Markham's Behavioral Health

Teens Who Experience Violence Likely to Be Violent

Reuters reported on May 26, 2005 on a study to appear in the May 27, 2005 issue of Science which shows that adolescents exposed to violence are twice as likely to be violent themselves.

"New study findings provide scientific proof for what some have already deduced: teens exposed to violence are more likely than their peers to become involved in violence in the future.

Specifically, the study found that adolescents who witness gun violence or are the victim of gun violence are twice as likely as their peers to commit serious violence during the following two years after their exposure.

"The primary implication of these findings is that violence can be transmitted from person to person by means of exposure in the community," study author Jeffrey B. Bingenheimer, a doctoral candidate at the University of Michigan's School of Public Health, told Reuters Health.

"This makes the 'epidemic of violence' metaphor seem particularly apt, and is consistent with sociological theories of violent crime as a contagious social process," he added.

If, as this finding and other research suggests, "violence begets violence," the implications of increasing rates of violent crime along and adolescent exposure to violence, are troubling, the report states."

These findings would seem to me to have implications for international relations as well, and makes me further question the Bush Administration's "war on terror" and the pre-emptive wars in Afghanistan and Iraq. The idea that strategies other than war like international dialogue, and the UN inspection process is particularly strong given the idea uncovered in this study that violence only begets more violence.

It turns out that the UN inspection process had worked and that Iraq had no WMD and no nuclear capability, and yet the Bush administration embarked on a violent strategy anyway which has brought about a retalitory insurgency that has killed more Americans and Iraqis after Bush's famous gaff of announcing "mission accomplished" than before his announcement.

This study done at a neighborhood and community level has important implications at a macrosystems level as well.

Link: MedlinePlus: Teens Who Experience Violence Likely to Be Violent.

Quote of the day

"If we could read the secret history of our enemies, we should find in each man's life sorrow and suffering enough to disarm all hostility."

Henry Wadsworth Longfellow

Success of Designated-driver Campaigns Unclear

Reuters reported on May 26, 2005 on a study which appears in the June, 2005 issue of the American Journal of Preventive Medicine which questions whether "Designated Driver" programs actually decrease the number of drunk driving incidents.

It appears in the review that the idea often gets poorly implemented such as in situations where a group is out drinking and only when its time to go home do they choose the least intoxicated person to drive.

"There is little evidence that designated-driver campaigns and promotions have helped reduce the number of people who drive drunk, according to a new research review.

The review, of nine studies that evaluated a single media campaign and several promotions at bars and clubs, found that some of these publicity efforts were mildly successful in getting drinkers to choose a designated driver.

However, the study authors report in the American Journal of Preventive Medicine, "The present evidence is insufficient to draw conclusions about the effectiveness of either type of designated driver promotion program."

Like anything else in life, a good idea is only a good idea and has little value unless it is properly implemented.

"Designated Driver" programs probably have value if included with other strategies such as good enforcement, decreased access to amounts of alcohol consumed on a single occasion, and a change in attitudes about drinking to begin with.

To send a message that everyone can and/or should get smashed, blitzed, totally gonzo, as long as there is a designated driver is probably counter-productive.

Link: MedlinePlus: Success of Designated-driver Campaigns Unclear.

Quote of the day

"Hatred is not diminished by hatred at any time. Hatred is diminished by love. This is an eternal law."

Buddha

Hotel Rwanda, the film

Hotel Rwanda is a British film distributed in 2004 which tells the story of the massacre of 1 million Tutsis by Hutus in Rwanda in 1994. It tells the true story of a Hutu hotel manager, Paul Rusesabagina (Don Cheadle), who saved over 1200 Tutsis, including his own wife and children, by harboring them in the Belgian four star hotel in which he was assistant manager.

This is a very moving film which makes me wonder about the tremendous hatred which human beings can harbor which leads to genocide of this proportion. The even sadder thing is that the rest of the world stood by and did nothing as it happened. The beleaguered United Nations peacekeeper general says to Paul at one point that the world did nothing because they are only "niggers".

It seems ironic that the Belgians, the French, the British, the Americans are very quick to intervene when it is money, oil, or other natural resources at stake, but human life is ignored.

