Dados do Trabalho

Título

SIMULAÇAO NA PERICIA MEDICA

Introdução

A materialização da intersecção entre Medicina e Direito se dá por meio da produção do laudo médico pericial, um trabalho técnico-científico produzido pelo médico perito. De forma prática, a identificação de simuladores não é tarefa fácil e muito menos objetiva.

Metodologia/ Discussão

Para a realização deste trabalho foi realizada uma busca na base de dados PubMed, a partir do ano 2000 e utilizando os seguintes descritores: malingering e jurisprudence. Foram listados 284 artigos, dos quais 26 foram selecionados por se aproximarem do objetivo deste trabalho.

Marco Conceitual/ Fundamentação/ Objetivos

Nesse sentido, este trabalho se propõe a discutir possíveis estratégias que o médico perito possa utilizar em sua prática para identificar os simuladores não se baseando apenas em sua experiência profissional, além de discutir alguns dos métodos existentes e mais comuns no auxílio da caracterização de simulação no contexto médico-legal e sua praticabilidade na perícia médica.

Resultados/ Conclusões

Considerando o cenário pericial brasileiro, talvez a aplicação de escalas com mais de 20 itens não seja realmente praticável no dia a dia do médico perito que possui em sua agenda múltiplos periciando para avaliar e produzir um laudo médico legal respeitável. Suas repercussões em relação ao que foi solicitado ao médico perito avaliar deve ser sempre avaliada, porém o julgamento da existência dessa entidade deve ser reservado para o poder judiciário.

Considerações Finais

Acima.

