Continued Abuse Research Articles

The Fierce Urgency of Now: The Case for Including the Environmental Field in Clinical Work

ABSTRACT The same forces that have caused climate change have also affected people. The impact of those forces has been hard to see because physical environments are primarily perceived as separate from the person. This bifurcation of the human-ecosystem relationship may be a factor in many common mental health problems as well as in continued environmental abuse. In this paper, I advocate for understanding the baseline human-ecosystem relationship along with speculating about climate change’s impacts on mental health. Knowing this relationship can augment psychotherapeutic techniques to create a more integrated human-ecosystem relationship, mitigate the effects of climate change on psychological well-being, and foster increased care for the environment. Using object-relations theory and environmentally informed structural-developmental theory, I suggest the existence of ecological object relationships. They are acted upon systemically (Actor Network Theory), acquired developmentally through an integrationist view of language, and become units of analysis that can be therapeutically applied in clinical work. Ecotherapy is a therapeutic approach that utilizes the clinician, the physical environment, and the person being treated in a temporal framework that can heal the dissociative split in the human-ecosystem relationship, strengthening mental and communal health.

The Role of Physical Abuse on Well-Being After Separation and Divorce

Divorce can be detrimental to the psychological (Amato [2000],Journal of Marriage and Family,62(4), 1269–1287; [2010],Journal of Marriage and Family,72(3), 650–666) and physical health of many but not all (Sbarra & Coan [2017],Current Opinion in Psychology,13, 91–95). This review of 21 longitudinal studies is divided into two parts: individuals followed postdivorce/separation where there was no intimate partner violence (IPV) and where there was IPV. Given the past reviews of individuals followed postdivorce where IPV was not reported, this review focuses on individuals where there was IPV but also provides an update on the former results. Measures evaluating the impact of divorce or separation were dependent upon measures in the longitudinal studies, including evaluations of well-being, depression, and anxiety. When there was no IPV, variability in postdivorce well-being differed according to prior marital quality, with individuals in low-quality marriages experiencing relief postseparation/divorce. Lower income levels were associated with poorer well-being following divorce. For physically abused women, separation is often associated with continued abuse, but on average, the well-being of abused women increases across time, as abuse often declines. However, the worse the abuse prior to separation, the more likely the abuse continues, and in extreme cases, separation results in the homicide of abused individuals. Since IPV and intimate partner homicide are perpetrated disproportionately by Black men, there is a clear need for longitudinal research on intimate relationships with populations of color. A model predicting the mental health of individuals in preseparation IPV relationships is presented, which includes internalizing characteristics of the victim, preseparation abuse, contact with ex-partner, support variables, and beliefs in accord with separation being the right thing.

Self-powered wearable biosensor based on stencil-printed carbon nanotube electrodes for ethanol detection in sweat

Herein we introduce a novel water-based graphite ink modified with multiwalled carbon nanotubes, designed for the development of the first wearable self-powered biosensor enabling alcohol abuse detection through sweat analysis. The stencil-printed graphite (SPG) electrodes, printed onto a flexible substrate, were modified by casting multiwalled carbon nanotubes (MWCNTs), electrodepositing polymethylene blue (pMB) at the anode to serve as a catalyst for nicotinamide adenine dinucleotide (NADH) oxidation, and hemin at the cathode as a selective catalyst for H2O2 reduction. Notably, alcohol dehydrogenase (ADH) was additionally physisorbed onto the anodic electrode, and alcohol oxidase (AOx) onto the cathodic electrode. The self-powered biosensor was assembled using the ADH/pMB-MWCNTs/SPG||AOx/Hemin-MWCNTs/SPG configuration, enabling the detection of ethanol as an analytical target, both at the anodic and cathodic electrodes. Its performance was assessed by measuring polarization curves with gradually increasing ethanol concentrations ranging from 0 to 50 mM. The biosensor demonstrated a linear detection range from 0.01 to 0.3 mM, with a detection limit (LOD) of 3 ± 1 µM and a sensitivity of 64 ± 2 μW mM−1, with a correlation coefficient of 0.98 (RSD 8.1%, n = 10 electrode pairs). It exhibited robust operational stability (over 2800 s with continuous ethanol turnover) and excellent storage stability (approximately 93% of initial signal retained after 90 days). Finally, the biosensor array was integrated into a wristband and successfully evaluated for continuous alcohol abuse monitoring. This proposed system displays promising attributes for use as a flexible and wearable biosensor employing biocompatible water-based inks, offering potential applications in forensic contexts.Graphical A novel water-based graphite ink modified with multiwalled carbon nanotubes designed for the development of a wearable self-powered biosensor enabling alcohol abuse detection through sweat analysis.

