​TRANSLATIONAL/ ​TRANSITIONAL JUSTICE MONDAY

The Challenge of dealing with the inequities in mental Health without scapegoating

5/23/2025

Val's Take/Conjecture

What I most appreciate is a relatively newer mantra by researchers saying we need PRECISION MEDICINE --- the right treatment, at the right time, for the right patient.

That is no easy trick in Mental Health whose patients are often NEURO-DIVERSE.
- Neuro-Diverse people are more different from one another than Neuro-Typical people are different from one another.

The APA (American Psychiatric Association) Foundation helped to fund a NOVA episode on the "Mysteries of Mental Illness."

The APA Foundation could be helpful in engaging National and Local News Outlets on the RAMIFICATIONS of emerging research to public policy, especially with regard to Homeless and Justice-Involved people.

The Menninger Clinic
Dr. Peter Fonagy --- Improving the Delivery of Mental Healthcare in the U.K. (2013)

Dr. Fonagy is talking about getting Research to the Clinicians ---- FASTER.

Fonagy also makes the point that mental health patients PUT UP WITH more bad treatment quality than most patients.

No Good Deed goes unpunished

Personality Disorders, Developmental Differences --- Conceptualization Matters and It Matters A Lot in the Criminal Law

Why the dsm 5-TR fails --

5/17/2025

Val's Take/Conjecture

Metabolome subtyping reveals multi-omics characteristics and biological heterogeneity in major psychiatric disorders (2023)

*Chinese Researchers

Abstract

Growing evidence suggests that major psychiatric disorders (MPDs) share common etiologies and pathological processes.

However, the diagnosis is currently based on descriptive symptoms, which ignores the underlying pathogenesis and hinders the development of clinical treatments.

This highlights the urgency of characterizing molecular biomarkers and establishing objective diagnoses of MPDs.

Here, we collected untargeted metabolomics, proteomics and DNA methylation data of 327 patients with MPDs, 131 individuals with genetic high risk and 146 healthy controls to explore the multi-omics characteristics of MPDs.

First, differential metabolites (DMs) were identified and we classified MPD patients into 3 subtypes based on DMs.

The subtypes showed distinct metabolomics, proteomics and DNA methylation signatures.

Specifically, one subtype showed dysregulation of complement and coagulation proteins, while the DNA methylation showed abnormalities in chemical synapses and autophagy.

Integrative analysis in metabolic pathways identified the important roles of the citrate cycle, sphingolipid metabolism and amino acid metabolism.

Finally, we constructed prediction models based on the metabolites and proteomics that successfully captured the risks of MPD patients.

Our study established molecular subtypes of MPDs and elucidated their biological heterogeneity through a multi-omics investigation.

These results facilitate the understanding of pathological mechanisms and promote the diagnosis and prevention of MPDs [Major Psychiatric Disorders].

Shared Genes & Psychiatric Disorders

DSM-5-TR: overview of what’s new and what’s changed (2022)

"The American Psychiatric Association continues to welcome empirically-grounded proposals for change. Guidelines for submitting such proposals can be found at www.dsm5.org."

If the APA is not embracing the "underlying biology" --- it is making an attempt to endorse "empiricism."

Further, there does seem to be a recognition that the DSM 5-TR is not the last word --- and that is a good thing.

Additionally, the APA is working on DSM 6.

What is missing are the more fundamental criticisms of the DSM and a loss of "Faith" as a result of "Empiricism" in the category structure --- even with some updates.

Precision Psychiatry Is the Future. Europe Can Lead the Way (2023)

"Today, the field is held back by a nosology that has good inter-rater reliability, but that has seen no validation of any diagnostic entity by specific biomarkers that would inform diagnosis, possibly irrespective of existing diagnostic entities.

"The lack of progress in the development of drugs is largely due to the fact that patients are seldom prescreened for specific biomarkers before being included in clinical trials.

"Neither are they commonly prescreened for the pathology, subgroup, and/or dimensions of interest to potentially respond to a specific drug.

"Both clinicians and regulatory agencies still work under the notion of “one size fits all,” which has induced errors and failures of clinical trials in past decades."

