Psychiatrists OK vast changes to diagnosis manual

CHICAGO (AP) — For the first time in almost two decades the nation's psychiatrists are changing the guidebook they use to diagnose mental disorders. Among the most controversial proposed changes: Dropping certain familiar terms like Asperger's disorder and dyslexia and calling frequent, severe temper tantrums a mental illness.

The board of trustees for the American Psychiatric Association voted Saturday in suburban Washington, D.C., on scores of revisions that have been in the works for several years. Details will come next May when the group's fifth diagnostic manual is published.

The trustees made the final decision on what proposals made the cut; recommendations came from experts in several task force groups assigned to evaluate different mental illnesses.

Board members were tightlipped about the update, but its impact will be huge, affecting millions of children and adults worldwide.

The manual "defines what constellations of symptoms health care professionals recognize as mental disorders and more importantly ... shapes who will receive what treatment. Even seemingly subtle changes to the criteria can have substantial effects on patterns of care," said Dr. Mark Olfson, a Columbia University psychiatry professor who was not involved in the revision process.

The manual also is important for the insurance industry in deciding what treatment to pay for, and it helps schools decide how to allot special education.

The guidebook's official title is the Diagnostic and Statistical Manual of Mental Disorders. The new one is the fifth edition, known as the DSM-5. A 2000 edition made minor changes but the last major edition was published in 1994.

The manual "seeks to capture the current state of knowledge of psychiatric disorders. Since 2000 ... there have been important advances in our understanding of the nature of psychiatric disorders," Olfson said.

Expected changes include formally adopting a term for children and adults with autism — "autism spectrum disorder," encompassing those with severe autism, who often don't talk or interact, and those with mild forms including Asperger's. Asperger's patients often have high intelligence and vast knowledge on quirky subjects but lack social skills.

Some Asperger's families opposed the change, fearing their kids would lose a diagnosis and no longer be eligible for special services. And some older Asperger's patients who embrace their quirkiness vowed to continue to use the label.

But experts say the change won't affect the special services available to this group.

Catherine Lord, an autism expert at Weill Cornell Medical College who was on the psychiatric group's autism task force, said anyone who met criteria for Asperger's in the old manual would be included in the recommended new diagnosis.

One reason for the recommended change is that in some states and some school systems, children and adults with Asperger's receive no services or fewer services than those given an autism diagnosis, she said.

Other proposed changes include:

—A new diagnosis — disruptive mood dysregulation disorder, which critics argued would medicalize kids' normal temper tantrums. Supporters said it would address concerns about too many kids being misdiagnosed with bipolar disorder and treated with powerful psychiatric drugs. Bipolar disorder involves sharp mood swings from feeling sad and depressed to unusually happy or energetic. Affected children are sometimes very irritable or have explosive tantrums. The new diagnosis would be given to children and adults who can't control their emotions and have frequent temper outbursts in inappropriate situations.

—Eliminating the term "dyslexia," a reading disorder that causes difficulty understanding letters and recognizing written words. The term would be encompassed in a broader learning disorder category.

—Eliminating the term "gender identity disorder." It has been used for children or adults who strongly believe that they were born the wrong gender — they dispute their normal biological anatomy. But many activists believe the condition isn't a disorder and say calling it one is stigmatizing. The term would be replaced with "gender dysphoria," which means emotional distress over one's gender. Supporters equated the change with removing homosexuality as a mental illness in the diagnostic manual, which happened decades ago.

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Online:

Diagnostic manual: http://www.dsm5.org

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AP Medical Writer Lindsey Tanner can be reached at http://www.twitter.com/LindseyTanner

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Couple kept girl as sex slave, beat her, police say

An Oceanside couple is being held on suspicion of keeping an underage Mexican immigrant as a sex slave, forcing her into prostitution and beating her severely, San Diego County Sheriff's Department officials said.

Marcial Garcia Hernandez, 45, and Inez Martinez Garcia, 43, were arrested Thursday on suspicion of 13 felony counts of aggravated sexual assault of a child under age 14.

The girl had been smuggled into the U.S. at age 12, and the abuse by Hernandez and Garcia occurred over a 21-month period, the Sheriff's Department said.

