Citation

Bourget D, Gagne P, Wood SF. J. Am. Acad. Psychiatry Law 2017; 45(2): 147-160.

Affiliation

Drs. Bourget and Wood are forensic psychiatrists, Integrated Forensic Psychiatric Program, Royal Mental Health Centre, and Dr. Bourget is Associate Professor of Psychiatry, and Dr. Wood is a lecturer in psychiatry, University of Ottawa, Ottawa, Ontario, Canada. Dr. Gagné is Associate Professor of Psychiatry, University of Sherbrooke, Sherbrooke, Québec, Canada.

Copyright

(Copyright © 2017, American Academy of Psychiatry and the Law, Publisher American Academy of Psychiatry and the Law)

DOI

unavailable

PMID

28619854

Abstract

Claims of amnesia and dissociative experiences in association with a violent crime are not uncommon. Research has shown that dissociation is a risk factor for violence and is seen most often in crimes of extreme violence. The subject matter is most relevant to forensic psychiatry. Peritraumatic dissociation for instance, with or without a history of dissociative disorder, is quite frequently reported by offenders presenting for a forensic psychiatric examination. Dissociation or dissociative amnesia for serious offenses can have legal repercussions stemming from their relevance to the legal constructs of fitness to stand trial, criminal responsibility, and diminished capacity. The complexity in forensic psychiatric assessments often lies in the difficulty of connecting clinical symptomatology reported by violent offenders to a specific condition included in the Diagnostic and Statistical Manual of Mental Disorders (DSM). This article provides a review of diagnostic considerations with regard to dissociation across the DSM nomenclature, with a focus on the main clinical constructs related to dissociation. Forensic implications are discussed, along with some guides for the forensic evaluator of offenders presenting with dissociation.

© 2017 American Academy of Psychiatry and the Law.

Language: en