Providentia

Australian Psychiatrist Goes to Court For Right to Treat Patient with MDMA

Melbourne psychiatrist Eli Kotler has launched a court battle against the state of Victoria for permission to treat a severely ill patient with MDMA (better known as "ecstasy").   According to Dr. Kotler, his patient (who cannot be named) suffers from numerous mental health issues for which conventional psychiatric medication have been ineffective.    Since MDMA is listed as a prohibited substance in Australia, it can only be administered for medical or scientific research.  Earlier this year, the Victorian health department rejected Dr. Kotler's application to use the drug for treating his patient.  A letter sent at the time by Stefan Tulloch, the acting chief officer of medicines and poisons regulation at the Department of Health,  informed the psychiatrist that ""There is insufficient data to establish the safety and efficacy … with regards to the safe use of a Schedule 9 poison in clinical practice."

As a result, Dr. Kotler has gone forward with a court challenge that sets a legal precedent in Australia.  While Australia's  Therapeutic Goods Administration, which regulates medicines, is considering making MDMA a controlled drug, it is still unclear how long this will take and whether it will resolve Dr. Kotler's challenge.  In the meantime, both sides are gearing up for what is expected to be a protracted legal battle with expert witnesses being called in from California and the United Kingdom where MDMA has already been used successfully in medical treatment.

Despite the controversy surrounding MDMA-assisted therapy in many places, research has already suggested that MDMA-assisted psychotherapy may be beneficial in treating posttraumatic stress disorder (PTSD), and depression though most researchers call for more studies given the potential dangers associated with its use.

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King William's Rise and Fall

Visitors to the Californa ghost town once known as Holy City would probably not spend much time exploring the place.  Located in an obscure corner of wilderness about ten miles from Los Gatos in the Santa Cruz Mountains, all that remains of the town are some old buildings and several tourist shops.   Anyone unfamiliar with the history of the town would be amazed to discover that it was once a thriving utopian community with its own radio station and a tourism industry.   During the 1930s, billboards proudly proclaimed Holy City to be the "headquarters for the world's most perfect government" and that it "answers all questions and solves all problems."  

To understand what happened to the town and why it is virtually forgotten today, you  would need to know something about the town's legendary founder:  William Edward Riker.   Born in California in 1873,  relatively little is known about Riker's early life (aside from what he provided himself, of course.)   Described as a handsome Californian who was "a favorite with the ladies,"  the self-styled "Professor" first established himself as a palmist and a professional mind reader who toured across the country on the carnival circuit.   

That is, until he was forced to flee to Canada after being charged with bigamy.   Having abandoned both of his wives, Riker took advantage of his Canadian exile to found what he described as "the Perfect Christian Divine Way."   This called for total celibacy (at least for his followers), abstinence from alcohol, hard-core white supremacy with total segregation of the races, and communal living.   With this new mission in place, Riker returned to California in 1918 and founded a commune near San Jose.  There was no word on what became of his bigamy charges but presumbly he managed to reach an understanding with his wives.  Those followers who were "born again" to be part of Riker's community were expected to abide by their leader's rules for living but, more importantly, to hand over their life savings as well.  That allowed Riker to buy the land where he had his commune and also ensured that his first thirty followers, mostly elderly people, had little choice but to live the "Perfect Christian Divine Way" or as long as they were under his rule.  

Though his followers were expected to remain celibate, Riker obviously felt exempt from that little rule (it's good to be king).   His new bride, Lillian, was quickly established as his co-leader in the commune which offended some of his early followers, who likely realized that their leader had feet of clay.   One of them, Frieda Schwartz, sued to regain the money she had given Riker but she ended up losing the case.  All this accomplished was to give Riker's commune more publicity than ever and draw in new followers. 

As the commune grew, Riker was able to establish a restaurant, a service station for those newfangled automobiles, a dance hall, a penny arcade, and an observatory for tourists to look at the Moon through a telescope (all in Riker's name).   The revenue from these various businesses, along with a side business selling mineral water, brought him an income of $100,000 a year, even at the height of the Depression.   But that wasn't enough for William Riker.   He also wanted to establish  a major media empire as well.   Not only did he launch a weekly newspaper, but Riker also set up one of California's first radio stations, KFQU, which featured a half-hour show with a Swiss yodeler.   His radio license was revoked in 1931 due to various "irregularities" but that didn't keep the irrepressible Riker down for long.

