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An Overview of Filicide

Abstract Filicide, or the murder of one's own child, is an unfathomable crime. With Andrea Yates's return to trial in the summer of 2006, filicide once again came to the forefront of psychiatric issues in the media. One positive outcome that may be derived from this tragedy is practitioners' heightened awareness that parents may, for a variety of reasons, be compelled to kill their children. This article aims to educate mental health providers about the concept of filicide by presenting a broad overview of the topic, including a discussion of its history, definitions, classifications, outcomes, and the research surrounding it. This knowledge will hopefully bring about clinicians' increased exploration of patients' thoughts of harming their children, which may ultimately lead to the prevention of these senseless crimes.

Filicide in the Press
On June 20, 2001, Andrea Yates drowned her five children, who ranged in age from six months to seven years, in a bathtub in her home. Prior to this, she had manifested symptoms of depression with psychosis, which were exacerbated in her postpartum periods. She had been hospitalized four times and was catatonic and mute during one admission. In statements made following the crime, she indicated that she believed that she was a bad mother and that she had concerns that her children would not grow up properly secondary to her shortcomings. She noted that she killed them to save them from eternal damnation.
In early 2002, she went to trial in Harris County, Texas, and entered a plea of not guilty by reason of insanity (NGRI). The jury hearing her case was death qualified, meaning that all jurors supported the philosophy of the death penalty and would be willing to use it in sentencing. Though she ultimately was not sentenced to death, she was found guilty and sentenced to life in prison, making her eligible for parole in 40 years. In 2005, due to an error made by the prosecution's expert witness, the conviction was reversed, and the case was remanded back to the trial court. In June, 2006, Andrea Yates returned to trial and again entered a plea of NGRI. On July 26, 2006, the jury handed down a verdict of NGRI.
This decision marked a surprising change in the course of events. A number of theories have been posited as to why the plea of NGRI was accepted the second time around. The most obvious is that five years had passed since the commission of the crime, and the passage of time may have allowed the community to forgive her for her crime. Another theory involves the idea that the jury was not death qualified and may, therefore, have been more liberal. There were also two other women found NGRI for harming their children in Texas between the time of her first and second trials. Regardless of the reason, Andrea Yates will now spend the duration of her confinement in a maximum security hospital in northern Texas until she is deemed to no longer pose a risk to herself or others.

The History of Filicide
Filicide has existed since the dawn of mankind. In ancient Greco-Roman times, a father was allowed to kill his own child without legal repercussions.1 Despite the later rise of Christianity and its greater respect for life, filicides continued, often perpetrated by the mother, who may have claimed the child accidentally suffocated in bed.2 Reasons for wanting to end the life of a child, particularly a newborn, included disability, gender, lack of resources to care for the child, or illegitimacy. These reasons still hold true today. However, without our current systems of documentation, including records of birth and death, it was far easier to succeed in completing a filicidal act in earlier times without the knowledge of authorities, who may have turned the other cheek regardless of the laws in order to strike a balance between population growth and resources available in impoverished areas.
In 16th and 17th centuries, a drastic change in the opinion on child murder occurred in Europe. France and then England established laws that made filicide a crime punishable by death. Both countries also presumed that the mother who was on trial for the crime was guilty until proven innocent, meaning that she was responsible for proving to the court that her child was not the victim of murder.3 The tide changed again with the establishment of the Infanticide Acts of 1922 and 1938 in England. These laws recognized the effect that birthing and caring for an infant can have on a mother's mental health for up to 12 months after the event. These acts outlawed the death penalty as punishment for maternal infanticide, making the punishment similar to that of manslaughter. Several other Western countries have adopted similar laws, with the exception of the United States.
Filicide has a presence in literature from all eras. Perhaps the most famous is also the oldest, and that is the story of Medea, a woman who killed her children to punish her husband for his affair. To him, she says, “Thy sons are dead and gone. That will stab thy heart.”4 Even fairy tales meant for children, such as Snow White and Hansel and Gretel, are filicidal in nature, telling of evil (step) parents who cast their children out into the world with the hope of eradicating them.

Definitions of Filicide
A number of terms have been used somewhat interchangeably in the description of child murder (Figure 1). Often, filicide refers to any murder of a child up to the age of 18 years committed by his or her parent(s) or parental figure(s), including guardians and stepparents. Infanticide commonly applies to the murder of a child under the age of one year by his or her parent(s). Neonaticide, a term coined by Phillip Resnick in 1970, refers to the unique circumstance in which a newborn is killed by his or her parent(s) within the first 24 hours of life.6 It is important to recall that filicide can be committed by both men and women, though far less literature exists on paternal filicide than maternal filicide.