Politicizing terror: the (ab)use of counterterrorism law for authoritarian ends in Tunisia

ABSTRACT This article analyses Tunisian President Kais Saied's abuse of counterterrorism law and his culpability in the country’s democratic backsliding. Following his election in 2019, Saied, with a split government and a growing economic and political crisis, took extreme measures to end the political deadlock, including dissolving the country’s parliament and claiming emergency powers in 2021. We argue that Saied has moved beyond making temporary moves to ensure political stability and is now seeking to use the country’s counterterrorism law as both his “weapon and shield,” conducting a targeted arrest campaign against opposition figures, and solidifying his authoritarian control of Tunisia. The arrest campaign, conducted primarily under the 2015 counterterrorism law, commenced in early 2023 and has included several prominent political figures in Tunisia. The charges, often stemming from an offender’s political statements, were framed as violations of the counterterrorism law, and were therefore justified to stem the tide of extremism and terrorism in Tunisia. Such legal abuse has allowed Saied to present his authoritarian actions as within the limits of the rule of law, a common approach for entrenched authoritarians. The analysis of arrest patterns suggests that a continued abuse of the counterterrorism law will eventually erode Tunisia’s nascent democracy.

Analyzing actual crime victimizations of people with dementia in criminal court judgment databases in Japan

ABSTRACT People with dementia suffer not only from symptoms but also from social vulnerability including an increased risk of abuse and criminal victimization. In existing quantitative studies, the data are based on reports by people with dementia themselves, their family members, or concerned persons, which may be insufficient to accurately identify the actual mechanisms and circumstances of abuse or victimization. To speculate on the exact realities of people with dementia victimization, we extracted criminal sentences of perpetrators collected from the Japanese judgment database. A total of 152 cases in approximately 23 years included various victimization situations; these cases were classified into six categories of harm (physical, psychological, neglect, sexual, financial, and miscellaneous) and five categories of perpetrator (spouse, child, other family, supporter, and stranger or other). There were 93 cases of physical victimization by the spouse or child, which were statistically analyzed. Through case inspections, we provide an accurate victimization process of people with dementia and propose a four-class typology of physical victimization by the family: care exhaustion, antipathy to people with dementia, self-righteous or self-contained family, and continuous abuse type. These case scrutinies and their classifications may contribute to interventions regarding the support of people with dementia and their families.

"I'd Rather Be Broke Than Harmed": A Qualitative Analysis of the Experiences of People Engaged in Commercial Sex Work During the COVID-19 Pandemic.

People involved in commercial sex work during the COVID-19 pandemic, particularly those compelled to sell sex, faced multiple challenges to their safety and well-being. We explored, in real time, the impact of the COVID-19 pandemic on people involved in commercial sex work and the broader commercial sex industry. Using a participatory action research approach, we interviewed 159 English- and Spanish-speaking adults who had engaged in commercial sex work under the direction of a third party in Sacramento County, California, within the past 5 years (approximately 2017-2022). As part of a larger study, our interview protocol included 1 question about the COVID-19 pandemic: "Has COVID-19 changed anything about your experience with sex work?" We transcribed and analyzed interviews using QSR-NVivo, a qualitative coding software. Participants described the effects of increased isolation, decreased demand, difficulty accessing social services, fear of contracting COVID-19, difficulty in following public health guidance on social distancing and wearing face masks, and how the pandemic resulted in some people entering or exiting commercial sex work. Most participants were familiar with recommended public health safety measures, but lack of agency and financial need limited their ability to comply with all recommendations. A lack of access to social services added stress to those most in need of emergency housing or substance use treatment and left them vulnerable to continued abuse. Stress and financial insecurity generally increased among people involved in commercial sex work during the pandemic, and no efforts were made to understand and mitigate the hardships that this population faced. Future research should address how to maintain social service availability during times of public health emergencies and other crises.

