Providentia

Teen 'Hero' Unmasked as Serial Arsonist

On July 26, John and Gina Richardson were awakened by the sound of someone banging on their door and warning them that their bungalow was on fire.After helping the elderly couple out of their Nottinghamshire, U.K. home, 19-year old Ben Welbourn then rushed back inside to save their dog. Although the blaze had largely destroyed their home, they were grateful to Welbourn for saving their lives and even posed with him afterward for pictures that were prominently displayed in the local newspaper. The Richardsons' daughter publicly thanked Ben Welbourn for saving her parents' live. Two weeks later, on August 8, a second fire began at the home of 89-year old Faye Florio. Once again, Ben Welbourn was on the scene to help the frightened woman out of her burning home and to accept praise for his courage. This time however, a sharp-eyed neighbour recognized Welbourn from his previous rescue and contacted the fire service.

After an investigation, Ben Welbourn was arrested and charged with two counts of arson and reckless endangerment. Pleading guilty in a Nottinghamshire court, he was sentenced to four years in prison. The revelation that Ben Welbourn was responsible for both fires left his victims devastated. The Richardsons, who had lost all their personal belongings in the fire, were especially vocal and Gina Richardson stated that, " I feel terrible. I feel he has taken everything away from me. Everything in that home was very precious."

In handing down his decision, Judge Michael Stokes informed Welbourn that, "'I'm prepared to accept that on the first occasion you probably didn't appreciate the unpredictability of what you were doing and you no doubt were taken aback by the way the fire spread. There can be no such explanation for your conduct on the second occasion." Although Welbourn is not considered to be mentally ill, Judge Stokes advised him to seek treatment for his psychological problems.

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Dealing with Animal Hoarders

As part of a new initiative to cope with the problems associated with animal hoarding, a workshop sponsored by the Central Arizona Animal Cruelty Task Force will be held in Casa Grande to provide a public forum to address the complex mental health and animal welfare issues involved. The workshop is intended to provide an overview of the problem of animal hoarding on a national basis and will include mental health professionals and representatives from animal welfare agencies. The workshop arose following a recent case in a nearby town where 185 animals were forcibly removed from a home and the owners were subsequently charged with neglect.

Defined as having a higher than usual number of pets without the resources to care for them, animal hoarding is a growing problem in many jurisdictions in the United States, Canada, and Europe. Animal hoarders begin taking in pets with good intentions, but develop an inability to recognize that their pets are being neglected. Linked to compulsive hoarding disorders such as Diogenes Syndrome and Obsessive-Compulsive Disorder, animal hoarding has also been associated with certain forms of dementia and delusional disorder.  In addition to problems with neglect and malnutrition, animal hoarding has led to significant health risk for humans including sanitation concerns (including the spread of parasites and dangerous ammonia levels), possible epidemics of animal-borne diseases such as toxoplasmosis, rabies, and bubonic plague, and the potential link between animal hoarding and other forms of abuse (i.e, child and elder abuse).

While most jurisdictions have no clear legal definition of animal hoarding, humane societies and animal welfare agencies across North America and Europe have organized "Hoarding Prevention Teams" to work with hoarders to deal with their pets. Stronger legislation is also being proposed in many jurisdictions to help control animal hoarding.

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Responding to Medication and Therapy in Depression

A study reported in the August 2009 issue of Journal of Consulting and Clinical Psychology examined the relative success rates for medication and cognitive therapy in depression. Previous research has shown the two treatments to be roughly equivalent in alleviating chronic depression although evidence suggests that patient factors may affect relative treatment success. A randomized controlled trial found nearly equivalent response rates for antidepressant medications and cognitive therapy in a sample of moderate to severely depressed outpatients. In the study, the authors attempted to identify the variables that were associated with response across both treatments as well as variables that predicted superior response in one treatment over the other. The sample consisted of 180 depressed outpatients: 60 of whom were randomly assigned to cognitive therapy; 120 were assigned to antidepressant medications. Treatment was provided for 16 weeks in both groups. Factors such as chronic depression, older age, and lower intelligence each predicted relatively poor response across both treatments. Three patient variables—being married, unemployment, and having experienced a greater number of recent life events—were identified, and each predicted superior response to cognitive therapy relative to antidepressant medications. Overall, six 6 markers of treatment outcome were identified, each of which might be expected to carry considerable clinical utility. The 3 prognostic variables identify subgroups that might benefit from alternative treatment strategies; the 3 client variables identify groups who appear to respond particularly well to cognitive therapy. The authors suggest that there are different mechanisms at work in both treatment modalities which can interact with client factors to affect outcome.

