Those interested in the cultural milieu in which Adler, Freud, Jung, et al, developed their theories may want to check out events at the U of M Center for Austrian Studies at http://www.cas.umn.edu/calendar/.
Their Lecture Series does not appear to be on their calendar at present:

Antipsychotic medications and cardiac conduction risks" by Marian Roman & Shirley Farmer -- appears in the journal *Issues in Mental Health Nursing* (vol. 31, #1).

Here's the abstract:

[begin abstract]

Many non-cardiac medications as well as non-medicinal substances (caffeine to cocaine) can affect cardiac conduction. Time and continued research have revealed that both first and second generation antipsychotics (as well as antidepressants) can effect a prolonged QTc interval on electrocardiogram (ECG), denoting a conduction change that sets the stage for serious arrhythmias.

This article reviews the effects of antipsychotic medications on cardiac conduction.

Topics covered include cardiac conduction as depicted on ECG, Torsades de Pointes (an arrhythmia that has been induced by some antipsychotic medications), and the effects of comorbid conditions on developing potentially fatal arrhythmias.

Guidelines are provided for the prudent prescribing of antipsychotic medications.

[end abstract]

The author note provides the following contact info: Marian Roman, University of Tennessee-Knoxville, School of Nursing, 1200 Volunteer Boulevard, Knoxville, TN, US, 37996, <mroman@utk.edu>.

"Opening Pandora's Box: The 19 Worst Suggestions For DSM5" by Allen Frances, MD.

The author note states: "Dr Frances was the chair of the DSM-IV TaskForce and of the department of psychiatry at Duke University School of Medicine, Durham, NC. He is currently professor emeritus at Duke. "Here are some excerpts:

[begin excerpts]I have previously criticized the DSM5 process--for its unnecessary secretiveness, its risky ambitions, its disorganized methods, and its unrealistic deadlines. Now, it is finally time to evaluate the first draft ... Poor and inconsistent writing. Perhaps it should occasion no surprise that a flawed process should yield a flawed product. The most fundamental problem is the poor and inconsistent writing.

<snip>Higher rates of mental disorder In terms of content, most concerning are the many suggestions for DSM5 that would dramatically raise the rates of mental disorder.

<snip>DSM5 would create tens of millions of newly misidentified false positive "patients," thus greatly exacerbating the problems caused already by an overly inclusive DSM4. There would be massive overtreatment with medications that are unnecessary, expensive, and often quite harmful. DSM5 appears to be promoting what we have most feared--the inclusion of many normal variants under the rubric of mental illness, with the result that the core concept of "mental disorder" is greatly undermined. Unforeseen consequences: A third pervasive weakness in the DSM5 options is their insensitivity to possible misuse in forensic settings.

<snip>PROBLEMATIC NEW DIAGNOSES: The Psychosis Risk Syndrome is certainly the most worrisome of all thesuggestions made for DSM5. The false positive rate would be alarming--70% to 75% in the most careful studies and likely to be much higher once the diagnosis is official, in general use, and becomes a target for drug companies. Hundreds of thousands of teenagers and young adults (especially, it turns out, those on Medicaid) would receive the unnecessary prescription of atypical antipsychotic drugs. There is no proof that the atypical antipsychotics prevent psychotic episodes, but they do most certainly cause large and rapid weight gains (see the recent FDA warning) and are associated with reduced life expectancy--to say nothing about their high cost, other side effects, and stigma.

<snip>Mixed Anxiety Depressive Disorder taps nonspecific symptoms that are widely distributed in the general population and would therefore immediately become one of the most common of all the mental disorders in DSM5.

<snip>Minor Neurocognitive Disorder is defined by nonspecific symptoms of reduced cognitive performance that are very common (perhaps almost ubiquitous) in people over fifty. To protect against false positives, there is a criterion that requires objective cognitive assessment to confirm that the individual has decreased cognitive performance, but getting a meaningful reference point is impossible in most instances and the threshold has been set to include a whopping 13.5% of the population (ie, the percent of population within the first and second standard deviation). Moreover, the suggestion for objective testing will probably be widely ignored in the primary care settings where the bulk of diagnosing will be done.

<snip>Binge Eating Disorder will have a rate in the general population (estimated at 6%) and this will probably become much higher when the diagnosis becomes popular and is made in primary care settings.

<snip>Temper Dysfunctional Disorder with Dysphoria is one of the most dangerous and poorly conceived suggestions for DSM5--a misguided medicalization of temper outbursts.

