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"Anti-Social Personality Disorder" as a Matter of Unfair Prejudice

10/18/2021

Most of the Researchers and Some Academics have moved beyond the DSM 5 and Clusters of Symptoms to Categorize Psychiatric Disorders --- that should be mattering a lot to Criminal Justice and those UNFAIRLY PREJUDICIAL PERSONALITY DISORDER DIAGNOSES.

The National Institute of Mental Health has a complicated "MATRIX" as part of their Research Domain Criteria Program --- and we're not quite there yet.

In the meantime, RESEARCHERS and ACADEMICS have started to look at PSYCIATRIC DISORDERS in terms of INTEGRATED SYSTEMS of the body.

On the other hand, there is NO PERFECT KNOWLEDGE --- yet.

It is hard to get away from the CONCEPT of BURDEN OF PROOF and how MESSY it looks in this CONTEXT.

"Burden of Proof" is especially problematic in terms of PUNISHMENT --- "PROOF BEYOND A REASONABLE DOUBT."

From a practical standpoint -- we've already started the TRANSITION to a PUBLIC HEALTH APPROACH to CRIMINAL JUSTICE and a "PROBLEM-SOLVING" Approach --- demanding both

Better Treatment, and
Better Safety.

Olmstead Planning is a BIG PART of that --- and all sides of Criminal Justice should be well represented.

Personality Disorders --- Unscientific & Vague -- Must Be Reformed

Hofstra Law Review: Deconstructing Anti-Social Personality Disorder and Psychopathy

What's UNFAIR and UNDULY PREJUDICIAL about "PERSONALITY DISORDERS," and SPECIFICALLY "ANTI-SOCIAL PERSONALTIY DISORDER"?

*Those diagnoses are UNSCIENTIFIC
*Those diagnoses are VAGUE
*Perhaps most importantly, those PERSONALITY DISORDER DISAGNOSES don't get to the UNDERLYING BIOLOGY --- and CLINICAL PROFESSIONALS TEND NOT TO CONSIDER THE BIOLOGY when it comes to PERSONALITY DISORDERS.
*On the other hand, Researchers and Academics are increasing considering the BIOLOGY of ANTI-SOCIAL PERSONALITY DISRDER ----

and it is looking much more COMPLICATED, DEVELOPMENTAL and related to the DEVELOPMENTAL DIFFERENCE or DISABILITY of "ADHD."

*This is going to the BLURRING of PSYSCHIATRIC CATEGORIES across the board and a move to understanding UNDERLYING BIOLOGICAL MECHANISMS rather than clusters of symptoms.
*One of those UNDERLYING BIOLOGICAL MECHANISMS is often MATERNAL IMMUNE ACTIVATION.

Orchid's 2020 Report on Anti-Social Personality Disorder & the Criminal Justice System

Anti-Social Personality Disorder as a Neuro-Developmental Disorder

Making Criminal Justice --- TRAUMA-INFORMED

10/12/2021

Childhood trauma and adulthood inflammation: a meta-analysis of peripheral C-reactive protein, interleukin-6 and tumour necrosis factor-α (2016)

"Childhood trauma confers higher risk of adulthood physical and mental illness; however, the biological mechanism mediating this association remains largely unknown.

"Recent research has suggested dysregulation of the immune system as a possible biological mediator. . .

"The analysis demonstrates that childhood trauma contributes to a pro-inflammatory state in adulthood, with specific inflammatory profiles depending on the specific type of trauma."

King's College London

Affiliations

1King's College London, Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
2King's College London, Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
3Department of Psychology, University College London, London, UK.
4King's College London, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, London, UK.
5National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre, South London and Maudsley, NHS Foundation Trust and King's College London, London, UK.

Becoming Trauma Informed: An Essential Element for Justice Settings

Trauma-Informed Care:
Evidence-Based and Promising Practices

SAMHSA --- Creating a Trauma-Informed Justice System for Women>>>>>

Trauma Training for Criminal Justice Professionals

The big Picture is the biological basis of behavior

10/5/2021

Forensic Mental Health Professionals have not taken the lead in Reform Efforts -- may be that's not fair ---
But it is NOT reasonable for Indigent Defendants with Cognitive Disabilities to have to wait on the Forensic Mental Health Profession or the American Psychiatric Association to get its act together.

