This has to do with the change in the penal model from the medical model to the model of increased control that we exercise on our prison population still today according to Seitel (2008). We have become as a society increasingly intolerant and afraid of the criminal element that dwell among us, and the current policy is to keep them more confined for longer periods than we ever have. The justice system accomplishes this by utilizing legislation such as the sentencing act of 1984, three strikes law, mandatory sentencing guidelines, and truth in sentencing guidelines.
References:
Chen, E. (2001). Impact of Three Strikes and Truth in Sentencing on the Volume and Composition of Correctional Populations. Retrieved From: https://www.ncjrs.gov/pdffiles1/nij/grants/187109.pdf
Justia, (n.d.). Rhodes v. Chapman-452 U.S. 337 (1981). Retrieved From: http://supreme.justia.com/cases/federal/us/452/337/

via BEHAVIOR AND LAW - General, Forensic and Prison Psychiatry News by Mike Nova on 7/8/12

Forensic Criminology: the scientific study of crime and criminals for the purposes of addressing investigative and legal issues. It is a science, a behavioral science, and a forensic science. This text is intended to educate ...

Friday, 06 July 2012 15:25

Forensic Criminology


Forensic Criminology: the scientific study of crime and criminals for the purposes of addressing investigative and legal issues. It is a science, a behavioral science, and a forensic science. This text is intended to educate students in an applied fashion regarding the nature and extent of forensic casework that is supported by, dependent upon, and interactive with research, theory, and knowledge derived from criminology. It is also intended to act as a preliminary guide for practitioners working with and within related criminal justice professions.
Updated

Additional Info

  • Download:Download
  • Password:learning.ge
Read 24 times
Published inLaw


10:28 AM 7/8/2012 - Mike Nova's starred items


via psychiatry research - Google Blog Search by Dr Justin Marley on 7/6/12
The statement is particularly interesting because the Foundation is supporting research which is at the 'intersection of culture, neuroscience, psychology, and psychiatry'. The blog can be navigated by scrolling down the page ...

Mike Nova's starred items

via international psychiatry journals - Google Blog Search by John D. Gavazzi, PsyD ABPP on 7/7/12
Last week, the American Psychiatric Association issued a press release highlighting an ongoing decline in the recruitment of medical students into the specialty—at a time when the numbers of practising psychiatric professionals in the USA is falling. Various reasons are proposed, including the short-term nature ... Our goal is to promote ethics education in Pennsylvania, across the country, and around the world. We have individuals reading and using our content from ...

via international psychiatry - Google Blog Search by Justice Lover on 7/5/12
The international pharmaceutical giant took top-prescribing psychiatrists to pricey resorts in Bermuda, Jamaica, Hawaii and other exotic locales where, in between spa services, they could hear speeches from fellow shrinks ...

via NYT > Psychiatry and Psychiatrists by By JENEEN INTERLANDI on 6/23/12
We were on something like the 15th round of rummy, and my father was winning decisively. He cracked a wide, toothy grin as he laid his cards on the table. ''That's 321 for BaBa, and 227 for String Bean,'' he said, tallying the ledger we were keeping on a piece of scrap paper. Before he finished writing the numbers, he began a rapid succession of anecdotes about his first car. And his second. And his third. He reached for a magazine to show me the vintage Mustang he said he was planning to b...


Views and News from Norway








Dueling diagnoses roil trial of Norway killer Breivik
Christian Science Monitor
The Norwegian psychiatrists behind the much-debated report deeming Anders Behring Breivik insane defended their diagnosis in court today, despite mounting evidence that the self-confessed killer was possibly sane and hence criminally punishable for ...
Psychiatrists get their day in courtViews and News from Norway

all 357 news articles »

via psychiatry research - Google Blog Search by Dr Justin Marley on 7/6/12
The statement is particularly interesting because the Foundation is supporting research which is at the 'intersection of culture, neuroscience, psychology, and psychiatry'. The blog can be navigated by scrolling down the page ...

via NYT > Europe by By D. D. GUTTENPLAN on 7/8/12
The possibility that Britain could follow the example of the United States, where the entry of for-profit schools into the market saw many students take on massive amounts of debt, is causing concern.


