Providentia

Risk factors For Violent Crime in Schizophrenia

A study published in the March 2009 issue of the Journal of Clinical Psychiatry examined the role of familial risk factors in occurrence of violent crime in patients with schizophrenia. The researchers used a cohort study that followed up patients with 2 or more hospitalizations for schizophrenia and investigated the risk for a violent conviction. All 13,806 patients with 2 hospital discharge diagnoses of schizophrenia from January 1, 1973, through December 31, 2004, in Sweden were followed until violent conviction, emigration, death, or end of follow-up (December 31, 2004). Associations with sociodemographic, individual (substance abuse comorbidity, and previous violence), and familial (parental violent crime and parental alcohol abuse) factors were examined. The results showed that, over an average follow-up period of 12 years, 17.1% of the men and 5.6% of the women with 2 or more hospitalizations for schizophrenia had a violent conviction after discharge from hospital. Familial risk factors had moderate effects, increasing the risk for violent convictions by 50% to 150%. After adjustment for sociodemographic and individual risk factors, the associations between parental violent crime and risk of violent convictions remained in men and in women, whereas parental alcohol abuse was no longer significantly associated with violent crime. The researchers concluded that Parental violent crime had moderate associations with violent crime in male and female offspring with at least 2 hospitalizations for schizophrenia, which were mostly stronger than the better documented sociodemographic risk factors. This suggests that familial (genetic or early environmental) risk factors have an important role in the etiology of violent offending among individuals with schizophrenia and should be considered in violence risk assessment.

Click here for the abstract.

What is Leblouh?

While harmful traditional practices such as female circumcision and breast ironing have become the focus of international campaigns for their abolition, another traditional practice is only beginning to attract attention.

In the African country of Mauritania, one of the oldest standards of female beauty has been that of obesity. Since slim women are considered to have a poorer chance of marriage, the practice of leblouh remains common. Girls (often as young as five) are force-fed by older women (known as "fatteners") with a large daily diet of camel's milk, millet, and even their own vomit to gain weight.Most common in rural areas and arising out of the country's strong Berber traditions, leblouh has become more prevalent since Mauritania's military coup in 2008.

Although local activists are attempting to end the practice, they are being opposed by conservative elements including the fatteners themselves and rural women who consider leblouh as being the only way to ensure that their daughters become wives. A 2007 survey determined that 70% of Mauritianian women over the age of 40 regard leblouh as being necessary for marriage. The same survey found that only 10% of girls living in cities are force-fed as opposed to 80% of girls in rural areas. The practice is expected to fade with better education concerning the dangers of forced feedings but progress remains slow.

Click here for more information .

Hunting The Wendigo (Part 1)

According to Algonquian folklore, a wendigo (also spelled windigo) is a carnivorous spirit or demon that often possessed or transformed humans. The legends described them as monstrous creatures that feasted on unwary travelers. Once a human became a wendigo, they became steadily larger with each human they ate and stories of fifteen-foot high monsters lurking in the woods were often told around campfires. In appearance, wendigos were often described as having yellow eyes, jagged teeth, enormous feet, clawed hands. Not only did the wendigo have a heart of ice but a body "swelled to the size of a pine tree, and as hard as stone. imopenetable by a bullet or arrow and insensitive to cold". Whenever a member of the tribe disappeared, the usual explanation was that a wendigo was responsible. Anyone killed by a wendigo became a tortured spirit that would never find rest. Although the legends differed on how a human could become a wendigo, one of the most common stories involved cannibalism or being possessed by a cannibal spirit while in a vulnerable state. For that reason, Algonquian law was clear concerning the need to kill anyone displaying symptoms of wendigo possession to prevent them from becoming a danger to others. Considering the importance of sorcery and wendigo legends in traditional Algonquian society, tribal elders were often called upon to deal with anyone suspected of practicing hostile magic or eating human flesh.