This gets to Stanford Professor Robert Sapolsky's plea -- to USE OUR REASON & SEE THE BIG PICTURE.

Categories & Behavioral Biology

Where these discussions have tended TO GO OFF THE RAILS is with questions like:

Is it NATURE or NURTURE?
Yeah, it's BOTH --- but what's MOST IMPORTANT?

So the problem with those questions is that they tend to ASSUME that BIOLOGY and ENVIRONMENT are OPPOSITES or at the very least BIOLOGY AND ENVIRONMENT are STRICTLY DISTINCT ENTITIES.

We've had to BREAK THINGS UP as best we can to ANALYZE them because of our own limitations --- BUT ULTIMATELY IT IS --- A WHOLE.

So BIOLOGY/ENVIRONMENT for any LIVING ORGANISM is --- A WHOLE.

BIOLOGY AND ENIVIRONMENT are 2 SEEMINGLY DIFFERENT WAYS to approach the problem of UNDERSTANDING --- BUT if you FOLLOW EITHER PATH FAR ENOUGH --- you'll run into the other.

THE CURRENT "MENTAL HEALTH CRISIS"

The Current Mental Health Crisis is exposing the CURRENT SUBJECTIVE NATURE of DIAGNOSIS and TREATMENT, BUT more importantly the need for MORE ACCURATE CONCEPTUALIZATIONS based on the latest research.

WHY ARE MORE ACCURATE CONCEPTUALIZATIONS SO IMPORTANT?

Much of the VULNERABILITY for a whole range of disorders, including:
- ADHD, Autism
- "Personality Disorders"
- Mental Illness
- Substance Issues
- PTSD and more SEVERE BRAIN INJURY
  - appear to be related to greater DEVELOPMENTAL INFLAMMATION

That looks a lot different than the DSM 5.

In fact, over 600 Research Institutions signed off on a paper --- regarding shared heritability of psychiatric disorders --- that doesn't look like the DSM 5 either.

The "PERFECT" as an ENEMY of REASON & HUMAN RIGHTS NOW

The big HUMAN RIGHTS NIGHTMARE is CRIMINAL JUSTICE ---Forensic Mental Health Professionals handing out "ANTI-SOCIAL PERSONALITY DISORDER" Diagnoses like they were CANDY.

If we understand the BIG PICTURE --- the BIOLOGICAL BASIS of BEHAVIOR (which is NOT DIVORCED from ENVIRONMENT), we can continue to proceed on a PUBLIC HEALTH APPROACH to Criminal Justice.

Olmstead --- Measurable Goals, Reasonable Time Frames & Funding to Support the Plan ----- could help get us out of this NIGHTMARE.

Part III --- Shared Genes & Psychiatric Disorders

"[W]HEN THE WRONG ANTIDOTE IS LIKE A BONE IN THE THROAT . . . "

9/28/2021

More EVIL SOCIETY GAMES --
Can We Turn This Around?
Mesa County caregivers charged in death of 86-year-old

Criminal Prosecution to change SYSTEMS comes at a HIGH MORAL COST.

When we're talking about WEALTHY CORPORATE OFFICERS where GREED is a driving force --- they are much less sympathetic than that FRONTLINE WORKER --- BUT even they are a product of the Society.

When it comes to the struggling FRONTLINE WORKER --- they can have more problems and challenges than their charges.

NOBODY is in favor of ABUSE or NEGLECT of ELDERS or PEOPLE WITH DISABILITIES.

BUT there are some HARD QUESTIONS about How We're Handling this --- and How We're NOT EFFECTIVELY HANDLING ABUSE and NEGLECT of People with Disabilities in Colorado and around the Country.

Ironically, just last week --- National Public Radio (NPR) had a discussion of NURSING HOME STAFFING PROBLEMS --- how long has that been going on --- DECADES --- and that was one of the points the Nursing Home Reform Coalition was trying to make.

In Nursing Homes, there is HIGH TURNOVER not just of that CNA, but of DIRECTORS of NURSING and ADMINISTRATORS as well -- their LICENSES are often on the line and IT DON'T ADD UP.

And as for ASSISTED LIVING --- the SUPPORT and OVERSIGHT is EVEN LESS than NURSING HOMES.

BUT not everybody can afford to leave those jobs.

