Loren Pankratz

Last updated
Loren Pankratz
Loren Pankratz 2011.jpg
Born (1940-02-27) February 27, 1940 (age 83)
Portland, Oregon
CitizenshipAmerican
Alma mater Oregon State University BA 1962
University of Oregon PhD 1968
Known for Posttraumatic stress disorder
Münchausen syndrome by proxy
Scientific career
Fields Psychology
Institutions Portland VA Medical Center
Oregon Health & Science University

Loren Pankratz (born February 27, 1940[ citation needed ]) is a consultation psychologist at the Portland VA Medical Center and professor in the department of psychiatry at Oregon Health & Science University (OHSU). [1]

Contents

Following his retirement in 1995, he maintained a forensic practice until 2012.[ citation needed ] He testified nationally on cases of Münchausen syndrome by proxy (MBP), often defending mothers accused of harming their children. [2] [3]

He has written and lectured on a wide variety of unusual topics such as dancing manias, spiritualism, Greek oracles, ghosts, plagues, historical enigmas, mesmerism, moral panics, con-games, self-deception, faith healing, self-surgery, miracles, ethical blunders, quackery, and renaissance science.[ citation needed ] He has also published magic history, magic tricks, and mentalism effects in magazines. [1] Pankratz, along with Ray Hyman and Jerry Andrus, was a founding faculty member of the Skeptic's Toolbox in Eugene, Oregon. Pankratz is also a Fellow for the Committee for Skeptical Inquiry. [4]

Personal

Pankratz received his B.A. from Oregon State University in 1962 and his Ph.D. from the University of Oregon in 1968. [5] He is a lifelong resident of Oregon.

In 2012, Pankratz constructed a display of historically significant books about quackery at the Oregon Health & Science University Library. [6]

Career

Loren Pankratz lectures at the Skeptic's Toolbox -2012 "Three Renaissance Philosophers: Evaluating Evidence Before Science Pankratz at Toolbox 2012.jpg
Loren Pankratz lectures at the Skeptic's Toolbox -2012 "Three Renaissance Philosophers: Evaluating Evidence Before Science

Pankratz was a psychologist at the Portland VA Medical Center for 24 years. [1] He was also responsible for psychiatry admissions, which gave him experience with emergency room physicians and procedures[ citation needed ] where he became aware of what he described in Summering in Oregon as false information that patients presented to clinicians. [7] [8]

In 1975, Pankratz became consultation psychologist for medical and surgical services where he remained until his early retirement in 1995.[ citation needed ] "The purpose of checking a veteran's story, of course, is not directed at catching lies but at identifying and treating the proper problem." [9]

Pankratz was appointed professor in the psychiatry department at Oregon Health Sciences University (now Oregon Health & Science University) in 1989.[ citation needed ] After retirement, he became a clinical professor in the department of psychiatry. [9]

As a reviewer for the American Journal of Psychiatry , Pankratz vetted potential publications on posttraumatic stress disorder (PTSD) in which he says some authors "merely gathered evidence for what they believed was true about symptoms and the underlying trauma". [9] He said that many aspiring authors did not check outside facts, and patients told therapists what they wanted to hear. [9]

In 1993, Pankratz was appointed to the scientific and professional advisory board of the False Memory Syndrome Foundation. [10] He has written about the lack of documented evidence for repressed memory and the resistance in acknowledging this professional blunder. [9]

In 1984, Pankratz and two colleagues founded the Drug-Seeking Behavior Committee which turned the focus of drug abuse from addiction to the earlier problem of risk.[ unreliable source? ] [11]

Münchausen syndrome by proxy

At Skeptic's Toolbox - 2012 Lorne at Toolbox.jpg
At Skeptic's Toolbox - 2012

Pankratz's articles on Münchausen syndrome [12] by proxy discussed what he says is a problem of false accusations associated with the diagnosis. Pankratz concluded that "mothers who present the problems of their children in ways perceived as unusual or problematic have become entangled in legal battles that should have been resolved clinically". In the majority of cases he reviewed, the mothers "were well meaning but inappropriately concerned about the health of their children, or their behavior was problematic in other ways". [13] [14] [15] In an interview with Psychology Today Pankratz stated "I have seen mothers accused of MBP simply because physicians disagreed about the medical management of their child..." it is "vastly overdiagnosed." [3]

After a contentious case in Pennsylvania, Pankratz told the Pittsburgh Post-Gazette that the accused mother was not creating medical symptoms in her children. Often called in as expert testimony, Pankratz stated, "for 30 years... (I have) been hired by prosecutors, defense attorneys, insurance companies and the Roman Catholic Church as an expert in medical deception." In his opinion, the mother had not created medical symptoms in her children. Instead, the symptoms were caused by a mitochondrial disorder, an uncommon condition that is difficult to diagnose. The children were returned to the care of the mother. [2]

