Providentia

Mother Convicted In Munchausen Syndrome Case

A Harris County jury has convicted a Texas woman accused of subjecting her young son to at least two unnecessary surgeries. Laurie Williamson, 44, was convicted Thursday of injury to a child in connection with the surgeries for implantation of a nerve-stimulation device and insertion of a gastric feeding button. She now faces the possibility of a life sentence. The punishment phase of the trial started Thursday and will resume next Tuesday.

State child welfare officials and prosecutors said Williamson has Munchausen syndrome by proxy, a rare disorder in which a person fabricates or induces symptoms in others to gain attention. Prosecutor Mike Trent said Williamson manipulated doctors and her son's condition to get the surgeries. They added that over ten years, Williamson took her three children to at least 500 medical appointments.

Child Protective Services took custody of the children in March 2006. Defense attorney Allen Isbell denied that his client has the syndrome. He said doctors told Williamson that her son needed the procedures.

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The Beast Within

It was in the autumn of 1572, following a rash of animal attacks in the woods near Dole, France, that the local peasants were authorized to seek out the werewolf assumed to be responsible. There were few actual sightings of the animal but the "loup garou" had carried off several small children and attacked horsemen who had driven it away " only with great difficulty and danger to their persons". The peasants were instructed "to assemble with pikes, halberts, arquebuses, and sticks, to chase and to pursue the said were-wolf in every place where they may find or seize him; to tie and to kill, without incurring any pains or penalties". Despite their search, it was only on November 8 of that year that peasants came upon a "monstrous creature" attacking a young girl. The creature was driven off although the girl later died of her injuries. Even in the darkness, some of the peasants thought they recognized the creature as a local hermit named Gilles Garnier.

Garnier was not popular in the region and was arrested after fifty witnesses filed depositions against him. Whatever protests of innocence he had were quickly ended by a session on the rack which "persuaded" him to confess to the charges. Garnier was sentenced to be burned alive at the stake and "that his ashes be then scattered to the winds". He was also ordered to bear all court costs and the sentence was carried out on January 18, 1573.

A similar case was brought to trial in 1603 involving a mentally disturbed (and possibly intellectually challenged) boy named Jean Grenier. Following reports of animal attacks on children in Gascony, France, Grenier confessed to all of the attacks and claimed to have eaten some of the children involved. He also stated that he was part of a werewolf "coven" and transformed himself using a "wolf's skin" given to him by a mysterious stranger. Survivors of the attacks confirmed Grenier's testimony and he was found guilty. In a remarkable move for the time, the court concluded that Grenier was mentally ill (but possessed) and he was sentenced to a Franciscan monastery for the rest of his life. When visited in the monastery years later, he was reported to be "diminutive in stature, very shy, and unwilling to look anyone in the face. His eyes were deep set and restless; his teeth long and protruding; his nails black, and in places worn away; his mind was completely barren; he seemed unable to comprehend the smallest things". Jean Grenier died at the age of 20.

There were an estimated 30,000 cases of lycanthropy reported in Europe between 1520 and 1630 alone. The epidemic of werewolf hysteria that plagued Europe seemed to be linked to the witchcraft mania occurring during the same period. Witches were frequently accused of changing themselves into cats or rabbits and attending demonic Sabbaths to meet Satan. Werewolves, in turn, were accused of transforming themselves with the Devil's aid. Convicted werewolves and witches were often condemned to be burned alive (except in England where they were merely hanged).

The werewolf hysteria seemed to be largely fuelled by lurid stories of wolf attacks (which were more likely to be due to wild dogs) and only subsided when wolves were hunted to virtual extinction across Europe. The growing recognition that testimony obtained through torture was basically unreliable probably played a role as well (waterboarding advocates take note). The last major werewolf panic was in Gevaudan, France following a series of killings by a "wolflike creature" between 1763 and 1767. The killings were never solved.

While clinical lycanthropy (the delusion of changing into an animal) remains a recognized psychiatric condition, actual cases tend to be rare (I've never encountered a case myself, alas, although I remain hopeful). Reports in the forensic literature of clinical lycanthropy patients committing violent acts are even rarer (but they have happened). Modern cases of lycanthropy tend to be part of broader psychiatric conditions such as schizophrenia. Along with the classic werewolf delusion, there have also been reported cases of patients believing that they have been changed into other types of animals including dogs, frogs, and bees. While werefrogs do not evoke the same superstitious terror associated with werewolves, the unusual nature of the psychopathology makes for fascinating case histories in the clinical literature.

