精神疾病司法鉴定中精神病患者防御方式结果对照分析

目的探索精神疾病司法鉴定中精神病患者的防御方式及与责任能力评定的关系。方法对2006年10月～2007年11月进行的精神疾病司法鉴定案例中的被鉴定人进行一般资料收集、责任能力判断、防御方式测查,共收集精神病患者70例,正常者34例。然后,进行对照分析。结果精神病患者与正常者之间在防御方式结果上无显著差异,分值均较高。结论进行精神疾病司法鉴定的被鉴定人有类似的防御方式。在司法鉴定阶段,防御方式测试是一个不敏感的测试工具。     

How Do Scientists Respond to Anomalies? Different Strategies Used in Basic and Applied Science

We conducted two in vivo studies to explore how scientists respond to anomalies. Based on prior research, we identify three candidate strategies: mental simulation, mental manipulation of an image, and comparison between images. In Study 1, we compared experts in basic and applied domains (physics and meteorology). We found that the basic scientists used mental simulation to resolve an anomaly, whereas applied science practitioners mentally manipulated the image. In Study 2, we compared novice and expert meteorologists. We found that unlike experts, novices used comparison to address anomalies. We discuss the nature of expertise in the two kinds of science, the relationship between the type of science and the task performed, and the relationship of the strategies investigated to scientific creativity.     

Peut-on tuer (violer) par procuration ? Traumatisme et transmission transgénérationnelle

This article considers the possibility that some delictuous acts or crimes in the family can be unconsciously induced in the author by a member of his family. Several clinical examples are presented including one concerning an adolescent who seriously beat his cousin, resulting in her death. Although the adolescent acted on his own, he also unconsciously repeated the story and the problem configuration of his mother. The principal works concerning the process of inter- and transgenerational transmission of phenomena of maltreatment and of traumatism are recalled. Mutual projective identification seems to be at work. The article ends with a plea for the investigation (court-ordered appraisal) and taking in charge of the family group as a whole, and not only the perpetrator.     

Behavioral and electrophysiological evidence for configural processing in fingerprint experts

Visual expertise in fingerprint examiners was addressed in one behavioral and one electrophysiological experiment. In an X-AB matching task with fingerprint fragments, experts demonstrated better overall performance, immunity to longer delays, and evidence of configural processing when fragments were presented in noise. Novices were affected by longer delays and showed no evidence of configural processing. In Experiment 2, upright and inverted faces and fingerprints were shown to experts and novices. The N170 EEG component was reliably delayed over the right parietal/temporal regions when faces were inverted, replicating an effect that in the literature has been interpreted as a signature of configural processing. The inverted fingerprints showed a similar delay of the N170 over the right parietal/temporal region, but only in experts, providing converging evidence for configural processing when experts view fingerprints. Together the results of both experiments point to the role configural processing in the development of visual expertise, possibly supported by idiosyncratic relational information among fingerprint features.     

精神病司法鉴定中分裂症患者MMPI结果对照分析

目的 探讨精神病司法鉴定中分裂症患者MMPI结果的特征。方法 在我院2004年～2005年鉴定中的刑事案例中，分成分裂症组34例和未见精神病性症状组30例，并设罪犯对照组和正常人对照组，收集一般资料，完成MMPI，并对数据进行统计学处理。结果 四组的MMPI结果彼此间存在统计学显著性差异。结论 伴有危害行为的分裂症患者的MMPI结果具有特征性。     

Dwelling with Alison: a reflection on expertise

Reflection is always purposeful toward realising expert practice. Yet how might expertise be recognised? Using a narrative approach, Benner, Tanner and Chesta (Expertise in nursing practice. Springer Publishing, New York, 1996) explicated a model of expertise that offers the practitioner a useful framework to reflect on their expertise which I do using my own narrative of dwelling with Alison, given that expert practice must be the concern of every practitioner.     

Neuropsychology and forensic assessment in brain injured patients

Neuropsychology, which deals with the relationships between upper mental functions and brain structures is directly involved with psychiatric and psychological disorders and thus constitutes one of the major domains of cognitive sciences. The impairment of upper mental functions is evident after severe brain injuries causing significant motor deficits. However, it is becoming increasingly evident that even mild or moderate brain injuries can cause sequelae which are difficult to analyze and quantify clinically. These sequelae constitute an "invisible handicap" which may greatly interfere with the patient's professional, relational and social life. The neuropsychological evaluation must be systematic and complete and has to be carried out with a sufficient hindsight (two to three years after the trauma) using neuropsychological and behavioural deficiency evaluation scales. Psychometric tests are also necessary. The data obtained from this evaluation must be correctly interpreted and constitutes the main exhibit in the forensic examination of the brain injured patient.     

Primary needle-knife fistulotomy for preventing post-endoscopic retrograde cholangiopancreatography pancreatitis: Importance of the endoscopist’s expertise level

BACKGROUNDNeedle-knife fistulotomy (NKF) is used as a rescue technique for difficult cannulation. However, the data are limited regarding the use of NKF for primary biliary cannulation, especially when performed by beginners.AIMTo assess the effectiveness and safety of primary NKF for biliary cannulation, and the role of the endoscopist’s expertise level (beginner vs expert).METHODSWe retrospectively evaluated the records of 542 patients with naïve prominent bulging papilla and no history of pancreatitis, who underwent bile duct cannulation at a tertiary referral center. The patients were categorized according to the endoscopist’s expertise level and the technique used for bile duct cannulation. We assessed the rates of successful cannulation and adverse events.RESULTSThe baseline characteristics did not differ between the experienced and less-experienced endoscopists. The incidence rate of post-endoscopic retrograde cholangiopancreatography (ERCP) pancreatitis (PEP) was significantly affected by the endoscopist’s expertise level in patients who received conventional cannulation with sphincterotomy (8.9% vs 3.4% for beginner vs expert, P = 0.039), but not in those who received NKF. In the multivariable analysis, a lower expertise level of the biliary endoscopist (P = 0.037) and longer total procedure time (P = 0.026) were significant risk factor of PEP in patients who received conventional cannulation with sphincterotomy but only total procedure time (P = 0.004) was significant risk factor of PEP in those who received NKF.CONCLUSIONPrimary NKF was effective and safe in patients with prominent and bulging ampulla, even when performed by less-experienced endoscopist. We need to confirm which level of endoscopist’s experience is needed for primary NKF through prospective randomized study.