Dissociative state and competence.
This report presents the results of forensic evaluation of the civil competence of a case of alleged dissociative identity disorder (DID) and discusses whether such dissociative states substantially jeopardize civil competence. A 40-year-old woman claimed that she had had many personalities since her college days. From the age of 37 to 40, she shopped excessively, which left her with millions of dollars of debt. She ascribed her shopping to a certain identity state, over which she had no control. (In this article, we use the term identity state to replace personality as an objective description of a mental state.) She thus raised the petition of civil incompetence. During the forensic evaluation, it was found that the identity states were relatively stable and mutually aware of each other. The switch into another identity state was sometimes under voluntary control. The subject showed consistency and continuity in behavioral patterns across the different identity states, and no matter which identity state she was in, there was no evidence of impairment in her factual knowledge of social situations and her capacity for managing personal affairs. We hence concluded that she was civilly competent despite the claimed DID. Considering that the existence and diagnosis of DID are still under dispute and a diagnosis of DID alone is not sufficient to interdict a persons civil right, important clinical and forensic issues remain to be answered.
Lin
Yu-Ju
YJ
Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan.
Hsieh
Ming-Hsien
MH
Liu
Shi-Kai
SK
D000328:Adult; D004213:Dissociative Disorders / Q000523:psychology*; D005260:Female; D005555:Forensic Psychiatry; D006801:Humans; D016743:Mental Competency / Q000331:legislation & jurisprudence*; D013624:Taiwan