We Need To Talk About The Domestic Abuse Of Autistic Adults

https://goo.gl/YDfXfa

In the scientific literature, a clear correlation had been found between being autistic and an increased risk for experiencing sexual violence during adulthood; a recent small-scale study detailing the general experiences of autistic females found that 9 of 14 had been sexually abused, many of them by their partners. But I found no systematic studies specifically regarding the prevalence and causes of domestic abuse within romantic relationships. It was almost as if this paradigm simply hadn’t occurred to researchers as something to look into.

Given this combination of ableism and lack of research, I decided to dig further into the issue myself. I began by joining and then posting a rather tentative ad on a closed Facebook group for autistic adults, in order to ask if anyone had any relevant stories to share for an article. I didn’t think I’d get many, or even any, replies, due to the traumatic and private nature of the question.

I was wrong.

The very next day, I found my inbox flooded with message requests from autistic people who had been continually subjected to domestic abuse, and who felt their abuse hadn’t been taken seriously. The response was so overwhelming that, over the following days, I was compelled to continue digging deeper — speaking, in the end, to literally dozens of survivors, as well as to experts and clinicians.

The personal stories were harrowing. One autistic woman told me of being punched in the stomach by her abuser when she was eight months pregnant, while neurotypical people looked on without saying anything. An autistic man told me about how a narcissist moved into his house and convinced him to look after her young children while she stole his disability allowance, before racking up thousands of pounds worth of bills and then suddenly leaving him — penniless.

Some, especially females, but also males, feared for their lives due to threats and acts of violence. Many reported developing the symptoms of post-traumatic stress — including flashbacks, anxiety, and suicidal ideation — after ending their relationship.



Talking to Yourself in the Third Person Can Help You Control Stressful Emotions

https://goo.gl/szUqEp

A first-of-its-kind study led by psychology researchers at Michigan State University and the University of Michigan indicates that such third-person self-talk may constitute a relatively effortless form of self-control. The findings are published online in Scientific Reports, a Nature journal.

Say a man named John is upset about recently being dumped. By simply reflecting on his feelings in the third person (“Why is John upset?”), John is less emotionally reactive than when he addresses himself in the first person (“Why am I upset?”).

“Essentially, we think referring to yourself in the third person leads people to think about themselves more similar to how they think about others, and you can see evidence for this in the brain,” said Jason Moser, MSU associate professor of psychology. “That helps people gain a tiny bit of psychological distance from their experiences, which can often be useful for regulating emotions.”

The study, partially funded by the National Institutes of Health and the John Temple Foundation, involved two experiments that both significantly reinforced this main conclusion.



Mind-body therapies immediately reduce unmanageable pain in hospital patients

https://goo.gl/AG9SmY

Mindfulness training and hypnotic suggestion significantly reduced acute pain experienced by hospital patients, according to a new study published in the Journal of General Internal Medicine.

After participating in a single, 15-minute session of one of these mind-body therapies, patients reported an immediate decrease in pain levels similar to what one might expect from an opioid painkiller. This study is the first to compare the effects of mindfulness and hypnosis on acute pain in the hospital setting.

The yearlong study's 244 participants were patients at the University of Utah Hospital in Salt Lake City who reported experiencing unmanageable pain as the result of illness, disease or surgical procedures. Willing patients were randomly assigned to receive a brief, scripted session in one of three interventions: mindfulness, hypnotic suggestion or pain coping education. Hospital social workers who completed basic training in each scripted method provided the interventions to patients.


Suicide surge at Wayne County jail ‘should be ringing alarm bells all over'

https://goo.gl/vTs9rM

8 suicides in 13 months dwarfs much larger jails

A surge of eight suicides in just over 13 months in Wayne County's jails dwarfs substantially larger facilities across the country, a 7 Action News investigation finds.

“That’s very, very, very high,” said Margo Schlanger, a professor at the University of Michigan law school and an expert in jail and prison reform. “That should be ringing alarm bells all over.”

The surge comes at a time when the county struggles to fill almost 200 deputy positions, jail facilities fall into further disrepair and plans for a new jail remain stalled.

“You don’t go to jail to get killed,” said Sallie Schultz, whose son Billy Adams took his own life this year while in jail for a probation violation. “You’re supposed to be safe in jail.”

