Report: Andrea Yates Believed She Was Possessed
ABC News, 1/21/2002

The Texas mother accused of drowning her five children in a bathtub last June told jail doctors she was possessed by the devil and that the sign of Satan, "666," was marked on her scalp, Time magazine reported. Jury selection is continuing in her trial, with eight people — five women and three men already seated. Defense lawyers are pursuing an insanity defense, and prosecutors are going to ask that Yates receive the death penalty. According to a Time magazine investigation, Yates told police who first came to her house last June that she had just drowned her five children because "they weren't developing correctly."

Bombarded With Talk of Satan?
After her arrest, Yates reportedly told prison doctors that the death of her children was her punishment, not theirs. She said their deaths were a mother's final act of mercy, and told doctors that only her execution would rescue her from the evil inside. Yates also said she wanted her hair shaved so she could see the number 666, the mark of the anti-Christ on her scalp.
    Author Suzy Spencer, who has just written a book about the case, told Good Morning America that Yates was profoundly influenced by a conservative minister, Michael Woroniecki, and his wife, Rachel, who had been close to the Yates' for years. The minister teaches a very conservative form of Christianity that says that women should have a very subservient position in the home, and that Satan is constantly trying to drive people wrong, Spencer said. In correspondence, the couple bombarded the troubled and isolated mother with talk of Satan, and the idea that God can see people's wickedness, Spencer said. In one letter, Rachel Woroniecki writes, "Life is so short. It is so very cruel. It is so lonely and empty. You must accept the reality that this life is under the curse of sin and death."
    Spencer said she thinks that because of Yates' deteriorating mental condition, the mother of five may have taken the message more literally than she might have otherwise, somehow believing that her sadness and loneliness meant that she had been overtaken by evil. "They constantly equate loneliness, depression, anything negative in your life is separation from God and alignment with Satan," said Spencer, the author of Breaking Point . The trouble seemed to begin several years ago, she said. "I think it goes back to the summer of 1998, when she and Rusty went to Florida to meet with the preacher and his wife, to look at a [motor home] they used to travel in and Rusty and Andrea were considering buying," she said.

Hammered About Faith
In talks with therapists later, Yates talked about the trip to Florida, and how at that time she first knew that the "devil had gotten into her," Spencer said. According to correspondence between Yates and the couple, they talked about Christianity and sent her religious pamphlets to help her embrace religion, and save herself. "According to the letters that I have read and looked at and studied, they hammered her about her faith," Spencer said. "You know, it's now, you've got to do it now." Since the day of her arrest, Andrea Yates' husband, Russell Yates, has steadfastly come to his wife's defense, saying that she had been suffering from postpartum depression since the birth of their daughter last year.
   Time says that Russell Yates was concerned about his wife's fixation on satanic influences but he also thought his wife was chemically weak and that her mental illness lowered her resistance to evil. He has said her depression was aggravated by the death of her father in March and that she was on antidepressant medication. She had been treated for depression, and attempted suicide after the birth of their fourth child in 1999, he added.
    Yet home videos show that Yates certainly seemed to have had happier days, and Spencer says there are indications that she had been a very good mom. Yates gave birth to her daughter, Mary six months before the children were slain. On videotapes exclusive to ABCNEWS, she is shown pulling food from her own hospital tray to give to the children after Mary was born. Two weeks later, another videotape shows her throwing a birthday party for one of her sons, putting out a birthday cake shaped like a hot air balloon. The next month, she videotapes her children performing a play about medieval times that she had written herself. Her son, Noah, is dressed in a king's robes with a breastplate a sword, and the other kids are also dressed in costumes that she made. "She was absolutely amazing," Spencer said.

Colorado Targets Family Abuse
Erin Emery, Denver Post- 1/22/2002

COLORADO SPRINGS - Colorado Springs' Domestic Violence Enhanced Response Team has created a CD-ROM to teach law enforcement agencies how to use a multi-pronged approach in combating domestic violence. The training video, paid for with a $200,000 grant from the Department of Justice, has been sent to more than 9,400 communities across the nation and several foreign countries, including China, Taiwan, Germany and Bangladesh. It illustrates how communities can develop collaborative programs to fight domestic violence. "The CD-ROM provides a sense of how we pull systems together," said Detective Howard Black, director of the domestic violence team, known as DVERT. "We only have about 600 left out of 10,000; the response has been huge."

Pioneering intervention
The CD-ROM begins with a man beating his wife. The viewer watches how the case is handled by a team from DVERT, shows how law enforcement can form partnerships with other agencies and demonstrates how those partners collaborate to find the best services available in the community - counseling, advocacy, support, shelter and legal services. In Colorado Springs, DVERT is made up of 27 people from a variety of disciplines. Members of the team are available around the clock to respond to the most lethal cases of domestic violence in the Pikes Peak region. DVERT has been in operation since mid-1996. It has three main goals: protect victims, contain perpetrators and ensure the system works and that cases don't fall through the cracks. If a responding officer believes the incident was very serious or potentially lethal, the officer can call in DVERT - including a detective, prosecutor, caseworker from human services and an animal protection officer, if there were pets. "This is pioneer intervention when we're bringing systems together," Black said. "We're focusing on the accountability of perpetrators." Colorado Springs police respond to between 15,000 and 20,000 cases annually of domestic violence and arrest about 3,800 people.

Earning victims' trust
"Do people report domestic violence here at a higher rate than in other cities? I think they do. I think victims have trust in the system. We still have a lot we can do in our own system, we still can grow, but I think there is a strong confidence in police, domestic-violence advocates and the Department of Human Services," Black said.
    DVERT offers training to law enforcement agencies throughout the nation. Last year, at least 32 people from 16 communities visited DVERT to observe the program. DVERT will host a national conference, Setting Sail & Staying the Course, from Jan. 30 to Feb. 1 at the Broadmoor Hotel. Featured speakers include Jeffrey Edelson, director of the Minnesota Center Against Violence and Abuse; Barbara Hart, legal director, Pennsylvania Coalition Against Domestic Violence; and Debby Tucker, National Training Center on Domestic & Sexual Violence.

Detroit Program Strives to Help Addicts Break Cycle
LL. Brasier, Detroit Free Press, 1/22/2002

DETROIT -- A group of 12 Oakland County residents are participating in a new county program geared toward those whose drug and alcohol addictions have led them to crime. Adult Treatment Court is part of a growing nationwide trend to find more efficient and effective ways to treat people whose addictions have led them to crime.  Two-thirds of the nation's prisoners have drug or alcohol problems. Four out of five will commit new crimes once they are released, often as a way to resume their addictions, according to studies by the U.S. Department of Justice.  There are 700 such courts in the nation. Michigan, including Wayne and Macomb counties, has 17. All have been developed in the last 12 years as a way to fight the cycle of addiction and crime.
    Oakland's program is designed to keep addicts who have committed nonviolent crimes out of jail -- where they would receive little help -- and start them to recovery through intensive counseling and a rigorous reporting system.  The first participants began in August, and were recommended for the program by judges and defense attorneys.  Every other Wednesday, they show up in Judge David Breck's courtroom, then take their turns at the podium to report on their progress. A committee, made up of a prosecutor, a probation officer, a defense attorney and a court coordinator, observes and sometimes asks questions. The participants are screened for drugs three or four times a week and report almost daily to a probation officer. Some live in a residential treatment center.
    All 12 were facing between five and 18 months behind bars. Most have a history of felony convictions, usually from turning to theft and fraud to support their habits. Even when they complete the program, their latest felony conviction will remain on their records. But Breck and the committee are banking on the hope that it will be their last brush with the law -- and that with the right kind of encouragement, support and treatment, the participants will rebuild their lives.
    Breck and his committee have set the courtroom rules, a blend of counseling, cajoling, interrogation and lecturing. He leaves the bench occasionally to shake hands with those who are progressing and gives out diplomas and gift certificates to those who are graduating into a new stage. Breck spent 18 years as a circuit court judge before his retirement in 2000. He returned to the bench to take over the drug court. He said the new program is much more satisfying because it gives him hope that some of those who appear before him will rebuild their lives.
    Judging the success of the Oakland effort and other courts is not easy. Each court varies, so there are no national statistics to assess how successful such programs are. Oakland's first candidates won't graduate until mid-2003, and the county will track them for three years to see whether they stay clean. For now, success is measured in small triumphs: a week of clean drug screens, a new job, reconciliation with a family member. There are failures. A 21-year-old was dropped from the program, and is in jail after he was found sleeping in a stolen car. He had sold his prized guitar to buy heroin.

