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Given the increase in suicidal behavior in recent years, psychologists should think through their policies about working with suicidal patients. Unfortunately, many psychologists have such an aversion to treating suicidal patients that they have developed policies of avoiding them, even to the extreme of refusing to treat any suicidal patients. However, avoidance policies may discourage such patients from being open about their suicidal thoughts and may increase the sense of self-stigma among some patients. Also, because suicidal thoughts occur so frequently among patients with the diagnoses commonly treated by psychologists, a question arises as to whether a psychologist could adequately treat those patients without showing an openness to explore suicidal thoughts. Because policies of being overly scrupulous in avoiding suicidal patients risk harming patients and can undercut the effectiveness of psychological services, they are poor risk management strategies that could paradoxically increase the risk of patient suicide. The authors conclude that the harms created by policies of avoiding to treat suicidal patients outweigh their benefits and that psychologists who deliver health care should become proficient in assessing and intervening with suicidal patients. Public Significance Statement: The authors argue that psychologists should eschew overly zealous policies of avoiding suicidal patients because such policies may not be the optimal way to promote patient well-being or protect psychologists from patient suicides. This article presents important considerations and supporting data for a more nuanced approach. [ABSTRACT FROM AUTHOR]

Background: How cognition is influenced by electroconvulsive treatment (ECT) and major depressive disorder (MDD) is still debated. The development and etiology of neurocognitive impairment in MDD were examined by investigating the cognitive profile following ECT related to the state, scar, and trait perspectives, with the former predicting improvements parallel with depressive symptoms, while the two latter expected persisting impairments. Executive functions (EF) and attention are central to cognition and alterations in these functions could influence other domains like memory. The main aims of the present study were to examine the short and long-term effects of ECT on EF and attention in patients with major depressive disorder by exploiting the rapid antidepressant effect of this treatment. Methods: A case-control longitudinal follow-up design was used to investigate the effects of unilateral brief-pulse ECT on EF and attention in patients with depression (n = 36) compared to untreated healthy controls (n = 16). EF and attention were measured pre-treatment, approximately two weeks, and six months post-treatment. Results: The patient group showed significantly worse performance on most tests compared to healthy controls pre-treatment, and no short- or long-term worsening of EF and attention following ECT was found. Significant improvement was identified in patients' attention, processing speed and inhibition after ECT. Conclusions: The present study showed that there was no cognitive worsening after ECT treatment. An improvement in several of the tests measuring inhibition, attention, and processing speed was parallel to symptom reduction, with the former showing associations to symptom change, suggesting state-related effects from improved mood. Still, the patient group performed significantly worse on most measures both pre-treatment and at the short and long-term follow-ups, indicating prevailing trait or scar effects on cognitive functions and potential lack of practice effects. Clinical trial number: NCT04348825 (14.04.20). [ABSTRACT FROM AUTHOR]

Abstract Background How cognition is influenced by electroconvulsive treatment (ECT) and major depressive disorder (MDD) is still debated. The development and etiology of neurocognitive impairment in MDD were examined by investigating the cognitive profile following ECT related to the state, scar, and trait perspectives, with the former predicting improvements parallel with depressive symptoms, while the two latter expected persisting impairments. Executive functions (EF) and attention are central to cognition and alterations in these functions could influence other domains like memory. The main aims of the present study were to examine the short and long-term effects of ECT on EF and attention in patients with major depressive disorder by exploiting the rapid antidepressant effect of this treatment. Methods A case-control longitudinal follow-up design was used to investigate the effects of unilateral brief-pulse ECT on EF and attention in patients with depression (n = 36) compared to untreated healthy controls (n = 16). EF and attention were measured pre-treatment, approximately two weeks, and six months post-treatment. Results The patient group showed significantly worse performance on most tests compared to healthy controls pre-treatment, and no short- or long-term worsening of EF and attention following ECT was found. Significant improvement was identified in patients’ attention, processing speed and inhibition after ECT. Conclusions The present study showed that there was no cognitive worsening after ECT treatment. An improvement in several of the tests measuring inhibition, attention, and processing speed was parallel to symptom reduction, with the former showing associations to symptom change, suggesting state-related effects from improved mood. Still, the patient group performed significantly worse on most measures both pre-treatment and at the short and long-term follow-ups, indicating prevailing trait or scar effects on cognitive functions and potential lack of practice effects. Clinical trial number NCT04348825 (14.04.20).

