Fischer Christopher A, Beckson Mace, Dietz Park
Department of Psychiatry and Behavioral Sciences, University of Southern California, 2250 Alcazar Street, CSC 2200, Los Angeles, CA, 90089-9074.
Health Sciences Clinical Professor of Psychiatry and Biobehavioral Sciences, University of California, 760 Westwood Plaza, Los Angeles, CA, 90095.
J Forensic Sci. 2017 May;62(3):822-826. doi: 10.1111/1556-4029.13340. Epub 2016 Dec 19.
Factitious disorder involves the conscious simulation of psychological or physiological symptoms of illness, for the purpose of fulfilling the unconscious desire to be taken care of or to assume the "sick role." Typically patients with factitious disorder simulate conditions that are designed to arouse feelings of empathy in care providers with the intention to engage them in caretaking. However, patients might also simulate conditions that arouse revulsion or rejection and still meet full diagnostic criteria for factitious disorder. In this case report, we present a patient who fabricated an elaborate history of being a sexually sadistic serial killer with homicidal ideation with the intention of obtaining personal attention, nurturance, and empathy from his psychotherapist. However, given the nature of his feigned condition, the patient frightened the very person whom he sought to engage in caretaking.
做作性障碍涉及有意识地模拟心理或生理疾病症状，目的是满足被照顾或扮演“病人角色”的无意识愿望。通常，患有做作性障碍的患者会模拟一些情况，旨在引起护理人员的同情，以便让他们参与护理。然而，患者也可能模拟引起厌恶或排斥的情况，但仍符合做作性障碍的全部诊断标准。在本病例报告中，我们介绍了一名患者，他编造了一段精心设计的历史，称自己是一名具有杀人意念的性虐待连环杀手，目的是从他的心理治疗师那里获得个人关注、关爱和同情。然而，鉴于他伪装病情的性质，该患者吓坏了他试图让其参与护理的人。
