Blog Posts

Do we have the right professional? From PSYCHOLOGY to integrative immuno-biology

6/21/2025

Val's Take/Conjecture

When all the research gets sorted out ---- Societal Responses won't be the Ethical & Moral Nightmare they are today.
BUT right now the research continues to corroborate Developmental multi-system Neuro-Immune Disorders.
Further, that is a refinement from a decade ago.

What has not been corroborated by the research is the DSM categorical system.

Perfectionism, and the failure to adequately address an out-of-date DSM --- we need interim procedures

Science Up

NAMI Montana
It's Time to Improve the Mental Illness Diagnostic Process
(2013)

TRANSLATIONAL JusTICE as "A THING"

6/21/2025

Val's Take/Conjecture

The article to the right addresses Translational Justice in Healthcare.
When I'm referring to "TRANSLATIONAL JUSTICE" --- I'm generally referring to the need to appreciate the ramifications of Medical Research through a Criminal Justice Lens.
- Might also be Translational Justice in Criminology or Translational Criminology.

Burden of Proof

Nothing About Us Without Us: Criminal Justice Edition

Inclusion: Nothing About Us Without Us

Building Better Medicine: Translational Justice and the Quest for Equity in US Healthcare (2025)

Affiliations
1Mayo Clinic.
2University of Toronto.
3University of Miami.
4Case Western Reserve University.
5University of Pennsylvania.
6ETH Zurich.
7Stanford University.

"Micro-Credentialling" in Behavioral Health & the crying need for more advanced care in immuno-psychiatry

6/20/2025

Val's Take/Conjecture

The Colorado Community College System is promoting "micro-credentialing" in Behavioral Health.
There have been work force problems in mental health for a long time --- and there are immediate, practical issues and needs.

Providing a more thorough understanding of Neuro-Developmental and Psychiatric Disorders with New and Modified Paradigms is also critical to addressing "work force" issues.

Neuro-Developmental and Psychiatric Disorders are more and more seen through a lens of "Neuro-Immunology" and "Brain, Behavior & Immunity."

Jonathan Kipnis
Pioneer in Neuro-Immunology

This isn't to say that everyone should be a world-renowned researcher --- but if you want to--- go for it.

Kipnis talks about how ideas can become entrenched and self-perpetuating even if they are wrong --- and that is a problem in Mental Health.

Further, out-dated paradigms are not irrelevant to the mental health profession's work force problems.

It's not just access To care ---It's access to Up-to-Date Translational medicine

6/19/2025

RE-allocating resources Responsibly

Val's Take/Conjecture

There are news reports of 500 mental health professionals in Colorado being laid off and 3 mental hospitals being closed.

Mental Health does need SIGNIFICANT TRANSFORMATION and INTEGRATION with the rest of Health Care.
- Better Systems and Support to Keep Up with the Research.

For me this is akin to the "Defund the Police" or "Cost Shift to the Police" debates and realities --- BUT re-purposing law enforcement to gain even more safety and humane treatment --- yes, that is worthy of doing.

And perhaps providing law enforcement an expanded career ladder into Public Health and Medicine.

Decision Lab --- Status Quo Bias

I am not for FUNDING THE STATUS QUO in mental health.

On the other hand, I'm not for people summarily losing their jobs either.

That's a lot of chaotic, unpredictable stress that is not going to be good for patients, clinicians or the community.

Scapegoating not necessarily the innocent, but the closest link in the chain of causality

The evil society games

When the wrong antidote is like a bone in the throat

One Thing Leads to Another

Why is MIchael Marshall Dead?

Neuro-Developmental Disorders, Criminal Justice & An Emerging Global Consensus

6/16/2025

Val's Take/Conjecture

The Connection between ADHD and greater risk of Criminal Justice involvement has been around at least since the 1990s.
Sweden led this at one point.
There has been more and more work on this in the UK and with this latest 2025 article in the International Journal of Law & Psychiatry --- Italy.

It does seem that European academic articles and government reports are asking more interesting questions:

What should the law be?
What should the range of services be?

American Academic articles can get bogged down in the finer points of Not Guilty by Reason of Insanity and Competency ---

We can' ignore current law.
But we need to be thinking about what "ought to be" not just what "is."

On the other hand, the American Legal System by and large would be happy to hand over the oversight of Defendants with various aspects of "ADHD" and "Co-Morbidities" to the Public Health System ----

Not only are the RESOURCES not there to handle that in PUBLIC HEALTH;
The UNDERSTANDINGS are getting a lot better but they're not perfect and it's not clear that you can get out of some kind of "CUSTODIAL CARE" in every case.
It's exceedingly inconvenient to know that there are actual biological mechanisms.
Further, these "Social Concerns" affect people's biology, too and are often diverse forms of "Chronic Stress."