Iran says it is willing to lower uranium enrichment levels to end sanctions. But it also set out red lines in PowerPoint presentation at recent Moscow talks.

The UN Committee on the Rights of the Child is pushing to abolish baby 'boxes' where mothers can legally abandon unwanted babies. Social workers argue otherwise.

Jorge Videla led Argentina's 1976 coup. He and eight others were convicted for stealing babies from 'enemies of the state' during the military junta's rule.


via BEHAVIOR AND LAW - General, Forensic and Prison Psychiatry News by Mike Nova on 7/15/12

Professional Prisoners (RT Documentary)




Published on Jul 15, 2012 by

Most people learn the tricks of a trade at college or university. Here in this institute you won't have to deal with lecturers, or find students sitting exams, and you can get an education here totally free. However, nobody will recommend that you apply to any of its faculties, because it is a penal colony. Yet the prisoners sometimes reveal hidden talents, learning new skills that will give them a better chance at a second life.

via BEHAVIOR AND LAW - General, Forensic and Prison Psychiatry News by Mike Nova on 7/22/12

via psychiatry - Google News on 7/21/12

scallywagandvagabond






James Holmes was set to lecture on psychiatric and neuroscience disorders at ...
scallywagandvagabond
dailybeast: The professor who ran his course on the biological basis of psychiatric and neurological disorders is a prominent member of the medical school's department of psychiatry. The two student-led seminars scheduled immediately after Holmes's ...
Aurora shooting suspect is tragic reminder of a big problemDenver Post
Q&A: Understanding the Mindset of a Shooter's ParentsTIME
Police beef up patrols in wake of movie shootingRochester Democrat and Chronicle
Sky Valley Chronicle -kvor -Newstrack India
all 12,811 news articles »

via psychiatry research - Google News on 7/19/12







Using neuroeconomics to study psychiatry
Medical Xpress
More information: "Neuroeconomics: A Bridge for Translational Research" by Carla Sharp, John Monterosso, and P. Read Montague (doi: 10.1016/j.biopsych.2012.02.029). The article appears in Biological Psychiatry, Volume 72, Issue 2 (July 15, 2012) ...

and more »

via BEHAVIOR AND LAW - General, Forensic and Prison Psychiatry News by Mike Nova on 7/21/12
Mike Nova's starred items - 12:01 PM 7/21/2012

via international psychiatry - Google Blog Search by Damiaan Denys on 11/28/07
In their recent paper, Natalie Banner and Tim Thornton evaluate seven volumes of the Oxford University Press series “International Perspectives in Philosophy and Psychiatry,” an international book series begun in 2003 focusing on the ...

Op-Ed Contributor

Learning From Norway’s Tragedy

By JONAS GAHR STORE
Published: July 19, 2012
One year ago Sunday, Norway experienced one of the worst extremist attacks Western Europe has witnessed since World War II when Anders Behring Breivik systematically killed 77 people and injured hundreds of others.
Erlend Aas Norway Out/European Pressphoto Agency
Opinion Twitter Logo.