These wendigo legends were a continuing source of fascination for the traders, missionaries, and government officials who came in contact with isolated native bands.Although numerous legends of wendigo activity were handed down and "wendigo psychosis" became identified as a culture-bound syndrome, actual recorded cases remain extremely rare. The most well known case occurred in 1879 when a Cree trapper named Swift Runner was reported to the Northwest Mounted Police. His wife and children had disappeared after he took them on a hunting trip and the wife's relatives asked the police to investigate. The police sent a patrol to Swift Runner's remote camp north of Edmonton, Alberta and found evidence that he had killed and eaten his family. When Swift Runner went on trial on August 8 of that year, he confessed to the killings and stated that he had seen spirits telling him to become a wendigo After returning to his campe from a moose hunt, all that he could hear were "young moose, nothing but moose".Despite evidence of insanity, he was found guilty and sentenced to be hanged. Swift Runner agreed with the verdict and actually made a speech from the gallows confirming his guilt and thanking his prison guards for his care. The case was especially remarkable for coming to the attention of the Canadian legal system at all. Previous incidents of actual or suspected cannibalism were typically dealt with by tribal custom, i.e., the offender being killed by the family members of the victim or by tribal elders.

While reported incidents of cannibalism were rare, cases of "wendigo killings" in which people suspected of being wendigos were considerably more common. Prosecution of these cases led to inevitable culture clashes between remote tribes attempting to protect themselves from what they viewed as a grave threat and Canadian police officers attempting to enforce legal codes based on European law. Considering the mistrust that many remote Native bands had for the judicial system, it was fairly unusual for cases to come to trial at all and the ones that did proceed were usually based on reluctant testimony by intimidated witnesses. One classic case involved an Ojibwa hunter named Machekequonabe who apparently shot and killed his foster father in the belief that he was a wendigo. According to the legal testimony at the trial held on December 3, 1896 in what is now Kenora, Ontario, Machekeqonabe and his foster-father were on sentry duty at a small reserve in Northern Ontario. Due to reports of a wendigo that had been stalking the reserve for months, all of the sentries were unusually tense. When a "tall Indian with a blanket over him" was spotted, he began to run and Machekeqonabe went after him. After shooting his quarry, Machekeqonabe began crying when he realized the identity of the man he had killed. The trial was extremely brief and represented the first experience that Machekeqonabe and most of the others involved had with Canadian law. The resulting manslaughter conviction set a legal precedent in Canadian law that is still recognized today.While an appeal was launched, the verdict was upheld and Machekeqonabe was sentenced to six months in jail for the killing.

The most famous criminal case involving a wendigo killing occurred in 1906.

More on that next week...

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Corporal Punishment and Brain Development

A study published in the March, 2009 issue of Neuroimage examines the role of harsh corporal punishment in later brain development. While harsh corporal punishment (HCP) during childhood has been identified as a chronic, developmental stressor associated with depression, aggression and addictive behaviors, there is little about the potential neurobiological consequences of HCP. The researchers used voxel-based morphometry (VBM) to investigate whether HCP was associated with discernible alterations in gray matter volume (GMV). By screening 1,455 young adults (18-25 years), 23 subjects were identified with a history of HCP (minimum 3 years duration, 12 episodes per year, frequently involving objects) as well as 22 age-matched controls. High-resolution T1-weighted MRI datasets were obtained using Siemens 3T trio scanner. The results showed that GMV was reduced by 19.1% in the right medial frontal gyrus (medial prefrontal cortex; MPFC, BA10) (P=0.037, corrected cluster level), by 14.5% in the left medial frontal gyrus (dorsolateral prefrontal cortex; DLPFC, BA 9) (P=0.015, uncorrected cluster level) and by 16.9% in the right anterior cingulate gyrus (BA 24) (P<0.001, uncorrected cluster level) of HCP subjects. There were significant correlations between GMV in these identified regions and performance IQ on the WAIS-III. The researchers concluded that exposing children to harsh HCP may have detrimental effects on trajectories of brain development although a causal relationship can not be clearly determined.

Click here for the abstract.

Investigation Continuing Following Bizarre Airplane Suicide

Nunavut RCMP are still searching for the body of a 20-year old Nunavut man who managed to open an aircraft door while the twin-engine plane was in flight and leap to his death on Wednesday night. The man was a passenger on an Adlair Aviation flight from Yellowknife to Cambridge Bay, Nunavut when he became unruly and aircraft personnel attempted to restrain him. He opened the aircraft door while the plane was at 23,000 feet and jumped out while the plane was still 180 kilometers from the Cambridge Bay airport. The two pilots managed to make an emergency landing and their remaining passenger was unhurt. He was later identified as Julian Tologanak of Cambridge Bay. The airline has provided RCMP with GPS coordinates for the approximate location of the remains but bad weather has impeded the investigation. A careful air and ground search is still being made.