Hernandez and Garcia forced the girl to care for their three children and cook and clean for the family, as well as have sex with Hernandez, according to Deputy G. Crysler, an investigator with the North County Human Trafficking Task Force.

"When the girl victim refused to participate in the sex acts or did not complete her tasks in a timely or correct manner, she was beaten," Crysler said.

The couple forced the victim into lying about her age so she could work at a local restaurant, with Garcia and Hernandez keeping the money she earned, according to the arrest documents. She was also forced into having sex with older men, with Garcia and Hernandez keeping the money paid by "johns," the documents said.

Authorities were called after the victim was allegedly beaten by Garcia. Reunited with her family, she returned to Mexico. Recently, she returned to the U.S. and is assisting in the criminal investigation, according to the Sheriff's Department.

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-- Tony Perry in San Diego

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Israel Moves to Expand Settlements in East Jerusalem

Rina Castelnuovo for The New York Times

From his home in East Jerusalem last year, Haj Ibrahim Ahmad Hawa looked at the separation barrier surrounding Jerusalem with the Israeli settlement of Maale Adumim in the background. More Photos »

JERUSALEM — As the United Nations General Assembly voted overwhelmingly to upgrade the Palestinians’ status Thursday night, Israel took steps toward building housing in a controversial area of East Jerusalem known as E1, where Jewish settlements have long been seen as the death knell for a two-state solution to the Israeli-Palestinian conflict.

A senior Israeli official, speaking on the condition of anonymity, said on Friday that the decision was made late Thursday night to move forward on “preliminary zoning and planning preparations” for housing units in E1, which would connect the large settlement of Maale Adumim to Jerusalem and therefore make it impossible to connect the Palestinian cities of Ramallah and Bethlehem to Palestinian neighborhoods of East Jerusalem. Israel also authorized the construction of 3,000 housing units in other parts of East Jerusalem and the West Bank, the official said.

The prime minister’s office refused to comment on whether the settlement expansion — first reported on Twitter by a reporter for the Israeli daily Haaretz — was punishment for the Palestinians’ success in upgrading its status from nonmember observer entity to nonmember observer state at the United Nations, but it was widely seen as such. The United States, one of only eight countries that stood with Israel in voting against the Palestinians’ upgrade, has for two decades vigorously opposed construction in E1, a 3,000-acre expanse of hilly parkland where a police station was opened in 2008.

In Washington, a State Department official criticized the move. “We reiterate our longstanding opposition to settlements and East Jerusalem construction,” he said. “We believe it is counterproductive and makes it harder to resume direct negotiations and achieve a two-state outcome.”

Hagit Ofran, who runs the Settlement Watch project of Peace Now, called E1 a “deal breaker for the two-state solution” and denounced the decision as “disastrous.”

“Instead of punishing the Palestinians, they are actually punishing Israel,” Ms. Ofran, who is Israeli, said in an interview. “Instead of taking advantage of this bid in the U.N. and calling for negotiations to get to a two-state solution, this government is choosing to take actions that might prevent the possibility of a two-state solution.”

But Dani Dayan, leader of Israel’s settler movement, welcomed the news, saying it was “a very important Israeli interest to develop E1.”

He described the two-state solution as “an existential threat to Israel” and said the E1 development was “beneficial for peace because a two-state solution is a prologue for another bloody confrontation.”

“The fear to develop the communities is not rational,” Mr. Dayan said. “The opposition to the settlements has become a kind of religious dogma for the West.”

Even Mr. Dayan, however, said he did not like the idea of expanding settlements “as a sort of retaliatory or punitive step.”

“Under the circumstances that we understand the government operates, I think it’s O.K.,” Mr. Dayan added. “We have a legal and a political and a moral right to build. It’s strategic for Jerusalem; to strengthen Jerusalem is the only horizon. We don’t see it as an obstacle to peace.”

Michael R. Gordon contributed reporting from Washington.