Analysis and study of the mechanism of narcotic addiction and withdrawal

Narcotic drugs refer to drugs that have anesthetic effects on the central nervous system, and they easily produce physical dependence and mental dependence and can be addictive due to continuous use, abuse or unreasonable use. In this paper, bioinformatics and data analysis and mining techniques were used to analyze the methylation differences in transcriptional and clinical data of narcotic addiction in public databases, to explore the mechanism of narcotic addiction, and to mine some norepinephrine drugs. This study confirmed the possibility of using norepinephrine as an auxiliary drug for drug addiction rehabilitation. In addition, we also conducted a similar analysis on the addiction of three drugs. The results showed that the differences in the body caused by the ingestion of opiates and cocaine were significantly greater than those caused by the ingestion of methamphetamine.

Reverse case in child sexual abuse.

Child sexual abuse is a public health and medico-legal problem in developed and developing countries. Prompted by rare presentations of cases from this issue that change the course and outcome of events, we present the completed criminal-medico-legislative procedure as a contribution to the dynamics of the investigative process from my own many years of forensic practice. Two preschool teachers of late reproductive age from a home for neglected children reported to the State Attorney's Office a former ward of the home, now an older minor, and an auxiliary employee of the same home, for having sexual relations with a two-year-old girl. But the state attorney also ordered an examination of the reported young man, so the reported case that the teachers "saw" penetrative intercourse was rejected by the expert and the state attorney as an action impossible without injuring the girl at that age. Further investigation proved the continuous sexual abuse by two teachers of the young man since he was 13 years old, i.e. for three years, which he did not report for fear that he would be kicked out of the home. He had sexual relations with each of them several times during those incriminated years. After his statement, other employees of the home were questioned as witnesses who confirmed the suspect boy's claims. He was then released from custody, and the teachers were dismissed from their jobs and accused of years of sexual abuse of minors and abuse of their position and authority as competent persons.

Age Differences in the Associations Between Incarceration and Subsequent Substance Use, Sexual Risk-Taking, and Incident STI Among Black Sexual Minority Men and Black Transgender Women in the HIV Prevention Trials 061 Cohort.

Incarceration can lead to different risk behaviors often due to increased distress and disruption of social networks. It is not well known, however, how these associations may differ by age. In this study, we measure age differences in longitudinal associations between incarceration and substance use, sex risk, and sexually transmitted infection (STI) among Black sexual minority men and Black transgender women (BSMM/BTW). We recruited BSMM/BTW from 2009 to 2011 that were part of the HIV Prevention Trials Network 061 study. We compared those less than 30 years old (n = 375) to those 30 years old or greater (n = 794) examining substance use, sex risk, and STI infection stratified by age. Logistic regression with inverse probability weighting was used for the statistical analysis. Approximately 59% of the sample reported incarceration history. In adjusted analysis, incarceration was more strongly associated with alcohol use and stimulant use among older individuals as was sexual risk behaviors including buying and selling sex. Concurrent partnerships were associated with the younger age groups. STI incidence was associated with younger individuals while associations with HIV infection were similar for the two age groups. Understanding differences in substance use and STI risk among age cohorts is imperative to the design and implementation of re-entry programs. Younger BSMM/BTW participating in re-entry support programs may benefit in particular from HIV/STI prevention and care efforts, while post-release substance abuse treatment and harm reduction programs should target older individuals with continued substance abuse.

Impact of fluoxetine preexposure on MDMA-induced taste avoidance in male and female rats.

The use of both prescription and illicit drugs creates the potential for drug interactions as a function of both pharmacokinetic and pharmacodynamic processes. One such interaction is that of fluoxetine and methylenedioxymethamphetamine (MDMA) in which fluoxetine attenuates the positive-like effects of MDMA. The present work extends the analysis of their interaction by examining the impact of fluoxetine on the aversive effects of MDMA which in balance with its rewarding effects may mediate its abuse potential. Male and female Sprague-Dawley rats were given fluoxetine (10 mg/kg every 4th day for five injections) prior to taste avoidance training with MDMA (3.2 mg/kg). MDMA induced taste avoidance in males and females (faster acquisition in females). Fluoxetine preexposure attenuated this avoidance in males, but not females. For males, the attenuation was partial as MDMA-conditioned animals with fluoxetine preexposure still displayed a significant reduction in fluid intake compared to controls. Consistent with prior work assessing the interaction of fluoxetine and MDMA, fluoxetine preexposure impacted the ability of MDMA to support taste avoidance learning, specifically attenuating the aversive effect of the drug. Prior work has shown that fluoxetine attenuates MDMA's positive effects which might lead to reduced intake of the drug; however, the concurrent reduction in the drug's aversive effects may still shift the overall affective balance of these two affective properties toward continued use and abuse. The fact that the attenuation was only evident in males needs further study to investigate the sex-dependent effects of drug history. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Women, power, and rape culture: The politics & policy of underrepresentation. By BonnieStabile, Aubrey LeighGrant, Bloomsbury Publishing. 2023. eISBN‐13: 9781440876981

