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PubMed1995

Emotional, behavioral, and physical symptoms reported by parents of sexually abused, nonabused, and allegedly abused prepubescent females.

There have been few studies that have examined emotional, behavioral, and physical symptoms that discriminate between well-defined groups of sexually abused and nonabused children. This study examined the results of a structured parent interview (SASA) completed on three matched samples of prepubescent females: 68 who were selected for nonabuse (NA Group), 68 from a sexual abuse clinic in which a perpetrator confessed (SA Group) and 68 seen at the same clinic who did not have a perpetrator confession (AA Group). Parents of girls in both the SA and AA groups reported increased sleep problems, fearfulness, emotional and behavioral changes, concentration problems, and sexual curiosity and knowledge. When contrasting the known (SA) with the allegedly abused sample (AA), self-consciousness, nightmares, and fearfulness of being left alone emerged significantly more frequently in the SA sample.

Affective Symptoms↗
PubMed1993

The 'control' question 'test' (CQT) polygrapher's dilemma: logico-ethical considerations for psychophysiological practitioners and researchers.

The so-called 'control' question 'test' (CQT) has been criticized on methodological and ethical grounds by psychophysiologists. The ethical analyses have focussed on the possibility that the CQT's interrogative features may elicit false confessions, but an empirical problem is that the rate of these false confessions is difficult to establish. In this conceptual note, this author raises a logico-ethical problem for the CQT, called the Polygrapher's Dilemma (PD). The two horns of the PD are to damage the innocent examinee classified as deceptive and damage to those examinees' psychological well being who are classified as non-deceptive to the relevant questions and who are not even debriefed concerning their feelings of unease about issues raised by the comparison, so-called 'control' questions. Although there may be arguments about which of the PD's two horns are more serious, there is no doubt that both are, in an absolute sense, ethically negative. Nor is there an ethically justifiable third alternative available. It is also contended that not only practitioners but also researchers (who use the CQT in laboratory, 'mock-crime' situations) are affected by PD. Finally, it is noted that PD exists only for the CQT procedure and not for the more standardized and scientifically based Guilty Knowledge Technique.

Ethics, Professional↗
PubMed1997

A validational study of the Structured Interview of Symptoms Associated with Sexual Abuse (SASA) using three samples of sexually abused, allegedly abused, and nonabused boys.

OBJECTIVE: With the rapid rise of sexual abuse allegations, there is a growing need to develop instruments to help clinicians determine the likelihood that sexual abuse has occurred. METHOD: This study evaluated the discriminant validity of a structured parent interview regarding emotional, behavioral, and physical symptoms by comparing results among three subsamples of age matched boys: 22 sexually abused boys whose perpetrator confessed, 47 boys evaluated in a sexual abuse clinic but without a history of perpetrator confession and 52 nonabused boys selected after rigorous screening. RESULTS: In comparison with the nonabused (NA) boys, the sexually abused boys were significantly more likely to demonstrate sudden emotional and behavioral changes, frequent stomach aches, more knowledge about sex and sexual activities than expected for age, unusual aggressiveness toward playmate or toy's private parts, crying easily, difficulty getting to sleep, and a change to poor school performance. The internal reliability of the SASA was determined to be .83 and scoring of an abbreviated 12-item scale demonstrated a sensitivity of 90.9% and a specificity of 88.5%. CONCLUSIONS: The findings suggest that Structured Interview of Symptoms Associated with Sexual Abuse (SASA) is an effective tool which may help in the comprehensive assessment of boys who may have been sexually abused.

Adolescent↗
PubMed2005

On the Christian in Christian bioethics.

What is Christian about Christian bioethics? And is an authentically Christian bioethics a practical possibility in the world in which we find ourselves? In my essay I argue that personhood and the personal are so fundamental to the Christian understanding of our humanity that body, soul, and spirit are probably best understood as the components of a triune (as opposed to dual) aspect theory of personhood. To confess to a Christian bioethics is to admit that Christians cannot pretend fully to understand either cures or their meaning. However effective and "knowledge-based" contemporary medical interventions are, a Christian must humbly and honestly confess a lack of complete knowledge on both levels. At the same time, a Christian bioethicist must express a total personal commitment to Christian Faith.

Bioethics↗
PubMedDate not supplied

Urinalysis of body packers in Japan.