Bibliografia

1. Vanrell JP, Borborema M de L. Perícias Médicas Judiciais - 2a edição. 2a. JH MIzuno; 2015. 64–72 p.
2. Machado C, Gonçalves R. Avaliação psicológica forense: Características, problemas técnicos e questões éticas. Coimbra: Quarteto; 2005.
3. Drob SL, Meehan KB, Waxman SE. Clinical and Conceptual Problems in the Attribution of Malingering in Forensic Evaluations. Vol. 37, J Am Acad Psychiatry Law. 2009.
4. Velsor S, Rogers R. Differentiating factitious psychological presentations from malingering: Implications for forensic practice. Behavioral Sciences and the Law. 2019 Jan 1;37(1):1–15.
5. Psychiatric Association A. Manual diagnóstico e estatístico de transtornos mentais: DSM-5 - 5a Edição.
6. Caruso KA, Benedek DM, Auble PM, Bernet W. Concealment of Psychopathology in Forensic Evaluations: A Pilot Study of Intentional and Uninsightful Dissimulators. Vol. 31, J Am Acad Psychiatry Law. 2003.
7. Easton S, Cpsychol MA, Akehurst L. Tools for the Detection of Lying and Malingering in the Medico-Legal Interview Setting. 2011.
8. Slick DJ, Tan JE, Strauss EH, Hultsch DF. Detecting malingering: A survey of experts’ practices. Archives of Clinical Neuropsychology. 2004;19(4):465–73.
9. Mendelson G, Mendelson D. Malingering Pain in the Medicolegal Context. 2004.
10. Alwes YR, Clark JA, Berry DTR, Granacher RP. Screening for feigning in a civil forensic setting. Journal of Clinical and Experimental Neuropsychology. 2008 Feb;30(2):133–40.
11. Areh I. Forensic assessment may be based on common sense assumptions rather than science. International Journal of Law and Psychiatry. 2020 Jul 1;71.
12. Kohutis EA. Assessing older adults in civil litigation cases. International Journal of Law and Psychiatry. 2016 Nov 1;49:226–32.
13. Sahoo S, Kumar R, Oomer F. Concepts and controversies of malingering: A re-look. Asian Journal of Psychiatry. 2020 Apr;50:101952.
14. Vasconcelos LPWC de. A Simulação na Perícia Médica: a arte e a ciência de investigar a verdade pericial. 2a. São Paulo: LTr; 2011.
15. Almeida Jr. A, Costa Jr. JB. Lições de Medicina Legal. 21a. São Paulo: Editora Nacional; 1996.
16. Cassano A, Grattagliano I. Lying in the medicolegal field: Malingering and psychodiagnostic assessment. Vol. 170, Clinica Terapeutica. Societa Editrice Universo; 2019. p. E134–41.
17. Mittenberg W, Patton C, Canyock EM, Condit DC. Base rates of malingering and symptom exaggeration. Journal of Clinical and Experimental Neuropsychology. 2002 Dec;24(8):1094–102.
18. Vitacco MJ, Rogers R, Gabel J, Munizza J. An evaluation of malingering screens with competency to stand trial patients: A known-groups comparison. Law and Human Behavior. 2007 Jun;31(3):249–60.
19. Almiro PA. Uma nota sobre a desejabilidade social e o enviesamento de respostas. Vol. 16, Avaliacao Psicologica. Instituto Brasileiro de Avaliacao Psicologica; 2017.
20. Maranhão OR. O M.M.P.I e Suas Aplicações em Criminologia.
21. Peck CP, Schroeder RW, Heinrichs RJ, Vondran EJ, Brockman CJ, Webster BK, et al. Differences in MMPI-2 FBS and rbs scores in brain injury, probable malingering, and conversion disorder groups: A preliminary study. Clinical Neuropsychologist. 2013 May 1;27(4):693–707.
22. Lyons2v4 JA, Why ", Cox3 W. Brief Report MMPI, MMPI-2 and PTSD: Overview of Scores, Scales, and Profiles’. Vol. 12, Journal of Traumatic Stress.
23. Dodd CG, Courrégé SC, Weed NC, Deskovitz MA. A Comparison of the Descriptive Information from the MMPI–2 and MMPI–2–RF. Journal of Personality Assessment. 2020 Jan 2;102(1):45–55.
24. Nguyen CT, Green D, Barr WB. Evaluation of the MMPI-2-RF for detecting over-reported symptoms in a civil forensic and disability setting. Clinical Neuropsychologist. 2015 Feb 17;29(2):255–71.
25. Nelson NW, Hoelzle JB, Sweet JJ, Arbisi PA, Demakis GJ. Updated meta-analysis of the MMPI-2 symptom validity scale (FBS): Verified utility in forensic practice. Clinical Neuropsychologist. 2010 May;24(4):701–24.
26. Martino V, Grattagliano I, Bosco A, Massaro Y, Lisi A, Campobasso F, et al. A new index for the MMPI-2 test for detecting dissimulation in forensic evaluations: A pilot study. Journal of Forensic Sciences. 2015;61(1):249–53.
27. Henry GK, Heilbronner RL, Mittenberg W, Enders C, Domboski K. Comparison of the MMPI-2 restructured demoralization scale, depression scale, and malingered mood disorder scale in identifying non-credible symptom reporting in personal injury litigants and disability claimants. Clinical Neuropsychologist. 2009 Jan;23(1):153–66.
28. Sellbom M, Wygant D, Bagby M. Utility of the MMPI-2-RF in detecting non-credible somatic complaints. Psychiatry Research. 2012 May 30;197(3):295–301.
29. Walters GD, Rogers R, Berry DTR, Miller HA, Duncan SA, McCusker PJ, et al. Malingering as a Categorical or Dimensional Construct: The Latent Structure of Feigned Psychopathology as Measured by the SIRS and MMPI-2. Psychological Assessment. 2008 Sep;20(3):238–47.
30. Jackson RL, Rogers R, Sewell KW. Forensic applications of the Miller Forensic Assessment of Symptoms Test (MFAST): Screening for feigned disorders in competency to stand trial evaluations. Law and Human Behavior. 2005 Apr;29(2):199–210.
31. Vitacco MJ, Jackson RL, Rogers R, Neumann CS, Miller HA, Gabel J. Detection strategies for malingering with the Miller forensic assessment of symptoms test: A confirmatory factor analysis of its underlying dimensions. Assessment. 2008 Mar;15(1):97–103.
32. Rogers R. Clinical assessment of malingering and deception. 3a. Nova Iorque: The Guilford Press; 2008.
33. Green D, Rosenfeld B. Evaluating the Gold Standard: A Review and Meta-Analysis of the Structured Interview of Reported Symptoms. Psychological Assessment. 2011;23(95):107.
34. Green D, Rosenfeld B, Belfi B. New and Improved? A Comparison of the Original and Revised Versions of the Structured Interview of Reported Symptoms. Assessment. 2013 Apr 1;20(2):210–8.
35. de Marchi B, Balboni G. Detecting malingering mental illness in forensics: Known-Group Comparison and Simulation Design with MMPI-2, SIMS and NIM. PeerJ. 2018;2018(7).
36. Mota MS. Comportamentos de simulação numa amostra de reclusos: Estudos de validação com a SIRS (Structured Interview of Reported Symptoms), o SIMS (Structured Inventory of Malingered Symptomatology) e o TOMM (Test of Memory Malingered). Tese de Mestrado Integrado em Avaliação Psicológica. [Coimbra]; 2007.
37. Danzer GS, Wasser TD. A literature analysis of the inventory of legal knowledge. Journal of the American Academy of Psychiatry and the Law. 2021 Mar 1;49(1):87–95.
38. Wisdom NM, Callahan JL, Shaw TG. Diagnostic utility of the structured inventory of malingered symptomatology to detect malingering in a forensic sample. Archives of Clinical Neuropsychology. 2010;25(2):118–25.
39. van Impelen A, Merckelbach H, Jelicic M, Merten T. The Structured Inventory of Malingered Symptomatology (SIMS): A systematic review and meta-analysis. Clinical Neuropsychologist. 2014 Nov 17;28(8):1336–65.
40. Hall RCW, Hall RCW. Malingering of PTSD: forensic and diagnostic considerations, characteristics of malingerers and clinical presentations. General Hospital Psychiatry. 2006 Nov;28(6):525–35.
41. Rappaport RG. Losing Your Rights: Complications of Misdiagnosis. Vol. 34, J Am Acad Psychiatry Law. 2006.
42. Iverson GL. Ethical issues associated with the assessment of exaggeration, poor effort, and malingering. Applied Neuropsychology. 2006;13(2):77–90.