[This is ironic --- Rice University is in Texas]

Towards a consensus roadmap for a new diagnostic framework for mental disorders (2024)

"In general, the meeting indicated a crucial need for a biology-informed framework to establish more precise diagnosis and treatment for mental disorders to facilitate bringing the right treatment to the right patient at the right time."

RFK JR., Autism --- and A Maternal Immune Activation Hypothesis

5/15/2025

Researchers actually already know a lot more about autism than They did --- even though it is not common knowledge

Val's Take/Conjecture

RFK Jr. is not wrong to be interested in addressing "autism."
Many researchers around the world are trying to address Neuro-Developmental & Psychiatric Disorders, and there is often a blurring and overlap.

Developmental Inflammation seems to be often involved with Neuro-Developmental & Psychiatric Disorders.

Well what causes Developmental Inflammation --- a lot of things.
- That's one of the reasons why researchers talk about "MULTI-FACTORAL" causes for Neuro-Developmental and Psychiatric Disorders.
- Further, that Developmental Inflammation can affect GENE EXPRESSION and EPIGENETICS.

At least some of what seems to be happening in utero during Maternal Immune Activation is dysregulation of MICROGLIA --- the Brain's Innate Immune Cells

Maternal Inflammation During Pregnancy and Offspring Brain Development: The Role of Mitochondria (2022)

[A]lterations in mitochondrial structure/function due to MIA may be programmed and, hence, can persist over the life span."

"Thus, in addition to the effects of MIA-induced alterations in mitochondrial function on the developing brain, these mitochondrial alterations may continue to exert long-term effects on the brain (and other systems) over the life span of the individual."

If we really want to provide better treatments for Neuro-Developmental & Psychiatric Disorders ---

the public, policy-makers and clinicians need a better understanding of the research that is already there.
more educational and translational medicine support is desperately needed.

Dr. Chris Palmer
Autism: Disorder, Disability or Difference

Palmer makes the point that genetics is not necessarily the biggest factor --- but individual issues during neuro-development in utero.

That would be consistent with the Maternal Immune Activation Hypothesis of Neuro-Developmental and Psychiatric Disorders.

Further, Paternal Immune Activation has also been recognized.

Resveratrol prevents offspring's behavioral impairment associated with immunogenic stress during pregnancy (2025)

*Brazilian Researchers

Does maternal immune activation dysregulate mitochondria in microglia?
(April 27, 2025)

Yes, maternal immune activation (MIA) can dysregulate mitochondria in microglia.

. . .

MIA activates microglia, the brain's immune cells, leading to the release of proinflammatory cytokines.

Mitochondrial Dysfunction:

This microglial activation can disrupt mitochondrial function in microglia, potentially leading to oxidative stress, altered mitochondrial membrane potential, and changes in mitochondrial protein expression.

. . .

Mitochondria as a Target and Mediator:

Mitochondria are not only affected by inflammation but can also contribute to the inflammatory process by releasing mitochondrial DAMPs, which can activate the inflammasome and further amplify inflammation.

Consequences for Brain Development:
.
Mitochondrial dysfunction in microglia, particularly during the critical window of brain development, can have consequences for neurodevelopment and increase the risk of neurodevelopmental disorders.

. . .

This is for informational purposes only. For medical advice or diagnosis, consult a professional. Generative AI is experimental.

The DSM 6 and Federal Rule of EVidence 407 ---Subsequent remedial Measures

5/15/2025

Val's Take

By and large, mental health patients and/or Defendants are not interacting directly with the American Psychiatric Association (APA).
- They are interacting with a Clinician and/or Forensic Evaluator.

When people complain to me of the medical model --- I say what medical model --- It's a Sham Medical Model at Best

The Need for a new Integrated DSM

In 2013, the National Institute of Mental Health (NIMH) said the DSM 5 ----- "lacked validity."

The DSM 6 is expected to be out by 2028 --- and there seem to be some highly significant REFORMS.