<snip>The misapplication of this diagnosis would provide a blanket excuse for reduced personal responsibility and will lead to forensic nightmares. It is a nonstarter. Paraphilic Coercive Disorder would expand the pool of sex offenders who are eligible for indefinite civil commitment because they have a "mental disorder" to include cases of sexual coercion. Paraphilic Coercive Disorder was initially considered for inclusion in DSM-III-R (under the name Paraphilic Rapism) but was rejected because it was impossible to reliably and validly differentiate those rapists whose actions are the result of a paraphilia from the large majority of rapists who are motivated by other factors (such as power).

<snip>Hypersexuality Disorder would be a gift to false positive excuse seekers and potential forensic disaster. Another clear nonstarter. A Behavioral Addictions category would be included with the substance addictions section and would start life with one disorder, Pathological Gambling (transferred from Impulse Disorders section). Next in line might be a new category for Internet Addiction. This could provide a slippery slope leading to the back door inclusion of a variety of silly and potentially harmful diagnoses (ie,"addictions" to shopping, sex, work, credit card debt, videogames etc,etc, etc) under the broad rubric of "behavioral addictions not otherwise specified." The construct "Behavioral Addictions" represents a medicalization of life choices, provides a ready excuse for off loading personal responsibility, and would likely be misused in forensic settings.

LOWERED THRESHOLDS: The greatest general impact would come from the suggestion to eliminate the "clinical significance" criterion required in DSM4 for each disorder that has a fuzzy boundary with normality (about two-thirds of them). These were included to ensure the presence of clinically significant distress or impairment when the symptoms of the disorder in mild form might be compatible with normality. Removing this requirement would reduce the role of clinical judgment as a gatekeeper in determining the presence or absence of mental disorders and thus would increase the already swollen rates of psychiatric diagnosis.

Attention Deficit/Hyperactivity Disorder. The DSM4 wording changes (along with extremely active drug company marketing) contributed to escalating rates of ADD - accompanied by the widespread misuse of stimulant medications for performance enhancement and the emergence of a large secondary illegal market. There are 4 suggestions for DSM5 that would make this existing overdiagnosis much worse.*The first change is to raise the required age of onset from 7 to 12. The second is to allow the diagnosis based only on the presence of symptoms, not requiring impairment. The third is to reduce by half the number of symptoms required for adults. These 3 changes greatly reduce the specificity of the ADD diagnosis in adolescents and adults and will result in a further flood of false positives and of resulting stimulus misuse for performance enhancement. The fourth change is to allow the diagnosis of ADD in the presence of autism. This might create the interaction of 2 false epidemics, encouraging increased stimulant use in an especially vulnerable population.

Addiction Disorder. DSM5 proposes to eliminate the distinction between substance abuse and substance dependence, lowering the threshold for diagnosing the new unified category-- "addiction"--that would be introduced to replace them both.

<snip>Autism Spectrum Disorder. Asperger's disorder would be collapsed into this new unified category. Although this consolidation appeals to some experts, it remains controversial and presents serious problems. Those with Asperger's (which is much less impairing) will be stigmatized by the association with classic autistic disorder. Moreover, in the average everyday practice conducted by non-experts, the spectrum concept will likely further fuel the "epidemic" of loosely defined autism that was already been triggered by the introduction of Asperger's in DSM4.

Medicalizing Normal Grief. DSM5 would reverse 30 years of diagnostic practice and allow the diagnosis of Major Depression to be made for individuals whose grief reaction symptomatically resembles a Major Depressive episode (eg, 2 weeks of depressed mood, loss of interest inactivities, insomnia, loss of appetite, and trouble concentrating immediately following the loss of a spouse would be a mental disorder.

<snip>Pedohebephilia is one of the most poorly written and unworkable of the suggested criteria sets.

<snip>Deleting the Multiaxial System. This would result in the loss of much valuable clinical information. Multi-axial diagnosis provides a disciplined approach to distinguishing between state and trait (Axis I versus Axis II) and to determining the contributions of medical conditions (Axis I II) and of stressors (Axis IV) to the diagnosis and treatment of psychiatric disorders. The GAF score (Axis V) provides the most convenient and familiar rating of overall functioning. No compelling rationale is offered for making so radical a change.

Various Small Changes. There are numerous small editorial changes meant to help clarify the existing criteria sets. Some of these appear to be improvements, many are trivial, and some are worse than their DSM4 counterparts. Any possible gain from wording changes has to be weighed against the risks that the new version will create its own set of unanticipated consequences.

<snip>Dimensional Assessments: Three dimensional assessments (for severity, co-morbid symptoms, and personality traits) are suggested for DSM5. Dimensions are most appropriate in describing continuously distributed phenomena that can be reduced to numbers. It has been widely accepted for several decades that adding dimensions would help to solve the categorical system's problem with fuzzy boundaries- thus improving the accuracy and precision of psychiatricdiagnosis. Unfortunately, however, the field has never achieved consensus on which dimensions to choose and how best to measure them. Moreover, and most crucial, clinicians find dimensional ratings far too unfamilar and cumbersome for use in everyday practice and all efforts to include even a few simple dimensional ratings into previous DSM's have been met by clinician resistance and neglect. The DSM5 dimensional proposals are especially problematic--ad hoc,unworkably complex, vague, untested, and premature.

