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聋人法医精神病学评估中的访谈、诊断及法律方面

Interview, diagnostic, and legal aspects in the forensic psychiatric assessments of deaf persons.

作者信息

Harry B

出版信息

Bull Am Acad Psychiatry Law. 1986;14(2):147-62.

PMID:3524712
Abstract

Forensic psychiatric assessments rely on many underlying presumptions concerning the language development and abilities of their subjects. Although these assumptions may apply across a culturally diverse group of hearing subjects, they probably do not apply to those who are prelingually deaf because such deaf persons never developed verbal language. In this article, a review of the range of literature focusing upon the unique aspects of interviews, diagnosis, and legal understanding of the deaf is conducted. An attempt to illuminate those features believed to be most relevant to forensic assessments of this unique population is made. The demands of interviews conducted in manual language are discussed and particular attention is paid to the impact of the interpreter upon confidentiality, privilege, agency, and the dynamics of the interview. It is also suggested that many of the baseline behaviors of the deaf may, at least partly, result from differences in communication style between the deaf and hearing. This article reports that many major mental disorders occur with the same frequency among the deaf and hearing and include many of the same symptoms. However, organic mental disorders may occur at a somewhat greater rate among the deaf because of the organic basis of deafness. Finally, the ways in which deafness and the use of an interpreter may influence the deaf person's ability to understand and relate to legal concepts and process are discussed. It is noted that many of these problems may arise from a deaf persons inexperience or undereducation about legal matters rather than psychopathology.

摘要

法医精神病学评估依赖于许多关于其评估对象语言发展和能力的潜在假设。尽管这些假设可能适用于文化背景多样的听力正常的人群,但它们可能不适用于那些在语言习得前就失聪的人,因为这些失聪者从未发展出言语语言能力。在本文中,我们对一系列聚焦于聋人访谈、诊断及法律理解独特方面的文献进行了综述。我们试图阐明那些被认为与对这一特殊人群进行法医评估最为相关的特征。文中讨论了使用手语进行访谈的要求,并特别关注口译员对保密性、特权、机构以及访谈动态的影响。文章还指出,聋人的许多基线行为可能至少部分是由聋人与听力正常者在沟通方式上的差异所导致的。本文报告称,许多主要精神障碍在聋人和听力正常者中出现的频率相同,且包括许多相同的症状。然而,由于失聪的器质性基础,器质性精神障碍在聋人中的发生率可能略高。最后,我们讨论了失聪及使用口译员可能影响聋人理解和关联法律概念及程序的方式。需要注意的是,这些问题中的许多可能源于聋人在法律事务方面缺乏经验或教育程度不足,而非精神病理学问题。

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