Like most of the eight inmate suicides, Adams hanged himself inside a jail cell. He spent 10 days in a hospital, being kept alive by a ventilator before his family decided to take him off of life support.

“Billy was working so hard to clean himself up, and I was working so hard to help him,” Schultz said.

Most people inside jails, like Adams, are accused of crimes but have not yet had their cases adjudicated.



Ketamine has 'truly remarkable' effect on depression and is effective in elderly patients, scientists say

https://goo.gl/UyPZQw

Of the study’s 16 participants, 11 reported an improvement in their condition while being treated with the drug, according to the research published in the American Journal of Geriatric Psychiatry.

After six months, 43 per cent of the subjects said they had no significant symptoms of depression – a high rate given that the participants had not responded to previous treatment, said Professor Loo.

“It is truly remarkable the way ketamine can work,” she said. “Other people have also found you get a rapid and powerful effect after a single dose of ketamine.”

“Some people mistakenly think we are inducing a temporary, drug-induced euphoria and people are ‘out of it’, which is why they’re not depressed. 

“But the effects take place in the first hour, and they’re not euphoric at all. In fact, all of our research participants disliked them. They considered them adverse effects. 

“The antidepressant effect kicks in a few hours later and are maximised about 20 hours later, when you’re fully alert and in your usual state of mind.”


Restructure your day to get a better night's sleep

https://goo.gl/fk3NfL

The free time that accompanies your older years may allow you to keep any schedule you like: sleep late one day or wake up early the next. But that lack of structure can have a negative impact on your sleep.

Risks of inconsistent sleep

Even though it may feel like a luxury, an inconsistent sleep schedule can throw off your circadian rhythm, the body's way of regulating sleep and waking. "That can lead to insomnia," warns Dr. Dorsey, "but people don't realize that their schedule is causing the problem."

Let sleep problems go on too long, and you may experience the effects of sleep deprivation, such as changes in mood, thinking skills, and judgment. A lack of sleep can also lead to many health problems, such as heart disease, obesity, and diabetes.

Getting help

Rather than suffer with sleeping difficulties, talk to your doctor or go to a sleep specialist for help. Get a physical exam to make sure there isn't an underlying cause for your sleep problems.

If the cause is unclear, a sleep diary can help. Dr. Dorsey recommends recording the details of your sleep for two weeks. "Each morning, write down when you went to bed, estimate how long it took to fall asleep, count how many times you woke up in the night, and record when you finally woke in the morning. That baseline data will help you see patterns that may need to be changed," says Dr. Dorsey. But keep the diary out of the bedroom and just estimate the values the next morning. Try not to look at a clock if you are awake during the night. That can create anxiety that makes sleeping more difficult.

Get back on schedule

To get your circadian rhythm back on track, start by waking up at the same time every day. The wake time is most important to getting on a schedule again. "It's the anchor of your circadian sleep rhythm," says Dr. Dorsey. She recommends using an alarm clock, since it sets a boundary for you.


Chester Bennington's life may help male sex abuse victims speak up

https://goo.gl/ujhdMk

Many fans are shocked and heartbroken over the loss this week of Chester Bennington, the fierce lead singer for the rock band Linkin Park. Police say they are treating his death as a possible suicide, which would make the pain even harder to bear.

There's a famous saying, "When you have a hammer, everything looks like a nail." That may be true. But in this case, as a clinical psychologist and researcher who specializes in trauma, I don't think I'm overreaching in saying that his troubled past may have been a factor in his death. Chester Bennington had openly said he was a survivor of childhood sexual abuse that haunted him and, he said, contributed to his excessive use of drugs and alcohol.

For far too long, boys and men who have been sexually abused or assaulted have been overlooked, neglected, minimized or stigmatized by society and, at times, by the health care community. It's time for that disregard to stop.
    One study in the United States estimated that one in six males are sexually abused at some point during their childhood. Let's stop and think about that for just a second. Picture all the boys and men you know, and then breathe that statistic in. That may include your father, your husband/lover, your boss, co-workers, coaches and friends.

    Survivors of childhood sexual abuse are at an increased risk of developing a wide range of medical, psychological, behavioral and sexual disorders. Indeed, a meta-analysis of published research on the effects of child sexual abuse verified the extensive and subsequent negative short- and long-term effects.


