第二編 詐病의 臨床的 理論的 考擦

The Personality characteristics of malingerers, simulated grandmal epileptic convulsion and admitted to army hospital was studied with MMPI and Machover test in comparison with normals, epileptics and hysterics. And the clinical value of the two tests in differencial diagnosis between malingering from epilepsy and hysteria was also evaluated in this paper. 1) MMPI of the malingerimg revealed a significantly neurotic pattern. This pattern was very similar to those of hysteria and epilepsy except higher Pd to hysteria and higher L to epilepsy. 2) Machover test of the malingering revealed significantly higher total problem index in contrast with normals, and was similar to that of delinquent pattern. No distinction of the malingering to hysteria could be evaluated in total problem index and each scale, and malin gering revealed definitely higher score in total problem index and Sch, Ps, in comparison with epilepsy. 3) The personality characteristics of the malingerers may be considered as a hysterical pattern with mild psychpathic tendency. 4) The significance of MMPI in differencial diagnosis between malingering from hysteria and epilepsy could not be found in our sample. 5) Machover test did not give any meaning to differenciation between malingering from hysteria, but gave some meaning differenciation fronx malingeres. Part II： Clinical and of the Malin gTehreerosr.etical study This part took the focus to study some antecdent factors, clinical problems and dynamic relationship between hysteria and malingering with case analysis and discussion. 1) Our malingerers revealed the relatively higher status in the socio-economico-cultural pattern. 2) In birth order, 73 per cent of the malingerers were the first son or the solitary. This interesting pattern was closely related to the overprotective child rearing of their parents. Many of them were passive and immature in premorbid personality. With above several patterns the similarity in some factors of early life history. and personality developement of hysteria and malingering was discussed with dynamic concept. 3) The soldiers begin to simulate some convulsive: disorders in the period of fresh-man who feels a difficulty in army adjustment. 73 per cent of cases were admitted to hospital with simulation within first 6 month of service, others within first 12 month, and all of them, under the private P. F. C. in army rank. 4) The clinical value of the various diagnostic methods was discussed in the light of the previous authors and my experience. Prognosis was partly depend upon the method of control Early detection and “early return to duty” with proper punishment were considered as the desirable methods. 5) Psychodynamically, malingering revealed many similarity to hysteria, in birth order, child rearing, pattern of personality developement and motivation of simulation, except conscious identification of the symptom in malingering With an interesting case who revealed alternately malingering and hysteria, I discussed also their similarity and concluded that hysteria, and malingering were a clinical transitionand not different entity in the meaning of dynamic concept.