Iatrogenesis and malingering of multiple personality disorder in the forensic evaluation of homicide defendants.

In this article I have addressed the possibility of iatrogenesis and/or malingering of MPD in 19 individuals who were charged with homicide. Due to the fragmentary nature of most of these case reports, it is not possible to state definitively who had genuine MPD and who did not. There is a strong possibility that a substantial proportion were malingering, however, because of their rather atypical presentations. Data from other sources suggest that the use of hypnosis in individuals accused of homicide may iatrogenically produce MPD-like phenomena when coupled with the defendant's desire to escape criminal responsibility. Finally, I have offered guidelines for the forensic evaluation of homicide defendants in whom MPD is suspected. Although hypnosis should generally be avoided in such defendants if it is used, rather strict guidelines should be followed. Clinicians using hypnosis with such individuals should be forewarned that such use will be strongly challenged in court and could pose an extreme threat to the defense position.