| ObjectiveThe case often involves the traumatic brain injury question in forensic psychiatry practice of the spiritual damage either the spiritual disabled civil case and the injury on job or the traffic accident. The nature and the degree of the rememberance and the intelligence damage are needed to evaluate in most cases of the traumatic brain injury. Because the case mostly involves the economic compensation and obtains some kinds of social welfare, results of the memory and intelligence appraisal make direct influence to the expert's immediate interest. Therefore, the result of memory and the intelligence test often cannot reflect their real horizon in forensic psychiatry practice with a considerable number of people identified who exaggerate the degree of the damage in the expert appraisal's process. According to the neuropsychology study of the traumatic brain injury litigation group, the withouttraumatic brain injury litigation group and the neurosis group, this topic checks the recognition capability for malingering of memory damage of patients with traumatic brain injury, enhances the discriminate level for malingering of memory damage, provides the reliable theoretical basis for the forensic psychiatry practice and the clinical appraisal of memory-related disorders.Subjects and MethodPatients of the litigation group come from Chaonan-Minsheng hospital of Shantou and forensic appraisement center of Shantou Universiry Medical College (40 cases). The without litigation group patients come from Chaonan-Minsheng hospital of Shantou (40 cases). The neurosis group is composed by neurotic patients who come from Mental health center of Shantou Universiry Medical College and Ankang hospital of Shandong province(40 cases). Each subject accepts questionnaire survey and psychology tests, which includes Scl-90, GCS, BFDMT, WAIS, MMPI-2, etc. At the same time, we record the general conditions, such as age, gender, educational level and dominant hand. The litigation group were follow up answering the RPQ , RHFUQ and clinical evaluation 6 months after injury.Results(1)There were no statistical significance in the gender and age among three groups. There were no statistically significance in the years of education between litigation group and without litigation group(P>0.05). The years of education in litigation group was significantly lower than neurosis group(P<0.05).(2)There were no statistical significance in the total score, mean value, number of positive and negative items, positive symptom average of Scl-90 between litigation group and without litigation group(P>0.05). But the average of the value of Scl-90 with litigation group was significantly lower than neurosis group(P<0.01).(3)There are statistical significance among the RPQ scores of the three groups. The RPQ scores of litigation group were significantly higher than the one followed up 6 months after injury(P<0.01).(4)The total score, the difficult score and the easy score of BFDMT of litigation group in mean was significantly lower than without litigation group (P<0.05). The total score, the difficult score and the easy score of BFDMT of litigation group in mean was significantly lower than neurosis group(P<0.01). The malingering rate was 32.5%, 5% and 12.5%. The malingering rate of litigation group was significantly higher than without litigation group and neurosis group(P<0.05).(5)There were statistical significance among groups in the full intelligence quotient, the verbal intelligence quotient and the performance intelligence quotient with WAIS in mean ( P<0.05; P<0.01). There were significant differences among groups in the normal intelligence quotien with 17 of litigation group, 31 of without litigation group and 35 of neurosis group ( P<0.01). The intelligence quotient of litigation group was mostly on the borderline. There were only 2 mild mental retardation without moderate and severe mental retardation.(6)The TTRIN scale, the TK scale and the subtle scale of MMPI-2 in mean of litigation group was significantly lower than without litigation group. The TF scale, the TFB scale, the TDS scale, the TFP scale and the obvious scale of MMPI-2 in mean of litigation group was significantly lower than neurosis group ( P<0.05; P<0.01). The TDS scale and the obvious scale of MMPI-2 in mean of litigation group was significant higher than without litigation group. The TK scale of MMPI-2 in mean of litigation group was significantly higher than neurosis group ( P<0.05; P<0.01).(7)The K scale, the Hy scale, the Pd scale, the Mf scale of MMPI-2 in mean of litigation group was significantly higher than norms group ( P<0.01). The F scale, the Hs scale, the Pt scale, the Sc scale, the Ma scale of MMPI-2 in mean of litigation group was significantly lower than norms group ( P<0.01).(8)There are significant positive correlation among K scale and the verbal factor, memory factor, verbal score, performance score, VIQ, PIQ, total score, and FIQ of the intelligence test in litigation group. There are significant negative correlation among F-K scale and the verbal factor, memory factor, verbal score, and FIQ of the intelligence test in litigation group.(9)There are significant positive correlation between TRIN scale and the memory quotient in litigation group. There are significant negative correlation between TRIN scale and the easy score in litigation group. There are significant positive correlation between F-K scale and the easy score in litigation group. There are significant negative correlation between F-K scale and the memory quotient in litigation group.(10)There are significant positive correlation among L scale and Hs scale, D scale, Hy scale, Pt scale, Sc scale, Ma scale in litigation group. There are significant positive correlation among L scale, Fb scale, Fp scale , Hs scale, D scale, Hy scale, Pd scale, Pt scale, Sc scale, and Ma scale in litigation group. There are significant positive correlation among Ds scale , Hy scale, Pd scale, Mf scale, Pt scale, Sc scale, Ma scale, and memory quotient in litigation group.Conclusions(1)The recognition rate was enhanced for detecting true memory deficit as well as dissimulation in forensic psychiatry practice with BFDMT. The total score, the difficult score and the easy score of BFDMT were useful for detecting true memory deficit as well as dissimulation. BFDMT was suitable specially for the patient of appraise difficult in the clinical evaluation as tool.(2)The patient of litigation group was not cooperated or memory deficit as well as dissimulation in WAIS. The result was not tally with the clinical evaluation. The digital scope test and the graph pieces together test of WAIS were useful for detecting true memory deficit as well as dissimulation. We are using the result to hold the cautious attitude.(3)The revisit result showed that the symptom of 6 month after head injury only then has improvement as well as, should bring to the attention in forensic psychiatry practice.(4)There are significant positive correlation among F scale, F-K scale and FIQ in litigation group. Also from another angle explanation that intelligence harm was not too serious with the camouflage ability patient, true moderate and the specific weight mental handicap patient does not have the camouflage ability, the gough dissimulation index of MMPI-2 were useful for detecting true memory deficit as well as dissimulation.(5)BFDMT, WAIS and MMPI-2 were useful for detecting true memory deficit as well as dissimulation. |
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