SUPPORT --- if we're providing the NECESSARY SUPPORT and NOT ENABLING GREED --- most of these problems go away.

We need an On-going System of Independent Staffing Audits that also makes an ANNUAL REPORT to the LEGISLATURE.

We're so critical of the former Hickenlooper Administration, BUT one of the GREAT THINGS they did was their response to a LEGISLATIVE AUDIT of the CHILD WELFARE SYSTEM.

They didn't put more money into another ineffective layer of OVERSIGHT --- they hired HUNDREDS More Child Welfare Workers.

Somehow we need to tie STATE MEDICAID FRAUD CONTROL UNITS to REAL SYSTEMIC REFORM that is going to make a difference rather than piecemeal prosecutions that at least sometimes are (generally are) morally suspect themselves.

The Hunger Games

The Fixx
One Thing [Still] Leads to Another

Thug Notes
The Hunger Games

The Evil Society Games

The Evil Society Games Revisited: Disability Laws, Resources, Corruption & Transparency

Take the "O" Train to Get to Criminal Justice Reform in a Hurry

9/21/2021

Two BIG Observations
- It is NOT just CLASSIC Mental Illness
- ADHD and Brain Injury appear to be even more represented in Criminal Justice, and for that matter are related to "MENTAL ILLNESS"

A BIG part of the Problem (just as it was for Clinton & Trump) --- a lot of these people have BIG TIME STRENGTHS and EXECUTIVE FUNCTIONING DIFFERENCES or DEFICITS
- For people at the TOP, they are often living a DELUSION that they don't have any WEAKNESSES
- For the people at the BOTTOM, the Society is often trying to IMPOSE a DELUSION that they don't have any STRENGTHS.

A lot of CONSERVATIVE People in this Country believe that EMPLOYMENT or SUPPORTED EMPLOYMENT should be a REQUIRED COMPONENT of CRIMINAL JUSTICE REFORM.
- That may not be possible for everyone --- but by and large we agree with that and most Justice-Involved People probably want that.

Additionally, ENTRENEURSHIP --- SUPPORTED ENTREPRENEURSHIP should be a BIG PART of Olmstead Planning & CRIMINAL JUSTICE REFORM
- That could and probably should be paired with greater ENTERPRENEUR SUPPORT throughout the Society.

Canada's Rise Asset Development Program for People with Mental Health & Addiction Challenges

The Olmstead Decision and Mental Health Systems Reform (Jan. 2021)

"This decision, commonly referenced as the Olmstead decision, is increasingly being used as a tool for reforming public mental health services.

"Since 2008, the U.S. Department of Justice (DOJ) has been particularly active in enforcing the Olmstead decision.

In states such as Georgia, Delaware, Oregon and North Carolina, DOJ has used its Olmstead authority to push for the development of comprehensive community-based …

Val's Take: WITHOUT COMPREHENSIVE COMMUNITY-BASED SERVICES AND A ROBUST CONTINUUM OF CARE --- CRIMINIAL JUSTICE REFORM IS UNLIKELY TO BE SUCCESSFUL

The Need for a Neuro-Diverse Perspective in Criminal Justice Reform

9/8/2021

Most people who discriminate against NEURO-DIVERSE people don't know they are discriminating ---- they often just think they are being REASONABLE.

When we talk CRIMINAL JUSTICE REFORM ----- SUPPORTED EMPLOYMENT and ENTRPRENEURSHIP are major components.

SUPPORTED EMPLOYMENT and ENTREPENEURSHIP must be informed with an understanding of NEURO-DIVERSITY.

If we don't take a NEURODIVERSITY PERSPECTIVE with INFORMED STRUCTURING ---- we're going to set a lot of people up for failure for SUPPORTED EMPLOYMENT and SUPPORTED ENTREPRENEURSHIP.

This is MORE & DIFFERENT than just teaching X, Y, Z skills.

This is assessing and understanding where the person may have both SIGNIFICANTLY HIGHER ABILITIES than NEURO-TYPICALS in some areas, while at the same time having DEFICITS or DIFFERENCES (often EXECUTIVE FUNCTIONING) -- that need to be worked around and compensated for.

Now there are a lot of people at the TOP THIS SOCIETY that are in that SITUATION --- but they have typically (not always) gotten a lot more support than people coming out of the CRIMINAL JUSTICE SYSTEM.

