Beitrag der Neurowissenschaften zur forensischen Psychiatrie

Forensic psychiatry is a subspecialty dedicated to the interface between psychiatry and law. It uses paradigms and knowledge from general psychiatry for diagnostics, assessment, therapy and research under consideration of the special requirements of legal aspects and framework conditions; therefore, scientific development in forensic psychiatry is substantially dependent on scientific progress in psychiatry and thus nowadays also in neurosciences. Neurobiological hypotheses on the neuronal foundations of psychiatric diseases have been established, for example the dopamine hypothesis for schizophrenia, in a manner that led to important therapeutic advances in the treatment and long-term quality of life for affected persons. Analogous advances should not be withheld from forensic psychiatric patients, who are doubly affected by the disease and the accompanying limitations in their rights to freedom, which is why research in this field must be driven forwards. Clear advances in knowledge of the neurobiological foundations of forensic psychiatric illnesses have, for example, already been made in the field of pedophilia and psychopathy. Based on studies of investigation populations, such neuroscientific knowledge on the neurobiological principles of forensic psychiatric diseases, however, requires a carefully concerted communication with respect to dissemination in the media as well as in the interpretation of individual cases, for example in court. This is of great importance in order to prevent simplifying misconceptions and to avoid a subsequent loss of trust in the scientific process. Therefore, training of the new generation of forensic psychiatrists in the understanding and communication of scientific methods of modern forensic psychiatric neuroscience is of great importance for the societal impact and further advancement of the discipline.     

Medikalisierung sozialer Prozesse

Medicalization of social processes increasingly more involves societal areas and leads to the extension of disease concepts and the creation of new diseases. In this article the disciplines in psychiatry and psychotherapy will be discussed with reference to the trends towards medicalization. Particular attention is paid to the diagnostic models and their critical implementation. The interaction between societal conditions, the medical healthcare model and the individual will be presented and discussed with respect to their influence on medicalization and psychopathologization. Furthermore, the importance will be shown by which the increasing societal openness for psychic phenomena and the influence of mass media on the medicalization process becomes incorporated. At the individual level societal-typical psychological characteristics which have an influence on the readiness of individuals to experience themselves as sick and socially deficient will be elucidated. The pathologization and chronification processes are exemplified using the case of unemployment and the psychological sequelae, such as on the term burnout. Finally, approaches of a societal-critical medical and psychotherapeutic science and practice will be sketched.     

Psychiatry, religious conversion, and medical ethics.

The interface between religion, psychiatry, and ethics is often a locus for considerable controversy. This article focuses on the response of American psychiatry to religious nonconformism, and to religious conversion generally. At issue is the societal pressure against unpopular religious movements. The author argues for an ethic that conserves the freedom of religious conscience, and that guards against inquisitions in the guise of medical expertise and nosology.     

Entwicklung und Stand des psychiatrischen Maßregelvollzugs (§ 63 StGB)

Psychiatric forensic commitment is at the interface between psychiatry and criminal justice. Both fields are subject to societal and political influences, which are not to be underestimated and have undergone many changes since the introduction of the catalogue of penal measures in 1933. This article provides a summarizing overview of the development of psychiatric penal measures in the 8 decades since its inception. The various developmental phases are chonologically presented and analyzed, in some cases with reference to the international situation. The main transition is the change from custodial detention up to modern treatment enforcement, even if many different factors influence the certainly to be strived for further development. Finally, the complex topics of “forensic psychiatry and the public” as well as the influence of the media on this aspect are briefly discussed.     

Societal and Ethical Implications of Anti-Spoofing Technologies in Biometrics

Biometric identification is thought to be less vulnerable to fraud and forgery than are traditional forms of identification. However biometric identification is not without vulnerabilities. In a ‘spoofing attack’ an artificial replica of an individual’s biometric trait is used to induce a system to falsely infer that individual’s presence. Techniques such as liveness-detection and multi-modality, as well as the development of new and emerging modalities, are intended to secure biometric identification systems against such threats. Unlike biometrics in general, the societal and ethical issues raised by spoofing and anti-spoofing techniques have not received much attention. This paper examines these issues.     

