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Let's use those tests! Evaluations of crime-related
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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This article may be used for research, teaching, and private study purposes. Any substantial orsystematic reproduction, redistribution, reselling, loan, sub-licensing, systematic supply, or distributionin any form to anyone is expressly forbidden. Terms & Conditions of access and use can be found at 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, Downloaded by [University of Maastricht] at 02:37 03 December 2013 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: firstname.lastname@example.org 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 Downloaded by [University of Maastricht] at 02:37 03 December 2013 (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.
Downloaded by [University of Maastricht] at 02:37 03 December 2013 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 Downloaded by [University of Maastricht] at 02:37 03 December 2013 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 Downloaded by [University of Maastricht] at 02:37 03 December 2013 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 Downloaded by [University of Maastricht] at 02:37 03 December 2013 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- Downloaded by [University of Maastricht] at 02:37 03 December 2013 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).
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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? ___________