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More on anti-Social Personality disorder

8/3/2024

Val's Take/Conjecture

Researchers around the world are viewing Anti-Social Personality Disorder as related to ADHD.

Maternal immune activation and neuroinflammation in human neurodevelopmental disorders (2021)

Epigenetics and Neuroinflammation Associated With Neurodevelopmental Disorders: A Microglial Perspective (2022)

Mitochondrial complex I activity in microglia sustains neuroinflammation (2024)

Academic Proposal that Anti-Social Personality Disorder is a Neuro-Developmental Disorder

We have had a tortured view of human behavior and "mental illness" ---- there are the BIOLOGICALLY-BASED MENTAL ILLNESSES and the "OTHERS" that are not biologically-based.

Is that right? I don't think so.

To come to terms with the BIOLOGICAL BASIS of BEHAVIOR and the influence of the ENVIRONMENT on BIOLOGY and FUTURE GENERATIONS --- that is a lot and it is fraught with peril.

We have made many steps along this road, and we need to start addressing the person (often a boy or a man) with an IQ over 70, a neuro-developmental disorder and behavior challenges.

The DSM 5, the Biological Basis of Behavior & the Need for Mitigation

Microglia: Key players in neurodevelopment and neuronal plasticity (2018)

Highlights

Microglia originate in the embryonic yolk sac and migrate to the brain during prenatal development.

    Microglia survey the brain through expansion and retraction of radial processes, and are essential for normal brain development and function.

    In addition to maintaining homeostasis and responding to CNS injury, microglia regulate synaptogenesis, neuronal maturation and activity.

    Adult microglial function can be programmed by developmental insults.

    Microglial dysregulation is associated with brain aging, neurodegeneration and a range of brain pathologies.

The Complex problem of "Reasonable accommodations" for slow Processors

7/16/2024

Val's Take/Conjecture

I will be posting some traditional accommodations.
But what I'm really trying to get at is the complexity of Neuro-Developmental Disorders and Hyper-Connected Brains.
This does require Precision Medicine or at the very least Individual Assessment.
That individual Assessment has to include both STRENGTHS and WEAKNESSES.
Not all people with Neuro-Developmental Disorders are Savants, but a significant percentage have some abilities above the norm.

Associations between ADHD traits and self-reported strengths in the general population (2024)

Results: We found positive correlations between ADHD traits and hyperfocus, sensory processing sensitivity, and cognitive flexibility.

Cognitive profiles of children with autism spectrum disorder with parent-reported extraordinary talents and personal strengths (2022)

The high number of children with skills in this study underscores the need for more research in this area, particularly using instruments focused on understanding the nuances of these strengths.

It is important for future studies to consider these skills in children with cognitive impairment.

Impact of maternal immune activation and sex on placental and fetal brain cytokine and gene expression profiles in a preclinical model of neurodevelopmental disorders. (2024)

"Maternal inflammation during gestation is associated with a later diagnosis of neurodevelopmental disorders including autism spectrum disorder (ASD). However, the specific impact of maternal immune activation (MIA) on placental and fetal brain development."

Those who were sad had rapid improvements in mood when they utilized their strongest skills.

---Jan. 23, 2022

So on the one hand it is critical to get the person in their strongest skills --- which can be quite high despite slow processing.

On the other hand, slow processing is often idiosyncratic processing that does bring practical and emotional challenges.

Often Overlooked: Slow Processing Speed

Yulika Forman, PhD, LMHC

Forman makes the point that processing speed issues can often look like Executive Functioning Issues.
Many highly intelligent people have slow processing speed and need environments that can accommodate both the slow processing speed and the intelligence..
- This requires a lot of self knowledge that many of us just didn't have.
See also Careers for People with Slow Processing Speed

the Neuro-deveLopmental-Psychiatric continuum, Epigenetics &the Criminal Law

7/2/2024

Val's Take/Conjecture

Somebody is going to make a great documentary about the mess in Criminal Justice and Forensic Psychiatry in 25 years.
In the meantime, we need to start educating ourselves about large scientific anomalies that are raising reasonable doubt about how we handle situations involving People with Neuro-Developmental Disorders not only in the Criminal Law but also Homelessness.