Reports indicate that the plane was making a medical flight and that Tologanak was being returned to Nunavut after the RCMP detained him under the Mental Health Act. He had been sent to a Yellowknife hospital by police due to his appearing distress. The airline had agreed to return him to Cambridge Bay at the request of Tologanak's family. Further information has not been released as the pilots were said to be too distraught to talk to the media.

It is unclear how the deceased was able to open the door while the cabin was pressurized. Despite speculation that one of the safety features of the Beechcraft King Air 200 twin-turboprop plane failed, the Transportation Safety Board has announced that it will not be conducting its own investigation. While police have not confirmed that the death was a suicide, the high rate of suicides among young Inuit males accounts for 40 per cent of deaths investigated by the coroner's office since Nunavut was created in 1999.

For more information.

Living In Silence

The assassination attempt should have been expected.

King Umberto I of Italy was strongly criticized for his harsh conservatism and his role in the brutal suppression of various reform movements during his reign. As a symbol of hated oppression (and despite his personal popularity), it seemed only natural that he be targeted by various left-wing and anarchist factions. On November 17, 1878, the king and queen were in the city of Naples taking part in a lavish royal procession through the city (paid for by a special tax). While King Umberto and Queen Margarita rode in an open carriage, Giovanni Passannante approached the royal couple and jumped onto the running board. His left hand was covered with a red handkerchief and, after he came within reach of the king, he pullled it off to reveal a small boxcutter knife. The queen screamed at the sight of the knife which alerted the Prime Minister, who had been sitting with the king in his carriage. Prime Minister Cairoli threw himself forward to protect the royal couple and was wounded in the thigh.The king in turn, was cut in the arm as he attempted to pummel Passannante with his sword while the queen beat him over the head repeatedly with the bouquet of flowers in her hands. Eventually, the police managed to restrain Passannante and took him into custody.

The 29-year old Passannante had grown up in poverty and eventually found work as a cook.After becoming involved with the anarchist movement (and already spending time in prison for his political activities), he decided to assassinate the king. Selling his jacket to buy the small knife, Passannte inscribed it with the statement, "Death to the King, long live the Republic Universal".Although he had almost certainly been acting alone, the arresting officers subjected him to brutal interrogation and torture to make him confess to being part of a conspiracy and to name the others involved. He insisted that he had not intended to kill the king and that no one else was involved in his plan. As part of the massive investigation while awaiting trial, his mother and most of his siblings were placed in a lunatic asylum (only one brother managed to escape). The rest of his family was harassed and eventually forced to move out of their home town of Salvia Lucania (which changed its name to distance itself from the would-be assassin). While pro-monarchists held protest marches against the would-be assassin, anarchists rallied to Passannante's defense with attacks across the country.

After spending nearly a year in prison, Passannante's case finally came to trial. Although assassination attempts involving royalty would become much more common later, the attempt on King Umberto's life attracted international attention.Passanante's defense was half-hearted at best and the outcome was a foregone conclusion (all those associated with the trial, including the judge and his defense counsel, were monarchists). He was sentenced to death in court (despite the fact that attempted assassination wasn't a capital offense under Italian law). It was only as a result of international pressure that the king personally intervened with a Royal Decree changing the sentence to life imprisonment. This was little comfort for Passannante who flatly stated that he would rather have been executed. Given his brief taste of what life in prison would be like, he may well have been right...

Giovanni Passannante was taken to a prison in the town of Portoferrario (the main town on the island of Elba).His cell was below sea level with a ceiling so low that he couldn't even stand upright. There was no latrine or light and he was shackled to the wall with a heavy chain. The attendants were under strict orders not to speak to him under any circumstances. It was there that he spent the next ten years of his life. Aside from the attendants who watched him carefully and the occasional screams that even the sailors on nearby boats could hear, there was no other contact with the outside world.