Transforming DSM-6 Development: A Call for Integrated Approaches and Cautious Innovation (2025)

By Dr. Steven E. Hyler
Professor Emeritus of Psychiatry at Columbia University Medical Center

Key Takeaways

AI and digital platforms can revolutionize DSM-6 development, enabling real-time updates and broader participation through a Wiki-D platform.
AI integration can bridge DSM and RDoC frameworks, supporting personalized medicine and continuous updates, enhancing diagnostic accuracy.

This article argues for greater use of technology in the DSM 6.

Part of the problem in previous DSMs has been that the APA didn't have the technology to keep up with the research --- and it's been EXPLODING the past several years --- BUT not necessarily getting to the clinicians or the patients.

NIMH Delivers a kill shot to the DSM 5

Burden of Proof

But this is NOT just about TECHNOLOGY.

This is about a medical professional organization struggling with major re-conceptualizations of "Mental Disorders" based on newer scientific discoveries and research.

A lot of this struggle is political.

Perfectionism and an out-of-date DSM -- We need Interim Procedures

The DSM Criminal Justice Wheel of Fortune

Conceptualization Matters --- It Matters a lot in the Criminal Justice System

Hair Analysis, Psychological Analysis

Law Professor Wes Porter at Golden Gate University Law School, former US Dept. of Justice Attorney

Federal Rules of Evidence (FRE) Rule 407 - Subsequent Remedial Measures

Harvard Law Review Sounds the Alarm on the "Anti-Social Personality Disorder" Diagnosis

The Evolution of Psychiatric Diagnosis: From DSM-5 to DSM-6 (2024)

By Emily Thatcher
Department of Psychiatry, Harvard University

"Advancements in neuroscience and genetics have profound implications for psychiatric diagnosis.

The DSM-5 began to incorporate findings from these fields, although it was constrained by the limits of contemporary research. [Val's Note: That was not the only problem.]

"As scientific understanding continues to evolve, the DSM-6 is poised to integrate more robust neurobiological data, enhancing the precision and reliability of diagnoses.

"This integration may involve the inclusion of biomarkers and genetic information, providing a more detailed picture of mental health disorders.

[Val's Note: Metabolomic Biomarker Signatures for Bipolar Disorder and Unipolar Depression --- JAMA Psychiatry (2024)]

"For example, genetic predispositions and neuroimaging findings could become part of diagnostic criteria, offering objective measures alongside clinical assessments.

Such developments promise to refine diagnoses, enable personalized treatment plans, and improve outcomes for patients.

"The categorical nature of the DSM has often been criticized for its limitations in capturing the complexity of mental health disorders, which frequently exist along spectrums rather than within discrete categories.

"The DSM-5 made some progress towards dimensional approaches, particularly with the introduction of severity specifiers for various disorders.

"The DSM-6 is likely to further this dimensional approach, recognizing that many psychiatric conditions are not binary but exist on a continuum."

Justice Delayed is Justice denied --- and an out-of-Date DSM

5/11/2025

Val's Take: I'm posting this for some contradictory reasons.

The research on Neuro-Developmental & Psychiatric Disorders ---- it is ON THE RISE --- and "YOU CAN'T STOP IT."

But one could certainly DELAY new paradigms from getting to clinical practice. This isn't about prematurely adopting experimental treatments.

This is about UNDERSTANDING the SIGNIFICANCE of major paradigm shifts at the Research Level across the Globe that are making current approaches and the DSM 5 untenable.

Beyond that, these paradigms and research have LEGAL RAMIFICATIONS.

Burden of Proof

New Understandings Matter

"Perfectionism" and the Failure to Address an Out-of-date DSM --- We need Interim Procedures

The "JUSTICE" of an accurate understanding of neuro-Developmental & Psychiatric Disorders

5/5/2025

Whole System Developmental Premature Aging

Val's Take/Conjecture

With Maternal Immune Activation --- we have a mechanism for:
- Neuro-Developmental and Psychiatric Disorders, as well as
- Whole System, Developmental Premature Aging.

Can ENERGY issues as the result of Dysregulated Microglia --- drive problematic lifestyle issues?

