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Is Bipolar Disorder Chronic?

Bipolar spectrum disorders have traditionally been thought to be chronic in course. However, recent epidemiological research suggests that there may be developmentally limited forms of bipolar disorder. An article published in the August 2009 issue of Journal of Abnormal Psychology presents the results of two large, nationally representative studies that challenge existing perceptions about the prevalence of bipolar disorder over time.   The results reveal a strikingly high prevalence of bipolar disorders in emerging adulthood (5.5%–6.2% among 18–24-year-olds) that appear to resolve substantially during the latter half of the 3rd decade of life (3.1%–3.4% among 25–29-year-olds). There is potential bias due to early mortality, institutionalization, incarceration, and homelessness that may account for some of this reduction, the prevalence distribution suggests a high incidence in late adolescence and emerging adulthood that appears to resolve spontaneously in most cases. There were very few differences across age groups in symptom endorsement and comorbid diagnoses, suggesting that 18–24-year-olds that meet criteria for bipolar diagnoses experience clinically significant impairment and associated consequences of the disorder. Better longitudinal research is needed to determine whether developmentally limited forms of bipolar disorder exist and, if so, what markers might distinguish these forms of the disorder from more chronic courses.

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Self-help Course Linked to Fatal Psychosis

In 2005, 34-year old Rebekah Lawrence signed up for a four-day course titled, "The Turning Point" that had been recommended for her by friends.  The course, promoted as a "journey to the core of the human spirit" was run by People Knowhow in the Sydney suburb of Cremorne.  Designed to help participants establish a dialogue between their adult and child selves, the course instructors trained the participants in childhood regression therapy.  Her husband, David Booth, reported that she came home from the course in a "dreamlike state-almost like someone on drugs" and that the usually gentle woman began to show alarming behavioural changes Despite her worsening psychological problems following the course, the instructors running the program, none of whom had professional training, were unable to help her.

On December 20, two days after the course ended, Rebekah Lawrence arrived late for work at her job as assistant for the CEO of the Royal Australasian College of Physicians in Sydney, Australia.  A coworker later described her as "quite unstable in a manner in which I had never seen before".  After stripping naked, she then screamed and acted "like a child having a tantrum".  She began screaming, "I love you David", climbed out a second-story window and then jumped. There was no history of mental illness and no trace of drugs or alcohol was found in her system.

At a recent inquest into Rebekah Lawrence's death, Deputy State Coroner Malcolm MacPherson ruled that her psychotic state and subsequent suicide could be linked to the self-help course and called for greater regulation and training to oversee the content of counseling or psychotherapy-oriented courses  He called for the health minister to enact legislation to set up a system of registration, either at the national or state level.  During the course of the hearing, the director of the Turning Point program conceded that the program had "inadequate" safeguards both in screening participants or in following up with them afterward.  Although the course provider's lawyers suggested that preexisting mental problems may have been to blame for Ms. Lawrence's death, there was little evidence to support the claim.  Mr. McPherson concluded that childhood regression therapy was "intrinsically unsafe" and played a clear role in the death.

Members of Rebekah Lawrence's family, including her husband David Booth, expressed satisfaction with the inquest's findings and urged that proper legislation be enacted to prevent future tragedies.  David Booth has not ruled out litigation against People Knowhow and the Turning Point program.

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Searching versus Surfing: Is there a difference?

People have different ways of finding information online. Whether searching for specific information or simply coming across new facts while surfing at leisure, the end result should be the same in terms of how that new information is perceived. Or is it? A recent study published in a 2009 issue of Journal of Media Psychology describes a mixed-design experiment exploring differences between searching and surfing on cognitive and emotional responses to online news. In a sample ofninety-two participants recruited from an undergraduate marketing class, the participants were asked to read three unpleasant news stories from a website. Half of the participants acquired their stories by searching, meaning they had a previous information need in mind. The other half of the participants acquired their stories by surfing, with no previous information need in mind. Heart rate, skin conductance, and EMG measures were while participants read each story. Self-report measures of article relevance and accuracy in a later recognition trial were also measured. Stories acquired by searching elicited greater heart rate acceleration, skin conductance level, and EMG activity during reading. These stories were rated as more unpleasant, and their details were recognized more accurately than similar stories that were acquired by surfing. The authors conclude the paper by discussing the implications of these results for understanding how people process new information online.

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Mental Illness Linked to Shocking Family Murder

It was a shocking crime that was never supposed to happen in peaceful Merritt, British Columbia.  On April 8, 2008, Darcie Clarke found her three children dead in their family trailer.  Her daughter Kaitlynne, 10, had been stabbed to death while her 8-year old brother Max and 5-year old brother Cordon had been smothered.  After the murders, the children's father, 40-year old Allen Shoenborn, fled into the local woods and evaded capture until April 16.  He was later charged with three counts of first-degree murder while police were left baffled over his motive for killing his children. 