Detroit Addicts Turn to Court for Help
LL. Brasier, Detroit Free Press, 1/22/2002

Charles -- no last names allowed -- told fellow addicts how he once thought he could control his drug and alcohol use, but now knows better. "You think you owe yourself that high, that you can do it just that once. But once is never enough," said the ponytailed middle-aged man, who has spent years bouncing in and out of jail. Charles is struggling with a cocaine and heroin addiction that at one time reached $500 a day. "I am pledging sobriety today, and I will succeed," he said. The room erupted in applause.
    The scene could have been any of dozens of Alcoholics Anonymous or Narcotics Anonymous meetings held every day in metro Detroit. But it wasn't. It was an Oakland County Circuit courtroom. Charles and 11 other Oakland county residents are the first to take part in the county's new Adult Treatment Court, part of a growing nationwide trend to find more efficient and effective ways to treat people whose addictions have led them to crime.
    The old way of just locking up users doesn't work, and the proof is in the numbers. Two-thirds of the nation's prisoners have drug or alcohol problems. Four out of five will commit new crimes once they are released, often as a way to resume their addictions, according to studies by the U.S. Department of Justice. There are 700 such courts in the nation. Michigan, including Wayne and Macomb counties, has 17. All have been developed in the last 12 years as a way to fight the cycle of addiction and crime.
    Oakland's program, more than a year old, is designed to keep addicts who have committed nonviolent crimes out of jail -- where they would receive little help -- and start them to recovery through intensive counseling and a rigorous reporting system. The first participants began in August, and were recommended for the program by judges and defense attorneys. Violent offenders are barred, and intense psychological testing weeds out those who show little prospect for recovery.
    Every other Wednesday, they line up on the wooden benches in Judge David Breck's courtroom, then take their turns at the podium to report on their progress. A committee, made up of a prosecutor, a probation officer, a defense attorney and a court coordinator, sits nearby and takes notes. Sometimes it asks questions. The participants are screened for drugs three or four times a week and report almost daily to a probation officer. Some live in a residential treatment center under contract with the state. All were facing between five and 18 months behind bars. Most have a history of felony convictions, usually from turning to theft and fraud to support their habits. Even when they complete the program, their latest felony conviction will remain on their records. But Breck and the committee are banking on the hope that it will be their last brush with the law -- and that with the right kind of encouragement, support and treatment, the participants will rebuild their lives.
    "How's your grandmother doing?" Breck asked Jeffrey, an alcoholic who has done well enough in the program to move out of the residential center and to move in with his grandmother. Jeffrey attends several meetings a week for recovering addicts and alcoholics. Jeffrey says all the attention -- and the pressure -- is working. "There was a time," he told Breck, "that short of putting me in jail, there was no way I was going to stop. But I have, and I am grateful."
    Judging the success of the Oakland effort and other courts is not easy. Because each court varies -- for instance, some treat only drug addicts, or first-time offenders -- there are no national statistics to assess how successful such programs are. There are encouraging signs. American University in Washington, D.C., tracks the efforts through its Drug Courts Clearinghouse. It has found that drug courts are much quicker to respond than the conventional legal system when a participant goes astray, and that such tighter monitoring maintains the positive pressure. The drug courts, as a whole, do reduce drug use and recidivism, according to the university.
    In 2000, a New York state commission reported the state's 20 drug courts found that only 15 percent of its graduates had been re-arrested within the first year after completing the program, compared with 35 percent of addicts released from jail or prison. Oakland County's program is so new that it's hard to gauge its success, court officials said.  The first candidates won't graduate until mid-2003, and the county will track them for three years to see whether they stay clean.
    During a recent hearing, Renee found herself back in trouble and explaining to Breck and her fellow addicts how she began using drugs and alcohol again, after going several weeks clean. "I left my husband. My car broke down. I was hanging around the wrong people, and I started writing bad checks," she said. "I was under a lot of stress, and I don't handle stress well." She turned herself in and voluntarily returned to a residential treatment program. Breck encouraged her to stay in the drug court program. "We're all behind you," he said.

Postpartum Depression: No Easy Answers
Jennifer Huget, Washington Post- 1/22/2002

Given the public furor surrounding the issue, you might think routine screening for postpartum depression (PPD) would be a sure bet in the near future. But hold those bets for now. Prompted in part by the case of Andrea Yates, the Texas mother now standing trial in Houston on charges of drowning her five children while purportedly suffering from a psychosis that grew out of postpartum depression, a bill now before Congress would improve diagnosis and treatment of the mood disorder that affects as many as half a million American women annually with symptoms ranging from feelings of vulnerability to obsessional thoughts about suicide and harming a newborn.
    The proposed Melanie Stokes Postpartum Depression Research and Care Act (named for the Chicago mother who died last summer after falling from a window during a postpartum psychotic episode) calls for the development of an overall plan for managing PPD, including exploration of the feasibility of routine screening. But the bill stops short of mandating such screening, perhaps because, even among experts keen to establish it, too many questions remain unanswered. Who, for instance, is best equipped to perform PPD screening? What's the best screening device -- informal doctor/patient conversation, one of many existing questionnaires or a new survey to be introduced next month? And -- perhaps the most troubling issue -- once a woman is identified as suffering from PPD, can the health care system offer the treatment she needs? There are no easy answers.

An Often Invisible Illness
PPD is nothing new: Hundreds of studies over the past several decades have investigated the epidemiology, treatment and repercussions of the condition that affects an estimated 10 to 15 percent of all new mothers. That's many fewer than experience "The Baby Blues," a milder condition that passes of its own accord and affects perhaps 80 percent of new mothers. And it's many more than the estimated 1 in 1,000 mothers whose postpartum disorder spirals into full-blown psychosis.
    Still, nobody is clear on PPD's causes. (Hormonal changes during and following childbirth are the prime suspects, but a woman's degree of family and community support appears to play a big role, as does her own or her family's history of depression.) Untreated, it can lead to the mother's long-term instability and to developmental and behavioral problems in her child.
    Early treatment through psychotherapy or medication can lessen its long-term effects, preventing its progression to a more dangerous condition (such as the psychosis that may have been experienced by Yates or Virginia's Seema Rothstein, charged with the November stabbing death of her husband) and ultimately saving health care dollars.
    The circumstances of the Yates case have muddied matters, at least in the public eye: Yates's was not a typical postpartum experience, and experts say most women who have PPD will never do anything like what she allegedly did. But the fear that they might be lumped in the same category as Yates has already reportedly deterred some new mothers from seeking help. "There was a backlash after about three weeks," says Diana Dell, assistant professor in the departments of psychology and obstetrics and gynecology at Duke University. "People were afraid to mention their symptoms for fear their babies would be taken away."  Women with PPD often don't seek treatment without being prodded, says Judith Mueller, executive director of the Vienna-based Women's Center, which provides psychological services to women throughout the Washington area.   "It would take somebody to say, 'Okay, we're making an appointment. Let's get in the car and go.'"

Screening: Dueling Devices
Women's reluctance to seek help has many sources. "Fifty percent of people who have PPD are having their first experience of mood disorder," says Dell. "They think they're going crazy." Mueller says the key to erasing much of the stigma that derives from PPD's classification as a mental illness is teaching patients that the disorder "is a natural phenomenon that's a part of maturation and change, not unlike the changes that accompany adolescence." Proponents of routine screening say it's one way to remove the stigma some women might associate with being questioned about their postpartum health: If everyone is screened, then nobody is being singled out as being crazy.
    Advocates often point to the United Kingdom's system, under which new mothers routinely complete the Edinburgh Postnatal Depression Scale (EPDS) and nurses make regular house calls to help care for baby and mother and to keep an eye out for trouble. Anecdotally, this sounds great, but data supporting the effectiveness of the U.K. system is sparse. By contrast, screening in the United States is conducted only sporadically, according to the provisions of individual health care plans and practices. While the EPDS, valued for its brevity and accuracy in detecting PPD, is frequently used, it is far from standard. The EPDS is a self-administered survey consisting of 10 questions, all of which relate equally to standard depression and PPD. But while PPD may be defined as a form of depression triggered by childbirth, it differs, researchers say, from standard depression.
    That's one of the reasons Cheryl Beck, a professor of nursing and a certified nurse midwife at the University of Connecticut, devised (with colleague Robert Gable) a new questionnaire, to be published in February. Beck's Postpartum Depression Screening Scale (PDSS), like the EPDS, offers health care providers a standardized means of assessing a patient's PPD risk. Beck's PDSS consists of 35 questions, written at a third-grade level, that can be answered in five to 10 minutes. The questionnaire is designed to target existing symptoms and risk factors, broken into seven categories associated specifically with PPD: sleeping and eating disorders, anxiety and insecurity, lack of control over emotions, cognitive impairment, loss of self, guilt and shame and contemplating harming self. Where the Edinburgh questionnaire asks women to respond to the statement "I have been so unhappy that I have had difficulty sleeping," for instance, Beck's, which tweaks every question to relate directly to the circumstances of new motherhood, asks them to report whether they have trouble sleeping "even when the baby is asleep."  Whichever tool is used, the next hurdle looms: how to handle its administration. Who will interpret the data, decide on treatment and make any necessary referrals? With practitioners already rushed to complete patient visits, they're not jumping at the prospect of new responsibilities.