We do have many new books and articles printed by major scientific publishing Houses such as Springer, Wiley, Nature and Oxford Press ---

addressing the emerging Biological/Cellular Basis of Neuro-Developmental, Psychiatric and Neuro-Degenerative Disorders.

Maternal immune activation imprints translational dysregulation and differential MAP2 phosphorylation in descendant neural stem cells (2025)

Is Schizophrenia a Disorder of Accelerated Whole-System Aging? (2024)

Val's Take/Conjecture

Maternal Immune Activation (MIA) alters gene expression.
MIA dysregulates microglia, astrocytes and other glial cells.
That dysregulation of glial cells is a form of premature aging.

Neuro-Tribe Blues

5/2/2025

Robert Johnson and Playing for Change cover featuring Keb' Mo'
Walking Blues

Val's Take: I love Playing for Change. One of the things I love is that they feature musicians from all over the world. Music is often seen as a Universal Language.

Science can also be a kind of Universal Language. It is amazing to me that Researchers around world --- are getting on the same page with regard to Neuro-Developmental and Psychiatric Disorders.

That doesn't mean there aren't still questions.

On the other hand, Researchers and Clinicians are not necessarily on the same page.

Certainly, the UK has recognized this disconnect --- I don't know that they have completely solved it.

It seems to me that Researchers around the world may have found their Neuro-Tribe. Maybe that is true for Clinicians around the world -- I'm not sure.

But we need these Neuro-Tribes to work together.

Research is Everybody's Business

The Last thing on my mind & Steadily growing weeds in Mental Health

4/29/2025

Val's Take: Tom Paxton grew up in my home state of Oklahoma and he is a favorite in Folk Music. He was certainly a favorite of my late husband Rick and this song was a particular favorite.

Further, there is something Universal about what Paxton is singing about --- you could arrange it in other genres including Country.

There is no limit to personal interpretations one could bring to this.

I am going to take it --- in a little bit different direction.

"The Weeds Have Been Steadily Growing" in Mental Health because it has not been sufficiently well grounded to the Underlying Biology.

Is this the result of Maliciousness or even Negligence --- well, there are a lot of factors that have played into this.

One of the biggest factors is IGNORANCE --- "They Know Not What They Do." A lot of people in Mental Health today did not get into it to be "Neuro-Immunologists." That is a problem.

Now many professionals might be willing to go in different directions if they had the proper support.

There are other problems across the board --- but in Criminal Justice the Contradictions are particularly harmful.

You have a DSM that wants to disclaim liability for being used in Court --- while everyone knows it is being used in Court and some American Bar Association Criminal Justice Standards are tying themselves to the DSM.

Tom Paxton

Dolly Parton & Porter Wagoner cover

One thing leads to another

Death by Suicide in 2025

4/20/2025

Val's Take

Approximately 90 years ago my great-uncle died by suicide.
I think his family thought being born using forceps contributed to some mental health issues. I have no idea if that is true or not.

In March of this year, a member of my extended family died by suicide after several years of difficult mental health struggles.

On the one hand, I am painfully aware of the shortcomings of our current Mental Health treatments and systems.

On the other hand, I'm aware of just how frickin' complicated this is and what it is currently taking to get paradigms and treatments that are significantly better.

Individuals, families, the public and policymakers need to know that the need for more up-to-date paradigms and treatments is just as important as access.

UC San Diego

Blood Testing Identifies Biomarkers of Suicidal Thoughts (2023)

Next-generation precision medicine for suicidality prevention (2024)

"We propose that our findings and comprehensive approach can have transformative clinical utility."

International Symposium on Suicidality & Public Health

Focusing on novel neuroinflammatory biomarkers and targets in understanding and managing suicide

Drug Addiction, Microglia and Neuro-Immuno-pharmacology

4/19/2025

Val's Take/Conjecture

Less than 10 years ago, Dual Diagnosis -- psychiatric disorders and substance use were considered "2 Distinct Disorders."
That is not as true today.
Further, some Neuro-Diverse people are very prone to use particular drugs, and others are highly unlikely to use recreational drugs.