Urinalysis was performed on nine body packers/smugglers who were referred to the emergency room of a hospital near the New Tokyo International Airport between September 1994 and February 1996. This analysis had rarely been used on suspected body packers in Japan. Only one of the nine body packers was a female. Foreign bodies were detected in the gastrointestinal tracts of the body packers by plain x-ray photography or computerized tomography, and the suspected drugs were cocaine (five cases), heroin (two cases), opiate (one case), and marijuana (one case). The results of urinalysis and confessions of the smugglers corresponded well for the latter three drugs (four cases). In two of the suspicious cocaine cases, opiates were detected along with cocaine by urinalysis, and the metabolites were confirmed by gas chromatography-mass spectrometry. The urinary screening tests of another two suspicious cocaine cases were negative. Opiates (morphine and codeine), but no cocaine metabolites, were detected in the urine of the subject who confessed to smuggling in cocaine only. It may be inferred from these results that urinalysis on body packers is beneficial to both the patient (body packer) and the physician in preventing the disastrous outcome of drug intoxication. It can also be concluded that there is a need for the prompt establishment of a protocol that includes urinalysis upon admission to the hospital for the management of body packers in Japan.

Cannabinoids↗
PubMed2004

In search of the Boston Strangler: genetic evidence from the exhumation of Mary Sullivan.

The Boston Strangler was one of the United States' most notorious serial killers, raping and strangling with decorative ligatures thirteen woman in Boston during the early 1960s. Albert DeSalvo, never a suspect in the slayings, confessed in prison (where he was later murdered) to being the Boston Strangler, and the investigation largely ended. Mary Sullivan was the last victim of the Boston Strangler, found sexually assaulted and strangled in her Boston apartment in 1964. Recently, a team of forensic scientists undertook the exhumation and subsequent scientific analysis of Mary Sullivan's remains, in hope of finding consistencies or inconsistencies between DeSalvo's confessed description of the murder and any evidence left behind. Included in these analyses was extensive DNA testing of all UV fluorescent material associated with the body. The large majority of results were negative, however, fluorescent material located on the underwear and entwined in her pubic hair generated two human mitochondrial DNA sequences. Neither of these matched the victim nor members of the forensic team who worked on the evidence. Most importantly, neither DNA sequence could have originated from Albert DeSalvo.

Autopsy↗
PubMed2005

[Some of middle age smokers' attitudes against smoking].

UNLABELLED: Smoking is pandemic spread in all parts of the population. Particularly, this is an autodestructive blind impulse or the vice. THE FORMULATION OF THE PROBLEM: This rough of smoking today incites an important interest, same with nonsmokers as with smokers, so the understanding of the harmfulness of smoking to their health in the population of the middle-age smokers has been the cause for this investigation. The aim of the investigation was to show the attitude of smokers toward smoking in a prospective study. The selection was performed according to the settled rules, as well as inquiry of 280 examinees, workers of Furniture Factory "Krivaja-Zavidovići". The examination group formed 140 smokers and the control group 140 nonsmokers, of the same age 35-45 years, and both gender. Received results were prepared statistically and the differences between groups were certified with chi2 test and t-test to the level of tasked signification ? = 0.05. RESULTS: Relativly high percentage of smoker examinees (84.28%) confessed to consider smoking to be harmful to their health; still, they continue to smoke. DISCUSSION: The establishing of these precise indexes, which show the attitude of smoker-examinees toward smoking enables developing of strategic, along with simultaneous forecaster estimation of succesful prevention, in the sense of the conduction of this program about quitting smoking. CONCLUSIONS: Among workes of Furniture Factory "Krivaja-Zavidovići" high percentage of smoker examinees (84.28%) confessed to consider the smoking harmful to their health. Smoker examinees in more than 50% cases would like quitting to smoke.

Adult↗
PubMed2006

[Psychopathological study of lie motif in schizophrenia].