The making of contemporary American psychiatry, Part 2: therapeutics and gender before and after World War II

In this article, the 2nd in a 2-part series, the authors use patient records from California's Stockton State Hospital to explore the changing role of gender norms and other cultural values in the care of psychiatric patients. The authors show that cultural values are always imbedded in psychiatric practice and that their role in that practice depends on the patients, treatments, and therapeutic rationales present in a given therapeutic encounter. Because the decade following World War II witnessed dramatic changes in psychiatry's patients, therapeutics, and rationales, Stockton State Hospital's patient records from this time period allow the authors to show not only the extent to which gender norms shape psychiatric practice but also how psychiatry's expansion into the problems of everyday life has led to psychiatry taking a more subtle and yet more active role in enforcing societal norms.     

Does Evidence-Based Medicine Apply to Psychiatry?

Evidence-based psychiatry (EBP) has arisen through the application of evidence-based medicine (EBM) to psychiatry. However, there may be aspects of psychiatric disorders and treatments that do not conform well to the assumptions of EBM. This paper reviews the ongoing debate about evidence-based psychiatry and investigates the applicability, to psychiatry, of two basic methodological features of EBM: prognostic homogeneity of clinical trial groups and quantification of trial outcomes. This paper argues that EBM may not be the best way to pursue psychiatric knowledge given the particular features of psychiatric disorders and their treatments. As a result, psychiatry may have to develop its own standards for rigour and validity. This paper concludes that EBM has had a powerful influence on how psychiatry investigates and understands mental disorders. Psychiatry could influence EBM in return, reshaping it in ways that are more clinically useful and congruent with patients’ needs.     

Can Ziskin withstand his own criticisms? problems with his model of cross-examination

Ziskin has mounted a concerted attack on the scientific basis of psychology and psychiatry and their ability to provide expertise to the courts. He has assailed both the clinical methods and conclusions rendered by these mental health professionals. To rebut expert testimony, Ziskin has proposed general principles of cross-examination. We discuss the limitations of this model and provide an initial study of its effectiveness.     

A Problem with Societal Desirability as a Component of Responsible Research and Innovation: the “If we don’t somebody else will” Argument

The implementation of Responsible Research and Innovation (RRI) is not without its challenges, and one of these is raised when societal desirability is included amongst the RRI principles. We will argue that societal desirability is problematic even though it appears to fit well with the overall ideal. This discord occurs partly because the idea of societal desirability is inherently ambiguous, but more importantly because its scope is unclear. This paper asks: is societal desirability in the spirit of RRI? On von Schomberg’s account, it seems clear that it is, but societal desirability can easily clash with what is ethically permissible; for example, when what is desirable in a particular society is bad for the global community. If that society chose not to do what was desirable for it, the world would be better off than if they did it. Yet our concern here is with a more complex situation, where there is a clash with ethical acceptability, but where the world would not be better off if the society chose not do what was societally desirable for itself. This is the situation where it is argued that someone else will do it if we do not. The first section of the paper gives an outline of what we take technology to be, and the second is a discussion of which criteria should be the basis for choosing research and innovation projects. This will draw on the account of technology outlined in the first section. This will be followed by an examination of a common argument, “If we don’t do it, others will”. This argument is important because it appears to justify acting in morally dubious ways. Finally, it will be argued that societal desirability gives support to the “If we don’t…” argument and that this raises some difficulties for RRI.     

On the nature of mental disorder: towards an objectivist account

According to the predominant view within contemporary philosophy of psychiatry, mental disorders involve essentially personal and societal values, and thus, the concept of mental disorder cannot, even in principle, be elucidated in a thoroughly objective manner. Several arguments have been adduced in support of this impossibility thesis. My critical examination of two master arguments advanced to this effect by Derek Bolton and Jerome Wakefield, respectively, raises serious doubts about their soundness. Furthermore, I articulate an alternative, thoroughly objective, though in part normative, framework for the elucidation of the concept of mental disorder. The concepts of mental dysfunction and impairment of basic psychological capacities to satisfy one??s basic needs are the building blocks of this framework. I provide an argument for the objective harmfulness of genuine mental disorders as patterns of mental dysfunctions with objectively negative biotic values, as well as a formally correct definition of the concept of mental disorder. Contrary to the received view, this objective framework allows for the possibility of genuine mental disorders due to adverse social conditions, as well as for quasi-universal mental disorders. I conclude that overall, the project of providing an objective account of the concept of mental disorder is far from impossible, and moreover, that it is, at least in principle, feasible.     

