Transsexual sisters

The first documented case of sisters with transsexualism is reported. Given the low incidence of female transsexualism this is a most unlikely event and suggests that familial factors may be of aetological importance.     

Burning charcoal: an indigenous method of committing suicide in Hong Kong

BACKGROUND: Carbon monoxide (CO) poisoning by burning charcoal has become one of the most common ways of committing suicide in Hong Kong since late 1998. The evolution of the phenomenon was explored in the current study. METHOD: Information about completed suicides between January 1996 and December 1999 was obtained from the Hong Kong death registry and hospital authority, and information about ambient temperature and humidity was obtained from the Hong Kong Observatory. News on completed suicides by burning charcoal was collected by computer search using the data bank of 6 major Hong Kong newspapers. The data were analyzed. RESULTS: CO poisoning by burning charcoal rose from 0% of all Hong Kong suicides in 1996 and 1997 to 1.7% in 1998 and 10.1% in 1999. The monthly incidence rate bore a reciprocal relationship with the ambient temperature. Suicidal pacts were overrepresented, and past history of mental illness was uncommon. Both demographic and clinical features of suicides by burning charcoal resembled those of suicides by domestic gas poisoning. The overall suicide rate remained unchanged in the above period. CONCLUSION: Suicide by burning charcoal is a new variant of domestic gas poisoning. A host of biopsychosocial and ethnological factors are responsible for the birth and indigenization of the method.     

Mental deficiency and military offense

Psychiatric Quarterly - The percentage of mental defectives in the army is about 0.75, or approximately one-half of that in the total population, but the percentage of defectives among general...     

Transsexual subtypes: clinical and theoretical significance

The present study was designed to investigate whether transsexuals can be validly subdivided into subtypes on the basis of sexual orientation, and whether differences between subtypes of transsexuals are similar for male-to-female (MF) and female-to-male transsexuals (FMs). Within a large transsexual sample (n = 187), homosexual and nonhomosexual subjects were compared on a number of characteristics before the start of treatment. Differences within MF and FM groups were also investigated. Homosexual transsexuals were found to be younger when applying for sex reassignment, reported a stronger cross-gender identity in childhood, had a more convincing cross-gender appearance, and functioned psychologically better than nonhomosexual transsexuals. Moreover, a lower percentage of the homosexual transsexuals reported being (or having been) married and sexually aroused while cross-dressing. The pattern of findings was different for MFs and FMs. No differences between homosexuals and nonhomosexuals were found in height, weight, or body mass index. A distinction between subtypes of transsexuals on the basis of sexual orientation seems theoretically and clinically meaningful. The results support the notion that in the two groups different factors influence the decision to apply for sex reassignment. The more vulnerable nonhomosexual transsexuals may particularly benefit from additional professional guidance before and/or during treatment.     

责任能力与作案特征、作案时精神症状的相关分析

目的:探讨责任能力与作案特征、作案时精神症状的相关性. 方法:通过使用精神疾病患者限定刑事责任能力评定量表及简明精神病评定量表(BPRS)等工具,对504例刑事案件鉴定案例的责任能力、作案特征及作案时精神症状进行相关分析. 结果:责任能力与BPRS中精神病性症状的相关性较大(0.5相似文献   