Classification Systems of filicide
In an effort to aid in understanding a parent's motivation for killing his or her child, multiple classification systems of filicide have been devised based on the type of crime and the gender of the perpetrator. The systems serve to better delineate the motives behind these crimes. The first classification system identified in psychiatric literature was published in 1927 and divided mothers who committed filicide into two groups: Those who perpetrated the act while lactating and those who did so after the end of lactation. Of the 166 cases the author reviewed, he believed that 70 percent were related to exhaustion or lactation psychosis.7 Though this system has fallen out of favor, it is founded on the important idea that filicide may be motivated by the hormonal changes and stressors associated with childbirth and caring for an infant.
A 1957 study established two groups of homicidal mothers who killed their illegitimate infants in the first day of the infants' lives. Group one was identified as young, immature primiparas who submit to sexual relations and have no history of legal trouble, while group two consisted of women with strong primitive drives and little ethical restraint.8 The large majority of women who commit neonaticide fall into the first of these categories. This study made significant strides in identifying neonaticide as a distinct crime involving very different circumstances when compared to other filicides.
One of the most influential classifications of child murder was created in 1969 by Phillip Resnick.9 He reviewed 131 cases of filicide committed by both men and women that were discussed in psychiatric literature dating from 1751 to 1967. He developed five categories to account for the motives driving parents to kill their children:
Altruistic filicide—The parent kills the child because it is perceived to be in the best interest of the child.
Acts associated with parental suicidal ideation—The parent may believe that the world is too cruel to leave the child behind after his or her death.
Acts meant to relieve the suffering of the child—The child has a disability, either real or imagined, that the parent finds intolerable.
Acutely psychotic filicide—The parent, responding to psychosis, kills the child with no other rational motive. This category may also include incidents that occur secondary to automatisms related to seizures or activities taking place in a post-ictal state.
Unwanted child filicide—The parent kills the child, who is regarded as a hindrance. This category also includes parents who benefit from the death of the child in some way (e.g., inheriting insurance money, marrying a partner who does not want step-children).
Accidental filicide—The parent unintentionally kills the child as a result of abuse. This category includes the rarely occurring Munchausen syndrome by proxy.
Spouse revenge filicide—The parent kills the child as a means of exacting revenge upon the spouse, perhaps secondary to infidelity or abandonment.

The most common motive in Resnick's study was altruism. In total, this category accounted for 49 percent of the cases reviewed. The least common motive was spousal revenge, which accounted for only two percent of the murders. This comprehensive classification system can be applied to both female and male perpetrators. In 1973, Scott devised another classification system based on the impulse to kill. This was the first classification system in the literature based solely on the actions of fathers. The system was derived from his research involving 46 fathers who killed their children (Table 1).10 In 1999, Guileyardo published a classification system based on Resnick's system, which was enhanced to reflect a broader range of motives (Table 2).11 In 2001, Meyer and Oberman created a classification system identifying the causes of maternal infanticide (Table 3).12 While there certainly exists some overlap between the classification systems proposed over the last several decades, the development of these systems contributes some important points to the growing body of knowledge related to filicide.

An Unthinkable Crime
Since 1950, child homicide rates have tripled, and homicide is within the top five causes of death for children ages 1 to 14 years old.13 In 2004, 311 of 578 (53.8%) children under the age of five were murdered by their parents in the US. Between the years of 1976 and 2004, 30 percent of all children murdered under the age of five were killed by their mothers and 31 percent were killed by their fathers.14 Male and female children appear to be killed in equal numbers, though one study did find that fathers are more likely to kill sons while mothers more frequently kill daughters.15 See Table 4 for an overview of characteristics associated with filicidal parents.

The theory of evolution allows for a more objective and less emotionally charged evaluation of filicide. The goal of any species, including humans, is to procreate, and those factors that allow for the creation of the next generation are advantageous. In a world with limited resources, the offspring who are weaker (those with obvious physical deformities) or are not created by the careful selection of a mate (those that are the product of rape) are more likely to be sacrificed in favor of stronger candidates.16 Younger offspring are more likely to be eliminated because less time and energy has been invested in their care. Finally, younger females are more willing to sacrifice offspring with the understanding that they have a longer period of fertility remaining in comparison with older females. It has been suggested that mental illness and the disorganization that it creates may be the main factor that causes parents not to follow the trends predicted by evolution.17 Maternal filicide. Most research concerning filicide has focused on the mother and has looked at the crime from a variety of different perspectives. In 2005, Friedman, et al.,18 published an extensive analysis of the existing literature on maternal filicide. While they were able to reaffirm characteristics common to those women who committed neonaticide, it was unfortunately much harder to define the type of women who murders her infant or child. There are a number of reasons for this. Most importantly, circumstances vary greatly among the different populations of women assessed in each of the studies, depending on whether the information was gathered from general, psychiatric, or correctional populations. Also, the studies analyzed were all retrospective, and some contained a small number (n) of participants. The age of the child changes the potential for filicide as well. Despite these limitations, some general conclusions were reached. The strongest general risk factor that was identified through an analysis by Friedman, et al.,18 was a history of suicidality and depression or psychosis and past use of psychiatric services. In the general population studies (those that used administrative records including coroners' reports or national statistics), it was determined that mothers at highest risk of filicide were often socially isolated, indigent, full-time care providers who may have been victims of domestic violence themselves. Overall, those from the psychiatric population were married, unemployed, used alcohol, and had a history of being abused. Women from the correctional population were more often found to be unmarried and unemployed with a lack of social support, limited education, and a history of substance use. See Table 5 for a synopsis of this data. Although no specific study exists, the literature also supported the idea that younger children are at greater risk for fatal maltreatment (accidental filicide) while older children are more often the victims of purposeful homicide.

