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Biomedical subjects

D O Lewis

Publications and source records attributed to D O Lewis.

At least 19 recordsLinked to original sources
PubMed2004

Immunization of broiler chicks by in ovo injection of infective stages of Eimeria.

Immunization of chickens by in ovo injection of infective stages of 5 species of Eimeria was investigated. Fertile Hubbard x Petersen broiler chicken eggs were injected through the air cell on d 18 of incubation with oocysts of E. acervulina, E. maxima, E. mitis, E. praecox, or E. brunetti. Injected doses of all species ranged from 1 x 10(2) to 1 x 10(6) sporulated oocysts per egg. Chicks receiving oocysts in ovo shed oocysts posthatch. After 2 wk in wire-floored cages, birds were given a challenge infection with the homologous Eimeria species. Chicks immunized by in ovo injection of oocysts had significantly reduced lesion scores, improved weight gain, or reduced oocyst output compared with their nonimmunized counterparts. In additional studies, eggs were injected with 1 x 10(5) sporozoites of E. tenella, E. maxima, or E. acervulina per egg. Sporozoites of E. acervulina were not infective for chick embryos when administered in phosphate-buffered saline, but if sporozoites were suspended in tissue culture medium when injected in ovo, hatched chicks shed oocysts with peak output occurring 3 to 4 d posthatch. Sporozoites of E. maxima and E. tenella were infective for 18-d-old embryos regardless of the vehicle. The results demonstrate that immunization of broiler chickens against several species of coccidia by in ovo injection of oocysts is feasible. The infectivity of sporozoites for 18-d-old chick embryos varied depending on the species of Eimeria and the vehicle in which the sporozoites were suspended prior to injection.

Animals↗
PubMed2001

Six adoptees who murdered: neuropsychiatric vulnerabilities and characteristics of biological and adoptive parents.

This article is the first to document the perinatal trauma and neuropsychiatric impairment of a sequential sample of male adoptees who committed murder. It also is the first to report objectively verifiable psychopathology and violence in their biological and adoptive parents. It explores the interaction of these variables in the genesis of violence. Subjects were six adopted murderers on whom data regarding biological and adoptive parents could be obtained. In all six cases, central nervous system (CNS) development was compromised in utero or perinatally. In adolescence and/or young adulthood, three met DSM-IV criteria for Bipolar Mood Disorder, one for Schizophrenia, and two for Schizoaffective Disorder. All subjects had at least one psychotic biological parent. In five cases, subjects were adopted into psychotic or violent households. There was no evidence of a specific "bad seed" for violence. Adoptees' intrinsic vulnerabilities to psychoses and to the impulsiveness and emotional lability often associated with early brain trauma, coupled with maltreatment, predisposed them to homicidal violence. As such, these subjects were similar to other extraordinarily violent, nonadopted, offenders. Conscious feelings regarding adoption did not contribute to the subjects' homicidal rages, so much as did conscious rage toward abusive, rejecting adoptive families.

Adolescent↗
PubMed2000

Mental illness, neuropsychologic deficits, child abuse, and violence.

This review of the psychiatric, neuropsychological, and familial contributions to aggressive behavior makes clear that conduct disorder is not a single diagnostic entity. It is, rather, the final common pathway of the interaction among a variety of different kinds of intrinsic vulnerabilities and environmental stressors. In every aggressive child all of these vulnerabilities (none of which necessarily meets full criteria for a specific DSM-IV diagnosis) and stressors must be considered and, if present, addressed systematically. We know that psychotic symptomatology, especially paranoia, combined with neuropsychological vulnerabilities and a history of severe abuse become a recipe for violence, and the more impaired the child, if abused, the more violent the child will become as an adolescent and adult. The clinician must, therefore, think of himself or herself as the only knowledgeable adult who will ever take the time to discover these ingredients and deal with the violent child positively and therapeutically.

Adult↗
PubMed2000

Diagnostic evaluation of the violent child and adolescent.

The diagnostic evaluation of the violent child and adolescent is a collaborative exercise, requiring diverse expertise. Ironically, after systematic, comprehensive psychiatric, neurologic, psychologic, neuropsychologic, psychoeducational, family, and social evaluations have been completed, the clinician probably will not be able to make a hard and fast DSM-IV diagnosis; that is, unless the clinician is satisfied with fitting the behavioral pieces into the Conduct Disorder category and ignoring the rest of the clinical data. From time to time the clinician will be able to diagnose a bipolar mood disorder underlying a violent youngster's behavior. Occasionally the clinician will recognize paranoid schizophrenia motivating a particularly heinous or bizarre violent act. Most often the clinician will be faced with a variety of different kinds of psychiatric, neurologic, cognitive, and environmental vulnerabilities that have come together and created a violent child or adolescent. That's fine because almost invariably each discovered vulnerability has implications for treatment. The clinician evaluating a violent child or adolescent must overcome his or her initial disgust or anger at the youngster's behaviors and resist the impulse to dismiss the child as conduct disordered, as an incipient psychopath. That diagnosis leads nowhere. The identification of vulnerabilities leads to specific interventions and ultimately to the prevention of future violence.

