Thursday, September 10, 2009

Chinese Dissidents Committed to Mental Hospitals

As reported on the PBS NewsHour of September 11, 2009

(Video Link Updated)

From the Transcript

China's emphasis on social harmony provides an incentive for petitioners to press for justice, but it also sets the stage for their persecution. That's because petitioners know that Chinese officials in the central government take unrest in local communities seriously, but the local officials who are being complained about will often seek retribution or try to stop people from petitioning in the first place.

Teng Biao, a professor at the University of Politics and Law in Beijing, says the system itself creates these kinds of problems. He runs an NGO to provide legal aid to petitioners.

TENG BIAO, University of Politics and Law, Beijing: From the top down, the petitioning situation is an assessing index for the officials on their political achievements. If there are many petitioners coming to Beijing from a place, then it will affect the local officials on their promotions and bonuses.

SHANNON VAN SANT: For his work, Teng Biao had his lawyers license and passport taken away. After this interview, Chinese authorities shut down Teng Biao's NGO, and police detained two of his colleagues. Despite the risk, Teng said he will continue his work.

I traveled to Wuhan to talk with another Chinese activist, Liu Feiyue, but he was under house arrest. Liu heads an NGO that is currently following 100 cases of wrongful psychiatric detention. Over the last three years, he says he knows of 500 more whistleblowers and protesters who have been detained in mental hospitals.

Robin Munro, who has extensively researched psychiatric detention in China and written two books on the topic, thinks the practice is widespread.

ROBIN MUNRO, human rights activist: China's experience in this area is far more serious and extensive than any other country.

SHANNON VAN SANT: Munro, who is based in Hong Kong, believes that since there are no national mental health laws protecting the rights of people who have been compulsorily hospitalized, but there are rules limiting arbitrary arrest, hospitals are becoming a convenient means of silencing protesters.

ROBIN MUNRO: Once diagnosed in this way, as dangerously mentally ill, citizens have no rights. They have no legal right to see a lawyer; they have no legal right to be brought before a judge so that a judicial determination can be made.

SHANNON VAN SANT: The Chinese press, including the Beijing News, has reported on the hospitalizations. The story was picked up by the state's official press agency, The People's Daily and, where it drew 23,000 comments. Such coverage in Chinese newspapers could imply there is central government support for preventing wrongful psychiatric detention by local officials.

China's Ministry of Health denied requests for an interview, but sent a list of relevant regulations on treatment of the mentally ill, which said, in part, "The diagnosis of psychiatric disease is, according to the Chinese mental disorder category and diagnosis standard third edition, approved by Chinese medical association and referring to the related standards of international disease diagnosis category."

When asked at a press conference about the increasing numbers of protesters being put in mental hospitals, the spokesperson for the Ministry of Foreign Affairs said...

QIN GANG, Spokesperson, Ministry of Foreign Affairs (through translator): It's the first time for me to hear the situation you addressed. I don't know about the situation of psychiatric hospitals, but please believe the related Chinese governmental departments conduct administration according to law.

SHANNON VAN SANT: But in Wuhan, another petitioner, Hu Guohong, said he has been forcibly hospitalized in mental institutions four times and that he and his wife, Cheng Xue, have been warned repeatedly by local officials to stop petitioning.

HU GUOHONG, petitioner: They said, "We don't allow you to go petitioning to the upper levels. If you do that, we will beat you to death."

Wednesday, July 15, 2009

The myth of the chemical cure - It only gets you stoned

A commentary publish on the BBC website It looks like the drugs merely get you stoned or something, and cost way too much as well.

Taking a pill to treat depression is widely believed to work by reversing a chemical imbalance.

Medication is a mainstay of mental health therapy

But in this week's Scrubbing Up health column, Dr Joanna Moncrieff, of the department of mental health sciences at University College London, says they actually put people into "drug-induced states".

If you've seen a doctor about emotional problems some time over the past 20 years, you may have been told that you had a chemical imbalance, and that you needed tablets to correct it.

It's not just doctors that think this way, either.

Magazines, newspapers, patients' organisations and internet sites have all publicised the idea that conditions like depression, anxiety, schizophrenia and bipolar disorder can be treated by drugs that help to rectify an underlying brain problem.

People with schizophrenia and other conditions are frequently told that they need to take psychiatric medication for the rest of their lives to stabilise their brain chemicals, just like a diabetic needs to take insulin.

The trouble is there is little justification for this view of psychiatric drugs.

Altered states

First, although ideas like the serotonin theory of depression have been widely publicised, scientific research has not detected any reliable abnormalities of the serotonin system in people who are depressed.

Second, it is often said the fact that drug treatment "works" proves there's an underlying biological deficiency.

Psychoactive drugs make people feel different

But there is another explanation for how psychiatric drugs affect people with emotional problems.

It is frequently overlooked that drugs used in psychiatry are psychoactive drugs, like alcohol and cannabis.

Psychoactive drugs make people feel different; they put people into an altered mental and physical state.

They affect everyone, regardless of whether they have a mental disorder or not.

Therefore, an alternative way of understanding how psychiatric drugs affect people is to look at the psychoactive effects they produce.

Drugs referred to as antipsychotics, for example, dampen down thoughts and emotions, which may be helpful in someone with psychosis.

Drugs like Valium produce a state of relaxation and a pleasant drowsiness, which may reduce anxiety and agitation.

Drugs labelled as "anti-depressants" come from many different chemical classes and produce a variety of effects.

Prior to the 1950s, the drugs that were used for mental health problems were thought of as psychoactive drugs, which produced mainly sedative effects.

'Informed choice'

Views about psychiatric drugs changed over the course of the 1950s and 1960s.

They gradually came to be seen as being specific treatments for specific diseases, or "magic bullets", and their psychoactive effects were forgotten.

However, this transformation was not based on any compelling evidence.

In my view it remains more plausible that they "work" by producing drug-induced states which suppress or mask emotional problems.

If we gave people a clearer picture drug treatment might not always be so appealing

This doesn't mean psychiatric drugs can't be useful, sometimes.

But, people need to be aware of what they do and the sorts of effects they produce.

At the moment people are being encouraged to believe that taking a pill will make them feel better by reversing some defective brain process.

That sounds good. If your brain is not functioning properly, and a drug can make it work better, then it makes sense to take the pill.

If, on the other hand, we gave people a clearer picture, drug treatment might not always be so appealing.

If you told people that we have no idea what is going on in their brain, but that they could take a drug that would make them feel different and might help to suppress their thoughts and feelings, then many people might choose to avoid taking drugs if they could.

On the other hand, people who are severely disturbed or distressed might welcome these effects, at least for a time.

People need to make up their own minds about whether taking psychoactive drugs is a useful way to manage emotional problems.

To do this responsibly, however, doctors and patients need much more information about the nature of psychiatric drugs and the effects they produce.

How to Interpret Your Rorschach Ink Blots

I occasionally poke around the news site Reddit, and came across this discussion related to the Rorschach Ink Blots. It seems only fair to post some of the interpretation summaries so that Redditors can see how they did.

From a legal standpoint, the Rorschach test images have been in the public domain for many years in most countries, particularly those with a copyright term of up to 70 years post mortem auctoris. They have been in the public domain in Hermann Rorschach's native Switzerland since 1992 (70 years after the author's death, or 50 years after the cut-off date of 1942), according to Swiss copyright law. They are also in the public domain under United States copyright law where all works published before 1923 are considered to be in the public domain. This means that the Rorschach images may be used by anyone for any purpose. William Poundstone was, perhaps, first to make them public in his 1983 book Big Secrets, where he also described the method of administering the test

I imagine that these days a lot of people will see imagery from many of the games they have played, movies they have seen, local TV shows, popular songs, etc. The standard imagery seems to be based on psychoanalysis and original conjectures of the 1920s. It would probably be dangerous to try to derive universals, when so many variations exist between cultures and subcultures, etc in each region of planet earth.

For example, a Yankee team uniform has different meaning in New York City vs in Boston. (The two cities are known for a long standing sports rivalry)

Thus we come to this SPECIAL NOTE OF IMPORTANCE: There are different responses seen as normal depending on culture!!! Something interpreted as normal in one culture (Europe, etc) can be seen as a sign of schizophrenia in another culture (North America). Military people have different responses compared to nonmilitary. Different political parties have different responses.

For these and other reasons, I believe that the tests are NOT valid. What is given below is a combination from various sources. I regard inkblots to be no better than fortune-telling.

Origins of the Test

As a child, Hermann Rorschach was a big fan of a popular game called Klecksography, so much so that his nickname was "Kleck" (meaning "inkblot"). The idea of the game was to collect inkblot cards that could be bought from local shops and make associations and stories from the inkblots.

