Avak Howsepian, MD, MA, PhD

Title(s)Clinical Professor, Psychiatry - Fresno
SchoolSchool of Medicine
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    Dr. Howsepian received his B.A. in Psychology from California State University, Fresno (CSUF), his M.D. from the University of California, Davis, and his M.A. and Ph.D. in Philosophy (with concentrations in Metaphysics, Philosophy of Mind, Ethics, Philosophy of Religion, and the History of Philosophy) from the University of Notre Dame. His doctoral dissertation in Philosophy was on the metaphysics of free will. He completed his residency training in Psychiatry at the University of California, San Francisco Fresno Medical Education Program (UCSF FMEP). Dr. Howsepian is board certified in Psychiatry by the American Board of Psychiatry and Neurology and is a member of the American Neuropsychiatric Association, the International Society for ECT and Neurostimulation, and the American College of Psychiatrists. He is also Staff Psychiatrist and Director of Electroconvulsive Therapy at the Veterans Administration Central California Health Care System, Health Sciences Clinical Professor of Psychiatry at UCSF Fresno, and has a private consultation practice primarily in forensic psychiatry, with special interests in legal insanity, nocturnal violence, capital case mitigation, sex offenses, false confessions, malingering, and religious themes in forensic psychiatry. His clinical interests include neuropsychiatry, psychotic and dissociative disorders, disorders on the bipolar spectrum, and psychodynamic psychotherapy. Dr. Howsepian conducts weekly individual supervision with UCSF Fresno psychiatry residents in addition to teaching courses in Psychopharmacology, Electroconvulsive Therapy, Paraphilias and Perversions, Sexual Dysfunction, Psychiatric Ethics, Psychiatry and Religion, and Forensic Psychiatry. He also teaches Psychopharmacology at CSUF and has taught various Philosophy classes at Fresno Pacific University. He has been awarded multiple UCSF teaching honors, including the George Sarlo Prize, the Haile T. Debas Academy of Medical Educators Award for Excellence in Teaching, and the Henry J. Kaiser Award. Dr. Howsepian's over 50 academic publications can be found in Psychiatry, Neurology, and Philosophy journals and book chapters. His current projects include papers on free will, sexual ethics, counterpossibles, various topics in the philosophy of psychiatry, diverse topics in philosophical theology, and book length manuscripts on psychotherapy’s capacity both to heal and to harm, conceptual problems in the foundations of psychiatry, and the intersection between Christian theology and psychodynamic psychiatry. He is on the editorial board of The Journal of Medicine and Philosophy and The Journal of Human Sexuality and is a peer reviewer for several psychiatry and philosophy journals. Dr. Howsepian is married to psychologist and educator, Barbara A. Howsepian, Ph.D., with whom he has a son (named after Aristotle), Aris — a musician, composer, and lyricist. Dr. Howsepian enjoys chess, tennis, ping pong, music, film, theater, cooking (and eating), sumo wrestling, traveling, and cheering on both all Wisconsin sports teams and all of one Indiana school’s sports teams, viz. the Fighting Irish of the University of Notre Dame.

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    Publications listed below are automatically derived from MEDLINE/PubMed and other sources, which might result in incorrect or missing publications. Researchers can login to make corrections and additions, or contact us for help. to make corrections and additions.
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    1. Lithium Snubbed, Yet Still Valuable: Review of Its Clinical Use in Psychiatry. World Journal of Pharmaceutical Research. 2024; 13(8):1-20. Hani Raoul Khouzam, M.D., M.P.H., Avak A. Howsepian, M.D., Ph.D., John Tran, M.D., D.F.A.P.A., Jacob J. Mathew, Ph.D.
    2. Possible Acromegaly Complicating the Death of George Floyd. Journal of Clinical Medicine and Case Reports. 2023; 3(1):1-7. Howsepian AA.