Adolescent↗
PubMed2000

Ethical implications of what we know about violence.

This article explores the moral implications of the previous articles in this volume. It looks at our knowledge regarding the neuropsychiatric and environmental influences on violence in light of concepts of justice, virtue, and responsibility.

Adolescent↗
PubMed1997

Objective documentation of child abuse and dissociation in 12 murderers with dissociative identity disorder.

OBJECTIVE: The skepticism regarding the existence of dissociative identity disorder as well as the abuse that engenders it persists for lack of objective documentation. This is doubly so for the disorder in murderers because of issues of suspected malingering. This article presents objective verification of both dissociative symptoms and severe abuse during childhood in a series of adult murderers with dissociative identity disorder. METHOD: This study consisted of a review of the clinical records of 11 men and one woman with DSM-IV-defined dissociative identity disorder who had committed murder. Data were gathered from medical, psychiatric, social service, school, military, and prison records and from records of interviews with subjects' family members and others. Handwriting samples were also examined. Data were analyzed qualitatively. RESULTS: Signs and symptoms of dissociative identity disorder in childhood and adulthood were corroborated independently and from several sources in all 12 cases; objective evidence of severe abuse was obtained in 11 cases. The subjects had amnesia for most of the abuse and underreported it. Marked changes in writing style and/or signatures were documented in 10 cases. CONCLUSIONS: This study establishes, once and for all, the linkage between early severe abuse and dissociative identity disorder. Further, the data demonstrate that the disorder can be distinguished from malingering and from other disorders. The study shows that it is possible, with great effort, to obtain objective evidence of both the symptoms of dissociative identity disorder and the abuse that engenders it.

Adult↗
PubMed1994

A clinical follow-up of delinquent males: ignored vulnerabilities, unmet needs, and the perpetuation of violence.

OBJECTIVE: This paper describes the adult adaptation of a group of 97 formerly incarcerated male delinquents. METHOD: Follow-up clinical interviews were administered to subjects, approximately 9 years after discharge from juvenile corrections. The records of the correctional school, state police, FBI, state psychiatric hospitals, and state health department also were reviewed. RESULTS: All but six had adult criminal records, most for violent crimes. Only 10% were graduated from high school; 30% received minimal job training; most worked sporadically at unskilled jobs. Few married. Although 35 had fathered children, only 5 were living with them. Psychiatric treatment for identified vulnerabilities was negligible. Upon discharge, the most neuropsychiatrically impaired and violent subjects tended to be placed in adult corrections; the most intact were placed in special schools and psychiatric hospitals. Numbers of vulnerabilities continued to contribute most significantly to violent outcome regardless of placement. Placement in families was associated with fewer adult aggressive offenses than was institutional placement, even while controlling for vulnerabilities and early juvenile violence. CONCLUSION: Based on their well-documented early vulnerabilities and needs, this sample of delinquents did not obtain the kinds of supports subsequent to juvenile incarceration that might have enabled them to function independently in society.

Adolescent↗
PubMed1993

Sexually assaultive male juveniles: a follow-up.

OBJECTIVE: The purpose of this study was to investigate the adult outcome of a group of male juveniles who committed sexual assault. METHOD: Nineteen sexually assaultive male juveniles and a comparison group of 58 violent juveniles were studied over an 8-year period through use of criminal records and clinical interviews. RESULTS: Although in adolescence the two groups were similarly violent, on follow-up those who had committed sexual assault were significantly more likely to commit adult sexual offenses. They also committed significantly more violent nonsexual offenses. Childhood sexual abuse, especially by females, was associated with adult sexual offenses. CONCLUSIONS: Sexually assaultive delinquents are at particularly high risk for subsequent violence. Hence, special efforts must be made to treat these delinquents in adolescence. Prevention of violent sexual behavior must include improved methods of detecting sexual abuse, especially that perpetrated by older females.

Adolescent↗
PubMed1992

From abuse to violence: psychophysiological consequences of maltreatment.

This paper reviews the psychophysiological literature related to violent behaviors. It explores the interactions of environmental influences, pain, stressors, hormones, and neurotransmitters. It presents ways in which maltreatment in the form of abuse or neglect exacerbates preexisting psychobiological vulnerabilities. It proposes that whatever forces increase impulsivity and irritability, engender hypervigilence and paranoia, diminish judgment and verbal competence, and curtail the recognition of pain in the self and others, will enhance violence, and presents evidence that maltreatment has all of these effects.

