New Understandings Matter


New Understandings are Raising Reasonable Doubt about our handling of "Anti-Social Personality Disorder" and Neuro-Developmental  Differences and Psychiatric Disorders in the Criminal Justice System

  •  Neuro-Developmental Differences and Psychiatric Disorders are "BLURRED."
  •     Neuro-Developmental & Psychiatric Disorders do involve the BRAIN --- but they also involve the Immune System, the Microbiome, the Endocrine System, the Metabolism, etc.
  • Maternal Immune Activation is associated with Neuro-Developmental and Psychiatric Disorders and can alter ADULT BEHAVIOR.
  •     New FIELDS of Study are Emerging:  Immuno-Psychiatry, Psycho-Neuro-Immunology, Psycho-Neuro-Endocrinology.
  • We need COLLABORATIVE MEDICAL GROUPS including not only traditional Psychology & Psychiatry but also Immunology, Gastroenterology, Endocrinology, etc. 
  • In addition to the HARD SCIENCE Medical Disciplines above, the HUMANITIES --- those DISCIPLINES that help facilitate the DUAL NEEDS of SELF EXPRESSION and SOCIAL BONDING are not irrelevant to health and some places including King's College London are specifically including them in their HEALTH PROGRAM. (See the Centre for Humanities & Health).
  • As a society we've been fascinated by the COMPLEXITIES OF THE BRAIN --- and it appears to be even more complicated with many BI-DIRECTIONAL RELATIONSHIPS between and among DIFFERENT SYSTEMS of the BODY.
    • THIS MATTERS.
  • Even if the American Psychiatric Association has not disavowed the DSM and doesn't have a replacement, Attorneys & Judges cannot ethically go a long with the "DIAGNOSTIC FUDGING" in the Criminal Justice System. 
    • We're critical of the Psychiatric & Psychological Disciplines --- but the fact is they have been carrying the load of at least 3 or 4 other Medical Disciplines in addition to their own.
    • It's no wonder they are exhausted, this has not quite worked out for either professionals or patients and the progress is slow on our Mental Health Crisis.
  • The US Criminal Justice System requires the Highest Burden of Proof in our Society --- Proof Beyond a Reasonable Doubt.
    • WE'RE NOT THERE.
Appendix A
History of "Personality Disorders"
The author of the blog to the right is an acclaimed Historian of Psychiatry and details the "HISTORY" of "PERSONALITY DISORDERS" and questions their validity.

The questioning is based primarily on the idea that people with personality disorders are just people who can't get it together.

Based on the new research, that could be people with Neuro-Developmental Disorders with Executive Functioning Challenges that are flying under the radar because they have an IQ above 70.

To me, we have "REASONABLE DOUBT" about:
  • DSM Categories
  • Personality Disorders, Anti-Social Personality Disorder specifically
  • The Assumption behind "MENS REA" --- which the BIOLOGICAL BASIS Of BEHAVIOR is UNDERMINING

With regard to MORAL HAZARDS ---- I think they are most pronounced when we have a SYSTEM based on PUNISHMENT but the RATIONALE for PUNISHMENT is no longer valid.
  • However, the MORAL HAZARD concerns are greatly MITIGATED if we're moving towards getting out of PUNISHMENT and focusing MORE on SAFETY ---
    • That potentially could get us out of PROOF BEYOND A REASONABLE DOUBT with regard to MENS REA --
      • Although keeping proof beyond a reasonable doubt for the ACTUS REUS --- or the acts that constitute the elements of the crime
    • and under a PUBLIC HEALTH APPROACH --- theoretically INCREASE SAFETY.
 
  • This may sound EXTREME --- but we have BIG LOGICAL & LEGAL PROBLEMS with "PUNISHING" people with Neuro-Developmental Disabilties and other Cognitive Disabilities.
    • IT'S NOT RATIONAL --- even as providing for SAFETY is RATIONAL.
Appendix B
Neuro-Developmental / Psychiatric Disorder Continuum
The Future of Psychiatry and Neurodevelopmental Disorders

A paradigm shift is now taking place in psychiatry with the emphasis on neurodevelopmental disorders with a neurobiologic emphasis and early onset including ...
APPENDIX C
IMMUNE SYSTEM & Cognitive Disability

APPENDIX D
THE ENDOCRINE SYSTEM & Cognitive Disability
APPENDIX E
The MICROBIOME & Cognitive Disability

Val's NOTE/Conjecture:  Improved Diet probably can help, but in 2022 in many cases I think it will not completely resolve the effects of DEVELOPMENTAL SYSTEMIC INFLAMMATION.

Now, a lot of research is going on and important gains have been made -- for example learning how to reverse food allergies.

BUT SYSTEMIC DEVELOPMENTAL INFLAMMATION may bring pervasive challenges affecting multiple systems of the body as well as some gifts.

The Anna Karenina Principle coined at Oregon State University recognizes that dysregulated microbiomes tend to be dysregulated in their own ways.

This really brings back the need for PRECISION MEDICINE and how half-right categories are NOT GOING TO SUFFICE.

I don't think that means nothing can be done --- one of the important things is getting a more accurate view of the causes of neuro-developmental and psychiatric challenges often involving SHARED GENES and MATERNAL IMMUNE ACTIVATION, IMPACTING AMONG OTHER THINGS EXECUTIVE FUNCTIONING.

""AWARENESS IS KEY --- AWARENESS MAKES THINGS BETTER ALREADY"  ---- Ellen Braaten, Ph.D, Director of Learning and Emotional Assessment Program, Massachusetts General Hospital.

The combination of RAMPED UP STRESS RESPONSES, EXECUTIVE FUNCTIONING CHALLENGES, SOME GIFTS and EPIGENETICS is a FRAUGHT COMBINATION.

On the plus side, with so many systems of the body implicated --- there are numerous avenues for potential treatments --- such as the microbiome.

We don't want to OVER-ESTIMATE what is required --- but we don't want to UNDER-ESTIMATE what is required or MIS-ESTIMATE based on PARTIAL UNDERSTANDINGS that have proven insufficient.
APPENDIX F
A SCIENTIFICALLY INVALID DIAGNOSTIC MANUAL


There are LOGICAL & ETHICAL PROBLEMS associated with trying to use a scientifically invalid diagnostic manual as our DICTIONARY.  
APPENDIX G
Anti-Social Personality Disorder
2-pager on Anti-Social Personality Disorder
  • Research Re-Conceptualizing the Diagnosis as a Neuro-Developmental Disorder
  • Some Innovative Legal Practices specific to addressing offenders diagnosed with "Anti-Social Personality Disorder"