Let’s say I’m a psychiatrist and have got a patient with total amnesia on my hands, but I’m suspecting he’s faking it. Of course I’ll question him and so on, try to get him to say too much, monitor his reactions to spoken names, described situations and so on, but is there a more hands-on way to do it? There is the polygraph, of course, but I’d like something a bit more credible.
For example, if I were to rig up an EEG and then show the patient images of his wife, his home and similar well-known things, would his recognition show up on the EEG?
Actually, one of the tests for faking in Anterograde amnesia is fairly simple.
Anterograde amnesia is where loss of memory following the trauma/injury occurs. Here information cannot be transferred from short-term to long-term memory. So, to test for malingering, what is done is that the doctor (psychiatrist, whatever) holds a coin in his hand in front of the patient. After a certain time interval has passed, he asks the patient which hand the coin was in. Based on chance, most actual patients end up answer correctly about 50% of the time. Those faking amnesia tend to “inflate” their supposed memory loss and end up giving the wrong answer significantly more often than 50% of the time. This procedure, by the way, has been statistically verified and validated often, and is also admissible in court. There many other such tests that tap visual memory loss, sensory memory loss, etc.
I’ll have to check up about Retrograde amnesia, though. Can’t for the life of me remember.
I got the impression from a class I took in learning and memory that the sort of full retrograde amnesia portrayed in TV and movies doesn’t really happen. I’m speaking of the “Who Am I?” variety here. Retrograde amnesia affects a limited time prior to the trauma, never the entire life of an individual.
Of course I’ve been wrong before (Twice!), but I remember the prof emphasizing the lack of any clinical data on amesias of this kind. It assumes, of course, that the patient was mentally intact before the trauma. If they had profound personality disorders prior to the event then all bets are off.
I can see a sevearl of “issues” with this procedure, including:
The trials would have to be repeated many times to get a statistically significant sample (off the top of my head I’d say 100+ trials) – given that each must allow enough time to elapse for the subject to forget (and how long is that?), it seems unduly time-consuming.
How could the tester ensure against giving unconscious cues to the subject, these would have unknown effects on a malingerer, but could have huge effects on the “integrity” of the results achieved with an amnesiac.
It could be argued that there may be a complex of disorders, that interrelate in such a way that explains any undue prevalence of “misses” (who knows what’s going on in the unconscious mind of an amnesiac?)
I’ve often wondered if it’s possible to fake the “who am I?” form of amnesia and get away with it … it’s not like they can do a blood test to prove you’re not amnesiac
This isn’t directly on point, but for whatever it’s worth:
Back around 1990 a man in St. Louis County, Missouri, expressed his chagrin over the course his divorce proceedings were taking by bringing a handgun with him to court and attempting to kill his wife, her attorney, his attorney, and the judge. It was apparently his considered opinion that he should be getting a better shake from the court on account of how he was so good and kind and rational.
Ever since then courthouses in Missouri have been equipped with metal detectors at the entrances, and I have gotten stuck in line behind a whining yahoo who is complaining to the guards that he should have been given some notice that he couldn’t bring his jackknife and his tear gas in with him besides all of those big signs outside of the building and in the lobby.
His trial was delayed a long while as he insisted he had amnesia with respect to the day of the shootings. His claims were ultimately rejected when it was found he could recall a great many things from that day and the days leading up to it, but only if they weren’t incriminating.
I think “amnesia” is mainly a BS condition. I can see a player in a football game “getting his block” knocked off and the player might not know where he is. But I have never heard of a case of long term amnesia ever, outside of the soap operas.
If someone had total amnesia, they would forget everything, how to speak, use the bathroom, anything. It would be like your a baby again.
Of course, I am not a psychiatrist. Nor unlike the famous Dr. Jethro Bodine of Beverly Hills, am I a brain surgeon.
So what’s retrograde amnesia? I though that was permanent and involved a person knowing how to walk, talk, read & write etc, but they have no memory of people, places, names etc … ?
Hanley, J., Baker, G., and Ledson, S. (1999) Detecting the faking of amnesia: A comparison of the effectiveness of three different techniques for distinguishing simulators from patients with amnesia, Journal of Clinical and Experimental Neuropsychology, 21, 59-69.
From the abstract…
For the record, I do not know what the distraction/no distraction test is, and I can only guess as to the word fragment completion test (based on my undergraduate knowledge of psycholinguistics).
As to the no. of trials for the coin test, yes, definitely multiple trials are used, otherwise there would be no reliability. Unconscious cues can be controlled because we are talking about researchers/practitioners who have based their entire careers on learning to control this kind of stuff. And finally, when a person is brought in with amnesia, they are also tested for other issues. If you go to your doctor with a flaming high fever, it’s likely they’ll ask for some exploratory or confirmatory blood work in order to understand the aetiology of your problem. Similarly for psychological problems. So it is unlikely that the person comes in saying they have amnesia, and the psychiatrists say “Oh you do? Well okay then.” and leave it at that.
