法医精神病学鉴定中的精神发育迟滞受害人

Victims with mental retardation in forensic psychiatric assessment

目的探讨法医精神病学鉴定中精神发育迟滞受害人的特征。方法采用四川大学法医精神病学教研室性自卫能力鉴定案例登记表、大体功能评定量表(GAF)、社会功能缺陷筛选量表(SDSS)、成人智残评定量表(AMDRS),对152例相关案例进行登记评分和统计处理。结果被害人的文化程度为文盲占53.9%,小学占42.8%。被鉴定的性受害人与被告人相识者占86.8%,发生在被害人家中(38.8%)、被告人家中(27.6%)或野外(21.1%),采取暴力、胁迫(56.6%)或诱骗(40.8%)的方式。受害时完全顺从者52.0%,受害后无所谓者78.3%。精神发育迟滞受害人的平均智商(IQ)为(40.29±11.40),SDSS的平均分数(12.84±2.65)。缺乏和无性自卫能力两组比较总智商(t=6.855,P<0.01)、言语智商(t=6.583,P<0.01),操作智商(t=4.878,P<0.01),SDSS评分(t=-6.292,P<0.01)、GAF评分(t=6.643,P<0.01)、AMDRS评分(t=-7.397,P<0.01)间的差异均有统计学意义。结论MR性受害人受教育程度低,易被熟人胁迫或诱骗,受害时多不知反抗,受害后多表现无所谓,智商低于正常,社会功能受损明显。智商和社会功能与性自卫能力有关,应该作为评定性自卫能力的重要依据。

Objective To explore the characteristics of sexual victims with mental retardation in forensic psychiatric assessment. Methods The record scale on the capacity of sexual self-defense designed by Forensic Psychiatry Department of West China Medical Center of Sichuan University, GAF （Global Assessment Function）, SDSS （Social Disability Screening Schedule） and AMDRS （Adult Mental Disability Rating Scales） were used to analysis the 152 cases. Results 53.9% of the victims never accepted the school education and only 42.8% of them got primary education. In all of the cases, 86.8% of the offenders involved were acquaintances, The cases occurred at the home of victims （38.8%） or of criminals （27.6%）, or the open country （21. 1%）, These offenders generally resorted to violence or threatened the victims （56.60/40） or tempted them （40. 8%）. 52.0% of the victims were abused without any revolt when it＇s happened, and 78, 3% of them were indifferent after that. Their average scores of IQ and SDSS is 40.29±11.40 and 12.84±2. 65 respectively. Statistical difference of FIQ （ t =-6. 855, P〈 0.01）, VIQ （t=4.878, P〈0.01）, PIQ（t=4.878, P〈0.01）, SDSS（t=-6.292,P〈0.01）, GAF （ t =6. 643, P〈0.01） and AMDRS （ t =-7. 397, P〈 0.01） were significant between reduction of sexual self- defense abilities and loss of sexual self-defense abilities. Conclusions The sexual victims with MR are deficient in enough education and vulnerable to be abused, They were generally ignorant of defense and indifferent to the victimization, They have lower IQ level than the general population and social function impairment. Intelligence and social function relate to the capacity of sexual selfdefense and should be the important factors for assessment.