Whose Job Is It, Anyway?
One federal agency has weighed in on the side of assigning postpartum screening to the primary care physician: the Health Resources and Services Administration recently awarded a $700,000 Healthy Start grant to D.C.'s Family Mental Health Foundation to establish routine postpartum screenings at three area primary care facilities. Others say OB-GYNs are best suited for the job, because they know the woman well, can start the screening even before the baby is born and are most likely to be familiar with PPD symptoms.
    But Diana Dell, who says the OB-GYN community has failed in its obligation to address PPD, worries that OB-GYNs, as a group, tend to over-ascribe symptoms of PPD to sleep deprivation. What's more, she says, "women want to be seen by their OB-GYN as a good parent." Even if the OB-GYN asks about PPD symptoms, she says, women will tend to "explain them away."
    Since timing plays a major role in detecting PPD, many argue that the pediatrician is likelier to be in the right place at the right time to observe symptoms. A woman whose PPD symptoms are not picked up at the six-week postpartum OB-GYN checkup may not see her OB-GYN again for another year. The doctor she's most likely to see over the course of that year -- a crucial time, as PPD symptoms can manifest any time within the 12 months following delivery -- is the baby's pediatrician. But, Dell suggests, "pediatricians don't have the relationship with the patient that the OB-GYN has."
    So screening has become a sort of hot potato tossed from discipline to discipline. Beyond the prospect of absorbing time-consuming new procedures into their practices, some practitioners may be put off by screening because, as Dell says, "doctors like to screen for things they know how to treat." Many doctors don't know what to do, she says, "if you make a diagnosis of depression and the patient says, 'No, just leave me alone.' What do you do then?" "You can't be identifying people who need assistance and then not know where to send them for assistance. That's the main challenge to the system."

After Screening, What?
Mild cases of PPD generally respond well to psychotherapy, and more severe cases can be treated with many standard antidepressants such as Prozac; even nursing mothers, following findings that such medications do not substantially affect breast milk, are routinely prescribed such treatments (though the long-term effects on the child's health are not yet established).
    Despite these treatment options, the biggest question troubling Michael O'Hara, professor of psychology at the University of Iowa and an eminent PPD expert, remains: Once you've identified affected women, what do you do with them? "In the U.S., we don't have a universal system of somebody being responsible" to attend to a woman after childbirth, he says. But "once you start identifying people, you have a responsibility to start providing services for them. I don't believe those services are really in place." And even if they were, O'Hara says, "there are all sorts of barriers to getting treatment," he says, from insurance issues to clinicians' inexperience in connecting patients with the appropriate specialists. Fewer than 50 percent of all depressed individuals actually get treatment, says O'Hara. Women on the lower rungs of the socioeconomic ladder may be most at risk and least likely to have easy access to the kind of care that could help them, he says. O'Hara's comments underscore the sad reality that screening is not a cure-all for PPD. After all, both Andrea Yates and Seema Rothstein reportedly had been diagnosed with -- and treated for -- postpartum illnesses.
    For more information about postpartum depression, consult the Postpartum Support International Web site, www.chss.iup.edu/postpartum

Comedian Tries to Save Her Career After Arrest
Bernard Weinraub, New York Times- 1/22/2002

HOLLYWOOD-- Seven months ago, until her arrest on child abuse charges, Paula Poundstone, a comedian with an amiably witty, improvisational style, had a flourishing career performing at theaters, colleges and corporate events. One of the few women to break out of the nightly grind of playing small clubs and theaters during the stand-up comedy boom of the 1980's, she had earned as much as $1.2 million annually in recent years. "It was a great career, and we think--we hope--that it still is," said Bonnie Burns, Ms. Poundstone's longtime manager.
    Ms. Burns is part of a small team facing probably one of the toughest reclamation efforts that Hollywood's strategists and image molders have encountered. The task is difficult chiefly because the initial charges against Ms. Poundstone last June were so repugnant: lewd acts upon a child and child endangerment. In September she pleaded no contest to one count of felony child endangerment and one misdemeanor count of inflicting injury upon a child, and the other charges were dropped. But the circumstances that led to her arrest remain hazy, in part because court records have been sealed. Ms. Poundstone was placed on five years' probation and in December completed six months in a court-ordered alcohol rehabilitation center.
    Ms. Poundstone, who at the time of her arrest had three adopted children and two foster children, ages 2 to 12, said after entering her plea that alcohol "helped to create a dangerous situation for the children." But she strongly denied committing any lewd acts or child abuse. Now Ms. Poundstone and her team are nervously moving ahead, most strikingly on Tuesday night, when she will be interviewed by Maria Shriver on "Dateline NBC" and presumably will address the circumstances of her arrest. An interview in Us magazine is scheduled to appear later in the week.
    But whether she has a future performing at corporate events, which provided a hefty share of her income, is unclear. Television appearances, too, remain uncertain. And for now Ms. Poundstone, 41, is back to playing smaller theaters, the types of places she had at one point left in favor of 1,500-seat houses. Her only appearance so far was Dec. 14 at the Rio Theater in Santa Cruz, Calif., a liberal college town. The 700-seat theater was mostly but not entirely filled, and by all reports she was well received.
    Ms. Burns said the rebuilding process is a slow one. "How do you come back?" she said. "It's one step at a time. I'm optimistic because I don't know what else to be." Holly wood and the public can be forgiving about stars with certain personal or legal problems. Ben Afflect has checked into a rehabilitation center for alcoholism, Winona Ryder has been accused of shoplifting, and Robert Downey Jr. has been in and out of legal trouble because of a narcotics addiction. Mr. Downey's legal problems make studios, networks and insurance companies nervous, but Mr. Affleck, Ms. Ryder and other stars who have had trouble remain highly employable. Will the public be forgiving about Ms. Poundstone?
    Public relations experts who have dealt with celebrity scandals, usually involving drugs and alcohol, said that it would take a long time for Ms. Poundstone to recover professionally from her arrest, if she ever does. The experts said that making it especially hard were the now vague allegations involving children, allegations that Ms. Poundstone will have to confront somehow if she wants to restore her career. One expert who represents top Hollywood stars, including some who have had to overcome personal crises, said that Ms. Poundstone must, in a handful of carefully selected interviews, be as brutally honest" as possible. She must, this expert said, say that she was on the edge of personal disaster that threatened her and her children, and that she is now on the road to recovery. The expert said that the public was generally forgiving so long as the celebrity involved seemed honest and serious about overcoming the difficulties. "It will be a slow road back for her."
    Making the job more difficult is that publicity over the initial charges far eclipsed the legal resolution, which came in a plea agreement at the Santa Monica courthouse on Sept. 12, one day after the terrorist attacks. Ms. Poundstone pleaded no contest to one count of felony child endangerment, which involved drinking and driving, according to the deputy district attorney in the case, Gina Satriano. The charge stemmed from an incident on June 6 when Ms. Poundstone drove four of her children to get ice cream, her lawyer, Steven Cron, said.
    At the time the records were sealed, the prosecutors dropped three counts of lewd acts upon a child. In exchange, Ms. Poundstone pleaded no contest to a misdemeanor charge of inflicting injury upon a child. Ms. Satriano said last week that the charge involved "inappropriate touching" of one of Ms. Poundstone's children, a 12-year-old girl. Ms. Satriano said the details of the case were sealed to protect the child.
    In addition to probation and six months in rehabilitation, Ms. Poundstone was ordered to perform 200 hours of community service, attend Alcoholics Anonymous meetings and a child-abuse program, and receive random drug and alcohol tests. She was barred from taking in foster children again. For the time being her adopted children are not allowed to live with her, but she sees them often in monitored visits, her lawyer said. He added that Ms. Poundstone hoped to regain full custody soon.

