A psychological autopsy (or psychiatric autopsy—the terms are used interchangeably) is a reconstructive mental state evaluation (RMSE) focused on understanding a deceased individual’s mental state at and around the time of death, typically for the purpose of identifying the cause of death (accident vs. suicide or another explanation). Norman Faberow, Robert Litman, and Edwin Shneidman are credited with developing the concept and pioneering the technique of the psychological autopsy in connection with their consultation with the Los Angeles County Coroner’s Office, which requested that they assist in determining the cause of death (i.e., suicide or accident) in a subset of “equivocal” cases.
心理尸检是一种形式的RMSE,可以被定义为专注于在早期及时挑战死者的某些方面的专家询问。精神卫生专业人员和基于RMSE的专家意见通常 - 但并非与某种类型的法律程序相关联。As such, RMSEs can be considered as a forensic evaluation or forensic inquiry the goal of which is to provide the legal decision maker (i.e., judge or jury) with information that it would not otherwise have (based on the expert’s inquiry and opinions), so that it can make a more informed and accurate decision in the legal issue at hand. For example, expert testimony regarding a deceased person’s mental state has been introduced in testamentary capacity proceedings (when a deceased individual’s capacity to execute a valid will at some prior time is at issue), life insurance and workers’ compensation litigation (when the cause of an individual’s death, including the existence of potential psychological contributors, is at issue), and criminal litigation (when the psychological state of a decedent is relevant to some aspect of a criminal proceeding). In addition, mental health professionals and mental health agencies sometimes employ psychological autopsies as a quality assurance mechanism in cases where clients commit suicide. Such inquires serve to aid in understanding what caused the suicide and identifying good or bad professional practice surrounding the person’s care, both of which are seen as having the potential to improve future care and practice.
因为感兴趣的人(即,Defedent)不可用,所以进行心理尸检的心理健康专业人员必须完全依赖于抵押品,或“第三方”信息来源,包括与熟悉兴趣个人的人的访谈;与有关时间和周围的人联系的人(例如,围绕意愿执行或死于死亡);以及对包括个人医疗保健记录,着作或通信的各种文件的审查。根据案件类型和手头的问题,可能是相关的调查领域包括(a)酒精和药物使用;(b)医疗状况和历史;(c)心理健康状况和历史;(d)经济和心理社会压力源;(e)人际关系,家庭和婚姻关系的性质和质量;(f)行为和口头和书面通信;(g)法律历史记录。
RMSE存在许多限制,其中一些也影响更常见的心理评估,包括治疗和法医评估。首先,如上所述,缺乏标准评估技术或程序增加了不可靠的评估和无效意见的可能性。其次,一个明显的限制是心理学家无法评估某些事先在某些情况下的心理状态的个人相关性(如果指出,通过访谈或管理心理测试)。第三,因为感兴趣的时间是(通常是遥远的)过去,所以可以有限的记录有限,并且可能受到审查员面谈的第三方的回忆可能会受到影响,并且由于结果可能会受到影响。Fourth, third-party informants who are interviewed by the psychologist may distort representations of the decedent’s mental state and behavior, either knowingly (e.g., because of their desire to bring about a particular outcome in a legal case, such as when a potential beneficiary intentionally denies the deceased testator’s severely impaired mental state at the time the will is executed so that the will is declared and the beneficiary receives the inheritance) or unknowingly (e.g., when a spouse fails to recognize and report the deceased spouse’s suicidal behaviors because of guilt over the death).
已经考虑了研究使用RMSE所形成的意见的可靠性和有效性的研究。当然,评估该技术的有效性是具有挑战性的,因为标准验证问题。也就是说,为了检查使用RMSE形成的意见的准确性,必须能够将形成的意见与实际的事实或结果进行比较(从未知道或已知)。由于有关使用RMSE技术所形成的意见的可靠性和有效性的有限数据,评论员建议要求被要求进行此类考试的专业人员谨慎行事,并清楚地清楚这些查询中固有的限制。
参考:
- ogloff,J. R.P.,&Otto,R. K.(2003)。心理尸检和其他回顾性精神状态评估:临床和法律问题。在I. Z. Schultz&D. O. Brady(EDS),心理伤害手册(第1186-1230页)。芝加哥:美国酒吧协会新闻。
- Poythress,N.,Otto,R. K.,Darkes,J.,&Starr,L.(1993)。APA的美国专家小组在美国国会审查中。爱荷华州事件。美国心理学家48,8-15。
- 斯科特,C.L.,&Resnick,P. J.(2006)。患者自杀和诉讼。在R. I. Simon&R.E.Hales(EDS。),自杀评估和管理教科书(第527-544页)。华盛顿特区:美国精神病出版社。