Treatment seems to be straightforward as lycanthropic delusions respond well to medication (no burning necessary). Despite the popularity of werewolf movies in the past few years, there has been no evidence of any upsurge of cases and the condition remains rare. Although werewolves live on as a cultural phenomenon, the hysteria that condemned Gilles Garnier to death has mercifully subsided (I hope).

Click here for a recent case history.

Ten Years After Traumatic Brain Injury

A research study published in the March 2008 issue of the Journal of the International Neuropsychological Society presents the results of a 10-year study examining the long-term effects of traumatic brain injury (TBI). Previous research investigating long-term has yielded mixed results linking severity of injury, demographic factors, and psychiatric problems. In the present study, a sample of 60 participants who had sustained TBI 10 years previously was used. Participants were tested with the Extended Glasgow Outcome Scale (GOSE) as well as neuropsychological measures of attention, speed of processing, memory and executive function and a measure of anxious affect. Outcome on the GOSE ranged from upper good recovery (32%) to lower severe disability (2%). Factors associated with poorer outcome on the GOSE included duration of posttraumatic amnesia, level of education, poor performance on cognitive measures of information processing speed, attention, memory, and executive function as well as showed higher levels of tested anxiety.

Click here for the abstract.

"Devout Christians" Kill Children as Part of Exorcism

It was on March 29 of this year when residents of Bangwe township in Blantyre, Malawi learned that two local women had allegedly burned two children to death to exorcise them of witchcraft demons. Agnes Kamanga Gadama, and her sister Catherine Kamanga reportedly suspected that Gadama's two children had been possessed by demons because "some neighbors were teaching them witchcraft"

After a week of continuous prayers and fasting with the two children in an enclosed room, 9 year old Yankho and 6 year old Martin Gadama were found dead by police investigating the ritual. The two children had been locked inside the family home along with two other children while Gadama and her sister lit a fire that engulfed the building in smoke to drive away demons.

Both suspects were devoted members of the Namiyango Assemblies of God and had reported the suspected witchcraft incident to the congregation. Representatives of the church group have expressed disbelief that the two women could have killed the children.

When asked to comment on the case, Limbe Police public relations officer Chifundo Chibwezo said the two women are expected to go to Zomba Mental Hospital for examination. “They are now being kept at Chichiri Prison but they are expected to go to the mental hospital to find out if they have mental disorders or not. I cannot comment much since the case is now in the hands of the court. The two women were charged with murder for causing death, contrary to section 209 of the Penal Code,” said Chibwezo.

The two surviving children are staying with their grandparents.

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The Children of War

A study focusing on the psychosocial effects chronic warfare among refugee children in Southern Darfur is presented in a recent issue of Omega. A sample of 331 children (aged 6-17) from three refugee camps were selected to be part of the study. Of those in the sample, 43 percent were girls and 57 per cent were boys with an average age of twelve years. All of the children in the study were interviewed and tested with measures of traumatic stress, depression, and grief.The study results indicate that there were no significant differences between genders in terms of exposure to traumatic experiences, including rape, but older children (13-17 years) experienced a larger number of traumatic exposures than younger children (6-12 years). Seventy-five percent of the children met the DSM-IV criteria for PTSD, and 38 per cent exhibited clinical symptoms of depression. Twenty per cent of the children sampled also reported significant levels of grief symptoms.

The authors found that increased exposure to war experiences led to higher levels of: (1) traumatic reactions; (2) depression; and (3) grief symptoms. Of the different war experiences examined, abduction, hiding to protect oneself, being raped, and being forced to kill or hurt family members were most predictive of traumatic reactions. Factors most likely to predict depressive symptoms included: being raped, seeing others raped, the death of a parent, being forced to fight, and having to hide to protect oneself. Similar findings were reported for grief reactions. While trauma, depression, and grief often occur together, the mechanisms and ways in which they interact are less understood. This is the first study examining the psychosocial effects of war experiences among refugee children currently living in Sudan's war-zone areas. The authors recognize the need for further research into war-related atrocities and their varying impact on the children's psychological well-being and overall adjustment. Implications for planning mental health interventions are also discussed.