The Urge to Punish Cheats Isn't Merely Vengeance
Natalie Angier, New York Times- 1/22/2002

Over the last couple of weeks, as the Enron fiasco has played itself out like a louche fusion of Shakespeare and the old "Dewey, Cheatum & Howe" routine, Americans have been transfixed by the story, united in a nearly seamless sense of outrage. Regardless of whether any laws were broken in the spectacular collapse of one of the nation's largest companies, citizens of all political pipings have voiced disgust at accounts of top Enron executives selling off their stock in time to enrich themselves handsomely, while ordinary Enron employees were later forced to sit by in impotent desperation as their retirement savings evaporated. In the ferocity of the public outcry, and the demand from even those with no personal stake in the Enron collapse that "justice" be done, some scientists see a vivid example of humanity's evolved and deep-seated hatred of the Cheat. The Cheat is the transgressor of fair play, the violator of accepted norms, the sneak who smiles with Chiclet teeth while ladling from the community till.
    Human beings are elaborately, ineluctably social creatures, social scientists say, and are more willing than any other species to work for the common good--to cooperate with nonkin and help out strangers, sometimes at great cost to oneself, as the death of hundreds of rescue workers at the World Trade Center only too sadly showed. Such a readiness to trust others, to behave civilly in a crowd, to share and empathize, to play the occasional Samaritan--all the behaviors that we laud and endorse and vow to cultivate more fully in ourselves--could not have evolved without a corresponding readiness to catch, and punish, the Cheat. Only recently have researchers realized that a willingness, even eagerness, to punish transgressors of the social compact is at least as important to the maintenance of social harmony as are regular displays of common human decency. And while the punitive urge may seem like a lowly and unsavory impulse, social scientists point out that the effort to penalize cheaters is very often a selfless act.
    In an article titled "Altruistic Punishment in Humans," which appears in the Jan. 10th issue of the journal Nature, Dr. Ernest Fehr of the University of Zurich and Dr. Simon Gachter of the University of St. Gallen in Switzerland offer evidence that people will seek to punish a cheat even when the punishment is costly to them and offers no material benefit--the very definition of altruism. The researchers propose that the threat of such punishment may have been crucial to the evolution of human civilization and all its concomitant achievements.
   In an article titled "Altruistic Punishment in Humans," which appears in the Jan. 10th issue of the journal Nature, Dr. Ernest Fehr of the University of Zurich and Dr. Simon Gachter of the University of St. Gallen in Switzerland offer evidence that people will seek to punish a cheat even when the punishment is costly to them and offers no material benefit--the very definition of altruism. The researchers propose that the threat of such punishment may have been crucial to the evolution of human civilization and all its concomitant achievements. "It's a very important force for establishing large-scale cooperation," Dr. Fehr said in a telephone interview. "Every citizen is a little policeman in a sense. There are so many social norms that we follow almost unconsciously, and they are enforced by the moral outrage we expect if we were to violate them."
    Dr. David Sloan Wilson, an evolutionary biologist at the State University of New York at Binghamton, said, "People are used to thinking of social control and moralistic aggression as forms of selfishness, and that you must be punishing someone for your own benefit. But if you look at the sort of punishment that promotes altruistic behavior, you see that it is itself a form of altruism."
    In their new work, Dr. Fehr and Dr. Gachter put 240 students through a series of "public goods" experiments with real monetary stakes, always a good incentive for cash-strapped young scholars. Each participant was given an initial lump sum of 20 "monetary units" and allowed to play a series of games with rotating groups of three other participants. By the rules of the game, the members of each group independently decided how much of their sum to contribute to a community project, which in turn determined how much would be divvied up to participants in the end. The more generous each contributor, the better the group did as a whole, but there was always the risk of a participant trying to freeload off the contributions of others.
    From one round to the next, students were kept apprised of the investment decisions by others in their group. In some cases, there was nothing they could do about their teammates' behavior. In other cases, though, participants were allowed to "punish" freeloaders and skinflints after the round was through; one monetary unit from them would cost the shirker three monetary units. Hence, cooperators had to pay out of their own pocket to express their disgust at another's selfish behavior.
    The outcome of the study was striking on two fronts. One was the popularity of punishment when it was permitted: 84 percent punished defectors at least once, 34 percent took punitive action five times or more and almost 10 percent punished the stingy 10 times or more. And all this, remember, involved the doling out of mad money from people who really needed it.
    The second significant result was that when the game was carried out under no-punishment conditions, cooperation among group members quickly broke down, and participants contributed progressively less to the public kitty as the rounds went on. But when the opportunity to punish and be punished was applied, individual contributions to the collective fund jumped sharply, and cooperation among group members grew stronger rather than weaker from round to round.
    The researchers also asked participants to describe their feelings toward free-riders on a seven point scale, from "no big deal" to "very angry," and about 84 percent ranked a five or higher. A sense of emotional outrage is very easily evoked, said Dr. Fehr, and sometimes it feels almost good to indulge and stoke it. Perhaps part of the reason it feels good to rail against the sinner is that not to do so seems irresponsible, if not cowardly. "Once you think of punishment as a form of altruism, then the kind of person who doesn't punish emerges as a kind of freeloader too," said Dr. Wilson, author with Dr. Elliott Sober of "Unto Others: The Evolution and Psychology of Unselfish Behavior."
    The emotional palette behind the effectiveness of social control is a rich one, composed not only of a sharp sense of moral indignation and a fear of being punished, but embarrassment and shame when one violates social norms. Dr. Wilson said that when he and his children, nonbowlers all, recently went bowling, they were mortified when others gently scolded them for failing to observe common bowling etiquette, like taking turns with bowlers in neighboring lanes. "My ears were burning with shame, and we fled as soon as we could," he said.
    And sometimes the severity of the emotion far outstrips that of the transgression. Dr. Fehr cited a case during the oil crisis of the 1970's that led to long waits at gas stations, when one motorist shot another to death for attempting to butt into line. Some of the most odious of human behaviors, including torture, public stonings and lynchings, may all be examples of the meting out of altruistic punishment run amok.
    The drive to punish selfish transgressors seems to be a basic human predilection. Paradoxically, it stems from something normally associated with rosy-eyed utopianism: according to most anthropological evidence, traditional hunter-gatherer societies have always been highly egalitarian. In such cultures, there are no kings or commanders, and the bounty of a good hunt or forage is generally shared with the entire community. If one person doesn't like or trust another, the person may walk away, or articulate that distrust with the tip of a spear. "Hunter-gatherer societies are scrupulously egalitarian, but not harmoniously so," said Dr. Herbert Gintis of the University of Massachusetts, a co-author on a commentary that appears with the current Nature research report. "They're violently egalitarian."
    Despite its antiquity, the strength and expression of the urge to scourge is clearly shaped by culture. Anthropological studies by Dr. Fehr, Dr. Gintis and others have shown considerable cross-cultural variation in the ardor with which people seek to punish shifty noncooperators. As a rule, said Dr. Fehr, the more closely a society's economy is based on market rather than kinship ties, the more prevalent the use of altruistic punishment to bring others into line. In other words, the more likely a person is to be negotiating with non-relatives, and hence the higher the chances that selfish freeloaders will seek to infiltrate the system, the more important it becomes that everybody play by the rules. Or else.

