Life Stressors and Posttraumatic Stress Disorder in a Seriously Mentally Ill Jail Population,

Inmates represent a vulnerable population with increased rates of trauma and posttraumatic stress disorder (PTSD). However, little is known about the rates of trauma and PTSD among male inmates with acute psychiatric illness. This prospective, randomized study was conducted to assess the current rates of trauma and PTSD in this population. The sample consisted of 48 patients admitted to a hospital jail psychiatry service in New York City. Subjects were administered the Life Stressor Checklist‐Revised and the Structured Clinical Interview for DSM‐IV‐TR Disorders, PTSD Module (SCID‐I). The rate of PTSD diagnosis via SCID‐I was 46.2% as compared to 2.1% diagnosis via clinical interview. All participants reported a history of at least one stressful and/or traumatic event, and many of these events occurred during incarceration. These results demonstrate that a great deal of trauma and PTSD goes unrecognized and untreated in this population, indicating the need for more effective treatment interventions.     

Occupational exposure to traumatic evidence and posttraumatic stress symptoms in forensic science professionals: Prevalence and patterns

Forensic science professionals are routinely exposed to potentially traumatizing evidence. This study aimed to estimate the prevalence of occupational posttraumatic stress disorder (PTSD) among forensic science professionals, identify job-related correlates of PTSD symptoms, and examine the role of social support in mitigating PTSD symptomology. In response to recruitment through the American Academy of Forensic Sciences, the American Society of Crime Laboratory Directors, and Evidence Technology Magazine, 449 forensic science professionals participated in the current study. Results found that 73.5% (n = 330) of the overall sample experienced at least one work-related traumatic event consistent with meeting Criterion A for PTSD, and these rates were higher for field-based respondents (n = 203, 87.9%). The prevalence of past-month provisional PTSD was 21.6% for the full sample. Disaggregated PTSD rates were 29.0% and 14.5% for field-based and non-field-based respondents, respectively. These rates were 6- to 8-fold higher than the past-year prevalence of PTSD in the general US population, estimated to be 3.5%, and were found to be at least as high as those observed in prior epidemiological research with non-treatment seeking members of the US military deployed to war zones in Iraq and Afghanistan. Results further showed that social support was protective against PTSD symptomology. The high rates of occupational exposure to trauma and consequent PTSD symptomology observed in this large sample of forensic science professionals highlight the under-acknowledged psychological risks of these occupations and the need for enhanced attention to mental health resources for these professionals.     

A meta-analytic review of the frequency and patterning of laryngohyoid and cervical fractures in cases of suicide by hanging

The frequency and distribution of fractures are commonly utilized to assist in interpreting the manner of death. In cases of alleged suicide by hanging, however, the evidence base for the frequency and patterning of laryngohyoid and cervical vertebrae fractures resulting from such blunt force traumatic events is limited and so fractures cannot be reliably used to assist in interpreting the manner. Using meta-analytic techniques, this study aimed to estimate frequency and distribution of fractures in the context of relevant intrinsic and extrinsic variables. A systematic review of the literature identified 20 studies with relevant data (8523 cases of suicide by hanging). Meta-analyses identified the frequency and distribution of fractures present and how fracture frequency was affected by the subgroups of age, sex, completeness of suspension, ligature knot position and study design. Results indicated that fracture frequency was variable, there was no unique patterning, and high levels of heterogeneity were present in all variable sub-groups. Age was the only subgroup to show differences. Findings suggest that neck fracture frequency is inconsistent and cannot be predicted by the chosen variables. Subsequently, neck fractures in isolation should not be given weight in medico-legal interpretations of a hanging death as suicidal.     

The utility of trauma evaluations in judicial decision-making in child sex trafficking cases: A qualitative analysis

Youth coerced into trafficking experience multiple forms of abuse, and are deprived of basic human rights associated with liberty and self-determination, all of which can adversely affect mental and psychological well-being (Ottisova et al., Behavioral Medicine, 44(3), 234-241.). This study uses a qualitative approach to exploring how judges use trauma-related information to make decisions about how to adjudicate cases involving minors who have been sexually trafficked. Additionally, the study identifies barriers to receiving data, the court resources needed to effectively respond, and potential remedies to address gaps in effective case management. The study uses data from 82 juvenile and family court judges from around the USA 27-item structured interview was used to determine the availability and utility of trauma services, needed resources, and solutions to overcome gaps in effective case adjudication. Themes emerged related to lack of access to and timing issues that limited the utility of reports, lack of congruency between recommendations and available resources and child and family resistance to disclosures. Solutions to overcome barriers are related to increased cross-disciplinary collaboration, awareness and responsiveness. Legal remedies such as Safe Harbor laws can only be realized if the systemic context is aligned and appropriately resourced toward responsiveness.     