As you might expect, the horrendous prison conditions left him broken mentally and physically. Not only did he waste away to the point that his kidneys were severely damaged by the weight of the chain he was forced to wear, but his mental deterioration left him catatonic. While left-wing politicians and sympathizers argued for his release, right-wing politicians opposed any attempt at lightening his sentence. After a psychiatric assessment was ordered by the government, it was determined that Passannante had gone insane and he was finally transferred to the criminal asylum at Montelupe Fiorentino.

Passannante was in good company there since he was later joined by Pietro Acciarito. After attempting to kill the king in 1897, Acciarito also went insane while serving a life sentence. By contrast, the anarchist who actually succeeded in assassinating the king in 1900, Gaetano Bresci, died in prison less than a year after being given a life sentence (Italy had abolished the death penalty by then). Passannante and Acciarito were likely in no condition to appreciate the irony.

When Giovanni Passannante died on February 4, 1910, an autopsy was held and his brain and skull were sent to the Superior Institute of Police at Regina Coeli Prison in Rome. Although the criminologists who examined the brain attempted to find some physical basis for his "deviance" (Cesare Lombroso's theories were still in vogue), no real evidence was found.The remains were later placed on display in Rome's Criminological Museum until May 11, 2007 when they were finally transferred to his hometown for burial. The fact that there is an ongoing controversy over whether to restore the town's name to "Salvia Lucania" in Passannante's honour shows the local determination to remember the man who is still regarded as a hero in many circles.

When Men Are Raped

While male sexual assault is being increasingly recognized as a public health issue, it continues to be underreported and unrecognized. A study published in a recent issue of Violence and Victims presents the results of a population-based study conducted on 705 adult men in the state of Virginia. Researchers found a lifetime prevalence of 12.9% in sexual assault among men, with 94% assaulted for the first time before the age of 18. Statistical analysis showed that male victims of sexual violence were 3.4 times more likely to be depressed and 2.4 times more likely have suicidal thoughts (only 15.4% sought counseling however). This study confirms that male sexual assault is a prevalent problem. The researchers also concluded that victimized men were more likely to be depressed and have suicidal thoughts and yet did not seek health services. Clinicians and social agencies need to make a greater effort to identify and treat male victims of sexual assault.

Click here for the abstract.

Two Hospitals Fined In Patient Dumping Scandal

College Hospitals in the California cities of Costa Mesa and Cerritos have agreed to a substantial penalty for their role in transporting homeless psychiatric patients to downtown shelters in Los Angeles. The Los Angeles City Attorney office has announced that more than 150 mentally ill patients were dumped at skid row shelters in what it described as the largest case of homeless dumping they've investigated to date.  Many of these patients were later found roaming the streets still wearing their hospital gowns.  Despite being left at shelter doors, there was no followup to ensure that they would be admitted.

As part of the settlement, the hospital agreed to make charitable contributions to numerous psychiatric and social service agencies servicing the L.A. downtown core. The hospital also agreed to an injunction on future transportation of homeless mental patients to downtown or southern L.A. In making the settlement, the hospitals are denying any wrongdoing but are in the process of developing new protocols for the release of homeless mental patients to "ensure homeless psychiatric patients will have the dignity and the continuum of care that everyone leaving a hospital deserves."

For more information.

The Salieri Rumour

If it ever becomes possible for the dead to sue the living for slander, there aren't many who would have a stronger case than poor Antonio Salieri...

Although he was one of the most important Viennese composers of his time, he is mainly remembered today as the villain in Peter Shaeffer's 1979 play Amadeus.The play, which was later made into a film of the same name in 1984, presents Salieri as a mediocre musician who becomes Wolfgang Amadeus Mozart's archenemy out of jealousy. After sabotaging Mozart's career and having a role in his death, Salieri eventually ends up in an insane asylum following a suicide attempt. In a futile effort to be remembered, Salieri leaves behind a confession that he had poisoned the great composer but eventually dies in obscurity. ; If Salieri is remembered at all these days, that memory is largely shaped by F. Murray Abraham's haunting performance as Salieri in the movie version

While Shaeffer took considerable liberties with the story of Mozart and Salieri, the actual facts about their relationship, the circumstances of Salieri's death, and what happened afterward is considerably more complicated. Although Mozart and Antonio Salieri had been rivals (they both wrote Italian operas) and Mozart would accuse Salieri of using his influence with Emperor Leopold against him, their relationship seemed friendly enough on the surface. There is evidence that Salieri had undermined Mozart's success at times (although Mozart often caused many of his own problems with his abrasive personality) but never to the extent suggested in Shaeffer's play. After Mozart's premature death, Salieri was one of the few mourners who attended his sparse funeral and would later train Mozart's son, Franz Xavier, as a musician.