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Jelly Bean update for DROID RAZR HD and MAXX HD set to roll out next week

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Powerball Winners Want to Go to the Beach, Set Up Scholarships with $300 Million

11/30/2012 at 04:35 PM EST

Cindy and Mark Hill

David Eulitt/Kansas City Star/Landov

Just in time for the holiday season the Hill family of Dearborn, Mo., got quite the gift: nearly $300 million, after winning half of the $587.5 million Powerball jackpot.

"We're still stunned by what's happened," Cindy Hill, 51, said during a press conference Friday alongside her family, according to an NBC News report. "People keep asking us, 'What are you going to buy with it?' I just want to go home and be back to normal."

Hill, who was an office manager until she was laid off in 2010, and her husband Mark, a mechanic, have three adult sons and a daughter, Jaiden, 6, whom they adopted from China.

On their list of possible purchases since their record win: a beach vacation for Jaiden (who has never visited the beach) and a red Camaro for Mark. The family has also spoken about possibly adopting again and setting up college funds for their extended family members, as well as a scholarship fund at their local high school.

As for their winning ticket, Cindy said she checked on Thursday morning after learning that one winning ticket was sold in Missouri.

"I didn't have my glasses, and I was thinking, is that the right number?" Cindy, who had bought five tickets, said, according to NBC.

The other winning ticket was sold in Arizona, and no winner has claimed the prize yet. On Thursday, however, a man in Upper Marlboro, Md., went into a gas station to check a handful of tickets (watch the CCTV video), reportedly presenting a ticket with the winning numbers (5-23-16-22-29-Powerball 6), CNN reports.

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Kenya village pairs AIDS orphans with grandparents

NYUMBANI, Kenya (AP) — There are no middle-aged people in Nyumbani. They all died years ago, before this village of hope in Kenya began. Only the young and old live here.

Nyumbani was born of the AIDS crisis. The 938 children here all saw their parents die. The 97 grandparents — eight grandfathers among them — saw their middle-aged children die. But put together, the bookend generations take care of one another.

Saturday is World AIDS Day, but the executive director of the aid group Nyumbani, which oversees the village of the same name, hates the name which is given to the day because for her the word AIDS is so freighted with doom and death. These days, it doesn't necessarily mean a death sentence. Millions live with the virus with the help of anti-retroviral drugs, or ARVs. And the village she runs is an example of that.

"AIDS is not a word that we should be using. At the beginning when we came up against HIV, it was a terminal disease and people were presenting at the last phase, which we call AIDS," said Sister Mary Owens. "There is no known limit to the lifespan now so that word AIDS should not be used. So I hate World AIDS Day, follow? Because we have moved beyond talking about AIDS, the terminal stage. None of our children are in the terminal stage."

In the village, each grandparent is charged with caring for about a dozen "grandchildren," one or two of whom will be biological family. That responsibility has been a life-changer for Janet Kitheka, who lost one daughter to AIDS in 2003. Another daughter died from cancer in 2004. A son died in a tree-cutting accident in 2006 and the 63-year-old lost two grandchildren in 2007, including one from AIDS.

"When I came here I was released from the grief because I am always busy instead of thinking about the dead," said Kitheka. "Now I am thinking about building a new house with 12 children. They are orphans. I said to myself, 'Think about the living ones now.' I'm very happy because of the children."

As she walks around Nyumbani, which is three hours' drive east of Nairobi, 73-year-old Sister Mary is greeted like a rock star by little girls in matching colorful school uniforms. Children run and play, and sleep in bunk beds inside mud-brick homes. High schoolers study carpentry or tailoring. But before 2006, this village did not exist, not until a Catholic charity petitioned the Kenyan government for land on which to house orphans.

Everyone here has been touched by HIV or AIDS. But only 80 children have HIV and thanks to anti-retroviral drugs, none of them has AIDS.

"They can dream their dreams and live a long life," Owens said.

Nyumbani relies heavily on U.S. funds but it is aiming to be self-sustaining.

The kids' bunk beds are made in the technical school's shop. A small aquaponics project is trying to grow edible fish. The mud bricks are made on site. Each grandparent has a plot of land for farming.

The biggest chunk of aid comes from the United States President's Emergency Plan for AIDS Relief (PEPFAR), which has given the village $2.5 million since 2006. A British couple gives $50,000 a year. A tree-growing project in the village begun by an American, John Noel, now stands six years from its first harvest. Some 120,000 trees have already been planted and thousands more were being planted last week.

