Simulação de esquizofrenia no Teste de Rorschach (R-PAS) / Schizophrenia simulation in the Rorschach Test (R-PAS) / Simulación de esquizofrenia en el Teste Rorschach (R-PAS)

Este trabalho teve como objetivo comparar o desempenho no Teste de Rorschach (R-PAS), de pessoas instruídas sobre os sintomas da esquizofrenia e solicitadas a responder ao Rorschach, tentando se passar por um paciente com esse diagnóstico (n = 40), com o de pacientes diagnosticados com esquizofrenia (n = 35). Os participantes responderam ao Teste de Rorschach (R-PAS), a Magical Ideation Scale (MIS) e ao Inventory of Problems-29 (IOP-29) tentando simular esquizofrenia. Os resultados das comparações entre os grupos evidenciaram diferenças estatisticamente significativas para as variáveis (Hd), An, FQo, FQu, FQ-, P, M, PEC, WSumCog, MAH, GHR e Complexity. Encontrou-se também associação positiva e de forte magnitude entre os escores obtidos no IOP-29 e os escores brutos da MIS (r = 0,73, p = 0,0001). Os achados evidenciaram que, mesmo diante das tentativas de distorção das respostas ao teste, simuladores não conseguem distanciar da própria precisão perceptiva. (AU)

This study compared the performance in the Rorschach Test (R-PAS) of people informed about the symptoms of schizophrenia and asked to respond to the Rorschach trying to impersonate a patient with this diagnosis (n = 40) with that of patients diagnosed with schizophrenia (n = 35). Participants responded to the Rorschach Test (R-PAS), the Magical Ideation Scale (MIS) and the Inventory of Problems-29 (IOP-29) trying to simulate schizophrenia. The results of the comparisons between the groups showed statistically significant differences for the variables (Hd), An, FQo, CFQ, CF-, P, M, PEC, WSumCog, MAH, GHR and Complexity. A positive and strong association was also found between the scores obtained in the IOP-29 and the gross scores of the MIS (r=.73, p=.0001). The findings show that even faced with attempts to distort the responses to the test, simulators cannot distance themselves from their perceptual accuracy. (AU)

Este estudio tuvo como objetivo comparar el rendimiento en el Test de Rorschach (R-PAS) de personas educadas sobre los síntomas de la esquizofrenia y solicitadas a responder al Rorschach, tratando de pasar por un paciente con este diagnóstico (n = 40) con el de los pacientes diagnosticados con esquizofrenia (n = 35). Los participantes respondieron al Test de Rorschach (R-PAS), a la Magical Ideation Scale (MIS) y al Inventory of Problems-29 (IOP-29) intentando simular la esquizofrenia. Los resultados de las comparaciones entre los grupos mostraron diferencias estadísticamente significativas para las variables (Hd), An, FQo, CFQ, CF-, P, M, PEC, WSumCog, MAH, GHR y Complexity. También se encontró una asociación de magnitud positiva y fuerte entre los scores obtenidos en la IOP-29 y los scores brutos del MIS (r = 0,73, p = 0,0001). Los hallazgos muestran que, incluso frente a los intentos de distorsionar las respuestas del test, los simuladores no son capaces de distanciarse de su precisión perceptiva. (AU)

Simulação de sintomas e transtornos mentais: uma revisão crítica do fenômeno para a psicologia / Symptoms and mental disorders simulation: a critical revision of the phenomenon for psychology / Simulación de síntomas y trastornos mentales: una revisión crítica del fenómeno de la psicología

