Question 6 - so according to Dr Lewis, everyone who commits violent acts is psychotic. WTH. Violence is not a necessary symptom of psychosis. She is frightening.
I think she means more than just the violence. She means all the incomprehensible, contradictory things T. said about it (so far as Dr L even read those reports). She can see that T. is not DID (and so refuses to give that diagnosis, ultimately). She seems to think she can keep researching T. (somehow re-ordering the tests she asked them not to do).
I do wonder if she had a medical license (to allow ordering the tests). Surely lawyers themselves cannot order an MRI or PET or similar?
I think Dr L thinks that her own interviews with T. show that T. is "psychotic." What I see, though, is what Freud and others have called "borderline" psychosis (one foot in reality, one foot out of reality).
This paper (2013) concludes (paraphrasing): "These symptoms are sometimes referred to as "pseudo-psychotic" or "psychotic-like", terms that suggest a distinction from those seen in primary psychotic disorders. Recent research, however, has indicated that there is more similarity between pseudo-psychotic symptoms in BPD and "true" psychosis than originally thought."
Wikipedia article on this disorder is pretty much up-to-date. From that article:
"The DSM-5 recognizes transient paranoia that worsens in response to stress as a symptom of BPD.
[9] Studies have documented both
hallucinations and
delusions in BPD patients who lack another diagnosis that would
better account for those symptoms"
en.wikipedia.org
While it is true that BPD people are more likely to self-harm than to harm others, there's quite a bit of research on Borderline PD people who murder. The way I understand the literature, BPD murderers are often classified or diagnosed as having multiple PD disorders, most notably Antisocial PD and Schizoid PD (and I personally see signs of Schizoid in T.)
^2021
The following article summarizes research on BPD criminal violence and says that when they are violent toward others, it can be "extreme."
^1993
Note that the research on BPD and violence spans a long period of time. The literature on murder and BPD is more recent. Maybe Dr. L hasn't read it. The below article from 2009 summarize a lot about BPD and criminality:
Borderline personality disorder is characteristically associated with a broad variety of psychiatric symptoms and aberrant behaviors. In this edition of The Interface, we discuss the infrequently examined association between borderline personality disorder ...
www.ncbi.nlm.nih.gov
It's important to remember that of all diagnoses, BPD is one that is almost always associated with some other, co-morbid Dx (or several of them). Antisocial PD and Narcissistic PD are common co-morbidities. Schizoid PD is also common (hence beliefs that the dead can be raised).
IMO. To my knowledge (and I keep looking - I'll do more looking today), no court has had a NGRI by reason of Borderline (or any other) PD. I'll start with this 2020 article to back up my point (made in other posts) that people found NGRI are increasingly called "psychopaths" (a non-DSM term) due to this overlapping and bewildering but fully antisocial set of symptoms. It focuses on women who end up in prison.
Understudied is psychopathy in females, particularly socially dangerous NGRI females, where the construct could be of forensic, clinical and criminolo…
www.sciencedirect.com
I don't think any jurisdiction allows "psychopathy" as a NGRI Dx, which is why I believe the Defense in this case needed to go elsewhere for its Dx.
IMO.