<snip>Severity ratings tailored for each disorder. In fact, this approach was tried for 8 categories in DSM3R, but was dropped in DSM4 because the anchors of the severity ratings were not validated and the system was too cumbersome for routine clinical use.

<snip>Ratings on "crosscutting" symptoms that exist across a number ofdifferent diagnoses to supplement the primary categorical diagnosis. Such assessment might be useful in some settings, but is far too cumbersome for use in routine clinical practice.

Dimensional ratings for personality. These would, in theory, have clear advantages over the clumsy categorical approach to personality assessment. In practice, however, the multiple, complicated, confusing, and cumbersome systems suggested for DSM5 would be far too unfamiliar and time consuming to ever be used by clinicians. Another side effect would be deletion of five of the personality disorders (paranoid, narcissistic, histrionic, dependent, schizoid) from the manual.

CONCLUSIONS: It will likely be argued by the DSM5 leadership that I am unduly and prematurely alarmist, that they are still early in the DSM5 process, and that any problematic suggestions will eventually be weeded out in the field trials. This is putting the cart (ie field testing) before the horse (ie having usable criteria sets to test) and continues to miss the point that DSM5 has been and remains in serious trouble. I feel it is my responsibility to raise clear alarms now because the past performance of the DSM5 leadership does not inspire confidence in its future ability to avoid serious mistakes. What leads me to this pessimistic conclusion? Every step in the development of DSM5 has been secretive and disorganized. The leadership has established a consistent track record of proposing unrealistic plans and impossible to meet timetables--with predictably erratic course changes and repeatedly missed deadlines. It was, for example, announced last May at the APA annual meeting (and in the press) that the DSM5 field trials were about to begin in the summer of 2009. Then, it turned out that none of the necessary preparatory steps had been accomplished and the field trials had to be postponed for at least a year.

<snip>I wish to emphasize that the problems in this DSM5 draft are not at all the fault of the Work Group members who have labored hard under very unpromising conditions. The DSM5 options are poorly conceived and executed because of the interaction of 4 unfortunate decisions made by the DSM5 leadership:
1. Requiring unnecessary confidentiality agreements that insulated the Work Groups from the usual and necessary corrective interaction with the field
2. Tightly restricting Advisors to a small and highly selected group
3. Establishing the expectation that Work Groups be innovative rather than risk/benefit conscious
4. Providing the Work Groups with remarkably little guidance,consistency, and editorial assistance. Because of the secretive and closed nature of the DSM5 process, the expectable enthusiasms of the experts who comprise the Work Groups have not been balanced, as they must always be, with real world practical clinical wisdom and a careful risk/benefit analysis of the possible unintended consequences of every suggestion.

<snip>What needs to be done next? The responsibility (and opportunity) for rescuing DSM5 falls most heavily on the field at large and on the Oversight Committee. Now that the DSM5 drafts are finally open for wide review, it behooves the field to be active in identifying problems and providing the needed pressure to ensure they will be corrected. My recommendations for the Oversight Committee are:
1. Extend the period allotted for public review to 3 months.
2. Use this time to ensure the careful editing of each word of each item of every criteria set to provide the clarity and consistency that is nowsorely lacking and is absolutely necessary before any meaningful field testing can begin.
3. Post field trial methods for public review.
4. Appoint 3 subcommittees reporting to the Oversight Committee(responsible, respectively, for monitoring forensic review, risk benefit analysis, and field trials.
5. Post the literature reviews and plans for ICD-11 harmonization. Every future step in the preparation of DSM5 should involve active interaction with the field and with the Oversight Committee and its subcommittees. Unnecessary secrecy has caused the current problems and only full transparency and openness to outside input will solve them. I have had the space and expertise to identify only the DSM5 troublespots that are most obvious to me. The rest is up to you.  Please take the time to review the DSM5 options (at least in your areasof interest) and supply your input. They can be found at www.dsm5.org.

[end excerpts]

The article is online at:<http://bit.ly/9DHv6L>

Here are the "Proposed Draft Revisions to DSM Disorders and Criteria": http://www.dsm5.org/Pages/Default.aspx

January 2010 ONLINE NOW

Borderline, bipolar, or both?
Frame your diagnosis on the patient history
Careful attention to conceptual distinctions may reduce the risk
of misdiagnosis.

WEB AUDIO
Borderline or bipolar? Don't skimp on the life story
Jess G. Fiedorowicz, MD, explains why a thorough and rigorous psychiatric history is essential to distinguish these 2 disorders.