By the 1930s, Holy City had grown to more than 300 inhabitants, all ruled over by "King William" and "Queen Lillian."   Most of the inhabitants were either elderly followers or out-of-work drifters looking for jobs.  Along with the billlboards proclaiming his message, Riker also declared himself to be the "phantom spokesman of all wise Christians -  God's chosen of all people in the world."   To spread his message of white supremacy and segregation even further, Riker first ran for Governor of California in 1938.   As part of his platform, he called for a ban on businesses in California being owned by non-whites.   In one of his political pamphlets, he wrote that:

The White Man can take care of any and all kinds of business in our own, White Man's California State Home, and no longer will the White Man tolerate your undermining and polluting tactics. Farmers, Business Men and The Workers say: Orientals get out and stay out of our business. Our new Government will see that you get a job. Your polluting, undermining system of business must eternally stop in Our California. And besides this, keep your polluting hands off our White Race Women; they also belong only to the White Race Man. This is the true law of our original White Man's Constitution, these statements explain the real and true spirit of California.

He was never more than a fringe candidate for the Progressive Party and only got 170 votes in the primary.  Still, he obviously felt encouraged enough to run three more times. It was his continuing support of Adolf Hitler and his Nazi policies, even after the United States entered World War II, that really got Riker into trouble though. 

After authorities learned about a series of letters of support that Riker had written to the German leader, "William the Comforter" was arrested in 1943.   Though he retained famed trial lawyer Marvin Belli to represent him during his trial, Riker would become incensed by the way his lawyer repeatedly referred to him as a "crackpot" in his defense.   Despite being acquitted, Riker was offended enough by Belli's comments to try suing him afterward for "defamation of character."   Riker lost his case and was forced to pay court costs.

The final end for Holy City (and Riker's empire) came in the 1940s when the construction  of a new highway doomed the thriving tourist trade.    Since Holy City was no longer on the main route through the Santa Cruz Mountains, businesses closed and many residents were forced to find work elsewhere.  Holy City was disincorporated in 1959 and Riker lost control of his empire in 1960.  Exactly what happened is still a mystery though many of the buildings that made up Holy City were destroyed in a large fire that occurred around that time.  

Even with his empire gone, Riker managed to hang on to the few acres remaining to him.   His white supremacy message had fallen increasingly out of favour, especially with the rise of the civil rights movement, and he had only a handful of followers.   Still, those same followers were likely astonished when William Riker suddenly convered to Roman Catholicism at the age of  93.   Three years later, he died at Agnew State Hospital.  

According to "Father" Riker's obituary, there was only one known survivor of his original disciples still living at the time (no word on what became of "Queen" Lucille).  Still, the loss of his following didn't keep him from his dream of reestablishing his empire. Just a month or so before his death, Riker produced a crayon drawing of a multi-million dollar church that he hoped to build with the right support. 

Though Riker's big dream died with him, there are still traces of Holy City left behind for the determined visitor.   The former post office of Holy City is now an upscale shop selling all types of handblown glass though a neon sign reading "Holy City, California" is still prominently displayed in the window.  That, and the small collection of Holy City memorabilia maintained by the shop's owner are all that remain of William Riker's utopian dream and the "headquarters for the world's most perfect government."

 

Post-infection depressive, anxiety and post-traumatic stress symptoms: A prospective cohort study in patients with mild COVID-19.

It remains unclear whether COVID-19 is associated with psychiatric symptoms during or after the acute illness phase. Being affected by the disease exposes the individual to an uncertain prognosis and a state of quarantine. These factors can predispose individuals to the development of mental symptoms during or after the acute phase of the disease. There is a need for prospective studies assessing psychiatric symptoms in COVID-19 patients in the post-infection period. In a prospective cohort study recently published in the journal Progress in Neuro-Psychopharmacology & Biological Psychiatry, nasopharyngeal swabs for COVID-19 tests were collected at patients' homes under the supervision of trained healthcare personnel. Patients who tested positive for COVID-19 and were classified as mild cases (N = 895) at treatment intake were further assessed for the presence of psychiatric symptoms (on average, 56.6 days after the intake). We investigated the association between the number of COVID-19 symptoms at intake and depressive, anxiety and post-traumatic symptoms approximately two months later, adjusting for previous mental health status, time between baseline and outcome, and other confounders. Multivariate logistic regression and generalized linear models were employed for categorical and continuous outcomes, respectively. Results: A clinically significant level of depressive, anxiety and post-traumatic stress symptoms were reported by 26.2% (N = 235), 22.4% (N = 201), and 17.3% (N = 155) of the sample. Reporting an increased number of COVID-related symptoms was associated with the presence of clinically significant levels of depressive (aOR = 1.059;95%CI = 1.002–1.119), anxiety (aOR = 1.072;95%CI = 1.012–1.134), and post-traumatic stress (aOR = 1.092;95%CI = 1.024–1.166) symptoms. Sensitivity analyses supported findings for both continuous and categorical measures. Conclusion: Exposure to an increased number of COVID-19 symptoms may be associated with depressive, anxiety and post-traumatic symptoms after the acute phase of the disease. These patients should be monitored for the development of psychiatric symptoms after COVID-19 treatment discharge. Early interventions, such as brief interventions of psychoeducation on coping strategies, could benefit these individuals. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