The theme of a statement is called "lie motif" by the authors when schizophrenic patients say "I have lied to anybody". We tried to analyse of the psychopathological characteristics and anthropological meanings of the lie motifs in schizophrenia, which has not been thematically examined until now, based on 4 cases, and contrasting with the lie motif (Lügenmotiv) in depression taken up by A. Kraus (1989). We classified the lie motifs in schizophrenia into the following two types: a) the past directive lie motif: the patients speak about their real lie regarding it as a 'petty fault' in their distant past with self-guilty feeling, b) the present directive lie motif: the patients say repeatedly 'I have lied' (about their present speech and behavior), retreating from their previous commitments. The observed false confessions of innocent fault by the patients seem to belong to the present directed lie motif. In comparison with the lie motif in depression, it is characteristic for the lie motif in schizophrenia that the patients feel themselves to already have been caught out by others before they confess the lie. The lie motif in schizophrenia seems to come into being through the attribution process of taking the others' blame on ones' own shoulders, which has been pointed out to be common in the guilt experience in schizophrenia. The others' blame on this occasion is due to "the others' gaze" in the experience of the initial self-centralization (i.e. non delusional self-referential experience) in the early stage of schizophrenia (S. Kato 1999). The others' gaze is supposed to bring about the feeling of amorphous self-revelation which could also be regarded as the guilt feeling without content, to the patients. When the guilt feeling is bound with a past concrete fault, the patients tell the past directive lie motif. On the other hand, when the patients cannot find a past fixed content, and feel their present actions as uncertain and experience them as lies, the present directive lie motif is told. Lie motifs are considered to have the effect of restoring the patient's own subjectivity by the following ways: (a) by actualizing the structural constituents elementary for the establishment of subjectivity, (b) by conducting a kind of speech act for declaring themselves as an active lying subject to co-presenting others for the resettlement in our inter-subjective world.

Adolescent↗
PubMedDate not supplied

[A metapsychological reading of questioning by police and during criminal investigations].

The pursuit and reception of a confession during police interrogation and cross examination lead to a dynamic interaction between interrogator and interrogated which can be examined under the light of psychoanalytical concepts. This reference framework enables a reading of the different positions occupied by the interrogator with regard to the interrogated, and allows to understand certain mechanisms in the arrival of a confession as well as some of its effects.

Criminology↗
PubMedDate not supplied

Criteria for judging the credibility of children's statements about their sexual abuse.

One hundred and three cases of child sexual maltreatment, where offenders confessed to some level of their abuse, were examined to determine the extent to which the children's statements about their victimization contained three widely accepted clinical criteria of a true sexual abuse allegation. The results support clinical assumptions that the criteria in question were valid ones for determining the truth of a sexual abuse allegation in cases involving confessions of abusers.

Age Factors↗
PubMed1988

Psychotherapy and the etiology of psychiatric disorders.

This paper compares two broad views of psychotherapy, the etiological and the rehabilitative. The etiological view is based on the premise that the psychotherapeutic process provides a basis for laying bare the causal link between 'deeply repressed' unconscious forces and the patient's current condition. Spence's critique of this position is based on drawing a distinction between narrative truth and historical truth, pointing out the persuasive or rhetorical power of a coherent synthesis of the material presented by the patient, regardless of its historical veracity. Michels also draws attention to this difficulty by pointing to Freud's discovery that reports from childhood were based not on fact, but on fantasies which re-emerge in the transference relationship. The proposal that the therapist provides a context more conducive to the resolution of childhood trauma implies that the trauma was fact and not fantasy. Frank has drawn the parallel between confession in a cueless vacuum with brainwashing techniques which result in the confession of non-events. Besides these difficulties, the etiological approach cannot establish the direction of supposed causality linking childhood events, repressed psychological forces and the patient's condition. The apparently consistent pattern of expectations, perceptions, behavior and 'defenses' may themselves be the effects rather than the causes of the patient's condition. The psychotherapeutic process is intrinsically incapable of deciding objectively between these possibilities. Grunbaum has emphasized this epistemological weakness in the etiological position. The author therefore proposes a more pragmatic, rehabilitative, view of the psychotherapeutic process. Psychotherapy that deals with the personal and social life of the patient may help to alter the circumstances that contribute to discomfort, or change behavior that leads to dissatisfaction, without any commitment to unproven etiological theories. In this sense, psychotherapy, like physiotherapy and rehabilitation, is non-specific and can be applied without making any assumptions regarding specific causal conditions or pathogenetic factors.

Fantasy↗
PubMed1995

Abusive head trauma: the relationship of perpetrators to their victims.

