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Let's use those tests! Evaluations of crime-related amnesia claims Maarten J. V. Peters a b , Kim I. M. van Oorsouw a b , Marko Jelicic a b & Harald
Merckelbach a ba Department of Clinical Psychological Science , Maastricht University , Maastricht ,The Netherlandsb The Maastricht Forensic Institute, Maastricht University , Maastricht , TheNetherlandsPublished online: 21 Feb 2013. To cite this article: Maarten J. V. Peters , Kim I. M. van Oorsouw , Marko Jelicic & Harald Merckelbach (2013) Let's use those tests! Evaluations of crime-related amnesia claims, Memory, 21:5, 599-607, DOI:
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Maarten J. V. Peters1,2, Kim I. M. van Oorsouw1,2, Marko Jelicic1,2, andHarald Merckelbach1,2
1Department of Clinical Psychological Science, Maastricht University, Maastricht,The Netherlands2The Maastricht Forensic Institute, Maastricht University, Maastricht, The Netherlands
Suspects awaiting trial often claim that they cannot remember important parts of their violent crimes. It is not unusual that forensic experts readily accept such claims and interpret them in terms ofdissociative amnesia or, more specifically, a ‘‘red-out’’. This interpretation hinges on the assumption thatheightened levels of stress implicated in violent crimes interfere with memory. We argue that the notionof red-out is a priori not plausible and that alternative interpretations*primarily malingering andsubstance-induced organic amnesia*should be considered and ruled out first before concluding thatmemory loss is dissociative in nature. We illustrate our point with four cases that superficially havethe contours of red-out tragedies. We believe that, in such cases, neuropsychological tests and/orpsychopharmacological information on doseÁresponse relationships can assist forensic experts to excludemalingering or substance-induced amnesia. There is no reason for not using tests and tools fromneuropsychology and psychopharmacology.
Keywords: Crime-related amnesia; Red-out; Malingering; Neuropsychological testing; Psychopharmacology.
Defendants regularly claim that they cannot
In the DSM-IV-TR dissociative amnesia is listed
remember vital parts of the (often violent) crime
as a separate nosological category and defined as
they committed (Cima, Nijman, Merckelbach,
‘‘an inability to recall important personal informa-
Kremer, & Hollnack, 2004; van Oorsouw &
tion, usually of traumatic or stressful nature, that is
Merckelbach, 2010). This alleged memory failure
too extensive to be explained by ordinary forget-
is technically known as crime-related amnesia (e.g.,
fulness’’ (American Psychiatric Association, 2000,
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Pujol & Kopelman, 2003). Most best-practice
p. 478). Other types of amnesia are given less
guidelines stipulate that psychologists who act as
consideration in the DSM-IV-TR. For example,
expert witnesses and evaluate such claims, should
offenders may deliberately feign amnesia in
consult the scientific literature. This sounds reason-
order to obstruct police interrogation and/or to
able enough, but what if the literature offers
reduce criminal responsibility (Christianson &
speculations that are not justified by solid research?
Merckelbach, 2004). Yet malingering is not elabo-
In our view the literature on crime-related
rated in the DSM-IV-TR, and much the same is true
amnesia overvalues the plausibility of dissociative
for the various manifestations of organic amnesia,
memory loss (e.g., Moskowitz, 2004; Porter, Birt,
which are the result of permanent neurological
Yuille, & Herve´, 2001) and in doing so biases
damage (e.g., traumatic brain injury) or temporary
expert witnesses in how they handle these cases.
brain dysfunction (e.g., alcohol blackout).