Calculating the Benefits of Managing Stress
David Tuller, New York Times- 1/22/2002

Teaching cardiac patients how to manage stress may be as effective as aerobic exercise in decreasing the long-term risk of further coronary illness, and it may also reduce medical costs, researchers at Duke University Medical Center have found. The idea that lowering stress can improve outcomes for heart patients is not new. But the Duke study, which followed heart patients for five years, is believed to be the first to measure the benefits of stress management over a sustained period and to demonstrate its potential economic benefits. "Lots of physicians remain very skeptical about the value of psychological interventions in treating patients with medical disorders," said Dr. James Blumenthal, a Duke psychologist, who was the lead author. "Our data suggest that these interventions do affect the process, and the benefits seemed to be maintained over time."
    The study, done in cooperation with the American Psychological Association, was published this month in The American Journal of Cardiology. It followed 94 men with previous heart problems and evidence of continuing ischemia, an insufficient flow of blood to the heart. The subjects were divided into three groups. One group attended a four-month aerobic exercise program; a second participated in weekly stress management classes for the same period, and a control group received just the usual care for cardiac patients, including medications and regular visits to doctors. Aerobic exercise has been long considered a key to cardiac health.
   The researchers followed up the patients each year for five years and recorded additional cardiac events, like heart attacks, angioplasty and bypass surgery. They calculated expenses from federal government averages for various procedures. After five years, members of the stress management group had an average of 0.8 additional cardiac events each, compared with 1.3 for the group that received only the usual care. When medical costs over five years were tallied, the stress management group averaged expenses of $9,251 each, compared with $14,997 for the members of the control group. The exercise group also experienced more cardiac events and higher average costs per member than the stress management group. But when results were adjusted for age and cardiac history, the differences were not statistically significant.
    Dr. Richard Stein, a professor of clinical medicine at the New York Weill Cornell Center in Manhattan and a spokesman for the American Heart Association, praised the study. "This study is suggesting that a cognitive-based model like this is one of the most powerful tools that we have," Dr. Stein said.
    The stress management program emphasized the physiological effect of stress on cardiovascular disease and gave training in muscle relaxation. It also taught participants to recognize how they created stress in their lives through cognitive distortions, like mistakenly blaming themselves for bad luck. Dan Saldana, a data systems analyst at Duke with a history of heart disease, who completed the stress management training, said the techniques helped him break a longstanding conflict with his wife over family visits. In the past, he tried to create a rigid schedule of when they should be with which family. After the stress classes, he realized that his effort to control the situation was causing anxiety for both him and his wife, so he decided to explore compromises and remain flexible. "It was an eye-opener for me," he said. "At first my wife was like, Who are you? But she began to trust me more when I told her that this was what I was trying to do to reduce stress, and that I wasn't trying to con her."

Study Finds Movie Characters Are Lighting Up More Often
Brian Rooney, ABC News- 2/22/2002

L O S A N G E L E S— Fewer Americans are smoking these days, but a new study finds that in the movies, many of which are R-rated, more characters are smoking than ever before. Emily Watson lounges and smokes in Gosford Park, Gene Hackman and Gwyneth Paltrow light up in The Royal Tenenbaums. Billy Bob Thornton's co-star in The Man Who Wasn't There said all Thornton's character does on screen is smoke and breathe.
    Stan Glantz, a professor at the University of California-San Francisco, who studied movie smoking from the 1960s to 2000, said the lead characters in films are four times more likely to smoke than real people. "If you look at the imagery of smoking in the movies as it's presented, it really looks much more like a cigarette advertisement than it does reality," he said.  Glantz's campaign for smoke-free movies tried to place an advertisement in Daily Variety objecting to Sissy Spacek's smoking and a prominent pack of Marlboros in the film, In the Bedroom. Variety rejected the ad, saying it unfairly singled out one movie. And the director said smoking was necessary for Spacek's character. "She smokes four cigarettes in the film that are very specific moments, and they're for very specific reasons," said the film's director and co-writer, Todd Field.
    In the old days, smoking was used to glamorize the stars. James Dean, who lit up in Rebel Without a Cause, made being a rebel a cause to smoke. These days, Rob Reiner, for one, keeps smoking out of his own movies, because he said it sends a bad message. "I do notice every time somebody lights up a cigarette in the movies, I'm always aware of it," Reiner said. "And I will say as it happens, 'Why did they need to do that?'" "That it has become a cliché — that a certain kind of character smokes," said Lindsay Doran, a Hollywood producer who used to run United Artists. "And when people think of it that way, sometimes they're challenged to do something else."
    In Saving Private Ryan, Tom Hanks was given a nervous twitch in his hand, instead of a cigarette. But in the current film Monster's Ball, one of the writers says smoking is a creative choice. "I don't say to myself, 'Well, you know, this would be really cool if this guy smokes, you know, because the smoke will come out of the face and we can do some great shots,'" said the writer, Milo Addica. "I'm saying, no, we say, 'Would this guy have smoked?'"  Maybe the guy would smoke, but some say every time an actor lights up a cigarette on screen, it seems to spark an argument.

220,000 Children in Massachusetts Are Latchkey Kids
Alice Gomstyn, Boston Globe- 1/22/2002

More than one-fifth of Massachusetts children as young as 6 years old return to an empty home after school mainly because the state lacks enough programs to engage children in constructive activities while mom and dad are at work, according to a survey released yesterday by Massachusetts 2020, a nonprofit group pushing for more quality after-school and summer programming.
    The study, based on a survey of 408 parents, found that roughly 220,000 children across the state are latchkey children, students who take care of themselves after school. Most parents surveyed favored after-school programs, but said few, if any, were available to them. ''The state has not made this a core priority, nor has any other state yet,'' said Chris Gabrieli, chairman of Massachusetts 2020. The dearth illustrates a failure on the part of state government to help children during a vulnerable time, he said.
    Between 3 and 8 p.m. - a period in which most children are out of school but many parents are still at work - violent juvenile crime triples, according to the FBI. Survey respondents said they believe after-school programs could help prevent children from entangling themselves in risky activities, Gabrieli said. ''Parents overwhelmingly saw after-school programs as critical to children's success,'' he said.
    Gabrieli acknowledged that the state's fiscal crunch makes it unlikely that more money will be allocated to expand after-school programs. But he said that much can be accomplished by simply having schools keep their doors open for students after the final bell rings and offering them a haven. What the survey found most surprising, Gabrieli said, was that Massachusetts communities seemed to lack after-school programs across the board. Parents of all races and all economic backgrounds echoed the same concerns regarding their children's after-school activities, he said.
    Fall River Mayor Ed Lambert said his city's after-school programs are available to all middle-school students and have reduced the youth violence rate. But the Legislature last year cut funding that the city depended on for two programs. ''I just hope they're not going to do less,'' Lambert said. In Boston, options for latchkey children have improved over the past five years as city officials have pushed for more funding and have gotten schools to stay open longer. Still, even in Boston, after-school programs remain too small to meet the demand with only about half of the 30,000 who seek after-school care being served, Gabrieli said.
    Some of the survey's specific findings: Eighty-seven percent of parents believe after-school tutoring would help children develop skills to succeed, yet the survey indicated that only 15 percent of children in the state receive such tutoring regularly. Eighty-four percent of parents believe children need extra learning, arts, and other activities after school, yet 62 percent of children almost never participate in an organized after-school program and only 13 percent participate in a program for three days or more per week.

Jury Selection for Yates Case Grows Harder
Carol Christian, Houston Chronicle- 1/22/2002

Finding impartial jurors in Andrea Pia Yates' capital murder trial appears to be getting more difficult. Half the 60 members of a third panel seated Tuesday said they had formed an opinion about the guilt or innocence of the Clear Lake mother who has admitted drowning her five small children in the family bathtub. Twenty-four said their opinions would influence the verdict they might render. By contrast, just eight members of the first 60-member panel, which was called Jan. 7, said they had already made up their minds about Yates' guilt or innocence. All 180 potential jurors empaneled to date said they had seen, read or heard something about the case before being called.
    During Tuesday's questioning of potential jurors, there was no specific reference to stories about Yates' family life reported over the weekend in national news media. During the first two weeks of jury selection, lawyers agreed on eight jurors -- five women and three men. Another four jurors and two alternates remain to be selected. As the painstaking process entered its third week Tuesday, lawyers interviewed the final three members of the second panel. None was selected. Of those three, the defense and prosecution each struck one for reasons they are not required to disclose. Defense lawyers George Parnham and Wendell Odom have used 11 of their 15 strikes, and prosecutors Joe Owmby and Kaylynn Williford have used nine. The third panel was brought to court in the afternoon, after members had filled out a lengthy questionnaire. Lawyers today are reviewing questionnaires and will begin individual interviews with the new panel members Thursday.