Within the US, children and adolescents who engage in sexually abusive behavior are often subjected to sex offender registration and notification requirements, which contribute to stigmatization and forfeiture of their civil rights without empirical basis (Lancaster, 2011; Pickett et al., 2023; Zilney & Zilney, 2009). To date, 39 states subject children with adjudicated sexual offenses to sex offender registration requirements, with most recent estimates revealing that approximately 200,000 youth have been placed on sex offender registries within the US and many are now on the registry as adults (Pickett et al., 2020). This severe response—by both members of the public and policymakers—toward children who engage in inappropriate sexual behavior is imposed upon children and adolescents with adjudicated sexual offenses in an effort to meet goals of reducing sexual violence and increasing community safety. Within the current discourse, we review the history of registration and notification practices for adolescents with sexual offenses, describe what registration and notification policies entail, and then present empirical and theoretical evidence of the harmful outcomes associated with implementation of registration and notification requirements for sexual offenses. Thus, the predominant aim of this discourse is to encourage thoughtful and critical examination of registration and notification policies and their iatrogenic impacts. [ABSTRACT FROM AUTHOR]

This study examined the prevalence of relationship undermining statements by psychotherapists as reported by clients in individual therapy who presented with relationship problems, and whether these statements were associated with worse outcomes for client relationships. Participants (n = 101) reported on recollections of whether their therapist had suggested that their partner would never change, had a diagnosable personality/mental health disorder, had negative motives, that the relationship was doomed from the start or beyond repair now, or that divorce/breakup was their best option. Findings showed high prevalence of these undermining statements and associations with poorer relationship outcomes and shorter duration of therapy. We discuss potential explanations for this phenomenon and offer implications for the training of therapists who treat individual clients with relationship problems. [ABSTRACT FROM AUTHOR]

Research Summary: We examined the impact of Raise the Age (RTA) in Massachusetts, which increased the maximum jurisdictional age for its juvenile court in late 2013. Using statewide re‐arraignment data and a difference‐in‐differences research design comparing affected 17‐year‐olds to unaffected 18‐year‐olds, we find that RTA increased recidivism for affected 17‐year‐olds. The observed increases in recidivism were especially large for 17‐year‐olds without prior justice involvement. This result may stem from the more extensive use of pretrial supervision or the diminished deterrence of prosecution within the Massachusetts juvenile justice system. Policy Implications: This study demonstrates that prosecuting older adolescents as juveniles can exacerbate rather than reduce future justice involvement. This finding highlights the ongoing risk of unanticipated and iatrogenic impacts of criminal justice interventions. It also suggests the need for caution in further expansions of RTA until evidence of anticipated programmatic benefits can be confirmed. [ABSTRACT FROM AUTHOR]

The recent review article by Zonnenberg, Türp and Greene 'Centric relation critically revisited – What are the clinical implications'? opens an important debate by addressing topics of central relevance in Dentistry, namely the relationship between occlusion and the condyle‐to‐glenoid‐fossa position, and the need for diagnostic assessment and therapeutic alteration of the condylar position in orthodontic patients. Zonnenberg, Türp and Greene concluded that the mandibular condyle is correctly situated in most orthodontic patients. Thus, in their view, orthodontists can disregard this aspect during treatment, and rely on the plastic properties of the masticatory supporting structures, while aiming at finishing the cases in a good occlusal relationship. We think that this approach fails to consider that biological variation of the stomatognathic structures can also be pathological and that, as dental occlusion determines condylar relative position within the glenoid fossa, changes in the occlusion are likely to alter the original condylar‐to‐glenoid‐fossa relation. Hence, we claim that whenever the occlusal relationship must be changed, the clinician should carefully monitor the condyle position and the mandibular function to prevent possible iatrogenic effects. To advance the discourse on the topic, we invite Zonnenberg, Türp and Greene to clarify their definition of 'average patient' and their interpretation of 'full‐mouth orthodontic and orthognathic treatment', their understanding of 'biologically acceptable condylar relationship', their justification of maximum intercuspation as reference position, the extent to which they think it is safe to rely on the TMJ resilience, and finally their alternative to centric relation in the treatment of patients needing condylar repositioning. [ABSTRACT FROM AUTHOR]

