scholarly journals How Trauma May Magnify Risk of Involuntary and False Confessions Among Adolescents

2021 ◽  
Vol 2 (3) ◽  
pp. 173-204
Author(s):  
Hayley Cleary ◽  
Lucy Guarnera ◽  
Jeffrey Aaron ◽  
Megan Crane

Empirical research on police interrogation has identified both personal and situational factors that increase criminal suspects’ vulnerability to involuntary, unreliable, or false confessions. Although trauma exposure is a widely documented phenomenon known to affect adolescents’ perceptions, judgments, and behaviors in a wide array of contexts (especially stressful contexts), trauma history remains largely unexamined by interrogation researchers and virtually ignored by the courts when analyzing a confession. This article argues that trauma may operate as an additional personal risk factor for involuntary and false confessions among adolescents by generating both additive and interactive effects beyond youths’ general, developmentally-driven vulnerabilities in police interrogations. First, we briefly review adolescent trauma symptomatology, emphasizing the heterogeneity of adolescents’ responses to trauma. Next, using Leo and Drizin’s (2010) “Three Errors” framework of police-induced false confessions, we systematically apply clinical findings to each of the three police errors—misclassification, coercion, and contamination—to outline the psychological mechanisms through which adolescents with trauma histories may be at increased risk for making involuntary or unreliable statements to police. Finally, we offer considerations for interrogation research, clinical forensic practice, police practices, and courtroom procedures that could deepen our understanding of trauma’s role in the interrogation room, improve the integrity of investigative and adjudicatory processes, and ultimately promote justice for adolescent suspects with trauma exposure.

2021 ◽  
Vol 10 (9) ◽  
pp. 2020
Author(s):  
Fariba Rad ◽  
Ali Dabbagh ◽  
Akbar Dorgalaleh ◽  
Arijit Biswas

Coronavirus disease 2019 (COVID-19), with a broad range of clinical and laboratory findings, is currently the most prevalent medical challenge worldwide. In this disease, hypercoagulability and hyperinflammation, two common features, are accompanied by a higher rate of morbidity and mortality. We assessed the association between baseline inflammatory cytokine levels and coagulopathy and disease outcome in COVID-19. One hundred and thirty-seven consecutive patients hospitalized with COVID-19 were selected for the study. Baseline interleukin-1 (IL-1), IL-6, and tumor necrosis factor alpha (TNF-α) level were measured at time of admission. At the same time, baseline coagulation parameters were also assessed during the patient’s hospitalization. Clinical findings, including development of thrombosis and clinical outcome, were recorded prospectively. Out of 136 patients, 87 (~64%) had increased cytokine levels (one or more cytokines) or abnormal coagulation parameters. Among them, 58 (~67%) had only increased inflammatory cytokines, 12 (~14%) had only coagulation abnormalities, and 17 (19.5%) had concomitant abnormalities in both systems. It seems that a high level of inflammatory cytokines at admission points to an increased risk of developing coagulopathy, thrombotic events, even death, over the course of COVID-19. Early measurement of these cytokines, and timely co-administration of anti-inflammatories with anticoagulants could decrease thrombotic events and related fatal consequences.


Circulation ◽  
2014 ◽  
Vol 129 (suppl_1) ◽  
Author(s):  
Lisa Kakinami ◽  
Tracie Barnett ◽  
Gilles Paradis

Background: One-quarter of children are already overweight or obese when they enter preschool, underscoring a critical need to improve our understanding of childhood determinants of health, including both sociodemographic (such as poverty) and social-familial influences (such as parenting style), as well as how these determinants may interact with one another. Objective: To examine the effects of parenting style on the risk of obesity in youth and determine if poverty is a mediator or moderator for this association. Methods: Participants (age 0-11) were from the National Longitudinal Survey of Children and Youth (NLSCY), a representative cross-sectional survey of youth collected bi-annually (1994-2008) throughout Canada. Factor analysis identified 4 parenting styles consistent with Baumrind’s theory of authoritative (demanding and responsive), authoritarian (demanding but not responsive), permissive (responsive but not demanding), and negligent (not demanding and not responsive) parenting control prototypes. Multivariable logistic regression assessed the risk of a child being obese (BMI percentile ≥ 97.7 th compared to age- and sex-specific WHO growth curves) based on parenting style after adjusting for age, sex, parental education, immigration status, family functioning score, birth order, and maternal age. Analyses were stratified by age (younger: 2-5 years of age, n=19,026; school-age: 6-11 years of age, n=18,551) due to age-related differences in parenting styles. Mediation or moderation by poverty (household income < low income cut-offs adjusted for household size and geographic region) was assessed. Analyses used sampling and bootstrap weights. Results: Younger children’s parents were primarily authoritative (42%, n=7357), followed by negligent (22%, n=3763), permissive (20%, n=3436), and authoritarian (16%, n=4470). Parenting styles in school-age children were similar (authoritative: 32%, n=7195, negligent: 31%, n=5586, permissive: 22%, n=3850, authoritarian: 15%, n=1920). In multivariable analyses, compared to authoritative parenting, younger and school-age children with authoritarian parents were 30% (95% CI: 1.1-1.5, p=0.0002) and 37% (CI: 1.1-1.7, p=0.006) more likely to be obese, respectively. In younger children, poverty moderated this association: authoritarian and negligent parenting was associated with 39% (CI: 1.2-1.6, p<0.0001) and 28% (CI: 1.1-1.5, p=0.002) increased risk of obesity, respectively, only among the children not living in poverty. In school-age children, poverty was not a mediator or moderator. Conclusions: Parenting style is associated with a child’s risk of obesity but is moderated by poverty in younger children. Successful strategies to combat childhood obesity need to reflect the independent and interactive effects of sociodemographic and social-familial influences on health especially in early childhood.