One man, Paul Rusesabagina, did what he could to stand up to the thuggery, the killing, and he saved lives. His actions make me proud to be a human being, but the actions of other members of the human race who perpetrated this genocide, and those who stood by and watched it happen, fill me with horror, then rage, then an overwhelming sadness. It makes me wonder, "What is wrong with people?"

I highly recommend this movie. It should be required watching for every thoughtful and caring person.

Link: Hotel Rwanda (2004).

Quote of the day

"It's really a wonder that I haven't dropped all my ideals, because they seem so absurd and impossible to carry out. Yet, I keep them, because in spite of everything, I still believe that people are really good at heart."

Anne Frank

Sick child or crazy parent?

Munchausen By Proxy is a form of child maltreatment in which the parent makes the child sick on purpose or fabricates an illness for the child in order to get attention and other rewards. It is the "stage mother" or "stage father" taken to the extreme in the health care arena.

Thank goodness is it relatively rare, but I have seen much milder forms in what we call "fix my kid" cases. These are situations in which the parent blames the child for whatever family dysfunction is occuring and insists that the problem has nothing to do with them or other family dynamics but resides primarily and exclusively in the child. These parents often resist therapy themselves and are resistant to taking any responsibility for the problems which exist.

Unfortunately, well meaning and earnest health care professionals sometimes play into the hands of the Munchausen By Proxy parent, and only after expensive tests, and sometimes treatment, does it become apparent that the child and the health care system has been manipulated.

When Munchausen By Proxy is suspected, the safety of the child becomes the primary concern, and the parent is in need of mental health services. Child Protective services need to be called so that an investigation, and if needed, an ongoing service plan can be developed and coordinated.

Link: Definitions and MBP / Munchausen by Proxy Basics.

Sideways, the film

I'd heard mixed things about Sideways. Some people loved it, and some people couldn't understand what all the adulation was about and were bored. I myself, while not bored, wondered what those who loved this film liked about it.

The movie is about a middle aged male bonding week away before Jack (Thomas Haden Church) gets married. Jack's buddy, Miles (Paul Giamatti), and he take a leisurely trip through California wine country to relax before the wedding. Miles has been divorced for two years and Jack is determined to get him laid during the week while Miles' interests focus on wine tasting, pining away for his ex-wife, and maybe playing a little golf. Miles is trying to get his novel published and Jack, a sometime actor, still isn't sure what he wants to do with his life.

I felt sad for these two boys/men. They are stuck in perpetual adolesence and don't appear to want to grow up. The idea of finding a mate and settling down seems to terrify both of them in different ways.

Perhaps the problem with this movie for me is that I didn't like either of these guys and really didn't care about their lives. They seemed childish, shallow, and their values at middle age are dysfunctional.

I don't recommend this movie

Link: Sideways (2004).

Quote of the day

"In defence of politicians, they are necessarily the products of a society. If it is a society that thinks only of money and power, without any concern for moral values, we should not be surprised if politicians are corrupt, and should not therefore consider that the responsibility for such a situation lies entirely with them."

Dalai Lama

Drug companies influence studies

More evidence is presented in the May 26, 2005 issue of the New England Journal of Medicine that pharmaceutical companies influence drug trial studies by partnering with medical schools.

Reuters reports on this study on May 25, 2005.

"A survey released Wednesday indicates many university medical schools permit the pharmaceutical industry to influence what gets published from industry-sponsored drug studies.

The findings raise concern because the industry provides 70 percent of clinical drug trial funding in the United States and the potential of pharmaceutical companies to withhold negative study results can have devastating consequences."

It is a scarey thing when science gets corrupted by pecuniary interests and researcher bias contaminates findings used as a basis by the FDA and other regulatory bodies to approve medications and medical procedures which could have negative consequences for the lives of patients.

Who do you trust this days?

I had a patient yesterday tell me that she has concerns and questions about her medical care but is afraid to ask her doctor, whom she likes, because "I know he has a temper and I don't want him to get mad."

Unfortunately, medicine and health care over the last 30 years has been turned into a commodity to be sold, and like any purchase "caveat emptor", let the buyer beware.

Link: MedlinePlus: Drug companies influence studies.