For the abstract

The Strange Death of James Moon

Despite being one of Lafayette, Indiana's most well-known landmarks and the site of that city's first hotel, the Lahr House Hotel has another claim to fame which is far more macabre.

When a guest named James Moon first checked into the hotel on June 10, 1876, nobody paid much notice despite the rather large and bulky trunk he had with him.  While living with his wife and six children on a farm in a nearby Quaker community, the 37-year-old Moon still traveled into Lafayette often enough to be fairly well-known to  staff from his previous stays at the hotel.    He also had a reputation of being an inventor and all-around "jack-of-all-trades" so nobody thought much about the trunk itself.    On checking in, however,  he asked hotel staff for a quiet room as he was a light sleeper who didn't wish to be disturbed.   After hearing some suggestions, Moon decided on a third-floor room located to the rear of the building and stated that he would only need it for a few days.   

After settling in his room, Moon then left to run several errands in the city.   Though he mostly kept to himself, he did mention in passing to one of the hotel's owners that he was working on "perfecting a patent of considerable importance."     What nobody knew at the time was that, during the course of his errands in the city, he bought a large ax-head at a nearby hardware store two thick iron plates at a foundry.   At that same foundry, he instructed staff to bore holes through the ax head and the plates and stated that they would be part of a machine he was building for creating "fruit baskets".    While  this foundry work was being done, he went to a barber shop and had his heavy beard shaved off and then stopped at a drug store and bought cotton padding and chloroform (it was a simpler time back then).   

Finally, he picked up his order from the foundry and placed his purchases in the heavy trunk which was still on his carriage.    After paying a visit to several of his comrades from his days fighting in the Civil War, Moon then returned to the hotel where he arranged for his trunk to be brought up to his room.  Despite being well over six feet tall and weighing close to 200 pounds, the trunk was still too heavy for Moon to carry himself  and he needed help from two baggage handlers to lug the trunk up to the third floor.   With that final chore taken care of, Moon then locked the door.   

On Sunday, June 11, a maid named Bridget Clogan tried several times during the day to enter Moon's room for cleaning but got no response.   At 5 pm, she tried once more and, getting no answer, she used her passkey to enter the room.   What she saw there sent her into a fit of screaming that alarmed all the guests in nearby rooms.  Two of these guests rushed to her assistance and found Moon's decapitated body strapped to the floor with his head lying nearby.   What he had passed off as a machine for making fruit baskets was actually a crude guillotine which he had used to cut off his own head in one of the most bizarre suicides on record.   

Hotel staff  called the police who then began examining the crime scene in elaborate detail.   He had apparently been carrying the disassembled pieces of the guillotine in his trunk and, once he got the ax head and metal plates needed to complete his device, had carefully assembled the device in the hotel room.  Moon's contraption basically consisted of a broadax attached to a jointed wooden arm that swung on a hinge screwed into the floor.   The ax head had two thick wooden bars which were bolted together to provide a counterweight.    But Moon's ingenuity didn't end there.   He also prepared a soapbox to hold his head secure and placed a large wooden block under his neck to ensure that the blade would make a solid hit.  He had then carefully fastened a cord to the wooden arm and attached the other end to the windowsill.   All that remained was for Moon to set a candle holder by the window with the flame being lit so that it would burn through the cord.    This allowed Moon enough time to get his head in position and wait for the cord to be burned all the way through.   It was a testament to Moon's ingenuity that this bizarre suicide method worked on his first try.

Since Moon failed to leave behind a suicide note, police were baffled over his motives for killing himself in such a bizarre fashion.  All that they could determine was that he had been dead for about ten hours before his body was discovered which put the time of death around 7:00 am on Sunday.    The body was moved to a nearby funeral home and his widow, Mary, came up with several relatives to make arrangements to ship the body home (no word on how long it took hotel staff to clean up the room to prepare it for the next guest).   