Rorschach went on to study psychiatry and while training, in 1918, he noticed that patients diagnosed with schizophrenia made radically different associations to the Klecksography inkblots than did normal people. He therefore developed the Rorschach test as a diagnostic tool for schizophrenia.

In 1896, a similar game was described in the United States by Ruth McEnery Stuart and Albert Bigelow Paine in a book titled Gobolinks, or Shadow-Pictures for Young and Old. The book explained how to make inkblot monsters ("gobolinks") and use them as prompts for writing imaginative verse.

The term Klecksography originates with the doctor and poet Justinus Kerner (1786-1862). Kerner also dealt with the interpretation of the images. After the color blobs were interpreted, he drew conclusions about the nature of the person. The interpretations were made using poetic rhymes.

As an artistic device and technique, the nature of the resulting images are affected to some degree by selective application and choice of the paint volume. Among the artists who experimented with Klecksography is J. Beuys.

Notes on the scientific value of the test

Rorschach never intended the inkblots to be used as a general personality test, but developed them as a tool for the diagnosis of schizophrenia. It was not until 1939 that the test was used as a projective test of personality, a use of which Rorschach had always been skeptical. Controversy about the reliability and validity of the Rorschach has been present since its conception. Today, many - probably most - psychologists think the Rorschach is nonsense.

A survey conducted on the members of The American Psychological Association Division-12, and The Indian Association of Clinical Psychologists showed concern from respondents about the limitations of the test (Wade et al 1978; Sharma, Ojha and Vagrecha, 1975; Dubey, 1982). Zubin (1965) has charged seven major failures as follows:
  1. Failure to provide an objective system, free of arbitrary conventions, and showing high interscorer agreement.
  2. Lack of satisfactory internal consistency, or test-retest reliability.
  3. Failure to provide cogent evidence for clinical validity.
  4. Failure of the individual Rorschach scoring categories to relate to diagnosis.
  5. Lack of prognostic, or predictive validity with respect to the outcome of treatment, or later behavior.
  6. Individual differences between groups of normal subjects.
  7. Failure to find any significant relationships between Rorschach scores and intelligence, or creative ability.
Many professionals now feel that the Rorschach is outdated, inaccurate, and meaningless. For example:
"Nobody agrees how to score Rorschach responses objectively. There is nothing to show what any particular response means to the person who gives it. And, there is nothing to show what it means if a number of people give the same response. The ink blots are scientifically useless." (Bartol, 1983).

"The only thing the inkblots do reveal is the secret world of the examiner who interprets them. These doctors are probably saying more about themselves than about the subjects." (Anastasi, 1982).
What these comments seem to indicate is that the Rorschach is potentially unreliable, easily misinterpreted, and essentially not a valid means of determining what it claims to detect. For more information on the use and potential unreliability of the Rorschach test read "Misuse of Psychological Tests in Forensic Settings: Some Horrible Examples" by Ralph Underwager and Hollida Wakefield.

Notes for if you take the test

Every Rorschach image has at least one obvious representation of sexual anatomy. You're not expected to mention them all. In some interpretation schemes, mentioning more than four sex images in the ten plates is diagnostic of schizophrenia. Most Rorschach workers believe the sex images should play a part in the interpretation of responses even when not mentioned.

The trouble is, subjects who took Psychology 101 often assume they should detail every possible sex response, so allowances must be made. People have since also come up with various methods and systems to try to objectively score the tests, but a lot of it is still the basis of you think it should mean this, and they think it should mean something else. It is like dream interpretation or fortune telling.

Your best bet when taking the test is probably to stick to "seeing" healthy, friendly images. Avoid dark or violent answers ("I see a monster eating a baby's brain!"). Butterflies, people holding hands, leaves, mountains, etc are all generally considered to be "safe" responses (although nothing is guaranteed when taking the Rorschach). If you can show how a particular shape really does resemble something, go ahead and say so. If you come up with a novel or particularly interesting answer you may get "points" for your creativity. The fact is, however, that in the end it's mostly up to the examiner as to how your responses are interpreted.

Further notes and advice on taking the test from this source
Just as secret as the blots themselves are the ground rules for administering the test. There are a few things that you, as a subject, are supposed to know and a lot of things you aren't supposed to know. If you ask about something you're not supposed to know, the psychologist will give you a pat answer as prescribed in Rorschach literature. For example, if you ask if it is okay to turn the card upside down, the psychologist will respond that you may do as you like; it's up to you. The psychologist won't say that many of the cards are easier to interpret when turned; that most people do turn the cards; that he or she will make a notation with a little arrowhead every time you do turn a card; and that you lose points in the initiative department if you don't turn the cards.

You'll be handed the cards one by one in the fixed order devised by Rorschach (there are numbers on the backs of the cards for the psychologist's benefit). The first card, for instance, looks like a fox's head or a jack-o-lantern. The cards are thick, rectangular cardboard, 6 5/8 inches by 9 1/5 inches. Half of the blots are black ink on a white background. Two others are black and red ink on white, and the last three blots are multicolored. The psychologist will always put each card in your hands "right" side up.

You aren't supposed to know it, but the psychologist will write down everything you say. This includes any seemingly irrelevant questions you may have. To keep you from getting wise, the psychologist always arranges to sit to your side and a little behind you, so that you can't look at the card and the psychologist at the same time. Most subjects realize the psychologist is taking notes, of course, but they don't realize that the notes are a special shorthand record of everything said. Some psychologists use hidden tape recorders.

The psychologist will also time how long it takes you to respond, using a "tickless" watch. The psychologist will not ask you to hurry up or slow down and will not make any reference to time, but response times (in seconds) are one of the things he or she is writing in the notes.

Don't hold the card at an unusual angle. Watch how you phrase things. Say "This looks like ..." or "This could be ..." never "This is..." After all, you're supposed to realize that it is just a blot of ink on a card. By the same token, don't be too literal and say things as, "This is a blotch of black ink." Don't groan, get emotional, or make irrelevant comments. Don't put your hands on the cards to block out parts. The psychologist will watch for all of the foregoing as signs of brain damage.

If there are no right answers for the test, there are some general guidelines as to what is a normal response. You can probably see images in the inkblots proper and in the white spaces they enclose. Stick to the former. Don't be afraid of being obvious. There are several responses that almost everyone gives; mentioning these shows the psychologist you're a regular guy.

It is okay to be original if you can justify what you see in the shape, shading, or color of the blot. If you see an abalone and can point out why it looks like one, then say so. Justifiable original responses are usually judged to be indicative of creativity or intelligence.

You don't want non sequiturs, images that don't fit the blot in the judgment of the psychologist. These may be interpreted as signs of psychosis. *(Comment: Again the cultural variation is important. If your are a big fan of Star Wars or Batman or Anime, you might upset some shrinks if all of your interpretations are filled with references to these cultural icons!)*

You're expected to see more than one thing on all or most of the cards. Not being able to see anything on a card suggests neurosis. Usually the more things you can see, the better, as long as they fit the form and color of the blot. Of course, you can see things in the whole blot or in parts of it, and images may overlap. *(Comment: Note more intelligent people tend to score higher on many pathology scales, since many scales do not correct for high response rate! if a subject gives twice as many responses overall, it is more likely that some of these will seem "pathological")*

Since time is a factor, it is important to come up with good answers fast. (It looks particularly bad if you take a long time and give a dumb, inappropriate answer.)

Information on Interpretations

The information on Interpretations is compiled from data seen at
  2. and
  3. Rorschach Test.htm
Pics are from Wikipedia, and are in the public domain in both Switzerland (their country of origin) and the USA.

Note that these pictures are pretty small, you can click on them to embiggen (i.e., see larger).

The Wikipedia article on the test now forwards the line that there is no specific correct answer to the test, and generally fudges any interpretation.

But see the general notes below, followed by the set of pictures.

I Repeat: SPECIAL NOTE OF IMPORTANCE: There are different responses seen as normal depending on culture!!! Something interpreted as normal in one culture (Europe, etc) can be seen as a sign of schizophrenia in another culture (North America)

French subjects often identify a chameleon in card VIII, which is normally classed as an "unusual" response, as opposed to other animals like cats and dogs; in Scandinavia, "Christmas elves" (nisser) is a popular response for card II, and "musical instrument" on card VI is popular for Japanese people, and different languages will exhibit semantic differences in naming the same object (the figure of card IV is often called a troll by Scandinavians and an ogre by French people).