AbstractThis book review is an analysis of how the author’s have connected the Trump presidency to the continued and rampant abuse towards women in the United States. Bonnie Stabile and Aubrey Leigh Grant have detailed their research of sexual harassment and assault long being an issue in the American society, however it has been echoed by many politicians whom have the power to impact our rights with their beliefs. This review breaks down the main points detailed in Women, Power, and Rape Culture: The Politics & Policy of Underrepresentation, and presents an understanding of abuse of power on a government level and the maltreatment women face because of this.

Dysphonia in Children; Clinical Profile, Conservative Treatment Modalities and Outcomes: An Institutional Experience.

Dysphonia in children represents broad-spectrum voice problems. Global prevalence of hoarseness in school-aged children is 6-23%. It impairs communication of child, thus affects social life. This study shows importance of appropriate preventive measures for paediatric dysphonia and diagnosis of voice problems in early stages. Continuous voice abuse in children can cause recurrent voice disorders as well as speech problems. This prospective study included 104 patients(78 males and 26 females) of 6-15years, with voice problems, in a tertiary care centre, North Kerala, during June 2022-March 2023. Chief complaints and risk factors evaluated. Voice analysis using maximum phonation time (MPT), Child Voice Handicap Index for Parents (CVHI-10-P), Reflux Symptom Index (RSI) and clinical examination including indirect laryngoscopy (IDL) and 70degree scopy were done. Treatment given for a maximum of 2weeks. Advised voice rest and voice therapy throughout. All patients followed up after 2weeks and up to 3months. Voice abuse was the commonest risk factor and voice change, the commonest symptom. MPT reduced in 23% males and 14% females. According to CVHI-10-P, screaming was present in 52% children and symptoms present mostly in afternoon. RSI identified the role of LPRD in dysphonia. IDL and 70 scopy identified most common diagnosis as vocal nodule. Treatment given and follow-up period noted. All except vocal polyp had complete relief. Most common diagnosis was vocal nodule which resulted from chronic voice abuse. Appropriate preventive measures, early diagnosis and adequate treatment of voice problems should be considered. Conservative management in early stages is recommended.

Pathophysiology, clinical presentation, and management of ketamine-induced cystitis.

Ketamine is illegally used as a recreational drug in many Asian countries. Long-term ketamine abusers often develop irritable bladder symptoms that gradually develop into more severe urinary frequency and urgency and eventually into a painful ulcerated bladder. These patients typically have reduced functional bladder capacity, increased bladder sensation, detrusor overactivity, severe urgency, urinary incontinence, and bladder contracture. Ketamine metabolites can cause severe inflammation of the urothelium, urothelial barrier deficits, vascular endothelial fibrinoid changes, increased oxidative stress, and bladder wall fibrosis. A decrease in bladder compliance, urinary tract infection, severe bladder pain with a full bladder, and painful micturition are also common symptoms. Finally, with continued abuse of ketamine, hydronephrosis, ureteral stricture, vesicoureteral reflux, and renal failure may develop. Cessation of ketamine is the mainstay of treatment. Lower urinary tract symptoms usually relapse if patients reuse ketamine after stopping. In cases of severe ketamine cystitis, only augmentation enterocystoplasty can relieve bladder pain and restore normal lower urinary tract function. This article reviews the underlying pathophysiology, clinical characteristics, and management of ketamine cystitis.

‘How dare you call that playground banter?!’: Service provider perspectives on coercive control and young people

AbstractThis article presents service provider perspectives on young people and coercive control. Findings illustrate that young people need help from service providers to identify coercive control whilst simultaneously, some service providers minimise young people's experiences using an adult focused frame of reference. This has the potential to deny their agency and render young people's experiences invisible. We highlight the need for education on the specific issues young people face including how that might differ from adults. Finally, we examine the paradoxical role of social media as having transformative possibilities yet in a parallel process, creating opportunities for continued abuse.