The police investigation and repeated forensic assessment have slowly unraveled a complex story of mental illness and domestic violence.  When questioned over his reasons for killing his children, Allen Shoenborn has maintained that his children were being sexually abused and was forced to kill them for their own protection.  Based on evidence presented by forensic psychiatrists, Shoenborn`s defense attorney maintains that his client is suffering from a delusional disorder that contributed to the killings.  The Crown is arguing that the killings occurred in a jealous rage due to fears that Darcie Clarke would leave and take their children with her.  Due to his long history of paranoid delusions and hallucinations going back years, social workers expressed concern at Shoenborn's escalating pattern of threatening behaviour toward his children.  They warned Darcie Clarke three days before the killings that they would intervene if she failed to take steps to protect them from their father. 

While Shoenborn is being held for trial at Kamloops Regional Correctional Centre, the nature of his charges require his placement in solitary confinement for his own protection. He told examining psychiatrists that he still speaks to his children wishing them a good morning when he wakes up and a good evening when he goes to sleep.  He also maintained that it was his duty to kill his children when they were threatened,  Due to his bizarre outbursts during the trial to date, he is kept in a Plexiglas-enclosed prisoner box while in the courtroom.  While he has pled not guilty, his attorney is attempting to have him declared not criminally responsible.

The trial is continuing.

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Sexual Harassment Among Male and Female Police Officers

An article published in the October 2009 issue of the Journal of Occupational Health Psychology examines the impact of sexual harassment on mental and physical health of both men and women, and to explore the possible moderating effects of gender on the relation between sexual harassment and health. Often defined as "“unwanted sex-related behavior at work that is appraised by the recipient as offensive, exceeding her resources or threatening well-being”, sexual harassment occurs frequently in many organizations. This is especially true in police forces where research has shown that 77% of policewomen from 35 countries have reported harassment from colleagues. Not only does sexual harassment impact psychological well-being, but it has been linked to health problems relating to emotional distress. The present study used a representative sample of 3,001 policemen and 1,295 policewomen in the Dutch police force who were asked to fill out an Internet questionnaire. Based on research results, it appeared that women were more often bothered by sexual harassment than men, but gender did not moderate the relation between sexual harassment and mental and physical health. In addition, victims who felt bothered by the harassing behaviors reported more mental and physical health problems than victims who did not feel bothered. The distinction between bothered and nonbothered victims is important because appraisal is an essential aspect in evaluating the impact of sexual harassment on victims.  The authors conclude that sexual harassment policies need to address male and female victims and also addresses the need to take sexual harassment seriously, even when the victims don't seem bothered by it.

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AA Gunman Found Not Criminally Responsible

On March 24 of this year, Anthony John Allen walked into the Weedon Pioneer Community Hall in Cochrane, Alberta where the Alcoholics Anonymous meeting that he usually attended was being held.  According to witnesses, the 49-year old Allen then  pulled out a sawed-off shotgun and handgun and told the other members in the room that he was, "the new sheriff in town and God had told him to come to the meeting with guns".   They added that Allen told them that his gun was fully loaded and he was willing to use it.  He also pulled out a bottle of vodka and a box of shells which fell to the floor.  Another member, a former newspaperman, defused the situation and persuaded Allen to surrender without incident.

At a Calgary hearing in which the results of a forensic assessment was presented, Provincial Court Judge Judith Shriar ruled on November 23 that Allen was not legally responsible for his actions.  In handing down her decision, Judge Shrier accepted the testimony of psychiatrist Kenneth Hashman who argued that the defendant had experienced a psychotic breakdown which led to his actions.  Under Alberta legislation, Allen must appear before a Provincial review board at Alberta Hospital within 45 days for the resolution of his case.  While free on bail, a house arrest provision has been included to safeguard his behaviour.

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When Families Are Homeless

The July 2009 issue of American Journal of Orthopsychiatry presents a special issue on the complex issue of parenting and homelessness.  Families are the fastest-growing segment of the homeless population and now make up more than one-third of the overall number of homeless people.  The epidemic of family homelessness has been linked to the current economic crisis, skyrocketing foreclosure rates, and failure of social service agencies to accommodate family needs.  There is a tendency to define homeless families only in terms of family members who present at shelters and other service programs with their children,  often only a single parent—most often a mother—with one or more children, 42% of whom are less than six years old.   Many of the homeless men and women who enter shelters as individuals are also parents who, for various reasons, are not currently in possession of their children.  Family composition may also change over time, as the structures of homeless family units are fluid due to the high rates of separations of family members who are homeless.   Social agencies dealing with the homeless often ignore the broader context of the nontraditional family system and support networks that homeless people need (including providing basic necessities for their children).  Homeless parents frequently face stigma and discrimination because of their homelessness status. Mothers who are homeless describe feeling that their parenting practices are being monitored closely; if not viewed as adequate, they risk losing their children to foster care.  The authors recommend continuing research into homeless families including: identifying the range of interrelationships of family and social support networks among individuals and families who are homeless,  identifying young women who are at risk for homelessness and pregnancy, and Identifying which families will succeed in independent living and which families require long-term supportive housing interventions.

