Category: Ethics and Morality

feature-_lg4-470x260_1-3169d1a3d17f2d96a339b23b310942e2c89804a7

Let's Eliminate Physical Restraints in Group Homes

00Adolescence, Autism, Caregiving, Ethics and Morality, Featured news, Trauma September, 17

Source: Valentine Svensson at flickr, Creative Commons

In April 2015, Justin Sangiuliano, a seventeen-year-old diagnosed with Autism, was physically restrained at his group home in Oshawa, Canada. To control an aggressive outburst, two staff members grabbed his arms and placed him on the floor as he kicked and screamed. Staff released him once he stopped struggling, but Justin never got up. He was rushed to the hospital without a heartbeat and died five days later.

Justin’s death, and the deaths of other children in Ontario group homes, raises questions about the provincial child protection system and the efficacy of using force to restrain vulnerable populations.

The Canadian Institute for Health Information defines physical restraint as when “a person is physically held to restrict his or her movement for a brief period of time in order to restore calm to the individual.”

Ontario regulations state that physical restraints can be used to prevent group home residents from injuring themselves, injuring others, or causing significant property damage. Restraints should only be used after less intrusive methods have been applied and deemed ineffective.

But a Toronto Star investigation found that physical intervention is being used as a frequent form of discipline in these homes. The report documented that, between 2010 and 2015, some 45,000 restraints were used in Ontario residential programs to discipline vulnerable children and youth. Restraints were used in more than one third of the 1,200 serious occurrence reports filed in 2013 by group homes in Toronto.

While there may be some benefits to using physical restraint in controlling violent children, inappropriate use of these practices suggests a power and control issue among some group home staff.

The Toronto Star investigation reported an instance of a child begging to be released: “I’m going to pee myself.” The staff members refused to let go of the child until he urinated on himself.

In another study by social work professors Laura Steckley and Andrew Kendrick at the University of Strathclyde in Glasgow, Scotland, children spoke to the injuries they incurred as a result of forcible restraint:

“Half the time when residential staff restrain you they just purely hurt you. I get hurt most of the time. I had a mark from a carpet burn, hurting on my shoulder, and marks on my chest.”

Additionally, preventable deaths and high rates of physical intervention on children with developmental disabilities demonstrate inadequate training of residential staff.

In an interview with the Toronto Star, Kim Snow, an associate professor at Ryerson University’s School of Child and Youth Care, speaks to the dangers of restraining children with developmental disabilities without safe and adequate staff training:

“Although the provincial government lists six approved training programs in the use of physical restraints, no one has looked at which techniques are best. Is one safer than the other? Should one be used in certain situations and not others? Sometimes staff can’t contain kids using a restraint. So what happens when those situations occur? Until we can answer those questions, the risk of harm as a result of restraints is quite high for both staff and kids.”

As an advocate for child safety within the Ontario residential system for over three decades, Snow wants the province to track the use of restraints more closely.

“It takes highly skilled staff to work with children with histories of trauma and accompanying rage to be able to contain them without physically intervening. When people lack those skills they become frightened and they intervene much too quickly. When that happens, the child or youth’s physical and psychological safety is at risk.”

Research by the Residential Child Care Project at Cornell University addresses the physical and psychological harm that can result from restraint use on a vulnerable population. The 2008 study found restraints to be “a considerable risk to vulnerable youth, are intrusive, have a negative effect on the treatment environment, and have a profound effect on those youth who have experienced trauma in their lives.”

And a 2013 report by Youth Leaving Care, a working group created by the Ontario government to investigate the quality of care vulnerable youth receive in group homes, identified high frequency of restraint use to be a major problem, and recommended the government “works with group home providers to clarify and reinforce policies and best practices to make sure they are followed.”

So, what is being done to improve the care of children with disabilities in Ontario residential homes?

Irwin Elman, the Provincial Advocate for Children and Youth, leads a group called Youth Leaving Care that caters to young people who grew up in Ontario’s group homes.

While certain advocates of children and youth in residential homes call for improved training to properly implement restraints, Elman believes these homes should eliminate restraint altogether to limit preventable deaths.

“These are children who often come with experiences of violence or serious mental health challenges. How in hell do we expect them to achieve to their full potential, to heal, to find supportive relationships in those kinds of environments?”

–Lauren Goldberg, Contributing Writer, The Trauma and Mental Health Report. 

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller.

