Co-Planar Stereotaxic Atlas of the Human Brain—3-Dimensional Proportional System: An Approach to Cerebral Imaging, J. Talairach, P. Tournoux. Georg Thieme Verlag, New York (1988), 122 pp., 130 figs. DM 268

The neurocognitive literature on test performance in schizophrenia is reviewed quantitatively. The authors report 22 mean effect sizes from 204 studies to index schizophrenia versus control differences in global and selective verbal memory, nonverbal memory, bilateral and unilateral motor performance, visual and auditory attention, general intelligence, spatial ability, executive function, language, and interhemispheric tactile-transfer test performance. Moderate to large raw effect sizes (d > .60) were obtained for all 22 neurocognitive test variables, and none of the associated confidence intervals included zero. The results indicate that schizophrenia is characterized by a broadly based cognitive impairment, with varying degrees of deficit in all ability domains measured by standard clinical tests.

Neurocognitive Deficit in Schizophrenia: A Quantitative Review of the Evidence

This survey of sexual practices in the United States has been combed by the media for items of interest to the public: monogamous sex is much more widespread in this country than has been thought; infidelity is less frequent than presumed; vaginal intercourse is the defining experience of heterosexual behavior; watching one's partner undress is stimulating to many people; married couples have more sex than single people (unmarried, cohabiting couples have the most sex of all); the majority of couples experience sex twice a week to several times a month; 2.8% of men identify themselves as homosexual and 1.4% of women do so, but a higher percentage of people consider a same-gender experience to have some appeal; 75% of men always experience orgasm compared with 28.6% of women, but more nearly equal numbers of men and women declare themselves satisfied with their sexual experiences. The book is, in fact, a

The Social Organization of Sexuality: Sexual Practices in the United States

This report builds on a highly valued predecessor, the 1994 Institute of Medicine (IOM) report entitled Reducing Risks for Mental Disorders: Frontiers for Preventive Intervention Research. That report provided the basis for understanding prevention science, elucidating its then-existing research base, and contemplating where it should go in the future. This report documents that an increasing number of mental, emotional, and behavioral problems in young people are in fact preventable. The proverbial ounce of prevention will indeed be worth a pound of cure: effectively applying the evidence-based prevention interventions at hand could potentially save billions of dollars in associated costs by avoiding or tempering these disorders in many individuals. Furthermore, devoting significantly greater resources to research on even more effective prevention and promotion efforts, and then reliably implementing the findings of such research, could substantially diminish the human and economic toll.

Preventing Mental, Emotional, and Behavioral Disorders Among Young People: Progress and Possibilities

Federal Abortion Policy and Politics: 1973-1996 Why is Abortion Such a Controversial issue in the United States Barriers to Access to Abortion Services The Impact of Anti-abortion Activities on Women Seeking Abortions Black Women and the Question of Abortion Latinos and Abortion Abortion and Asian Pacific Islander Americans The Acceptability of Medical Abortion to Women Understanding the Relationship of Violence Against Women to Unwanted Pregnancy and it's Resolution Testing a Model of the Psychological Consequences of Abortion Men and Abortion: The Gender Politics of Pregnancy Resolution Abortion Among Adolescents A Cognitive Approach to Patient-Centered Abortion Care Abortion Issues in Psychotherapy Bringing Lessons Learned to the United States Improving Access to Abortion Services Abortion Practice, Policy, and Research: Recommendations for the 21st Century

Violent offenders: Appraising and managing risk.

Background We report on mental disorders and violence for a birth cohort of young adults, regardless of their contact with the health or justice systems. Methods We studied 961 young adults who constituted 94% of a total-city birth cohort in New Zealand, April 1, 1972, through March 31, 1973. Past-year prevalence of mental disorders was measured using standardized DSM-III-R interviews. Past-year violence was measured using self-reports of criminal offending and a search of official conviction records. We also tested whether substance use before the violent offense, adolescent excessive perceptions of threat, and a juvenile history of conduct disorder accounted for the link between mental disorders and violence. Results Individuals meeting diagnostic criteria for alcohol dependence, marijuana dependence, and schizophrenia-spectrum disorder were 1.9 (95% confidence interval [CI], 1.0-3.5), 3.8 (95% CI, 2.2-6.8), and 2.5 (95% CI, 1.1-5.7) times, respectively, more likely than control subjects to be violent. Persons with at least 1 of these 3 disorders constituted one fifth of the sample, but they accounted for half of the sample's violent crimes (10% of violence risk was uniquely attributable to schizophrenia-spectrum disorder). Among alcohol-dependent individuals, violence was best explained by substance use before the offense; among marijuana-dependent individuals, by a juvenile history of conduct disorder; and among individuals with schizophrenia-spectrum disorder, by excessive perceptions of threat and a history of conduct disorder. Conclusions In the age group committing most violent incidents, individuals with mental disorders account for a considerable amount of violence in the community. Different mental disorders are linked to violence via different core explanations, suggesting multiple-targeted prevention strategies.

https://jamanetwork.com/journals/jamapsychiatry/articlepdf/481658/yoa9346.pdf

Mental disorders and violence in a total birth cohort: results from the Dunedin Study.