Address correspondence to: Maarten J. V. Peters, Department of Clinical Psychological Science, Faculty of Psychology and
Neuroscience, Maastricht University, P.O. Box 616, 6200 MD, Maastricht, The Netherlands. E-mail: m.peters@maastrichtuniversity.nl
Swihart, Yuille, and Porter (1999) launched the
context of these crimes of passion is almost
concept of red-out. Its underlying assumption is
invariably psychogenic in origin, rather than the
that some perpetrators experience rage to such
result of alcoholic intoxication or neurological
degree that they develop memory loss for their
disease. It is likely to have been caused either by
criminal acts. The only prerequisite for a red-out
dissociation or impaired memory encoding at the
seems to be extreme emotional arousal. The term
time of the offence (secondary to intense emo-
has been cited over and over again as if it were a
tional arousal), or as a result of suppression/
well-established manifestation of amnesia (see for
repression of the painful memory and/or avoid-
examples Porter et al., 2001; Pyszora, Jaldow, &
ance of rehearsal, resulting in a failure of memory
Kopelman, 2009). There is indeed some evidence
retrieval’’ (Pyszora et al., 2003, p. 486). The fact
that the incidence of claimed amnesia increases
that fewer amnesic offenders than non-amnesic
with the severity of the violence (e.g., Bradford &
offenders denied their crime is interpreted by
Smith, 1979; Taylor & Kopelman, 1984). But does
the authors as evidence for the integrity of the
this show that extreme rage is a reliable precursor
amnesia claims. They write: ‘‘Five (2.4%) of
of genuine memory loss? Our point is that the
the amnesic offenders were suspected of having
hypothetical state called red-out is at odds with
feigned their memory loss, according to either
the well-established memory principle that people
the psychiatric assessments or the trial judge’s
remember actions better than concepts (e.g.,
report’’ (Pyszora et al., 2003, p. 483).
Zimmer, 2001), and that people remember their
This low percentage stands in sharp contrast to
own actions better than those of others (i.e., self-
the study of Cima and colleagues (2004) which
reference effect; e.g., Kesebir & Oishi, 2010).
employed a test to screen for malingered amnesia.
Furthermore, intense emotions seem to enhance
They observed in their sample of offenders
rather than undermine the encoding of episodic
who claimed crime-related amnesia that 53% of
memories (Cahill & McGaugh, 1998). There is
them failed on this test. This finding allows for a
also much evidence demonstrating that the sup-
radically different interpretation of the statistics
pression of an emotional memory makes such
provided by Pyszora et al. (2003); namely crime-
memory hyperaccessible (i.e., white-bear effect;
related amnesia as an instrumental strategy that is
Rassin, 2001; Wegner, Schneider, Carter, &
employed by offenders when there is overwhelm-
ing forensic evidence against them (and no use in
Proponents of the red-out concept seem not to
denying) and that comes with a tendency to
be bothered by the implausibilities that surround
fabricate sad stories about one’s background and
this concept. Consider the study by Pyszora,
Barker, and Kopelman (2003), who investigated
In our view, dissociative amnesia*and particu-
amnesia for criminal offences retrospectively in a
larly red-out*can best be viewed as diagnoses by
sample of 207 British inmates. They found that
exclusion. More plausible alternatives should be
29% (n 0 59) had claimed amnesia for their
eliminated first. As said, one such alternative*
offences. These claims were particularly related to
and a very prominent one is sheer malingering.
self-reported alcohol abuse, previous blackouts
Another plausible route to amnesia is drug or
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(either alcohol or dissociative), previous psychia-
alcohol intoxication. We illustrate our point by
tric problems, and crimes of passion (i.e., red-
briefly describing four cases that we evaluated as
outs). Those claiming amnesia were significantly
expert witnesses over the past few years. Super-
more likely to have used the defence of dimin-
ficially they look like red-out cases. Yet if one goes
ished responsibility, provocation, and lack of
one step deeper, the alternative interpretations
intent secondary to intoxication than offenders
become apparent and often, turn out to be more
not claiming amnesia. At 3 years post conviction
no less than 33% of the amnesic sample reportedcomplete recovery of their memories, 26% had apartial return of memories, whereas 41% said
that there was no return of memories.