Thoughts and feelings and things: A new psychiatric epistemology

Epistemology — the study of knowledge — is a philosophical discipline with close ties to psychiatry. When epistemologists address specific questions about how knowledge is actually realized by human beings, their philosophy must be informed by empirical studies of the sort psychiatrists now take up in a variety of forms. As this paper describes, psychiatrists can likewise improve their understanding of human psychology through a deeper appreciation of philosophical analysis in epistemology.The aim of this article is to introduce a unifying framework within which the experience from different approaches to psychiatry — (1) the conceptual schemas of cognitive psychiatry, (2) the mental structures of psychoanalytic psychiatry, (3) the categorical forms of existential psychiatry, and (4) the neural pathways of biological psychiatry — can all be applied productively to the central question of epistemology. By establishing a broad understanding of the problem of knowledge, this new view of epistemology is developed within the idiom of each psychiatric approach. In addressing themselves to a unitary problem, these diverse psychiatric approaches are themselves revealed, not as competing points of view, but as complementary views of a single subject. The result is a new epistemology that can not only bring the insights of psychiatry to philosophy, but can also contribute to the care of patients when psychiatrists bring this broader view to their clinical work.     

乙肝病毒感染儿童面临的社会伦理学问题

我国是乙型病毒性肝炎高发区,母婴传播感染是一条极其重要且不易阻断的感染途径,由母婴传播导致的儿童乙肝病毒感染问题,不仅仅是现阶段我国严重的公共卫生问题,同时也是严重的社会伦理问题。HBV感染儿童在成长过程中所面临的社会歧视和自身权利保障是每一个患儿家庭迫切关心的,也是社会伦理学工作者的研究范畴。     

Putting the “We” Into Well‐being: Using Collectivism‐Themed Measures of Well‐Being Attenuates Well‐being's Association With Individualism

Studies repeatedly have documented that societal well‐being is associated with individualism. Most of these studies, however, have conceptualized/measured well‐being as individual life satisfaction—a type of well‐being that originates in Western research traditions. Drawing from the latest research on interdependent happiness and on family well‐being, we posit that people across cultures pursue different types of well‐being, and test whether more collectivism‐themed types of well‐being that originate in Confucian traditions also are associated with individualism. Based on data collected from 2,036 participants across 12 countries, we find support for the association between individual life satisfaction and individualism at the societal level, but show that well‐being's association with individualism is attenuated when some collectivism‐themed measures of well‐being are considered. Our article advances knowledge on the flourishing of societies by suggesting that individualism may not always be strongly linked with societal well‐being. Implications for public policies are signaled.     

Evolution of Counseling in Jamaica: Past,Present, and Future Trends

Counseling maintains a small yet growing presence in Jamaica as a profession. Practitioners are confronted with several societal problems. The authors provide a historical overview of Jamaica and a synopsis of the development of counseling. The emergence of counseling services through the limitations of psychiatry and psychology sets the stage for current practices and notable involvement of guidance counselors. It is concluded that the continued growth and effectiveness of counseling is dependent on overcoming negative attitudes and economic barriers.     

Generativity,the Big Five,and Psychosocial Adaptation in Midlife Adults

ABSTRACT The study examines the extent to which 2 sets of personality variables—(1) dispositional traits (and their facets) within the Big Five taxonomy and (2) the adult developmental construct of generativity—are associated with psychosocial adaptation in midlife adults (N=128), conceived as the combination of individual well‐being and positive societal involvements. Generativity is conceived as an adult's concern for and commitment to promoting the well‐being of future generations. Multiple regression analyses showed that dispositional traits were more strongly associated with individual well‐being than was generativity, but generativity was much more strongly associated with positive societal engagement than were the traits. Correlations between dispositional traits and generativity revealed that highly generative adults were elevated on most of the facets of Extraversion and Openness. For the other 3 traits, generativity was positively related to facets of competence, achievement striving, dutifulness, altruism, and trust and negatively related to vulnerability, anxiety, depressiveness, and modesty.     