As you might expect,  stories about Moon's bizarre suicide were carried by newspapers across the country.    Most of the coverage on the story came from the local paper in Lafayette which also provided further details about Moon's life.  This included his being a self-taught blacksmith and his various attempts at creating a perpetual motion machine.   But most of the details that we know about James Moon came from the coroner's inquest and the various people who provided testimony about the deceased inventor.   

Many of the witnesses called were former neighbours who described Moon as a well-educated man who was kind to his family. Being the son of a Quaker minister, it was likely no surprise that he was thoroughly familiar with the Bible though, intriguingly enough, he was also a bit of an atheist.    Other people who knew Moon also described his fascination with machines for causing death.   One of these neighbours, O.W. Phillips, testified that Moon had  told him back in 1875 that he could "make a better machine that could take life than has yet been invented."   To nobody's surprise, the jury returned a verdict of suicide though the reason he chose to kill himself they way he did died with him.

James Moon was buried in the Farmer's Institute Cemetery, not far from his farm.  As for the guillotine used to kill Moon, that went on display at a site not far from the hotel where the bizarre death took place.  Thousands of men, women, and children came to see the device before it was finally disassembled.  Photographs of the bizarre apparatus can still be found online.

Experiences of becoming widowed in old age—A cross-countries study with qualitative interviews from Denmark and quantitative measures of association in a Swedish sample.

Becoming widowed is a stressful health-threatening event causing major life changes. In a study recently published in the International Journal of Qualitative Studies on Health and Well-being, we explored how widowed people experience becoming widowed and examined if these experiences are quantitatively associated with widowhood.  A multi-methods study using an exploratory sequential mixed-methods approach including a qualitative descriptive study with widowed people from Denmark and a Swedish cohort study. Qualitative interviews (n = 9) were analysed using qualitative content analysis, describing experiences as explained by the widowed people. The quantitative association of the experiences was examined by identifying proxies for the qualitative experiences of widowhood in the cohort study and examining the occurrence in widowed people compared to married people (n = 1,095). Results showed that six categories of experiences emerged: the circumstances around spousal death, mental health and well-being, physical health, social relations, activities and practicalities. The quantitative examination showed a significant association with widowhood regarding mental and physical health problems. In conclusion, the circumstances around spousal death and the time before spousal death, in general, were important to how participants felt being widowed. Being ill negatively affected mental health and well-being, partly because of the inability to participate in activities and social relations. This is important, as health problems are more common among widowed people than married people. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

For the abstract (Open Access) 

Is There a "COVID-19" Effect for Aging?

As older adults have frequently been portrayed as one homogeneous and vulnerable risk group in public debates and in the media immediately after the outbreak of the Coronavirus disease (COVID-19) pandemic, a general shift toward less favorable attitude toward own aging (ATOA) might have resulted. In contrast, individuals may feel younger than before the pandemic, reflecting a psychological mechanism to avoid identifying themselves with the old age “risk group.” A new study in the journal Psychology and Aging examines e 12-year trajectories of ATOA and subjective age among middle-aged and older German adults based on assessments between 2008 and Summer 2020 (N = 7,730; age in 2008: 40–93 years, M = 62.41). Based on longitudinal multilevel regression models, we found that for ATOA, a model including a potentially “pandemic-driven” change component between 2017 and 2020 in addition to an overall linear change between 2008 and 2020 revealed a better fit than a linear change model without that additional change component. Mean-level decline in ATOA between 2017 and 2020 was five times steeper in such a model than in a linear change model that did not include an additional 2017–2020 change component. The extent of intraindividual ATOA change between 2017 and 2020 varied interindividually, but for more than 99% of the sample, particularly among those with poorer self-rated health, ATOA became less favorable. There was very limited evidence for a pandemic-specific change in subjective age. In conclusion, our findings suggest that the early phase of the pandemic might have caused a change toward less favorable ATOA, whereas it did not affect subjective age. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

For the abstract

Child In Ireland Left Permanently Disabled by "Faith-Based Abuse" by Parents

A nine-year-old child was left with permanent neurological damage and disfigurement due to a horrific "exorcism" carried out by the child's parents in 2019, Irish gardai have reported.  The parents of the child, who cannot be named by the media, have both been convicted of assault causing serious harm and three charges of child cruelty and have yet to be sentenced.  During the twelve-day trial at Dublin's Criminal Court, evidence was presented that the parents carried out the "exorcism" at the family home in Dublin on dates between June 28th and July 2nd, 2019.  

