Coercive psychiatry and human rights: An assessment of recent changes in the Soviet Union

Conclusion In light of the historical context in which the visit of the United States delegation took place, the emphasis was on the political abuse of psychiatry. It should be clear, however, that the repression of dissidents is only the most visible manifestation of a system of psychiatric control that has been, and continues to be, profoundly insensitive to human rights. Although some tentative steps have been taken to subject coercive psychiatry to the rule of law, these limited initiatives have not yet become operational. Implementation of the legal reforms recommended by the delegation would help to reduce the likelihood that the pattern of psychiatric repression will reemerge. But the proposed reforms have a larger purpose—to assure that the practice of psychiatry in the Soviet Union is properly respectful of fundamental human rights, whether or not the patients have engaged in political or religious dissent.This is a revised and expanded version of the Fifth Samuel and Kathryn Yochelson Lecture, delivered at Yale Law School, New Haven, Connecticut, U.S.A., September 28, 1989, and of a paper presented to the Second International Conference on Health Law and Ethics, London, England, July 21, 1989, which paper was reprinted in 18Law, Medicine, and Health Care 123 (1990).B.A., Johns Hopkins University 1966; LL.B., University of Virginia 1969. The author was one of two lawyers who served on an official United States Department of State delegation that visited the Soviet Union (February 26–March 12, 1989) at the request of the Soviet government to assess recent changes in psychiatry there. The U.S. delegation was led by Loren H. Roth, M.D., M.P.H. (psychiatric team leader) and Daniel A. Regier, M.D., M.P.H. (scientific director).This article summarizes the delegation's findings and, in so doing, draws heavily on its report, which was drafted by the delegation as a whole. However, the opinions expressed in this article are the author's and should not be attributed to the delegation.     

Leisure Behavior Pattern Stability During the Transition from Adolescence to Young Adulthood

Leisure is an important context in which human development occurs. Changes in leisure behavior patterns may indicate changing developmental needs or reflect contextual changes that impact leisure behavior. The transition from adolescence to young adulthood provides an excellent opportunity for the study of the stability of leisure behavior as individuals' contexts are changed with the adoption of adult roles and the potential for disruption of leisure patterns exists. Previous studies investigating leisure and the transition from adolescence to young adulthood have tended to be cross-sectional and focus on specific leisure behaviors rather than identifying patterns of leisure behavior. The present study involved a longitudinal investigation of leisure behavior patterns over a three-year period during the transition from adolescence to young adulthood, and determined the nature of leisure pattern stability and instability during this period. In general, leisure pattern stability was the most common pathway into young adulthood. The patterns of leisure behavior and the nature of the changes that occurred with the transition from adolescence to young adulthood differed to some degree for males and females, although similarities in patterns and transitions were also found.     

Intimate partner violence, PTSD, and adverse health outcomes

The high prevalence of adverse health outcomes related to intimate partner violence (IPV) is well documented. Yet we know little about the pathways that lead to adverse health outcomes. Research concerning the psychological, biological, neurological, behavioral, and physiological alterations following exposure to IPV--many of which are associated with posttraumatic stress disorder (PTSD)--represents a promising area of empirical discovery. New technologies and interdisciplinary collaborative efforts are required to integrate diverse methodologies and to apply new findings to improving the health and well being of those affected by IPV. This article focuses on victimization by IPV and addresses the most important research findings in the last 20 years (health and mental health burden of IPV), the most important research issue for the next decade (pathways between IPV and adverse health outcomes), and the most promising methodological innovation for the study of IPV (integrated, interdisciplinary, biobehavioral methodology).     

Disorders of extreme stress (DESNOS) symptoms are associated with type and severity of interpersonal trauma exposure in a sample of healthy young women

Childhood abuse and other developmentally adverse interpersonal traumas may put young adults at risk not only for posttraumatic stress disorder (PTSD) but also for impairment in affective, cognitive, biological, and relational self-regulation ("disorders of extreme stress not otherwise specified"; DESNOS). Structured clinical interviews with 345 sophomore college women, most of whom (84%) had experienced at least one traumatic event, indicated that the DESNOS syndrome was rare (1% prevalence), but DESNOS symptoms were reported by a majority of respondents. Controlling for PTSD and other anxiety or affective disorders, DESNOS symptom severity was associated with a history of single-incident interpersonal trauma and with more severe interpersonal trauma in a dose-response manner. Noninterpersonal trauma was associated with elevated prevalence of PTSD and dissociation but not with DESNOS severity. Study findings indicate that persistent posttraumatic problems with self-regulation warrant attention, even in relatively healthy young adult populations.     

Forensic mitochondrial DNA analysis of 691 casework hairs

A five year retrospective review of mitochondrial DNA (mtDNA) analysis on 691 casework hairs was carried out. A full or partial mtDNA profile was obtained for > 92% of hairs. With increasing age of the hair, the likelihood of obtaining a full profile decreased, although "mini-primer sets" could often be used to capture a partial profile. With increasing color and diameter of the hair, the likelihood of obtaining a profile increased. Full or partial profiles were obtained on more than 80% of 114 hairs < or = 1.0 cm. Mixtures were observed in 8.7% of hairs tested; mixtures increased with the age of the hair and were presumed to be due to exterior surface contamination that could not be sufficiently cleaned prior to extraction, since the overall level of laboratory contamination was low. The frequency of sequence heteroplasmy was 11.4%, and both hot-spot and novel sites were observed. In about one-third of these observations, another sample in the case showed either the same heteroplasmic site or a nucleotide substitution at that site.