It is this century that researchers refer to the Neurodevelopmental - Psychiatric Continuum and that is considered a significant Paradigm Shift.

Ultimately we need to get rid of Punishment not Safety -- and that Safety Burden will often be higher than that imposed by punishment.

As biomarkers become more and more available, it is going to be harder and harder to deny people the supports they need.

Additionally, I think as more directly practical and helpful supports are identified, more people will be interested in "treatment."

EPIGENETICS

The Epigenome in Neurodevelopmental Disorders (2021)

EXPOSOME

Exposome of attention deficit hyperactivity disorder in Taiwanese children: exploring risks of endocrine-disrupting chemicals (2021)

INFLAMMASOME

NEURODEVELOPMENTAL-PSYCHIATRIC CONTINUUM

PRECISION MEDICINE

Neurodevelopmental Disorders, Criminality, and Criminal Responsibility (2022)

{S}pecific training in NDs {Neurodevelopmental Disorders} is limited both in general psychiatry residencies and forensic psychiatry fellowships, this topic represents a common practice gap among forensic examiners.

The paper above, published in the Journal of the American Academy of Psychiatry and Law, begins to raise some important issues regarding Neuro-Developmental Disorders and Criminal Justice.

Additionally, medical assessments of the law tend to be simplistic and timid and a deeper analysis asking tougher questions is not so much side-stepped as not appreciated --- which is perhaps understandable.

On the other hand, psychiatry seems far behind the research in its own domain -- that is surprising until one realizes most medical professionals are not on top of the research.

Further, most attorneys are not looking to become experts in the scientific research --- so if Forensic Psychiatry is behind so too are the attorneys who rely on its practitioners.

While the authors missed a lot, this nonetheless is HUGE.

Neurodevelopmental Disorders in the Criminal Law (and Homelessness) are the Elephant in the Room.

Even a dog distinguishes between being stumbled over and being kicked

The Structure of Legal Revolutions

Psychiatry & the Criminal Justice System: Simplicity on the near side of complexity

Beyond the dsm 5 to new paradigms

4/27/2024

Val's Take

Attempted suicide is not a crime in most Western Countries, but it can serve as the basis for a Mental Health Certification.
Homicidality is a much more complicated issue -- and I suspect we will find bio-markers for that as well.
Dangerousness can also serve as a basis for a Mental Health Certification --- but what is mental health and what's not is very subjective in 2024.
If "Anti-Social Personality Disorder" is really a form of ADHD according to some academics and researchers--- that matters.
We're at a little bit different place than just saying logically the DSM 5 doesn't hold up --- some stronger, biologically based paradigms seem to be emerging.

Decriminalization of attempted suicide law: Journey of Fifteen Decades (2015)

Internationally, Germany, in 1751, was the first country to decriminalize attempted suicide.

After the French revolution, all countries of Europe and North America subsequently decriminalized suicide.

n 1983, the Roman Catholic Church reversed the canon law that prohibited proper funeral rites and burial in church cemeteries for those who had committed suicide.

All of these developments have been instrumental in shifting attitudes about suicide in modern society.

Some countries like Scotland never considered suicide a crime and had no law for the same.

India recently announced the decriminalization of suicide, but its neighboring countries Pakistan, Bangladesh, Malaysia, and Singapore among others still continue to consider suicide a crime.

How Many Angels Can Dance on the Head of a Pin and the Free Will vs. Determinism Debate

What is it going to take to get Mental Health Clinicians (and other clinicians) on top of the research?

the current general estimate to get new understandings from the researcher to clinician is 17 years.
that wasn't good enough for Covid
we don't have a SYSTEM of TRANSLATIONAL RESEARCH in this country that can bring clinicians up to speed in 6 months to a year.
further, so many mental health professionals are busy chopping in the wrong forest with an unabated Mental Health Crisis--- they don't have time to incorporate significant new understandings.
It is easy enough to say that Researchers are far ahead of the Clinicians --- BUT THE RESEARCHERS ARE BEING PAID TO DO IT.
- and that is a huge issue in this society.
- Further, information overload is such a big issue and such a problematic issue in medical research that we can't expect Clinicians to solve this on their own.