Pyszora et al. (2003) relied on the differences
In 2009, 10 August began as a normal summer day
between those claiming crime-related amnesia
and those who did not as a jumping-off point
unemployed. Around 10 a.m. he took his daugh-
for speculating about the origins of crime-related
ter to ballet class, he returned to his home and
amnesia. The authors note that ‘‘Amnesia in the
started to clean up the attic. Around 11 a.m. he
descended to get a coffee. His wife was sitting
malingering*deliberate cognitive underperfor-
on the patio reading a book. While leaving the
mance and symptom exaggeration*are evaluated
kitchen Mr Cowin passed a small cabinet. There
was a hammer lying on its top. It had been used
To screen for deliberate underperformance we
for construction works. Mr Cowin picked up
the hammer, walked onto the patio, and started
test (ASTM; Schmand & Lindeboom, 2005), an-
Tombaugh, 1996). To assess symptom exaggeration
memory of what happened thereafter. But we
we employed the Structured Inventory of Mal-
have the description of Mrs Cowin. That same day
ingered Symptomatology (SIMS; Smith & Burger,
she made her first official statement to the police
1997) and the MMPI-2 validity scales (Butcher,
at the emergency room of the local hospital.
Dahlstrom, Graham, Tellegen & Kaemmer, 1989).
She remembered that she started screaming at
On the ASTM test, which is an easy passive
Mr Cowin, after which she fell on the floor.
recognition test based on floor-effect principles
(i.e., scores below the cut-off are unlikely, even inbona fide neurological patients), Mr Cowin
At that moment I could not recognise my own
scored far below the cut-off of 84/85, which raised
husband anymore. He was in a rage. I tried to
the suspicion that he was exaggerating his
talk to him. There was blood everywhere.
memory problems. Much the same was true for
I managed to put my hands between his hands.
his performance on the ToMM. In this task
All of a sudden he stopped and stood up.
participants are presented with 50 line drawings
after which they have to make oldÁnew discrimi-
blurring my sight. My hands were slippery, so
nations for 50 pairs of line drawings. Each pair
I asked my husband to dial 911 after which
contains a wrong alternative and the original line
drawing that was presented earlier (correct alter-native). The ToMM involves two repetitive series
Mr Cowin stated that from that point onwards
of such oldÁnew discriminations. On the first,
he had clear memories again: ‘‘I had blood on my
Mr Cowin only attained a score of 30 correct,
hands, so I knew I had done something to my
while on the second series, his score dropped
wife. I asked for an ambulance. I blacked out. We
to 24, a pattern that indicates deliberate under-
are in the middle of a divorce but are still living
performance. His scores on the MMPI-2 validity
together. I don’t know why I did it. My brain
scales were raised and suggested that his
tilted. The situation is tense at home due to the
responses to the clinical items could not be
divorce. I can’t remember anything’’.
interpreted in a reliable way. As for the SIMS,
The court appointed one of us as an expert
however, we found that his scores were within the
witness to evaluate the alleged memory loss of
normal range test. So he did not attempt to
Mr Cowin. At first sight his case seems to be a
present himself as a psychiatric patient with an
perfect example of a red-out scenario: intense
abundance of bizarre and atypical symptoms.
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emotional arousal due to an acrimonious divorce
In our report to the court we concluded that
dispute builds up and then explodes, leading to
Mr Cowin had deliberately underperformed on
violence and memory loss. What further supports
our memory tests and that therefore we could not
this scenario is that the family had financial
exclude the possibility that he was fabricating his
problems and Mr Cowin had kept the details of
crime-related amnesia. Mr Cowin was sentenced
Mr Cowin did not contain any clues that hismemory problems might have an organic back-
ground. However, malingering so as to reducecriminal responsibility was a distinct possibility.
Jack, Robin, and David went on a skiing trip to
So, when evaluating Mr Cowin, we included
Poland. They left their Dutch hometown around
malinger tests, thereby following the so-called
3 a.m. and arrived at their destination in the late
multi-method approach (e.g., Giger, Merten, &
afternoon of the next day after a 16-hour drive.
Merckelbach, 2010; Larrabee, 2007). The crux of
Tired but excited about their skiing trip they went
this approach is that the two basic dimensions of
to a local pub, where they consumed two bottles
of vodka and a couple of beers. When walking
criminal responsibility; van Oorsouw et al., 2004).
home the three friends quarrelled about a girl that
Yet several studies have demonstrated that, even
they met at the pub. The discussion radicalised,
at moderate dosages, alcohol has a memory-
there was a fight, and Jack was killed. Cause of
death was hypothermia and extreme loss of blood
Tollestrup, 1992; van Oorsouw & Merckelbach,
2012). It is therefore vital to systematically recon-
When the police interrogated Robin, he said
struct the alcohol dosages. Without objective
data about the precise alcohol intake, a claim ofalcohol blackout should be met with scepticism.