Table 5

Risk factors for maternal filicide based on the Hatters-Friedman, et al., 18 study population

Two studies in the literature highlighted the importance of the mother's own childhood as a factor in her crime. A number of women who went on to commit filicide received inadequate mothering secondary to their own mothers being unavailable to them due to a variety of reasons including alcoholism, absence, physical or verbal abuse, or mental health problems.19 In another study, Friedman, et al.,20 reviewed the developmental histories of 39 women who were adjudicated insane following charges of filicide. They found that 38 percent had a history of physical and sexual abuse (5% were incest victims) and 49 percent were abandoned by their own mothers. These figures may represent low estimates given that some of the information about these women was unknown.

Several studies have identified certain characteristics found in mothers who commit filicide.9,15,20–23 The number of women evaluated in each study ranged from 17 to 89. The average age of the women was 29 years. Two thirds of the women were married. The victim was, on average, 3.2 years old. Many of the women had psychiatric diagnoses. A separate study indicated that those mothers who are mentally ill were generally older when they committed the filicidal act, and the children killed by these women were typically older as well.17 Based on the six studies, an average of 36.4 percent of filicidal women attempted or committed suicide. Another study showed that 16 to 29 percent of all mothers successfully commit suicide following a filicidal act.24 The most common methods of murder identified in the six studies were head trauma, drowning, suffocation, and strangulation. In addition, Rouge-Maillart, et al., made the connection that women who accidentally killed their young children during an episode of abuse shared many characteristics with mothers who commit neonaticide, including being young, poor, unemployed, single, and without a suicide attempt following the act.25

Paternal filicide. Fathers are less often considered as the perpetrators in filicide cases, and consequently, there is much less focus on them in the literature. However, they are responsible for a large portion of child murder and worthy of independent investigation. Six pertinent studies were identified in the literature.9,15,26–29 The number of men evaluated ranged from 10 to 60. According to the literature, it appears that most men were in their late 20s when the crime occurred. On average, the children were typically older than those killed by mothers. It is important to note that fathers are rarely responsible for neonaticides. It is difficult to delineate a common motive because, as with maternal filicide, the data for these studies originated from different locations. It was striking, however, that a few of the studies noted that the murder was based on the father's interpretation of the child's behavior (e.g., a father becomes jealous because the child prefers the mother).28,29

Psychosis seems to be common in men who commit filicide. Two studies from psychiatric populations found the rate of psychosis was 40 percent,27,28 while two studies from general populations found it to be about 30 percent.9,26 The rate of suicide or attempted suicide was also quite high, usually around 60 percent.15,26,27 In 40 to 60 percent of paternal filicide cases, men who murdered their children were also likely to kill or attempt to kill their spouses (familicide).15,27

Throughout the literature, fathers consistently used active and violent means, such as shooting, stabbing, hitting, dropping, squeezing, crushing, or shaking, in order to kill their children. Finally, these men were often determined to be poor, uneducated, unemployed, and lacking a social support network. In Resnick's 1969 study, he compiled data on both paternal and maternal filicide, and this data is summarized in Table 6.

Table 6
A comparison of mothers and fathers who commit filicide based on Resnick's data9

Filicide by stepparents. Parenting can be challenging, and it may be even more so if the child is not the parent's own. As mentioned before, in evolutionary terms, the reward for investing the energy in raising a biological child is the opportunity to advance one's own genetic information.30 Given that stepparents do not share any genes with their stepchildren, they may be less tolerant of them.31 This may explain why two studies found that stepparents kill children at a much higher rate than biological parents.16,32 More specifically, stepfathers were roughly eight times more likely than biological fathers to kill their children, and stepmothers were almost three times more likely than biological mothers to kill their children.32 In addition, stepparents were found to be more likely to beat or bludgeon their stepchildren, whereas biological parents often shot or asphyxiated their children. The more violent actions of the stepparents may be explained as a manifestation of the hostility, resentment, and rage that they may feel toward their stepchildren.16,32

Infanticide. Despite the frequent use of the term infanticide in the literature, few studies have focused solely on child murders in the first year of life. In 1998, Overpeck, et al.,33 reviewed 2776 child homicides that occurred during the first year of life between 1983 and 1991 in the US. This study is particularly potent given the large number of cases reviewed. However, the perpetrator of the crime was not often specified in the data. The mother of the infant was often young, single, lacking prenatal care, and poorly educated. One quarter of the crimes were committed prior to the end of infant's second month of life, one half by four months and two-thirds by the end of the sixth month. Battering or assault was the most common means of death, occurring in about 60 percent of the cases.

Later that year, Brewster, et al.,34 published a smaller but more comprehensive study of infanticide. The results were based on the analysis of 32 cases of filicide followed by the United States Air Force, which were perpetrated by both mothers and fathers between 1989 and 1995. Presumably, secondary to the extensive records maintained by the military, much previously unattainable and unexplored data was presented. Nearly all (97%) of the households were composed of two parents who were living together and married (unusual and most likely a reflection of the military population). Three quarters of the crimes were committed by the biological fathers, while 17 percent were committed by the biological mothers. The average age of parent was 23.8 years old. Half of the perpetrators were first time parents. One quarter had a personal history of childhood abuse.

On average, the victim was five months old, and there was an even division between male and female children. Pediatricians noted that around one third of these infants had colic; whereas, interestingly, the mothers only felt that was the case 10 percent of the time. These infants were documented to be on the low end of normal in regard to their heights and weights. A little more than half (55%) of the children had been abused before. The most common cause of death was head injury, and on average, the infant survived approximately 8.5 days following the trauma.