ADHD in adults and criminal behavior: The role of psychiatric comorbidities and clinical and sociodemographic factors in a clinical sample (2025)

[Italian Researchers]

Conclusions: Adult ADHD, particularly in males, with combined presentation and in the presence of comorbidities such as oppositional defiant disorder and alcohol use disorder, is associated with an increased risk of criminal behavior.

The findings highlight the need for personalized and multimodal interventions to mitigate these risks.

Future studies should adopt longitudinal designs to explore causal dynamics and evaluate the effectiveness of therapeutic strategies in forensic contexts.

Offending and clinical characteristics of adults with autism spectrum disorder: Experience at forensic psychiatry center in Türkiye between 2012 and 2022 (2025)

[Turkish Researchers]

The Challenge of dealing with the inequities in mental Health without scapegoating

5/23/2025

Val's Take/Conjecture

What I most appreciate is a relatively newer mantra by researchers saying we need PRECISION MEDICINE --- the right treatment, at the right time, for the right patient.

That is no easy trick in Mental Health whose patients are often NEURO-DIVERSE.
- Neuro-Diverse people are more different from one another than Neuro-Typical people are different from one another.

The APA (American Psychiatric Association) Foundation helped to fund a NOVA episode on the "Mysteries of Mental Illness."

The APA Foundation could be helpful in engaging National and Local News Outlets on the RAMIFICATIONS of emerging research to public policy, especially with regard to Homeless and Justice-Involved people.

The Menninger Clinic
Dr. Peter Fonagy --- Improving the Delivery of Mental Healthcare in the U.K. (2013)

Dr. Fonagy is talking about getting Research to the Clinicians ---- FASTER.

Fonagy also makes the point that mental health patients PUT UP WITH more bad treatment quality than most patients.

No Good Deed goes unpunished

Personality Disorders, Developmental Differences --- Conceptualization Matters and It Matters A Lot in the Criminal Law

Why the dsm 5-TR fails --

5/17/2025

Val's Take/Conjecture

Metabolome subtyping reveals multi-omics characteristics and biological heterogeneity in major psychiatric disorders (2023)

*Chinese Researchers

Abstract

Growing evidence suggests that major psychiatric disorders (MPDs) share common etiologies and pathological processes.

However, the diagnosis is currently based on descriptive symptoms, which ignores the underlying pathogenesis and hinders the development of clinical treatments.

This highlights the urgency of characterizing molecular biomarkers and establishing objective diagnoses of MPDs.

Here, we collected untargeted metabolomics, proteomics and DNA methylation data of 327 patients with MPDs, 131 individuals with genetic high risk and 146 healthy controls to explore the multi-omics characteristics of MPDs.

First, differential metabolites (DMs) were identified and we classified MPD patients into 3 subtypes based on DMs.

The subtypes showed distinct metabolomics, proteomics and DNA methylation signatures.

Specifically, one subtype showed dysregulation of complement and coagulation proteins, while the DNA methylation showed abnormalities in chemical synapses and autophagy.

Integrative analysis in metabolic pathways identified the important roles of the citrate cycle, sphingolipid metabolism and amino acid metabolism.

Finally, we constructed prediction models based on the metabolites and proteomics that successfully captured the risks of MPD patients.

Our study established molecular subtypes of MPDs and elucidated their biological heterogeneity through a multi-omics investigation.

These results facilitate the understanding of pathological mechanisms and promote the diagnosis and prevention of MPDs [Major Psychiatric Disorders].

Shared Genes & Psychiatric Disorders

DSM-5-TR: overview of what’s new and what’s changed (2022)

"The American Psychiatric Association continues to welcome empirically-grounded proposals for change. Guidelines for submitting such proposals can be found at www.dsm5.org."

If the APA is not embracing the "underlying biology" --- it is making an attempt to endorse "empiricism."

Further, there does seem to be a recognition that the DSM 5-TR is not the last word --- and that is a good thing.

Additionally, the APA is working on DSM 6.

What is missing are the more fundamental criticisms of the DSM and a loss of "Faith" as a result of "Empiricism" in the category structure --- even with some updates.

Precision Psychiatry Is the Future. Europe Can Lead the Way (2023)

"Today, the field is held back by a nosology that has good inter-rater reliability, but that has seen no validation of any diagnostic entity by specific biomarkers that would inform diagnosis, possibly irrespective of existing diagnostic entities.