The blood alcohol concentration (BAC) of the
aggressive. We quarrelled about a girl we met at
offender is an important indicator for the like-
the local pub. When we arrived at our cabin,
lihood of a genuine blackout. At BACs exceeding
Jack grabbed me by the throat and attempted
to choke me. David tried to separate us, but got
(Kalant, 1996), interfering with the consolidation
punched in the face by Jack. I was terrified.
of memories (White, 2003). A reconstruction
I never experienced Jack being so violent, he
of Robin and David’s BACs at the time of the
totally lost control. I literally feared for my life.
stabbing, based on blood and breath tests con-
Jack continued to attack us. We had nowhere to
ducted by the police, yielded BAC estimates
go, we were standing in a small corridor. The
ranging between 0.18% and 0.27%. In addition
last thing I remember is Jack hitting us. After
a blurry onset, islands of memory, and shrinking
that, all is blank. My first memory is of some-
of the amnestic episode while time passes are
one calling me. It came from outside. At that
indicative of genuine amnesia (e.g., Jelicic &
moment, I was lying on the floor between the
living room and the kitchen. I got up and
reported a blurry onset, islands of memory, and
looked out the window. There was Jack, in the
later described details that they initially could not
snow, covered in blood. I was confused. What
remember. They tried to reconstruct the events,
had happened? That’s when I called the emer-
resulting in source-monitoring errors (Johnson,
Hashtroudi, & Lindsay, 1993). People who
attempt to reconstruct a blacked-out episoderegularly report such errors. Malingerers, on the
David’s last memory was about the three
other hand, are often dogmatic about their mem-
quarrelling in the corridor when he was suddenly
ory loss (Christiansson & Merckelbach, 2004).
hit in the face by Jack. His next memory is ofRobin waking him up the following morning.
They report a sudden onset, claim that they will
Jack was stabbed 25 times with a knife that was
not benefit from cues, and are reluctant to under-
later found in the kitchen sink. Both Robin and
David claimed to have no memory whatsoever of
To assess memory functioning and potential
the stabbing. Given the provocations and argu-
malingering tendencies of the defendants, we
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ments that preceded the crime, it is tempting to
administered the Verbal Learning Task (VLT;
interpret the memory loss as the manifestation of
Heslinga, van den Burg & Saan, 1983), and the
David. Both displayed normal memory function-
feature of many violent crime cases, but its role
ing on the VLT and did not underperform on the
is often overlooked (van Oorsouw, Merckelbach,
ASTM or over-endorse symptoms on the SIMS.
Ravelli, Nijman, & Mekking-Pompen, 2004).
In our report to the court we concluded that
A total of 30% to 65% of convicted violent
excessive alcohol consumption rather than red-
offenders say that they were intoxicated at the
out was most likely to be responsible for the
time of the crime (e.g., Evans, Schreiber Compo, &
memory loss of both defendants. The court of
Russano, 2009). Over a third of these offenders
appeal ruled that the threatening situation had
report problems with recollecting details of the
warranted self-defence reactions of the defen-
crime due to intoxication (Cima et al., 2004;
dants. Yet, given the disproportional and extre-
Kopelman, 1995). Of course, like dissociative
mely violent character of this reaction, the
amnesia and red-outs, a claim of alcohol blackout
court sentenced both defendants to 7 years of
may serve a strategic function (i.e., to minimise
She had a blurred memory of waking up in a
psychiatric institution. The defendant did at least
A middle-aged woman was accused of murdering
have one island of memory: She vaguely recalled
her 14-year-old daughter. She claimed amnesia
drinking coffee with a neighbour the day before
for a period of roughly 2 days: the day her
her daughter died. When asked if she would be
daughter died and most of the preceding day.