Many "popular" responses (those given by at least one third of the North American sample used) seem to be universally popular, as shown by samples in Europe, Japan and South America, while specifically card IX's "human" response, the crab or spider in card X and one of either the butterfly or the bat in card I appear to be characteristic of North America.

Some critics argue that the testing psychologist must also project onto the patterns. A possible example sometimes attributed to the psychologist's subjective judgement is that responses are coded (among many other things), for "Form Quality": in essence, whether the subject's response fits with how the blot actually looks. Superficially this might be considered a subjective judgment, depending on how the examiner has internalized the categories involved. One example is that the response "bra" was considered a "sex" response by male psychologists, but a "clothing" response by females psychologists. Scoring systems have be developed to get around this, but in my personal opinion they sound like reading astrology charts, elaborately complex constructions on a foundation of sand.

For these and other reasons, I believe that the tests are NOT valid. What is given below is a combination from various sources. I regard it no better than fortune-telling.

The Rorschach Ink Blots

The cards are numbered 1 through 10, and that is the order in which they're always given to you by the psychologist. The originals are thick, rectangular cardboard, 6 5/8 inches by 9 1/5 inches. This will make a difference on what you see, vs the smaller images on a computer screen.

Plate I

Possible Sexual Imagery: Breasts, primarily the rounded areas at the top of the image.

Good/Common Answers: "Bat, butterfly, female figure (in the centre), moth"

You may be a little paranoid if you see: "Mask, animal face, jack o lantern"

Bad Answer: "Anything insulting about the female figure (it is an indicator of your own body image)"

The first blot is easy. How fast you answer is taken as an indication of how well you cope with new situations. The best reaction is to give one of the most common responses immediately.

A bad response is any that says something untoward about the central female figure. "She" is often judged to be a projection of your own self-image. Avoid the obvious comment that the figure has two breasts but no head.

If you don't give more than one answer for Plate I, many psychologists will drop a hint -- tell you to look closer.

Plate II

Possible Sexual Imagery: Male sex organ at top center or, in some cases, a vagina (at the center near the bottom).

You should see this image as: "Two human-like forms (females or clowns) If you don't it is an indicator that you have trouble relating to people."

Other Good/Common Answers: "Butterfly, cave entrance"

It is important to see this blot as two human figures usually females or clowns.

If you don't, it's seen as a sign that you have trouble relating to people. You may give other responses as well, such as cave entrance (the triangular white space between the two figures) and butterfly (the red "vagina," bottom center).

Should you mention the penis and vagina? Not necessarily. You may not say that the lower red area looks like a vagina, but psychologists assume that what you do say will show how you feel about women. Nix on "crab"; stick with "butterfly."

Plate III

Possible Sexual Imagery: Male sex organs and female breasts, right about where you would expect to find them.

This is the blot that allegedly can determine sexual preference.

A heterosexual response would be: "Seeing two male figures"

A homosexual response would be: "Seeing two androgynous (remember "Pat" from SNL?) or female figures."

Most people see the two human figures. Both figures have prominent "breasts" and an equally prominent "penis." If you don't volunteer the gender of the figures, you'll be asked to specify it.

This blot has been the subject of much debate, so it's best to take your answer's meaning with a grain of salt. Does it work? Not really

The splotches of red ink are usually perceived separately. Common responses are "bow-tie" or "ribbon" (inner red area) and a stomach and esophagus (outer red areas).

Plate IV

Plate IV is the "father card." At first glance it is a difficult blot to see as a single image. The two lower corners are often described as shoes or boots. This card may also be seen as viewing a person from below or a male figure with an enormous sex organ.

The "boots" are fairly conspicuous; between them is the apparent head of a dog or Chinese dragon. Many subjects see the blot as an animal skin. After a few seconds, though, most can see it as a standing figure seen from below.

The boots become the feet, enlarged because of the unusual perspective. The arms and head, at the top, are smaller. Common descriptions are bear, gorilla, or man in a heavy coat. Rorschach theorists equate your description of the figure with your perception of your father or male authority figures.

Possible Sexual Imagery: A pair of male sex organs, typically seen at the top of the image. Some subjects may instead visualize a vagina in the upper center of the blot.

Good/Common Answers: "A standing figure (man, bear, gorilla)"

A Bad Answer Would Be: "To describe the figure as menacing in any way, i.e. a monster, or attacking gorilla, as this blot indentifies with your perception of your father, or authority figures."

Plate V

Possible Sexual Imagery: A pair of male sex organs at the very top of the inkblot.

Good/Common "Answers: Bat, Butterfly"

Bad Answers: "Seeing the butterfly antennae as scissors or any cutting device is an indicator of a castration complex. Schizophrenics occasionally see moving people in this image. Seeing crocodile heads on the ends of the bat's wings indicates hostility."

Rorschach himself thought this was the easiest blot to interpret. It is a bat or a butterfly, period. You don't want to mention anything else.

Many psychologists take particular note of the number of responses given to this plate. If you mention more images here than in either Plate IV or VI, it is suggestive of schizophrenia.

Plate VI

Possible Sexual Imagery: The head of the male sex organ (the portion at the top of the card) or alternately, a female sex organ (middle and bottom part of the card).

Common Answers: "animal hide, boat, submarine, mushroom cloud, men with long noses and goatees. Apparently this blot reveals subconscious attitudes about sexuality."

Occasionally described as a foreshortened view of a person with their arms outstretched.

Basically, the secret of this plate is to turn it. A good response is to say it looks like an animal hide (about the only reasonable response when held right side up), then turn it on its side and say it looks like a boat or surfaced submarine with reflection, and then turn it upside down and say it looks like a mushroom cloud, a pair of theater masks, or caricatures of men with long noses and goatees.

Plate VII

Possible Sexual Imagery: The female sex organs (seen at the bottom of the card where the figures join.

Good/Common Answers: "Two Girls, or Women"

Bad Answers: "Insulting descriptions of the two figures i.e. gossips, girls fighting, witches.

This card has a rough "V" shape sometimes described as faces pointing towards one another, "bunny ears", or similar visualizations.

This blot is supposed to reveal how you really feel about your mother. Virtually everyone sees two girls or women. Deprecating descriptions of the figures~ "witches," "gossips," "girls fighting," "spinsters" indicate poor maternal relations. Seeing the blot as thunderclouds instead of female figures suggests anxiety to some psychologists; seeing it as a walnut kernel may mean a vulvar fixation.

There is an entirely different side to this blot, but you're not supposed to see it. The white space between the girls or women can be interpreted as an oil lamp or similar object. It is claimed that only schizophrenics usually see the lamp.

Plate VIII

A very colorful card with blue, orange, pink, and gray ink. A roughly diamond-shaped image with lots of places to see things

Possible Sexual Imagery: Female sex organs, usually seen at the bottom of the card.

Good/Common Answers: "Four legged animals such as lions, pigs, bears, etc. on the sides. Other common responses are tree, butterfly, rib cage, christmas tree."

Bad/Answers: "Not seeing the four legged animals can indicate that you are mentally defective"

It is important that you see the four-legged animals- lions, pigs, bears, etc. -on the sides of the blot. They're one of the most common responses on the test, and you're assumed to be a mental defective if you don't see them. Other good responses are tree (gray triangle at top), butterfly (pink and orange area at bottom), and rib cage or anatomy chart (skeletal pattern in center between blue rectangles and gray triangles). The entire configuration can be seen as a heraldic design (good answer) or a Christmas tree with ornaments (reaching).

Children tend to like this blot and say a lot about it-the bright colors and animal shapes make it more interesting than your basic penis/vagina number (II, IV, or VI).

Plate IX

Another colorful card, this time with orange, pink, and green inks. This one is tough to visualize anything specific in; most test subjects struggle to find something to "see" in it.

Possible Sexual Imagery: Female sex organs, usually seen at the bottom of the card.

Good/Common Answers: "Fire, smoke, explosion, map, anatomy, flower."

Bad Answers: "Mushroom cloud on the centre line at top can indicate paranoia. Monsters or men fighting can indicate poor social development."

If you're going to throw up your hands (figuratively!!!) and plead a mental block, this is the place to do it. The colors clash, apparently by Rorschach's design.

If you turn the card ninety degrees, you can make out a man's head in the pink areas at bottom. (The man is identified as Mark Twain, Santa Claus, or Teddy Roosevelt.)

As with Plate V, the psychologist may be counting the number of responses you give to this blot for comparison with the preceding and succeeding blots. You want to give fewer responses to this blot.

Plate X

This is the last Rorschach card and certainly the most colorful, consisting of blue, gray, pink, green, orange and yellow inks. It's a very complex mish-mash of shapes with lots of "activity" and plenty of places to "see" things.