"The lack of progress in the development of drugs is largely due to the fact that patients are seldom prescreened for specific biomarkers before being included in clinical trials.

"Neither are they commonly prescreened for the pathology, subgroup, and/or dimensions of interest to potentially respond to a specific drug.

"Both clinicians and regulatory agencies still work under the notion of “one size fits all,” which has induced errors and failures of clinical trials in past decades."

[This is ironic --- Rice University is in Texas]

Towards a consensus roadmap for a new diagnostic framework for mental disorders (2024)

"In general, the meeting indicated a crucial need for a biology-informed framework to establish more precise diagnosis and treatment for mental disorders to facilitate bringing the right treatment to the right patient at the right time."

RFK JR., Autism --- and A Maternal Immune Activation Hypothesis

5/15/2025

Researchers actually already know a lot more about autism than They did --- even though it is not common knowledge

Val's Take/Conjecture

RFK Jr. is not wrong to be interested in addressing "autism."
Many researchers around the world are trying to address Neuro-Developmental & Psychiatric Disorders, and there is often a blurring and overlap.

Developmental Inflammation seems to be often involved with Neuro-Developmental & Psychiatric Disorders.

Well what causes Developmental Inflammation --- a lot of things.
- That's one of the reasons why researchers talk about "MULTI-FACTORAL" causes for Neuro-Developmental and Psychiatric Disorders.
- Further, that Developmental Inflammation can affect GENE EXPRESSION and EPIGENETICS.

At least some of what seems to be happening in utero during Maternal Immune Activation is dysregulation of MICROGLIA --- the Brain's Innate Immune Cells

Maternal Inflammation During Pregnancy and Offspring Brain Development: The Role of Mitochondria (2022)

[A]lterations in mitochondrial structure/function due to MIA may be programmed and, hence, can persist over the life span."

"Thus, in addition to the effects of MIA-induced alterations in mitochondrial function on the developing brain, these mitochondrial alterations may continue to exert long-term effects on the brain (and other systems) over the life span of the individual."

If we really want to provide better treatments for Neuro-Developmental & Psychiatric Disorders ---

the public, policy-makers and clinicians need a better understanding of the research that is already there.
more educational and translational medicine support is desperately needed.

Dr. Chris Palmer
Autism: Disorder, Disability or Difference

Palmer makes the point that genetics is not necessarily the biggest factor --- but individual issues during neuro-development in utero.

That would be consistent with the Maternal Immune Activation Hypothesis of Neuro-Developmental and Psychiatric Disorders.

Further, Paternal Immune Activation has also been recognized.

Resveratrol prevents offspring's behavioral impairment associated with immunogenic stress during pregnancy (2025)

*Brazilian Researchers

Does maternal immune activation dysregulate mitochondria in microglia?
(April 27, 2025)

Yes, maternal immune activation (MIA) can dysregulate mitochondria in microglia.

. . .

MIA activates microglia, the brain's immune cells, leading to the release of proinflammatory cytokines.

Mitochondrial Dysfunction:

This microglial activation can disrupt mitochondrial function in microglia, potentially leading to oxidative stress, altered mitochondrial membrane potential, and changes in mitochondrial protein expression.

. . .

Mitochondria as a Target and Mediator:

Mitochondria are not only affected by inflammation but can also contribute to the inflammatory process by releasing mitochondrial DAMPs, which can activate the inflammasome and further amplify inflammation.

Consequences for Brain Development:
.
Mitochondrial dysfunction in microglia, particularly during the critical window of brain development, can have consequences for neurodevelopment and increase the risk of neurodevelopmental disorders.

. . .

This is for informational purposes only. For medical advice or diagnosis, consult a professional. Generative AI is experimental.

The DSM 6 and Federal Rule of EVidence 407 ---Subsequent remedial Measures

5/15/2025

Val's Take

By and large, mental health patients and/or Defendants are not interacting directly with the American Psychiatric Association (APA).
- They are interacting with a Clinician and/or Forensic Evaluator.

When people complain to me of the medical model --- I say what medical model --- It's a Sham Medical Model at Best

The Need for a new Integrated DSM

In 2013, the National Institute of Mental Health (NIMH) said the DSM 5 ----- "lacked validity."

The DSM 6 is expected to be out by 2028 --- and there seem to be some highly significant REFORMS.