Offender Programs Report
Recovery Through Entrepreneurship (2014)

Supported Employment & Entrepreneurship --- A key component to criminal justice reform

9/5/2021

Beyond Assertive Community Treatment and Supportive Housing, we need Supportive Employment and Entrepreneurship for Neuro-Diverse People with Executive Functioning Differences and often Unrecognized and Under-Developed Talents.

As much satisfaction as an Advocate such as much myself gets in MORALLY-JUDGING the POWER ESTABLISHMENT --- the REALITY is if we had known how TO SOLVE these problems we would have already done it.

Further, from my perspective, "THESE PROBLEMS" are at both the BOTTOM and TOP of our SOCIETY.

We're either pretending that NEURO-DIVERSE PEOPLE with UNCOMMON TALENT are PERFECT, or we're pretending that NEURO-DIVERSE PEOPLE with UNCOMMON DEFICITS are without WORTH and DIGNITY.

When we talk about "MENTAL ILLNESS" --- it is often starting as DEVELOPMENTAL DIFFERENCE. That "DEVELOMENTAL DIFFERENCE" is often greater SENSITIVITY TO THE ENVIRONMENT of one or more types.

I started ORCHID with the idea of the "ORCHID CHILD" --- a Dandelion can thrive in most ENVIRONMENTS -- but an ORCHID needs a SPECIALIZED ENIRONMENT.

We're becoming a POPULATION of ORCHIDS and that is being driven by NEURO-DEVELOPMENTAL INFLAMMATION. It's not that DIET & EXERCISE aren't important, but like Michael Phelps and Simone Biles or probably most people with "ADHD"--- the person is dealing with significant DEVELOPMENTAL INFLAMMATION at the get-go.

Further, when being so SENSITIVE --- just working to be PERFECT seems like a VIABLE STRATEGY to keep the PAIN at bay.

BUT at some point that is NOT VIABLE even for OLYMPIC ATHLETES.

Right now addressing NEURO-DIVERSITY in the Homeless Population, Justice-Involved People, Employment and Entrepreneurship seems like such an "UNDUE HARDSHIP" but not to do so FAILS to solve the problems this SOCIETY is facing as are many other societies.

Canada's Rise Asset Development Program

Brain Injury

9/5/2021

This is an hour long video with Dr. Kim Gorgens wth the University of Denver. Gorgens is a national leader in TBI and Criminal Justice.

Val's Take: No matter how you slice it Dr. Gorgens is a leader in this area--- as are other Colorado clinicians and policymakers.

Having said that, they have also sometimes been pressed into giving LEGAL OPINIONS when they rally don't have a sufficient understanding of the concepts involved.

This is a dicey area for me to get into because I'm submitting all kinds of CONJECTURE regarding the latest scientific disoveries BECAUSE:

they are EXCRUCIATINGLY RELEVANT, and
the TRANSLATIONAL RESEARCH and MEDICINE are not being provided in a timely manner
and these DISCOVERIES create ALL KINDS of REASONABLE DOUBT regarding the RATIONALITY of our CURRENT CRIMINAL JUSTICE SYSTEM.

So What Is My Concern: My concern is that Clinicians are not that far from the rest of the public in thinking if the person "INTENDED IT" --- the person deserves to be PUNISHED and/or has a PERSONALITY DISORDER.

I think that gets to the MANTRA of the NATIONAL INSTITUTE of MENTAL HEALTH and really should be the MANTRA of DEFENSE ATTORNEYS, PROSECUTORS and JUDGES ---- we need to understand the UNDERLYING BIOLOGY and TREAT that where there may be a lot of COMMONALITY of INTEREST.

SO we have time to THOROUGHLY INVESTIGATE & LITIGATE where there is a TRUE FACTUAL DISPUTE.

Brain Injury, the Immune System & Mental Health

Brain Injury Index

Banged up

Brain injuries are startlingly common among those who have committed crimes.

Preventing them could lower crime rates.

Knocked out and locked up

A huge share of prisoners have brain injuries. They need more help

It would be best to prevent such injuries in the first place

Val's Take: Brain Injury is often one of a number of cognitive issues people are facing in Criminal Justice and that the COMMUNITY by extension is struggling to deal with.