St. Thomas, Graduate School of Professional Psychology, is seeking an MFT adjunct faculty member for the 2010-2011 year. The position would require leading the 12-month practicum class sequence for MFT students, beginning June 2010 and ending May 2011. This is a seminar class (max of 8 students) that is typically held on Wednesday evenings (4:30-7:30pm).  The class meets weekly to discuss clinical issues & professional development. Students are expected to read texts, submit work samples for review, complete formal case presentations, & submit a formal person, theory, practice paper.  Courses that make up the practicum sequence include: CPSY608, CPSY 609, CPSY 610 and CPSY 655 for a total of 12 credits.

The ideal candidate must hold a doctoral degree, be an approved supervisor with the MN Board of Marriage and Family Therapy, and have experience providing clinical supervision to MFT students/ practitioners. St. Thomas offers a competitive adjunct salary, extensive support (orientation, office space, training in the use of classroom technology, & monthly practicum supervisors meetings), and all classes are held on the downtown Minneapolis campus.

Interested parties are asked to send a CV and letter of interest to:

Susan E. Andersson, PsyD, MA, LMFT
Director of Evaluation & Practica
University of St. Thomas
Graduate School of Professional Psychology
Office: MOH 445 J
Mail:    MOH 217
1000 LaSalle Avenue
Minneapolis, MN 55403
(651) 962-4641 (phone)
(651) 962-4651 (fax)

A colleague sent this out. The flaw in studies like this is that they don't measure someone's actual exposure to sunlight.
Many depressed people don't go outside a lot so how much sunlight is out there does not tell you who
is taking advantage of it.

Gary

Subject: Darkness Linked to Depressed People's Cognitive Impairment

• The state of Minnesota estimates that only 68% of those that are eligible for Food Support are participating in the program.

• Approximately 80% of eligible seniors are not enrolled due to a variety of barriers and misconceptions about eligibility.

• According to the U.S. Department of Agriculture, $5 in new Food Support benefits generates $9.20 in total community spending.

Subject: APA et al.: Joint Statement on Atypical Antipsychotic Use in Kids; stats, recommendations

Psychologist Kenneth Pope sent this out.

Subject: Lexapro vs. Zoloft vs. other antidepressants

Narrative Therapy Certificate program

Program Description
Completely new, revised and updated,
the Kenwood Center Training
Institute offers a Narrative Therapy Certificate Program providing training with leading Narrative therapists Walter Bera, PhD, John Stillman, LICSW, author/therapist William Madsen, PhD, and John Windslade,. This advanced clinical training program runs from September to May. Those who complete the program will have the foundational
knowledge to work with individuals, couples, families and communities creatively, effectively and ethically across a wide range of problems.
The Certificate Program generally consists of monthly Friday workshops, small group training, texts, readings, research, and written assignments. The program is open to students and graduates of a major clinical discipline:
Psychology, Marriage and Family Therapy,
Social Work, Drug Counseling,
Nursing, Pastoral Counseling, etc.
CEU’s applied for/approval pending.
Many small groups provide MFT or LPC Supervision Hours.

2009-2010 Program
Orientation/Open House
Introduction to Narrative Therapy
Narragrams: Visualizing Narrative Practice for Trauma and Addiction
Narrative Mapping of Preferred Identities and Realities
William Madsen: Collaborative Therapy with Multi-stressed Families
Unstuck! Inviting Struggle, Stress and Conflict Free Couples Therapy
Narrative, Solution-Focused & Collaborative Therapies Today!,
Working Creatively with Families and Children with Art, Sculpture and Music
John Windslade: Narrative Mediation: A New Approach to Conflict Resolution
Narrative Supervision Process and the Self-of-the-Therapist

Note: Final Course Program and Dates to be confirmed. Check below for updates:
Phone: 612-377-9190 x 1
Website: www.kenwoodcenter.org

Main Faculty
Walter H. Bera, PhD, Founder and Director of the Kenwood Therapy Center has been a therapist for 30 years with special interests in the development of clinical theory and
practice, issues of abuse, power and ethics. Walter holds licenses as a LP, LMFT and LPC.
William C Madsen, PhD, is the Director of the Training Program in Collaborative and Narrative Therapies in Cambridge, MA. He is the author of Collaborative Therapy with Multi-stressed Families.
John R. Stillman, LICSW is a graduate of the first International Diplomate Program in Narrative Therapy with Michael White at the Dulwich Centre in Adelaide, Australia and a member of their international faculty and has taught in Bangladesh, India, South Korea and Russia.
John Windslade.is the co-director of the and the author of Narrative Mediation: A New Approach to Conflict Resolution. John teaches at universities in California and New Zealand.