Connect With Us on Twitter

For Op-Ed, follow @nytopinion and to hear from the editorial page editor, Andrew Rosenthal, follow @andyrNYT.
Prime Minister Jens Stoltenberg’s reaction was unequivocal. He declared that Norway’s strongest weapon in responding to this was to employ more openness and more democracy.
Norwegians took up his call. Neither politicians nor the media turned it into a partisan political issue. The public reacted with grief but did not call for extraordinary measures. And the state chose to prosecute Brevik in an ordinary public court with full media coverage.
Many outside Norway have questioned this. Does not responding with openness allow an extremist to broadcast his fanatical views? Does it not risk strengthening extremist movements? Why not create a special, closed legal setting?
As Norway’s foreign minister, I have been frequently confronted with these questions over the past year. Without prejudice to the ongoing legal proceedings, I believe these are key questions. How we, as independent nations and as an international community, should fight violent political extremism is at the heart of politics in the 21st century. I also believe that Norway’s experience after the attack has important lessons that may be relevant beyond our borders.
The last decade has shown us that ideology can never fully explain why specific groups or individuals commit unimaginable acts. Social, psychological and individual factors always play crucial roles. Yet political extremism does not grow in a vacuum. Ideas are the oxygen that allows it to flourish and spread. Extremist perspectives win sympathy and recruits because they offer narratives that claim to identify deep injustices and enemies.
Without this fuel, the blaze of extremism is quickly extinguished. Al Qaeda networks were nourished by the ideas of Islamic fundamentalists just as Breivik invoked and may have drawn sustenance from the ideas and stories of other Western extremists.
Confronting and undermining the narratives and ideas of extremism must therefore be one of our key tasks. To do this, we must retain the courage of our convictions in the face of extremism.
Virtually all modern forms of extremism accuse liberal Western democratic systems of being hypocritical and, ultimately, weak. Al Qaeda portrays the West as anti-Islamic imperialists masquerading as promoters of democracy. Right wing extremism suggests the West is committing cultural suicide through its lax judicial system and naïve multiculturalism.
Both have committed horrific acts designed to bait us into betraying our values and making them martyrs. In fact, it is remarkable to see the many similarities between these two sorts of extremism in their disdain for diversity and their indiscriminate violence against civilians.
In this context, it is a mistake to treat crimes committed by extremists as exceptions, subject to special processes. They must be held accountable in accordance with and to the full extent of the law. Hiding suspects from public view merely dehumanizes the perpetrators and undermines any moral or judicial lessons.
By contrast, prosecuting extremists who have committed crimes in a public courtroom makes it all the more shockingly clear that their horrific acts were undertaken by human beings, and that all of us must work every day to combat the ideas of extremism.
It has been remarkable to observe that the younger generation of Norwegiens — and especially the young survivors of the island massacre — have expressed their trust in Norway’s open approach to dealing with the affair. They know that a political system based on the rule of law cannot turn its back on its standard procedures on an ad hoc basis; that doing so would only provide extremists with evidence of the supposed double standards of democracy.
I believe that the same basic principle holds true in the global fight against terrorism. Osama bin Laden successfully provoked the West into using exceptional powers in ways that sometimes have been in conflict with its commitment to human rights and democracy. This only strengthened the case of extremists, and it shows that we should try to avoid exceptionalism and instead trust in the open system we are defending.
This is not a soft approach. It requires and allows for tough security measures. But it is firmly anchored in the rule of law and the values of democracy and accountability.
That the open public square can be an impressive antidote to extremism should not be surprising. This is not only a bedrock democratic principle. We also have ample historic evidence that extremist views thrive best when confined to the gutter.
Open debate is our strongest tool in standing up to extremism. The far more dangerous avenue is to force extremist ideas underground, where they can fester without competition.
Besides, in a globalized world where ideas and networks circulate beyond the control of states, we have little choice but to forcefully present our strongest counter-arguments and embrace the challenge of fighting extremism in the open.
Jonas Gahr Store is the Norwegian minister of foreign affairs.
A version of this op-ed appeared in print on July 20, 2012, in The International Herald Tribune.

via psychiatric diagnosis - Google Blog Search by Brendan B. Lupetin, Esq on 7/17/12
On Dec. 3, Foster saw psychiatrist Sarah Hicks in Philadelphia. Hicks diagnosed Foster with hypochondriacal panic attacks and prescribed Zyprexa. Foster continued treating with Hicks through 2002, at which point he was still ...

via psychiatric diagnosis - Google Blog Search by teen health - Google News on 7/18/12
The AtlanticHow Thoughts Become a Psychiatric DiagnosisThe AtlanticLloyd Sederer, MD, is medical director of the New York State Office of Mental Health and Adjunct Professor at the Columbia/Mailman School of Public ...