Zoonotic and non-zoonotic diseases in relation to human personality and societal values: Support for the parasite-stress model

The parasite-stress model of human sociality proposes that humans' ontogenetic experiences with infectious diseases as well as their evolutionary historical interactions with these diseases exert causal influences on human psychology and social behavior. This model has been supported by cross-national relationships between parasite prevalence and human personality traits, and between parasite prevalence and societal values. Importantly, the parasite-stress model emphasizes the causal role of non-zoonotic parasites (which have the capacity for human-to-human transmission), rather than zoonotic parasites (which do not), but previous studies failed to distinguish between these conceptually distinct cate- gories. The present investigation directly tested the differential predictive effects of zoonotic and non-zoonotic (both human-specific and multihost) parasite prevalence on personality traits and societal values. Supporting the parasite-stress model, cross-national differences in personality traits (unrestricted sexuality, extraversion, openness to experi- ences) and in societal values (individualism, collectivism, gender equality, democratiza- tion) are predicted specifically by non-zoonotic parasite prevalence.     

Art as Neglected ‘Text’ for the Study of Gender and Religion in Africa

The visual and performing arts in Africa provide unique opportunities not just for the reinforcement of gender differences but also for the subversion or transcendence of those differences to ensure societal harmony. A close reading of the various forms of artistic expression provides valuable data on women's perceived mystical powers—procreation, metaphysical knowledge and intimate communication with the spirit world as well as their social and religious status.     

社会公平感对不同阶层目标达成的影响及其过程

基于目标追求理论和社会阶层心理学的相关理论, 本文通过3个研究, 逐步深入地考察了社会公平感对不同阶层个体目标达成的影响作用及其过程。研究1为相关研究, 考察了高低阶层成人被试的教育领域社会公平感与为孩子进行教育投入的目标承诺及目标达成之间的关系; 研究2为准实验研究, 通过操纵公平或不公平教育情境启动公平感, 考察其对高低阶层中学生的学习目标承诺与目标达成的影响; 研究3为实验研究, 通过实验操纵社会公平感和社会阶层, 考察社会公平感对高低阶层大学生的实验任务目标承诺和目标达成的影响。研究发现, 社会公平感通过正向影响低阶层者的目标承诺, 进而正向影响其目标达成; 而对于高阶层者来说, 变量之间这些关系则不显著。这表明：相对于高阶层来说, 低阶层者的目标追求易受社会公平感的影响; 低阶层者的社会公平感水平越高, 其追求目标的动机水平就越高, 进而越有利于目标达成。     

Reflections on the use of patient records: Privacy,ethics, and reparations in the history of psychiatry

One of the most common questions we get asked as historians of psychiatry is “do you have access to patient records?” Why are people so fascinated with the psychiatric patient record? Do people assume they are or should be available? Does access to the patient record actually tell us anything new about the history of psychiatry? And if we did have them, what can, or should we do with them? In the push to both decolonize and personalize the history of psychiatry, as well as make some kind of account or reparation for past mistakes, how can we proceed in an ethical manner that respects the privacy of people in the past who never imagined their intensely personal psychiatric encounter as subject for future historians? In this paper, we want to think through some of the issues that we deal with as white historians of psychiatry especially at the intersection of privacy, ethics, and racism. We present our thoughts as a conversation, structured around questions we have posed for ourselves, and building on discussions we have had together over the past few years. We hope that they act as a catalyst for further discussion in the field.     

Art as Neglected ‘Text’ for the Study of Gender and Religion in Africa

The visual and performing arts in Africa provide unique opportunities not just for the reinforcement of gender differences but also for the subversion or transcendence of those differences to ensure societal harmony. A close reading of the various forms of artistic expression provides valuable data on women’s perceived mystical powers—procreation, metaphysical knowledge and intimate communication with the spirit world as well as their social and religious status.