Dr. Henry Paul, MD

Psychiatrist, Author and Educator

DATE RAPE – THE DANGERS

November 25th, 2014

“It is up to all of us to ensure victims of sexual violence are not left to face these trials alone. Too often, survivors suffer in silence, fearing retribution, lack of support, or that the criminal justice system will fail to bring the perpetrator to justice. We must do more to raise awareness about the realities of sexual assault; confront and change insensitive attitudes wherever they persist; enhance training and education in the criminal justice system; and expand access to critical health, legal, and protection services for survivors.” President Barack Obama, April 2012

Sexual assault on our college campuses is a growing epidemic. According to a White House report earlier this year, about one in five women are sexually assaulted while they are college students. Rape occurs when a woman is subjected to sexual intercourse, oral or anal sex, or any other sexual act against her will through the use of threat of force. “Date rape”, also called acquaintance rape or hidden rape, is when a woman is raped by an acquaintance.

Although it is impossible to know the exact frequency of date rape, in some surveys up to 20 or 30 percent of young women have stated that they been date raped or been victims of attempted date rape. Most of them knew their attacker and most of this sexual coercion occurred on dates. About five to ten percent of young males have stated they have attempted date rape. Date rape is rarely reported to the police. As a result, victims rarely get help, despite the fact that they have been seriously traumatized.

The typical scenario for date rape involves a young women who, at a club, bar, party or other recreational gathering, feels social and sexual pressure to meet a boy. Drinking is often involved and sometimes sexual provocations are made by both girl and boy. Eventually, the two end up alone in a car, in an isolated area, or in one of their homes. It is at that point that the male often overpowers, threatens and forces the rape victim to give in and have sexual intercourse.

Increased risk factors for getting date raped include “traditional” assumptions among some young women that they should be passive or submissive, and the boy is “supposed” to be dominant. The rapist often picks out victims who he feels, based on their personalities, will not turn him in. The young men who commit date rape are often influenced by a powerful version of “machismo” – an assumption that it is the male’s prerogative to be dominant and take what he wants sexually. Sexual aggression in this context is not only acceptable but idealized. The use of drugs or alcohol by the aggressor is very common.

After date rape, the victim often tries to rationalize what happened. She blames herself. Despite these attempts at rationalization, she often suffers some degree of post-traumatic stress symptomatology and depression, and may even contemplate or attempt suicide. A very small number of date rapes are reported to the police, because of her guilt (her sense that somehow she may have caused it), her acquaintance with her attacker, and sometimes even the dismissive way she may be treated by family. Sometimes, sadly, the victim’s family members or friends look for reasons to accuse her, such as claiming she drank too much, dressed too provocatively, or in some other way “brought it on herself.” Other effects of having been date raped include promiscuity, social withdrawal, chronic anxiety, and persistent mistrust.

DISCLAIMER
Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

AUTISM – WHAT IS REALLY BEHIND THE RISING NUMBERS?

November 7th, 2014

“The dramatic increase in the number of children diagnosed with an autism spectrum disorder is largely the result of changes in how the condition is reported,” Danish researchers contend in a study out this week, and I agree!

The Danish study says that the increase in numbers is due largely to the changes in diagnosing and reporting.

“As our study shows, much of the increase can be attributed to the redefinition of what autism is and which diagnoses are reported,” said lead researcher Stefan Hansen, from the section for biostatistics in the department of public health at Aarhus University in an interview with CBS News. “The increase in the observed autism prevalence is not due alone to environmental factors that we have not yet discovered.”

In the United States, the U.S. Centers for Disease Control and Prevention estimates that one in 68 children have an autism spectrum disorder. The reported prevalence of the condition has increased over the past 30 years, according to the new study.

In the same CBS News interview, Amy Daniels, the assistant director for public health research at Autism Speaks, a New York City-based advocacy group, agreed that a significant part of the increase in autism has resulted from changes in diagnosis and reporting.

“The findings from this study are consistent with past research documenting the role of non-causal factors, such as increase in autism awareness, changes to diagnostic criteria and the increase in autism prevalence over time,” she said.

Scientists aren’t certain about what causes autism, but it’s likely that a combination of genetics and environmental factors play a role, according to the U.S. National Institute of Neurological Disorders and Stroke.

I believe that autism is a neurological disorder and not an environmental one. There are plenty of new studies and research about Autism. I just posted a blog in September about a research study that indicates that children’s brains with autism fail to trim the synapses as they develop, and that if safe therapies can be developed to clear these synapses, there might be new hope for treating autism.

Now, the most important thing about autism is that people are talking about it. The medical community is stepping up its research, and medical professionals and schools are looking at treatment and accommodations to help those diagnosed with the disorder. We have a lot of work to do to understand and to treat autism, and that work has begun! Stay tuned.