Possible Sexual Imagery: Male sex organs at the top center of the card.

Good/Common Answers: "Sea life, or a view through a microscope. Also common: spiders, crabs, caterpillars, rabbit's head"

Bad Answers: "Two faces at top centre blowing bubbles, or smoking pipes can indicate an oral fixation"

The unspoken purpose of this last blot is to test your organizational ability. Plate X is full of colorful odds and ends easy to identify---blue spiders, gray crabs, paired orange maple seeds, green caterpillars, a light-green rabbit's head, yellow and orange fried eggs--and you're expected to list them.

But the psychologist will also be looking for a comprehensive answer, something that shows you grok the whole Gestalt. There are two good holistic answers: sea life and a view through a microscope.

Some subjects see two reddish faces at top center, separated by the orange maple key. If you describe them as blowing bubbles or smoking pipes, it may be interpreted as evidence of an oral fixation. Seeing the gray "testes" and "penis" as two animals eating a stick or tree indicates castration anxiety.

Misuse of Psychological Tests in Forensic Settings: Some Horrible Examples

As seen on We have not quoted the entire paper, but only the introductory section with a few of the smaller examples.

The original post has many fine examples, plenty of detailed references, and is oriented to situations where parents are separated. Unfortunately, given other news reports of recent years, this paper is still quite relevant

Misuse of Psychological Tests in Forensic Settings: Some Horrible Examples

Ralph Underwager and Hollida Wakefield

American Journal of Forensic Psychology, Volume 11, Issue 1

Psychological tests are often used inappropriately and are misinterpreted and overinterpreted in the forensic setting. This harms the person being evaluated and interferes with the cause of justice. It also does a disservice to the reputation of psychologists and the science of psychology. Actual examples of misuse of particular techniques and tests and misinterpretation illustrate what has been done in forensic settings.

A forensic evaluation is different from a clinical evaluation. When an evaluation is done in the clinical setting, the conclusions are used to develop a treatment plan. These conclusions form working hypotheses which can be confirmed or rejected during treatment. However, in the forensic setting, a one-time decision is made about the individual — a decision which can markedly affect the person's life.

If tests are misinterpreted in the clinical setting, the treatment plan developed from the evaluation may not be the most effective for the client. However, since treatment plans are generally modified and revised throughout the course of treatment, the mistaken conclusions can be corrected. But, an erroneous decision in the forensic setting can result in immediate and severe consequences, such as losing custody of a child or being jailed. If decisions and recommendations by the psychologist are not based on adequate data, the psychologist is acting both incompetently and unethically.

In addition, conclusions drawn by the psychologist are subject to cross-examination in the adversarial setting. If the conclusions are not based upon adequate data, the psychologist's testimony will be discredited or impeached by a skillful opposing attorney. Therefore, the psychologist should only present conclusions in reports and testimony which can be defended when challenged in cross-examination.

In the course of examining hundreds of reports, we have seen many examples of tests that are misadministered, misinterpreted, overinterpreted, or should never have been given in the particular setting. We are presenting a sample of these to illustrate what should be avoided by any psychologist who does forensic evaluations.


Tests such as the House-Tree-Person (HTP) and Kinetic Family Drawings are often overinterpreted and misinterpreted. There is a lack of validity and reliability in the use of drawings as projective assessment devices. In a review of the Draw-A-Person test in the Seventh Mental Measurements Yearbook, Harris (1) notes that there is very little evidence for the use of "signs" as valid indicators of personality characteristics. With children's drawings there is so much variability from drawing to drawing that particular features of any one drawing are too unreliable to say anything about them. The Tenth Mental Measurements Yearbook (2), in reviews by Cundick and Weinberg (p.422-425) continues the consistent finding since the first edition, 1938, that interpretations of drawings (as are often done in forensic evaluations) are unsupported by empirical evidence. Both reviewers note that there are no normative data establishing reliability and validity of the Kinetic Drawing System.

Here are some of the examples as given:

Example 2
A four-year-old girl was asked to draw a picture of herself and the family doing something. She instead, according to the school psychologist who was evaluating her, "seemed to be preoccupied with drawing circles within circles which she called 'caves.' Her second representation bore a significant resemblance to male genitalia (when asked what it represented, she reported that it was a ball rolling into a lion's cave)." This was interpreted as being suggestive of sexual abuse and the fact that the child has been subjected to some type of traumatic experience.

When we saw the child, now age five, we tested her and found borderline to low-average intelligence and no ability to draw anything other than scribbled circles. The child clearly had difficulties with visual motor perception and indeed, could not draw, a fact which was ignored by the other evaluator. This example, therefore, illustrates the importance of recognizing the child's developmental level.

Example 5
A four-year-old girl's drawing of a tree in the HTP was considered significant because the child, when asked to draw a tree, also drew a cactus. This was interpreted in terms of "unconscious expression of danger and fearfulness." However, the child was not asked if she had a cactus in her yard (this was in Texas).

The child also brought a drawing of a clown's face to the therapist which she had ostensibly drawn while in the waiting room with her parents. The clown was interpreted as being significant because "there is an element of sadness in the clown's eyes." This clown is of much greater sophistication and detail than the child's other drawings. When pressed about this in his deposition, the psychologist acknowledged that the parents probably drew it and she colored it. This example illustrates both problems in administration and in interpretation.

Example 20
A baby was returned to the foster mother following a visit with the parents and was described as having the "smell of sex." An emergency hearing was held in which social services attempted to cut off visits because this "smell of sex" triggered the suspicion that the parents were having sex with their baby. A psychologist agreed that the sex smell was significant and indicated probable abuse on the part of the parents. Fortunately, the parents had been at a church potluck dinner during the entire visit so they were able to disprove, the accusations.

We can just imagine the horror that happens when this gets involved with separation and divorce proceedings.

Tuesday, July 14, 2009

Attorneys begin closing arguments in William Ayres trial

As reported in the San Mateo County Times

Closing arguments are expected to conclude today in the trial of Dr. William Ayres, the once-prominent child psychiatrist accused of lewdly touching half a dozen boys under the guise of medical necessity.

Prosecutor Melissa McKowan and defense attorney Doron Weinberg began their closing statements Monday in San Mateo County Superior Court. Ayres, 77, faces nine counts of lewd and lascivious conduct with a minor younger than 14. The charges are based on the accusations of six former patients who argue that they were molested by Ayres between the ages 9 and 13.

McKowan said Monday that a 10th charge had been dropped during the course of the trial that stemmed from the accusations of a man referred to in court as Eric B., who testified that Ayres masturbated him during a physical exam when he was 13. He originally was going to testify that a second incident had occurred, McKowan said.

She told the jury Monday that Ayres performed physical and genital exams exclusively on male patients because he is a pedophile — a psychiatrist who desired to undress, touch and see the bodies of young boys. She referred to the exams he conducted as "sloppy, drop your pants and sit on the table" procedures.

"If genital exams are necessary in the diagnosis of adolescent children with psychological or mental health issues, why would you only conduct those exams on boys?" she asked the jury.

McKowan urged the jury to consider why Ayres kept poor notes of the exams and the unusual conditions under which he gave them. She also pointed out that no witness ever testified for the defense that Ayres taught the importance of physical exams at UC San Francisco, something he told the court last week that he had done.

Judge Beth Freeman issued jury instruction before closing arguments. She told the jury that four former patients who accused Ayres of molesting them but whose charges fall outside the state's statute of limitations can be considered in deciding if Ayres has a disposition to commit sexual offenses, or if their testimony can show that Ayres had a plan to lewdly touch the in-statute accusers.

Weinberg told the jury that there is simply no evidence Ayres committed a crime. He said the case rests entirely on memory, asking jurors to recall the testimony of memory expert Dr. Elizabeth Loftus.

"This case is about memory and memory alone," Weinberg argued. "There is no physical evidence."


Tuesday, June 30, 2009

Psychiatrist Sam Castellani Allegedly Forced Patient To Perform Sex Act To Receive Prescription

From WSMV - Nashville - Nashville Doctor Arrested On Rape Charge - Psychiatrist Allegedly Forced Patient To Perform Sex Act To Receive Prescription

NASHVILLE, Tenn. — A Madison-based psychiatrist is facing a rape charge after he was arrested on Thursday.

Police said Dr. Sam U. Castellani, 67, is accused of raping a 36-year-old female patient on March 23.

Castellani, a Brentwood resident, was taken into custody at his 500 Lentz Road office in Madison.

Police charged him with one count of rape for allegedly forcing the patient to perform a sex act on him in order to receive her medication prescription.

The investigation of the March 23 incident began on May 27 when the victim came to police headquarters and reported the matter.

