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多重人格:法医精神病学中的一个问题。

Multiple personality: an issue for forensic psychiatry.

作者信息

Serban G

机构信息

Department of Psychiatry, New York University Medical Center, School of Medicine.

出版信息

Am J Psychother. 1992 Apr;46(2):269-80. doi: 10.1176/appi.psychotherapy.1992.46.2.269.

Abstract

The formulation of Multiple Personality (MP) as a distinctive entity by DSM-III while helpful clinically requires, at best, very rigid evaluatory criteria based on independent verification when used as a defense in a Court of Law. The use of the set of eight criteria developed by specialists are helpful guidelines. A case of MP disorder discovered under hypnosis by a psychiatrist and later on vehemently denied by the patient became the object of legal action as part of a malpractice suit. While some well-known experts consulted during treatment believed that she was a MP, the expert witnesses at the trial felt that the patient was not. As a mixed (borderline-histrionic) personality, the patient possibly might have dissociated under stressful life circumstances. The case raises serious issues about the role of auto-suggestion in mimicking MP. It questions the validity of the use of the diagnosis in Court. Legally only carefully evaluated independent data about incongruent past patterns of behavior suggesting alternate personality, can be considered reliable reference for the diagnosis.

摘要

《精神疾病诊断与统计手册》第三版(DSM - III)将多重人格(MP)认定为一种独特的病症,这在临床方面虽有帮助,但在作为法庭辩护依据时,充其量需要基于独立验证的极为严格的评估标准。专家制定的八项标准有助于提供指导方针。一名精神病医生在催眠状态下发现的一例多重人格障碍病例,后来患者强烈否认,该病例作为医疗事故诉讼的一部分成为法律诉讼的对象。虽然治疗期间咨询的一些知名专家认为她患有多重人格,但审判时的专家证人认为该患者并非如此。作为一种混合型(边缘型 - 表演型)人格,该患者可能在生活压力环境下出现了解离。该病例引发了关于自我暗示在模仿多重人格中作用的严重问题。它质疑了在法庭上使用该诊断的有效性。从法律角度看,只有经过仔细评估的、表明存在交替人格的过去行为模式不一致的独立数据,才能被视为该诊断的可靠参考依据。

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