根据S—100蛋白阳性胶质细胞的变化判断脑挫伤时间的实验研究

本文米用免疫组织化学ＡＢＣ法，观察了２４只大白鼠脑挫伤不同时间的胶质细胞特异性标志物Ｓ－１００蛋白的变化。结果表明，挫伤２天后Ｓ—１００阳性胶质细胞的胞体开始增大，突起不明显，随着脑挫伤时间的延长，胞体增大，突起明显的Ｓ—１００阳性胶质细胞数量明显增加，到第五天时达高峰，在脑挫伤的周围区均为胞林大、突起明显的Ｓ—１００阳性细胞，此结果表明Ｓ－１００蛋白的变化可用于挫伤后时间的判断。     

Buttressing regulation of cognitive enhancement devices with principles of harm reduction

Maslen and colleagues offer an excellent model for regulating cognitive enhancement devices (CEDs), and we largely endorse their approach of extending medical device policy to include CEDs. Maslen et al. argue that since the risks and benefits of CEDs can be identified, consumers are best placed to evaluate the impact of these effects on their own wellbeing: ‘experts are to assess what the risks are, the consumer how much they matter’. In principle, we agree: consumers should be allowed to decide what risks are worth taking, but the situation is somewhat more complicated, for the evidence that consumers are in a strong position to evaluate the many risks associated with CED use is lacking. Indeed, a glance at online forums on CEDs suggests that undue risks are already being taken. Importantly, given the ease with which devices can be built using easily obtainable parts, overly tough regulation will not effectively curtail use, but rather push it underground. For these reasons, we suggest that any regulatory framework be buttressed by principles of harm reduction, providing real-world users with expert-backed recommendations for safe use. We argue for the development of tools that facilitate this dialogue, while recognizing the challenges in so doing.     

Reframing the brain drain

Theorists concerned about the distributive effects of skilled emigration (‘brain drain’) often argue that its harmful effects can be justly mitigated by restricting emigration from sending countries or by limiting immigration opportunities to receiving countries. I raise moral and practical concerns against restricting the movement of skilled migrants and contend that conceptualizing the moral issue in these terms leads theorists to neglect the moral salience of institutions that determine the distributive effects of migration. Using an analogy to skilled migration in a domestic context, I argue for locating brain drain in a more holistic, institutional context that includes the reform of global institutions and of policies affecting migration.     

Offenders as victims: post-traumatic stress disorder and substance use disorder among male prisoners

Background: Comorbid substance use disorder(s) and post-traumatic stress disorder (SUD-PTSD) is common among prisoners and linked to an increased risk of criminal recidivism; however, little is known about the characteristics of prisoners with this comorbidity. Aim: This study provides a preliminary examination of the clinical and criminal profile of male inmates with symptoms of SUD-PTSD, and examines whether this profile differs according to whether a person has experienced a trauma while in prison. Methods: Thirty male inmates from two correctional centres in Sydney, Australia, were recruited and assessed using a structured interview. Results: The sample reported extensive criminal, substance use and trauma histories. A history of substance dependence was almost universal (90%) and 56.7% met diagnostic criteria for PTSD with the remainder experiencing sub-threshold symptoms. Forty-three per cent reported a traumatic event while in prison. Those who had experienced trauma in prison, compared to those who had not, were more likely to nominate heroin as their main drug of concern and to be receiving drug treatment in prison. There was also a trend toward inmates who had experienced a trauma in prison being more likely than inmates who had no prison trauma to have experienced a physical assault. Conclusion: Male prisoners with SUD-PTSD are a high-needs group yet treatment responses are poor. Further research examining treatment options for this comorbidity may improve prisoner well-being and reduce recidivism.     

THE DEFEAT THAT CHANGED CHINA'S HISTORY

正This year marks the 120th anniversary of the outbreak of the First Sino-Japanese War of 1894-95,commonly known in China as the Jiawu War.Time has passed,but the trauma of the conflict is still felt by the Chinese people even today.The war,during which China’s then-ruling Qing Dynasty(1644-1911)was defeated,changed the fate of the country.It exposed the     

Blast Injury and the Human Skeleton: An Important Emerging Aspect of Conflict‐Related Trauma

Recent decades have seen an accelerating trend in warfare whereby a growing proportion of conflict‐related deaths have been caused by explosions. Analysis of blast injury features little in anthropological literature. We present a review of clinical literature that includes prevalence of injury to anatomical regions and potential indicators of blast injury which can be used by forensic anthropologists. This includes high prevalence of extremity (22.8–91.2%) and facial (19.6–40%) injury in combat contexts, lower limb fractures (19–74.3%) in suicide bombing, traumatic amputation (3–43%) and diffuse fracture patterns in terrorist bombings. Potential indicators of blast trauma include blowout fractures in sinus cavities from blast overpressure, transverse mandibular fractures, and visceral surface rib fractures. Ability to recognize blast trauma and distinguish it in the skeleton is of importance in investigations and judicial proceedings relating to war crimes, terrorism, and human rights violations and likely to become increasingly crucial to forensic anthropology knowledge.