The New York Times

July 16, 2012

Mental Illness Cited in Challenge to Terror Case


http://www.nytimes.com/2012/07/17/nyregion/mansour-arbabsiars-lawyers-cite-mental-illness-in-challenge-to-charges.html?src=rechp&pagewanted=print

By

Lawyers for an Iranian-American man charged in a 2011 plot to assassinate Saudi Arabia’s ambassador to the United States asked a judge in Manhattan on Monday to order the suppression at trial of statements their client made during interrogation on the ground that he was suffering from serious mental illness, a new court filing shows.
In the filing, two experts retained by the defense each said they had diagnosed bipolar disorder in the defendant, Mansour J. Arbabsiar, a former used-car salesman from Corpus Christi, Tex., who was arrested last fall at Kennedy Airport and was said to have confessed to his role in the plot during the first 12 days he was in custody.
The filing was part of a heavily redacted motion asking Judge John F. Keenan of Federal District Court to dismiss all charges.
Prosecutors have said Mr. Arbabsiar “knowingly and voluntarily” waived his rights to remain silent, to have a lawyer present and to be quickly taken before a judge. But the filing shows the defense will challenge whether those decisions were voluntary.
Dr. Michael B. First, a professor of clinical psychiatry at Columbia University, said he had concluded that Mr. Arbabsiar “was likely cycling in and out of manic episodes during the period” of his interrogation. Professor First said he had examined Mr. Arbabsiar several times at the Metropolitan Correctional Center, where he is being held pending trial.
“Because I believe that Mr. Arbabsiar was suffering from episodes of mania while he was being questioned by the F.B.I.,” Professor First wrote, “there are serious questions as to whether any decisions made by him during this period were made rationally, with a full understanding of the consequences. Indeed, it is likely that his decisions were influenced, at least in part, by his mental illness.”
He said individuals with bipolar disorder who are in a manic state often “display feelings of invincibility and grandiosity,” and such feelings “may cause them to enter into agreements that they would not otherwise enter into.”
The second expert, Dr. Joel E. Morgan, a clinical neuropsychologist in private practice in Madison, N.J., said an M.R.I. of Mr. Arbabsiar’s brain “indicated abnormalities.”
Mr. Arbabsiar’s lawyers and prosecutors declined to comment.

Open AccessHighly AccessedCommentary

How new is the new philosophy of psychiatry?

http://www.peh-med.com/content/2/1/22/


Damiaan Denys
Department of Psychiatry, AMC, University of Amsterdam, PA.2-179, PO Box 75867, 1070 AW Amsterdam, The Netherlands
Philosophy, Ethics, and Humanities in Medicine 2007, 2:22 doi:10.1186/1747-5341-2-22

The electronic version of this article is the complete one and can be found online at: http://www.peh-med.com/content/2/1/22

Received:8 October 2007
Accepted:20 October 2007
Published:20 October 2007

© 2007 Denys; licensee BioMed Central Ltd.
This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

In their recent paper, Natalie Banner and Tim Thornton evaluate seven volumes of the Oxford University Press series “International Perspectives in Philosophy and Psychiatry,” an international book series begun in 2003 focusing on the emerging interdisciplinary field at the interface of philosophy and psychiatry. According to Natalie Banner and Tim Thornton, the series represents a clear indication that the interdisciplinary field of philosophy of psychiatry has been flourishing lately. Philosophers and psychiatrists face a “new philosophy of psychiatry”. However, the optimism which the “new” philosophy of psychiatry celebrates is precisely the exiling of philosophy from the foundations of psychiatry. The 150 year old belief that psychopathology cannot do without philosophical reflection has virtually disappeared from common psychiatric education and daily clinical practice. Though the discipline of psychiatry is particularly suited to contributions from philosophy, the impact of philosophy on psychiatry nowadays remains limited. With some exceptions, philosophical papers are embedded in a philosophical context inscrutable to ordinary psychiatrists. Much current philosophical work is perceived by psychiatrists as negativistic. I would encourage the field of psychiatry to incorporate once again basic philosophical attitudes which render possible true dialogue with philosophy and enrich both disciplines. The views developed here should not discredit the value and importance of Natalie Banner and Tim Thornton’s paper and the excellent series “International Perspectives in Philosophy and Psychiatry.” As Jaspers said “Everybody inclined to disregard philosophy will be overwhelmed by philosophy in an unperceived way”.