BACKGROUND Tragic and high profile killings by people with mental illness have been used to suggest that the community care model for mental health services has failed.

AIMS To consider whether such homicides have become more frequent as psychiatric services have changed.

METHOD Data were extracted from Home Office-generated criminal statistics for England and Wales between 1957 and 1995 and subjected to trends analysis.

RESULTS There was little fluctuation in numbers of people with a mental illness committing criminal homicide over the 38 years studied, and a 3% annual decline in their contribution to the official statistics.

CONCLUSIONS There are many reasons for improving the resources and quality of care for people with a mental disorder, but there is no evidence that it is anything but stigmatising to claim that their living in the community is a dangerous experiment that should be reversed. There appears to be some case for specially focused improvement of services for people with a personality disorder and/or substance misuse.

Homicides by people with mental illness: myth and reality.

Two hundred and three male remanded prisoners were interviewed with respect to their current offence, mental state, and social and psychiatric histories. All but nine of the sub-group of 121 psychotic men showed active symptoms at the time of committing a criminal offence; 20% of the actively ill psychotics were directly driven to offend by their psychotic symptoms, and a further 26% probably so. If some of the indirect consequences of the psychosis were taken into account, 82% of their offences were probably attributable to the illness. Among the normal and neurotic men, none claimed psychotic motives for offending, but motives suggesting high emotional arousal such as panic or retaliation triggered the greatest violence. Within the psychotic group, those driven to offend by their delusions were most likely to have been seriously violent, and psychotic symptoms probably accounted directly for most of the very violent behaviour.

Motives for offending among violent and psychotic men

BACKGROUND From a first clinical description of a complete resident sample of special (high security) hospital patients, we examined the association between mental disorder and violence.

METHOD A record survey of all 1740 patients resident at any time between 1 January and 30 June 1993, inclusive, and, for most, the official criminal record.

RESULTS 1015 patients (58%) had functional psychosis, one-quarter of whom also had an independent personality disorder; 461 (26%) had personality disorders uncomplicated by psychosis, and 264 (16%) had learning disabilities. Pre-admission substance misuse, which was probably under-recorded, had been most common among those with psychosis and an independent personality disorder. Less than 10% had never been convicted of a criminal offence, although 25% had been admitted directly from other hospitals. Direct personal violence was more common among men, and fire-setting among women. Schizophrenia was most strongly associated with personal violence. More than 75% of those with a psychosis were recorded as being driven to offend by their delusions. In the absence of delusions, hallucinations had no such effect.

CONCLUSIONS For people with personality disorder better clinical descriptions seem essential. For people with a pure psychosis, as symptoms were usually a factor driving the index offence, treatment appears as important for public safety as for personal health.

Mental disorder and violence. A special (high security) hospital study.

A survey of the records of 1241 men remanded in prison on criminal charges over four months yielded a high prevalence of psychiatric disorder. Of the total prison intake of 2743 men over the same period, 246 (9.0%) showed major symptoms of psychiatric illness and a further 237 (8.6%) symptoms of withdrawal from drugs or alcohol. Symptoms of neurotic disorders were underrecorded, so in terms of diagnosis 237 men (8.7%) were considered to be psychotic. Of these, 166 (70%) were schizophrenic. The influence of affective psychosis was small. The risk of violence among men with schizophrenia was high. Twenty five (9%) non-fatal personal assaults and 24 (21%) offences of damage to property were committed by men with schizophrenia. The presence of mental illness probably influences the decision to remand in custody for some of these offences, but this is unlikely to explain the substantially higher prevalence of schizophrenia among men convicted of homicide (five (11%) ) and arson (six (30%) ) than would be expected in the general population of Greater London (0.1-0.4%). The prevalence of schizophrenia among men convicted of homicide may even be an underestimate, as may the prevalence of affective psychosis and possibly of other psychiatric abnormalities, given the substantial incidence of concurrent suicide in such men.

https://www.bmj.com/content/bmj/288/6435/1945.full.pdf

Pamela J. Taylor

Papers

Mental disorders and violence in a total birth cohort: results from the Dunedin Study.

Homicides by people with mental illness: myth and reality.

Motives for offending among violent and psychotic men

Mental disorder and violence. A special (high security) hospital study.

Violence and psychosis. I. Risk of violence among psychotic men.