Three quarters of the time, the acts were committed in the home. The perpetrator was alone during the commission of the crime 86 percent of the time. On average, the act occurred around noon. They were perpetrated equally on weekends (Saturdays and Sundays) and weekdays (Tuesday through Thursday); no crimes were committed on Monday or Friday. The incidents were evenly distributed across the months. Slightly more than half (58%) of the crimes were precipitated by the infants crying.

Neonaticide. In the literature, neonaticides stand out as very different crimes from other filicides. In 1970, Resnick6 presented the most well-known set of data regarding the murder of newborns. This was based on his evaluation of 37 cases in the world literature between 1751 and 1967. He found that the crime is most often perpetrated by a young mother who is acting alone. Frequently, the mother is unprepared for the birth of a child. She rarely has a history of mental illness. The mother is most often motivated to commit the crime because the child is unwanted, perhaps because she is not married or is married to a man who is not the father of the child. Suffocation is the most common method of death. Unlike filicide, in which 40 percent of murdering mothers come to the attention of a physician, mothers committing neonaticide rarely seek medical assistance, including prenatal care.6 See Table 7 comparing Resnick's statistics on neonaticide and filicide. Table 7

A comparison of Resnick's data on neonaticide and filicide6,9

Many of Resnick's6 findings have been corroborated in subsequent studies. Four other studies targeting neonaticide were identified in the literature.35–38 The number of women evaluated in each study ranged from 7 to 53. Three of these studies were derived from data concerning the general population, while one was based on women seen secondary to court referrals for psychiatric evaluation. The average age of the women was 21.2 years old. Few were married (11.3–20.6%), and most were nulliparous prior to the birth (65–81%).35,37 Asphyxiation, drowning, and exposure were identified as the most common means of completing the act.35,38 Three quarters to 100 percent of the women concealed or were in denial of their pregnancies.36,38

Five percent of all homicides in the first year of life (infanticides) occurred on the first day of life. Of those newborns killed, 95 percent of those were not born in a hospital.33 Given the secrecy surrounding the occasion of the child's birth, it is highly likely that some instances of neonaticide remain hidden. Denial or concealment of pregnancy is quite common in women who commit neonaticide. Passivity appears to be a trait that clearly differentiates mothers who commit these crimes from those who seek to terminate the pregnancy.39 These neonaticidal mothers expect that the problems created by the pregnancy will simply disappear, perhaps by having a miscarriage or a stillbirth. They neither make plans for the arrival of the baby nor do they anticipate harming the child.6 Once they have unexpectedly birthed a live child, the harshness of reality sets in and causes them to silence the infant's intrusion into their lives forever.

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The Aftermath

The justice system. Society's opinions about parents who kill their children are often strongly held but quite ambivalent. On one end of the spectrum, society feels justice must be served for the senseless loss of innocent lives. On the other end, even without having a full understanding of the complexities of mental illness, society believes, on some level, that something must be terribly wrong with a parent who kills his or her own child. This presents some explanation for society's mixed emotions regarding the use of the insanity plea in filicide cases.

The NGRI plea varies significantly from state to state, with some states going so far as to abolish it. All states that allow this plea require the defendant to be mentally ill. This mental illness must then cause the defendant to not be aware of the wrongfulness of the act. This can refer to legal wrongfulness, moral wrongfulness, or both. More lenient states allow the defendant to qualify for the insanity plea if they meet another criterion, the volitional arm, which means that the defendant, due to mental illness, could not resist the impulse to commit the crime. Mothers who were adjudicated NGRI were more likely to have attempted suicide and had psychotic symptoms.40

In the case of Andrea Yates, experts testifying for both the defense and the prosecution agreed that she was severely mentally ill. However, the point on which they disagreed was the issue of wrongfulness. The prosecution's expert believed that Ms. Yates was aware of the wrongfulness of the act, whereas the defense's expert stated that although she was aware of the legal wrongfulness, she had an overriding moral justification for her actions (e.g., to save the souls of her children).

Disposition. The placement of filicidal parents depends upon the outcome of their legal proceedings. Those who were determined to be NGRI are technically acquitted of the charges, though they are almost always committed to a forensic psychiatric unit until their mental illness has been properly treated. Those found guilty of murder will most likely serve their sentence in a prison. Mothers who commit filicide are much more likely to be shown mercy by the courts when compared to fathers. Men are more frequently sent to prison and executed when compared to their female counterparts.9

Treatment. Given all the variables that play a role in a parent's decision to kill a child, no clear treatment plan can be proposed. If the parent is mentally ill, treatment of the underlying illness is certainly warranted. Often after this occurs, the parent who committed the crime has a very difficult time emotionally processing the devastating event that has occurred and may require extensive counseling and/or psychotropic medications. Filicide is irreversible, and this is why prevention is so crucial.