Monkey Cocaine Study Sheds Light on Drug Addiction
Will Dunham, Reuters News Service, 1/23/2002

WASHINGTON -- Social standing -- being dominant or subordinate -- plays a vital role in determining susceptibility to drug use, scientists said on Tuesday in a study using monkeys that may shed light on human addictions. Researchers at Wake Forest University in Winston-Salem, North Carolina, found that macaque monkeys deemed to be subordinate in small groups of the animals were much more likely to give themselves doses of cocaine in a laboratory setting than dominant monkeys.
    Brain chemistry linked to social rank explains the phenomenon, the scientists said in a study published in the journal Nature Neuroscience. Where an individual monkey stands on the simian totem pole is reflected in a brain chemical called dopamine, which is intimately linked with cocaine and other types of substance abuse, they found. The dominant monkeys experienced an increase in a type of dopamine receptor known to be involved in brain pathways for reward processing, and were less vulnerable to cocaine abuse than their wallflower laboratory companions.
    Michael Nader, who led the study, said the research demonstrated that environmental changes can have a profound impact on brain chemistry relating to sensitivity to a given addictive drug -- a finding that could have parallels in people. For example, researchers have pondered why some cocaine users end up as addicts while others do not. Cocaine acts on the brain by raising levels of dopamine in synapses -- gaps between nerve cells -- with elevated dopamine levels corresponding to the "high" experienced by the user. Dopamine, categorized as a "neurotransmitter," is released during normal nerve impulse transmission in the brain.
    Nader and his colleagues studied 20 male monkeys. The animals initially were housed by themselves for a year and a half. The researchers looked at the monkeys' hormonal activity and behavior, then used a sophisticated imaging technique to measure chemical activity in the brain. A change in living arrangements was then imposed. The monkeys were moved into groups of four. In the ensuing social interaction over three months, dominant monkeys emerged in the five groups, and a hierarchy was established. The researchers then introduced cocaine to the monkeys, allowing them to self-administer doses. The five top monkeys were far less likely to do so than the others.
    Brain scans revealed that the dominant monkeys -- those that were the most aggressive and least submissive toward others -- experienced major changes relating to dopamine starting after the group-housing arrangement was imposed. Because these changes occurred after only three months of group housing and were not seen when the monkeys lived by themselves, the scientists said the changes in brain chemistry resulted from the process of becoming dominant. "The environmental consequences of those social hierarchies resulted in these changes," Nader said in an interview.\ "And the changes were in the dominant animals and not in the subordinate animals. So the positive spin on that is that environmental enrichment can produce rapid changes in the brain that, in this particular case, protected the individual from drug abuse. And that is the applicability (to people)."
    Nader said the findings involving these monkeys should not be interpreted to mean that, in people, those at the top of the social ladder are the least susceptible to substance abuse. "Not so much that every time you get a promotion or you move up in rank, you're less likely to abuse drugs. I don't think it's the social subordination versus the CEO that's the main point. It's that environmental enrichment ... can produce rapid and robust changes in the brain." Nader also said he envisions the development of drugs that mimic the brain chemistry changes that appear to reduce cocaine susceptibility. But he added that many factors come into play in determining whether a person becomes an addict. "There are other things going on, for sure," Nader said. "So I shouldn't say that this is the end-all answer to everything. But I think it is a very promising finding."

Supreme Court Sets Limits on Confining Sex Offenders
Gina Holland, Associated Press- 1/23/2002

WASHINGTON— The Supreme Court says states must prove convicted sex offenders can't control themselves if they are to be kept confined after their prison terms expire. Rapists, child molesters and other sex criminals must be treated the same as other people singled out for involuntary commitment under the 7-2 decision handed down by the court Tuesday. Even though the court did not ban such commitments, the ruling was a defeat for states that use them to extend the time offenders are locked away because of concerns about repeat offenders. ``On one hand, sick people can be kept off the streets. On the other hand, the average citizen doesn't need to worry about getting locked up for unpopular ideas,'' said Richard Samp, chief attorney for the Washington Legal Foundation.
    More than 1,200 sex offenders are confined in nearly 20 states with laws resembling the 1994 Kansas statute at issue in this case, the court was told. It was unclear how the ruling may affect them. John C. Donham, the attorney for Kansas sex offender Michael Crane, said that state and others with similar programs will have to change the way they handle such cases. ``They created a new subclass of people and felt that because of the nature of their crimes, that in and of itself was enough to justify hustling them off to a mental hospital without proving a serious mental illness,'' Donham said.  Kansas Attorney General Carla Stovall said she expects states to be able to produce the proof that the court's ruling requires. ``They absolutely have to have an abnormality that makes them likely to be sexual predators,'' Stovall said Tuesday.

    Justices did not go as far as the Kansas Supreme Court, which held that states must prove that inmates totally lacked control. ``It is enough to say that there must be proof of serious difficulty in controlling behavior,'' Justice Stephen Breyer wrote.
Justices had upheld the Kansas sex predator law in 1997. The law allows the indefinite confinement of violent sex offenders beyond their prison terms if they suffer from mental abnormalities making them likely to commit similar crimes in the future. Justices in 1997 did not consider offenders' ability to control their behavior. The court's two most conservative members said the latest ruling guts the 1997 decision. ``Not only is the new law that the court announces today wrong, but the court's manner of promulgating it — snatching back from the state of Kansas a victory so recently awarded — cheapens the currency of our judgments,'' Justice Antonin Scalia, joined by Justice Clarence Thomas, wrote in a dissent.
    Crane had been convicted of sexually assaulting a video store clerk and exposing himself to a tanning salon attendant in a suburb of Kansas City. When he was about to be paroled, a jury determined that he should be committed to a state hospital. The Supreme Court overturned the state court ruling. Justices sent Crane's case back to that court for reconsideration. Crane's attorney said his client now has a job but still spends nights at a community prison center. He said Crane can control his behavior.
    The states with laws like the Kansas statute are Arizona, California, Florida, Illinois, Iowa, Massachusetts, Minnesota, Missouri, New Jersey, North Dakota, South Carolina, Texas, Virginia, Washington and Wisconsin, the Supreme Court was told. The attorneys general in Alabama, Delaware, Maryland, Mississippi, Nebraska, Oklahoma, and Pennsylvania also told the court that their states could be affected by the case. The case is Kansas v. Crane, 00-957.
    On the Net:
Supreme Court: http://www.supremecourtus.gov/
For the state court ruling: http://www.courts.net and click on ``Kansas''

Detroit Grants a Reprieve to Two Mental Crisis Clinics
Tim Norris, Detroit Free Press- 1/23/2002

The Detroit Medical Center, which planned to close all of its mental health facilities at the end of this month, said Tuesday it will keep its two crisis clinics and a limited number of hospital beds open until October to give the county time to find alternative care for the 15,000 patients who visit the DMC's emergency clinics annually.
    Under the arrangement, which will take effect later this week, DMC will supply only the facilities at its Sinai-Grace and Detroit Receiving hospitals. The doctors who provide the care are Wayne State University physicians contracting directly with the Detroit-Wayne County Community Mental Health Agency. The agency is responsible for administering psychiatric care to the county's Medicaid, uninsured and indigent populations. The Detroit-Wayne agency oversees a budget of approximately $560 million, nearly $400 million of which goes for mental health care.
    "Our hope from the beginning was to find a long-term solution to the limited funding and lack of access to care experienced by the thousands of psychiatric patients in our community," Manuel Tancer, chief of psychiatry at the DMC, said in a statement to be released to DMC staff today. "This plan should give the county a short window to establish a long-term program." The 30 inpatient beds at Harper Hospital and the substance abuse program at Hutzel Hospital will not be reopened.
    In addition to the crisis centers, the contract covers limited outpatient services at Sinai-Grace. The DMC will retain some non-contracted beds at the two hospitals for people who need immediate hospitalization. Most patients who need hospitalization will be transferred to hospitals contracting with the county. Karen Schrock, director of the Detroit-Wayne County Mental Health Agency, said the agency is working with other Wayne County hospitals to handle the inpatient volume. "We were not seeing a large number of people at the DMC. The average daily census was around 20 or less, even though our contract was for 70 or so beds," she said. The new agreement with the county lasts until October, when new contracts will take effect.
    `Under federal law, Michigan's 48 community mental health boards are required to submit proposals on how they plan to serve their community by Feb. 22. If a board does not meet the standards set by the state, the state will open the contract to outside bids from neighboring community mental health organizations and private entities such as managed care companies. The process is expected to result in the consolidation of community mental health boards, said Michigan Department of Community Health spokeswoman Geralyn Lasher. Schrock said Wayne County will be putting out bid proposals for mental health services. The intention is to award contracts to networks that provide the full range of psychiatric services: crisis, inpatient and residential.

Childbirth and OCD
Jenette Restivo, ABC News- 1/23/2002

B O S T O N— For new mothers, having a baby is a time of emotional highs. But the postpartum period can also deliver a severe blow to the state of mind of some women. "I was constantly shuddering at the thoughts that were going on in my mind," the Rev. Kristen Looney, a new mother, told ABC News' Deborah Roberts in an interview for 20/20 Downtown. Looney said she was tormented by fears that she might harm her baby girl, Caitlin. One of the most distressing thoughts, she said, was that of drowning her newborn. "It was horrible to give her a bath, and once I got her in the towel, there was huge relief, like, 'She's safe, she's out.'" She also worried that she would suffocate the baby or throw Caitlin into the fireplace.  And while such horrific thoughts may seem inexcusable or even insane to many people, mental health professionals say they are — while potentially serious to the mother's mental health if left untreated — "more bark than bite" in terms of posing direct harm to the child.

