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Pharmacological Interventions with Adult Male Sexual Offenders

November 17, 2018October 23, 2017 by admin

Introduction

The treatment of sexual offending behaviors is complex and involves multiple etiologies, individualized risk reduction and risk management needs, and heterogeneous biopsychosocial, interpersonal, and legal factors. Clinicians and researchers have attempted to identify approaches which promise the greatest success in addressing these behaviors. Findings from a meta-analysis examining the effectiveness of various treatment interventions for adult sex offenders indicated that, when used in combination with other treatment approaches, biological interventions like testosterone-lowering hormonal treatments may be linked to greater reductions in recidivism for some offenders than the use of psychosocial treatments alone (Losel and Schmucker, 2005). Other data, described below, suggest that non-hormonal psychotropic medications can also be effective supplements to standard therapeutic interventions for sex offenders as well.

This document is designed to provide an overview of key issues pertaining to the use of hormonal and non-hormonal agents to...

Sexual Signaling at a Nightclub

November 17, 2018October 23, 2017 by admin

Alek is a physical space where typically males of a species congregate to display sexual signals meant to impress the discerning females (see Fiske, Rintamäki, & Karvonen, 1998 for a review of such species across many taxa). Click here to see a male Greater Sage-Grouse engaging in lekking behavior. In a few rare role-reversal species, it is the females who engage in lekking behaviour as a means of attracting prospective male suitors (cf. Funk & Tallamy, 2000). In my work, I have long argued that many consumer phenomena are nothing more than forms of lekking behavior. In the human context, men and women use sex-specific products as sexual signals. For additional details see my books The Evolutionary Bases of Consumption, and The Consuming Instinct: What Juicy Burgers, Ferraris, Pornography, and Gift Giving Reveal About Human Nature; also see one of my earliest Psychology Today posts here on the use of Porsches as a lekking signal; ...

Mating Success In Lekking Males:a Meta-Analysis

February 21, 2019October 23, 2017 by admin

Traits that are correlated with mating success are likely to be subject to sexual selection. In lekking species, a male's mating success can be estimated as the number of females that he copulates with. Earlier reviews of sexual selection in lekking species have been inconclusive, suggesting that different traits may be important in different species. To obtain a more complete understanding of the outcome of sexual selection in this mating system, we performed a meta-analysis in which we combined the results from different studies across a wide variety of taxa. Our aim was to synthesize available information about correlates of male mating success in lekking species. We found that behavioral traits such as male display activity, aggression rate, and lek attendance were positively correlated with male mating success. Further, territory position was negatively correlated with male mating success, such that males with territories close to...

Media Influences on Teen Sexual Behavior

November 17, 2018October 23, 2017 by admin

American teenagers are exposed to substantial amounts of sexual content on television. Though it is widely believed that this exposure affects teens, there has been surprisingly little scientific investigation of this issue. To address this knowledge gap, RAND conducted a multi-year year study that broke new scientific ground as the first to examine whether adolescents' viewing of sexual content on television predicts their subsequent behavior and health outcomes. The study found that:

Teens who watch a lot of television with sexual content are more likely to initiate sexual intercourse in the following year (see figure). Frequent exposure to TV sexual content was associated with a significantly greater likelihood of teen pregnancy in the three years following exposure. Portraying the risks of sex in television shows appears to help educate teens about the potential consequences of sexual behavior...

Teenage Sexual Behaviour: Attitudes Towards And Declared Sexual Activity.

November 5, 2018October 23, 2017 by admin

Abstract

Although the teenage pregnancy rates in the UK are falling in the 16 to 19 year old range, they are still rising in the 13 to 15 year olds. Overall, they remain one of the highest within Western Europe. Teenagers continue to present a challenge to the health services due to the increase in their sexual risk taking behaviour, the earlier age at which they are starting sexual activity and a reluctance to utilise services available to them. In an attempt to develop current services and make them more 'user friendly', a sexual health needs assessment was carried out on teenagers, part of which looked at their attitudes towards risk taking sexual behaviour and their declared sexual behaviour. A quantitative survey, using a questionnaire in schools, was answered by 1500 pupils aged between 13 and 18 years old, and showed ..

Medication-Induced Sexual Dysfunction

November 17, 2018October 23, 2017 by admin

Target Audience and Goal Statement

This activity is intended for psychiatrists, primary care physicians, psychologists, neurologists, pharmacists, and other mental health professionals.

The goal of this activity is to provide current treatment protocols and clinical strategies for the treatment and management of psychiatric disorders and to update the clinician and the researcher on the latest developments in psychiatry and mental health.