Mitochondria Dysfunction --- is a hot topic for several complicated health issues, including the Neuro-Developmental/Psychiatric Continuum. See video below.

See also Val's Tables.

Douglas C. Wallace, Ph.D.
Director, Center for Mitochondrial and Epigenomic Medicine (CMEM) Professor, Department of Pathology & Laboratory Medicine
The Children's Hospital of Philadelphia

A Mitochondrial Etiology of Common Complex Diseases

Disability Law Colorado and an Important settlement

4/20/2024

Val's Take: Building out the high end of the Continuum of Care in Medicaid Mental Health has been a fraught process.

D.J. Jaffe of the Mental Illness Policy Organization documented that in his book "Insane Consequences: How the Mental Health Industry Fails the Mentally Ill." I think advocates see a lot more common ground than they did 10 years ago.

Right now the scientific understandings are evolving quickly and they don't quite look like the DSM 5. In another 10 years, Mental Health could be a much more standard medical discipline in which patients, families, Medicaid, private insurance, and the community at large would pay for medical care that included metabolomic biomarkers.

Settlement expected to significantly improve intensive behavioral health services for Colorado youth receiving Medicaid

Pollution, damage to mitochondria and mental Ill Health

4/18/2024

The lung microbiome regulates brain autoimmunity (2022)

"Our data demonstrate the existence of a lung-brain axis in which the pulmonary microbiome regulates the immune reactivity of the central nervous tissue and thereby influences its susceptibility to autoimmune disease development.

P erspective: Cell danger response Biology-

The new science that connects environmental health with mitochondria and the rising tide of chronic illness (2020)

PBS NewHour
Why air quality is getting worse in many places and how it puts human health at risk

2:24: Ultra Fine Particles able to penetrate cell mitochondria.

Harvard
How Air Pollution Affects Our Brains

Beefing up biomarkers and Continuums of care to address public concerns

4/6/2024

George Brauchler

‘Incompetence’ as a cover for criminals to walk free

Val's Take

Well, Brauchler has a very provocative title to his opinion piece.
I don't agree with it AND I'm glad he wrote it.
Mental Health generally and Forensic Psychiatry specifically need to move to BIOMARKERS where possible --- and more and more are available.
Additionally, "incompetence" should not be a cover for someone walking free ---
- We have to have a robust CONTINUUM of CARE, especially at the higher end.
  - If the State isn't providing that and the State is not ---
  - That needs to be addressed directly and FUNDED.

Metabolomic Biomarker Signatures for Bipolar and Unipolar Depression (2023)

Counties are the ones who are bearing the burden of people with mental illness in jails.

On the other hand it is States like Colorado who never caught up after DE-INSTITUTIONALIZATION in the 1960s and 1970s that need to FULLY FUND the Continuum of Care.

Now in 2024 and many more people, we don't have the bed space, housing or intensive services that we need --- although we have some bed space, housing and intensive services.

saying goodbye to the non-biological mental illness

Coming to terms with not only biologically based mental illness, but human behavior

Neuro-Diversity in Justice

4/6/2024

Val's Take

My observation has been that there is a lot of Neuro-Diversity in Criminal Justice on all sides.
Certainly in Brittain, this is being openly talked about and there have been some government reports issued with respect to criminal defendants.
Getting this out on the table so we can learn from one another is important.

ADHD Chatter Podcast
The Shocking Link Between ADHD And Crime. 2 Policemen Open Up! - Carl Mumford & Daley Jones

The Bizarre Intersection between Law & Giftedness --- Adulting with Exceptionalities In the Criminal Justice System

Dyslexia, HoMelessness & Justice-Involvement

3/29/2024

Val's Take/Conjecture

Maternal Immune Activation and Neuro-Diversity are not that new.
Our appreciation of what is going on is linking back to 'Aristotle.
There are a lot of different aspects to neuro-diversity
- It may come in the guise of Dyslexia, Dyspraxia, Dysgraphia, ADHD, Autism, Giftedness, OCD, etc.
My experience is that a great deal of human suffering is wrapped in having that "Genius" but often struggling in ways that do not seem "REASONABLE."