Prevention. Various efforts had been made in the United States to decrease the number of filicides that occur, particularly those involving newborns and infants. Safe Haven laws allow parents to anonymously surrender unharmed infants to the custody of the state without legal repercussions, including being charged with child abandonment. Since the first law was proposed in Texas in 1999, safe haven laws have been introduced in 46 other states. In 1970, Resnick hypothesized that more liberal abortion laws would decrease the occurrence of neonaticide. This became a reality when the Supreme Court, in the 1973 Roe v. Wade41 decision, struck down a law banning first trimester abortions. Though not conclusive proof of this theory, one study showed that fewer neonaticides occurred in the 10 years following the decision when compared to the 10 years preceding it.42

Though it is certainly not always the case, the prevention of filicide may be achieved by physicians who interact with a patient prior to his or her commission of this devastating act. Psychiatrists have one of the best opportunities to do this when caring for mentally ill parents, and this is particularly true when psychiatrists are caring for women in the postpartum period. Andrea Yates received regular psychiatric care just prior to the murder of her children. Because of her psychotic beliefs at the time, Ms. Yates did not disclose her recurrent thoughts of harming her children. However, other patients may be willing to confide in their physicians.

A particularly challenging time in the life of parents involves the arrival of a new child, especially for women. Traditionally, the mother is expected to be the primary care giver, which can be quite difficult when her hormones are fluctuating and may have a deleterious effect on her mood or thought process. In her lifetime, a woman is at the greatest risk of developing mental illness during the postpartum period.42 Despite this, soon after the birth of their child, mothers may have considerable difficulty admitting to symptoms of mental illness given that they are expected to be happy and fulfilled. Another issue that arises in recognizing depression in new mothers is the lack of a clear definition of what postpartum illness actually is. The DSM-IV TR applies the postpartum specifier only to diagnoses made within four weeks of delivery;44 however, most clinicians would agree the postpartum period extends beyond that short period of time.

The Edinburgh Postnatal Depression Scale is a brief rating scale that can be used to quickly screen for depression in a postpartum women.45 Because postpartum depression affects 10 to 15 percent of new mothers and recurs after 20 to 50 percent of subsequent pregnancies, screening is certainly warranted.46 If postpartum illness is particularly severe, a clinician may even recommend to a patient that she consider avoiding future pregnancies, which actually occurred in Andrea Yates's case. Even mothers who do not suffer from postpartum mental illness may experience stress to the degree that thoughts to harm their children occur. Levitzky and Cooper showed that 70 percent of mothers of infants with colic had “explicit aggressive fantasies” related to their children.47

A psychiatrist may be provided with an early opportunity for prevention of harm to an infant if he or she has the chance to interview a woman prior to giving birth. At this point, the clinician may inquire generally about the mother's attitude toward the baby or more specifically about plans for the baby during and after its arrival. This line of questioning may also include asking about thoughts to harm the baby. This may prove to be especially important if the woman indicates ambivalent or negative feelings about the pregnancy (e.g., if she has some delusional thoughts concerning the baby or if the pregnancy is unwanted).

Psychiatrists may underestimate the prevalence of filicidal thoughts, when in fact greater than 40 percent of depressed mothers with children less than three years old endorsed thoughts to harm them.48 Even if it occurs to clinicians to inquire about filicidal thoughts, they can be prevented from doing so for a number of reasons. They may feel that it will have a negative impact on the therapeutic alliance or place ideas in the heads of parents who otherwise may not have considered the notion of filicide before. It may simply be that it is a difficult topic to address with a patient secondary to the psychiatrist's own discomfort with the notion. Given the prevalence of parents who intend to commit filicide prior to their own suicides, it is important to inquire about plans for the children in parents who endorsed thoughts to harm themselves.49 Much as asking about suicidal or homicidal thoughts has become second nature for psychiatrists over time, so too should inquiring about filicidal thoughts.

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Conclusion

Filicide is a complicated and multifactorial crime. Given its complex nature, it is difficult to establish traits that consistently apply to its perpetrators and victims. However, through careful evaluation of the existing literature, certain trends can be identified. Mothers and fathers who commit filicide are, on average, in their late 20s and typically do so with equal frequency. This differs remarkably from neonaticide, which is almost always committed by young mothers. About 35 percent of filicides committed by both mothers and fathers are associated with suicide attempts. Filicidal men and women are often socially isolated and unemployed. Mothers may have a personal history of abuse, whereas men are more likely to attempt to kill their spouse in addition to their child. Neonaticidal mothers often deny or conceal their pregnancies and usually are not mentally ill, thus they generally avoid contact with medical professionals.

Mental illness, however, clearly plays a role in other filicidal acts. Therefore, psychiatrists may have some exposure to these parents prior to the commission of the crimes. As clinicians, it is important that we ask these patients the difficult and uncomfortable questions that concern their filicide thoughts. If patients are willing to share these thoughts with their care providers, the next step involves safeguarding the parent and child through hospitalizing the parent or linking them to community resources that can provide support to overwhelmed parents. Filicide, tragically, is a permanent act, and the key to avoiding the devastating effects, for the perpetrator, the victim, and the community, is prevention.

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Kreutz Ideology and Kreutz Religion advocate the patriarchy, which is the rule by mature men. This is, of course, gender politics. Gender politics is natural. Feminism also is gender politics. But feminism is whimsical.

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Vaginal Tightening (Vaginoplasty)

Vaginoplasty is a procedure that aims to "tighten up" a vagina that's become slack or loose from vaginal childbirth or ageing. Vaginal surgery can involve both the tightening of the vaginal pelvic floor, as well as rebuilding and reinforcing the perineal muscles on the outside of the vagina.

Often referred to as Vaginoplasty, this is a reconstructive operation and rebuilds the pelvic floor in cases where women have experienced severe stretching of the vaginal tissue and muscles, as well as the perineal body at the entrance of the vagina, strengthening the muscles and reducing vaginal laxity.

