Individuals can carry out complex activity while in a state of impaired consciousness, a condition termed "automatism". Consciousness must be considered from both an organic and a psychological aspect, because impairment of consciousness may occur in both ways. Automatism may be classified as normal (hypnosis), organic (temporal lobe epilepsy), psychogenic (dissociative fugue) or feigned. Often painstaking clinical investigation is necessary to clarify the diagnosis. There is legal precedent for assuming that all crimes must embody both consciousness and will.
As clinicians become more sophisticated regarding MPD, we can expect many more cases to come to the court's attention, especially among violent offenders. This is because violence and MPD have very similar origins in early extraordinary physical and sexual abuse. As offenders become more knowledgeable, we can also expect to encounter more and better malingering. At this time, however, we are far more likely to overlook the problem than we are to overdiagnose it. Why is it that MPD is recognized so infrequently in the offender population?
In this article I have addressed the possibility of iatrogenesis and/or malingering of MPD in 19 individuals who were charged with homicide. Due to the fragmentary nature of most of these case reports, it is not possible to state definitively who had genuine MPD and who did not. There is a strong possibility that a substantial proportion were malingering, however, because of their rather atypical presentations.
The International Journal of Clinical and Experimental Hypnosis
Thirty real, hypnotized subjects and 34 simulating, unhypnotized subjects were given either a suggestion to respond when they heard a cue (general) or a suggestion to respond when they heard a cue after hypnosis (posthypnotic). Half the subjects were given the cue during hypnosis (hypnotic test) and half were given it after hypnosis (posthypnotic test). Those who were given the cue during hypnosis were also given it after hypnosis. Between- and within-group comparisons were made of subjects' behavioral responses, latencies to respond, and ratings of experiential compulsion.
Journal of Manipulative and Physiological Therapeutics
This article details how to identify and treat the malingering patient, which we feel is seen more often than was originally thought in chiropractic practice. A historical perspective of a malingering vs. a factitious personality is examined. The factitious patient is reviewed in detail with special attention to the classic case of Munchausen syndrome. An extensive treatment plan is discussed, including short- and long-term care. The common characteristics, objective tests and studies are reviewed.