This article was originally published on Psychology Today

Feature-1-1-470x260-7370e314f7f46195133c383e9c06afb9539bf7e0

Prisoners Gain Understanding of Others Through Literature

00Emotional Intelligence, Empathy, Ethics and Morality, Featured news, Psychopathy, Social Life December, 16

Source: Homes and Antiques

Does reading have the ability to increase empathy? Writer and activist Alaa Al Aswany thinks so. He believes that the role of literature has been captured by the single word ‘also’ from the Dostoyevsky novel The House of the Dead, in which a prisoner, witnessing the death of another, comments “He, also, had a mother.” Aswany says that in this context, the word ‘also’ is an attempt to understand what is common to all humans, and that this understanding is the essence of literature.

Literature as a tool for human understanding and empathy… The idea has been a powerful socializing influence in a very unlikely setting: prison.

The organization Book Clubs for Inmates facilitates 22 book clubs across Canada to allow inmates in federal penitentiaries to read and discuss novels. Their slogan is‘Literacy, Self-Awareness and Empathy’. They reason that most inmates will re-enter society at some point and, by encouraging reading while in prison, the organization believes that prisoners can improve vital social skills.

Volunteers guide conversations through themes that range from self-sacrifice to overcoming adversity, and how these topics relate to inmates’ lives. Through these discussions, prisoners develop pro-social skills, such as taking turns speaking and listening, which may enable easier reintegration later on.

The Book Clubs for Inmates website claims that 85% of prisoners report improved reading skills; 90% realize improved communications skills; 93% report reduced recidivism; and 86% see the book clubs as an opportunity to engage in meaningful discussion.

One inmate expressed:

“The Book Club is an enormous source of intellectual and social—sometimes even spiritual—inspiration to both myself and the many others who attend. I have watched men in that group realize their potential to analyze and reflect that I don’t know if they even realized they had.”

Research conducted by David Kidd and Emanuele Castano at The New School for Social Research in New York provides evidence to support idea that literary fiction can enhance the capacity to understand the thoughts and feelings of others.

In their study, participants read randomly assigned texts, either non-fiction, thrillers, romance, or literary fiction. After reading, they perform a series of tasks to measure empathy, social perception, and emotional intelligence by examining how accurately the participants could identify emotions in others. For example, one task involves inferring emotion simply from a picture of someone’s eyes. Scores of empathy were significantly higher for those who had read the literary fiction.

Kidd and Castano explain this phenomenon as literary fiction’s ability to leave more to the imagination by not explaining characters’ behaviour explicitly. Readers then have the freedom to make inferences about characters’ thoughts and motivations. This kind of interpretation requires sensitivity to emotional nuance.

Kidd explains:

“In literary fiction, the incompleteness of the characters turns your mind to trying to understand the minds of others.”

Readers can then carry this awareness into the real world to understand others who are different and think differently. Kidd argues that this transference is to be expected:

“The same psychological processes are used to navigate fiction and real relationships. Fiction is not just a simulator of a social experience, it is a social experience.”

Current research in the neurosciences supports the idea that reading allows people to experience life from a character’s perspective. A study at Carnegie Mellon University found that reading a Harry Potter excerpt, in which Harry rides a broom, activates the same brain regions that would be responsible if one were to actually fly a broom. That is, readers live vicariously through the characters they read about in literary works.

Raymond Mar, a social psychologist at York University, stresses the role of fiction in teaching empathy to children as well, saying that “Even though fiction is fabricated, it can communicate truths about human psychology and relationships,” which can be very important lessons for the developing child.

Exposure to fiction can improve children’s social functioning, as well. Not only does it allow them to step into another’s shoes, improving empathy, but it helps to develop vocabulary for their feelings, allowing them to communicate more effectively. Mar viewsreading as developing their theory of mind, their ability to understand others’ thoughts, desires and motivations.

As one inmate said:

“When you’re reading books, you realize that the world’s not all about you. You’re not the only one going through these trials and tribulations. You get to have a little empathy for other people.”

–Caitlin McNair, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Feature-21-470x260-16199941c39c021ed0d6cf208a18ff2a0424f8bb

Biased Publication Standards Hinder Schizophrenia Research

00Addiction, Bias, Deception, Education, Ethics and Morality, Featured news, Psychopharmacology, Therapy September, 16

Source: Erin on Flickr

The effects of schizophrenia are profound. Characterized by delusions, hallucinations, and social withdrawal, the disorder has no known cure. The introduction of antipsychotic medications in the 1950s has helped many sufferers cope. Following diagnosis, patients usually take antipsychotics for the rest of their lives.

But recently, a 20-year study by professor emeritus Martin Harrow and colleagues at the University of Illinois found evidence to support alternative treatment methods. In fact, non-medicated patients in the study reported better community functioning and fewer hospitalizations than patients who stayed on antipsychotics.