A "arte de simular" com objetivo de obter ganhos tem se inserido em diversos contextos, desde situações do dia-dia até processos cíveis e criminais. É difícil delimitar fatores para definir sua presença, manifestando-se como um contínuo. Assim, sua avaliação consiste identificá-la como um fenômeno complexo, multidimensional e multifacetado que requer abordagem biopsicossocial. Ou seja, é um tema que requer atenção de todos os profissionais que lidam com ele. O presente estudo objetiva uma revisão crítica da literatura disponível sobre o problema na área da Psicologia. Realizou-se uma pesquisa nas principais bases de produção acadêmica utilizando os verbetes: "simulação", "sintomas" e "transtornos mentais". Encontrou-se 508 publicações, porém, somente 20 publicações atenderam os critérios de relevância. Neste sentido, é notória a escassez de publicações na área e pouca visibilidade do tema, principalmente no Brasil. Torna-se imperativo que esse tema seja mais pesquisado e que conquiste espaço na formação e na prática do psicólogo devido a sua importância e consequências.

The "art of simulating" in order to obtain advantages can be found in various contexts, from day to day situations to civil and criminal cases. Its prevalence varies according to the context and type of simulation, with higher rates in the prison context. It is difficult to delineate specific factors to define its presence, manifests itself as a continuum, and it is necessary to recognize the various scenarios where it occurs. The evaluation is a complex, multidimensional and multifaceted phenomenon that requires a biopsychosocial approach. The aim of this study was a critical review of the available literature on the subject in the area of psychology. Was conducted a survey in major academic production bases using the entries: "simulation", "symptoms" and "mental disorders". It was found 508 publications; however, only 20 publications met the relevancy criteria. Considering this, there are very few publications in the area and a little visibility for this theme, especially in Brazil. It is imperative that this theme be further researched, conquering space in the formation and in the psychologist's practice because of its importance and consequences.

El "arte del engaño" con fin de obtener ganancias se ha insertado en varios dominios, desde situaciones del día a día hasta los procesos civiles y criminales. Es difícil identificar los factores específicos para delimitar su presencia. Manifiestase en un continuo, siendo necesario reconocer los diferentes escenarios donde el mismo ocurre. Así, su evaluación consiste en la identificación de un fenómeno complejo, muldimensional y multifacético que requiere un abordaje biopsicosocial. En este sentido, la ausencia de tal práctica y su realización cuidadosa constituyese en un desafío y un recto para todos que trabajan con el fenómeno. Este artículo tiene como objetivo hacer una revisión crítica de la literatura disponible sobre el tema en Psicología. Se ha realizado una búsqueda en las principales bases de producción académicas utilizando las entradas: "simulación", "síntomas" y "trastornos mentales". Encontraranse 508 publicaciones, sin embargo, sólo 20 de las encontradas cumplían los criterios de pertinencia. Así, hay pocos estudios en el área y baja visibilidad, especialmente en Brasil. Es imprescindible que este asunto sea investigado más profundamente y conquiste espacio en la formación y la práctica del psicólogo debido a su importancia y consecuencias.

Revisión de dos instrumentos de simulación neurocognitiva y su utilidad en el contexto forense / Review of the neurocognitive malingering instrument and its useful in a forensic contex

Gran parte de la precisión de la evaluación neuropsicológica, depende que los instrumentos que utiliza, sean medidas estandarizadas, válidas y confiables. Sin embargo, la simulación, la exageración y el bajo esfuerzo son aspectos que pueden interferir en los resultados de los test. El objetivo de esta revisión pretende describir y analizar dos instrumentos en el contexto de la Neuropsicología Forense que evalúan simulación de síntomas cognitivos: el Test of Memory Malingering (TOMM) y el Victoria Symptoms Validity Test (VSVT). Se realizó una búsqueda dirigida no exhaustiva, en diversas bases de datos y libros afines. El criterio de inclusión fue la utilización o revisión de los test. Se seleccionaron 68 trabajos publicados. Cada uno de los cuales fue analizado en base a las características técnicas de los instrumentos. La revisión ha demostrado que el TOMM y el VSVT son instrumentos pertinentes para valorar simulación y exageración de sintomatología cognitiva. Estos instrumentos cuentan con un cúmulo de investigaciones que avalan sus propiedades, pero también las limitaciones y restricciones de su utilización.