Medical testimony reported evidence of multiple bites, burns marks, and bruises found on the child's body following her hospitalization on July 2.  As a result, she suffered welling of the brain and subdural hematoma, or bleeding between the skull and the brain surface, and had bleeding in both eyes.  Garda sources told the media that the girl had been left “incapable of having any control over her body, she can no longer see, hear, touch, she can’t swallow”, the garda said.  As a result, she will likely require permanent round-the-clock care.  The couple's remaining children have been taken into care by Family Services.

In speaking on the case following the conviction, Gardai  Detective Inspector Brian Downey described it as the first instance of "faith-based abuse" successfully prosecuted in Ireland.  “The child had suffered at the hands of her parents an exorcism, which involved pain, burning, cutting, choking, and ultimately a serious, serious assault,” he added.  He was also quick to describe the case as an "exception" rather than the rule but that Gardai would continue searching for similar cases.  

Though the child had only been in the country for three months before the abuse occurred, there was no prior indication of what the parents had been planning.   “There’s no winners in this, we have a family that is broken,” Downey said.  “A nine year old relies on their parents for support and protection, and when that’s taken away it’s traumatic,” he said.  The couple will remain in custody until their sentencing in January of next year.   A victim impact statement is scheduled to be filed on the child's behalf by her carers.

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Trends and disparities in suicidal behaviors for heterosexual and sexual minority youth 1995–2017.

The current study examines disparities and longitudinal trends of suicidal behaviors among sexual minority youth disaggregated by self-reported sex and sexual orientation. Despite evidence that attitudes toward sexual minorities have improved during recent decades, few studies have examined whether suicidal behaviors in youth of varying sexual minority identities have likewise improved. Using population-based data from Massachusetts, a study published in the journal Psychology of Sexual Orientation and Gender Diversity,conducted a series of logistic regression analyses to examine disparities and trends for suicidal ideation (SI), suicide attempt (SA), and suicide attempt resulting in medical treatment (SM) by sexual minority and heterosexual youth during four cohort periods ranging from 1995 to 2017. Results found that the overall prevalence of suicidal behavior has decreased over time for all groups. However, there were significant disparities between sexual minority and heterosexual groups for all suicidal behaviors across cohorts. Sexual minority groups ranged from being 1.28 times to 15.45 times more likely to engage in suicidal behavior as heterosexual peers within a cohort period. During the most recent cohort period (2013 to 2017), the rates for SI and SA across sexual minorities ranged from three to seven times that of heterosexual peers. The gap for SI and SA widened across time for almost all female sexual minority groups. The gap for SA and SM narrowed for all male sexual minorities but varied across groups for SI. These results indicate that despite societal improvement in acceptance of sexual minorities, sexual minority youth continue to be at higher risk for suicidal behavior, particularly females for whom most disparities increased over time. (PsycInfo Database Record (c) 2021 APA, all rights reserved)

For the abstract

Preventing Incel Terrorism

On November 2, 2018, a 40-year-old man later identified as Scott Paul Beierle walked into Tallahassee Hot Yoga, a yoga studio in Tallahassee, Florida. Almost immediately after entering, he shot six people, killing two women, A male customer confronted the shooter with either a broomstick or a vacuum cleaner (witness accounts vary) before being pistol-whipped, allowing other customers to flee to safety. Minutes later, officers arrived and found two women, Maura Binkley, 21, and Dr. Nancy Van Vessem, 61, dead at the scene. They also found Beierle's body; he had apparently shot himself.  

 

A military veteran and former high school, Beierle showed few of the warning signs linked with extremist violence aside from prior charges for battery involving him grabbing a woman's buttocks on two occasions. Investigators later determined that he self-identified with the involuntary celibate (Incel) movement after turning up several YouTube videos he had posted in 2014. These videos also showed him sympathizing with the perpetrator of a 2014 Incel shooting, as well as reflecting his deep-rooted misogyny as well as ranting about interracial relationships, illegal aliens, and African-Americans. The International Centre for Counter-Terrorism later classified the Tallahassee shooting as a case of misogynistic terrorism.  

While the early Incel movement was originally considered largely harmless and made up of "unlucky in love" individuals forming a loosely-knit community, this changed drastically in 2014 with a mass shooting in Isla Vista, California, in which six people were killed. Though the shooter, Elliot Rodger, killed himself at the scene, his online manifesto clearly described his misogynistic beliefs and made him a hero in violent Incel circles. Since the Isla Vista attack, there have been 13 recorded incidents of violent Incel extremism—a 500 percent increase from 2014 to the present day. As a result, the Southern Poverty Law Center now includes "male supremacy" as an extremist ideology along with religious and racial extremism.

To read more, check out my Psychology Today blog post,