Adolescent↗
PubMed1992

Hypnoanalgesia for chronic pain: the response to multiple inductions at one session and to separate single inductions.

Serial hypnotic inductions conveying the same analgesic message produce a progressively longer response in an increasing number of patients. The resulting analgesia appears to be independent of the spacing of inductions--whether given at a single session or on separate occasions--and to depend upon their number. However, multiple inductions at a single session save time. Elimination of pain can be achieved, by either approach, for a year or more in up to 70% of patients.

Adolescent↗
PubMed1991

A follow-up of female delinquents: maternal contributions to the perpetuation of deviance.

Twenty-one female delinquents, neuropsychiatrically evaluated while in a juvenile correctional facility, were followed up to 7 to 12 years later. Compared with a matched sample of male delinquents, they committed fewer and less violent offenses. Unlike the males, early biopsychosocial variables were not predictive of adult criminality; however, most females were seriously impaired neuropsychiatrically. Mortality rates were high. Having come from abusive households, the female delinquents became suicidal, alcoholic, drug addicted, enmeshed in violent relationships, and unable to care for their children.

Adolescent↗
PubMed1991

Multiple personality and forensic issues.

As clinicians become more sophisticated regarding MPD, we can expect many more cases to come to the court's attention, especially among violent offenders. This is because violence and MPD have very similar origins in early extraordinary physical and sexual abuse. As offenders become more knowledgeable, we can also expect to encounter more and better malingering. At this time, however, we are far more likely to overlook the problem than we are to overdiagnose it. Why is it that MPD is recognized so infrequently in the offender population? Probably because so many of its characteristics are similar to the symptoms associated with antisocial personality. For example, amnesia for behaviors is dismissed as lying, fugue states appear to be attempts to evade justice; finding things in one's possession looks like stealing; self-mutilation and suicide attempts seem manipulative; and the use of different names at different times and in different circumstances is interpreted as the conscious use of aliases in order to evade the law. Even the dramatic, at times heart-wrenching emotional catharses relating to abuse revealed during hypnosis are so painful that the average person has difficulty accepting that they happened and, therefore, dismisses them as exaggeration or total fabrication. Most often, the diagnosis is missed because the clinician does not even consider it a possibility. In this article we have reviewed some of the ways in which courts have approached the issue of MPD and some of the problems specific to its diagnosis in forensic settings. The clinician must keep in mind that in cases in which issues of mental illness are raised, the law reflects that which it is taught by alleged experts. The case law on multiple personality is still sparse, leaving much room for new data and new interpretations of these data. The current tendency to treat each alternate as though it were a whole and responsible individual as opposed to an imaginary construct, a symptom of a mental illness, reflects the confusion among clinicians as well as attorneys regarding the phenomenon of MPD. As we continue to learn more about the disorder and its forensic implications, we must be careful to avoid presenting to the court clinical impression as fact or mythology as truth.

Diagnosis, Differential↗
PubMed1990

Neuropsychiatric and experiential correlates of violent juvenile delinquency.

This article reviews evidence regarding contributions of neuropsychiatric and psychological vulnerabilities to violent delinquency, and the interaction between intrinsic vulnerabilities and experiential factors in the genesis of antisocial juvenile behavior. Consideration is given to biochemical and physiological factors, genetics, medical status, and neurological, psychiatric, and neuropsychological factors. Implications for treatment are discussed.

Adolescent↗
PubMed1990

Child abuse: adolescent records vs. adult recall.

In a follow-up study of incarcerated Connecticut youth, 69 subjects were interviewed during young adulthood. On follow-up, 26 gave histories of abuse discrepant with histories obtained from records and interviews conducted in adolescence. Eleven subjects agreed to an additional clarification interview, at which time they were apprised of the discrepancies. Of these, eight had adolescent records indicating that abuse had occurred but denied abuse during the adult follow-up interview. The remaining three had adolescent records indicating no abuse had ever occurred, but, on follow-up, reported having been abused. The additional clarification interviews revealed that all 11 subjects with discrepant histories had, in fact, been abused. Reasons for these discrepant data and strategies to enhance the investigator's ability to obtain accurate data regarding abuse are discussed.

Adolescent↗
PubMed1990

Mortality in a group of formerly incarcerated juvenile delinquents.

A 7-year follow-up study of formerly incarcerated delinquents revealed an extremely high mortality rate. Of 118 male and female subjects, seven had died before their 25th birthdays, making the mortality rate of the sample approximately 58 times the national average for individuals in their age group. All died violent deaths, making the violent death rate of the sample approximately 76 times the national average for that age group. Differences in mortality rates according to the race and sex of the subjects are reported, and possible clinical predictors of early death are explored.

Adolescent↗