    Chronic pain: The “invisible” disability

    https://goo.gl/AkEwVS

    Sometime back in 2010, a good friend of mine from college who had since become a pediatrician posted a complaint on Facebook about “made up” health conditions. “Fibromyalgia, I’m looking at you,” she wrote. At this time, pain was more of an occasional visitor in my body rather than the permanent tenant it has since become. Still, I was offended on behalf of those patients with the disease.

    Fast forward to today and my life is all about pacing. This is because everything I do — cook, sleep, work, walk — takes time. This gradual approach to every aspect of my life is not about enlightenment or mindfulness. It is about pain. Or more specifically, trying to evade or minimize it. To minimize is key because I’ve learned it can’t be avoided, at least not entirely, no matter my effort. For me, fibromyalgia became a default diagnosis — a catch-all phrase the doctors slapped on me to encompass all the aches and health complaints that had begun to persistently plague me. I received this diagnosis even as imaging showed degenerative changes and other damage in my spine and hips, even as endometriosis was confirmed to be spreading like strands of spider web inside my abdomen, wrapping its tendrils around my organs with the insidiousness of an invasive plant. When the pain reached the point of making it impossible to work more than on a very part-time basis most weeks, I began to inquire about disability. But my doctors — the same ones who diagnosed me, treated me, and viewed my MRI results — all shook their heads and refused to sign off on any paperwork.


    CMS looks to launch behavioral health pay model

    Hard to trust....

    https://goo.gl/sdNr3q

    On Thursday, the CMS announced that its Innovation Center would like to design a payment or service delivery model to improve healthcare quality and access for Medicare, Medicaid or Children's Health Insurance Program beneficiaries with behavioral health conditions. 

    The model may address the needs of beneficiaries battling substance use or mental disorders. It could also target Alzheimer's disease and related dementias.

    The Innovation Center will be soliciting ideas at a public meeting on Sept. 8 at CMS headquarters in Baltimore. 

    The announcement comes at a time when agency officials say they are still committed to value-based care. For months, there have been concerns the CMS would abandon its move toward value-based pay models after Dr. Tom Price became HHS secretary. Price had been critical of the Innovation Center and bundled-pay efforts when he was a member of Congress.

    These concerns intensified when the CMS delayed the effective dates for four Obama-era bundled-payment initiatives covering cardiac and orthopedic care and announced it was seeking public comment on the overall future of the models. The agency also announced plans to allow up to 800,000 small and rural providers to be exempt from the new quality reporting system outlined in the Medicare Access and CHIP Reauthorization Act.

    Since then, CMS officials have reiterated that clinicians who have invested millions in implementing pay models or the quality reporting system under MACRA don't need to worry about the CMS changing course.

    Prescribing Barriers in Psoriasis

    This is interesting because of the possibility that reducing the effect of an immune factor could lead to depression (not proven though)...

    https://goo.gl/RwnHos

    In February, the FDA approved brodalumab (Siliq, from Valeant Pharmaceuticals) for adults with moderate-to-severe plaque psoriasis. The injectable biologic shines for its impact on the disease. In one phase III study published in 2015 in the New England Journal of Medicine, researchers reported that 44% of psoriasis patients taking 210 mg of brodalumab every two weeks had a complete response, or Psoriasis Area and Severity Index (PASI) 100, at week 12, and 86% achieved PASI 75.

    Dermatologists who plan to prescribe brodalumab may face a rough road. Concerns about increased risks of suicidal ideation and behavior in phase III studies were so great that the FDA approved brodalumab with a boxed warning and instituted a Risk Evaluation and Mitigation Strategy (REMS) program that raises barriers to prescribing the drug.

    Four of them occurred in psoriasis patients; two occurred in psoriatic arthritis trials. The FDA has characterized this as a strong signal for suicidal ideation and completed suicide -- events that have not been observed to the same degree in other systemic psoriasis drug development programs," Leonardi said.

    But there's more to this story.

    "The other side of the argument," according to Leonardi, "is when you look at the number of events, it is not statistically significant. In a strict accounting sense, it's not known if these events are related. But what causes everybody to stop short is the serious nature of the event."