There were numerous theories surrounding the death of Wolfgang Amadeus Mozart on December 5, 1791 but modern historians tend to agree that he died of natural causes (probably due to rheumatic fever as well as the repeated bleedings that doctors gave him to treat his final illness). Despite numerous rumours at the time that Mozart had been poisoned (with possible villains including the Freemasons, fellow musicians, or even the husband of one of his students), Salieri wasn't implicated. Until..

After a lifetime as a successful composer and musician, Antonio Salieri's health began to decline. His music began to fade in popularity as more prominent composers came along although he trained some of the greatest musicians of his generation. Salieri began to suffer regular episodes of depression and, by the early 1820s, had become increasingly frail. In the spring of 1823, Antonio Salieri fell and struck his head which apparently left his legs paralyzed. While his eldest surviving daughter cared for him at home, she eventually arranged for to be transferred to the Vienna Allgemeine Krankenhaus in October of that year.

Which is when the rumours started...

Although there is some evidence that Salieri had somehow injured his throat before being taken to hospital, the rumours suggested far more. Old allegations that Mozart had made against Salieri accusing him of sabotaging his career emerged.The story that Salieri had confessed to poisoning Mozart and cut his throat out of remorse became the talk of Vienna. It probably didn't help that Mozart's widow Constanze did nothing to put the rumours down (despite the help that Salieri had given to her son in launching his musical career). The idea that Mozart had been poisoned had never really died down and the circumstances of Salieri's illness made him a perfect suspect. If there's any mercy, it's that Salieri was probably too ill to even be aware of the allegations made against him (which also made it impossible for him to defend himself).

While his friends and colleagues rallied to his defense, the rumour-mongers were hard at work. At an 1824 performance in Vienna, a leaflet was distributed to the members of the audience containing a poem which pictured Salieri as Mozart’s rival “standing by his side with the poisoned cup.” Letters on the subject were written back and forth and Mozart's own physician was pressed to provide details of the composer's final illness to rule out the possibility of poisoning (since Mozart's grave was lost, an autopsy would have been out of the question even for nineteenth century medicine).

Even after Salieri finally died on May 7, 1825, the accusations continued. To try settling the rumour that Salieri had confessed to the murder, his physician Joseph Rohrig and the two attendants who had been with him continually during his illness signed sworn affidavits that no confession had been made in their hearing. Although the accusations died down, a juicy rumour isn't so easily suppressed.

In 1831, Alexander Pushkin published his play Mozart and Salieri which featured a jealous Salieri poisoning Mozart out of envy (it later became an opera). The poisoning rumour seemed largely forgotten until the Peter Shaeffer play and the movie version of it brought it back to public attention.; Ironically, the publicity from the poison rumour has also sparked a renewed interest in Salieri's music. Many of his operas have been released on DVDs and there's even been a push by opera companies around to feature some of his works as part of their regular season.

If Salieri does manage a comeback, it may represent an intriguing example of the lasting power of rumour. Even after centuries, a good story can still linger, especially when Hollywood is involved.

After 9/11

The March 2009 issue of the Journal of Traumatic Stress provided the results of a study examining positive social and individual changes noted by individuals following collective trauma. The researchers examined perceived benefits of the September 11, 2001 (9/11) terrorist attacks in a 3-year study of a national sample of 1382 adults. Of the sample participants, 57.8% perceived social benefits of 9/11, including increased prosocial behavior, religiousness, or political engagement. Individuals who found increased national religiosity as a benefit 2 months post-9/11 reported greater positive affect and life satisfaction and lower distress and posttraumatic stress up to 3 years post-9/11. Pre-9/11 religiousness and Republican political affiliation predicted perceiving religion-related social benefits post-9/11. The authors conclude that perceptions of social change are important but understudied responses to stressful events.

Click here for the abstract.