In medical language, an iatrogenic disease is one that resulted from the treatment of some other disease. About one-sixth of the hospital patients in Scandinavia lie there for diseases that they have gotten from the treatment, often at the hospital. This may sound bad, but actually signifies a great improvement: it is only a century ago since the probability of survival if taken to the hospital became greater than if not. There are several factors behind this development. Medical practice has improved, with the idea of Ignaz Semmelweiss that medical staff should wash their hands between different operations as a first major breakthrough (it spread quicker among midwives than among his doctor colleagues). Medical research and theory have taken great steps ahead, dramatically improving the prognoses of formerly lethal diseases. Medical practice and medical theory have moved from being virtually separate fields to close interaction. Medical ethics has given increasing emphasis to the illegitimacy of the doctor putting his own interests before those of the patient. So while there is still a long road to travel in medicine, the road already traveled is impressive. This paper discusses the effects of attempts by international intervention to “cure” domestic conflicts in various countries in what has been described as an age of globalization. Has any progress been made that is comparable to that in medicine? What can we expect? What results do we actually find?

In the 50 years since it was first introduced, cognitive therapy has been shown to be as efficacious as antidepressant medications (on average) in the acute treatment of nonpsychotic depression, although some patients will do better on one than on the other. Moreover, patients treated to remission with cognitive therapy are less than half as likely to relapse following treatment termination as patients treated to remission with medications. However, a recent study suggests that adding medications interferes with any such enduring effect and medications themselves may have an iatrogenic effect that suppresses symptoms at the expense of prolonging the underlying episode. Neural imaging suggests that cognitive therapy works from the "top down" to facilitate cortical regulation of affect processes whereas medications work from the "bottom up" to dampen the stress response. Adaptationist theory suggests that depression is an evolved adaptation that served to keep our ancestors ruminating about complex social problems until they arrived at a solution; if true then any intervention that facilitates problem solving is likely preferable to one that merely anesthetizes distress. [ABSTRACT FROM AUTHOR]

Literature on antiepileptic-induced iatrogenic hypoglycemia is scanty. Due to its broad spectrum of activity and mechanisms of action, valproic acid (VPA), a fatty acid, is one of the most widely prescribed epilepsy treatments worldwide. Herein, we describe an adult epileptic patient, in whom persistent, otherwise unexplained, hypoglycemia was most likely induced by VPA, as suggested by the VPA and glucose blood level time course. Indeed, no further hypoglycemic episodes occurred after VPA discontinuation and the diagnostic work-up ruled out other possible causes of hypoglycemia. This case supports the hypothesis that VPA may induce hypoglycemia, even in the absence of a VPA hepatotoxicity syndrome, due to still not well-defined metabolic mechanisms of action. Moreover, it emphasizes the fact that an iatrogenic pathogenesis should be considered if an apparently unexplained hypoglycemia occurs in a patient on chronic therapy with VPA, even at a therapeutical dosage. [ABSTRACT FROM AUTHOR]

Commensurate with the serious risks bullying poses to students' mental health, substantial attention has been devoted to evaluating school bullying prevention programs. Research on the effectiveness of these interventions shows mixed outcomes. Recent evidence suggests that even programs that reduce overall bullying may have negative outcomes for victims. Most bullying prevention programs incorporate a range of strategies, but we know little about which strategies actively reduce bullying and whether some may have iatrogenic effects. Questions have been raised about programs that involve working with peer bystanders and whether some strategies stigmatize victims. In this article, I propose three theoretically derived hypotheses that describe mechanisms through which encouraging peers to actively defend victims may produce adverse outcomes for victims. More research is needed to test these hypotheses. A deeper understanding of the differential impact of bullying prevention strategies will lead to improvements in programs and more targeted use of effective strategies. [ABSTRACT FROM AUTHOR]

