/pdf/practice-guideline-for-the-treatment-of-patients-with-major-ofberaz3o1.pdf

PRACTICE GUIDELINE FOR THE Treatment of Patients With Major Depressive Disorder

Acts of violence account for an estimated 1.43 million deaths worldwide annually. While violence can occur in many contexts, individual acts of aggression account for the majority of instances. In some individuals, repetitive acts of aggression are grounded in an underlying neurobiological susceptibility that is just beginning to be understood. The failure of “top-down” control systems in the prefrontal cortex to modulate aggressive acts that are triggered by anger provoking stimuli appears to play an important role. An imbalance between prefrontal regulatory influences and hyper-responsivity of the amygdala and other limbic regions involved in affective evaluation are implicated. Insufficient serotonergic facilitation of “top-down” control, excessive catecholaminergic stimulation, and subcortical imbalances of glutamatergic/gabaminergic systems as well as pathology in neuropeptide systems involved in the regulation of affiliative behavior may contribute to abnormalities in this circuitry. Thus, pharmacol...

/pdf/neurobiology-of-aggression-and-violence-5ewexbhk11.pdf

Neurobiology of Aggression and Violence

Quality of mothering relies on the integrity of multiple physiological and behavioral systems and on two maternal factors, one proximal and one distal, that have a great impact on how a mother mothers: postpartum depression and early experiences. To mother appropriately requires the action of systems that regulate sensation, perception, affect, reward, executive function, motor output and learning. When a mother is at risk to engage in less than optimal mothering, such as when she is depressed or has experienced adversity in childhood, the function of many or all of maternal and related systems may be affected. In this paper, we will review what is currently known about the biological basis of mothering, with attention to literature on hormones but with a particular focus on recent advances in the fields of functional neuroimaging. Instead of discussing strictly ‘maternal’ brain imaging studies, we instead use a systems approach to survey important findings relevant to brain systems integral to and/or strongly related to the mothering experience: (a) social behavior; (b) reward and affect; (c) executive function; and (d) maternal behavior. We find that there are many commonalities in terms of the brain regions identified across these systems and, as we would expect, all are sensitive to the influence of, or function differently in the context of, depression and adverse early experience. It is likely that the similarity and cross-talk between maternal, affect and stress systems, observed behaviorally, hormonally and in the context of brain function, allows for mood disturbance and early adverse experiences to have a significant impact on the quality of mothering and the motivation to mother. Keywords: Adversity, maternal depression, brain imaging, parenting, mothers.

/pdf/annual-research-review-all-mothers-are-not-created-equal-3lracphk45.pdf

Annual Research Review: All mothers are not created equal: neural and psychobiological perspectives on mothering and the importance of individual differences

The author believes that the killing of a newborn baby is a separate entity from other filicides, differing in regard to the diagnosis, motives, and legal disposition of the murderer Whereas most filicides are committed for "altruistic" reasons, most neonaticides are carried out simply because the child is not wanted The author notes the different psychological characterisctics of mothers who commit these two crimes Legal considerations and the present status of neonaticide are also discussed

Murder of the Newborn: A Psychiatric Review of Neonaticide

Objective. —To review the epidemiology, patterns, and major determinants of murder-suicide and to discuss the clinical and research strategies for identifying the individuals at greatest risk for this type of violence. Data Sources. —Data were obtained from English-language articles based on searches using MEDLINE (from 1966), PsychINFO (from 1967), and EMBASE (from 1974) programs. In addition, relevant articles, books, and monographs identified from the reference list of retrieved articles were reviewed. Study Selection. —Case-control studies, descriptive epidemiologic surveys, and case series were chosen for review. Data Extraction. —Because of the limited scope of the pertinent research literature, all data relevant to the incidence, demographics, circumstances, and precipitants of murder-suicide were summarized by the authors. Data Synthesis. —Murder-suicide occurs with an annual incidence of 0.2 to 0.3 per 100000 person-years and accounts for approximately 1000 to 1500 deaths yearly in the United States. The annual incidence of these events is relatively constant across industrialized nations and has not significantly changed over several decades. The principal perpetrators are young males with intense sexual jealousy, depressed mothers, or despairing elderly men with ailing spouses. The principal victims are female sexual partners or consanguineous relatives, usually young children. Clinical depression, specific motivations such as male sexual proprietariness or maternal salvation fantasies, and a history of previous suicide attempts are important in explaining underlying psychopathological mechanisms. Conclusions. —Murder-suicide occupies a distinct epidemiological domain that overlaps with suicide, domestic homicide, and mass murder. These events may be categorized into one of only several phenomenologic typologies that share similar demographics, motivations, and circumstances. Despite the disruption of families and communities caused by murder-suicide, there are no standardized operational definitions, validated taxonomic systems, or national surveillance networks for these events, all of which are needed to develop prevention strategies. (JAMA. 1992;267:3179-3183)

https://jamanetwork.com/HttpHandlers/ArticlePdfHandler.ashx?journal=JAMA&articleId=397893&pdfFileName=jama_267_23_031.pdf

The epidemiology of murder-suicide.

The author reviews 131 cases of child murder and proposes a new classification of filicide by apparent motive: altruistic, acutely psychotic, unwanted child, accidental, and spouse revenge. The high frequency of altruistic motives distinguishes filicide from other homicides. The psychodynamics of the filicidal impulse are explored: displacement of the murderer's original aggression from his parents, spouse, or sibling is documented. The author offers some considerations for prevention.

Child Murder by Parents: A Psychiatric Review of Filicide

Objective: Maternal filicide, or child murder by mothers, occurs more frequently in the United States than in other developed nations. However, little is known about factors that confer risk to children. The authors review the literature to identify predictors of maternal filicide and identify gaps in knowledge about maternal filicide. Method: Databases were systematically searched for studies of maternal filicide and neonaticide (murder in the first day of life) that were conducted in industrialized countries and were published in peer-reviewed, English-language publications after 1980. Results: Women who committed filicide varied greatly by the type of sample studied. Neonaticide was often committed by young, poor, unmarried women with little or no prenatal care. Conclusions: The results of the review suggest that little is known about the predictors of maternal filicide and that a systematic, focused program of research on reliable markers for maternal filicide is needed to better prevent these events.

Child Murder by Mothers: A Critical Analysis of the Current State of Knowledge and a Research Agenda

Malingering of posttraumatic disorders.

The purpose of this phenomenological study was to identify commonly occurring factors in filicide-suicide offenders, to describe this phenomenon better, and ultimately to enhance prevention of child murder. Thirty families' files from a county coroner's office were reviewed for commonly occurring factors in cases of filicide-suicide. Parental motives for filicide-suicide included altruistic and acutely psychotic motives. Twice as many fathers as mothers committed filicide-suicide during the study period, and older children were more often victims than infants. Records indicated that parents frequently showed evidence of depression or psychosis and had prior mental health care. The data support the hypothesis that traditional risk factors for violence appear different from commonly occurring factors in filicide-suicide. This descriptive study represents a step toward understanding filicide-suicide risk.

http://jaapl.org/content/jaapl/33/4/496.full.pdf

Phillip J. Resnick

Papers

Child Murder by Parents: A Psychiatric Review of Filicide

Murder of the Newborn: A Psychiatric Review of Neonaticide

Child Murder by Mothers: A Critical Analysis of the Current State of Knowledge and a Research Agenda

Malingering of posttraumatic disorders.

Filicide-Suicide: Common Factors in Parents Who Kill Their Children and Themselves