    3. Statement in Support of Revising the Uniform Determination of Death Act and in Opposition to the Revision Proposed by Lewis, Bonnie and Pope prepared by D. Alan Shewmon (MD) [Signatory/Endorsement]. Journal of Medicine and Philosophy. 2021. A.A. Howsepian. .
    4. Sex and gender are distinct variables critical to health: Comment on Hyde, Bigler, Joel, Tate, and van Anders (2019). Am Psychol. 2019 10; 74(7):842-844. Cretella MA, Rosik CH, Howsepian AA. PMID: 31580112.
      View in: PubMed   Mentions: 3     Fields:    Translation:Humans
    5. Psychiatry's Dysphoric Turn: Psychophysical Dysmorphia, Transgender Euphoria, and the Rise of Pedophilia. Christian Bioethics. 2019; 25(1):41-68. A.A. Howsepian. .
    6. American Psychiatry's Retreat from Reality. Ethics & Medicine. 2018; 34(3):153-161. A.A. Howsepian. .
    7. Is Christianity Bad for Your Health?. Christian Research Journal. 2015; 38(2):10-17. A.A. Howsepian. .
    8. Hugh LaFollette (EIC) International Encyclopedia of Ethics. "Brain Death". 2013. A.A. Howsepian, Hugh LaFollette (EIC).
    9. Moral Injury and Spiritual Repair in Post-traumatic Stress Disorder. Christian Research Journal. 2013; 36(2):21-25. A.A. Howsepian. .
    10. A Psychosomatic Symphony in Four Movements. California Association of Marriage and Family Therapists - Central San Joaquin Valley Chapter Newletter. 2012. A.A. Howsepian. .
    11. Mental illness and firearm violence. JAMA. 2011 Sep 07; 306(9):930; author reply 931. Howsepian AA. PMID: 21900131.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    12. On describing "seizure length" in electroconvulsive therapy. J ECT. 2011 Mar; 27(1):93-4; author reply 94. Howsepian AA. PMID: 21336054.
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    13. Persons, Moral Worth, & Embryos: A Critical Analysis of Pro-Choice Arguments. Stephen Napier (Ed.). "Fetal Pains and Fetal Brains" (Chapter 10). 2011; 187-210. A.A. Howsepian, Stephen Napier (Ed.).
    14. The Ethics of Organ Transplantation. Steven J. Jenson (Ed.). "Consciousness and Aesthetics in Decisions Concerning Organ Donation Using Anencephalic Neonates". 2011; 72-91. A.A. Howsepian, Steven J. Jenson (Ed.).
    15. Domain-Specific Associations between Burden and Mood State in Dementia Caregivers. Clinical Gerontologist. 2010; 33:237-247. Matthew J. Wright (PhD), Matthew A. Battista (PhD), Debra S. Pate (PhD), Robert Hierholzer (MD), Jeffrey Mogeloff (MD), A.A. Howsepian (MD, PhD).
    16. Controversies about brain death. JAMA. 2009 Jul 22; 302(4):381; author reply 381-2. Howsepian AA. PMID: 19622813.
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    17. Summa Psychopathologia: Psychiatric Nosology in the Light of Aquinas. Edification. 2009; 3(1):21-23. A.A. Howsepian. .
    18. On Referring. Ethics & Medicine. 2009; 25(1):31-47. A.A. Howsepian. .
    19. What's So Good About Libertarian Free Will?. Philosophia Christi. 2008; 10(1):181-197. Mark Hodges, A.A. Howsepian, Timothy Donovan.
    20. Four queries concerning the metaphysics of early human embryogenesis. J Med Philos. 2008 Apr; 33(2):140-57. Howsepian AA. PMID: 18480498.
      View in: PubMed   Mentions: 3     Fields:    Translation:HumansCells
    21. The Pain of Depression and the Spirit of Christianity "Viewpoint". Christian Research Journal. 2008; 31(6). A.A. Howsepian. .