So why do medications continue to be the most commonly prescribed treatment for schizophrenia?

Antipsychotic drugs are the largest grossing category of prescription medication in the United States, with a revenue of over $16 billion in 2010. And much of the research that exists on treatment of schizophrenia is directly funded by pharmaceutical companies, making it challenging for independent researchers like Harrow and his team to get studies published. A bias exists towards silencing unfavourable research.

An analysis looking into possible publications biases surrounding antipsychotic drug trials in the U.S. found that, of the trials that did not get published, 75% were negative, meaning that the drug was no better than placebo. On the other hand, 75% of the trials that did get published found positive results for the antipsychotics being tested.

The Washington Post wrote an article in 2012 claiming that four different studies conducted on a new antipsychotic drug called Iloperidone were never published. Each of the studies pointed to the ineffectiveness of the drug, finding that it was no more effective than a sugar pill for the treatment of schizophrenia. A publication bias like this is worrisome.

Research has also shown that staying on antipsychotic drugs for long periods of time negatively impacts brain functioning and could potentially lead to a worsening of some of the initial symptoms of the illness, including social withdrawal and flat affect.

A growing body of research is focusing on cognitive therapy and community based treatments for schizophrenia, as either a replacement for or in combination with traditional pharmacological treatments. So far, outcomes have been promising.

A study by Anthony Morrison, a professor at the University of Manchester found that patients undergoing cognitive therapy showed the same reduction in psychotic symptoms as patients receiving drug treatment. Likewise, research by psychiatristLoren Mosher, an advocate for non-drug treatments for schizophrenia, showed that antipsychotic medication is often far less effective without added psychotherapy. Onestudy by Mosher showed that patients receiving alternative community based treatment had far fewer symptoms of schizophrenia than patients who received traditional treatment in a hospital setting.

When antipsychotic medication was introduced, many hoped it would represent themagic pill for an illness previously thought to be incurable. But little was known about the long-term effects, and even today, many claims of medication efficacy or lack of side effects remain questionable.

Research in schizophrenia is burgeoning and whether a safer, more effective treatment can be developed remains to be seen. Yet for such developments to be possible, it is important for the scientific and medical communities to open themselves up to the possibility of alternative treatments instead of limiting research that challenges the status quo. While antipsychotic medications offer great benefits in terms of reducing acute positive symptoms like hallucinations or delusions, they are by no means a cure.

–Essi Numminen, Contributing Writer, The Trauma and Mental Health Report

–Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Feature2-470x260-6a09682879b9cf0b0a121faf9a2cdd5baed4afb0

Russian Adoption Laws Leave Children Warehoused and Unwanted

00Attachment, Child Development, Ethics and Morality, Featured news, Health, Law and Crime, Parenting June, 16

Source: John Manuel Sommerfeld on Flickr

It is a life of deafening silence, colourless walls, and empty corridors, a life of intense longing and disappointment. For over 600,000 children living in Russian orphanages waiting to be adopted, it is the only life they know.

In 2013, Russia passed a law to ban the adoption of orphaned children by American citizens, in part because of tense political relations between the two countries. In 2014, Russia also banned the adoption of orphans into any country that acknowledges same-sex marriage in order to “protect children’s psyche from the undesirable effects of exposure to unconventional sexual relationships.”

With these measures in place, finding homes for orphans outside the country has become very difficult.

Meanwhile, adoption within the borders of Russia faces its own set of barriers. Cultural prejudice against adoption perpetuates feelings of rejection among orphaned children and contributes to fears amongst potential adoptive parents that orphans have inherited undesirable traits and tendencies from their biological parents.

As one adoptive parent, Vera Dobrinskaya, stated in a BBC interview, many orphanage staff members discourage adoption when meeting with prospective parents. She quoted a nurse as saying to her, “Their parents abandoned them, and you want to take care of them?”

Unlike orphans in other countries, 95% of Russian orphans have at least one living parent. Often, they are taken forcibly into state custody because of family illness, disability, or poverty.

While institutions manage to provide for children’s basic physical needs, most Russian orphanages fail to take mental health into consideration. Research has shown that mass institutionalization and the absence of regular adoption practices harm children’s health and development.

To make matters worse, the interaction of staff members and children in these facilities is minimal and conducted in a formal manner, with little warmth or emotion. Daily activities like waking up, showering, dressing, and feeding are carried out in a militaristic way.

As the BBC explains, the problem of Russian orphanages is mainly in their self-identification as warehouses for unwanted children.