Language development after cochlear implantation: an epigenetic model

Growing evidence supports the notion that dynamic gene expression, subject to epigenetic control, organizes multiple influences to enable a child to learn to listen and to talk. Here, we review neurobiological and genetic influences on spoken language development in the context of results of a longitudinal trial of cochlear implantation of young children with severe to profound sensorineural hearing loss in the Childhood Development after Cochlear Implantation study. We specifically examine the results of cochlear implantation in participants who were congenitally deaf (N = 116). Prior to intervention, these participants were subject to naturally imposed constraints in sensory (acoustic–phonologic) inputs during critical phases of development when spoken language skills are typically achieved rapidly. Their candidacy for a cochlear implant was prompted by delays (n = 20) or an essential absence of spoken language acquisition (n = 96). Observations thus present an opportunity to evaluate the impact of factors that influence the emergence of spoken language, particularly in the context of hearing restoration in sensitive periods for language acquisition. Outcomes demonstrate considerable variation in spoken language learning, although significant advantages exist for the congenitally deaf children implanted prior to 18 months of age. While age at implantation carries high predictive value in forecasting performance on measures of spoken language, several factors show significant association, particularly those related to parent–child interactions. Importantly, the significance of environmental variables in their predictive value for language development varies with age at implantation. These observations are considered in the context of an epigenetic model in which dynamic genomic expression can modulate aspects of auditory learning, offering insights into factors that can influence a child’s acquisition of spoken language after cochlear implantation. Increased understanding of these interactions could lead to targeted interventions that interact with the epigenome to influence language outcomes with intervention, particularly in periods in which development is subject to time-sensitive experience.     

Brief Report: Female-To-Male Transsexual People and Autistic Traits

The ‘extreme male brain’ theory suggests females with Autism Spectrum Conditions are hyper-masculinized in certain aspects of behavior. We predicted that females with Gender Identity Disorder (who are masculinized) would have elevated Autism Spectrum Quotient (AQ) scores. AQ scores from five groups were compared: (1) n = 61 transmen (female-to-male transsexual people); (2) n = 198 transwomen (male-to-female transsexual people); (3) n = 76 typical males; (4) n = 98 typical females; and (5) n = 125 individuals with Asperger Syndrome (AS). Transmen had a higher mean AQ than typical females, typical males and transwomen, but lower than individuals with AS. Transmen have more autistic traits and may have had difficulty socializing with female peers and thus found it easier to identify with male peer groups.     

不同类型抑郁障碍患者作案特征的比较

目的 探讨不同类型抑郁障碍患者作案特征。方法 对云南省精神病医院于1980－2000年鉴定的37例抑郁症（抑郁症组）和31例抑郁障碍组[包括15例心因（反应）性抑郁症、9例抑郁性神经症、7例其他类型抑郁障碍]的作案特征进行对照研究。结果 抑郁症组作案行为发生突然、随机性强（占62％）,缺乏诱因（占76％）,病理性动机作案多见（占54％）,并多以凶杀和伤害案为主（占76％）,侵害对象主要涉及家庭成员（占54％）;作案后自杀未隧及主动求死者较多（占38％）。抑郁障碍组作案多有诱因（占55％）、作案后逃离现场（占45％）,事后为其行为作辩解（占38％）、并要求宽大（占34％）。两组比较,差异有显著性（P＜0．05）。结论 抑郁症组和抑郁障碍组在作案特征上有各自不同的特点,可能与两者的起病（病因）、病情发展、症状表现和严重程度等差异有关。     

Male adolescent sexual offenders: the offender and the offense

A group of male adolescent sexual offenders were divided into three groups: Courtship Disorders (Exhibitionism, Toucherism and Obscene Phone Calls), Sexual Assaults, and Pedophilic Offenses. Group I offenders tended to come from a less disorganized family background, were better adjusted to school and in the community and were seen by clinicians as less seriously disturbed than the adolescents in the other two groups. In addition, these adolescents did not experience the offense as a sexual act. Group II offenders (Sexual Assaulters) came from a more disturbed family background characterized by a high rate of long-term parent-child separations, committed more violent offenses and had a higher frequency of intellectual functioning in the Borderline Range of Intelligence. Group III offenders (Pedophilic Offenses) were Canadian born, had witnessed physical violence between their parents, were described as having been infants who did not enjoy being cuddled and had siblings who were truant. This study suggests that classifying adolescent sexual offenders along the line suggested in adult literature seems to be justified.     