Upon completion of this activity, participants will be able to:

1.Distinguish among the various subtypes of bipolar disorder. 2.Review aspects of violence and some of its causes. 3.Delineate recent findings in the treatment of sexual side effects of psychotropic medications.

Sexual Assault, Irresistible Impulses, And Forensic Psychiatry In Sweden

November 17, 2018October 23, 2017 by admin

Abstract

After forensic psychiatry was firmly established in Sweden in the 1930s, many rapists and individuals charged with assaulting children underwent a forensic psychiatric examination. The physicians found that most of them had not been “in control” of their senses or not “in complete control” of their senses at the time of the crime. If the court ordered a forensic psychiatric examination, the defendant had a very good chance of either being discharged or having his sentence reduced considerably. By the 1950s psychological perspectives began to dominate in forensic psychiatry. In the forensic records of the 1950s we can notice a shift from a biomedical to a socio-psychological perspective, and crime was increasingly related to conditions that were not seen as mental derangement from a legal point of view. As a result, it became less and less common, from the...

Evaluation for Civil Commitment of Sex Offenders: A Survey of Experts

November 17, 2018October 23, 2017 by admin

Abstract

At this study's commencement, 17 states had enacted sex offender civil commitment legislation. Although each statute outlines broad criteria that must be met, civil commitment evaluators are given considerable latitude in how to conduct their assessment. Forty-one experts who conduct sex offender civil commitment evaluations were surveyed to identify the usual practice of these evaluators. A great deal of agreement exists across experts regarding the conduct of sex offender civil commitment evaluations. However, these patterns appear quite different from the usual practice outlined in other types of forensic evaluations. Experts in sex offender civil commitment endorsed documentation as the core method for evaluation. The majority of evaluators reported the assessment of paraphilias, substance abuse, other Axis I disorders, Axis II disorders, and psychopathy as essential to the evaluation. Virtually all survey respondents utilized actuarial risk assessment measures, primarily the Static-99, in assessing for risk of...

Management of Retrograde Ejaculation

November 5, 2018October 23, 2017 by admin

The goal of treatment methods for retrograde ejaculation is to restore antegrade ejaculation though medical therapy or with surgical procedures, or to retrieve sperm from the urine to be used with assisted reproduction.

Medical management aims to increase the tone of the bladder neck, preventing retrograde flow of semen into the bladder. This can be achieved either by stimulating sympathetic activity (closure of the bladder neck is under sympathetic control) or by blocking parasympathetic input (para sympathetic activity is responsible for bladder neck relaxation) (Jonas, Linzbach, & Weber, 1979; Stewart, & Bergant, 1974; Stockamp, Schreiter, & Altwein, 1974). Treatment of retrograde ejaculation includes antihistamines (brompheniramine), tricyclic antidepressants (imipramine), and other agents, including anticholinergic and adrenergic agents (Kamischke, & Nieschlage, 2002). Araja and Tabie (2008) noted in cases of males with diabetes mellitus with complete retrograde ejaculation that imipramine (25 mg twice a...u

Drugs That May Cause Muscle Weakness Or Wasting

November 17, 2018October 22, 2017 by admin

Muscle problems have many possible causes. Inflammation of the muscle, called myositis, causes muscle weakness and wasting. Several types of drugs are linked to the development of myositis in some people. These include some recreational drugs, antibiotics, chemotherapy drugs, drugs affecting the hormonal system, drugs for cholesterol as well as heart and stomach drugs.

Recreational Drugs

Consumption of some recreational drugs is known to cause muscle problems. Alcoholic myopathy, also known as alcoholic rhabdomyolysis, is a condition in which the skeletal muscle breaks down during an alcohol binge or withdrawal from chronic use. If mild it may cause no symptoms. It can lead to muscle weakness and wasting, and if severe the proteins released from muscle break down into the blood and can damage the kidneys. A binge on cocaine can also cause muscle tissue to break down...

Statewide Law Enforcement | Mental Health Efforts

February 21, 2019October 22, 2017 by admin

Introduction

Nationwide, law enforcement agencies in rapidly increasing numbers have embraced specialized policing responses (SPRs, pronounced “spurs”) to people with mental illnesses. These efforts, which prioritize treatment over incarceration when appropriate, are planned and implemented in partnership with community service providers and citizens. The two most prevalent SPR approaches are Crisis Intervention Teams (CITs) and police-mental health co.-responder teams. CITs, pioneered by the Memphis (TN) Police Department, draw on a self-selected cadre of officers trained to identify signs and symptoms of mental illness, to de-escalate any situation involving an individual who appears to have a mental illness, and to connect that person in crisis to treatment. The second approach, co-responder teams, forged by the Los Angeles (CA) Police Department and San Diego County (CA) Sheriff’s Department, pairs officers with mental health professionals to respond to calls involving people in or combined these strategies, but a common...