"My wife and I got married as teenagers and started out being very poor. Lived in a trailer. And we found out what it was like to be in a situation where you can't support yourself," he said. "As an entrepreneur I looked to my enterprise skills to see what we could do to sustain the village forever, because we are in our 60s and we wanted to make sure that the thousand babies and children, all the little ones, were taken care of."

He hopes that after a decade the timber profits from the trees will make the village totally self-sustaining.

But while the future is looking brighter, the losses the orphans' suffered can resurface, particularly when class lessons are about family or medicine, said Winnie Joseph, the deputy headmaster at the village's elementary school. Kitheka says she tries to teach the kids how to love one another and how to cook and clean. But older kids sometimes will threaten to hit her after accusing her of favoring her biological grandchildren, she said.

For the most part, though, the children in Nyumbani appear to know how lucky they are, having landed in a village where they are cared for. An estimated 23.5 million people in sub-Saharan Africa have HIV as of 2011, representing 69 percent of the global HIV population, according to UNAIDS. Eastern and southern Africa are the hardest-hit regions. Millions of people — many of them parents — have died.

Kitheka noted that children just outside the village frequently go to bed hungry. And ARVs are harder to come by outside the village. The World Health Organization says about 61 percent of Kenyans with HIV are covered by ARVs across the country.

Paul Lgina, 14, contrasted the difference between life in Nyumbani, which in Swahili means simply "home," and his earlier life.

"In the village I get support. At my mother's home I did not have enough food, and I had to go to the river to fetch water," said Lina, who, like all the children in the village, has neither a mother or a father.

When Sister Mary first began caring for AIDS orphans in the early 1990s, she said her group was often told not to bother.

"At the beginning nobody knew what to do with them. In 1992 we were told these children are going to die anyway," she said. "But that wasn't our spirit. Today, kids we were told would die have graduated from high school."

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On the Internet:

http://www.trees4children.org/

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Couple kept girl, 12, as sex slave, police allege

An Oceanside couple is being held on suspicion of keeping an underage Mexican immigrant as a sex slave, forcing her into prostitution and beating her severely, San Diego County Sheriff's Department officials said.

Marcial Garcia Hernandez, 45, and Inez Martinez Garcia, 43, were arrested Thursday on suspicion of 13 felony counts of aggravated sexual assault of a child under age 14.

The girl had been smuggled into the U.S. at age 12, and the abuse by Hernandez and Garcia occurred over a 21-month period, the Sheriff's Department said.

Hernandez and Garcia forced the girl to care for their three children and cook and clean for the family, as well as have sex with Hernandez, according to Deputy G. Crysler, an investigator with the North County Human Trafficking Task Force.

"When the girl victim refused to participate in the sex acts or did not complete her tasks in a timely or correct manner, she was beaten," Crysler said.

The couple forced the victim into lying about her age so she could work at a local restaurant, with Garcia and Hernandez keeping the money she earned, according to the arrest documents. She was also forced into having sex with older men, with Garcia and Hernandez keeping the money paid by "johns," the documents said.

Authorities were called after the victim was allegedly beaten by Garcia. Reunited with her family, she returned to Mexico. Recently, she returned to the U.S. and is assisting in the criminal investigation, according to the Sheriff's Department.

ALSO:

Lindsay Lohan is 'victim' despite criminal charges, lawyer says

Teacher pleads guilty to having sex with 17-year-old ex-student

Inmate charged in 1991 slaying, rape of 16-year-old Compton girl

-- Tony Perry in San Diego

Read More..

Benghazi Violence Beyond Control of Militias

Esam Omran Al-Fetori/Reuters

Libyan police officers carried the body of Faraj Mohammed el-Drissi, the Benghazi security director, after he was gunned down last week.

BENGHAZI, Libya — The killing was not a shock here, in the city where Libyans started their quest to shake off dictatorship and now struggle, nearly two years later, to douse the simmering violence that is a legacy of the revolt.

One evening last week, a car screeched down a residential street. Three men stepped out and with startling ease gunned down Faraj Mohammed el-Drissi, the man whose job it was to ensure this city’s security.