Commentary

In their recent paper, Natalie Banner and Tim Thornton evaluate seven volumes of the Oxford University Press series "International Perspectives in Philosophy and Psychiatry". Launched in 2003, "International Perspectives in Philosophy and Psychiatry" is an international book series focusing on the emerging interdisciplinary field at the interface of philosophy and psychiatry.
Natalie Banner and Tim Thornton identify three broad interconnected themes in the series: the role of values in psychiatric diagnosis and treatment; the question of the place of understanding subjects' experiences, their meanings and the relationship of understanding to natural scientific explanation, and the scientific status of the 'facts' or 'evidence' that contribute towards psychiatric diagnoses. The three themes correspond with the three main parts of Tim Thornton's new book "Essential Philosophy of Psychiatry" meant to be a concise introduction to the growing field of philosophy of psychiatry. The first part, Values, outlines the debate about whether diagnosis of mental illness is essentially value-laden and argues that the prospects for reducing illness or disease to plainly factual matters are poor. The second part, Meanings, examines the central role of understanding and a shared first person perspective, both against attempts to reduce meaning to basic information-processing mechanisms and to explain away the difficulties of understanding psychopathology. The third part, Facts, shows the importance of uncodified clinical judgments, both in assessing the validity of psychiatric taxonomy and in the application of Evidence Based Medicine.
According to Natalie Banner and Tim Thornton, the series represents a clear indication that the interdisciplinary field of philosophy of psychiatry has been flourishing lately. There has been recent growth in the philosophy of psychiatry during the past fifteen years. Philosophers and psychiatrists face a "new philosophy of psychiatry" in addition to analytic philosophy and to the broader interpretation of mental health care.
How new is this new philosophy of psychiatry? Does the new philosophy really impact on the field of psychiatry? Should we share Natalie Banner and Tim Thornton's optimism?
Since psychiatry has been established as a field of medicine, psychiatric literature has always been full of philosophical thought and direct reference to philosophy. "Just meditations for the philosopher who, liberated from the daily turmoil, walks through a psychiatric hospital! He will find the same ideas, the same errors, the same passions, the same ill-fated: it's the same world, but in this house, traits are more pronounced, nuances much sharper, colors more vivid, lives more shattered, because man are naked, they don't conceal their thoughts, hide their shortcomings, they don't draw on their passions to articulate charming seduction, on their vices to express deceiving appearances" [1]. The broad themes: values, meanings and facts identified by Natalie Banner and Tim Thornton in the recent series have been examined in psychiatry for many years. Bertrand Morel discusses in his "Traité des maladies mentales" (1850) the role of political and religious values in psychiatry referring to Rousseau and Locke [2]. Jaspers' project of the General Psychopathology (1913) originally aimed at examining facts and perspectives in psychiatry thereby using "meaning" from Dilthey (1900) as a methodological tool [3]. The validity of psychiatric diagnoses, the relation between scientific explanation and human understanding, and the scientific status of psychiatric facts have been studied extensively by Continental phenomenological psychiatrists. For my part, the recent themes of the new philosophy of psychiatry are just an extension or repetition of earlier work of the last centuries. There has always been a longstanding debate on truth, method and the scientific status of psychiatric knowledge, and questions about the possibility of true knowledge in psychiatry are inherent to psychiatric thinking.
Nevertheless, I agree with Natalie Banner and Tim Thornton that something has radically changed within the field of psychiatry and philosophy during the past fifteen years. The novelty is not that philosophy has reconquered psychiatry, but that psychiatry has lost philosophy. Philosophical thinking used to be embedded in psychiatry. This was self-evident since psychiatry and philosophy share interest in the same matters – reality, freedom, personal identity, social reality, perception, free will, thought and affect. However, the belief that psychopathology cannot do without philosophical reflection, so obvious the last 150 years, has recently vanished. Reflecting, conceptual thinking, questioning, and criticizing have all virtually disappeared from common psychiatric education and daily clinical practice. Jaspers was a resident in psychiatry and not a philosopher when he wrote his "General Psychopathology." Unfortunately, the vital, basic philosophical attitude of naive astonishment towards psychiatric phenomena is no longer part of residency training. Philosophy has left the psychiatric building. It is exiled from psychiatry, externalized and sequestered in the "new" philosophy of psychiatry.
