Changing with the times; the DSM :Thoughts

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Posted on 26th May 2009 by Gordon Johnson in Brain Injury

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issuesdaily.com staff article

I have been involved in dog training for some time and as such, I spend a great deal of time researching new findings in how dogs learn. Developments are fast and furious in the realm of dog behavior with major studies usurping our traditional ideas of how dogs think and why they do what they do. From University of Pennsylvania’s current year-long study into dog aggression to the American Veterinary Medical Association’s stand on acceptable training methods…it is a field in transition.

So it is with some interest that an article featured in the Los Angeles Times today regarding current deliberations going on over the DSM – V, the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders. It was one of those headlines which caught my eye and made me think, of course, why shouldn’t it be updated?

If we are publishing changes in our thinking on the subject of canine brains, isn’t it a certainty that we need to revamp our thinking on the human brain? Advances in research, technology and a change in our society should be reflected when dealing with the topic of human mental functioning.

According to the La Times article, this will affect what services people will be eligible for, anti-discrimination laws, and what insurance companies will cover. Medicalizing mental disorders will bring about a wider range of care.

The DSM-V is expected to go into more detail and also take into consideration many different factors such as age, race, gender, culture and physical health.

The DSM-V has been under scrutiny because of ties to the pharmaceutical industry. The New England Journal of Medicine commented on May 7 that “56% of DSM-V task force and committee members have industry ties.” Committee members are required to abide by conflict-of-interest rules with caps on the amount they can receive from the pharmaceutical industry while serving on committee.

I think it is a development well worth keeping an eye on. With all the changes in our ideas about addiction, developments in brain imaging and genetics, as well as the increasing occurrence of conditions such as autism and bi-polar disorder, it will be interesting to see how these changes will be reflected in the revised edition. With the care of so many dictated by the DSM-V and services approved or denied based on its guidelines, we can only hope that the promise of a more science-based measuring tool will soon become a reality.

It is cause for some concern that the so-called ‘bible of psychiatry’ is not as dynamic as the fields of technology which surround it. As psychiatrists spend the next 18 months debating the issues to be addressed in the new edition, one has to wonder at its relevance in a world in which technology is moving forward so quickly.

Los Angeles Times Article:
http://www.latimes.com/news/nationworld/nation/la-sci-mental-disorder26-2009may26,0,3081443.story

Deliberations begin in Mo. ‘Precious Doe’ case

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Posted on 8th October 2008 by Gordon Johnson in Brain Injury

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Date: 10/8/2008 3:19 PM

By ANDALE GROSS
Associated Press Writer


KANSAS CITY, Mo. (AP) _ Jurors began deliberating the case Wednesday of a man accused of kicking a 3-year-old girl in the head, waiting hours without seeking help while she died, then decapitating the girl and dumping her body.

During closing arguments, Jackson County prosecutors told jurors that Harrell Johnson, 29, of Muskogee, Okla., killed Erica Green, the daughter of his girlfriend at the time, by kicking her in the head in 2001 and failing to seek medical help.

“This selfish coward made the decision to put himself before this 3-year-old child’s life,” said prosecutor Jim Kanatzar.

Johnson is charged with first-degree murder, endangering the welfare of a child, abuse of a child resulting in death and abuse of a child. If convicted of the murder charge, Johnson would be sentenced to life in prison without parole.

Defense attorney Chris Slusher told the jury that Johnson didn’t know the girl would die. He said prosecutors haven’t proven that Johnson is guilty of deliberately intending her death.

“It’s our position to you that the evidence in this case has not established that Harrell Johnson intended or deliberately meant for Erica Green to die,” Slusher said.

A police officer found Erica’s naked, headless body in a wooded area of Kansas City in April 2001. Lacking an identity, she was known only as “Precious Doe” until 2005, when a community activist received a tip from Johnson’s grandfather in Muskogee, Okla., where he lived with Erica’s mother, whom he married a year after the girl’s death.

Johnson’s trial began Monday in Jackson County Circuit Court, and prosecutors completed their presentation Tuesday with testimony from Johnson’s wife, Michelle Johnson, and a videotaped confession by the defendant.

Michelle Johnson, 33, pleaded guilty last year to second-degree murder in Erica’s death.

She testified Tuesday that Harrell Johnson was high on drugs when he kicked Erica at the Kansas City home where they were staying. She said she knew the girl would die but that they didn’t seek medical help for fear of being arrested on outstanding warrants.

A pediatric neurosurgeon testified Monday that if the couple had quickly sought medical attention for Erica, doctors probably could have reversed the damage.

Prosecutors are not seeking the death penalty, partly because Johnson agreed to withdraw his request to have the case moved out of Kansas City.

Copyright 2008 The Associated Press.