Georgette Mulheir, an advocate in the movement to end child abuse, explains why mental health neglect is a problem for these children in a recent TED Talk. While visiting a Russian orphanage, Mulheir reported seeing rooms lined with rows of barred beds, with children quietly gazing up at the ceiling. Newborns also lay in silence, often wearing soiled diapers but not crying, unfamiliar with the help that comes from attentive caregiving. And the head nurse proudly told Mulheir, “You see, our children are very well-behaved.”

Lacking proper stimulation and without secure attachment, many children develop odd and often self-injurious behaviours, such as rocking back and forth or banging their heads into walls. Just as healthy attachment between children and caregivers provides a sense of security for psychological, emotional, and physical development, lacking appropriate caregiving can seriously damage mental health.

As Stephen Bavolek, in the field of child abuse suggests, some of the problems these children can expect as they grow up include poor impulse control, impaired foresight, and a lack of trust in and affection for others.

Several months after the Russian adoption bans were implemented, the United Nations held a meeting to develop alternate childcare programs. Local governments within Russia were instructed to begin transferring children from orphanages to foster families.

This process, however, has encountered resistance from the institutional staff. As child rights protection activist, Maria Ostrovskaya, explains, “Institutions reject sending children into families, as state funding brings jobs and paychecks.”

The situation remains unresolved while many thousands of children wait for politicians to decide their fate. The stakes are high, as many of the children grow up with a risk of being sold into slavery, committing crimes, entering prostitution, or taking their own lives.

– Sara Benceković, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. MullerThe Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Autism, Bullying, and Psychological Impacts

An Ice Bucket, an Autistic Child, and a Cruel Joke

10Autism, Bullying, Child Development, Ethics and Morality, Featured news, Health, Law and Crime February, 16

Source: Lee Morley on Flickr

A social media campaign aimed at raising awareness for one health problem becomes the cruel vehicle by which awareness is raised for another.

On August 18, 2014, a 15-year-old autistic boy in Bay Village, Ohio was encouraged by five teenage friends to participate in what he thought would be the ALS ice bucket challenge. Instead, the teenagers dropped a bucket of urine, feces, and tobacco spit on his head. When the boy’s parents found a video of the prank on his phone, they immediately took it to Fox 8 News to show how children with mental illness can be victimized.

The video went viral and was met with outrage by the general public and heralded as a disgrace to the purpose of the ALS Association’s campaign.

In an interview with Fox 8 news, the boy’s mother identifies herself as Diane to protect her son’s identity:

“The bucket challenge is supposed to be raising awareness for this disease and now they’ve turned it into a sick joke. I just can’t understand why kids would do something this cruel.”

But there is nothing that can’t be used to bring about suffering, especially when the victim is an easy target.

In a study by Benjamin Zablotsky of Johns Hopkins Bloomberg School of Public Health and his colleagues, 1221 parents of children with Autism Spectrum Disorder were asked to enroll in the Interactive Autism Network (IAN) and asked about their child’s history with bullies at school. The results showed that 63% of autistic children experienced victimization by their peers at some point in their lives and that 38% were bullied in the past month. An extreme finding when compared to the average bullying rate of 20-30% reported by students in general.

The study also revealed that autistic children in regular classroom settings with peers who do not have ASD are more likely to be bullied than children who are placed in specialized educational settings.

Catherine Cappadocia, a doctoral student, along with psychologists Jonathan Weiss and Debra Pepler in the faculty of health at York University, has studied the effects of bullying on the development of autistic children. She found that autistic children who have parents with mental health issues are three times as likely to become victims, especially at a young age.

Speech difficulties also serve to increase the risk of being bullied. For autistic children who are unable to express themselves to the offenders or to authorities, victimization can become unavoidable.

A combination of many of these factors may be what led to the victimization of Diane’s son. Yet what makes this issue more disturbing is that the five juveniles responsible claimed to be his friends.

Bay Village’s County Prosecutor, head of the office’s Juvenile Division said: “The victim and the five charged juveniles were and are friends and classmates. They regularly associate with one another and, at times, engage in distasteful and sophomoric pranks. However, this incident is clearly different. It crossed a moral and legal line, and even the five alleged perpetrators understand that and have expressed regret.”

Three of the boys involved in the prank were charged with two counts of delinquency, assault and disorderly conduct. The remaining two perpetrators were charged with a single count of disorderly conduct.

Researchers Vicki Bitsika and Christopher Sharpley have shown that a large number of children with ASD often have few or no friends and spend most of their free time at school alone. Around 40% of these children have also said that the few people they believe to be their friends tend to bully them too.

Bitsika and Sharpley also explain that this harassment can create a positive feedback loop, slowing healthy development and increasing autistic children’s difficulty displaying emotions and communicating with others.