Mr. Drissi, who had been on the job since October, was among roughly three dozen public servants killed over the last year and a half, including army officers, security agents, officials from the deposed government and the United States ambassador, J. Christopher Stevens. In all the cases, no one has been convicted, and in many, no one has even been questioned. That is unlikely to change anytime soon.

Since Col. Muammar el-Qaddafi was killed more than a year ago, Benghazi has in many ways regained its balance, as residents build long-delayed additions to their homes and policemen direct traffic on some streets. But Mr. Drissi’s killing made it hard to ignore a darker rhythm — one that revolves around killing with impunity. The government is still weaker than the country’s militias, and neither is willing, or able to act.

“It is impossible for members of a brigade to arrest another,” said Wanis al-Sharif, the top Interior Ministry official in eastern Libya. “And it would be impossible that I give the order to arrest someone in a militia. Impossible.”

The violence was thrown into sharp relief after the September attack on the United States intelligence and diplomatic villas. Libyan and American officials accused militants associated with Libya’s ubiquitous militias, and specifically, members of Ansar al-Shariah.

“The killing of the ambassador brought back the true reality of this insecure state,” said Ali Tarhouni, a former Libyan finance minister who leads a new political party. “It was a major setback, to this city and its psyche.”

Justice itself is a dangerous notion here and throughout Libya, where a feeble government lacks the power to protect citizens or to confront criminal suspects. It barely has the means to arm its police force, let alone rein in or integrate the militias or confront former rebel fighters suspected of killings.

“Some had to do with personal grudges,” said Judge Jamal Bennor, who serves as Benghazi’s justice coordinator. But most were like the killing of Mr. Drissi. “This was a political assassination,” he said.

Adding to the feeling of lawlessness are the revelations that foreign intelligence services, like the C.I.A., are active around the country without answering to anyone, people here said. Every day, an American drone circles Benghazi, unsettling and annoying residents. Police officers share Kalashnikovs. The courts are toothless. Libyan and American investigators, faced with Benghazi’s insecurity, are forced to interview witnesses hundreds of miles away, in the capital, Tripoli.

And so the government is forced to reckon with the militias, who by virtue of their abundant weapons hold the city’s real power. Men like Wissam bin Hamid, 35, who before the revolution owned an automobile workshop, is now the leader of an umbrella group of former rebel fighters. Some groups, like Mr. Hamid’s, operate with the government’s blessing, while others are called rogue. The distinctions often seem arbitrary, but either way, the militias are effectively a law unto themselves.

Mr. Hamid and others insist that they are loyal to the state. Leading political figures said they respected Mr. Hamid but had concerns about many of the other militia leaders, among them hard-line Islamists.

The militias are called on for crucial tasks, including safeguarding elections. Mr. Hamid’s militia, a branch of a group called Libya Shield, has been called on to enforce order hundreds of miles away from Benghazi, in towns beyond the government’s reach. The militia has also worked with American officials: they escorted intelligence officers and diplomats away from the besieged villas on Sept. 11, and later, provided protection for American investigators visiting the city in search of evidence in the attack, Mr. Hamid said.

Osama al-Fitory and Suliman Ali Zway contributed reporting.

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Sony sells over half a million PlayStation 3 consoles over Black Friday week

Both Microsoft (MSFT) and Nintendo (NTDOY) had a big week of console sales during Black Friday’s week of shopping madness in the U.S. So how did Sony (SNE) do in comparison? Sony Computer Entertainment of America president and CEO Jack Tretton announced on Thursday that the company sold 525,000 PlayStation 3 consoles and 160,000 PS Vita handhelds during the Black Friday week. Overall PlayStation sales of hardware, software and accessories are up 9% over the same period last year. Tretton was also happy to reveal that subscriptions to its PlayStation Plus grew 259% since last year with customer satisfaction flying high at 95% after Sony added the Instant Game Collection to the service earlier this year.