精神发育迟滞患者犯罪危险因素的对照研究

为探讨影响精神发育迟滞（ＭＲ）患者犯罪的危险因素，对１３１例司法鉴定为犯罪的ＭＲ患者，与４４例未犯罪的ＭＲ患者进行对照，并行单因素与多元逐步回归分析。结果表明，两组在对违法行为的辨认能力、是否自感受歧视、是否伴精神病、家庭监护能力、有无违法史、性格分型及受教育年限方面的差异均有显著性（Ｐ＜０．０５）。逐步回归分析（α＝０．０５）揭示，ＭＲ犯罪危险因素依次为家庭监护能力差、自感受歧视、性格为兴奋型、伴癫痫，特别是有人格改变、或意识障碍、或幻觉、伴精神病特别是处于发病期。提示ＭＲ犯罪受诸多因素的影响。     

Young offenders in forensic institutions in the Netherlands after committing serious crimes: Contribution of mandatory treatment and reduction of reincarceration

Background

In the Netherlands, young offenders who have been convicted of a particularly serious offence may be subjected to a so-called ‘Placement in an Institution for Juveniles’ (PIJ) measure if they are considered to pose a high ongoing risk to public safety. They form a rarely studied distinct group. Treatment in specialist forensic custodial institutions for young people (FYCI) is an intervention of last resort and costly. The most serious young offenders tend to be the hardest to rehabilitate while preventing further offending. Treatment is focussed on reducing risk of harm as well as improving health and other protective factors.

Aims

To explore the contribution of treatment in an FYCI under a forensic treatment order—the PIJ-measure—to the reduction of risk of reoffending.

Methods

In a pre–post intervention study, the Juvenile Forensic Profile (JFP) was used to score complete case files of 178 young offenders at the start and end of their placement in an FYCI under the PIJ-measure, 59% of those serving between the years 2013 and 2016 inclusive. The JFP covers risk and protective factors in seven domains encompassing criminal behaviour, family, environment, risk factors, psychopathology, psychology and behaviour during incarceration. Change or stability in scores was tested against reincarceration within 2 years of PIJ-measure completion.

Results

Impulse control and alcohol and drug use problems showed the greatest improvements. Behaviour that deteriorates during the stay is primarily related to obtaining more autonomy during reintegration efforts, including furlough. Reincarceration in the 2 years of community follow-up was unusual (13.5%). The two main variables associated with reincarceration were problematic behaviour during the pre-discharge year and lack of behavioural improvement during treatment.

Conclusions

Outcomes of mandatory treatment in this group of serious young offenders have not previously been studied in a rigorous pre–post intervention study design. We found evidence of an overall tendency to improvement over time in mental state and social skills, reflected by risk assessment scale scores. Continued substance use problems while incarcerated and continuing social skills deficits were most strongly associated with reincarceration suggests a possible need for review of these areas in the PIJ-measure programme. Results contribute to knowledge about risk assessment, treatment and preventions of harms by serious young offenders and may inform evidence-based policies and practices in the Netherlands and beyond.

     

Transsexual symptoms in a male child treated by a female therapist.

The literature on the psychodynamics and treatment of transsexualism indicates a pathological mother-son relationship, yet uniformly recommends a male therapist. A case of a six-year-old boy with transsexual symptoms treated by a female therapist is presented, and there is a discussion of the theory and implications arising from the case.     

不同作案动机的心理学、医学要件对照研究

目的探讨动机论在司法精神病鉴定中的应用。方法根据田氏动机论的观点,将364例刑事责任能力鉴定案例分组:其中现实动机131例,病理动机113例,混合动机89例,不明动机31例;对不同作案动机的心理学和医学标准进行对照。结果不同作案动机在案型、预谋、诱因、作案对象、作案手段、自我保护、后果意识以及临床特征、责任能力评定等方面均存在显著性差异(P0.001)。结论动机论在司法精神病鉴定实践中具有重要的参考价值。     

Transsexual limb transplants in fiddler crabs and expression of novel sensory capabilities.