willing to undergo therapy to recover her mem-
The woman had just spent a vacation overseas
ories of the tragic events, she replied she would do
with her boyfriend. He had informed her that he
anything to understand what happened on the day
wanted to break up. The prosecutor argued that
her daughter died. Thus, it seems that the amnesia
the defendant had been unable to cope with this
of the defendant had bona fide elements (e.g.,Jelicic & Merckelbach, 2007).
crisis and had decided to take her own life and
We asked the defendant to fill out the SIMS
that of her daughter (filicideÁsuicide). According
and also administered Rey’s Complex Figure test
to the prosecutor the defendant had wanted her
(RCF; Lezak, Howieson, Bigler & Tranel, 2012),
daughter to die along with her, because the
which can be used as a test of underperformance.
biological father of the daughter (the defendant’s
On the SIMS she scored well below the cut-off for
ex-husband) was a drug addict and was unable to
malingering. Her high score on the RCF revealed
look after their child. What is known with
that her memory (at time of testing) was excel-
certainty is that a neighbour alerted the police
lent. Thus test performance of the defendant was
when she saw two bodies lying in the defendant’s
not suggestive of deliberate underperformance or
home. Paramedics were able to reanimate the
intentional over-endorsement of symptoms.
defendant, but could not revive her daughter.
What is remarkable in this case is that the
Autopsy showed that the girl had traces of
defendant reported memory loss after taking
prescription medications (sleeping pills and anti-
sleeping pills. In their review Daley, McNeil,
depressants) and butane (a gas sold in bottles as a
and Binder (2011) concluded that the ingestion
fuel for cooking and camping) in her blood. The
of zolpidem might undermine the ability to store
medical experts concluded that she had died
new information in memory. Hence it is concei-
because of asphyxia. The defendant’s blood also
vable that the defendant’s amnesia was an adverse
contained traces of medication and butane.
reaction to zolpidem ingestion. There is also a
Note that the amnesia claim fits perfectly a
possibility that her memory loss was brought about
red-out scenario. We carefully read the defen-
by a combination of paroxetine and zolpidem
dant’s file and her medical records, interviewed
(Katz, 1995). In any case, an interpretation of her
her, and also gave her tests and questionnaires.
amnesia along the lines of adverse psychopharma-
The defendant was highly educated. After college
cological effects is far more likely than one in
she completed art school and had moderate
terms of malingering or red-out. Although the
success as a sculptor. She had a history of mild
court of appeal did not reject the possibility that
depression and at the time of her daughter’s
the defendant had no memory for the eventsleading to her daughter’s death, it did find the
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death had been taking paroxetine, an SSRI
defendant guilty of premeditated murder. She was
antidepressant, for many years. Apart from
depressive episodes she had never had an illnessaffecting cognitive functioning. During the inter-view the defendant told us that a few days before
the tragic events she had been overseas with herboyfriend. Back in the Netherlands she visited her
Due an escalating conflict between his own family
general practitioner because of sleeping problems
and another family, this man had been threatened
due to jet lag. She was prescribed zolpidem,
with death. And so, some 10 years ago, he had
a nonbenzodiazepine hypnotic used to initiate
been forced to flee from Kurdistan to the
sleep. The defendant said she could remember
Netherlands. He learned Dutch, got himself a
going to the pharmacy and ingesting a zolpidem
job as a courier, and lived a quiet life, until that
pill, but was unable to recall subsequent events.
fatal summer evening in 2011. That evening his
She reported amnesia for the day her daughter
friend visited him in his flat. While he was
died and also could not remember much from the
preparing a meal the doorbell rang. His boss
was standing at the front door. He wanted to have
the parcels back that the Kurdish courier should
dant must choose between two equally plausible
have delivered that day. The Kurdish man refused
answers, one of which is correct and the other is
to hand over the parcels because the boss had not
incorrect. Again, below chance performance
paid him in the past two weeks. The boss became
indicates strategic avoidance of correct answers,
furious and alerted his son and another man who
and is therefore an indication that someone is
were waiting outside. They invaded the flat, while
intentionally not telling what he/she knows.
shouting and making intimidating movements.