The alleged victim told police that her March 23 appointment was changed from mid-afternoon to 6 p.m. According to police, she said during the appointment Castellani wrote out her prescription, placed it on his desk and then exposed himself.

During the investigation, police said detectives found evidence that the alleged incident occurred and that Castellani may have had sexual contact with other female patients.

The public is urged to call the Metro Sex Crimes unit at 862-7540 if they had any inappropriate or illegal activity connected with Castellani.

The doctor is free on $74,999 bail.

Wednesday, June 10, 2009

Update: The Prosecution of Psychiatrist Dr. Alan Beitel

We have an update on the prosecution of psychiatrist Allan Beitel. Essentially, the charges were dropped for a number of practical reasons as seen in the article below.

  1. He wasn't going to get anymore jail time than what he had already served while waiting for trial, and
  2. the victim was moving out of the country, and would not be available to give testimony.
These circumstances are not a clean verdict such as acquittal, and leaves a cloud of suspicion over the doctor's head. This is also not a clean statement of innocence by the prosecutor, although the original charges were a little convoluted. The psychiatrist still faces other criminal charges, according to the report. As reported in The Hamilton Spectator.
Charges of accessing and possessing child pornography against a psychiatrist who formerly practised in Hamilton and Burlington have been stayed by the Crown.

Dr. Allan Beitel, who now practices in Toronto, had been facing the charges since 2003.

The Crown also stayed a charge of possession of stolen property and two counts of failing to comply against Beitel.

The Crown's prosecutor concluded that it was no longer in the public's interest to continue prosecution of the case, according to a spokesperson for Ontario's Ministry of the Attorney General.

"Even if Dr. Beitel had been found guilty of all charges, it was unlikely that he would serve a single additional day in jail beyond the time he had already served in pre-trial custody," the spokes-person indicated.

"Given that completing the trial would have required significant amounts of additional court time and resources, the Crown concluded that it was not in the public interest to continue."

Beitel had spent a number of months in custody last year related to other charges.

A charge of sexual assault against Beitel has also been withdrawn by the Crown after concluding there was no longer a reasonable prospect of conviction.

"The victim was moving out of the country and would not be returning for the trial," the ministry spokesperson indicated.

Beitel is still facing a number of other charges, including perjury, fraud under $5,000, two counts of theft under $5,000 and six counts of fail to comply with a recognizance.

Beitel remains an active member of the College of Physicians and Surgeons of Ontario, with no past disciplinary findings against him.

UPDATE: see also this Blog Post by David Akin

Monday, June 08, 2009

Science and the Psychiatric Publishing Industry

A paper in the journal Ethical Human Psychology and Psychiatry, Volume 11, Number 1, 2009 , pp. 29-36(8) Publisher: Springer Publishing Company, by McLaren and Niall


Objective: An empirical examination of the scientific status of psychiatry.

Method and Results: Analysis of the publications policy of the major English-language psychiatric journals shows that no journal meets the minimum criteria for a scientific publishing policy.

Conclusion: Psychiatry lacks the fundamental elements of any field claiming to be a science. Furthermore, its present policies are likely to inhibit scientific development of models of mental disorder rather than facilitate them. The psychiatric publishing industry is in urgent need of radical reform.

We told you so.

Friday, June 05, 2009

Electroshock therapy is being used on chinese teenagers to treat Internet addiction

From a report first seen here

Electroshock therapy is being administered to youngsters at a controversial Internet addiction clinic where patients are "reborn".

More than 3,000 youths have been tricked or forced in to a four-month program run by Dr Yang Yongxin at a clinic in Shandong province. About 100 people are currently receiving treatment at the clinic.

Patients are given electroconvulsive therapy (ECT) for breaking any of the center's 86 rules, including eating chocolate, locking the bathroom door, taking pills before a meal and sitting on Yang's chair without permission, the Information Times reported.

Parents or guardians sign a contract acknowledging that the child will be given ECT and pay 6,000 yuan ($878) per month for treatment.

Details about the treatment were revealed online recently when a number of former patients began to write about their experience.

According to the posts, the clinic administers continuous ECT in a current of up to 200 milliamperes.

Meanwhile, patients are forced to admit "wrongdoings" and those of others and are also instructed to kneel down in front of their parents to show obedience.

In addition, patients - known as "members of the alliance" at the clinic - are not permitted to talk about anything other than overcoming their Internet addiction, numerous former patients write.

Most are found to be "cured" - or "reborn" according to Yang - by simply "admitting" that they have overcome their addiction.

Internet addiction is not classified as a mental illness in China, a country with nearly 300 million Internet users, many of whom are adolescents who willingly indulge in endless hours of online games per day.

Depression, fainting, muscle weakness and twitching and anorexia have been listed as typical syndromes of Internet addiction.

The government established the first Internet addiction treatment clinic in Beijing in 2004.

Today, all online game operators are required to install a "fatigue system" for players under 18 years, which is designed to restrict their play time to three hours a day. But analysts say there are too many ways to work around the rules.

Until recently, media reported on Yang's alleged "success". Liu Mingyin, a China Central Television reporter, called Yang "a fighter in the Third Opium War", framing the doctor's combat against Internet obsession as part of an ongoing war against "spiritual opium".

For his part, Yang views his acts as part of "a holy crusade" and says the electric current he applies to his "patients" is mild and "not dangerous".

What the youths receive at the clinic isn't really ECT, but a "refreshment therapy" that cautiously helps Net-addicted children calm down, says a story written in Yang's name and published online.


Tao Ran, director of the China's first Internet addiction clinic, said that ECT is "the last resort" in treating people with severe depression who are suicidal.

"It'll make patients more submissive, no doubt. But at the same time, ECT will cause memory loss," Tao says, adding that Yang's clinic is "the only Internet addiction clinic in the world that applies ECT to patients".

Tao's own center has treated more than 4,000 Internet-addicted youths. Patients have "comprehensive therapy" that includes medication and psychological counseling.

About 30 percent of Internet addicted youngsters are hyperactive and uncontrollable in a family environment, Tao said.

They need treatment at a professional institution that does not administer ECT, he said.

Zhuo Xiaoqin, a public health expert with the China University of Political Science and Law, said it was wrong to link Internet obsession with mental illness.

"A consistent standard must be in place to determine what Internet addiction really is," he said.

(China Daily June 3, 2009)

Monday, June 01, 2009

Trial for psychiatrist Dr. William Ayres, accused of molestation begins

Report from the San Mateo County Times

After two years of events worthy of a prime time legal drama, embattled child psychiatrist Dr. William Ayres will finally stand trial Monday. He is accused of molesting seven of his young male patients.

Ayres, 77, was a prominent member of the San Mateo medical community and served as president of the American Academy of Child and Adolescent Psychiatry.

He also performed physical examinations and inspected the genitalia of many of his juvenile psychiatric patients.

The once well-respected doctor was arrested in April 2007 and charged with 14 counts of lewd and lascivious acts with three victims, ages 9, 11 and 12 at the time of the alleged abuse.

The case's publicity brought forward four more accusers, bringing the number of Ayres' felony molestation counts to 20. He was freed on $750,000 bail.

The shocking story made international headlines, and the trial beginning Monday is expected to draw more public attention.

"We are exceedingly pleased that we are now on the doorstep of getting justice," San Mateo County Chief Deputy District Attorney Steve Wagstaffe said Friday.

A trial judge will be selected by Judge James Ellis in San Mateo County Superior Court in Redwood City on Monday morning.

Wagstaffe predicted jury selection and pretrial motions would take two weeks, but that the entire trial would last eight to 10 weeks.

Ayres practiced for decades in San Mateo County, seeing patients referred to him
through local school districts and the county's juvenile court, in addition to his private practice.


Police first began investigating him in 2002 after being told by a man who was a patient of Ayres in the 1970s that the doctor had molested him on multiple occasions. But the case had to be dropped after a U.S. Supreme Court ruling effectively changed the statute of limitations on such cases.

Childhood molestation can only be brought by victims who are younger than 29 or whose alleged abuse occurred after Jan. 1, 1998.

The San Mateo Police Department reopened the case in March 2006, at the urging of a friend of one of the victims to seek out other possible victims who fell within the legal statute of limitation.

That friend was New York-based freelance writer Victoria Balfour, who made it a personal crusade to unearth possible molestation victims of Ayres and help authorities build a case against him.

A search warrant was executed for Ayres' records, and a list was compiled of more than 800 patients.

Prosecutors believe they know of at least 39 former patients of Ayres who had been molested by him, but most did not fall under the state's statute of limitations.