For more on the Danish study visit CBS News “What’s Behind the Dramatic Rise in Autism Cases?” For more on autism visit my recent blogs:

Children with Autism Have Oversupply of Synapses, Says New Study
Shock Em’ Out of Autism
CDC Says 11 in 68 Children is on the Autism Spectrum – So What Does That Really Mean?

DISCLAIMER

Information contained in this blog is intended for educational purposes only. It is not intended as medical or psychiatric advice for individual conditions or treatment and does not substitute for a medical or psychiatric examination. A psychiatrist must make a determination about any treatment or prescription. Dr. Paul does not assume any responsibility or risk for the use of any information contained within this blog.

CHILDREN WITH AUTISM HAVE OVERSUPPLY OF SYNAPSES, SAYS NEW STUDY

September 3rd, 2014

Study Finds That Brains with Autism Fail to Trim Synapses as They Develop — Now a new study suggests that in children with autism, something in the process goes awry, leaving an oversupply of synapses in at least some parts of the brain.

The finding provides clues to how autism develops from childhood on, and may help explain some symptoms like oversensitivity to noise or social experiences, as well as why many people with autism also have epileptic seizures.

It could also help scientists in the search for treatments, if they can develop safe therapies to fix the system the brain uses to clear extra synapses. The New York Times

This is a very interesting article showing some of the latest research on Autism. The study, recently published in the journal Neuron, involved tissue from the brains of children and adolescents who had died from ages 2 to 20. About half had autism; the others did not.

The study suggests that children with autism have an oversupply of synapses in some parts of their brain. These synapses are normally “pruned” during childhood and adolescent development so different areas of the brain can develop specific functions without an overload of stimuli. When that pruning does not happen, and there is a continued overload of the synapses, the research suggests that this might be the cause of autism. If safe therapies can be developed to clear these synapses, there might be new hope for treating autism.

What I find interesting about this study is that there has been an ongoing debate in the medical community for years as to whether autism is a problem of too little, too much or a combination of connectivity in the brain.

In the NY Times article, Ralph-Axel Müller, a neuroscientist at San Diego State University, said, “Impairments that we see in autism seem to be partly due to different parts of the brain talking too much to each other. You need to lose connections in order to develop a fine-tuned system of brain networks, because if all parts of the brain talk to all parts of the brain, all you get is noise.”

The research is very interesting. What needs much further study is rapamycin, a drug that has serious side effects, and which is being discussed as a form of therapy for this neurological finding. Finding the cause is the beginning of finding a cure. Best not to jump too quickly looking for a silver-bullet cure, however. Let’s all follow the research. I am sure this will open up a much wider debate on the cause of autism and how to treat it. Stay tuned!

SHOCK EM’ OUT OF AUTISM?

August 21st, 2014

Jennifer Msumba is on the autism spectrum. For seven years, she was treated at the Judge Rotenberg Center in Canton, Massachusetts, where she received painful electric shocks aimed at modifying her behavior. She describes being strapped, spread-eagle to a restraint board and shocked multiple times before she left the center in 2009. CBS Evening News.

Autism Spectrum Disorder (ASD), also known as Pervasive Development Disorder, is a diagnosis that is more prevalent than ever before and one that is concerning not only for the medical community, but for the parents and families of those diagnosed with it, too.

Back in March of this year, a CDC study reported that one in 68 children has Autism (ASD). This was a 30 percent increase since the agency estimated just two years before that one child in 88 suffered from the disorder. There is some controversy as to the validity of the reported increase in diagnosis but ASD remains a major issue in this country. It is one of a parent’s most feared diagnoses.

The CBS News story is the first to really “out” electric shock as a treatment for those with ASD. After watching the segment, you certainly can see there is controversy attached to its usage, as well.

ASD is a condition that has a number of variables, and those are specific to each person diagnosed with it. Some people cannot communicate at all while others are social. Some can be compulsive and inflexible, preoccupied with similar ritualized behaviors that can go on for hours. Others can be aggressive and prone to angry outbursts or temper tantrums. Some have mood swings, can be hyperactive, and the list goes on. The important thing to recognize is that all these symptoms do not show up in every person diagnosed with ASD.

Without knowing the full story and seeing the diagnoses of the patients included in the news story, I cannot render an appropriate opinion on specific treatment recommendations, but I can say that the use of shock therapy for these types of children seems far-fetched to me. Using shock conditioning seems primitive, if not downright out of the realm of accepted standards of care. When I treat young people with ASD I almost always recommend medication and behavioral therapy, as well as proper educational placement. I have never recommended electric shock and find it difficult to imagine ever prescribing.