We used transsexual limb transplants in fiddler crabs to examine how peripheral sensory structures interact with the central nervous system (CNS) to produce a sexually dimorphic behavior. Female and male chemosensory feeding claws were transplanted onto male hosts in place of nonfeeding, nonchemosensory claws. Successfully transplanted claws retain donor morphologies and contain chemosensory neurons. Neurons in successfully transplanted female feeding claws express the enhanced sensitivity to chemical cues seen in female, but not male, neurons in claws of normal animals. When chemically stimulated, the transplanted claws evoke feeding behavior not observed in normal males, even though the sensory neurons in the transplanted limb project to the host's sexually dimorphic neuropil not known to receive chemosensory input. Behavioral sensitivity is directly related to the sensitivity of peripheral neurons in the transplanted feeding claw. Thus, the interactions between peripheral neurons and their targets may restructure the CNS so that novel sensory capabilities are expressed, and this can produce sexually dimorphic behaviors.     

What's next after 50 years of psychiatric drug development: an FDA perspective

This article discusses changes in psychiatric drug development from a US Food and Drug Administration (FDA) standpoint. It first looks back at changes that have been influenced by regulatory process and then looks forward at FDA initiatives that are likely to affect psychiatric drug development in the future. FDA protects the public health by ensuring the safety and efficacy of drug products introduced into the US market. FDA works with drug sponsors during development, and, when applications are submitted, reviews the safety and efficacy data and the proposed labeling. Drug advertising and promotion and postmarketing surveillance also fall within FDA's responsibility. Among the many changes in psychiatric drug development over the past 50 years, several have been particularly influenced by FDA. Populations studied have expanded diagnostically and demographically, and approved psychiatric indications have become more focused on the clinical entities actually studied, including in some cases specific symptom domains of recognized syndromes. Trial designs have become increasingly complex and informative, and approaches to data analysis have evolved to better model the reality of clinical trials. This article addresses 2 general areas of innovation at FDA that will affect psychiatric drug development in years to come. Several programs falling under the general heading of the Critical Path Initiative, ie, biomarkers, adaptive design, end-of-phase 2A meetings, and data standards, are described. In addition, a number of important safety initiatives, including Safety First, the Sentinel Initiative, the Safe Use Initiative, and meta-analysis for safety, are discussed.     

Long-term follow-up of exhibitionists: psychological, phallometric, and offense characteristics

Exhibitionism has historically been viewed as more of a nuisance than a serious criminal justice matter. Research has demonstrated that the number of exhibitionists who are detected re-offending is a significant under-representation of the number who actually re-offend. The objective of this study was to extend a previous study conducted on exhibitionists, while attempting to solve the limitations described in that study. Two hundred eight exhibitionists were assessed at a university teaching hospital between 1983 and 1996. Archival data were derived from police and medical files. Results indicated that, over a mean follow-up period of 13.24 years, 23.6, 31.3, and 38.9 percent of exhibitionists were charged with or convicted of sexual, violent, or criminal offenses, respectively. Undoubtedly, this is an under-representation of the true rate, as we have no way of knowing how many exhibitionists re-offended and did not get caught. Nevertheless, in the present investigation, sexual recidivists compared with non-recidivists were less educated, scored higher on the Michigan Alcohol Screening Test (MAST), the Psychopathy Checklist, Revised (PCL-R), and the Pedophile Index. Violent recidivists were also less educated and scored higher on the MAST, PCL-R, and the Pedophile Index, and had accumulated a greater number of prior violent or criminal charges and/or convictions. Criminal recidivists were less educated; scored higher on the MAST, Buss-Durkee Hostility Inventory (BDHI), PCL-R, and Pedophile Index; and had accumulated a greater number of prior sexual, violent, and criminal offenses. Finally, the hands-on sexual recidivists accumulated a greater number of prior violent and criminal charges and or convictions than did the hands-off sexual recidivists.