Posthumously Conceived Children: An International and Human Rights Perspective

This essay considers posthumous conception from an international and child-centered approach. After a sketch in Part I of the phenomenon of posthumous conception and the complexities it evokes, Part II examines the types of issues arising in court cases concerning posthumous conception. Part III considers how courts in their rulings have addressed the welfare and best interests of posthumously conceived children and analyzes the scope and meaning of relevant decisions. Part IV looks into children’s rights or interests raised in those judicial decisions: parental acknowledgement, family structures, identity harm, and inheritance and social benefits. This part draws on the Convention on the Rights of the Child (CRC), a prime instrument to advance children’s rights on the international level, incorporating as much as possible the perspectives of children. I argue that the discourse must include concern for the rights and interests of posthumously conceived children and that a new special category of children who are “outcast” cannot stand the test of equality and non-discrimination, nor of the entrenched principles of child welfare and best interests. Moreover, I suggest that attending to children’s perspectives may illuminate the gaps in the current discourse and what needs to be addressed. Finally, Part V draws some conclusions and calls for a more relational approach to ensure that posthumously conceived children do not pay the price of their parents’ decisions and that their welfare and best interests are upheld

Analysis of diabatic compressed air energy storage systems with artificial reservoir using the levelized cost of storage method

A detailed analysis has been carried out to assess the thermodynamic and economic performance of Diabatic Compressed Air Energy Storage (D-CAES) systems equipped with above-ground artificial storage. D-CAES plant arrangements based on both Steam Turbine (ST) and Gas Turbine (GT) technologies are taken into consideration. The influence of key design quantities (ie, storage pressure, turbine inlet pressure, turbine inlet temperature) on efficiency, capital and operating costs is analysed in detail and widely discussed. Finally, D-CAES design solutions are compared with Battery Energy Storage (BES) systems on the basis of the Levelized Cost of Storage (LCOS) method. Results show that the adoption of D-CAES can lead to better economic performance with respect to mature and emerging BES technologies. D-CAES ST based solutions can achieve a LCOS of 28 €cent/kWh, really close to that evaluated for the better performing BES system. Interesting LCOS values of 20 €cent/kWh have been attained by adopting D-CAES plant solutions based on GT technology

Treatment decision-making capacity in children and adolescents hospitalized for an acute mental disorder: The role of cognitive functioning and psychiatric symptoms

OBJECTIVE: This study was conducted to assess treatment decision-making capacity (TDMC) in a child and adolescent psychiatric sample and to verify possible associations between TDMC, psychiatric symptom severity, and cognitive functioning. METHODS: Twenty-two consecutively recruited patients hospitalized for an acute mental disorder, aged 11-18 years, underwent measurement of TDMC by the MacArthur Competence Assessment Tool for Treatment (MacCAT-T). The MacCAT-T interview focused on patients' current treatment, which comprised second-generation antipsychotics (45.5%), first-generation antipsychotics (13.6%), antiepileptic drugs used as mood stabilizers or lithium carbonate (45.5%), selective serotonin reuptake inhibitors (32%), and benzodiazepines (18%). We moreover measured cognitive functioning (Wechsler Intelligence Scale for Children III) and psychiatric symptom severity (Brief Psychiatric Rating Scale v 4.0). RESULTS: Patients' TDMC varied within the sample, but MacCAT-T scores were good in the sample overall, suggesting that children and adolescents with severe mental disorders could be competent to consent to treatment. The TDMC proved independent of psychiatric diagnosis while being positively associated with cognitive functioning and negatively with excitement. CONCLUSION: The MacCAT-T proved feasible for measuring TDMC in a child and adolescent psychiatric sample. TDMC in minors with severe mental disorders was not necessarily impaired. These results deserve reconsidering the interplay between minors and surrogate decision-makers as concerning treatment decisions

Condotte aggressive ed antisociali nell’infanzia e nella adolescenza: alcune riflessioni cliniche e psicopatologiche

In Childhood and Adolescence, conduct problems and antisocial behaviour are largely widespread and the most commonreason for referral to public and private mental health professionals. Aggressive and defiant behaviour is not pathologicalitself, but is part of normal functioning, particularly at some specific ages, and a component of human nature. Therefore, deciding when aggressive or antisocial behaviour needs clinical intervention is a challenge, especially across developmentalstages when the plasticity of mental functioning has an impact on the fluency and instability of the diagnosis. In this paper,we are going to consider psychological, emotional and interpersonal features of children and adolescents displaying a psychopathological conduct, beyond behaviour and acts, which, according to a clinical perspective, could be more useful andshould address effective interventions.&nbsp