The loss of critical philosophical thinking in psychiatry has led on one hand to the shameful conclusion that zoologists are much more accurate and subtle than psychiatrists in the observation of behavior. "The available analysis of the phenomenology of compulsive rituals pales before elegant observations of analogous behaviors in fish and birds" Thomas Insel (1988) [4]. The loss has led on the other hand to the necessity of two different disciplines both struggling to detect a fruitful crossover. I agree with Natalie Banner and Tim Thornton that the discipline of psychiatry is particularly suited to contributions from philosophy. However, the impact of philosophy on psychiatry is still limited. Though the conditions for systematic thought over the last decades have changed fundamentally – not only phenomenology is at our disposal but the philosophy of mind – they have not yet been used widely to deal with psychopathological problems. The focus in training is on scientific knowledge, such as clinical neuroscience, behavioural and social sciences. There is very little content devoted to anthropology and philosophy in relation to psychiatry [5]. The language of academic philosophy is not the language of bedside psychiatry. With some exceptions, philosophical papers are so dense, so laden with jargon, and so embedded in a philosophical context inscrutable to the ordinary psychiatrist that their message is lost. Moreover, much of current philosophical work is criticism, emphasizing the limitations of modernist thinking and rejecting its claims, and critically analyzing the conceptual foundations of academic psychiatry. The majority of the reviewed seven volumes of the Oxford University Press series "International Perspectives in Philosophy and Psychiatry" criticize present psychiatric values, meanings and facts. Coming from outside, the criticism is perceived by psychiatrists as negativistic and the deconstruction as destructive.
In my opinion, neuroscience is currently much more successful in embracing philosophy than psychiatry. Philosophy interacts positively with neuroscience and the philosophy of neuroscience is accepted as a natural result. The emerging area of philosophy of neuroscience certainly was spurred by remarkable recent growth in the neurosciences. Cognitive neuroscience continues to encroach upon issues traditionally addressed within philosophy, including the nature of consciousness, action, knowledge, and morality. Examining the implications of neurological syndromes for the concept of a unified self as well as studying the neural systems underlying appraisal and its relevance to the self is one example [6]. Other examples (among many) include: The concept of neurophenomenology, introduced by Francesco Varela into neuroscience, in which observers examine their conscious experience using scientifically verifiable methods [7]. The use of deep brain electrical stimulation to modulate behavioral responsiveness in a patient who remains in a minimal conscious state (thereby offering a new tool to comprehend consciousness) [8]. Another topic examines threatened morality and physical cleansing, or the neural constituents of moral cognition [9]. Or the investigation of subjective certainty and its relationship to dopamine alterations in the striatum [10].
In closing, I agree that we live in interesting philosophical times in which there is potential for a fruitful crossover between the disciplines of philosophy and psychiatry. However, I disagree that there needs be a "new" cross-over between philosophy and psychiatry as regards values, meaning and facts. These three themes must necessarily be – as they have historically been – intrinsic to psychiatric thinking, as their "self evidence" has shaped psychiatry as a distinctive medical science. I would encourage the field of psychiatry to incorporate once again basic philosophical attitudes which render possible true dialogue with philosophy and consequently enrich both disciplines. At the moment, for most practicing psychiatrists, philosophy is a bridge too far.
The views that I develop here should not discredit the value and importance of Natalie Banner and Tim Thornton's paper and the excellent series "International Perspectives in Philosophy and Psychiatry." I hope that my comments that were inspired by their thoughtful paper may help emphasize the importance of philosophical reflection within psychiatry. As Jaspers said "Everybody inclined to disregard philosophy will be overwhelmed by philosophy in an unperceived way".