OCD vs. Psychosis
Looney's symptoms are part of postpartum obsessive compulsive disorder, or postpartum OCD, a condition in which a new mother's hypervigilance about possible harm to her baby (posed by other people, situations or even herself) leads to intrusive thoughts, obsessive thoughts, avoidance behavior, anxiety, depression or fear. Women with postpartum OCD will typically have thoughts that are out of character and very frightening. She may be consumed with recurrent thoughts of harm coming to her infant from other people or other situations, or even herself. She might be so preoccupied with harming her child that she avoids the baby all together.
    But mental health professionals are clear in drawing the distinction between postpartum OCD and postpartum psychosis, an extremely serious and rare mental illness that is at issue in the trial of Andrea Yates, the Houston mother who drowned her five children last year. The symptoms of postpartum OCD "may be uncomfortable and even tormenting to a woman, but in postpartum psychosis, a woman will act on those thoughts," says Dr. Lee Cohen, director of the Perinatal and Reproductive Psychiatry Clinical Research Program at Massachusetts General Hospital in Boston.
    Women afflicted with postpartum psychosis tend to have difficulty sleeping, are prone to agitation or hyperactivity, and intermittently experience delusions, hallucinations and paranoia. In this delusional state, a mother loses touch with reality and may no longer be able to distinguish between right and wrong. By contrast, experts say, women afflicted with postpartum OCD understand the thoughts are wrong.

Occurrence of OCD
Obsessive compulsive disorder is a mental disorder that has received a fair amount of media attention, including Jack Nicholson's depiction of a dry-witted neurotic in the movie As Good As It Gets. The National Institute for Mental Health reports that about 3 percent of people in the United States have OCD, making it more common than either schizophrenia, bipolar disorder or panic disorder.
    Still, experts aren't quite sure of the prevalence of OCD in new mothers, though they say their clinical experience suggests it's high. Liz Torres, a psychologist at McLean Hospital in Belmont, Mass., and a psychology instructor at Harvard, says she has seen many patients with the condition in her own clinical practice. "Pregnancy throws your mood-regulating system into the air. This is a biochemical experience and a major life transition," says Torres. Some experts suspect that the cause of postpartum OCD is associated with a cascade of hormones released by the brain during pregnancy and birth. A history of premenstrual syndrome, infertility, stress in the marriage, or a difficult delivery can all contribute to the condition. And while a past history of OCD prior to delivery or a family history of anxiety or mood disorders places a woman at greater risk in the postpartum period, the condition can also surface in women who have had not prior symptoms.

Finding Help
Aside from the debilitating symptoms, Torres says one of her main concerns with postpartum OCD is that women feel too embarrassed to talk about it. "A lot of women will tell [physicians] of their OCD thoughts. The problem is that women don't tell each other about it." Cohen says women often keep their symptoms to themselves for fear of the consequences of disclosure. "Unfortunately, women are very reluctant to reveal those symptoms because they're fearful that [child welfare] is going to be at their door taking their baby away. So this is a disorder in which patients suffer in silence," says Cohen.
    Besides talking with friends and family, mental health professionals urge women suffering from postpartum OCD to seek professional help to alleviate their symptoms. "It is common for young mothers to have a fear of hurting her child. If she's having those feelings at all, she should talk to a professional. If, for no other reason, to tell them [the women] that it's OK," says Jerilynn Ross, president and CEO of the Anxiety Disorders Association of America.
    Professionals can also offer women proven treatment options such as behavior therapy or medications. That's especially important, because, left untreated, postpartum OCD may lead to more chronic conditions such as depression or a recurrence of the condition with a subsequent pregnancy, say experts. "I think the good news is that today we have really good treatments for OCD in general," says Cohen, who adds that the class of antidepressants called SSRIs (such as Prozac and Zoloft) are "exquisitely effective" in treating the condition.

Three More Jurors Chosen in Yates Trial
Carol Christian, Houston Chronicle- 1/24/2002

Three more jurors were selected Thursday for Andrea Pia Yates' capital murder trial, increasing the panel to seven women and four men. The last juror selected, a woman, lives near the Clear Lake neighborhood in which Yates drowned her five children in the family bathtub June 20. Other jurors added Thursday are a woman who works as an air conditioning technician for the Fort Bend Independent School District and a man who teaches sixth-grade mathematics at a junior high school in the Houston Independent School District. The jurors' names are not being made public. Those chosen Thursday were selected from the third 60-member jury pool.
    Jury selection, now at the end of the third week, will continue until lawyers agree upon the 12th juror and two alternates. Prosecutors used two more of their 15 peremptory strikes Thursday, leaving them with four. Defense lawyers George Parnham and Wendell Odom used one and have three remaining. Peremptory strikes allow lawyers to dismiss a juror without explanation.

Women Were Fined for Returning to Men Who Beat Them
Deborah Amos, ABC News- 1/24/2002

L E X I N G T O N, Ky. — In Lexington two victims of domestic violence are being punished twice, say advocates for battered women. These advocates are outraged over a county judge's decision to hold two women in contempt of court for returning to the men who had abused them. "It goes against any sense of justice and fairness that I think that we all have as a society," said attorney Lisa Beran, who heads the Kentucky Domestic Violence Association. Beran plans to appeal the cases.
    Judge Megan Lake Thorton, of Fayette County District Court, fined the women after they had both been granted a protective order forbidding their partners from contacting them following an abusive incident. Thorton ruled that the order was mutually binding when the women returned to their partners, and cited the men for contempt, too. "When these orders are entered you don't just do what you damn well please and ignore them," said Thorton at the hearing on Dec. 12, according to court records. " They are orders of the court, and people are ordered to follow them and I don't care which side you're on." Sandy Rios, an advocate for women's issues, agrees. "There has to be a certain amount of self control," she said. "That's good for us to exercise that, that the judge is trying to get these women to exercise some self control."
    Protective orders are a standard tool in domestic abuse cases. Kentucky courts issue about 30,000 emergency protective orders every year. It is one of the reasons for the stunning decline in domestic violence over the last 20 years across the country. However, Thorton's unusual comments in court may reflect frustration over the epidemic of domestic abuse cases in the state. "I take those calls all hours of the day or night for true emergencies," she said, according to court records, "And it drives me nuts when people just decide to do whatever they want to do and they don't care what the order says."
    But Lisa Beran plans to argue that protective orders are not a mutual responsibility. "The mutuality makes her responsible for his illegal conduct. Our law is to prohibit the abusive act that occurred, not to constrict or determine what the victim, the person who has suffered this, what her next move would be." Suzanne Walters, who is a victim's advocate and heads the Lincoln Trail domestic violence program, is also alarmed by the judge's decision that she says has become standard practice in Kentucky courts. "I see it on a weekly basis," she said.
    Walters, who was a battered woman herself, says that abusive relationships are more complicated than most judges realize, that it is not always easy for a woman to walk away. "She has no money coming in, she has no job coming in, she has no support of family for friends due to isolation," said Walters, "and the only person trying to contact her is the perpetrator." Research shows that it can take up to seven tries before an abused women finally ends the relationship. "It's an entire process and when you go to walk out, you walk out in steps." In her cramped office in Lexington, Walters, who meets and helps battered women every day as they arrive in the court house says there is a solution, "The solution is, we need housing, we need transportation, we need jobs for women and we need to see the perpetrators of the violence in jail."

Anatomy of a Child’s Murder Plot
Bryan Robinson, ABC News- 1/25/2002

What would make two children plan to kill their grandmother and other siblings? Officials in Columbus, Ohio, are trying to answer that question as an 11-year-old boy and his 10-year-old sister sit in a juvenile detention center for allegedly plotting — and attempting — to kill their strict grandmother and their other two siblings on Monday.
    Police say the brother and sister planned to fatally stab their grandmother, Judith Follette, and their older sister and younger brother, then make the deaths appear accidental by setting fire to their home. Ultimately, police said, they wanted to move in with their grandfather, Follette's ex-husband, and have his much larger home to themselves.  Detectives say the children, especially the boy, were angry with their grandmother for her tough-love tactics. Follette admitted in news reports that she made him take timeouts, grounded him and sometimes made him stand in the middle of a room on one leg.