For autistic children to grow up in a healthy environment, schools, parents, and children need to be educated not only about bullying, but about autism itself.

– Afifa Mahboob, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Nasal Spray May Prevent PTSD, Study Finds

Nasal Spray May Prevent PTSD, Study Finds

00Ethics and Morality, Featured news, Law and Crime, Memory, Neuroscience, Post-Traumatic Stress Disorder, Therapy, Trauma January, 16

Source: Stan Dominguez on Flickr

The emotional connection between a memory and an event can be powerful. A child rescued from a house fire or a soldier returning from Afghanistan may be plagued by flashbacks that elicit guilt, fear, and anxiety. These associations may disrupt daily functioning, causing social isolation, difficulty sleeping, and paranoia—all symptoms of Post-Traumatic Stress Disorder (PTSD).

Traditionally, PTSD has been treated with counseling and cognitive behavioural therapy, as well as psychiatric medications. Now, new research by biochemistry professor Esther L. Sabban and colleagues at New York Medical College is exploring how to stop the negative emotional association from being formed in the first place. They developed a nasal spray that, when administered before, during, or after crises, may do just that.

The spray contains Neuropeptide Y (NPY) which, at low levels, is associated with reduced negative emotional processing of events. Increased NPY in the amygdala and hippocampus—structures of the brain involved in processing memory and emotional responses—is associated with decreased anxiety, fear, and depression resulting from stressful situations.

Sabban and colleagues found that, when inhaled, the peptide acts as a neurotransmitter that has an immediate effect on the brain and prevents the development of PTSD symptoms in rats. In their study, rats were first subjected to stress by being immobilized, forced to swim, and exposed to chemicals which made them lose consciousness. Thirty minutes before or after the stress, some rats were given NPY. After seven days, rats that received NPY had lower levels of anxiety, decreased avoidant behaviour, and fewer startle responses.

Similar results were obtained when the spray was administered a week after the stressful event.

If effective for people, the spray might benefit those with high-risk jobs or those who help others during emergencies. By reducing negative emotional processing of a traumatic event, victims and responders might have a weaker emotional reaction to the memory, limiting the subsequent development of PTSD symptoms.

But there are many questions as well as practical impediments.

Professor Evelyn Tenanbaum of Albany Law School outlines a number of legal and ethical issues that using this spray might have. She argues that blunting the emotional impact of such an event could hinder a victim’s ability to impact a judge or jury in criminal trials. Social change may also be more difficult as the emotional stories of trauma victims often act as catalysts.

Informed consent before administration must also be considered. Victims need to know they may no longer be a reliable witness to a crime and that their memory of the incident may become unclear. Informed decisions may be hard to make during crisis situations.

It is also important to remember that the spray has only been tested on animal populations. NPY purportedly severs ties between emotion and memory; it is unclear what this would mean for humans. Would individuals be left feeling neutral regarding the traumatic event?

A lack of emotion may leave some victims confused or depressed in an entirely different way. Philosophical counselor Elliot Cohen writes how some individuals may become depressed over not feeling guilt, even if they were not personally responsible for the event’s occurrence. And, some victims find their traumatic histories become vital parts of their identities. Personal experiences, memories, and feelings about painful events inform how we see ourselves. What does blunting memory do to a person’s sense of who they are?

NPY’s unpredictable effects on human emotion require much research. If effective, the spray might be a powerful tool for preventing PTSD in some.

Still for others, a painful memory may be preferable to none at all.

– Anjali Wisnarama, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Underage Models Need Federal Protection and Regulation

Underage Models Need Federal Protection and Regulation

00Environment, Ethics and Morality, Featured news, Gender, Law and Crime, Post-Traumatic Stress Disorder, Stress, Work October, 15

Source: Anna Fischer/Flickr

When Jennifer Sky launched her career at age fourteen, she imagined a glamorous lifestyle, fame, and designer clothes.  Flash forward to seventeen:  Her experiences turned out to be very different.

For Jennifer and many other young models, the fashion world includes foreign locations and a cascade of highly sexualized situations with little supervision, grueling twelve-hour days with few breaks, and high-stress photo-shoots.

In a recent interview with the Trauma & Mental Health Report, Jennifer shared her experiences as a young model abroad, and discussed the repercussions she’s now facing.

Jennifer: In Japan I was molested several times on the subway.  In France, I stood in hypothermic-temperature waters every day for a week.  In Mexico, I was given drugs and coerced into going topless at age sixteen.  The human trafficking elements of fashion were all around me.  