Multilevel analysis of factors associated with perinatal intimate partner violence among postpartum population in Southern Ethiopia

Violence around pregnancy is critical in nature and major public health problem worldwide. Thus, the present study aims to determine the extent of perinatal partner violence and to identify its individual and community-level factors among postpartum women in Southern Ethiopia. A total of 1342 postpartum women nested in 38 ‘Kebles’ (clusters) were enumerated using multistage-clustered sampling techniques for multilevel analysis. Different parameters were computed for model comparison and model fitness. The overall prevalence of intimate partner violence before, during, and/or after pregnancy was estimated to be 39.9% [95% CI 36.9–44.5]. About 18% of women reported continuous abuse over the perinatal period. Postpartum women who live in rural areas [adjusted odds ratio (AOR) = 2.46; 95% CI 1.21–5.01], or in neighborhoods with high IPV favoring norms [AOR = 1.49; 95%CI 1.01–2.20], high female literacy [AOR = 2.84; 95%CI 1.62–5.01], high female autonomy [AOR = 2.06; 95%CI 1.36–3.12], or in neighborhoods with lower wealth status [AOR = 1.74; 95%CI 1.14–2.66] were more likely to encounter PIPV. The complex patterns of interplaying factors operating at different levels could put pregnant or postpartum women at higher risk of IPV victimization. Therefore, policies that prioritize the improvement of contextual factors, particularly norms toward IPV and women’s empowerment are likely to be the most effective interventions.

“The most shocking thing was that I didn't respond to the abuse”: The peritraumatic responses and transitions as conveyed by survivors of continuous child sexual abuse

BackgroundChild sexual abuse (CSA) is a worldwide phenomenon with ongoing and far-reaching consequences for millions of children worldwide. It is a consensus among researchers that continuous CSA represents a unique challenge. ObjectiveThe current study aimed to explore the peritraumatic responses of survivors of continuous CSA as described in their written narratives of abuse. The transitions between the peritraumatic responses will also be examined, highlighting the unique context of continuous CSA. Participants and settingWritten narratives of CSA were recruited via an advertisement in the media inviting CSA survivors to share their stories of abuse on an anonymous online platform. The data collection was carried out under the Israeli Independent Public Inquiry on CSA. MethodsA qualitative thematic analysis was applied to 32 richly written accounts of abuse. ResultsThree peritraumatic responses were identified: the adaptive response, hinting, and attempts to fight and flight. Transitions between these responses were described by the survivors and addressed the heavy load of the abuse, realization of the abuse, fear of consequences and the central role of the survivor's environment. ConclusionsThe current study provides a unique platform for the exploration of peritraumatic responses in continuous CSA. Alongside the identification of three peritraumatic responses described by the survivors, the current study provides an initial glance into transitions between peritraumatic responses. This insight strengthens the developing notion that peritraumatic responses in the unique context of CSA are a top-down process, often shaped by various contexts and multidimensional dynamics in the children's lives.

Providers Assessing Child Abuse and Neglect

Providers Assessing Child Abuse and Neglect

Relapse Rate after Opioid Detoxification in Drug Addict Patients

Background: Drug addiction is widely regarded as a pathological condition that involves the continued abuse of drugs in the development of drug-seeking behavior and a decrease in the ability to respond to naturally rewarding stimuli.
 Objective: To determine the frequency of relapse after opioid detoxification in drug addict patients.
 Methods: A descriptive cross-sectional survey was performed in psychiatry department of Pakistan Institute of Medical Sciences, PIMS, Islamabad, from October 2017 to April 2018. All adult patients who were using cannabis for at least 1 year, irrespective of gender ages between 18 to 60 years were included in the study. For drug use characteristics about preferred choice of drugs and injection-related risk behaviors were noted and analyzed. All findings were entered in a structured Proforma. Data was entered in SPSS version 21 and analyzed. Effects modifiers like age, gender, marital status, types of drugs, etc., were controlled by stratification. Post stratification chi square test was applied. A p value ≤ 0.05 was considered significant.
 Results: Total 310 patients were included; 83% patients were male and 17% were females. The mean age of the patients was 39.02±21.42 years. 70% patients had relapse after opioid detoxification while 30% patients had NO relapse. The relapse rate after detoxification was more common in first month of detoxification (56%). After 3 months the relapse rate after detoxification was 12.5%. The statistical analysis showed that there was a very significant association between types of drugs, ages of patients, marital status and relapse rate (p ≤ 0.05). There was an insignificant association between gender and relapse rate (p ≥ 0.5).
 Conclusion: The study concluded that the relapse within six months of opioid detoxification in drug addicts is very common. Many factors contribute in relapse rate.