Transforming DSM-6 Development: A Call for Integrated Approaches and Cautious Innovation (2025)

By Dr. Steven E. Hyler
Professor Emeritus of Psychiatry at Columbia University Medical Center

Key Takeaways

AI and digital platforms can revolutionize DSM-6 development, enabling real-time updates and broader participation through a Wiki-D platform.
AI integration can bridge DSM and RDoC frameworks, supporting personalized medicine and continuous updates, enhancing diagnostic accuracy.

This article argues for greater use of technology in the DSM 6.

Part of the problem in previous DSMs has been that the APA didn't have the technology to keep up with the research --- and it's been EXPLODING the past several years --- BUT not necessarily getting to the clinicians or the patients.

NIMH Delivers a kill shot to the DSM 5

Burden of Proof

But this is NOT just about TECHNOLOGY.

This is about a medical professional organization struggling with major re-conceptualizations of "Mental Disorders" based on newer scientific discoveries and research.

A lot of this struggle is political.

Perfectionism and an out-of-date DSM -- We need Interim Procedures

The DSM Criminal Justice Wheel of Fortune

Conceptualization Matters --- It Matters a lot in the Criminal Justice System

Hair Analysis, Psychological Analysis

Law Professor Wes Porter at Golden Gate University Law School, former US Dept. of Justice Attorney

Federal Rules of Evidence (FRE) Rule 407 - Subsequent Remedial Measures

Harvard Law Review Sounds the Alarm on the "Anti-Social Personality Disorder" Diagnosis

The Evolution of Psychiatric Diagnosis: From DSM-5 to DSM-6 (2024)

By Emily Thatcher
Department of Psychiatry, Harvard University

"Advancements in neuroscience and genetics have profound implications for psychiatric diagnosis.

The DSM-5 began to incorporate findings from these fields, although it was constrained by the limits of contemporary research. [Val's Note: That was not the only problem.]

"As scientific understanding continues to evolve, the DSM-6 is poised to integrate more robust neurobiological data, enhancing the precision and reliability of diagnoses.

"This integration may involve the inclusion of biomarkers and genetic information, providing a more detailed picture of mental health disorders.

[Val's Note: Metabolomic Biomarker Signatures for Bipolar Disorder and Unipolar Depression --- JAMA Psychiatry (2024)]

"For example, genetic predispositions and neuroimaging findings could become part of diagnostic criteria, offering objective measures alongside clinical assessments.

Such developments promise to refine diagnoses, enable personalized treatment plans, and improve outcomes for patients.

"The categorical nature of the DSM has often been criticized for its limitations in capturing the complexity of mental health disorders, which frequently exist along spectrums rather than within discrete categories.

"The DSM-5 made some progress towards dimensional approaches, particularly with the introduction of severity specifiers for various disorders.

"The DSM-6 is likely to further this dimensional approach, recognizing that many psychiatric conditions are not binary but exist on a continuum."

Justice Delayed is Justice denied --- and an out-of-Date DSM

5/11/2025

Val's Take: I'm posting this for some contradictory reasons.

The research on Neuro-Developmental & Psychiatric Disorders ---- it is ON THE RISE --- and "YOU CAN'T STOP IT."

But one could certainly DELAY new paradigms from getting to clinical practice. This isn't about prematurely adopting experimental treatments.

This is about UNDERSTANDING the SIGNIFICANCE of major paradigm shifts at the Research Level across the Globe that are making current approaches and the DSM 5 untenable.

Beyond that, these paradigms and research have LEGAL RAMIFICATIONS.

Burden of Proof

New Understandings Matter

"Perfectionism" and the Failure to Address an Out-of-date DSM --- We need Interim Procedures

<<Previous

Forward>>

Transitional/ Translational Justice Monday

Do we have the right professional? From PSYCHOLOGY to integrative immuno-biology

TRANSLATIONAL JusTICE as "A THING"

"Micro-Credentialling" in Behavioral Health & the crying need for more advanced care in immuno-psychiatry

It's not just access To care ---It's access to Up-to-Date Translational medicine

RE-allocating resources Responsibly

Neuro-Developmental Disorders, Criminal Justice & An Emerging Global Consensus

The Challenge of dealing with the inequities in mental Health without scapegoating

Why the dsm 5-TR fails --

RFK JR., Autism --- and A Maternal Immune Activation Hypothesis

Researchers actually already know a lot more about autism than They did --- even though it is not common knowledge

The DSM 6 and Federal Rule of EVidence 407 ---Subsequent remedial Measures

Justice Delayed is Justice denied --- and an out-of-Date DSM

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