Competing interests

The author(s) declare that they have no competing interests.

References

  1. Esquirol J D.,E.: Des maladies mentales considerées sous les rapports médical, hygiénique et médico-legal. Volume 2 vols. Paris, Ballière; 1838.
  2. Morel BA: Traite des maladies mentales. Paris, Masson; 1850.
  3. Jaspers K: Allgemeine Psychoptahologie. Berlin, Springer; 1913.
  4. Insel TR: Obsessive-compulsive disorder: a neuroethological perspective.
    Psychopharmacol Bull 1988, 24:365-369. PubMed Abstract OpenURL
  5. Fulford KW, Stanghellini G, Broome M: What can philosophy do for psychiatry?
    World Psychiatry 2004, 3:130-135. PubMed Abstract | PubMed Central Full Text OpenURL
  6. Schmitz TW, Johnson SC: Relevance to self: A brief review and framework of neural systems underlying appraisal.
    Neurosci Biobehav Rev 2007, 31:585-596. PubMed Abstract | Publisher Full Text | PubMed Central Full Text OpenURL
  7. Rudrauf D, Lutz A, Cosmelli D, Lachaux JP, Le Van QM: From autopoiesis to neurophenomenology: Francisco Varela's exploration of the biophysics of being.
    Biol Res 2003, 36:27-65. PubMed Abstract OpenURL
  8. Schiff ND, Giacino JT, Kalmar K, Victor JD, Baker K, Gerber M, Fritz B, Eisenberg B, O'Connor J, Kobylarz EJ, Farris S, Machado A, McCagg C, Plum F, Fins JJ, Rezai AR: Behavioural improvements with thalamic stimulation after severe traumatic brain injury.
    Nature 2007, 448:600-603. PubMed Abstract | Publisher Full Text OpenURL
  9. Casebeer WD: Moral cognition and its neural constituents.
    Nat Rev Neurosci 2003, 4:840-846. PubMed Abstract | Publisher Full Text OpenURL
  10. Fiorillo CD, Tobler PN, Schultz W: Discrete coding of reward probability and uncertainty by dopamine neurons.
    Science 2003, 299:1898-1902. PubMed Abstract | Publisher Full Text OpenURL

Full text | How new is the new philosophy of psychiatry?

In their recent paper, Natalie Banner and Tim Thornton evaluate seven volumes of the Oxford University Press series “International Perspectives in Philosophy and Psychiatry,” an international book series begun in 2003 focusing on the ...

For example, in this month's issue of the International Journal of Social Psychiatry, researchers from Maywood University studied records from a state psychiatric institution across the last century and found that while the ...








Congressman illustrates difficulties minorities face when seeking mental ...
The Newark Advocate
Proper diagnosis and treatment depend on a trust-based relationship between the patient and the provider of mental health services. Absent reliable scientific tests to determine the state of the client's mental health, the provider must make a ...

and more »


PsychCentral.com






Anxiety Disorders in Poor Moms Likely to Result from Poverty, Not Mental ...
Science Daily (press release)
Currently, psychiatric diagnoses are based on the Diagnostic and Statistical Manual of Mental Disorders (DSM), which uses symptom-based criteria to determine disorders. Recent versions do not consider context, such as poverty conditions, in determining ...
Poverty May Be the Leading Cause of Generalized Anxiety Disorder, Not Mental ...Medical Daily
Poverty, not mental illness, leaves moms anxiousFuturity: Research News

all 14 news articles »

via BEHAVIOR AND LAW - General, Forensic and Prison Psychiatry News by Mike Nova on 7/21/12

Psychiatrist's Failure to Diagnose Results in Defense Verdict Prior to ...









from psychiatric diagnosis - Google Blog Search by Brendan B. Lupetin, Esq
On Dec. 3, Foster saw psychiatrist Sarah Hicks in Philadelphia. Hicks diagnosed Foster with hypochondriacal panic attacks and prescribed Zyprexa. Foster continued treating with Hicks through 2002, at which point he was still ...