This article aims to encapsulate the effect of appliances on the periodontal health of patients undergoing orthodontic treatment. While orthodontic treatment provides benefits to a wide range of intra-oral and extra-oral issues starting from aesthetics to mastication, there are some major setbacks in terms of relapse if the treatment is not carried out with a proper plan. Therefore, with limitations in maintaining a desired oral hygiene, which breeds various periodontal problems, iatrogenic causes further narrow down a good prognosis which is desired at the end of an orthodontic treatment or in fact, any medical procedure. This is a review of the unnatural and natural impact of orthodontic treatment on the tissues periodontium and the treatments associated with it. [ABSTRACT FROM AUTHOR]

Recent research suggests that combining putative reinforcers for problem behavior into a single, synthesized contingency may increase efficiency in identifying behavioral function relative to traditional functional analysis (FA). Other research suggests potential shortcomings of synthesized contingency analysis (SCA), such as the potential for false‐positive outcomes. In prior comparisons of traditional FAs and SCAs, investigators could not ascertain with certainty the true function(s) of the participants' problem behavior for use as the criterion variable. We conducted a translational study to circumvent this limitation by training a specific function for a surrogate destructive behavior prior to conducting a traditional FA and SCA. The traditional FA correctly identified the previously established function of the target response in all six cases and produced no iatrogenic effects. The SCA produced differentiated results in all cases and iatrogenic effects (i.e., an additional function) in three of six cases. We discuss these findings in terms of the mechanisms that may promote iatrogenic effects. [ABSTRACT FROM AUTHOR]

In medical language, an iatrogenic disease is one that resulted from the treatment of some other disease. About one sixth of the hospital patients in Scandinavia lie there for diseases that they have gotten from the treatment, often at the hospital. This may sound bad, but actually signifies a great improvement: it is only a century ago since the probability of survival if taken to hospital became greater than if not. There are several factors behind this development. Medical practice has improved, with the idea of Ignaz Semmelweiss that medical staff should wash their hands between different operations as a first major breakthrough (it spread quicker among midwifes than among his doctor colleagues). Medical research and theory has taken great steps ahead, dramatically improving the prognoses of formerly lethal diseases. Medical practice and medical theory have moved from being virtually separate fields to close interaction. Medical ethics has given increasing emphasis to the illegitimacy of the doctor putting his own interests before those of the patient. So while there is still a long road to travel in medicine, the road already travelled is impressive. This paper discusses the effects of attempts by international intervention to "cure" domestic conflicts in various countries in what has been described as an age of globalization. Has any progress been made that is comparable to that in medicine? What can we expect? What results do we actually find? [ABSTRACT FROM AUTHOR]

The following question was posed, has social science research helped or harmed us? Social work research was used for the purpose of illustration. Three hazards of applying social work basic research were outlined: (1) It is bias (reflecting the left-leaning values of many academics) and leads to the reduction in our freedoms; (2) the social work bias is rooted in a supposed moral high ground called social justice; and (3), the voice of the non-academics becomes deflated, as epistemic elitism is used to foist views upon us by the political class, undermining common cultures. On the heels of the three points, conclusions were offered to consider if any moderating factors exist to address the concern about the loss of freedoms discussed. [ABSTRACT FROM AUTHOR]

The ongoing conflict in the war on terrorism puts two emblematic modes of violence into sharp relief: the drone, as an ostensibly rational, clinical and measured weapon of war, and suicide bombings, frequently portrayed as the horrid deeds of fanatics. In this article, I seek to challenge this juxtaposition and instead suggest that both modalities of killing are part of the same technologically-mediated ecology of violence. To do this, I examine the material-semiotic assemblage of the drone and of the suicide bomber, paying attention to the technological production of each mode of violence, as well as the narratives that render each figure intelligible in the war on terrorism. I argue that the strongly divergent narratives found in Western discourse serve as a politically expedient sense-making device, whereby suicide bombing is pathologised, thereby justifying ever more intrusive violent acts with seemingly rational technologies like the drone. Rather than “solving” the problem of terrorism, this creates counter-productive, or iatrogenic, effects, in which technological mediation escalates rather than diminishes cycles of violence. By way of response, I suggest that a better understanding of the relational nature of violence in the war on terrorism might be gained by reading the two not as antithetical figures, but instead as operating in the same technological key. [ABSTRACT FROM AUTHOR]