After seven months of exhaustive and painful interviews with patients on the list, police took Ayres into custody at his San Mateo home on April 5, 2007.

Ayres' medical license was suspended, and has since expired.

On April 28, 2007, the child psychiatrist accused of molesting dozens of pre-adolescent boys in San Mateo County for decades declared his innocence of the multiple counts against him.

Now, more than two years later, the once-prominent child psychiatrist's fate will likely be left to a jury.


Ayres was known nationally as one of the country's top child psychiatrists; he was just as well respected on the Peninsula where he ran a private practice for decades.

He was probably one of fewer than 10 San Mateo County psychiatrists with a subspecialty in child and adolescent psychiatry, according to San Mateo County Medical Association Executive Director Sue Malone.

He told colleagues he performed medical examinations because that was the way he had been trained. He had done his residency in the early 1960s at the Judge Baker Center in Boston, one of the country's premier centers for the study of child psychology.

While most child psychiatrists admit that administering physical exams to patients is uncommon today, many professionals defend the practice as another instrument in a psychiatrist's toolbox.

A spokeswoman from the American Academy of Child and Adolescent Psychiatry, of which Ayres was president for more than a decade, told MediaNews that performing physicals on patients in a psychiatric setting can be "consistent with good medical practice."

Wagstaffe said he expected attorneys on both sides to present expert opinions on the matter.

While the passing of time between charges and trial can often damage prosecutors' cases, Wagstaffe said all their witnesses were ready to go.

"This case is more than ripe for trial," he said.

Thursday, May 28, 2009

A Celebrity Patient's Backing Turns Sour for Drug Company

The Wall Street Journal has published a revealing story about one of the seamier sides of the drug industry's marketing campaigns: paying patients to offer testimonials about their drugs. Despite side effects one man had to continue because the money way so good. He is now writing a book about his experience. Here's the Video.

I note in the video that they show the complete original testimonial, which sort of defeats the purpose of the original news story. Way to go WSJ!

(the embedded player is a little funky, you might have to pause and push play an extra time or to to get past the intro)

Wednesday, May 27, 2009

Bitterness To Be Classified As a Mental Illness

Some psychiatrists are trying to get excessive bitterness identified as a mental illness named post-traumatic embitterment disorder. Of course this has some people who live perfect little lives, and always get what they want, questioning the new classification. The so called "disorder" is modeled after post-traumatic stress disorder because it too is a response to a trauma that endures. "They feel the world has treated them unfairly. It's one step more complex than anger. They're angry plus helpless," says Dr. Michael Linden, the psychiatrist who put a name to how the world works. Reported in the LA Times, via Slashdot

Wednesday, May 13, 2009

US soldier who shot five troops was 'broken' by counsellors

As seen in the Telegraph

Army Sgt. John M. Russell, 44, has been charged with murder and aggravated assault in the Baghdad shootings, which his father said took place about six weeks before the end of his third tour of duty in Iraq.

Wilburn Russell, 73, alleged his son had been treated poorly at the stress centre and had e-mailed his wife calling two recent days the worst in his life.

"I hate what that boy did," said Mr Russell, speaking in front of the two-story suburban home his son is buying with his wife. "He thought it was justified. That's never a solution."

Excerpts of his military record, obtained by The Associated Press, show Sgt. Russell previously did two one-year tours of duty in Iraq, one starting in April 2003 and another beginning November 2005. The stress of repeat and extended tours is considered a main contributor to mental health problems among troops serving in Iraq and Afghanistan.

His father said the soldier, an electronics technician, was at the stress centre to transition out of active duty. He said his son was undergoing stressful mental tests that he didn't understand were merely tests, "so they broke him."

"John has forfeited his life. Apparently, he said (to his wife), 'My life is over. To hell with it. I'm going to get even with 'em,"' he said.

"He lived for the military," Mr Russell said. "We're sorry for the families, too. It shouldn't have happened."

The soldier's son, John M. Russell II, said that he has communicated with his father by e-mail regularly. In the last message he received from him, April 25, his father sounded normal and planned to be back in Texas to visit in July.

"He's not a violent person," he said. "He's just a loving, caring guy.

He doesn't like to see anyone get hurt. For this to happen, it had to be something going on that the Army's not telling us about."
Related Articles

Wednesday, May 06, 2009

Why people should be concerned with the impending revision of the DSM

An excellent but long post from the fine folks at, with only a portion quoted below

The Diagnostic and Statistical Manual of Mental Disorders (DSM) has been called the "bible of mental illness" because it lists and defines all of the "official" psychiatric diagnoses according to the American Psychiatric Association. The DSM is in the early stages of undergoing its 5th major revision; each previous revision has seen the total number of mental disorders recognized (some might say invented) by the APA greatly increase. Last year, trans activists were particularly concerned to learn that Ken Zucker and Ray Blanchard had been named to play critical lead roles in determining the language of the DSM sections focusing on gender and sexuality, especially given that these researchers are well known for forwarding theories and therapies that are especially pathologizing and stigmatizing to gender-variant people.

Blanchard has recently presented some of his suggestions to revise the "Paraphilia" section of the DSM. In the past, this section has generally received little attention from feminists, as it has been primarily limited to several sexual crimes (e.g., pedophilia, frotteurism and exhibitionism) and a handful of other generally consensual but unnecessarily stigmatized sexual acts (such as fetishism and BDSM) that are considered "atypical" by sex researchers. However, there are two aspects of the proposed Paraphilia section revision that should be of great concern to feminists, as well as anyone else who is interested in gender and sexual equality.

Expanding "Paraphilia"

First, Blanchard is proposing a significant expansion of the DSM's definition of "paraphilia" to include:

"any intense and persistent sexual interest other than sexual interest in genital stimulation or preparatory fondling with phenotypically normal, consenting adult human partners."

The first concern here is the term "phenotypically normal" (meaning "normal" with regards to observable anatomical or behavioral traits). Thus, according to this definition, attraction to any person deemed by sex researchers to be "abnormal" or "atypical" could conceivably be diagnosed as paraphilic. So, do you happen to be attracted to, or in a relationship with, someone who is differently-abled or differently-sized? Or someone who is gender-variant in some way? Well congratulations, you may now be diagnosed with a paraphilia!


Blanchard and other like-minded sex researchers have coined words like Gynandromorphophilia (attraction to trans women), Andromimetophilia (attraction to trans men), Abasiophilia (attraction to people who are physically disabled), Acrotomophilia (attraction to amputees), Gerontophilia (attraction to elderly people), Fat Fetishism (attraction to fat people), etc., and have forwarded them in the medical literature to denote the presumed "paraphilic" nature of such attractions.

This tendency reinforces the cultural belief that young, thin, able-bodied cisgender women and men are the only legitimate objects of sexual desire, and that you must be mentally disordered in some way if you are attracted to someone who falls outside of this ideal. It's bad enough that such cultural norms exist in the first place, but to codify them in the DSM is a truly terrifying prospect.

Another frightening aspect of Blanchard's proposal is that any sexual interest other than "genital stimulation or preparatory fondling" is now, by definition, a paraphilia.

In his presentation, he claimed that paraphilias should include all "erotic interests that are not focused on copulatory or precopulatory behaviors, or the equivalent behaviors in same-sex adult partners." Copulatory is defined as related to coitus or sexual intercourse (i.e., penetration sex). So, essentially, all forms of sexual arousal and expression that are not centered around penetration sex may now be considered paraphilias.

So, do you and your partner occasionally role-play or talk dirty to one another over the phone? Or engage in arousing play that is not intended to necessarily lead to "doing the deed"? Do you masturbate? Do you get a sexual charge from wearing a particularly sexy outfit or performing any act that falls outside of "genital stimulation or preparatory fondling"? Well, then congratulations, you can be diagnosed with a paraphilia!

Tuesday, May 05, 2009

Brain scan studies busted by statistics

As seen in New Scientist, regarding a paper published in Nature NueroScience

There is fresh evidence that the budding field of social neuroscience is producing misleading results because of statistical methods often used to analyse brain scans.

In January, Hal Pashler of the University of California, Davis, and colleagues, sparked controversy when they criticised the statistical methods used by a clutch of high-profile research teams to link brain activity to emotions. They said the teams' results could be inflated because random noise was not properly accounted for.

Now Nikolaus Kriegeskorte of the National Institute of Mental Health in Bethesda, Maryland, and his colleagues report that of more than 100 brain-imaging papers in five top journals that they looked at, 40 per cent use similar methods (Nature Neuroscience, DOI: 10.1038/nn.2303).

Russell Poldrack of the University of California, Los Angeles, says the latest study "will drive more people to take the problem seriously".