Click here for the abstract.

"Supernatural Hybrid" Arrested In Sexual Assault Case

A 19-year old Pennsylvania man who convinced a 15-year old girl that he was a vampire/werewolf hybrid has been arrested for corruption of a minor. Kristian Allen Carl turned himself in to Schuylkill County authorities after admitting to having consensual sex with an underage female. He had originally been charged with statutory sexual assault but pled guilty to the lesser charge to avoid a jail sentence. The girl's family reportedly agreed to the plea bargain.

Asked by a reporter if he had believed that he was a hybrid, Carl lowered his head and whispered, ''Yes. I watched a lot of movies" but has since retracted the claim. Police reported that Carl had previously shown them his canine teeth as proof of his lineage and also told them that he had a guardian dragon that protected him from evildoers.

He denied knowing that the victim, whom he had been seeing for a year, was underage and believed that she was over 16. A bench warrant had been issued for him after he missed a January 29 preliminary hearing.

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How Families of Organ Donors Deal with Grief

A study published in the February 2008 issue of Clinical Transplantation examines the effect of the organ donation process on families dealing with grief. Using the British Columbia Transplant Society (BCTS) database, the authors mailed test packages to families of deceased organ donors. Each package contained three standardized, validated questionnaires (including scales of depression, post-traumatic stress, and bereavement). Seventy-three completed packages were received (an overall response rate of 46%) and the responses were analyzed. The results of the study showed that grief varied in terms of age of the deceased and length of time since donation. Donor families reporting negative aspects about the donation process were also more likely to experience post-traumatic stress. Based on their findings, the authors concluded that organ donation can have a beneficial effect on the grief process providing that donor families receive proper counseling and support before and after donation.

Click here for the abstract.

Cave Sect Leader Hospitalized With Head Wounds

A leader of a doomsday sect who had inspired his followers to hide in a cave for five months as they waited for the end of the world has been hospitalized with serious head wounds, Penza government officials said today. Self-styled prophet Pyotr Kuznetsov is described as being in serious condition in a hospital in the town of Bekovo, some 500 kilometres (310 miles) southeast of Moscow. Eleven of Kuznetsov's followers are still occupying the cave nearby.

Although the government representative and the hospital declined to say what caused his injuries, he had been undergoing court-ordered psychiatric treatment. Penza Deputy Governor Oleg Melnichenko had stated earlier in televised comments that Kuznetsov was hospitalized with a self-inflicted open head wound. Melnichenko further added that Kuznetsov had laid his head on a tree stump and hit himself repeatedly on the head with a piece of wood. This contradicts an eariler statement that had been made alleging that cult members had beaten Kuznetsov during an argument. There was no explanation for the discrepancy.

While thirty-five of Kuznetsov's followers had originally barricaded themselves in the cave last October in anticipation of the end of the world, all but eleven have since come out due to deteriorating conditions caused by rainfall.

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The Stroker’s Legacy

Faith healing has a long and varied history but certain cases still have a special fascination. So it was with Valentine Greatrakes, the Stroker. Born in 1628 in to a prominent Irish family, Greatrakes (also spelled Greatorex or Greatraks) was caught up in the volatile politics of the time. He fought in the English Civil War as part of Oliver Cromwell's army before returning to his family estate in 1654. Aside from his prominent role as one of the interrogators in a witchcraft trial in 1661 (he and other judges were obliged to "prove" that the defendant was a witch using the recommended tortures of the time), there seemed little else in his life to provide a hint of what came later.

It was in 1663 when Greatrakes was struck by an "impulse, or strange persuasion" in his mind. He came to believe that God had given him the power to cure "the King's evil" (as scrofula, or tuberculosis of the lymph nodes, was known in those days). He reportedly told his wife who categorically denounced him as a fool. Despite her objections (and she was hardly the only one), he approached a young boy named William Maher who was disfigured by severe scrofula. According to Greatrakes' own later account, "I laid my hand on the place affected, and prayed to God for Jesus' sake to heal him". Greatrakes took great satisfaction in reporting that the boy had become completely healed within a month. That was the beginning of his healing career.