As I discussed in my last post on psychiatric malpractice, recent studies have determined that psychiatric patients in Pennsylvania with brain tumors may present with a variety of psychiatric symptoms for a sufficient period of time without obvious neurologic symptoms and signs. As a result it has become the standard of care for psychiatrists to consider brain imaging not only for psychiatric patients with neurologic symptoms and signs, but for all psychiatric patients who present with atypical psychiatric symptoms, with late onset of psychiatric symptoms (>50 years of age), or when there is a change in clinical presentation of psychiatric symptoms. My research suggests that this recommendation has become the standard of care more recently. This may explain the outcome in the matter of Foster v. Hicks, M.D. a case where the plaintiff's theory was that his psychiatrist failed to diagnose his brain tumor.

In 2001, plaintiff Craig Foster, 18, a high school student, began experiencing cognitive and neurological problem, including memory impairment, odd use of language, headaches, sweating, tremors and numbness in his left hand. On Dec. 3, Foster saw psychiatrist Sarah Hicks in Philadelphia. Hicks diagnosed Foster with hypochondriacal panic attacks and prescribed Zyprexa. Foster continued treating with Hicks through 2002, at which point he was still suffering from headaches.

On Jan. 7, 2003, Foster's primary care physician ordered an MRI of his brain, which showed the presence of a large tumors measuring 3.4 x 3.4 x 2.9 cm. On Jan. 10, Foster underwent surgical decompression of the mass, which was later diagnosed as a craniopharyngioma.

Claiming medical malpractice, Foster sued Hicks, alleging that she failed to diagnose his brain tumor. Plaintiff's counsel argued that Hicks failed to obtain all of Foster's medical history and records from his parents and health care providers. Plaintiff's counsel further argued that Hicks failed to advise the necessary diagnostic testing to rule out a brain disorder, and failed to recommend and/or perform cognitive capacity screening tests. Plaintiff's counsel further argued that Hicks failed to recommend and/or perform such other tests as were necessary and indicated, especially in light of Foster's clinical presentation and history.

Plaintiff's psychiatry expert testified that Hick's substandard evaluation and follow-up treatment of Foster resulted in a significant delay in his diagnosis and thus directly contributed to the nature and severity of his clinical condition and his limited response to surgical intervention, his ongoing significant oncological and neurological conditions, and his endocrinological impairment.

The defendant denied the allegations. The defense psychiatry expert, testified that the care that Hicks provided to Foster was reasonable and appropriate. Emanuel Rubin, defense endocrinology expert, testified that since craniopharyngioma grows very slowly, the tumor very likely had been present for many years, and it was improbable that any significant growth occurred in the one-year interval between referral to Hicks and surgery for craniopharyngioma. Rubin further testified that any delay in diagnosing Foster's craniopharyngioma that occurred during his psychiatric treatment by Hicks played no role in the development of endocrinological problems. Stephen Fedder, defense brain and spinal surgery expert, testified that significant interval growth of a tumor from March 2001 through January 2003 was unlikely.

Following the Jan. 10 operation, Foster had an MRI that showed residual tumor, measuring 2.2 x 1.4 x 1.6 cm. He underwent radiation therapy from Feb. 19 to March 31. He then developed panhypopituitarism and diabetes insipidus, which was treated with hormonal replacement, and as a result missed a semester of college due to the treatment. Serge Jabbour, plaintiff's endocrinology expert, testified that if the diagnosis of Foster's brain tumor had been made earlier, there was a higher chance that his endocrine function would have been preserved preoperatively or would have been recovered, either partially or totally, if the surgery were performed sooner. Jabbour also testified that the combination of Foster's surgery and radiation treatment could lead to hypopituitarism; that Foster's prognosis was good; and that recent brain MRIs have been stable.

Foster sought an unspecified amount in damages for past and future pain and suffering.

Fedder testified that there was no cognitive deficits related to any alleged delay in diagnosis as demonstrated by Foster's B+ GPA in college and Foster's current job as an accountant, and that there were no visual changes noted since Sept. 28, 2004. Rubin testified that Foster did not suffer any cognitive or neuro-opthalmic problems, and there was no reason to believe that any such symptoms would develop in the future.

After a lengthy deliberation the jury found the defendant doctor not guilty. I can only wonder if the current standard of care, applied to this case, would have resulted in a different outcome.

Posted by at

No comments:

Post a Comment

Subscribe to: Post Comments (Atom)