It was during this time that Jennifer began experiencing symptoms of what was later diagnosed as Post-Traumatic Stress Disorder (PTSD). In her latest book, Queen of the Tokyo Ballroom, and herYouTube video that went viral earlier this year, Jennifer describes how her normally gregarious personality started to change.  She became withdrawn, easily startled, and feared new places.  Eventually, she felt so timid she barely spoke.

Although the symptoms began in the 1990s, Jennifer did not seek treatment until 2010 when she moved back to New York City.

Jennifer: I moved back to finish college and the symptoms returned with such a force that I could no longer ignore them.

Jennifer experienced panic attacks during stressful events, which were sometimes followed by dissociative episodes where she would lose, in her words, “whole swaths of time.” These overwhelming symptoms led her to visit her university’s clinic where she was formally diagnosed.

Almost twenty years since modeling, through anti-anxiety medication and psychotherapy, Jennifer is managing her symptoms and is now a graduate student and activist.

Jennifer: I’m working toward transforming a problematic and corrupt industry into a positive one. Fashion can be fun.  It can be a rewarding opportunity.  It can also be abusive, opportunistic, corrupt, and traumatizing.

So what is currently being done to make youth modeling a safer profession?

In the Fall of 2013, New York State passed the Child Model Law, which ensures protection for individuals under eighteen, who work in the fashion industry.  The law requires tutors and chaperones, and that 15% of the model’s earnings be held in financial trust.  It also requires that all working children and adolescents be in possession of a permit while on set, and limits the amount of time they are allowed to be there.

The changes to labour laws in New York State saw instant successat the 2014 New York Fashion week, where only three underage models obtained permits, and were able to work the fashion shows.  Previously, as many as 60% of the models were under eighteen.

As promising as these changes are, the new labour laws are not federal – they only protect models that are working in the state of New York. In general, models still face a working world devoid of adequate labour regulation or protection.

Jennifer still questions whether the modeling industry is the right environment for children. But, by raising awareness and promoting models’ rights, Jennifer hopes to convince the U.S. federal government to change laws on underage modeling.

Jennifer: When we are talking about the protection of children, there really should be no debate.

– Magdelena Belanger, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright: Robert T. Muller

This article was originally published on Psychology Today

Cosmetic Vaginal Surgery Ignores Women’s Mental Health

Cosmetic Vaginal Surgery Ignores Women’s Mental Health

00Body Image, Ethics and Morality, Featured news, Gender, Health, Media, Self-Esteem October, 15

Source: summerbl4ck/Flickr

“I just thought I was so different from everyone else that I wanted my vagina to be changed,” said 21-year-old, Rosie, during her interview for The Perfect Vagina, a 2008 documentary on vaginal reconstructive surgery.

Rosie received a labiaplasty to remove the skin of her labia minora (internal genitalia). While the operation is relatively simple, the risks include bleeding, infection, permanent scarring, nerve damage, and a painful three-month recovery.

David Matlock, a cosmetic surgeon and director of the Los Angeles Laser Vaginal Rejuvenation Institute pioneered the vaginal surgery market in Los Angeles. He claims he can create “the perfect vagina,” a promise that brings in about 12 million (USD) a year.

But researchers at the UCLA Center for the Study of Women believe the concept of a “perfect vagina” arises from consistent exposure to homogenous images of women’s genitalia.  Pornography, medical textbooks, and sex shops show a similar vagina that is pink, hairless, with only the labia majora (external genitalia) visible.  Even the popular women’s health and sexuality book Our Bodies Ourselves shows only one image of the vagina.  Yet, the appearance of the healthy vagina is highly variable.

Why are more women opting for vaginal reconstructive surgery?  John R. Miklos, director of Urogynecology and Reconstructive Vaginal Surgery at the Atlanta Medical Center, found that most of his patients (on average 35 years of age) pursue the labiaplasty to improve sexual function, or to reduce pain during intercourse.

Other reasons for labiaplasty include alleviating discomfort from clothing or exercise, pressure from male or female sexual partners, reducing shame from having large labia minora, and boosting self-esteem.  And many labiaplasty patients are dissatisfied with the appearance of their genitalia and have lower sexual satisfaction.

Cosmetic surgeons state that women have the right to make decisions about their bodies. The American Academy of Facial Plastic and Reconstructive Surgery reported that women are the highest consumers of cosmetic surgery. In 2013, they accounted for 80% of all surgical (rhinoplasty, chin implants) and non-surgical procedures (BOTOX).

But many researchers take issue with that idea, arguing that vaginal cosmetic surgery patients often struggle with mental health.

Labiaplasty becomes problematic when young girls and women are looking for a self-esteem boost, as the surgery does not necessarily result in a positive outcome.  And for women struggling with low self-esteem, when one body part gets “fixed,” the dissatisfaction may shift rapidly to another.  This ongoing pursuit may be reflected in depression, anxiety, and even plastic surgery addiction.