    22. Childhood Sexual Abuse Indicators (SAI) for Differentiating Genuine from False Alegations. American Journal of Forensic Psychiatry. 2008; 29(3):5-23. Howard B. Terrell (MD), Brian E. Terrell, Anthony Capozzi (Esq.), Hon. Victor N. Papadakis (Ret.), Hon. H.N. Papadakis (Ret.), Kathy Sullivan (PhD), Mark Hodges, A.A. Howsepian (MD, PhD), Timothy Donovan (Esq.), Karen Kraus (MD), David Fox (MD).
    23. The DSM-IV-TR 'Glossary of Technical Terms': a reappraisal. Psychopathology. 2008; 41(1):28-34. Howsepian AA. PMID: 17952018.
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    24. Cerebral Neurophysiology, "Libetian" Action, and Euthanasia. Ethics & Medicine. 2007; 23(2):131-121. A.A. Howsepian. .
    25. Compatibilism, Evil, and the Free Will Defense. Sophia. 2007; 46:215-234. A.A. Howsepian. .
    26. Must Physicians Always Act in their Patients' 'Best Interests'?. Ethics & Medicine. 2006; 22(3):151-161. A.A. Howsepian. .
    27. Very Quiet People: Ethical, Medical, and Theological Perspectives on those in 'Vegetative' and other Hypokinetic States. Christian Research Journal. [Reprinted in Incapacity and Care, Helen Watt (Ed.) Linacre Center for Healthcare Ethics]. 2006; 29(1):31-41. A.A. Howsepian. .
    28. Fetophilia: A Study in the Metaphysics of Pregnancy. Philosophia Christi. 2005; 7(1):199-206. A.A. Howsepian. .
    29. Clinical Gerontologist. Caregiver Reports: A Systematic Method of Comparison with Clinical Impressions. 2004; 27(4):53-70. Matthew Battista, PhD (first author), Debra Sue Pate, Robert Hierholzer, A.A. Howsepian, Jeffrey Mogelof.
    30. Sexual modification therapies: ethical controversies, philosophical disputes, and theological reflections. Christ Bioeth. 2004; 10(2-3):117-35. Howsepian AA. PMID: 15764091.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    31. Treating homosexuality: a response to Yarhouse. Christ Bioeth. 2004; 10(2-3):259-67. Howsepian AA. PMID: 15764099.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    32. A Libertarian-Friendly Theory of Compatibilist Free Action. Southern Journal of Philosophy. 2004; XLII:453-480. A.A. Howsepian. .
    33. Switching from Chlorpromazine to Quetiapine Relieves Chronic Headache and Reduces Dangerous Adverse Effects in an Elderly Patient with Long-Term Schizophrenia. Primary Care Psychiatry. 2004; 9(3):95-96. A.A. Howsepian. .
    34. Toward a general theory of persons. Christ Bioeth. 2000 Apr; 6(1):15-35. Howsepian AA. PMID: 12166488.
      View in: PubMed   Mentions:    Fields:    Translation:HumansCells
    35. In defense of whole-brain definitions of death. Linacre Q. 1998 Nov; 65(4):39-61. Howsepian AA. PMID: 12199254.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    36. Palliative options at the end of life. JAMA. 1998 Apr 08; 279(14):1066; author reply 1066-7. Howsepian AA. PMID: 9546559.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    37. Invoking natural law. Hastings Cent Rep. 1998; 28(2): author reply 4. A.A. Howsepian. .
    38. Post-traumatic stress disorder following needle-stick contaminated with suspected HIV-positive blood. Gen Hosp Psychiatry. 1998; 20(2): author reply 123-4. A.A. Howsepian. .
    39. Are Advance Directives an Advance?. Ethics & Medicine. 1998; 14(2):34-41. A.A. Howsepian. .
    40. Sowing the Seeds of Christian Anthropology: Contributions from Scripture, Philosophy, and Neuroscience. Ex Auditu. 1998; 13:41-56. A.A. Howsepian. .
    41. Lockwood on human identity and the primitive streak. J Med Ethics. 1997 Feb; 23(1):38-41. Howsepian AA. PMID: 9055161; PMCID: PMC1377183.