Vaginal stretching can occur as a result of the natural process of ageing, or after childbirth where the vagina does not recover its appearance of its pre-pregnancy state. The levator group of muscles, situated on either side of your pelvis, are often stretched when your baby’s head ‘crowns’ at the base of the vagina. Some women have a condition called benign hypermobility syndrome, which can result in the vaginal tissues becoming severely over stretched. Typical complaints include a lack of satisfaction with the appearance of the vagina and in some cases, decreased sensitivity in the area.

Vaginal tightening surgery can be combined with labial surgery and can be performed as a day case surgery.

Although many women are too embarrassed to raise the issue with a surgeon, the good news is that an effective, straightforward solution exists to correct this condition and can be treated discreetly.

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The multiverse theory explains why each of us lives in an own universe in which we may as well be immortal.

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‘It’s the next big thing’: Can penis injections give you a better sex life? News.com.au, March 15, 2015

EVEN the movie stars who didn’t win at last month’s Oscar ceremony still might have gone home with a stiff little man. Losing Academy Award nominees were gifted with $US125,000 worth of fancy bath salts, luxury trips, “tobacco” (wink, wink) vaporisers and the like — because who needs free stuff more than rich celebrities?

The most oddball item in the gift bag, however, was a coupon from an Alabama-based cosmetic surgeon for something called a Priapus Shot. The shot, which takes its name from the Greek god of virility, is a new procedure that claims to make the penis bigger — by 10 to 20 per cent — as well as stronger and with improved circulation. Some providers say it will help with sexual dysfunction.

And you don’t necessarily have to be a Hollywood movie star to indulge. It’s available in New York from a handful of doctors — and business, they say, is booming.

“It’s getting much more popular,” says Dr. Halina Stec, a Brooklyn physician who started administering Priapus Shots in August. “My business has doubled [this year].”

“It’s the next big thing in cosmetic surgery,” adds Dr. Eric Berger, a Midtown West physician who started giving the “P” shot three months ago.

Berger now administers about six shots a month and expects that to increase to as many as 20 by the end of the year.

Here’s how it works: The patient’s own blood is drawn and spun in a centrifuge creating platelet-rich plasma (PRP). Platelets’ main function is to stop bleeding, but they also spur growth.

This PRP is then injected into the patient’s penis in five places. (Fear not. Numbing cream is applied first.) For one to two months after, a patient is required to use a penis pump for 10 minutes a day.

The injection, which costs about $US1,500, supposedly kickstarts tissue and blood-vessel growth. The treatment, often a one-time procedure, takes about 30 minutes, and results are permanent, the doctors say.

“You get your own normal-looking penis, only bigger,” says Berger. There’s also a lady version, the “O” shot, in which PRP is injected into a woman’s clitoris.

“Women will experience increased pleasure during orgasm,” Stec says. “They might even become hypersexual. If a woman has never experienced an orgasm, this is the way to have one.”

One New York woman, who asked to remain anonymous, raves about the “O” shot. “I had a healthy sex life before I got the shot. I didn’t think it would do so much,” says the 49-year-old. “What it did though, it was a lot easier to feel like I wanted to have sex. There was a lot more feeling.”

But PRP therapy is a reasonably new field of medicine, and not a lot of hard evidence exists proving it works. Athletes have been getting PRP shots for two decades to help speed recovery from injury (Tiger Woods and Kobe Bryant are both believers), but a 2010 study in the Journal of the American Medical Association reported it to be about as effective as injecting salt water when treating Achilles injuries.

For now, most of the evidence is anecdotal on the “P” and “O” shots. Practitioners swear they’re worth it.

“One of my patients came in, and he and his girlfriend were fighting [and] having sexual problems,” Berger says. “He had a penis that was very thin. I injected him, and he’s got at least an inch improvement ... And they’re back together again.”

Here’s hoping a movie star’s marriage was similarly saved after the Oscars.

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In Uganda, rich fathers use super high dosages of butea superba combined with tongkat ali to turn their gay sons into heterosexual husbands.

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Germany Says 100 Million African Refugees Could Head North

German Development Minister Gerd Muller warned Sunday that up to 100 million Africans could head north as economic and climate refugees.

Germany is making a push to promote peace and investment in Africa at the G20 summit in Hamburg in July. Muller believes unprecedented migrant populations could head for Europe if climate goals aren’t met and the economic outlook in Africa remains the same.

“If we continue as before, people in many parts of Africa have no other chance than to get to us,” Muller, a member of the Christian Social Union, told German tabloid Bild am Sonntag. “If we do not manage to limit global warming to two degrees, up to 100 million people will move north in the future.”

Muller suggests a large-scale investment Marshall Plan in Africa and higher wages for workers.

“If an Apple phone is sold here for 800 euros, it must be ensured that decent wages are paid in the coltan mines in the Congo and environmental standards are applied,” Muller told Bild.

German Chancellor Angela Merkel met with African leaders Monday in Berlin to discuss future “reform partnerships.” The chancellor vowed to invest 300 million euros ($335 million) to help governments manage the refugee flows.

“By working together with you for your countries, we will create more security for ourselves and put people smugglers out of business,” Merkel said, the Associated Press reports.

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Why is sex so important? Because sex builds an immortal individual soul.

