Richard T. Rada

Plasma testosterone levels in the rapist

&NA; Plasma testosterone level was measured in 52 rapists and 12 child molesters who had completed the Buss‐Durkee Hostility Inventory, the Megargee Overcontrolled Hostility Scale, and the Michigan Alcoholism Screening Test. The rapists were classified according to the degree of violence during the commission of the rape. The ranges and means of the plasma testosterone level for the rapist and child molester controls were within normal limits. The group of rapists who were judged to be most violent had a significantly higher mean plasma testosterone level than normals, child molesters, and other rapists in this study. Mean Buss‐Durkee hostility rating scores for rapists were significantly higher than the mean for normals, but there was no correlation between individual hostility scores and plasma testosterone levels. There was no correlation between age, race, or length of incarceration and plasma testosterone level.

Thiothixene in the Treatment of Geriatric Patients with Chronic Organic Brain Syndrome

ABSTRACT: Thiothixene was used in a four‐week double‐blind placebo‐controlled study of 42 geriatric patients with chronic organic brain syndrome (psychotic or nonpsychotic). The results, according to several rating measures, showed no significant difference between placebo and thiothixene. Side effects were mild and few. These data support the safety of thiothixene therapy for geriatric patients; however, there is no conclusive evidence of its efficacy in the treatment of chronic organic brain syndrome.

ALCOHOLISM AND THE CHILD MOLESTER

This study shows a high association among drinking, alcoholism, and child molestation. Forty-nine percent of the child molesters were drinking at the time of commission of the offense, and 34% were drinking heavily, defined as 10 or more beers or the equivalent. The alcoholism rate for the group was 52% based on the MAST or 33% based on the more stringent Pokorny shortened version of it. An interesting and unexpected finding was a statistically significantly lower incidence of drinking at the time of commission of the offense in male-child molesters compared with female-child molesters. In addition, the male-child molesters had a definitely lower alcoholism rate compared with female-child molesters. The importance of these findings for treatment programs is emphasized.

The violent patient: rapid assessment and management.

Abstract Management of the violent patient begins with rapid, systematic global assessment of the behavior followed by attention to its most likely cause. The evaluation should focus on the issue of provocation in the pre-assault phase; the goal-directedness of the assaultive behavior in the assault phase; and the response of the patient after the attack. Organic and psychodynam ic causes as well as drug-related violence are discussed. The author gives recommendations for assessment and management of assault on the general hospital ward and in the emergency room, and discusses violence directed toward physicians.

The Effects of One-Day Treatment of Anxiety with High Doses of Halazepam

The main purposes of this study were to examine the effects of one-day treatment of anxiety and to test whether significant relief of anxiety can be achieved in a short time period by frequency individual adjustment of doses. A double-blind crossover study of halazepam and placebo was carried out with 22 patients, 20 completing the study. Each treatment lasted for one day. Oral medication was administered starting with a dose of 40 mg and the dose adjusted every 2 hours. The total daily dose did not exceed 600 mg. Several rating and self-rating scales were used. All observer rating scales and several self-rating scales discriminated at a significant level. The design appeart to be suitable for the rapid screening for anti-anxiety properties of new drugs.

Issues in developing quality aftercare clinics for the chronic mentally III

Two large aftercare clinics were established to provide treatment and rehabilitative care for a chronic mentally ill population requiring neuroleptic drugs. The clinics have evolved rapidly and expanded their service over the past 3 years but have required constant monitoring and modification in order to provide quality as well as quantity care in the community setting. These modifications are described and the importance of further community-based investigation in the rehabilitation and treatment of the chronic mentally ill is stressed.

Chlordiazepoxide and Alcohol: A Fatal Overdose

Chlordiazepoxide hydrochloride (Librium®) has been a safe and effective drug in the treatment of the acute effects of alcohol withdrawal [1] and has been a popular psychotropic agent in the treatment of chronic alcoholism because of its low incidence of side effects, low reported incidence of abuse leading to addiction, and wide margin of safety. Hollister [2] states that massive overdoses of the benzodiazepines offer little difficulty in management and concludes that the benzodiazepines are “virtually suicide-proof.” Davis et al [3,4] note that fatalities due to overdose of chlordiazepoxide alone have not been reported. In addition, there have been, to our knowledge, no reported fatalities with a combination of chlordiazepoxide and alcohol. The purpose of this paper is to report a fatal overdose in which a combination of chlordiazepoxide and ethanol was found. A second fatal overdose is presented in which chlordiazepoxide and ethanol were probably the only drugs taken.

Legal Aspects in Treating Rapists.

The development of new evaluation treatment methods for rapists and child molesters has created unique legal and ethical problems for therapists and researchers dealing with this population. These clients by definition are more dangerous than those normally dealt with by psychotherapists. As a consequence, greater care must be taken to protect the client, the therapist, the staff, and potential victims from the sexual assaults of the rapist or child molester. Rada outlines the various legal and ethical problems involved in dealing with such dangerous individuals. A critical element of working with a child molester or rapist is to have a detailed understanding of his history, his current behavior, his response to treatment, and his current ability to control his behavior. The very act of obtaining such information, however, generates issues of confidentiality and privileged communication normally not dealt with by the average therapist. Rada explores the issues of confidentiality, privileged communication, and informed consent to acquaint the reader with the potential problems incurred while working with such clients.