Over the course of the next two years, Greatrakes, motivated by "further impulses from on high", began healing numerous other diseases including epilepsy, ulcers, ague (chills and fevers), and paralysis. His fame spread quickly and he was swamped by requests for healing. Due to conflicts with his own farm work, Greatrakes established regular hours (three days a week, twelve hours each day) in which he saw patients. He became known as "the Stroker" through his habit of stroking his hands on each invalid as part of the healing session. The explanations that he provided on how his healing worked, which mainly involved casting out the evil spirits causing the disease, did little to reassure the local clergy and physicians. He was finally summoned to a local Bishop's Court and ordered to stop his healing activities. While Greatrakes gave in at first, he quickly began healing again (it was God's will, after all).

In 1666, Greatrakes was contacted by Lord Edward Conway for help in treating his wife's severe migraines. Lady Anne Conway, a brilliant philosopher/writer of her time, was often incapacitated by her headaches and none of the other physicians that she had consulted had been able to help. Greatrakes lived on their Warwickshire estate for months but his stroking sessions did nothing to relieve her pain. As Lady Conway and her husband were prominent in English society, a group of distinguished scholars and physicians gathered at their castle to witness the sessions. Despite his failure with Lady Conway, he still attracted a steady stream of patients who came to the estate to be healed.

Greatrakes then went to London at the request of King Charles II who had asked for a demonstration. Despite a testimonial from Robert Boyle (then president of the Royal Society), Greatrakes failed to impress the court with his healing powers. There seems to be a certain irony in that since the king himself was not shy about holding healing audiences demonstrating his own Royal Touch. Still, Greatrakes spent months in London at a private house at Lincoln's Inn-Fields that reportedly became "the daily resort of all the nervous and credulous women of the metropolis". In that same year, he published a pamphlet titled A Brief Account of Mr. Valentine Greatrakes and Divers of the Strange Cures by him lately performed. Written by himself in a letter Addressed to the Honourable Robert Boyle, Esq. Although Greatrakes then returned to his family farm, he continued to revisit London until his death in 1682. His healing career dwindled over the years and he faded into obscurity.

Writing about Greatrakes In his classic Extraordinary Poplar Delusions and the Madness of Crowds, Charles Mackay agreed with most contemporary observers that there was no conscious deception involved. The Stroker genuinely believed in his healing gift even though his successes seemed mostly due to suggestion. Mackey added that: "So great was the confidence in him, that the blind fancied they saw the light which they did not see – the deaf imagined that they heard – the lame that they walked straight, and the paralytic that they had recovered the use of their limbs... Those who saw through the delusion kept their opinion to themselves, knowing how useless it was to declare their disbelief to a people filled with prejudice and admiration". These same words can apply to just about any other "healer" that has come along since Greatrakes' time. Whenever a new healing marvel comes along, skeptics are still forced to deal with the cult of adoration that goes with it.

Fighting miracles is never easy.

Does Mild Traumatic Brain Injury Cause Cognitive Problems?

A study reported in the December 2007 Journal of Psychosomatic Research examined cognitive complaints in head-injured patients referred to the emergency department of a level 1 trauma center in the Netherlands.  A sample of 79 patients (ranging in age from 18 to 60) who had been admitted for mild traumatic brain injury were followed up over six months post-admission. In addition to a battery of neuropsychological tests and use of the Rivermead Postconcussional Symptoms Questionnaire (RPSQ), patients were also asked to self-monitor their cognitive and memory problems over a 12-day period. Results indicated that 39 per cent of the sample self-reported cognitive problems. These complaints were strongly related to lower educational levels, emotional distress, personality, and poorer physical functioning (especially fatigue) but not to actual extent of injury.  Severity of self-reported cognitive complaints was found not to be associated with the patients' daily observations of cognitive problems or with outcome on a range of neuropsychological tests.  The researchers concluded that self-reported cognitive complaints were more strongly related to preexisting personality factors, as well as physical and emotional problems rather than actual cognitive impairments. This would suggest that treatment of emotional distress and fatigue may also reduce cognitive complaints. They also concluded that neuropsychological screening and daily monitoring of complaints is a useful method to gather information about the frequency and pattern of cognitive problems in regular life.

Click here for the abstract.