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Gunman Howard Unruh dies at 88

It has been six decades since Howard Unruh's shocking mass murder but surviving family members of his victims still remember the terror of that day on September 6, 1949 when Unruh's rampage claimed thirteen lives.  Many of those family members expressed satisfaction on learning that the 88-year old Unruh died yesterday at a Trenton N.J. nursing home following a long illness.  Diagnosed as a paranoid schizophrenic and confined to the New Jersey Hospital for the Insane (later the Trenton Psychiatric Hospital)  after the rampage, Howard Unruh had been a model patient who lived for decades without incident.

Howard Unruh had been a returning veteran of World War Two who had become alienated in his civilian life in Camden, New Jersey.  Deeply affected by his wartime experiences, he lived in an apartment building with his mother.  Despite being a war hero, he remained unemployed and seemed to have little to do with his time except look at the medals and other war memorabilia decorating his bedroom walls and care for his considerable collection of firearms. He also maintained a target range that he set up in the basement of his apartment building which didn't prevent him from getting into trouble with his neighbours.The spectacle of a grown man being financially supported by his mother who worked at a local factory made him the target of considerable teasing as a "mama's boy".  In his diaries, he kept careful note of every personal grievance (real or imagined). When the diaries were later examined, it was found that he had written the word "retal" (short for retaliate) next to the name of every neighbour whom he had thought deserving of special consideration.

On September 6, 1949, Howard came home from a local movie theatre to find that the new gate that he had built onto the front of the apartment building had been stolen.  That was the apparent trigger that led to his rampage.  After dressing up in his best suit and arming himself with a German luger and thirty-three rounds of ammunition, Unruh went hunting for those he felt had wronged him.  In the twelve-minute rampage that followed, Howard shot at over twenty-six people, killing thirteen and wounding a number of others.Most of the victims were from his list but many others were apparently just in the wrong place at the wrong time. Hearing the approaching sirens, he returned to his mother's apartment and prepared to make a final standoff.  After being wounded, he was convinced to turn himself in. He was eventually charged with thirteen counts of murder and three counts of "atrocious assault and battery" According to the two psychiatrists who examined him before his trial, Unruh stated that "I'm no psycho. I'd have killed a thousand if I had bullets enough".

Although he was found mentally fit to stand trial, Unruh was sent to a psychiatric hospital to serve his life sentence.  Other returning veterans had committed acts of violence following the end of the war but Howard Unruh certainly stood out as the first spree killer in U.S. history. 

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New Study Finds High Rates of Childhood Exposure to Violence and Abuse in US

A new study published in a recent issue of Pediatrics is reporting that nearly half of all children in the United States are being exposed to violence or abuse. Jointly sponsored by the U,S, Department of Justice, Office of Juvenile Justice and Delinquency Protection, and the Centers of Disease Control and Prevention, the study was conducted by a team of researchers from the University of New Hampshire. Based on a nationwide sample of 4,549 children up to the age of seventeen as well as caregivers, the researchers collected information of victimization experiences through direct interviewing. Their results indicated that three out of five children were exposed to violence, abuse, or criminal victimization in the past year. These numbers include 46 percent who had been physically assaulted, 10 percent who had been abused by a caregiver, 6 percent who had been sexually victimized, and 10 percent who had witnessed an assault in their family. More than a third of the children had two or more different kinds of violent exposure in the past year and 11 percent had five or more. In outlining their results, the researchers urge child care workers, teachers, and parents to be more aware of the range of potentially violent situations that children may face, including dating violence and bullying.

In addition to the journal publication, the results have also been released in an Office of Justice Programs/OJJDP bulletin titled "Children's Exposure to Violence: A Comprehensive National Survey."

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NFL Players Union Forms Concussion Committee

In a bid to deal with the problem of head injuries in professional football players, the National Football League Players Association (NFLPA) has formed a new committee. The purpose of the new concussion and traumatic brain injury committee will be to address the diagnosis, prevention and treatment of concussions and traumatic brain injury in active players. The committee will also be examining evidence concerning potential long-term effects of cumulative head injuries in players. The committee will be headed by Arizona Cardinals wide receiver, Sam Morey, as well as NFLPA medical director, Dr. Thom Mayer.p>

Support for the establishment of the committee grew following a recent study commissioned by the NFL showing that retired players have an elevated risk of debilitating neurological conditions including Alzheimer's Disease. While the cumulative effects of repeated head injuries has been well documented in professional boxing and wrestling, the potential for similar problems arising in other sports where head injuries occur have only recently been explored. Recent statistics suggest that as many as 300,000 sports-related traumatic brain injuries of varying severity occur in the United States alone each year.

Potentially fatal brain syndromes that have been linked to repeated head injuries include dementia pugilistica and second-impact syndrome. While both syndromes have been primarily diagnosed in boxers, cases involving professional football and hockey players have gained significant media exposure in recent years.

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Does Food Advertising Affect Eating Habits?

