Dissimulation in forensic psychiatric evaluations, a case-control study of the Millon Clinical Multiaxial Inventory-III.

The possible tendency of subjects to decrease, hide, or omit symptomatic aspects of their mental functioning is one of the main problems in forensic psychological and psychiatric evaluations. We aimed at verifying the possible existence of significant differences in the Millon Clinical Multiaxial Inventory-III (MCMI-III) scales scores between a sample of dissimulators (n = 40) and their non-dissimulator counterpart matched by age, sex, and diagnosis. Cases and comparisons were retrieved from the archive of a single university forensic psychiatric centre between 2013 and 2022. Results showed statistically significant higher scores in the sample of dissimulators in the Desirability, Histrionic, Narcissistic, and Compulsive MCMI-III scales than in the comparison sample. Point biserial correlation test disclosed a strong positive correlation between the Desirability, Histrionic, Narcissistic, and Compulsive scales of the MCMI-III and being in the dissimulator group of subjects while a negative correlation emerged for all the other scales except drug dependence. Key points: The forensic setting can affect a subject's behaviour.Dissimulation is a mechanism of minimization or concealment of a psycho-pathological condition.The MCMI-III can be a useful tool for a forensic psychiatrist or forensic psychologist in assessing dissimulation.

Violent patients: what Italian psychiatrists feel and how this could change their patient care.

The study takes a detailed look at psychiatric patient violence towards their psychiatrists. It takes into consideration the views and opinions of Italian psychiatrists, whether they have experienced violent behaviour first hand and, if so, which type of aggression and whether this caused them to modify their behaviour towards the patient and his or her treatment. A multiple-choice questionnaire is sent to all members of the Italian Society of Psychiatry, with 1,202 psychiatrists responding (20.23% of the sample). The data are evaluated using SPSS with chi-square test calculations for discrete and continuous variables and t-testing for independent samples (significance p < .05). Almost all psychiatrists (90.9%) have experienced verbal aggression; 72% have been threatened with dangerous objects and 64.58% have suffered physical aggression. Physical aggression experiences result in a 50% increase in the probability of modifying one's therapeutic behaviour. Significant differences emerge between the psychiatrists, according to differences in age and career experience. Psychiatrists state that they do not consider themselves to be adequately prepared to deal with the violence of patients, and almost all psychiatrists felt the need for specific training in how to manage such violence.