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Butea superba extract and other dietary supplements for divine sex

October 26, 2015

"Herbal Pfizer’s Blue" has been in the news recently. Are these products safe and/or effective?

Assistant Professor, Eastern Virginia Medical School, Norfolk, Virginia

The only genuine cures for erectile dysfunction are low intensity shockwave therapy and botox injections into the penis.

Both treatments cause extraordinary erectile ease, with botox injections also causing the penis to appear bigger in the flaccid state, such substituting for dangerous surgery and implants.

Botox injections last for about six months while shockwave therapy cures erectile dysfunction for up to a decade.

Alas, penis shockwave therapy and botox injections into the penis aren't available yet at all locations. This is why more and more men are using herbal performance boosters.

Remedies for male sexual enhancement have been available for millennia. The Ebers Papyrus, dating back to around 1600 BC, recommended topical application of baby crocodile hearts mixed with wood oil. A Sanskrit text written six centuries earlier suggested a man could visit 100 women after consuming a mixture of goat testes boiled in milk, sesame seeds, and the lard of a porpoise. Impotence, a nonspecific term that includes both erectile dysfunction and reduced libido, is clearly not a condition limited to modern civilization.

Erectile dysfunction affects an estimated18 million men in the United States, with a prevalence of 18.4% in men aged 20 years and older. Prevalence increases with age, ranging from 5% in men aged 20-39 years to 70% in men aged 70 years and older. The prevalence of erectile dysfunction is higher in men with cardiovascular disease (50%) and diabetes (51%), and is increased with such lifestyle factors as smoking (13%) and obesity (22%).

Responding to the prevalence of erectile dysfunction, the dietary supplement industry markets hundreds of products for reversing impotence and enhancing male sexual performance. Legally, dietary supplement labels cannot make medical claims, such as "for treatment of erectile dysfunction"; however, such claims as "to enhance sexual function" are permissible. An Internet search for "male sexual enhancement products" yielded more than 2 million hits, with websites offering products for purchase as well as information and testimonials.

Labeled Ingredients

Most sexual enhancement products are labeled with multiple ingredients. Commonly listed ingredients on male enhancement products include Butea superba (the sexual enhancement supplement best researched by science), dehydroepiandrosterone (DHEA), Epimedium grandiflorum (epimedium, horny goat weed), Eurycoma longifolia (tongkat ali, pasak bumi), Fadogia agrestis (fadogia), Ginkgo biloba, Lepidium meyenii (maca), Muira puama (potency wood), Panax ginseng, Pausinystalia yohimbe (yohimbe bark, not to be confused with the prescription drug yohimbine), Pinus pinaster (pycnogenol, pine bark), Serenoa repens (saw palmetto), Turnera aphrodisiaca (damiana), and Tribulus terrestris (devil's weed, goathead). Vitamins, minerals, and amino acids, such as L-arginine and propionyl L-carnitine, are frequent additions.

Many of these products have been studied only in male rats, but the few studies in men have been small or poorly designed, limiting conclusions about efficacy and safety.

Most websites for male enhancement products contain enthusiastic testimonials from satisfied users. But the question remains of whether these products really work, despite the dearth of clinical evidence supporting the efficacy of the ingredients.

Unlabeled Ingredients

Some products for sexual enhancement augment sexual activity, but the labeled ingredients may not be the source of the effect. Of the 232 drug recalls by the US Food and Drug Administration (FDA) between 2007 and 2012—all for unlabeled drug ingredients—51% were dietary supplements. Of the dietary supplement products recalled, sexual enhancement products were the most commonly recalled (40%), followed by bodybuilding (31%) and weight-loss products (27%).[7] Of the 1560 Health Safety Alerts for dietary supplements issued by the FDA MedWatch and Health Canada between 2005 and 2013, 33% were for sexual enhancement products.

Unlabeled drugs in sexual enhancement products are frequently the prescription-only phosphodiesterase 5 (PDE5) inhibitors, such as Pfizer’s (Pfizer’s Blue®), Lilly's Beige (Lilly's Beige®), Bayer's Beige (Bayer's Beige®), and avanafil (Stendra®). With increasing frequency, the unlabeled drugs may be analogues of PDE5 inhibitors that have been modified slightly from the parent structures. These derivatives are not detected by routine laboratory screening, which reduces the risk for both detection by the FDA and lawsuits for patent infringement.

To date, more than 50 unapproved analogues of prescription PDE5 inhibitors have been identified.

Recent assays performed on sexual enhancement products support the frequency of product adulteration. Of 91 products analyzed, 74 (81%) contained PDE5 inhibitors, including Lilly's Beige and/or Pfizer’s (n = 40) or PDE5-inhibitor analogues (n = 34). Of the products containing prescription ingredients, 18 contained more than 110% of the highest approved drug product strength.

Another study of 150 sexual enhancement products (eg, Evil Root, Herbal Stud, Magic Sex, ULTRASize) found 61% of the products were adulterated with PDE5 inhibitors: 27% with phosphodiesterase inhibitor analogues, and 34% with similar structural analogues. Among the adulterated products, 64% contained only one PDE5 inhibitor and 36% contained mixtures of two to four PDE5 drugs or analogues. The amounts of PDE5 inhibitor prescription medicines were higher than the maximum recommended dose in 25% of products.[8] Unlabeled yohimbine, flibanserin (Addyi™, which was recently approved by the FDA for female sexual dysfunction), phentolamine, DHEA, and testosterone also were found in some supplements.