This idea of "Distinct Disorders" when it comes to Neuro-Developmental and Psychiatric Disorders started to obviously breakdown with the findings of the National Institute of Mental Health in 2013--- that 5 disorders (ADHD, Autism, Bipolar Disorder, Depression, and Schizophrenia) shared common genes and also involved immune epigenetics and calcium channels.

The breaking down of "Distinct Disorders" has also seen the rise of more sophisticated understandings of biological mechanisms such as the microbiome and glial cells and the role of innate immunity in Neuro-Developmental, Psychiatric and Substance Use Disorders as well as Autoimmune Disorders, Cancer, etc.

There is a move away from "Symptom Clusters" to "Mechanism-Based Sub-Typing."

Shared Genes & Psychiatric Disorders

All of this is highly relevant to our out-dated, half-right DSM 5 conceptualization of "Anti-Social Personality Disorder" which in the Research is now being conceptualized as a Neuro-Developmental Disorder.

Association patterns of antisocial personality disorder across substance use disorders (2024)

"The present study expands our understanding of polysubstance addiction and co-occurring mental health disorders.

"Our findings support personalized interventions targeting mechanism-based subtyping in relation to ASPD-SUD comorbidities."

Maternal immune activation and adolescent alcohol exposure increase alcohol drinking and disrupt cortical-striatal-hippocampal oscillations in adult offspring (2022)

Neuroimmune Mechanisms as Novel Treatment Targets for Substance Use Disorders and Associated Comorbidities
(2021)

Microglia in neuroimmunopharmacology and drug addiction (2024)

Affiliations

1Laboratory of Chemical Biology, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, Jilin, 130022, China.
2Department of Psychology and Neuroscience, and the Center for Neuroscience, University of Colorado Boulder, Boulder, CO, 80309, USA.
3Laboratory of Chemical Biology, Changchun Institute of Applied Chemistry, Chinese Academy of Sciences, Changchun, Jilin, 130022, China.
4School of Applied Chemistry and Engineering, University of Science and Technology of China, Hefei, 230026, China.
5Beijing National Laboratory for Molecular Sciences, Beijing, 100190, China.

Abstract

Drug addiction is a chronic and debilitating disease that is considered a global health problem.

Various cell types in the brain are involved in the progression of drug addiction.

Recently, the xenobiotic hypothesis has been proposed, which frames substances of abuse as exogenous molecules that are responded to by the immune system as foreign "invaders", thus triggering protective inflammatory responses.

An emerging body of literature reveals that microglia, the primary resident immune cells in the brain, play an important role in the progression of addiction.

Repeated cycles of drug administration cause a progressive, persistent induction of neuroinflammation by releasing microglial proinflammatory cytokines and their metabolic products.

This contributes to drug addiction via modulation of neuronal function.

In this review, we focus on the role of microglia in the etiology of drug addiction.

Then, we discuss the dynamic states of microglia and the correlative and causal evidence linking microglia to drug addiction.

Finally, possible mechanisms of how microglia sense drug-related stimuli and modulate the addiction state and how microglia-targeted anti-inflammation therapies affect addiction are reviewed.

Understanding the role of microglia in drug addiction may help develop new treatment strategies to fight this devastating societal challenge.

Substance Use Disorders Are Psychiatric Disorders (2023)

<<Previous

Transitional/ Translational Justice Monday

The Challenge of dealing with the inequities in mental Health without scapegoating

Why the dsm 5-TR fails --

RFK JR., Autism --- and A Maternal Immune Activation Hypothesis

Researchers actually already know a lot more about autism than They did --- even though it is not common knowledge

The DSM 6 and Federal Rule of EVidence 407 ---Subsequent remedial Measures

Justice Delayed is Justice denied --- and an out-of-Date DSM

The "JUSTICE" of an accurate understanding of neuro-Developmental & Psychiatric Disorders

Neuro-Tribe Blues

The Last thing on my mind & Steadily growing weeds in Mental Health

Death by Suicide in 2025

Drug Addiction, Microglia and Neuro-Immuno-pharmacology

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