Psicoanalisi e Psichiatria forense: una difficile integrazione

This work aims to emphasize what should be the convergence between the analytical instrument and the forensic psychiaty and the contribution that psychoanalysis can provide in forensic evaluation. The contribution is partitioned into three parts that correspond to the three main issues discussed. The first issue relates to similarities between psychoanalysis and forensic psychiatry from a gnoseological point of view. If is possible to think of the analytical position as an instrument that allows you to build up the “story” of a person trying to not let drag from preconceived assumption or own beliefs, this is also valid in forensic psychiatry in wich is crucial to seek and record data in a falsifiability and verifiable point of view. What becomes fundamental in both fields, is the method whether is clinical or forensic, as a guarantee of the cognitive process and the “ systematic doubt” as a guarantee to the self-referentiability. The second main issue concerns the problem of the link between analytical position and the internal position of the expert during a forensic evaluation. There are two concepts depth here and that could be considered fundamental in both fields, that of “abstinence” and “optimal distance”. If abstinence for psychoanalysts is a well known concept, for the forensic evaluators is expressed as an ethical rule need to define its role in front of the Magistrate and those who have to evaluate. The expert is, in fact, in a difficult position different from that of the doctor with the patient. The concept of optimal distance implies, however, the need to find a “proper distance” between analyst and patient as between the forensic evaluator and who is evaluated. Obviously in forensic practice that neutrality is even more difficult by the emotional response, that can’t be eliminated, of the technician in front of the offender and the victim. The third issue as to do with the concept of real and reality with wich both analyst and the forensic psychiatrist have to compare. The expert is not called to account for the reality of the case, he can’t and should not, unlike the Magistrate, define the reality, the scope of inquiry of the expert is the clinical reality of the expertise not its historical reality. In this the forensic function and the analytical one profoundly differ as the reality of the analytic pair is usable only by that particular patient and analyst while, what is noted by the forensic evaluator must be certified and guaranteed by scientific laws of coverage.Il lavoro si propone di evidenziare quelle che possono essere le convergenze tra lo strumento analitico e la psichiatria forense e l’apporto che la psicoanalisi può fornire in ambito peritale. Il contributo è suddiviso in tre parti che corrispondono ai tre temi principali trattati. Il primo tema è relativo alle similitudini tra psicoanalisi e psichiatria forense da un punto di vista gnoseologico. Se è possibile immaginare la posizione analitica come uno strumento che permetta di costruire la “storia” di una persona cercando di non lasciarsi trascinare da un’ipotesi preconcetta o dalle proprie convinzioni, ciò è valido anche nella psichiatria forense in cui è fondamentale ricercare e registrare dati in un’ottica falsificazionista, e verificabile. Ciò che diviene essenziale, in entrambe i campi, è il metodo sia esso clinico o peritale, come garanzia del processo conoscitivo ed il “dubbio sistematico” come garanzia alla autoreferenzialità. Il secondo tema riguarda il problema del rapporto tra la posizione analitica e la posizione interna del perito durante una Consulenza. Due sono i concetti qui approfonditi e che si potrebbero ritenere significativi in entrambi i campi, quello di “astinenza” e quello di “distanza ottimale”. Se l’astinenza per gli psicoanalisti è un concetto ormai noto da tempo, per i periti si concretizza quale regola deontologica nella necessità di definire il proprio ruolo davanti al magistrato ed al periziando. Il perito si trova, infatti, in una posizione molto diversa da quella del medico con il proprio paziente. Il concetto di distanza ottimale implica, invece, la necessità della ricerca di una “giusta distanza” tra analista e paziente come tra perito e periziato. Ovviamente, nella pratica forense tale neutralità è resa ancora più ardua dalla risposta emotiva, ineliminabile, del tecnico di fronte al reato o alla vittima. Il terzo tema infine, ha a che fare con il concetto di reale e di realtà con il quale si confrontano sia l’analista sia lo psichiatra forense. Il perito non è chiamato a rispondere della realtà processuale, non può e non deve, a differenza del Magistrato, definire la realtà, l’ambito di indagine del perito è la realtà clinica del periziando e non la sua realtà storica. In ciò la funzione peritale e la funzione analitica differiscono profondamente in quanto la realtà della coppia analitica è fruibile solo da quel particolare paziente ed analista mentre, quanto rilevato dal perito deve essere dimostrabile e garantito da leggi scientifiche di copertur

Personality and suicidal ideation in the elderly: factorial invariance and latent means structures across age