However, Bruce Allan, an obstetrician-gynecologist from Calgary, Alberta, considers his patients to be very “well-adjusted people,” stating that a woman getting a labiaplasty is the same as a bald man getting a hair transplant.

Scientists at the Centre for Appearance Research at the University of the West of England have developed a psychological screening tool for all cosmetic surgery patients.  And specifically for labiaplasty candidates, there is the genital appearance satisfaction scale.

According to The American Society for Aesthetic Plastic Surgeons, psychological evaluations are not a mandatory procedure. Yet, most cosmetic surgeons are aware of body dysmorphic disorder, a chronic psychological illness characterized by obsessive, negative thoughts about one’s body and real or imagined flaws in physical appearance.  If patients opting for this surgery are doing so because they are suffering from a mental illness, one may ask whether it is indeed ethical to proceed?

Cosmetic surgeons would do well to consider the patient’s age when it comes to vaginal reconstructive surgery.  Young girls may prioritize a “quick fix” without understanding the surgery’s invasiveness.

And with adequate training to administer psychological screening tools, cosmetic surgeons could identify which patients should speak to a mental health professional before signing up for a labiaplasty.

Perhaps labiaplasty candidates can be given the opportunity to consider taking another route to address underlying body image dissatisfaction.  Patients might be better off if their doctors started tackling the problem from the top-down.

– Shira Yufe, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

Media Fail to Respect Crime Victims

Media Fail to Respect Crime Victims

00Ethics and Morality, Featured news, Law and Crime, Media, Post-Traumatic Stress Disorder, Trauma August, 15

Source: Kurt Bauschardt/Flickr

Pickton, Gein, Dahmer, Bundy. Few of us forget these names; names belonging to four infamous serial killers who shocked the world.

But the names Andrea Joesbury, Bernice Worden, Steven Tuomi, and Lisa Yates belong to the killers’ victims.  All were tortured, raped, and killed.

Unlike their murderers, they were not awarded Wikipedia pages.  They do not have Hollywood-made biographies.  And they do not have a place in the minds and memories of the public.

With so much news vying for attention, the need to sensationalize stories has grown, making the media complicit in the way we think of and remember heinous acts.  We read “Gunman Kills Six” instead of “How Poverty and Desperation Breed Crime.”

The need to shift media attention away from criminals is more than just a matter of principle.  While most suicides go unpublicized because psychologists have discovered that media coverage breeds imitation, the same findings have been shown to apply to the reporting of violent offenses. Yet media coverage of such crimes is still extensive enough to inspire new killers on a regular basis, giving the incentive of fame and profit from publicity.

In the U.S., the Son of Sam Law was passed following a 1977 murder trial, where it was ruled that any proceeds garnered by criminals for publicizing their crimes would be seized and turned over to victims.  A recent amendment has extended this legislation to not-criminally-responsible rulings as well.  Yet with crimes and the publicity they earn transcending borders and regulations, this is increasingly difficult to enforce.

The last few years have seen “popular” criminals earning fame and fortune through grisly deeds.  In 2007 in Japan, a man murdered Lindsay Ann Hawker, an English teacher, avoiding capture for several years.  His story became a hot topic for media speculators, earning him quasi-celebrity status.  Other killers who were acquitted on technicalities or due to legal loopholes also went on to turn profits from books, TV appearances, and years of controversial media exposure.

At times, the media create the very controversy they exploit.  This is especially true of crime reporting, where the focus is slanted to include graphic details of events and frightening images of suspected criminals.  The longer a manhunt or trial continues, the more attention the media are able to gain from what would otherwise be a single story.  It is this persistent coverage that creates a painful, damaging atmosphere for victims.

Psychologists agree that being re-traumatized by overwhelming life experiences can lead to difficulty with recovery.  Symptoms of Post Traumatic Stress Disorder (PTSD) can become aggravated when survivors are repeatedly reminded of painful private events in an exposing public context.  As a result, experts recommend that families and victims recovering from crime avoid contact with the media by minimizing their viewing of the news until they regain a sense of personal safety and stability.

Unfortunately, advice like that can be next to impossible to follow when a single Google search can return millions of hits for killers’ names.  When TV stations spend years showing photos of terrorists and their attacks.  And when headlines across the globe follow murderers who drag out court cases for years by slowly admitting to more crimes.

At the same time, the media can turn on the victims themselves. Reporters often hound victims of high-profile crimes, starting out benevolently, but becoming doggedly persistent if ignored.  Yet there is no formal protection from either the harassment of reporters or the reports themselves.

