Fonzworth Bentley consults Dr. Vasey and NYJSM.com

Matthew Vasey, MD

Thank you Mr. Bentley, we would be delighted to research this topic. Swagger, as defined by Fonzworth Bentley in his book Advance Your Swagger, is a combination of manners, confidence and style.(10) Having been both entertained and enlightened by this read, we can say with certainty people would be far more pleasant if they took cues from this book. So is it healthy to advance your swagger? Let's take a closer look at the key elements that embody the 'swagger' and review the medical literature as it relates to it. We'll let you draw your own conclusion.

Manners

Manners are a method of speaking to and treating others.(6) While we can assume that those with manners have simply been in less "fights", an obvious reduction in a number of cuts, scrapes and bruises we were looking for supportive medical evidence. The American Psychiatric Association's (APA) Diagnostic and Statistical Manual states Antisocial Personality Disorder must have the essential feature for the diagnosis which is a pervasive pattern of disregard for, and violation of, the rights of others that begins in childhood or early adolescence and continues into adulthood.(1) A review of 23,000 prisoners established 47% of inmates carried a diagnosis of Antisocial Personality Disorder.(7) A disease profile of prison inmates shows much higher rates than their non-prison counterparts in infectious disease, musculoskeletal and connective tissue disease, circulatory disease, mental disorders and diseases of the respiratory system.(2) If you could please notice the relation between the lack of manners in antisocial personality disorder and the increased health risk of being a prison inmate, thank you.

Confidence

Confidence is the belief in oneself and one's powers or abilities.(6) It has been shown in populations of patients recovering from mental illness that self-esteem influences the effect of life satisfaction on their symptoms.(9) It is important not to confuse, solely a lack of confidence with depression. Adolescent depression is a chronic, recurrent, and a serious illness that requires the care of a medical professional.(3) A diagnosis of depression is made by standard clinical criteria such as those published by the APA.(4) One study showed hospitalization for adolescent depression in both boys and girls has increased in the United States over a ten year period.(5) If we as the "healthy" adult population and the "healthy" adolescent population focus on the experienced "feelings of hopelessness", a feature in the criteria for depression, it would be possible to take charge of improving our own mental health by being confident in oneself.

Style

While there are many definitions for the word style, we will look at style as a mode of fashion.(6) A component of advancing your swagger entails paying close attention to personal hygiene. Attention to personal hygiene is well established to prevent outbreaks of infectious disease.(8) The Center for Disease Control and Prevention (CDC) outlines specific recommendations for hand hygiene in the hospital setting which translates to a sensible strategy when you are either at home or out on the town.(4) While CDC does not make recommendations of what to wear when getting ready, hand hygiene is certainly a part of the getting ready process.

NYJSM Consultion Answer

As we stated, it is our intention to leave the conclusion to our audience. After a careful analysis of the three elements - manners, confidence, and style - we support the claim that it is in fact, healthy to advance your swagger. For further information on how to advance your swagger, check out Bentley's book, Advance Your Swagger. See for yourself how much healthier you feel by advancing your swagger.




REFERENCES:

1. American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders. Washington, DC: American Psychiatric Association, 645-650.

2. Baillargeon J, Black S, Pulvino J, Dunn K. The Disease Profile of Texas Prison Inmates. Annals of Epidemiology. Feb 2000 10(2): 74-80.

3. Brent D, Birmaher B. Adolescent Depression. N Engl J Med 2002 347: 667-671.

4. Center for Disease Control and Prevention. Fact Sheet - Hand Hygiene Guideline. http://www. cdc. gov/handhygiene/.

5. Center for Disease Control and Prevention. Rate of Hospitalization for Depression Among Persons Aged 5--19 Years, by Sex --- United States, 1990--1992 and 2002--2004. National Hospital Discharge Survey annual data files for 1990, 1991, 1992, 2002, 2003, and 2004. http://www. cdc. gov/mmwr/preview/mmwrhtml/mm5526a5. htm

6. Dictionary. com, Style, Manners, Confidence. http://www. dictionary. com

7. Fazel S, Danesh D. Serious mental disorder in 23000 prisoners: a systematic review of 62 surveys. The Lancet, Volume 359, Issue 9306, Pages 545-550.

8. Greenough P., Kirsch T. Public Health Response -- Assessing Needs. N Engl J Med 2005 353: 1544-1546.

9. Markowitz F. Modeling Processes in Recovery from Mental Illness: Relationships between Symptoms, Life Satisfaction, and Self-Concept. Journal of Health and Social Behavior. Mar 2001 42(1) 64-79.

10. Bentley, F. Advance Your Swagger. Random House Publishing Group, September 2007.