Objectives: Suicide among the elderly is a dramatic global health problem. Although fatal attempts are frequent in the elderly, research indicated that they rarely present long-term elaboration of suicidal ideation and communicate their intents. Consequently, risk factor detection and assessment are salient. Although evidence on the association between personality and suicidal ideation in young adults is accumulating, little is known about its relevance in the elderly. The purpose of the present study was to analyze the components of a measurement model that are invariant across young adults and older adults and then investigate the relations among dimensions of personality and suicide risk. We postulated a specific relation pattern a priori and tested the hypotheses statistically in order to examine the models for equivalency of the factorial measurement. Method: We investigated 316 young adults and 339 older adults, who were administered self-report questionnaires to assess depression, hopelessness, alternative five-factor model of personality, and self–other perception. Results: Multigroup confirmatory factor analyses were conducted, yielding a final model with excellent fit to the data. This model showed a similar pattern of associations between suicidal ideation and personality across both groups. Conclusions: Although the elderly are exposed to specific life stressors associated with suicidal ideation, our findings suggest that the elderly and young adults may be similar on personality and psychopathology variables predicting suicidal ideation than previously hypothesized. Implications are provided for enhanced assessment and intervention of the elderly high in neuroticism, depression, hopelessness, and with negative self–other perception

Less Worthy Lives? We Must Prioritize People with Intellectual and Developmental Disabilities in COVID-19 Vaccine Allocation

Individuals with developmental and intellectual disability should prioritized during COVID-19 vaccination allocation

Psychoanalysis and Affective Neuroscience. The Motivational/Emotional System of Aggression in Human Relations

This article highlights the evolutionary biological epistemology in Freud psychoanalytic theory. The concepts of aggressive and sexual drives are cornerstones of the psychoanalytic epistemological system, concerning the motivational/emotional roots of mental functioning. These biological roots of mental functioning, especially with regard to aggressive drive, have gradually faded away from psychoanalytic epistemology, as we show in this article. Currently, however, Neurosciences, and in particular Affective Neuroscience (Panksepp, 1998), can help us to have a better understanding of the biological roots of human mental functioning. The motivational/emotional systems studied by Affective Neuroscience can give a new epistemological foundation to the aggressive drive concept in psychoanalytic theory. Over the course of human evolution, motivational/emotional systems have played a role in social relationships and also in mental functioning. In this regard, among the various types of aggression (ANGER in Panksepp taxonomy 1998) that we consider in our article, inter-male aggression, also named Dominance motivational/emotional system, is that which regulates social interactions between sexually matured adults. This type of aggression acts in complementary connection with FEAR motivational/emotional system that regulate submissive behavior and social defeat, and the latter one is of the more important stressors. The interaction between aggression and FEAR motivational/emotional systems gives rise to agonistic behavior or dominance/submission motivational/emotional system, as we propose in our article. There is now a large literature that identifies in the dynamic of Competitive behavior, which is one of the main factors of mental illness. When social interactions activate the competitive behavior, the subject can perceive himself as “destined to victory” or “destined to defeat,” activating either behaviors or emotions connected to the Involuntary Defeat Strategy or Involuntary Dominant Strategy (Sloman, 2002), which we can find in many types of mental disorders, for example, mood disorders or anxiety disorders

Executive functions, impulsivity, and inhibitory control in adolescents: a structural equation model

Background. Adolescence represents a critical period for brain development, addressed by neurodevelopmental models to frontal, subcortical-limbic, and striatal activation, a pattern associated with rise of impulsivity and deficits in inhibitory control. The present study aimed at studying the association between self-report measures of impulsivity and inhibitory control with executive function in adolescents, employing structural equation modeling. Method. Tests were administered to 434 high school students. Acting without thinking was measured through the Barratt Impulsiveness Scale and the Dickman Impulsivity Inventory, reward sensitivity through the Behavioral Activation System, and sensation seeking through the Zuckerman–Kuhlman–Aluja Personality Questionnaire. Inhibitory control was assessed through the Behavioral Inhibition System. The performance at the Wisconsin Card Sorting Task indicated executive function. Three models were specified using Sample Covariance Matrix, and the estimated parameters using Maximum Likelihood. Results. In the final model, impulsivity and inhibitory control predicted executive function, but sensation seeking did not. The fit of the model to data was excellent. Conclusions. The hypothesis that inhibitory control and impulsivity are predictors of executive function was supported. Our results appear informative of the validity of self-report measures to examine the relation between impulsivity traits rather than others to regulatory function of cognition and behavior

Concerns about the use of polygenic embryo screening for psychiatric and cognitive traits

Private companies have begun offering services to allow parents undergoing in-vitro fertilisation to screen embryos for genetic risk of complex diseases, including psychiatric disorders. This procedure, called polygenic embryo screening, raises several difficult scientific and ethical issues, as discussed in this Personal View. Polygenic embryo screening depends on the statistical properties of polygenic risk scores, which are complex and not well studied in the context of this proposed clinical application. The clinical, social, and ethical implications of polygenic embryo screening have barely been discussed among relevant stakeholders. To our knowledge, the International Society of Psychiatric Genetics is the first professional biomedical organisation to issue a statement regarding polygenic embryo screening. For the reasons discussed in this Personal View, the Society urges caution and calls for additional research and oversight on the use of polygenic embryo screening