Biodiversity Conservation of National Parks and Nature-Protected Areas in West Africa: The Case of Kainji National Park, Nigeria

Due to rising global warming and climate change, biodiversity protection has become a critical ecological concern. Rich biodiversity zones are under threat and are deteriorating, necessitating national, regional, and provincial efforts to safeguard these natural areas. The effective conservation of national parks and nature-protected areas help to improve biodiversity conservation, forest, and urban air quality. The continuous encroachment and abuse of these protected areas have degraded the ecosystem over time. While exploring the geophysical ecology and biodiversity conservation of these areas in West Africa, Kainji National Park was selected for this study because of its notable location, naturalness, rich habitat diversity, topographic uniqueness, and landmass. The conservation of national parks and nature-protected areas is a cornerstone of biodiversity conservation globally. This study is aimed at the target United Nations’ Sustainable Development Goal 13, 2030—Climate Action targeted at taking urgent action towards combating climate change and its impacts. The study captures both flora and fauna that are dominant in the study area. The 15 identified tree species were selected from over 30 species with 563,500,000 (an average of 3,700,000 in each sample frame) trees for every tree species/type with a total of 63% tree green canopy cover. The study areas divided into three zones were randomly sampled within a stratum of 25 × 25 km frames divided into 150 sample frames for proper analyses using the i-Tree Eco v6.0.25. It is a United States Department of Agriculture (USDA) Forest Service peer-reviewed application (software) designed which includes tools for urban and rural forestry study and benefits evaluations. The following microclimatic data were captured and analyzed photosynthetically active radiation, rain/precipitation, temperature, transpiration, evaporation, water intercepted by trees, runoff avoided by trees, potential evaporation by trees, and isoprene and monoterpene by trees. This study also further discusses the tree benefits of a green, low carbon, and sustainable environment within the context of biodiversity conservation, considering carbon storage, carbon sequestration, hydrology effects, pollution removal, oxygen production, and volatile organic compounds (VOCs). There is a quick need for remotely-sensed information about the national parks, protected areas and nature reserves at regular intervals, and government policies must be strict against illegal poaching, logging activities, and other hazardous human impacts.

Alcohol Induced Cerebellar Ataxia: A Case Report

<p style="text-align: justify;">Consumption of alcohol excessively causes dependence and leads to psychological discomfort. Motivation to drink is influenced by a variety of neurobiological and environmental variables. The proclivity of an individual to imbibe is thought to reflect a balance between alcohol&rsquo;s positive reinforcing (i.e., rewarding) effects, such as euphoria and anxiety reduction (i.e., anxiolysis), and the drug&rsquo;s aversive effects, which are typically associated with negative consequences of alcohol consumption (e.g., hangover or withdrawal symptoms). Neuroadaptive alterations caused by continuous alcohol use and abuse (such as tolerance and physiological dependence) are regarded to be critical in the shift from regulated alcohol use to more frequent and excessive, uncontrollable drinking which induces cerebellar degeneration considered as common type of acquired toxic ataxia. Excessive use leads to degeneration of the midline cerebellum. Progressive trunk and gait ataxia is characteristic, with little involvement of upper limbs, eyes or speech (a corollary of relative cerebellar hemispheric sparing). Abrupt termination of alcohol use after a period of heavy drinking may result in alcohol withdrawal seizures. Generalized tonic&ndash;clonic seizures are the most common and severe form of seizure in this conditions. Current case report presents complaints of astasia and slurred speech with few episodes of seizures. The diagnosis indicated Mild cerebellar atrophy. Patient was advised to undergo de-addiction and cure. <p style="text-align: justify;"><strong>Key words:</strong> Cerebellar ataxia, Alcohol, Cerebellar atrophy, GABA, astasia,seizures.