Most of the accuracy in neuropsychological assessment depends that the instruments used are standardized, valid and reliable measures. However, malingering, exaggeration and poor effort are aspects that can interfere with the interpretation of the results. The aim of this review was to describe and analyze two instruments in the context of forensic neuropsychology that assess malingering of cognitive symptoms: Test of Memory Malingering (TOMM) and Victoria Symptoms ValidityTest (VSVT). Several scientific databases and related books were searched non-exhaustively. The criterion for inclusion in this review was the use of test. We selected 68 documents, each one was analyzed based on the technical characteristics of the instruments. Review showed that the TOMM and VSVT are relevant instruments for assessing malingering and exaggeration of cognitive symptoms. These instruments have several evidence that support their psychometric properties but also limitations and restrictions on their use.

Calabash pregnancy: a malingering response to infertility complicated by domestic violence / Embarazo de calabaza: una respuesta de fingimiento a la infertilidad complicada con violencia doméstica

This is a case report of a 20-year old para 0+0 who presented with an 11-month pregnancy. On evaluation, the pregnancy was found to be a fake made-up 'calabash pregnancy There were no pregnancy symptoms and she had just menstruated three weeks prior to presentation. This was a deliberate event in response to delayed pregnancy attainment complicated by domestic violence. Domestic violence was in the form of verbal and physical abuse and later was on a monthly basis precipitated by onset of her menstrual flow. The patient's age, monogamous union and the fact that she is an orphan made her vulnerable to domestic violence.

Éste es un reporte de caso de una para 0 + 0 de 20 anos de edad, que se presentó con un embarazo de 11 meses. En la evaluación, se encontró que se trataba de un embarazo de calabaza, es decir, inventado, fingido. En realidad, no había ningún síntoma de embarazo, y había tenido la menstruación tres semanas antes de presentarse. Se trataba de un acontecimiento deliberadamente construido, en respuesta a una largamente demorada expectativa de lograr un embarazo, complicada con violencia doméstica. La violencia doméstica seproducía enforma de abuso verbalyfísico, precipitándose luego mensualmente con la aparición de cadaflujo menstrual. La edad de los pacientes, la unión monógama, y el hecho de que era huérfana, la hacía vulnerable a la violencia doméstica.

Application of contrast vision in identifying the malingering decreased vision / 法医学杂志

OBJECTIVE@#To study the application value of contrast vision in identifying the malingering decreased vision in the practice of clinical forensic medicine.@*METHODS@#Thirty-one young and middle aged volunteers were selected and divided randomly into group 1 (16 persons with 32 eyes) and group 2 (15 persons with 30 eyes). The optotype contrast was 100%, 25%, 10% and 5%, respectively. The contrast vision of group 1 was tested. The contrast vision of group 2 was tested as follows: (1) the volunteers cooperated without inspector's interference; (2) the volunteers cooperated under inspector's interference; (3) the volunteers disguised decreased vision without inspector's interference; (4) the volunteers disguised decreased vision under inspector's interference. The data was then analyzed by statistics.@*RESULTS@#There was a close correlation between contrast vision and contrast. As the contrast decreased, the vision acuity also decreased. The contrast vision curve of former two methods showed a good reproducibility while the contrast vision curve of latter two methods had a bad reproducibility.@*CONCLUSION@#The repetition of contrast curve with or without inspector's interference can be used to discriminate malingering vision. The acquired contrast curves can be provided to the court as direct evidence and can help enhance the verification conclusion.

The investigation of event-related brain potentials in malingered neurocognitive deficit / 法医学杂志

In the fields of judicial psychiatric identification, about 40%-60% of the people maybe exaggerate their injury for personal profit. Though some psychological tests are effective in identification, they are limited in cunning liars. This article summarizes previous experimental mode, results and effects of event-related potential (ERP) in detecting cognitive malingering. ERP technology can be highly sensitive and specific. It is a kind of objective physiological index and is a promising technology in detecting cognitive malingering.