In this case the defendant attained a score of 10,
The Kurdish courier stabbed the son three times
with a knife, thereby hitting him in the heart. The
In sum, then, there was not a single hint that
son stumbled outside and died right in front of the
flat. It was the Kurdish courier himself who called
amnesia. Was it a red-out? We do not think that
this diagnosis by exclusion would help us to
The police arrested him and interrogated him
understand what happened in this case. Rather
several times. During the interrogations he
we would argue that an interpretation in terms
described how his boss had been standing at the
door, the invasion of the three men, how he had
Eyewitnesses had told the police that the critical
called the police, but he consistently claimed that
incident happened in a split second, as the
he was unable to remember how he had stabbed
defendant stood in an open kitchen, close to the
the son with a knife. He added that of course he
front door, preparing a salad with a knife. Thus, at
had to be punished, but he simply could not
the moment the boss and his associates invaded
remember that he had stabbed the man with
the apartment, the defendant might have been
a knife. Did the defendant malinger his memory
caught in a double-capture slip (e.g., Reason,
loss or was it authentic? We interviewed the
1992) in which he used the knife to ward off his
defendant and administered a series of tests and
aggressors. Of course, most people do not have
tasks. His performance on standard VLT was
vivid memories of their double capture slips. They
within the normal range. His score on the SIMS
notice the fatal results, but the slips themselves
was well below the cut-off, indicating that he was
are outside awareness. However, the lack of
not trying to impress with rare symptoms.
memory that is implicated in such automatism
As a measure of deliberate underperformance
is not motivationally driven and has nothing to
do with repression or dissociation. One might
abstraction subtests of the Malingering Scale
even question whether the term amnesia is
(Schretlen, Wilkins, van Gorp & Bobholz, 1992).
appropriate at all in such cases, because that
The items of these tests involve target stimuli
term has pathological connotations. The court
(e.g., words or sequences) and for each target the
accepted our conclusion that the memory loss in
participant has to choose from two alternatives
this case was bona fide and probably had to
the one that fits best with the target (because it is
do with a fatal coincidence of preparing a meal
a synonym or because it is the next logical step in
while one is attacked. The man from Kurdistan
the sequence). The items are simple enough that
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even persons with low IQ levels can recognise thecorrect alternative. The subtests are based onthe binomial principle of forced-choice testing.
Correct responses on both subtests are totalled(range: 0Á46). Scoring 18 or less would indicate
If we, as expert witnesses, had relied on the
below-chance level (p B .05) performance. The
literature on red-outs (e.g., Bourget & Whitehurst,
defendant had a score of 42, which is far above
2007; Porter et al., 2001; Pyszora et al., 2003), we
would have concluded in the cases described above
Finally we administered a 15-item autobiogra-
that the amnesia claims were probably authentic
phical Symptom Validity Test (SVT; Merten &
and had a dissociative origin. The courts, in turn,
Merckelbach, 2012). Such an SVT involves a
might have accepted such a conclusion and would
forced-choice procedure in which the defendant
have considered diminished responsibility in these
is asked a series of questions about the details of
cases, arguing that defendants who are provoked
the purportedly forgotten episode (e.g., ‘‘How
into a state of extreme rage cannot fully control
many times was the victim stabbed? a. One time;
their behaviours (i.e., they are lured into a state of
b. Three times.’’). For each question the defen-
Clearly, in crime-related amnesia cases, the
that many people are prescribed sleep medica-
opinions provided by forensic psychiatrists or
tion, the base-rate of this type of memory loss
psychologists are often crucial in determining
may be higher than is typically appreciated.
the legal outcomes. Our point is that in crime-
Meanwhile psychopharmacologists have observed
related amnesia cases experts are well advised to
that, even in low dosages, a drug like zolpidem
define the literature they consult broadly, pre-
seriously interferes with, for example, driving
ferably including neuropsychological and psycho-
behaviour (Leufkens, Lund, & Vermeeren, 2009).