The Danish government’s counter-radicalization Action Plan of 2009 had intended and unintended effects. Primarily targeting Danish Muslims, it employs neoliberal governmentality approaches of governance through individual support and response, information and knowledge, empowerment, surveillance and intervention, and anti-discrimination. It aims to prevent radicalization by transforming, shaping, and disciplining illiberal and violence-prone “radicals” into active, liberal citizens. Prolonged fieldwork and in-depth interviews with seventeen Muslims from a targeted milieu reveal skepticism about the effectiveness of the measures. Implementation of the action plan in practice may yield iatrogenic effects.

The effects of workload, fatigue, and practice on the performance of cognitive tasks are often intertwined. Previous research has shown that these influences can be separated with the two cusp catastrophe models. This study expanded an earlier investigation of the two models for workload and fatigue in a vigilance task to include a wider range of bifurcation variables that could affect the elasticity versus rigidity of the operator in response to workload and added performance variability resulting from fatigue. The study also responded to a concern in the literature that performance on cognitive tasks can be complicated by adaptive responses to artificial task situations and thus distort underlying cognitive events. Therefore, we also explored whether wearing biometric sensors, frequently used in workload studies, can affect performance dynamics. Participants were 279 undergraduates who responded to target stimuli that appeared on a simulated security camera display at three rates of speed while completing a secondary task. Participants worked alone, in pairs, or in pairs wearing GSR sensors. Results supported the efficacy of the two models and isolated the impact of wearing sensors on the fatigue process. The strongest control variables across both the workload and fatigue models were field independence, anxiety, indecisiveness, inflexibility, secondary task completion, working in pairs, and wearing the sensors. The contributing effect of wearing sensors could possibly extend to other types of wearable technologies. [ABSTRACT FROM AUTHOR]

Criminology has paid increasing attention to the prospect that prevention programmes can cause harm. The Cambridge-Somerville Youth Study, a delinquency prevention experiment of 506 boys that began in 1939, provides some of the earliest evidence of programmatic iatrogenic effects. A series of hypotheses were advanced by Joan McCord and other scholars to explain these unintended effects. Drawing upon this scholarship, related research and developmental theory, this article examines the leading explanations and offers new appraisals of iatrogenic effects of crime prevention programmes. The research suggests that there is not a grand explanation, and we encourage a more nuanced perspective for understanding iatrogenic effects of crime prevention programmes. Implications for policy and practice are discussed. [ABSTRACT FROM AUTHOR]

Assessing suicidality is common in mental health practice and is fundamental to suicide research. Although necessary, there is significant concern that such assessments have unintended harmful consequences. Using a longitudinal randomized control design, the authors evaluated whether repeated and frequent assessments of suicide-related thoughts and behaviors negatively affected individuals, including those at-risk for suicide-related outcomes. Adults (N = 282), including many diagnosed with borderline personality disorder (BPD), were recruited through psychiatric outpatient clinics and from the community at large, and were randomly assigned to assessment groups. A control assessment group responded to questions regarding negative psychological experiences several times each day during a 2-week main observation phase. During the same observation period, an intensive suicide assessment group responded to the same questions, along with questions regarding suicidal behavior and ideation. Negative psychological outcomes were measured during the main observation phase (for BPD symptoms unrelated to suicide and for BPD-relevant emotions) and/or at the end of each week during the main observation phase and monthly for 6 months thereafter (for all outcomes, including suicidal ideation and behavior). Results revealed little evidence that intensive suicide assessment triggered negative outcomes, including suicidal ideation or behavior, even among people with BPD. A handful of effects did reach or approach significance, though these were temporary and nonrobust. However, given the seriousness of some outcomes, the authors recommend that researchers or clinicians who implement experience sampling methods including suicide-related items carefully consider the benefits of asking about suicide and to inform participants about possible risks. [ABSTRACT FROM AUTHOR]