We monitor all this with a mildly skeptical eye.

Saturday, May 02, 2009

Waterboarding, Interrogations: The CIA's $1,000 a Day Specialists

As reported on ABC News

As the secrets about the CIA's interrogation techniques continue to come out, there's new information about the frequency and severity of their use, contradicting an 2007 ABC News report, and a new focus on two private contractors who were apparently directing the brutal sessions that President Obama calls torture.

According to current and former government officials, the CIA's secret waterboarding program was designed and assured to be safe by two well-paid psychologists now working out of an unmarked office building in Spokane, Washington.

Bruce Jessen and Jim Mitchell, former military officers, together founded Mitchell Jessen and Associates.

Both men declined to speak to ABC News citing non-disclosure agreements with the CIA. But sources say Jessen and Mitchell together designed and implemented the CIA's interrogation program.

Click here to see Jessen refusing to talk to ABC News.

"It's clear that these psychologists had an important role in developing what became the CIA's torture program," said Jameel Jaffer, an attorney with the American Civil Liberties Union.

Click here to see Mitchell refusing to talk to ABC News.

Former U.S. officials say the two men were essentially the architects of the CIA's 10-step interrogation plan that culminated in waterboarding.

Associates say the two made good money doing it, boasting of being paid a $1,000 a day by the CIA to oversee the use of the techniques on top al Qaeda suspects at CIA secret sites.

"The whole intense interrogation concept that we hear about, is essentially their concepts," according to Col. Steven Kleinman, an Air Force interrogator.

Both Mitchell and Jessen were previously involved in the U.S. military program to train pilots how to survive behind enemy lines and resist brutal tactics if captured.

Mitchell and Jessen Lacked Experience in Actual Interrogations

But it turns out neither Mitchell nor Jessen had any experience in conducting actual interrogations before the CIA hired them.

"They went to two individuals who had no interrogation experience," said Col. Kleinman. "They are not interrogators."

The new documents show the CIA later came to learn that the two psychologists' waterboarding "expertise" was probably "misrepresented" and thus, there was no reason to believe it was "medically safe" or effective. The waterboarding used on al Qaeda detainees was far more intense than the brief sessions used on U.S. military personnel in the training classes.

"The use of these tactics tends to increase resistance on the part of the detainee to cooperating with us. So they have the exact opposite effect of what you want," said Sen. Carl Levin (D-Mich).

The new memos also show waterboarding was used "with far greater frequency than initially indicated" to even those in the CIA.

Abu Zubaydah was water boarded at least 83 times and Khalid Sheikh Mohamed at least 183 times.

Former CIA Officer John Kiriakou Says Waterboarding is Torture

That contradicts what former CIA officer John Kiriakou, who led the Zubaydah capture team, told ABC News in 2007 when he first revealed publicly that waterboarding had been used.

He said then, based on top secret reports he had access to, that Zubaydah had only been water boarded once and then freely talked.

Kiriakou now says he too was stunned to learn how often Zubaydah was waterboarded, in what Kiriakou says was clearly torture.

"When I spoke to ABC News in December 2007 I was aware of Abu Zubaydah being waterboarded on one occasion," said Kiriakou. "It was after this one occasion that he revealed information related to a planned terrorist attack. As I said in the original interview, my information was second-hand. I never participated in the use of enhanced techniques on Abu Zubaydah or on any other prisoner, nor did I witness the use of such techniques."

A federal judge in New York is currently considering whether or not to make public the written logs of the interrogation sessions.

The tapes were destroyed by the CIA, but the written logs still exist, although the CIA is fighting their release.

A CIA spokesperson declined to comment for this report, except to note that the agency's terrorist interrogation program was guided by legal opinions from the Department of Justice.

Sunday, April 12, 2009

The Drugs, They Do Nothing!

Some selected snippets from this report

Short-term Intensive Treatment Not Likely to Improve Long-term Outcomes for Children with ADHD

Initial positive results gleaned from intensive treatment of childhood attention deficit hyperactivity disorder (ADHD) are unlikely to be sustained over the long term, according to a recent analysis of data from the NIMH-funded Multimodal Treatment Study of Children with ADHD (MTA). The study was published online ahead of print March 2009 in the Journal of the American Academy of Child and Adolescent Psychiatry.

Using reports from parents and teachers as well as self-reports from the children, now high school-aged, the researchers found that the youth’s functioning remained improved overall compared to their functioning at the beginning of the study, suggesting that available treatments can still be effective. However, they also found the following:

  • The eight-year follow-up revealed no differences in symptoms or functioning among the youths assigned to the different treatment groups as children. This result suggests that the type or intensity of a one-year treatment for ADHD in childhood does not predict future functioning.
  • A majority (61.5 percent) of the children who were medicated at the end of the 14-month trial had stopped taking medication by the eight-year follow-up, suggesting that medication treatment may lose appeal with families over time. The reasons for this decline are under investigation, but they nevertheless signal the need for alternative treatments.
  • Children who were no longer taking medication at the eight-year follow-up were generally functioning as well as children who were still medicated, raising questions about whether medication treatment beyond two years continues to be beneficial or needed by all.

Basically, parents become disillusioned with the failed promise of the easy fix of drugs for the treatment of this "condition"

Friday, March 13, 2009

Anna Nicole's doctors Sandeep Kapoor and Khristine Eroshevich charged in her death

As reported in the Independent, psychiatrist Khristine Eroshevich has been charged with others for misconduct in the death of Anna Nicole Smith. Documents obtained after Smith's death showed Eroshevich authorized all 11 prescription medications found in the model's hotel room the day she died. Most of the drugs were prescribed in the name of Stern, her lawyer-turned-companion, and none were prescribed in Smith's own name.

Anna Nicole Smith's boyfriend Howard K. Stern and two doctors have been charged with giving thousands of prescription drugs to the former Playboy Playmate in the years leading up to her fatal drug overdose in 2007.

Stern and doctors Sandeep Kapoor and Khristine Eroshevich were each charged yesterday with three felony counts of conspiracy and several other charges of fraudulent prescriptions. Prosecutors said the doctors gave the drugs — including opiates and sedatives — to Stern, who then gave them to Smith.

The prescriptions were issued between June 2004 and January 2007, just weeks before Smith's death.

"These individuals repeatedly and excessively furnished thousands of prescription pills to Anna Nicole Smith, often for no legitimate medical purpose," California Attorney General Jerry Brown said in a statement.

Brown's spokesman, Scott Gerber, told The Associated Press that Stern and Kapoor surrendered last night and posted $20,000 bond, and that Eroshevich will surrender Monday. An arraignment date was not set.

The medical examiner's office has said Eroshevich, a Los Angeles psychiatrist and friend of the starlet's, authorized all the prescription medications found in the Hollywood, Florida, hotel room where the 39-year-old Smith was found unresponsive shortly before her death in Feb. 8, 2007.

Eroshevich's attorney, Adam Braun, acknowledged his client wrote some of the prescriptions using fictitious names for Smith, but said that the intent wasn't to commit fraud.

"It was done for privacy reasons," Braun told the AP. "She did the best she could under difficult circumstances in the best interest of the patient."

Braun said Eroshevich began treating Smith following the death of the playmate's son in September 2006. The doctor traveled on several occasions over a six-month period to the Bahamas where Smith was living with Stern and wrote the prescriptions.

The criminal complaint also alleges Kapoor wrote prescriptions for Smith under a patient alias Michelle Chase. Prosecutors allege the doctor gave her excessive amounts of sleep aids, opiates, muscle relaxants and methadone-like drugs used to treat addiction, knowing she was an addict.

Messages left with attorneys for Stern and Kapoor were not immediately returned.

Brown said Eroshevich and Kapoor "violated their ethical obligations as physicians, while Mr. Stern funneled highly addictive drugs to Ms. Smith."

The criminal complaint includes eight other felony charges, including obtaining fraudulent prescriptions and unlawfully prescribing a controlled substance. In all, Stern faces six felonies and the doctors each are charged with seven. Prosecutors did not immediately know how many years in prison they faced if convicted.

Rumors swirled for weeks after Smith's death, but police cleared those around Smith of any wrongdoing and the medical examiner's probe deemed it an accidental overdose.

Because the playmate was found unresponsive in a hotel on American Indian land, the case was handled by tribal police and their exemption from public records laws kept most of the investigation from being made public.

Documents obtained by The Associated Press after Smith's death showed Eroshevich authorized all 11 prescription medications found in the model's hotel room the day she died. Most of the drugs were prescribed in the name of Stern, her lawyer-turned-companion, and none were prescribed in Smith's own name.

