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.

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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.

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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.

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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.

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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.

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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."

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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.

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Teenager Who Killed Mother After Grade Fight Given Life Sentence

A model teenager who beat his mother to death with a baseball bat after an argument over his grades has been given a life sentence. Lewin C. Powell III was a 16-year old honour student at a prestigious private school in Maryland when he attacked his mother last May at their home in Towson, Maryland. His father had also been injured in the attack but he recovered in hospital. Powell later made a full confession to police and pleaded guilty to first-degree murder in January of this year. Although his defense attorney presented evidence that he suffered from psychiatric problems and that he "just snapped", the court rejected this argument given further evidence that the victim's death "took hours" in which she made multiple attempts to escape.

Despite pleas for leniency by Powell's father, teachers, and supporters, a Judge Kathleen Cox handed down her decision in a case that she described as "horrible". She recommended that Powell serve at least part of his sentence at the Patuxent Institute in Jessup, Maryland although he will likely be first placed in the state correctional system. He may be eligible for parole in twelve years but while require approval from Maryland's governor.

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Problem Gambling in Inner-City Youth

A paper published in the March 2009 issue of Psychology of Addictive Behaviors presents the results of a large study of past year gambling in a sample 1128 youths aged 14 to 18 (54.1% female, 58.0% African American) who were seen at an inner-city emergency department (ED).  Overall, 22.5% of the sample reported past-year gambling. Male youth were more likely to gamble than female youth, and African American youth reported higher rates of past-year gambling than non-African American youth. Significant correlates of gambling included lower academic achievement, being out of school, working more than 20 hours per week, alcohol, cigarette, and marijuana use, alcohol problems, severe dating violence, moderate and severe general violence, and carrying a weapon. When examined simultaneously, being male, African American, out of school, working for pay, alcohol and marijuana use, severe general violence, and carrying a weapon all emerged as significant correlates of past-year gambling, largest amount of money gambled, and gambling frequency. In addition, involvement in severe dating violence was associated with frequency and largest amount gambled. The results suggest that gambling is common among youth in the inner city and is associated with several risk behaviors. The authors conclude that inner-city emergency departments may provide a good context for screening and intervention to address multiple risk behaviors.

Click here for the abstract.