Legislation exists to curb the reporting of suicides.  But there is none to oversee the press when it comes to publicizing crimes or dealing with criminals and victims.

Organizations like Fairness & Accuracy in Reporting are doing their best to stop sensationalistic journalism.  But until a fundamental change occurs in legislation or the public’s appetite for detail, victims will continue to be victimized further by the media.

– Nick Zabara, Contributing Writer, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today

5146901365_dd08f61324_o

Wisdom From a Psychopath?

00Behavioral Economics, Ethics and Morality, Evolutionary Psychology, Featured news, Narcissism, Psychopathy, Wisdom April, 15

Source: Ross/Flickr

The word psychopath conjures images of skulking figures and dark alleys.  The media equate psychopaths with infamous serial killers like Ted Bundy and Robert Picton.

But psychopaths and psychopathy are much more complex. In 1980, Robert Hare, a psychology professor at the University of British Columbia, published the most widely used measure of psychopathy to date, the Psychopathy Check List (PCL), including symptoms like callousness, parasitic existence, and criminal versatility. With later studies finding the prevalence of psychopathy to range between 1 and 2 percent in the general population, it is hard not to feel a twinge of fear.

Are psychopaths really the hollow killers the media make them out to be? Kevin Dutton, a research psychologist at the University of Oxford and author of the controversial book, The Wisdom of Psychopaths, doesn’t think so.  Dutton argues that not only are the majority of psychopaths far from monsters, but that psychopathy itself is a potentially useful trait that we can benefit from.

Evolutionary psychologists have conducted studies that suggest the existence of psychopathy as a fundamental part of human development, predating homo sapiens.

Dutton claims that when it comes to getting ahead, from a financial or social perspective, psychopaths often come out on top.  He points out that the majority of psychopaths are, in fact, affluent members of the community.  The all-important distinction, in his view, lies in how high their “psychopathy dial” is turned.

Dutton’s research has yielded eight aspects of psychopathy, seven of which are seen as potentially beneficial for everyday life, and one that is harmful.

The harmful characteristic consists of symptoms typically associated with Antisocial Personality Disorder (ASPD), like difficulties with impulse control and irresponsibility.  In Dutton’s view, when these traits are present, psychopaths often turn their minds to crime and violence, seeking immediate gratification of lust, greed, and vanity. Since psychopaths lack morality, the only check on their disregard for rules is conscientiousness and the ability to plan long-term. This ability helps them predict negative consequences like getting caught and being punished, and reins in their wilder, more criminal tendencies.

While the impulsivity of psychopaths is unlikely to benefit most people, Dutton argues that the other seven traits may. These characteristics vary in intensity among individuals.

The first two of the seven traits are persuasiveness and a self-serving attitude. These traits make up the core image of the smooth-talking, egocentric individual who has no trouble lying to get ahead. For most, the wish to lie is thwarted by conscience, but psychopaths have developed two complementary traits to aid their machinations:  emotional detachment and alienation from others.  These two traits ensure that psychopaths are unable to feel pity or empathy for victims, contributing to their reputation as cold-hearted manipulators that walk over others without remorse. But it is also these traits that contribute to success in business and some professions.

Apart from morality, another characteristic that stops most of us from trying to fly under the legal or moral radar is fear. But two traits that psychopaths exhibit are rebelliousness and fearlessness, making them not only unafraid of getting caught, but actually excited by the prospect of subverting authority.

Even the greatest manipulators are sometimes found out, but even here psychopaths have a trait they benefit from, calmness under pressure, which ensures that if they do get caught, they are able to talk their way out of an otherwise career-ending situation.

So why aren’t these traits seen more widely?

Dutton explains that while certain levels of psychopathy are likely to net gains for an individual, they do nothing for a community.  As humans are largely dependent on social structure for survival, psychopaths essentially pit themselves against the world.  Too many of them in the group, and they outwit themselves into extinction.

And perhaps this is where the real lesson lies.  In a world where unbridled self-interest rules, Dutton’s psychopath may be viewed as effective…at most.  But wise?  This seems like a stretch.

This seems like a stretch.

On a small scale, radical self interest may be enticing.  Imagine being wholly unencumbered by morality, conscience, or altruism. You certainly could go far.

In aggregate though, not only does this prospect seem rather unwise, but it represents a world far more terrifying than that of Ted Bundy or Robert Picton.

– Contributing Writer: Nick Zabara, The Trauma and Mental Health Report

– Chief Editor: Robert T. Muller, The Trauma and Mental Health Report

Copyright Robert T. Muller

This article was originally published on Psychology Today