Sony’s PlayStation 3 and PS Vita sales were largely bolstered by $ 199.99 bundles packaged with free games that the company pushed to retails on Black Friday. The sell-out of the bundles within minutes at retailers such as Amazon (AMZN) is a good indicator that there is huge demand for a sub-$ 200 PlayStation 3. Currently, the lowest-priced PS3 is a second-gen 160GB slim model with an MSRP of $ 249.99. The redesigned third-gen PS3s start at $ 269.99 with a 250GB hard drive.

In terms of which home console did the best over Black Friday, it looks like the Xbox 360′s 750,000 consoles took first place, while Sony came in second with 525,000 PS3s and Nintendo came in third with 400,000 Wii U systems.

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Stephen Fishbach Blogs: Abi-Maria Gomes Has 'Subtlety of a Wounded Walrus' on Survivor

TV Watch

Survivor

By Stephen Fishbach

11/29/2012 at 04:45 PM EST

Abi-Maria Gomes (left) and Lisa Whelchel

Monty Brinton/CBS (2)

Stephen Fishbach was the runner-up on Survivor: Tocantins and has been blogging about Survivor strategy for PEOPLE.com since 2009. Follow him on Twitter @stephenfishbach.

"You need to pick one side or the other. You can't keep flipping."
– Amanda Kimmel, Survivor: Micronesia

Hey guys – I have a secret. It's a really, really big secret. You'll never discover it. Not even if you follow me around all day. Look – just follow me a little. Please? For your sake. This secret is frickin' huge. It's going to change everything.

Okay, here's a hint. Starts I. Ends with DOL.

It's an immunity idol, alright?! And I have this secret paper here, which proves it. But I'm going to rip it up into little pieces. Because it's soooo secret.

Poor Abi. Is there anything more heartbreaking in this broken world than someone pretending that they have a secret? The dreamy Malcolm said it best on Survivor: she's like a wounded ex-girlfriend.

As much as Abi is playing at strategy, she really craves attention. Everyone wants to feel wanted. Who hasn't done the whole "I have a secret immunity idol in my pocket, so you'd better be my friend" trick?

Abi's "hints" reminded me of Heroes vs. Villains, when Amanda "hinted" to Parvati about 18 times that she was a target. At the time, I said that Amanda "clobbered Parvati with the Amanda bat."

Okay, so she has the subtlety of a wounded walrus. Nevertheless, Abi wins her first Fishy Award for showing impressive discipline at the food auction. While Denise and Skupin blow their cash on cheap carbs, Abi saves up for that special something. She buys a valuable advantage in the immunity challenge, and wins three more days on the island. In Survivor, three days can change everything.

On Wednesday's episode, Abi also lost her title as the season's most annoying player. Lisa Whelchel turned in another weepy, woe-is-me performance – and let me be the first to say, "Enough!" I threw up a little in my mouth when Lisa went sobbing to Penner ... that she had to vote out Penner. Tears might win you Emmys, Lisa, but on Survivor they only win you enemies.

She's even starting to repeat the same lines. Did you notice she trotted out her old remark about how "Survivor is bigger than I am?" I get that she was a sitcom star, but that doesn't mean she needs a catch phrase. Moreover, the remark basically makes no sense, since Survivor is an abstract concept and Lisa is a physical being. It's just a lazy excuse for not having the will to play the game.

The real victim of Lisa's hemming and hawing is poor Jonathan Penner. With only a couple episodes left, I already miss the lovable goon. What makes Penner such a great player is that, at every moment, he's willing to do whatever it takes to advance himself.

He makes mistakes; he misjudges people's motivations; he fails to make alliances when he needs to most. But he is always scheming, always evaluating. He is always ready to completely rewrite the rulebook of the entire game, so long as it advances Jonathan Penner one space further on the board.

And he always engages his fellow contestants. I loved Penner's brief conversation with Abi after the auction. Abi was feeling petulant and abused. Penner didn't placate her, but by simply representing his intentions, he managed to foster a bond with the outcast Brazilian.

I can't think of many contestants who are better talkers than Penner. Even when he's making mistakes and uttering nonsense, he sounds brilliant.

And is there any more perfect summation of the experience of Survivor than Penner's closing remarks? "It's been fun – and extremely painful," he says. I'm sorry for his pain, but watching him has been a real pleasure.

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