An examination of the self-reported scale of brief psychopathological symptoms to detect malingering in forensic psychiatric subjects / 法医学杂志

OBJECTIVE@#To examine the self-reported scale of brief psychopathological symptoms (SBPS) to detect malingering in forensic psychiatric cases.@*METHODS@#Two hundred and six cases with different types of psychiatric problems were tested by SBPS. All cases were separately evaluated by two experts.@*RESULTS@#About 34.5% cases (71/206) were classified as malingering by the cut-off 13 scores of SBPS. Compared with expert's evaluation, SBPS showed a false negative rate of 19.8% and a false positive rate of 1.7%, respectively, with a total accuracy rate of 90.8%. Cases involved in compensations including working injury and traffic accidence showed the highest rate of malingering (51%).@*CONCLUSION@#SBPS is useful for detecting malingering psychopathological symptoms.

Technical development of detecting deception / 法医学杂志

Polygraph, as a traditional lie detector, is used to detect lies by some changes of human peripheral neuro-vegetative responses. The reliability of this technique, which depends on some other none-instrumental factors to a great extent, has drawn lots of attention and question. Event related potentials (ERPs) have good specificity and time resolution and can monitor instant cognitive processing and brain electric activity. However, its space resolution is poorer than brain function nuclear magnetic resonance imaging (fMRI) relatively. Brain fMRI can show the brain functional changes directly. It has good space resolution but bad time resolution, and all images of fMRI are just the final results of brain changes after lying. So, fMRI technique for detecting deception is still in the basic research phase at present. Contrary to other techniques, psychometrics has been used and studied more in detecting deception or malingery in practice.

Aspectos comportamentais das síndromes de dor crônica / Behavioral aspects of chronic pain syndromes

O conhecimento dos mecanismos biológicos da dor não é suficiente para a compreensão das síndromes de dor crônica frequentemente encontradas pelos neurologistas, como lombalgias, cervicobraquialgias e mialgias, nas quais nenhuma anormalidade significativa é encontrada. Aspectos psicológicos, como distúrbios do humor e ansiedade, e aspectos sociais, como ganhos secundários do tipo aposentadorias e indenizações, podem ter papel relevante na iniciação e perpetuação dos sintomas. Fatores psicológicos e sociais produzem um comportamento de doença anormal, caracterizado basicamente por uma desproporção entre sinais objetivos escassos, queixas exacerbadas e alegação de incapacidade. A identificação de um comportamento de doença anormal, através da observação e avaliação dos comportamentos dos pacientes, é um método válido e útil para fins diagnósticos e quanto a natureza das queixas. O médico deve agir de modo a não reforçar as convicções organicistas dos pacientes, orientando-se quanto à propedêutica e tratamento pelos sinais objetivos e não pelo vigor das queixas e alegação de incapacidade. A sociedade deve também abster-se de adotar políticas que estimulam comportamentos de doente anormais.

Síndrome de Münchhausen: laparotomofilia migrans: informe de dos pacientes / Münchhausen's syndrome: laparatomaphilia migrans: report of two patients

Se presentan dos casos de pacientes con múltiples antecedentes patológicos y particularmente quirúrgicos que habían sido atendidos en diferentes hospitales por diferentes grupos médicos y que consultaron supuestamente por persistencia de problemas derivados de cirugías previas. En ambos se demostró la falsificación de información médica con el único objetivo de encontrarse bajo el cuidado médico sin tratar de obtener ninguna ganancia secundaria. A este padecimiento ficticio o facticio se le conoce como síndrome de Münchhausen en su variedad de laparatomofilia migrans. Este síndrome ocasiona múltiples internamientos hospitalarios con estudios y procedimientos innecesarios. En estos casos llamó la atención la multiplicidad de procedimientos quirúrgicos a los que estas pacientes se habían sometido e intentaban someterse a otros más. Consideramos que el médico y en particular el cirujano debe conocer esta entidad con el objeto de detectar oportunamente a esos pacientes.