While health advocates have focused on the role of advertising for calorie-dense low-nutrient foods as a major contributor to the obesity epidemic, research remains limited.  An experimental study published in the July 2009 issue of Health Psychology examines the hypothesis that exposure to food advertising during TV viewing may also contribute to obesity by triggering automatic snacking of available food. In the first experiment, elementary-school-age children watched a cartoon that contained either food advertising or advertising for other products and received a snack while watching. In a second experiment, adults watched a TV program that included food advertising that promoted snacking and/or fun product benefits, food advertising that promoted nutrition benefits, or no food advertising. The adults then tasted and evaluated a range of healthy to unhealthy snack foods in an apparently separate experiment.  The amount of snack foods consumed during and after advertising exposure was carefully measured. Results showed that children consumed 45% more when exposed to food advertising. Adults however, consumed more of both healthy and unhealthy snack foods following exposure to snack food advertising compared to the other conditions. In both experiments, food advertising increased consumption of products not in the presented advertisements, and these effects were not related to reported hunger or other conscious influences. The researchers concluded that the experiments demonstrate the power of food advertising to trigger automatic eating behaviors and can influence far more than brand preference alone

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"Scared Straight" Psychologist Loses Licence

An Alabama court has upheld a decision to suspend the license of a psychologist for his bizarre treatment methods.  The Alabama Court of Civil Appeals overturned a previous decision by a Circuit Court judge to reverse a decision by the Alabama Board of Examiners in Psychology regarding the case of Leroy Richardson. Richardson,
a psychologist working for the Alabama Department of Youth Services had been cited by the Board for numerous ethical violations surrounding his use of a "Scared Straight" program for youths referred to him by a social worker in the Birmingham, Alabama school district system.; The youths, who often had not been charged with any crime, were "recruited" by various social workers, including one who testified on Richardson's behalf at his trial.& Once the youths were sent to Richardson, they were kept shackled and locked in cells at a DYS facility as part of his "Scared Straight" program.; Although at least one social worker testified that she was aware of the nature of the program, the chief operating officer for the Birmingham City Schools system indicated that he had no knowledge of the use of forced restraints and has since launched an investigation. Richardson defended his actions by insisting that his program was not psychological in nature and not subject to Board review.

While "Scared Straight" programs enjoyed a brief popularity since first being introduced in the 1970s, later researchers have shown that the program (involving introducing potentially delinquent youths to hardened criminals) had no real value in preventing juvenile delinquency and may even be harmful. Despite the lack of empirical support, "Scared Straight" programs continue to be supported in some circles due to the relative simplicity of the program and the apparent testimonials of its success.

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Dealing With Tinnitus

A paper published in the May 2009 issue of Rehabilitation Psychology examines explore the effects of a new tinnitus treatment program (tinnitus intensive therapy [TIT]) based on auditory perception principles and neural habituation. The researchers used a follow-up study with measurement of treatment effects every third month over a 2-year period in which the cases were their own controls. There were 25 participants with a mean age 50.1 years (SD = 16.1); 10 women (52.7 years; SD = 16.8) and 15 men (48.3 years; SD = 15.9). The participants were recruited from clinical population admitted to a polyclinic tinnitus treatment program in western Germany. Results showed that there was a significant reduction of tinnitus in the follow-up period. Mean baseline tinnitus scores (Tinnitus Fragebogen; Goebel & Hiller, 1998) at the start of the treatment were 50.9 (SD = 14.5) and the final scores were 14.2 (SD = 5.9). In total, the clinical improvement over the follow-up period was 72.1%. The authors concluded that the TIT program showed a significant clinical treatment effect and should be tested further in a multicenter treatment project. The findings support the Jastreboff habituation model of tinnitus, but social cognition factors should also be taken into account.

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Doctors call for 'Munchausen' blacklist

Whether dealing with medical services directly or through a proxy, cases of Munchausen Syndrome represent a major drain on time and resources needed for dealing with patients in need of medical services. First identified in 1951, Munchausen Syndrome (formally recognized as a form of factitious disorder) can lead to multiple hospital admissions by patients seeking attention and/or sympathy by doctors and nurses. A related syndrome, Munchausen Syndrome by Proxy (MSP)involves use of a second person (usually a child) to gain attention and treatment using false or exaggerated symptoms. Although child protective services have successfully prosecuted  cases of MSP on the grounds of child abuse, the true incidence of MSP and Munchausen Syndrome remains unknown.

Doctors in the Australian state of Victoria have called for an electronic "blacklist" to alert hospitals and private clinics about patients who repeatedly seek medical treatment for suspicious symptoms. Although emergency department physicians have dubbed these patients, "frequent flyers", medical ethicists are warning about the possible risks of the proposed blacklist. Patients who have been flagged as possible Munchausen cases may be deprived of necessary treatment despite actual need as well as concerns about lack of privacy. Doctors are also recommending psychiatric referrals for suspected cases as well as working with family members to ensure that proper care is maintained and to avoid the health risks resulting from repeated medical test and hospitalizations.

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