OBJECTIVE: Abusive head trauma is the most common cause of morbidity and mortality in physically abused infants. Effective prevention requires the identification of potential perpetrators. No study has specifically addressed the relationship of the perpetrators of abusive head trauma ("shaken baby syndrome") to their victims. The objectives of this study were to identify the abusers and their relationship to victims in these cases. METHODS: We reviewed the medical charts of 151 infants who suffered abusive head trauma to determine the perpetrator of the abuse. Caretakers were classified by level of certainty: confession to the crime, legal actions taken, or strong suspicion by the staff. The relationship of abusers to victims was analyzed. RESULTS: Male victims accounted for 60.3% of the cases. Twenty-three percent of the children died, although death rates for boys and girls did not vary significantly. Male perpetrators outnumbered females 2.2:1, with fathers, step-fathers, and mothers' boyfriends committing over 60% of the crimes. Fathers accounted for 37% of the abusers, followed by boyfriends at 20.5%. Female baby-sitters, at 17.3%, were a large, previously unrecognized group of perpetrators. Mothers were responsible for only 12.6% of our cases. All but one of the confessed abusers were with the child at the time of onset of symptoms. CONCLUSIONS: Our data suggest male caretakers are at greater risk to abuse infants. Baby-sitters are a concerning risk group, because they represent a significant proportion of abusers, and they more easily escape prosecution. In addition, no prevention efforts have been directed at baby-sitters. These statistics could help change the focus of efforts to prevent abusive head trauma.

Adult↗
PubMed1996

[Appearance of cytoplasmic processes of megakaryocytes in the peripheral blood in a Munchausen syndrome with factitious anemia].

Many cytoplasmic processes of megakaryocytes were seen in a 45-year-old male patient of Munchausen syndrome with sustained severe anemia due to repeated self-blood drawing. He had a past history of repeated infection and removal of skin-graft transplanted for giant congenital melanocytic nevus due to self-infliction (later confessed by the patient). On the admission, he presented with high fever (39 approximately 40 degrees C) and severe sustained anemia refractory to repeated blood transfusions. Any specific clinical data indicating bleeding or hemolysis were not found. Self-blood drawing was discovered by a nurse on his 27th hospital day. Syringes and needles for blooddrawing were also found. He recovered from anemia under intensive watching without any specific treatment. He confessed that the high fever was artificial. It was of interest that cytoplasmic processes of megakaryocytes were seen in the peripheral blood film until he recovered from anemia for one month. The serum level of erythropoietin was elevated (1540 mU/ml), but not significantly was that of thrombopoietin (1.54 fmol/ml). This case was considered to be valuable to understand the mechanism of platelet-production by megakaryocytes at persistent bleeding.

Anemia↗
PubMedDate not supplied

[Discrepancies in homicide statistics by suffocation].

Elucidating the estimated number of undetected murders by suffocation is difficult. Leaving aside criminalistical reasons it is worth to reflect about this problem from the viewpoint of forensic pathologists. 6 unknown cases of homicides from the last 15 years which occurred in Hamburg, Germany, are analysed. In five cases forensic pathologists were involved by postmortem examination, four times an autopsy was performed. In spite of questionable findings none of these fatalities could be elucidated by the investigations until the offenders addressed to the police in order to make unexpected confessions. Homicides had been performed by strangulation, suffocation or drowning. Another case demonstrates the problematic nature of false confessions.

Adult↗
PubMed1988

Labial adhesions and posterior fourchette injuries in childhood sexual abuse.

Six cases involving six sisters, all of whom were sexually molested, are presented to illustrate the association between labial adhesions and posterior fourchette injuries in sexually abused children. Although labial adhesions are a relatively common lesion, they only recently have been associated with childhood sexual abuse. Labial adhesions are ordinarily found in girls between 2 months and 7 years of age and are usually very superficial and disappear spontaneously by the time the child approaches puberty. We encountered six sisters, all of whom had been sexually abused, who had labial adhesions. Four of the six had changes in the area of the posterior fourchette that were consistent with previous trauma. In addition, four of the girls' hymens had thickened, irregular edges or other changes that were considered abnormal. The father, the grandfather, and an uncle confessed to lewd and lascivious misconduct with the children. Although labial adhesions alone are not reason enough to make a report of sexual abuse, the physician is obligated to inquire as to the possible cause if the adhesions do not fit the usual pattern or if there are other suspicious findings.

Child↗
PubMed1979

Patients' requests of an outpatient clinic.

