Dr. Rahman and Dr. Hartz are Associate Professors, Washington University in St. Louis, Missouri. Dr. Xiong is Assistant Professor, University of Maryland, College Park, Maryland. Dr. Meloy is Clinical Professor, University of California, San Diego. Dr. Janofsky is Associate Professor, Johns Hopkins Hospital, Baltimore, Maryland. Dr. Harry is Associate Professor, University of Missouri-Columbia. Dr. Resnick is Professor, Case Western Reserve University, Cleveland, Ohio.
J Am Acad Psychiatry Law. 2020 Sep;48(3):319-326. doi: 10.29158/JAAPL.200001-20. Epub 2020 May 14.
An extreme overvalued belief is shared by others in a person's cultural, religious, or subcultural group. The belief is often relished, amplified, and defended by the possessor of the belief and should be differentiated from a delusion or obsession. Over time, the belief grows more dominant, more refined, and more resistant to challenge. The individual has an intense emotional commitment to the belief and may carry out violent behavior in its service. Study participants ( = 109 forensic psychiatrists) were asked to select among three definitions (i.e., obsession, delusion, and extreme overvalued belief) as the motive for the criminal behavior seen in 12 randomized fictional vignettes. Strong interrater agreement (kappa = 0.91 [95% CI 0.83-0.98]) was seen for vignettes representing extreme overvalued belief. Vignettes representing delusion and obsession also had strong reliability (kappa = 0.99 for delusion and 0.98 for obsession). This preliminary report suggests that forensic psychiatrists, given proper definitions, possess a substantial ability to identify delusion, obsession, and extreme overvalued belief. The rich historical foundation of extreme overvalued belief and this small survey study highlight the benefit of inclusion of "extreme overvalued belief" in future glossaries of the Diagnostic and Statistical Manual.
其他人在一个人的文化、宗教或亚文化群体中共同分享一种极度高估的信念。这种信念通常被拥有者所喜爱、放大和捍卫，应该与妄想或痴迷区分开来。随着时间的推移，这种信念变得更加主导，更加精细，更能抵抗挑战。个人对这种信念有着强烈的情感投入，并可能为此进行暴力行为。研究参与者（= 109 名法医精神病学家）被要求从三个定义（即痴迷、妄想和极度高估的信念）中选择一个作为 12 个随机虚构情节中所见犯罪行为的动机。对于代表极度高估的信念的情节，评分者之间具有很强的一致性（kappa = 0.91 [95%CI 0.83-0.98]）。代表妄想和痴迷的情节也具有很强的可靠性（kappa = 0.99 表示妄想，0.98 表示痴迷）。这份初步报告表明，法医精神病学家在获得适当定义的情况下，具有识别妄想、痴迷和极度高估信念的能力。极度高估信念的丰富历史基础和这项小型调查研究突出了在未来的《诊断与统计手册》词汇表中纳入“极度高估信念”的好处。