H.R. 731 (114th): Justice and Mental Health Collaboration Act of 2015

November 5, 2018October 22, 2017 by admin

Amends the Mentally Ill Offender Treatment and Crime Reduction Act of 2004 to: (1) expand the assistance provided under such Act, and (2) reauthorize appropriations for FY2016-FY2020.

Authorizes the Attorney General to award grants to establish or expand: (1) veterans treatment court programs, which involve collaboration among criminal justice, veterans, and mental health and substance abuse agencies to provide qualified veterans (preliminarily qualified offenders who were discharged from the armed forces under conditions other than dishonorable) with intensive judicial supervision and case management, treatment services, alternatives to incarceration, and other appropriate services, including housing, transportation, job training, education, and assistance in obtaining benefits; (2) peer to peer services or programs to assist such veterans in obtaining treatment, recovery, stabilization, or rehabilitation; (3) practices that identify and provide treatment, rehabilitation, legal, transitional, and other appropriate services to such veterans who have been incarcerated; and (4) training programs to teach...

Mental Health Training In Emergency Homeless Shelters.

November 5, 2018October 22, 2017 by admin

Abstract

The prevalence of mental illness among homeless persons points to the importance of providing mental health training to emergency shelter staff. The authors report on their own work and argue that such training offers the potential to significantly improve shelter staffs ability to respond to the needs of shelter residents with mental illness, and to the behavioral problems some of these individuals may pose for shelter operation. Mental health care providers should take into consideration organizational dynamics when planning and implementing such training...

Mental Health By the Numbers

November 17, 2018October 22, 2017 by admin

Prevalence of Mental Illness

Approximately 1 in 5 adults in the U.S.—43.8 million, or 18.5%—experiences mental illness in a given year. Approximately 1 in 25 adults in the U.S.—9.8 million, or 4.0%—experiences a serious mental illness in a given year that substantially interferes with or limits one or more major life activities. Approximately 1 in 5 youth aged 13–18 (21.4%) experiences a severe mental disorder at some point during their life.

For children aged 8–15, the estimate is 13%. 1.1% of adults in the U.S. live with schizophrenia.

2.6% of adults in the U.S. live with bipolar disorder.

6.9% of adults in the U.S.—16 million—had at least one major depressive episode in the past year.

18.1% of adults in the U.S. experienced an anxiety disorder such as posttraumatic stress disorder, obsessive-compulsive disorder and specific phobias...

Misdiagnosing Normality: Psychiatry’s Failure To Address The Problem Of False Positive Diagnoses Of Mental Disorder In A Changing Professional Environmen

November 5, 2018October 22, 2017 by admin

Abstract

BACKGROUND:

In psychiatry's transformation from primarily an asylum-based profession to a community-oriented profession, false positive diagnoses that mistakenly classify normal intense reactions to stress as mental disorders became a major challenge to the validity of psychiatric diagnosis. The shift to symptom-based operationalized diagnostic criteria in DSM-III further exacerbated this difficulty because of the contextually based nature of the distinction between normal distress and mental disorder, which often display similar symptoms. The problem has particular urgency because the DSM's symptom-based criteria are often applied in studies and screening instruments outside of the clinical context and by non-mental-health professionals.

AIMS:

To consider, through selected examples, the degree of concern, systematicity and thoroughness - and the degree of success - with which recent revisions of the DSM have attended to the challenge of avoiding false positive diagnoses.

METHOD:

Conceptual analysis of selected criteria sets, with a focus on possible counterexamples...

Everyone’s Neighborhood: Addressing “Not in My Backyard” Opposition to Supportive Housing for People with Mental Health Disabilities

February 21, 2019October 21, 2017 by admin

Chapter 1: Introduction

Organizations that provide housing and supportive services to people with mental health disabilities have their work cut out for them. It is enough of a challenge to identify housing sites, obtain necessary funding, arrange for services, navigate complex administrative systems and secure scarce funding sources if neighbors and local government support the project. But the process becomes much more difficult when neighbors start complaining about housing “those people” in “our” neighborhood. This paper discusses efforts that housing developers, advocates and local governments have made to promote supportive housing for people with mental health disabilities, suggests strategies for bolstering community support, and provides tools for addressing neighborhood opposition if it does arise. “Not In My Backyard” – or NIMBY1 – opposition to affordable and supportive housing “has deep roots in fear, racism, classism, ableism, and growing antidevelopment reactions. ....