pharmacological studies. In the first case, not
red-out but rather feigned amnesia turned out
Kurdistan came closest to a red-out state. There
to be the most likely scenario. This became
were no indications for malingered memory loss,
evident only after we administered neuropsycho-
he had not been drinking heavily, and neither did
logical malingering tests. To avoid that claims of
he use any sleep medication. He was, though,
amnesia become an easy route to an automatism
provoked by his boss. But even in that case one
defence, malingering tests are necessary.
wonders what the concept of red-out*or disso-
The first case also illustrates the importance of
ciation for that matter*adds in terms of expla-
a multi-method approach while investigating
natory power. At the moment his boss and his
claims of crime-related amnesia. The rationalebehind this approach is that malingering is a
associates entered his house, the man was cooking
multidimensional phenomenon that may involve
and had a knife in his hand. Also, the threatening
nature of the situation resembled an episode in
(i.e., Iverson, 2006). Thus, during a forensic
which he had been beaten up by the police in
examination, both dimensions should be assessed
Kurdistan. Thus the man acted in a reflex-like
with tools. In simulation studies in the laboratory
manner rather than in a state of rage when he
this multi-method approach has proven to be
stabbed his boss’s son. Such a conditioning inter-
effective in identifying malingered amnesia (e.g.,
pretation allows for the possibility that people
Giger et al., 2010). Given that there are dedicated
engage in acts of transgression without con-
tests with known error rates to investigate mal-
sciously monitoring their behaviour. We think
ingered amnesia, the failure to use such tests is an
that conditioning might offer a far better account
indication that the forensic examination does not
of those rare cases of psychogenic amnesia than
meet the professional standards, a conclusion that
concepts like red-out, but this point merits further
was drawn some years ago by the neuropsycho-
research, preferably laboratory research.
logical community (e.g., Bush, Ruff, Troster,
For expert witnesses who have to evaluate
Barth, Koffler, et al., 2005; Professional Practice
crime-related amnesia cases, the literature on red-
Board of the British Psychological Society, 2009).
outs and dissociative amnesia is simply not good
Forensic psychologists and psychiatrists should
enough as a solid starting point (see also Centor,
take neuropsychological evaluations as an exam-
1982; Ornish, 2001). What expert witnesses need is
the knowledge accumulated in neuropsychology
The second case illustrates that psychopharma-
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about malingering and how to detect it. What they
cology too is an important field for expert witnesses
also need is psychopharmacology and what it says
who evaluate claims of crime-related amnesia.
about alcohol and drug intoxication in relation to
Many violent crimes are associated with alcohol
memory loss. If we, as expert witnesses, fail to
intoxication (e.g., Evans et al., 2009; Haggard-
consult these neighbouring fields we run the risk of
Grann, Hallqvist, Langstrom, & Moller, 2006). And so alcohol blackout rather than the emotional
becoming lopsided in our approach. Over the past
stress implicated in red-outs might be considered
years the psychology and law domain has generated
an important antecedent of memory loss. Psycho-
detailed knowledge about memory accounts of
pharmacology has greatly advanced our insights
offenders and witnesses (Howe, 2012). But we
into doseÁresponse relationships. For instance, we
should not become overconfident and neglect the
now know that, at intoxication levels of 0.31%,
tools that neuropsychology and psychopharmacol-
chances are 50% that an offender develops genuine
ogy offer us. Let us use those tools.
memory loss for his crime (Perry et al., 2006).
The third case makes plain that zolpidem or
the interaction between zolpidem and antidepres-
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www.rgsp.de rgsp@ptv-solingen.de extrablatt Mitteilungen der Rheinischen Gesellschaft für Soziale Psychiatrie Liebe Kolleginnen Vergessene Kinder? und Kollegen, der nebenstehende Beitrag von Prof. Kinder psychisch kranker Eltern Borg-Laufs von der Hochschule Nieder-rhein behandelt ein Thema, das unserem von Michael Borg-Laufs Eindruck nach aus Angst vor
How did you hear about Dermatology at Winslow Animal Hospital: _________________________1. Describe your pet’s skin problem (check al that apply):( ) Scratching, chewing, licking, rubbing skin( ) Other (describe) ________________________________2. Was itching the first sign of your pet’s skin disease that you noticed? ( ) Yes; ( ) No. 3. How long has your pet had this problem? ___________