Three-hundred-twenty-five consecutive predominantly lower-class new patients at a psychiatric outpatient clinic rated the importance they attached to each of 14 categories of treatment needs or requests. Psychiatric residents subsequently rated the importance of each request for each patient at the conclusion of their initial assessment interview. Requests reflecting needs for intrapsychic therapy, clarification, and control of feelings were considered very important by approximately two thirds of the patients; needs for institutionalized contact, advice, and community triage by one half; and other requests for medication, reality contact, succorance, ventilation, confession, social intervention, administrative requests by a minority (one fourth to one third). Residents significantly underestimated the importance their patients attached to 10 of 14 requests. Factor analyses confirmed several systematic sources of disparity between patient and therapist perception of lower-class patient needs.

Factor Analysis, Statistical↗
PubMed2003

A population-based study of inflicted traumatic brain injury in young children.

CONTEXT: Physical abuse is a leading cause of serious head injury and death in children aged 2 years or younger. The incidence of inflicted traumatic brain injury (TBI) in US children is unknown. OBJECTIVE: To determine the incidence of serious or fatal inflicted TBI in a defined US population of approximately 230 000 children aged 2 years or younger. DESIGN, SETTING, AND SUBJECTS: All North Carolina children aged 2 years or younger who were admitted to a pediatric intensive care unit or who died with a TBI in 2000 and 2001 were identified prospectively. Injuries were considered inflicted if accompanied by a confession or a medical and social service agency determination of abuse. MAIN OUTCOME MEASURE: Incidence of inflicted TBI. Multivariate logistic regression models were used to compare children with inflicted injuries with those with noninflicted injuries and with the general state population aged 2 years or younger. RESULTS: A total of 152 cases of serious or fatal TBI were identified, with 80 (53%) incurring inflicted TBI. The incidence of inflicted traumatic brain injury in the first 2 years of life was 17.0 (95% confidence interval [CI], 13.3-20.7) per 100 000 person-years. Infants had a higher incidence than children in the second year of life (29.7 [95% CI, 22.9-36.7] vs 3.8 [95% CI, 1.3-6.4] per 100 000 person-years). Boys had a higher incidence than girls (21.0 [95% CI, 15.1-26.6] vs 13.0 [95% CI, 8.4-17.7] per 100 000 person-years). Relative to the general population, children who incurred an increased risk of inflicted injury were born to young mothers (< or =21 years), non-European American, or products of multiple births. CONCLUSIONS: In this population of North Carolina children, the incidence of inflicted TBI varied by characteristics of the injured children and their mothers. These data may be helpful for informing preventive interventions.

Age Factors↗
PubMed2003

[Pharmacy as a means of propagating the Lutherian doctrine of justification].

Pharmacy serving to propagate the Lutherian doctrine of justification: "Christus as a pharmacist" is an interconfessional, but confessionally differentiated symbolic motif (Sinnbildmotiv) of Christian folklore art in German-speaking countries. The article investigates the sociocultural conditions and prerequisites (German bible translation, religion and confession, piety, pharmacy, chymiatry, chemistry, apothecary training and status) for transfering the old metaphor and idea of Christ as a physician to the new vision of Christ as a apothecary who prepares and dispenses his heavenly medicine all by himself. In the early 17th century (especially in the 1610's) these requirements were fulfilled, so that the oldest known witness to this motif transfer (picturing the so-called Heilandsruf of Matthew 11, 28), a genre picture of 1619, will be the first pictural version of this motif in general. It was created by the protestant Painter Mich(a)el Herr of Nuremberg. In the abstract and reduced form of a devotional picture this motif then became widespread in churches and vicarages, in monasteries and their apothecaries as well as in private houses (with small altars: Herrgottswinkel). The oldest yet known examples are works from around 1630. For the first time during the Thirty Year's War, it served in this form for propagating the Lutherian justification doctrine (now referring to Jesaja 55, 1), saying that the belief in Christ is enough to be released from all sins (sola fide). Around 1650, as a reaction to that, a catholic version of the devotional picture was created, claiming and picturing that in contrast eucharist is the highest and real, healing medium' of Christ to redemption. All pictures of this version avoid quoting Jesaja 55, 1, whereas all protestant pictures quote this verse from the Bible word-for-word.

Germany↗