Experts say incidents like the children's alleged murder plot are motivated by more than questionable tough-love tactics or a desire to live in a larger home. They are a cry for help and can be a manifestation of repressed anger over past abuse. "I don't know why kids or anyone would do such a thing. But it's a red flag that there was abuse in the background," said Mark Soler, president of the Youth Law Center in Washington, D.C. "What's important is that investigators focus on who were the perpetrators of the abuse, what is their [the children's] relationship with them now, and what their current living conditions are like."

A ‘Blueprint of Violence’
All four children have lived with Follette since 1995, when she won custody of them from their parents amid allegations that the two girls were sexually molested, the boys physically abused and that they lived in squalor in a Louisiana mobile home. All four children have undergone counseling; the two children in custody had been taking medication for depression before their arrest. The children, experts say, may have also been reacting to their trauma and anger over their past abuse and current living situation the only way they knew how — with violence. In the past, they saw adult figures deal with their anger by physically abusing or humiliating others, and that was the only way they knew how to cope with their own anger.
    "Children really model what they see," said Gail Gross, a Houston-based child psychologist who lectures extensively on juvenile behavior. "I always tell parents, 'Be what they need to see.' And with these children, they were going through a lot of anger issues, feelings of abandonment and separation and they were under medication for depression. And that depression has a lot to do with their being abused in the past. In cases like this, you always have to look to the history of the child because they model what's been done to them. It's like a blueprint for violence."

A Detailed — and Failed — Plan
Officially the two children face arson charges, but investigators stress the focus is not necessarily on their punishment. They want to make sure that the children receive much-needed counseling. "These kids have serious, serious problems and they need psychological help," said Franklin County Sheriff's Detective Al Judy. "They've been the victims of previous sexual abuse and really need some counseling. We're not excusing what they did … we had to do something. But our reason for charging them is to make sure they get in the system and get the help that they need."
    Police say the boy poured kerosene in his sister's room as she laid out knives: they intended to light the fire first, thinking that it would burn slowly enough to give them time to kill their grandmother, 8-year-old brother and 12-year-old sister while they were sleeping. But their plan failed when the fire burned too quickly and awoke one of their siblings and the rest of the household. Everyone escaped the burning house safely.
    However, hours later, the truth behind what investigators and fire officials initially thought was an accidental fire was revealed. The 10-year-old girl confessed the murder plot to Follette during breakfast at a restaurant. "They don't know what they have done … they have no idea," Follette told ABC affiliate WSYX-TV in Columbus, Ohio. "It just breaks my heart. Like any parent, you think you have done something wrong and could do something different."

‘Tough-Love’ Backlash?
Judy said the 11-year-old boy and the 10-year-old girl did not have a previous record of offenses. But they had psychological problems stemming from their previous abuse. Follette, he said, tried to control them and sought more counseling for them but was turned away each time. "You look at the grandmother, and she did the best she could," said Judy. "It's not that she's a charity case. She kept trying to get the help that they needed and just kept getting the runaround."
    And Follette's best included self-described tough-love discipline. But it wasn't enough to prevent two of her grandchildren from trying to kill her. It may, Follette implied, have even driven them to try murder. "Anything can become abusive, depending on how it's carried out, how humiliating it is, how physically excessive it is," said Soler. "Being forced to stand in the middle of a room on one leg … I can see how it can be humiliating to a child."
    Some experts believe that the tough-love doesn't inspire love and discipline at all and can only trigger humiliation and in Follette's case, a rash, desperate reaction from children. It may also reopen old wounds from previous abusive encounters. "'Tough-love' is an oxymoron," Gross said. "When you have a child stand on one leg in the middle of the room, it's humiliating … the child feels humiliated, ashamed. It may trigger those same feelings of humiliation they felt when they were [previously] abused. … Acts like these [in Ohio] reflect a rage that was turned within and then was extended outward."
    However, police still have an investigation to complete, and experts agree that no one should pass judgment on Follette's attempts to help and discipline her grandchildren until all the facts become clear. "Before anyone becomes too critical, we have to find out all the facts," Soler said. "They've been with their grandmother since 1995, more than half their lives. There should be an investigation into the period of abuse and what their lives have been like since then. No one should take what the children say too much to heart and no one should take what the grandmother says too much to heart until investigators look extensively at their living situation the past seven years. To draw any conclusions now would be irresponsible."

Vital Individual — and Family — Counseling
Lawyers for the two children have entered not guilty pleas to aggravated arson charges. Because of their young age, they cannot face prison time under Ohio law, but could remain in state custody until they turn 21. Both have been ordered to undergo psychiatric evaluations before their next appearance in juvenile court.
    Judy said investigators will re-examine the children's alleged years of abuse, interview the children's grandmother again and examine the years they have spent living in her household. A family is now separated, but Judy said it's necessary to save two very young lives. "I've talked to the [Franklin County] prosecutor's office, and we're all on the same page on this," Judy said. "This was such a horrendous act. These kids are true victims in need of some serious help, and now that they're in the system they can get some of that help."
    While finding good psychologists to help evaluate the children should be a first priority, experts say, it is important that they are taught interdisciplinary skills and better ways of dealing with their anger, especially since they apparently have not learned it from the parental figures in their life. Then, doctors have to determine and closely monitor the medication for the children. Experts say the children cannot begin to rebuild their relationship with their grandmother and siblings without taking those steps first.
    But, Gross said, the two children are not the only ones who must undergo therapy. Their grandmother and siblings must seek counseling. Follette, Gross said, is the mother of the abused children's mother, and without help, abuse tends to be repeated from generation to generation "The family needs counseling, too. They need to become part of the process," said Gross. "They need to be counseled as a group as well as individually." Gross remains optimistic about the children's chances at recovery because of their young age. "The counseling, the interdisciplinary skills do work, and at 10 to 11 years old, it's not too late for them," Gross said. "It gets more difficult as children grow older but there's still hope for these two."

Colorado Bill Revamps Sex-Offender List
Kirk Mitchell, Denver Post- 1/25/2002

A centralized sex offender registry would prevent convicts from slipping through the cracks, the governor's task force has concluded. The move would repair major problems with the current system, which has been criticized for containing inaccurate information and lax tracking methods, the report said. "Absent a statewide database, we don't know when a sex offender moves," said Arvada Police Chief Ron Sloan, a task force member.
    Under SB 95, drafted based on findings of the task force formed in August, the Colorado Bureau of Investigation would receive change of address information and distribute it to law enforcement agencies, Sloan said. If a sex offender failed to register, CBI would notify the police department or sheriff's office in the area where they are supposed to be living and eventually post their picture on the Internet, according to the task force's final report, released earlier this month.
    Gov. Bill Owens created the task force after hundreds of sex offenders were released from prison or taken off parole after a court battle over conflicting laws governing sex offenders. Currently, more than 8,000 sex offenders are registered with 340 police and sheriffs' offices across the state. But the task force report said as many as 40 percent of sex offenders have failed to register.
    Under the proposed bill, the registration process would begin as soon as the offender is convicted. The sentencing court -- not the sex offender himself -- would register him into the CBI system. "It puts a little more integrity in the process," rather than relying on sex offenders to register, Sloan said. "It's more of an early warning component to let us know they are in the pipeline." When an offender nears his prison-release time, the Department of Corrections would update an offender's registration with information about where he is going to live.
    Under the proposed bill, residents could obtain sex offender registration lists from the CBI or from local law enforcement, Sloan said. The CBI's Internet site also would warn families about limitations of the registration, said task force member Jill McFadden, executive director of the Colorado Coalition Against Sexual Assault. "The listing doesn't necessarily assess the risk" of sex offender movements in the community, McFadden said. Local law enforcement would continue confirming sex offender addresses under the proposal.
    Although some money would trickle down from CBI to local law enforcement, police departments and sheriffs' offices would still shoulder most of the financial responsibility for checking addresses, Sloan said. He said it has been a burden for many law enforcement agencies. The bill's tougher measures would cost up to $800,000, which might be a tough sell in a lean budget year.
    A Denver Post study found that many police departments do not check addresses because of staffing concerns. Running the registration program requires one law enforcement officer for every 100 sex offenders, according to the task force report. The task force also advised: Each time a sex offender registers, he or she should be required to be photographed and fingerprinted. Registration data collection forms should be standardized and include details about the offender's crime.