HAVING that COMPREHENSIVE PLAN to address MULTIPLE COGNITIVE & PHYSICAL ISSUES to prevent the UNNECESSARY INSTITUTIONALIZATION of PEOPLE WITH DISABILITIES is what OLMSTEAD is all about.

Neurodiversity in the Criminal Justice System

8/31/2021

Neurodiversity is a viewpoint that brain differences are normal, rather than deficits. The idea of neurodiversity can have benefits for kids with learning and thinking differences. This concept can help reduce stigma around learning and thinking differences.

Neurodiversity: What You Need to Know - Understood.org https://www.understood.org › articles › neurodiversity-wh...

I think the important thing is that it is the POWER of NEURODIVERSITY ---- NOT the POWER of PERFECTION.

Further, our POLITICAL CLASS and ARTISTIC / CELEBRITY CLASS are sometimes / often going OFF THE RAILS. I think there are lot of reasons for that.

Many of these people do have amazing STRENGTHS, ABILITIES and TALENTS -----but STRENGTHS, ABILITIES and TALENTS often bring with them their own WEAKNESSES.
We don't want to spend most of our time on WEAKNESSES -- but we do need to spend SOME --- MAYBE 20% on WORKAROUNDS.
If we're telling these people at the TOP ---- they don't have any weaknesses--- we're producing a NIGHTMARE SCENARIO for the person and everyone else.

Neurodiversity in the criminal justice system: A review of evidence

July 21, 2021

Really whether people are at the TOP, BOTTOM or Middle of Society ----

We need to be spending 80% of the time on STRENGTHS-DEVELOPMENT and 20% on Workarounds for Weaknesses --- when it comes to THERAPEUTIC ACTIVITIES.

To me what the TOP and BOTTOM have in common is ACUTE SENSITIVITY / REACTIVITY to the ENVIRONMENT.

Neuro-Diverse People at the Bottom of the Society

Education is doing better than any segment of society --- but there is a lot of room for improvement there
Employment is AT-WILL
Most Mental Health Professionals much less Employers are NOT well versed in ACCOMMODATING Executive Functioning Differences

Our Justice System is often CRIMINALING problems with ORGANIZATION, TIME MANAGEMENT, etc.
When we have JUSTICE-INVOLVED PEOPLE who would prefer PRISON over PROBATION because PROBATION is TOO STRESSFUL --- that among a MYRIAD of other PROBLEMS is forcing a RE-IMAGINING of CRIMINAL JUSTICE.

Case Management

8/30/2021

--- INTENSIVE CASE MANAGEMENT is NOT going to be enough for some Justice-Involved people with cognitive disability.

Many Justice-Involved People need Supportive Housing and Assertive Community Treatment . ACT involves access to a multi-disciplinary team --- 24-7 on an as needed --- prn basis.

It must involve DEVELOPMENT & EMPLOYMENT of STRENGTHS. A lot of people who are HOMELESS or JUSTICE-INVOLVED are NEURO-DIVERSE --- NOT NEURO-TYPICAL.

It is often NOT A GOOD USE OF TIME OR RESOURCES to attempt to MICRO-MANAGE EXECUTIVE FUNCTIONING DIFFERENCES or see that as some kind of ESSENTIAL DEFICIT---- people with EXECUTIVE FUNCTIONING DIFFERENCES often by definition have CURRENTLY UNEXPECTED STRENGTHS in other areas that need to be INTEGRATED INTO THE COMMUNITY.

On the other hand, understanding how to ACCOMMODATE and WORK-AROUND EXECUTIVE FUNCTIONING DIFFERENCES is ESSENTIAL.

Colorado and most states are providing SUPPORTIVE HOUSING,, ASSERTIVE COMMMUNITY TREATMENT, etc. ---- just not at the SCALE NEEDED.

We need on-going Olmstead Planning to bring this to SCALE over the next DECADE and continuing planning after that to modify and improve as knowledge and circumstances warrant.

Case Management for Justice Involved Populations: Colorado (2017)

Case Management is a critical issue for many homeless and justice-involved people with cognitive disabilities.

It is NOT A SUBSTITUTE for HOUSING --- but it could be used creatively to reduce the cost of Assertive Community Treatment (ACT) where Intensive Case Management is inadequate.

Assertive Community Treatment and Flexible ACT Index

Strength-Based Approach

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