      View in: PubMed   Mentions: 1     Fields:    Translation:Humans
    42. Central Pontine Myelinolysis Related to Lithium Toxicity [letter] co-authored with Aman U. Khan & Fen-Lei Chang. General Hospital Psychiatry. 1997; 150-152. Aman U. Khan, Fen-Lei Chang, A.A. Howsepian. .
    43. The American Psychiatric Association's Guidelines Regarding Possible Conflict between Psychiatrists' Religious Commitments and Psychiatric Practice: A Conceptual Critique. Ethics & Medicine. 1997; 13(2):35-38. A.A. Howsepian. .
    44. Sin and Psychosis. Limning the Psyche: Explorations in Christian Psychology, Robert C. Roberts and Mark R. Talbot (Eds.). 1997; 264-281. A.A. Howsepian. .
    45. Cinematic Realism and Right to Die Legislation. International Journal of Applied Philosophy. 1997; 11:63-66. A.A. Howsepian. .
    46. Reductionism Revisited: Return of the Biomedical Model. Biopsychosocial Approaches in Primary Care: State of the Art and Challenges for the 21st Century, Hoyle Leigh MD (Ed.). 1997; 179-200. A.A. Howsepian. .
    47. The evolution of the serotonin-dopamine antagonist concept. J Clin Psychopharmacol. 1996; 16(1): author reply 99. A.A. Howsepian. .
    48. Military position on homosexuality. Am J Psychiatry. 1996; 153(2): author reply 296-7. A.A. Howsepian. .
    49. Are Mormons Theists?. Religious Studies. 1996; 32:357-370. A.A. Howsepian. .
    50. Some Reservations about Suicide. Ethics & Medicine. [Reprinted in Timothy J. Demy and Gary P. Stewart, eds. Suicide and the Christian Community: An Ethical Dilemma]. 1996; 12(2):34-40. A.A. Howsepian. .
    51. The 1994 Multi-Society Task Force consensus statement on the Persistent Vegetative State: a critical analysis. Issues Law Med. 1996; 12(1):3-29. Howsepian AA. PMID: 8764530.
      View in: PubMed   Mentions: 3     Fields:    Translation:Humans
    52. Tardive pain. Neurology. 1995 Nov; 45(11):2113; author reply 2114. Howsepian AA. PMID: 7501173.
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    53. Refusing lifesaving treatment. Am J Psychiatry. 1995; 152(10): author reply 1532-3. A.A. Howsepian. .
    54. Book Review of Malcolm Jeeves 'Mind Fields: Reflections on the Science of Mind and Brain. Ethics and Medicine. 1995; 11(2):45-47. A.A. Howsepian. .
    55. Book Review of Jonathan L. Kvanvig's 'The Problem of Hell'. The Philosophical Review. 1995; 104(3):487-489. A.A. Howsepian. .
    56. Philosophical Reflections on Coma. Review of Metaphysics. 1994; 47(4):735-755. A.A. Howsepian. .
    57. The family physician and adolescent homosexuality. Am Fam Physician. 1994 Apr; 49(5):1065; author reply 1066, 1069. Howsepian AA. PMID: 8154395.
      View in: PubMed   Mentions:    Fields:    Translation:Humans
    58. Middle Actions. International Journal for Philosophy of Religion. 1993; 34:13-28. A.A. Howsepian. .
    59. Who or what are We? Rev Metaphys. 1992; 45(3):483-502. A.A. Howsepian. .
    60. Is God Necessarily Good?. Religious Studies. 1991; 27(4):473-484. A.A. Howsepian. .
    61. Philosophical Contributions to Psychiatry [letter]. American Journal of Psychiatry. 1988; 145(9):1184-1185. A.A. Howsepian. .
    62. Response to Stanley Fahn, M.D., letter concerning the management of Neuroleptic Malignant Syndrome. Seminars in Neurology. 1987; (December): author reply. A.A. Howsepian. .
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