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Australian "Shaman" Loses Bid to Keep Name out of Report

A self-styled "North American Indian shaman healer" has failed in his bid to prevent an Australian Health Service Commissioner from naming him in a report to Victoria's State Parliament. Due to reports of sexually inappropriate behaviour with female patients, Shamir Narra Avorham Djuwani Kiefa Israel Marlon Wati Dakota Jessie Malakhi-Zion-Angel-Shalom (born Peter Marlon de Angelis) was ordered to stop his healing practice.  After repeated refusals to comply, Health Service Commissioner Beth Wilson told Shalom that he would be named in the report to warn vulnerable members of the public about him.

Shalom, 52, and his lawyer disputed Ms. Wilson's allegations and maintained that the shaman was not a healer but rather a "teacher who empowered patients to heal themselves".   Through "tantric dances" and other rituals, Shalom offered his services in the treatment of various diseases, including cancer.  Charging $220 Australian dollars for each shamanic healing session, claimed that he was a spiritual teacher and sage who often assisted other healers and even police departments with "ongoing psychic detective investigations".  A twice-divorced father of two, Shalom was recently reduced to living in his car following a domestic dispute.  While Ms. Wilson referred to various advertisements that described him as ''(Wakinyan) Thunder Eagle'', a ''Shaman, psychic, spiritualist, healer, counsellor'', Shalom denied placing the ads himself.

Beth Wilson's concerns about Shalom and his health practices arose from several complaints filed by female patients.  According to their statements, Shalom had promised to cure their cancer and entered into sexual relationships with several of his patients.  By falsely representing himself as a healer and failing to respect proper boundaries with his patients, Wilson maintains that he poses a danger to the public. Shalom, in turn, maintains that being publicly named in the report would "destroy his life" and ruin his practice.  He also stated that the allegations of sexual misconduct raised against him are part of a conspiracy arising from his "sensitive dealings" with the police.

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Learning to be a Parent

An article published in a recent issue of Developmental Psychology presents the results of a longitudinal study of cross-generational parenting quality.  The researchers examined parenting skills in a sample of 61 participants (26 boys and 35 girls) in a lower socioeconomic status sample of moderate ethnic diversity. All subjects were part of a long-term study involving mothers recruited from Minneapolis public health clinics between 1976 and 1977.  The current study participants are second-generation subjects permitting assessment  of parenting skills across generations. Data was collected based on direct observation assessments for both generations in the study with controls being made for critical background factors such as stress, socioeconomic status, child and parent IQ.  For both parenting samples, parenting skills were assessed over a 24-month period.   Statistical analysis showed moderate stability (r = .43) in parenting quality across generations, and findings held after controlling for all other factors. The authors suggest that early parenting experience may play a significant role in passing on parenting skills to the next generation although extensive research is needed to demonstrate it further

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Blood-Note Stalker Trial Proceeding

Glasgow therapist, Dr. Lorna Relton, first realized that something was wrong when her patient, Brian Johnstone, asked her for help with his camera during a treatment session in early 2006. The 31-year old Johnstone then took her picture. The next day, Dr. Relton received an anonymous package at her house containing three broaches and a note saying, "Lorna, a gift from guess who" Since she suspected that the package was from Johnstone, she notified her supervisor at Glasgow''s Shawpark Resource Centre and they agreed that she would no longer be his therapist.Days after Johnstone was told of the decision, the external mirrors and windshield wipers from Dr. Relton's car were stolen although police told her that there was insufficient evidence to charge the patient.

Some time later, two mental health nurses who had visited the unemployed Johnstone's home told Dr. Relton that he had a large photograph of her as the background of his computer screen. Police investigated when the mirrors from her car were stolen again. In their search of Brian Johnstone's home, they found more than a thousand photographs and videos of Dr. Relton, her car, and her house. They also found the missing items from her car sealed in plastic bags as well as several notes which he had written in his own blood proclaiming his love for Dr. Relton. At least one of the notes had been written as if it were from her stating, "Brian, I'm keeping my body warm for you, when I see your muscles my heart starts pounding". Police also found handcuffs, pepper spray, smoke grenades, a handgun and a crossbow in their search of Johnstone's home.

Johnstone, now an inpatient at a secure care facility in Glasgow's Stobhill Hospital, has admitted to committing a breach of the peace in his harassment of Dr. Relton. His defense counsel is maintaining that his client is suffering from obsessive-compulsive disorder. A forensic psychiatrist evaluating Johnstone has warned that he poses a risk to society if he is ever released. Legal complications have delayed sentencing in the case but Sheriff Norman Ritchie is awaiting forensic reports before the case can proceed. Brian Johnstone faces a possible life sentence.

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