2002 ◽  
Vol 11 (6) ◽  
pp. 504-519 ◽  
Author(s):  
Deborah Chyun ◽  
Viola Vaccarino ◽  
Jaime Murillo ◽  
Lawrence H. Young ◽  
Harlan M. Krumholz

• Objective To examine the association between (1) comorbid conditions related to diabetes mellitus, clinical findings on arrival at the hospital, and characteristics of the myocardial infarction and (2) risk of heart failure, recurrent myocardial infarction, and mortality in the year after myocardial infarction in elderly 30-day survivors of myocardial infarction who had non–insulin- or insulin-treated diabetes. • Methods Medical records for June 1, 1992, through February 28, 1993, of Medicare beneficiaries (n = 1698), 65 years or older, hospitalized for acute myocardial infarction in Connecticut were reviewed by trained abstractors. • Results One year after myocardial infarction, elderly patients with non–insulin- and insulin-treated diabetes mellitus had significantly greater risk for readmission for heart failure and recurrent myocardial infarction than did patients without diabetes mellitus, and risk was greater in patients treated with insulin than in patients not treated with insulin. Diabetes mellitus, comorbid conditions related to diabetes mellitus, clinical findings on arrival, and characteristics of the myocardial infarction, specifically measures of ventricular function, were important predictors of these outcomes. Mortality was greater in patients not treated with insulin than in patients treated with insulin; the increased risk was mostly due to comorbid conditions related to diabetes mellitus and poorer ventricular function. • Conclusions Risk of heart failure, recurrent myocardial infarction, and mortality is elevated in elderly patients who have non–insulin- or insulin-treated diabetes mellitus. Comorbid conditions related to diabetes mellitus and ventricular function at the time of the index myocardial infarction are important contributors to poorer outcomes in patients with diabetes mellitus.


2019 ◽  
Vol 3 (Supplement_1) ◽  
pp. S86-S86
Author(s):  
Macy Zou ◽  
Ronald Kelly ◽  
Betty Chinda ◽  
Mckenzie Braley ◽  
Tony Zhang ◽  
...  

Abstract Frailty Index (FI), polypharmacy and cognition status are significant health concerns in older adults. We conducted this study to investigate the interplay of frailty, polypharmacy, and cognition, in determining health outcomes. InterRAI Residential Care (RAI-RC MDS2.0) data were retrieved from residential care homes in Surrey, BC, Canada. Older residents (65+ years) who had RAI-RC records between 2016 and 2018 were used in the analysis (n=976). A deficit accumulation-based FI was generated using 36 variables. Information on polypharmacy and cognition were obtained by accounting the total number of medications and the cognitive performance scale. Information on falls, emergency visits, and mortality were followed. Multivariate Cox proportional hazard models were used to examine the effects of these variables on different outcomes. The FI showed a near Gaussian distribution (median= 0.370 mean= 0.372 SD= 0.143), and increased linearly with age on a logarithm scale (R=0.75, p&lt;0.001). Residents with cognitive impairment showed a higher level of the FI (KW= 863.3, p&lt;0.001). A higher FI was associated with an increased risk of death (HR=15.2 p=0.006) and emergency visits (HR=2.72 p=0.048), adjusting for age, sex, medications, and education levels. Frailty, polypharmacy, and cognition levels are associated and have interactive effects on health outcomes. Ongoing research is to validate the findings with large samples in different health settings, and to understand the underlying processes of the effect. The close relationships between frailty, polypharmacy, and cognition with health outcomes call for effective integrated strategies for healthcare of older adults with multiple complex health problems.


2019 ◽  
Vol 11 (3) ◽  
pp. 280-285 ◽  
Author(s):  
Bruno Follmer ◽  
Rodolfo Andre Dellagrana ◽  
E. Paul Zehr

Background: Brain injury arising from head trauma is a major concern in mixed martial arts (MMA) because knockout (KO) and technical knockout (TKO) are frequent fight outcomes. Previous studies have shown a high incidence of matches ending due to strikes to the head but did not consider weight categories and female fights. This study aimed at analyzing match stoppages in MMA and the exposure to head trauma distinguished by sex and weight categories. Hypothesis: The heavier the weight class, the greater the risk and incidence of head trauma will be, regardless of sex. Study Design: Descriptive epidemiology study. Level of Evidence: Level 3. Methods: Publicly available data of 167 MMA events from 1903 fights between 2014 and 2017 were assessed, comprising 8 male and 2 female weight categories. Results: The combined KO/TKO rates per 100 athlete-exposures in the middleweight (19.53), light heavyweight (20.8), and heavyweight (26.09) divisions were greater than previously reported for MMA. While stoppage via KO/TKO occurred in 7.9% of combats in the female strawweight division, it occurred in 52.1% of the male heavyweight fights. The male middleweight ( P = 0.001), light heavyweight ( P < 0.001), and heavyweight divisions ( P < 0.001) had an increased risk of KO/TKO due to strikes to the head by 80%, 100%, and 206%, respectively. The risk in the flyweight division decreased 62% ( P = 0.001). All categories were compared with the lightweight division. The female bantamweight category presented a 221% increased risk in matches ending due to KO/TKO compared with the strawweight division ( P = 0.012). Punches to the head were the major technique used to end a combat via KO/TKO, regardless of sex and weight class. Conclusion: Head injury risk and incidence varies considerably according to sex and weight category in MMA. Clinical Relevance: The analysis of head trauma exposure in MMA athletes should be distinguished according to sex and weight category.


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