期刊
EUROPEAN PSYCHIATRY
卷 23, 期 4, 页码 309-314出版社
ELSEVIER FRANCE-EDITIONS SCIENTIFIQUES MEDICALES ELSEVIER
DOI: 10.1016/j.eurpsy.2007.09.001
关键词
Munchausen syndrome by proxy; fabricated or induced illness; miscarriage of justice; fMRI; ventrolateral prefrontal cortex; anterior cingulate cortex; response time; factitious or induced illness; lies; truth
类别
'Munchausen's syndrome by proxy' characteristically describes women alleged to have fabricated or induced illnesses in children under their care, purportedly to attract attention. Where conclusive evidence exists the condition's aetiology remains speculative, where such evidence is lacking diagnosis hinges upon denial of wrong-doing (conduct also compatible with innocence). How might investigators obtain objective evidence of guilt or innocence? Here, we examine the case of a woman convicted of poisoning a child. She served a prison sentence but continues to profess her innocence. Using a modified fMRI protocol (previously published in 2001) we scanned the subject while she affirmed her account of events and that of her accusers. We hypothesized that she would exhibit longer response times in association with greater activation of ventrolateral prefrontal and anterior cingulate cortices when endorsing those statements she believed to be false (i.e., when she 'lied'). The subject was scanned 4 times at 3 Tesla. Results revealed significantly longer response times and relatively greater activation of ventrolateral prefrontal and anterior cingulate cortices when she endorsed her accusers' version of events. Hence, while we have not 'proven' that this subject is innocent, we demonstrate that her behavioural and functional anatomical parameters behave as if she were. (c) 2007 Elsevier Masson SAS. All rights reserved.
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