The quantity was staggering. More than 600 pills — including about 450 muscle relaxants — were missing from prescriptions that were no more than five weeks old. Ultimately, it was a syrup — the powerful sleeping aid chloral hydrate — blamed with tipping the balance in the toxic mix of drugs and causing her death.

Stern, who initially claimed he was the father of Smith's infant daughter, Dannielynn, appeared distraught as he spoke last year at a memorial marking the one-year anniversary of Smith's death.

"Few people who knew Anna might not realize how smart she actually was because unless she wanted you to know you didn't know," Stern said.

Stern, who came to the Bahamas with Smith during her pregnancy in 2006, gave up custody of Dannielynn in spring 2007 after DNA tests proved Smith's ex-boyfriend Larry Birkhead was the father.

Dannielynn has been named the sole heir of her late mother's estate, with Birkhead and Stern as co-trustees. Dannielynn could inherit millions of dollars if the estate wins an ongoing court fight over the oil fortune of Anna Nicole's late second husband, J. Howard Marshall.

Monday, March 02, 2009

Photos of notorious abandoned "Children's Center" in Maryland

A Photo set on Flickr:

Wikipedia says: "Forest Haven was a children's developmental center in Laurel, Maryland. It is sometimes referred to (inaccurately) as "DC Children's Center", although this was not an official moniker.

It was notorious for its poor conditions and abuse of patients. It was shut down in 1991 by a federal court."

We spent more than 5 hours walking around the campus and probably only saw half of the buildings. Just a huge area of urban decay to explore.

An interesting write-up of Forest Haven can be found here:

If you want to see more photos from Forest Haven, check out the photosets from Jon and Chris.

Thursday, February 26, 2009

Tuesday, February 24, 2009

3 Skilled Nursing Facility staff arrested for drugging deaths of patients

Report from thje Kern Valley Sun

Attorney General Jerry Brown today announced the arrests of a nurse, physician, and a pharmacist of the Kern Valley Healthcare District's Skilled Nursing Facility for “forcibly administering psychotropic medications for their own convenience, rather than for their patients’ therapeutic interests.” The Attorney General said these actions are alleged to have resulted in the deaths of three residents.

Taken into custody earlier today, Feb. 18, by California Department of Justice special agents were Gwen Hughes, the former Director of Nursing at the Skilled Nursing Facility of the Kern Valley Healthcare District in Lake Isabella, on charges of elder abuse and assault with a deadly weapon; Debbi Hayes, the former pharmacist at KVHD, on charges of elder abuse and assault with a deadly weapon; and Dr. Hoshang Pormir, a staff physician at Kern Valley Hospital, who was serving as the medical director of the Skilled Nursing Facility, on charges of elder abuse.

“These people maliciously violated the trust of their patients, by holding them down and forcibly administering psychotropic medications if they dared to question their care,” Attorney General Brown said. “This is appalling behavior, which amounts to assault with a deadly weapon.”

According to the statement issued by the Attorney General's office, Hughes, upon taking over as Director of Nursing in September 2006, ordered that Alzheimer’s and other dementia patients be given high doses of psychotropic medications to make them more tranquil and easy to control. It goes on to say, “She ordered the administration of these medications to patients who argued with her, were noisy, or who were otherwise disruptive.” Two patients who resisted were held down and forcibly given injections.

The complaint also alleges that Hughes directed Debbi Hayes, the hospital pharmacist, to fill prescriptions for these psychotropic medications. Hayes wrote and filled these prescriptions without first obtaining a doctor’s approval, the complain said.

According to complaint, Pormir approved these psychotropic medications only some time after they had been administered and without examining the patients first and determining whether these psychotropic medications were medically necessary.

Investigators allege that several of these patients had medical complications as a result of being given these psychotropic medications, including lethargy and the inability to eat or drink properly. It is believed that that three patients died and one patient suffered great bodily injury as a result.

The case came to the attention of authorities in January 2007, when an ombudsman reported to the Bakersfield office of the California Department of Public Health that a patient in the Skilled Nursing Facility had been held down and given an injection of psychotropic medication by force.

The Department of Public Health immediately sent an investigative team with a doctor, a nurse, and a doctor of pharmacology. They determined that 22 patients, including some who were suffering from Alzheimer’s at the Skilled Nursing Facility, were being given high doses of psychotropic medication not for therapeutic reasons, but to simply control and quiet them for the convenience of the staff.

The Department of Public Health issued a Certificate of Immediate Jeopardy which resulted in the immediate dismissal of the Ms. Hughes. The matter was then turned over to the California Department of Justice, Bureau of Medi-Cal Fraud and Elder Abuse.

Special Agents from the Bureau of Medi-Cal Fraud and Elder Abuse began a year-long investigation, with the co-operation and assistance of the Department of Public Health and the administration of the Kern Valley Healthcare District.

Pamela Ott, CEO at the time, left the district in May 2007. Current KVHD Board of Directors Chair Kay Knight said, “A lot of people don't understand that this happened more than two years ago and is not going on now.”

Chet Beedle, Chief Financial Officer, reported that CEO Rick Carter and Board of Directors spokesperson Victoria Alwin were unavailable. He added that he was prohibited from commenting on the arrests and that a formal statement was coming.

A search warrant was served on the facility in August 2008, resulting in the seizure of 36 patients' medical files and records.

Criminal charges were filed in Kern County Superior Court and the defendants are being held in Kern County Jail in Bakersfield. Pormir is charged with one felony count of causing harm/death of an elder of dependent adult. He is being held on $400,000 bail. Hughes and Hayes are each charged with two felony counts, one count of causing harm/death of an elder of dependent adult and another felony count of assault with a deadly weapon other than a firearm of great bodily force. The trio will be arraigned in Superior Court in Bakersfield Friday morning. If convicted, the defendants could face up to 11 years in prison.

The case is being prosecuted by the Attorney General’s Bureau of Medi-Cal Fraud and Elder Abuse, with the co-operation and assistance of the Kern County District Attorney’s Office.

More than half of all foster children in Texas above 6 are drugged, 41,3% of those who receive medication receive 3+ different classes of medicines

Who are the real child abusers here? More than half of all foster children in Texas above 6 receive psychotropic medication, 41,3% of those who receive medication receive 3+ different classes of medicines. A study published in Pediatrics, the Official Journal of the American Academy of Pediatrics

Psychotropic Medication Patterns Among Youth in Foster Care

Julie M. Zito, PhD a,b,
Daniel J. Safer, MD c,
Devadatta Sai, MS a,
James F. Gardner, ScM a,
Diane Thomas, BA d,
Phyllis Coombes, MA d,
Melissa Dubowski, BS d and
Maria Mendez-Lewis, MPA d

Departments of

a Pharmaceutical Health Services Research
b Psychiatry, University of Maryland, Baltimore, Maryland
c Department of Psychiatry and Pediatrics, Johns Hopkins Medical Institutions, Baltimore, Maryland
d Office of the Texas Comptroller of Public Accounts, Austin, Texas


CONTEXT. Studies have revealed that youth in foster care covered by Medicaid insurance receive psychotropic medication at a rate >3 times that of Medicaid-insured youth who qualify by low family income. Systematic data on patterns of medication treatment, particularly concomitant drugs, for youth in foster care are limited.

OBJECTIVE. The purpose of this work was to describe and quantify patterns of psychotropic monotherapy and concomitant therapy prescribed to a randomly selected, 1-month sample of youth in foster care who had been receiving psychotropic medication.

METHODS. Medicaid data were accessed for a July 2004 random sample of 472 medicated youth in foster care aged 0 through 19 years from a southwestern US state. Psychotropic medication treatment data were identified by concomitant pattern, frequency, medication class, subclass, and drug entity and were analyzed in relation to age group; gender; race or ethnicity; International Classification of Diseases, Ninth Revision, psychiatric diagnosis; and physician specialty.

RESULTS. Of the foster children who had been dispensed psychotropic medication, 41.3% received ≥3 different classes of these drugs during July 2004, and 15.9% received ≥4 different classes.

The most frequently used medications were antidepressants (56.8%), attention-deficit/hyperactivity disorder drugs (55.9%), and antipsychotic agents (53.2%).

The use of specific psychotropic medication classes varied little by diagnostic grouping.

Psychiatrists prescribed 93% of the psychotropic medication dispensed to youth in foster care. The use of ≥2 drugs within the same psychotropic medication class was noted in 22.2% of those who were given prescribed drugs concomitantly.

CONCLUSIONS. Concomitant psychotropic medication treatment is frequent for youth in foster care and lacks substantive evidence as to its effectiveness and safety.

Full Study at the Link