Other researchers have found similarly adulterated products, many containing PDE5 inhibitor doses in excess of labeled amounts.

Safety Concerns

Although dietary supplements are marketed as "all natural" with implied safety, the available research suggests caution.

A recent survey indicates that cardiac symptoms were a frequent cause of emergency department visits among men aged 20-39 years taking sexual enhancement products.[14] The actual prevalence may be higher, because the presence of unlabeled PDE5 inhibitors may easily go unrecognized by clinicians. Common adverse effects of PDE5 inhibitors, such as flushing, lightheadedness, or dyspepsia, may be attributed to niacin and yohimbe, ingredients often found in sexual enhancement products. Profound hypoglycemia after ingestion of sexual enhancement products containing sildenafil and glyburide (Micronase® and others) also has been reported.

The covert addition of analogues of PDE5 inhibitors, which are not readily detectable by chemical screens, is particularly concerning. Although these chemical cousins of PDE5 inhibitors may retain the desired pharmacologic effect, none have been clinically tested for safety and toxicologic effects.

Obtaining dietary supplement products for sexual enhancement products has several perceived advantages. The purchase can be made discreetly, conveniently, and without a visit to a prescriber. Unlike drugs, dietary supplements are not required to be labeled with adverse effect or drug interaction information. Men taking prescription drugs, such as nitrates, may perceive dietary supplements for sexual enhancement as safe alternatives to contraindicated PDE5 inhibitors.

Clinicians should maintain a high degree of awareness for the potential for adverse effects of sexual enhancement products in men with unexplained cardiovascular symptoms. Patients who express interest in sexual enhancement supplements should be referred to their healthcare provider. Explain that even though a PDE5 inhibitor is not on the label, the supplement may have these ingredients added illegally without regard to patient safety. Patients should be warned of possible changes in vision and decreases in blood pressure, and the potentially dangerous combination of PDE5 inhibitors and nitrates that require medical advice.

PDE5 inhibitors are substrates of cytochrome P450 3A4 (CYP3A4). Monitoring is required to avoid an interaction with CYP3A4 inhibitor drugs, such as erythromycin, which may result in high PDE5 levels.

In summary, advise patients that dietary supplements for sexual enhancement fall into one of two categories: those that might be safe but do not work, and those that might work but are not safe.

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Judge: Rape facilitates a natural society where men are protectors

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95 percent of the victims of work accidents are men. Because women are cowards, and just want to rule from behind.

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Pro-rape' US pick-up artist posts personal details and pictures of female journalists online in revenge for negative coverage

Mail Online

A controversial 'pro-rape pick-up artist' is posting the personal details of journalists who have criticised him online.

Daryush Valizadeh - also known as Roosh V - is infamous for arguing that raping women should be legal on private property.

Labelled 'Operation Bullhorn', Roosh has asked his online supporters to 'adopt' a journalist and post their details on his forum. They have been instructed to gather photos, Facebook profiles and have even been told to save addresses for possible future use.

One forum user said the backlash was 'because women are scared that they won't be able to get a free lunch anymore by virtue of having a vagina.'

The backlash follows criticism of international meetups which included eight UK cities, including Manchester, London, Leeds, and Glasgow.

The meet-ups, set to take place today, were cancelled after Roosh claimed he feared for the safety of his supporters.

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Terrorists are developing a new tactics. Instead of killing victims, they just castrate them, and let them live on. Planned for Swedish and Norwegian men. Perpetrators will just get 6 months in jail.

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How surgery restores pleasure for female cut victims

Whenever other women talked about their sexual escapades, Naomi* always wondered what an orgasm felt like. The possibility of getting one was robbed from her when she was put through female genital mutilation (FGM) at age 14.

Now at the entrance of the Karen Hospital in Nairobi, she stands at the door of opportunity that may restore what was violently taken away from her. Clitoraid, a non-profit organisation based in the US, has pitched tent at the hospital to offer clitoris restorative surgeries for free.

The Kenya Demographic Health Survey of 2014 shows that 21 per cent of women aged 15 to 49 have undergone FGM.

Nine per cent underwent the most severe form where the genital area is sewn shut after being cut off. To restore the clitoris which is normally 11 centimetres long, with only five per cent cut off even in the worst case of FGM, the remaining part of the clitoris which is buried in the body is brought to the surface.

The restoration of sexual pleasure is possible because the entire clitoris is sensory, not just the amputated portion. “Sensation is lost because the amputated portion retracts and gets covered by scar tissue. The clitoris is shortened but not removed. The restoration surgery exposes the clitoral stump.

Then, with plastic surgery, we are able to bring the exposed portion to the surface and even create new labia minora using the surrounding skin. The newly exposed portion is then able function,” said Dr Marci Bowers, Clitoraid’s gynaecological surgeon, who has operated on the women with the help of Kenyan plastic surgeon Dr Abdullahi Adan.

“Women orgasm for the first time in their lives after this,” she added. By Wednesday last week, more than 20 women had been operated on at Mama Lucy Hospital in Nairobi, and more women queued silently at the Karen Hospital waiting for surgery.

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Demography is destiny. That is why Saudi Arabia and Qatar have established billion-dollar funds to provide financial support for every child born in Europe to a Muslim parent. The money is available through mosque charities.

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