Now, about tests for retrograde amnesia, I did some research. There are tests that rely both on the organic, as well as the non-organic approach. On this page, if you scroll down, you will see some interesting case studies. Apparently, one of the battery of tests administered to check for memory loss is a “famous face” recognition/recall test. Most of the retrograde amnesiacs performed pretty much around chance level at these.
As for those who fake, well, I could find no information. I’m assuming that besides these tests, there are questionnaire batteries, EEGs, PET scans, fMRIs etc that are also used depending on the nature of the case. Which brings me to the point that amnesia of any sort is very, very subjective, and there can be many intricate differences between two cases. As such, it is impossible to say that the rate of detection of malingering is 100%.
Finally, crazy grady, “soap opera amnesia” is indeed bullshit, but only to a point. There is a condition called global amnesia where you do end up asking “Where am I”. It should be noted that there is usually no loss of personal identity…one’s name is remembered. Also, semantic memory (meanings of words and objects, how the world generally works), metamemory (memory of what you are supposed to know) and procedural memory (memory for skills and how to do things) remain unimpaired. You could http://schatz.sju.edu/neuro/disorders/tga.html]look here for more extensive information, if you are interested. (Oh yes, SEX is one of the triggers for this, apparently! :eek: )
Interestingly enough, there is a more generalized form of amnesia where the person even forgets their name, but I’m too exhausted to go look for info now.
Trying to read between the lines of the quote you gave, the patients with amnesia “performed excellently”? So, they weren’t “forgetting” at all? But 19 of the “simulators” performed at chance or below chance? Makes me think they weren’t told what they were meant to be simulating? (I would guess they were trying to simulate being unable to form short term memories, however this symptom doesn’t occur in the genuine patients. Nevertheless, I agree that those that performed below chance gave the game away (if they were trying to fake those sympoms alone).
Still, I can’t help but thinking that if I wanted to fake amnesia, I’d have a different frame of mind to a participant in a test, who presumably volunteers for an unknown test, and is asked to fake amnesia “on the fly”. I guess what I’m suggesting is, that a “real” faker (clumsy nomenclature, I know), would be better prepared and/or researched (certainly if they knew the conclusion of the test might be used against them in a court of law).
Your cite seems to prove that the symtoms of amnesia are not generally well understood, and that people are generally bad at faking random data, and these seem very reasonable observations to me.
Your answer to my second point: “Unconscious cues can be controlled because we are talking about researchers/practitioners who have based their entire careers on learning to control this kind of stuff,” I am not convinced about at all – can you point me in the direction of data that demonstrates this assertion? (I don’t doubt that “researchers/practitioners” may have a greater understanding of non-visual cues, and, are capable of controlling them to a degree, but wholly (or merely sufficiently for the integrity of this experiment) controlling them? This surely goes too far (else the world of psychological testing could do away with double-blind experiments, for one).
You also said “This procedure, by the way, has been statistically verified and validated often, and is also admissible in court” and I half-hoped you’d cite me such a court case.
Momento was a really good movie. I suggest if anyone on this board hasn’t seen to rent it. It is one of those under-advertised movies that is great. The reciprocal of Matrix?
Actually, I was unable to get the entire article I cited owing to some subscription problem with my varsity library. As such, I cannot vouch for their procedure. However, as is normal process in any psychology experiment, they must have done their best to eliminate extraneous factors. Precisely how, I can’t be too sure, but they probably did. Please also note, that my cite was only one of 3 or 4 validating studies for this procedure.
Furthermore, when evaluating a patient, the psychiatrist must perform more than one test to minimise chances of a false positive diagnosis. So, questionnaires, personal histories, tests for implicit and explicit memory, fMRIs, PETs etc, are generally used in some combination. I merely gave the “coin-in-hand” example because it was the first one to pop into my mind.
To a reasonable extent, they must, or else the results of the process are to be considered useless. As you mentioned, the double-blind procedure is one method of accomplishing this. Another is standardization. Using an identically worded question for each trial, maintaining a similar environment, using the same coin, etc are all possible ways of standardizing the process. This issue, while definitely important, is really not all that difficult to accomplish in such experiments.
Ah, now here you have me. I skimmed throught 4 or 5 journal articles yesterday in order to get a decent idea of what I was talking about, and now I really cannot remember which one I read that in. My apologies.
There was in fact a test in that movie, performed on a guy faking anterograde amnesia. I assumed it was completely made up for the film, but does anyone know a reason why it wouldn’t work?
There were a few objects and the subject was asked to pick one up at random. One of them, the same one every time, was rigged up to give him an electric shock. The tester said that eventually he’d develop some sort of reflex memory and avoid that one if he were for real, but since he kept picking it and getting shocked, he was faking it.
Or simply get them drunk, so they will blab stuff out.