Getting a MORE BALANCED VIEW of these STRENGTHS & CHALLENGES might be something the Ancient Greeks could appreciate.

Having PARADIGMS that ACTUALLY REFLECT REALITY--- is also CALMING.

I can't pretend anymore that I don't know more than most people "in some respects."

BUT I also can't pretend anymore that the CHALLENGES that I have (that many people don't have) --- don't exist --- THOSE CHALLENGES DO EXIST.

“Too Far Gone”: Dyslexia, Homelessness, and
Pathways to Drug Use and Dependency (2016)

Strength-Based Approach

Common challenges for many neuro-diverse people across wide swathes of the "SPECTRUM," include:

Fatigue
Emotional Responses that are Greater than the Norm
And Pain Responses that are greater than the Norm.

This is fairly problematic, especially if these challenges are not perceived as "REASONABLE" --- which they often are not.And people push themselves and other people, and are getting pushed beyond their limits, and the consequences can be quite disastrous.

Neurodivergent Rebel
Setting and Maintaining Healthy Boundaries

High IQ and Psycho-Neuro-Immunology

Overcoming the Challenges & Realizing the Gifts of Dyslexia

Reading Disorders and Psychiatric Co-Morbidity

I think there are a lot of Neuro-Diverse people who wouldn't necessarily see themselves as having a problem with READING, BUT they might be somebody in which VISUAL-SPATIAL thinking is difficult or auditory processing----

or something else

An important point is that who gets to STRUCTURE THE ENVIRONMENT has been very important and people typically structure it to suit themselves.

I've been in environments in which I've THRIVED and I've been in environments in which I've WITHERED and there was A LOT MORE TO THAT than I appreciated at the time and that the people around me appreciated.

As an adult, I saw that in my own children who have their own DIFFERENCES and need ENVIRONMENTS that work for them.

To me, this is a JUSTICE ISSUE.

Imperfect Knowledge, Proof Beyond a Reasonable Doubt & Punishment

3/26/2024

Val's Take/Conjecture

Certainly Christianity historically struggled with the image of Jesus as a harsh Judge or a loving Judge providing Salvation.
With the advent of the Modern Age ---- the "Meritocracy" has largely taken over as the "Judge" today ----
- For those who have lived through it, it's flaws are rarely acknowledged.
- Another big fly in the ointment is recognizing that DEVELOPMENTAL ISSUES of the Neuro-Developmental/Psychiatric Continuum as well as "Brain Injuries" are HIGHLY RELEVANT to:
  - Metabolism
  - the Endocrine System
  - the Microbiome
  - the Immune System
  - the Nervous System, and
  - Behavior

Conservatives and Liberals often have radically different views of Criminal Justice and some of them do seem to go back to dueling ideas of Jesus as Judge.

One of the BIG CONCERNS that I have is that we seem to be unable to deal ethically with our own IGNORANCE.

"Come back to me when you've got this all figured out."

The problem is that kind of CERTAINTY is often quite "BRITTLE" and that it seems to me is where we are at with the Mental Health Profession and Criminal Justice.

Smarthistory
"The Harrowing of Hell" --- 1440-70

The BETTER THE SCIENCE is the BETTER THE SYSTEM OF JUSTICE.

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Transitional/ Translational Justice Monday

More on anti-Social Personality disorder

The Complex problem of "Reasonable accommodations" for slow Processors

the Neuro-deveLopmental-Psychiatric continuum, Epigenetics &the Criminal Law

Beyond the dsm 5 to new paradigms

Disability Law Colorado and an Important settlement

Pollution, damage to mitochondria and mental Ill Health

Beefing up biomarkers and Continuums of care to address public concerns

‘Incompetence’ as a cover for criminals to walk free

Neuro-Diversity in Justice

Dyslexia, HoMelessness & Justice-Involvement

Imperfect Knowledge, Proof Beyond a Reasonable Doubt & Punishment

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