Defense: ‘Precious Doe’ defendant kicked girl, 3

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Posted on 7th October 2008 by Gordon Johnson in Brain Injury

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Date: 10/6/2008 10:09 PM

By DAVID TWIDDY
Associated Press Writer


KANSAS CITY, Mo. (AP) _ The man accused of murdering 3-year-old Erica Green kicked her in the head but didn’t mean to kill her, his attorney told a jury Monday in the case of a victim the city mourned for four years only knowing her as “Precious Doe.”

But while Harrell Johnson did kick Erica, his girlfriend’s daughter, that was not the premeditated act necessary for a first-degree murder conviction, defense lawyer Kenton Hall said.

“Erica Green died of a single, traumatic blow to the head, a blow that was forceful and reckless and out of control but was not intended to kill,” Hall said.

Special prosecutor Tim Dollar countered that Johnson, 29, of Muskogee, Okla., and the girl’s mother, Michelle Johnson, committed murder by failing to seek medical help as Erica lay dying for hours and possibly days. Instead, the mother tried to revive Erica with a cold bath and even attempted to feed her with an eyedropper.

“The defendant and Michelle decided that they would not call for help for little Erica because the defendant and Michelle were ‘on the run’ from the police and neither this defendant nor Michelle wanted to go to jail,” Dollar said.

A pediatric neurosurgeon testified later that if the couple had quickly sought medical attention for Erica, physicians could likely have reversed the damage.

“I think she would have survived,” said Dr. Gregory Hornig, who reviewed records from the girl’s autopsy.

Prosecutors claim that after Erica died, the couple took the girl’s body out of the house and that Harrell Johnson decapitated her with hedge clippers and dumped the body in the woods.

The jurors viewed crime scene and autopsy photos of the girl’s severed head and neck, but Hall cautioned them that the decapitation didn’t cause the girl’s death and was meant only to hide her identity.

“You are here to judge what happened before that moment,” he said.

Erica’s body was discovered in a wooded Kansas City park area on April 28, 2001, by a Kansas City police officer searching for an elderly man who had wandered from his home.

Police Sgt. Jason Rusley testified Monday that he thought he saw a dog or a toy lying in the bushes off a gravel road and took a closer look.

“I said a gasp and ‘Oh, no,’” he said. “You could tell it was the body of a young child.”

A volunteer searcher found her head three days later about two blocks away wrapped in a pair of garbage bags.

Dollar told jurors that police had hoped that media reports about the body being found would coax the girl’s parents to come forward or file a missing person’s report.

But “no call comes and no report comes,” Dollar said. “Instead, Kansas City’s long nightmare has begun.”

For four years, the case haunted residents who longed to know the identity of the girl they had nicknamed “Precious Doe” and who could have killed her in such horrific fashion.

Homicide Sgt. David Bernard testified that he initially thought the girl would be identified quickly because of her age. He said the department used numerous drawings and clay busts of the girl’s likeness to drum up leads.

Erica was finally identified in 2005 after Harrell Johnson’s grandfather in Muskogee tipped a Kansas City community activist who had kept the case in the spotlight. Johnson and the girl’s mother, who had married a year after Erica’s death, were arrested in Oklahoma.

Michelle Johnson pleaded guilty to second-degree murder last year and agreed to testify against her husband.

The trial is expected to last about a week. If convicted of first-degree murder, his only possible sentence would be life in prison without parole. Prosecutors are not seeking the death penalty, partly because Johnson agreed to withdraw his request to have the case moved out of Kansas City.

Copyright 2008 The Associated Press.

Largest study of US children to begin in January

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Posted on 3rd October 2008 by Gordon Johnson in Brain Injury

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Date: 10/3/2008 2:23 PM

WASHINGTON (AP) _ The largest study of U.S. children ever performed — aiming to track 100,000 from conception to age 21 — will start recruiting mothers-to-be in North Carolina and New York in January.

The ambitious National Children’s Study aims to learn how the environment and other factors affect youngsters’ health, especially development of such conditions as autism, asthma, learning disabilities, diabetes and obesity. Scientists will examine a range of factors, from the diets of pregnant women and young children to the effects of chemicals used in plastics.

Tight budgets from Congress have delayed the project, which in 2004 began selecting 105 locations where women and their children can participate.

But on Friday, the National Institutes of Health took a long-awaited step, announcing that two research centers will start signing up women for the study’s pilot phase in January: The University of North Carolina, Chapel Hill, recruiting women from Duplin County, N.C., and the Mount Sinai School of Medicine, recruiting in Queens County, N.Y.

By spring, enrollment in the remainder of the pilot sites is planned, in parts of California, Pennsylvania, Utah, South Dakota and Minnesota. Nationwide enrollment for the full study is set for summer 2010.

No, scientists won’t have to wait until participating babies grow up for results: Initial data on preterm births could come as early as 2012.

Friday’s announcement came as the NIH expanded its list of research centers that ultimately will participate. For locations, see http://www.nationalchildrensstudy.gov.

Copyright 2008 The Associated Press.