Publications

Each of the faculty of 2012's Skeptic's Toolbox are presented by Carl and Ben Baumgartner, with an honorary In The Trenches award. Ray Hyman, Lindsay Beyerstein, James Alcock, Harriet Hall and Loren Pankratz Toolbox Faculty Awards.JPG
Each of the faculty of 2012's Skeptic's Toolbox are presented by Carl and Ben Baumgartner, with an honorary In The Trenches award. Ray Hyman, Lindsay Beyerstein, James Alcock, Harriet Hall and Loren Pankratz

Pankratz published Patients Who Deceive in 1998 which is part of the Charles Thomas Behavioral Science and Law series. Reviewer Phillip Resnick wrote that Pankratz clearly explains the difference between a malingerer (someone who wants to appear sick) and a person with factitious disorder who wants to be sick (even when no one is watching). Resnick says the book showcases "many dramatic examples of creating illusions of illness." [17] Pankratz and psychiatrist Landy Sparr described factitious posttraumatic stress disorder in 1983, saying the stories of trauma always require external verification. [18] In November 2021, a revised edition of Patients Who Deceive was published with KDP and is available on Amazon in print and ebook. It will be available on iBooks shortly.

Pankratz described forced-choice testing[ vague ] as a strategy for the assessment of malingering related to any sensory deficit. [19] [20] He later expanded forced-choice testing to assess malingering on neuropsychological assessment. [21]

In the Journal of the American Medical Association (JAMA), Pankratz published an article on the assessment and treatment of "geezers". [22] The Los Angeles Times review said geezers, "are never more misunderstood than when, laid low by medical problems they can't shake themselves, they are forced to swallow their pride and go to the doctor." The Times quoted Pankratz's article, "So all the medical profession can do is wait for the geezer to appear, on his own time and his own terms. If eccentric older men can be approached with interest, understanding and respect, half the battle is won—and the war may be avoided." [23]

In 2021 Pankratz's book Mysteries and Secrets Revealed: From Oracles at Delphi to Spiritualism in America was published by Prometheus books. [24]

Related Research Articles

<i>Diagnostic and Statistical Manual of Mental Disorders</i> American psychiatric classification and diagnostic guide

The Diagnostic and Statistical Manual of Mental Disorders is a publication by the American Psychiatric Association (APA) for the classification of mental disorders using a common language and standard criteria. It is the main book for the diagnosis and treatment of mental disorders in the United States and is considered one of the principal guides of psychiatry, along with the ICD, CCMD, and the Psychodynamic Diagnostic Manual. However, not all providers rely on the DSM-5 as a guide, since the ICD's mental disorder diagnoses are used around the world and scientific studies often measure changes in symptom scale scores rather than changes in DSM-5 criteria to determine the real-world effects of mental health interventions.

Dissociative identity disorder (DID), formerly known as multiple personality disorder, split personality disorder or dissociative personality disorder, is a member of the family of dissociative disorders classified by the DSM-5, DSM-5-TR, ICD-10, ICD-11, and Merck Manual for diagnosis. It remains a controversial diagnosis, despite rigorous study in the scientific literature since 1975.

Factitious disorder imposed on self, also known as Munchausen syndrome, is a factitious disorder in which those affected feign or induce disease, illness, injury, abuse, or psychological trauma to draw attention, sympathy, or reassurance to themselves. Munchausen syndrome fits within the subclass of factitious disorder with predominantly physical signs and symptoms, but patients also have a history of recurrent hospitalization, travelling, and dramatic, extremely improbable tales of their past experiences. The condition derives its name from the fictional character Baron Munchausen.

Post-traumatic stress disorder (PTSD) is a mental and behavioral disorder that develops from experiencing a traumatic event, such as sexual assault, warfare, traffic collisions, child abuse, domestic violence, or other threats on a person's life or well-being. Symptoms may include disturbing thoughts, feelings, or dreams related to the events, mental or physical distress to trauma-related cues, attempts to avoid trauma-related cues, alterations in the way a person thinks and feels, and an increase in the fight-or-flight response. These symptoms last for more than a month after the event. Young children are less likely to show distress, but instead may express their memories through play. A person with PTSD is at a higher risk of suicide and intentional self-harm.

<span class="mw-page-title-main">Thought disorder</span> Disorder of thought form, content or stream

A thought disorder (TD) is a disturbance in cognition which affects language, thought and communication. Psychiatric and psychological glossaries in 2015 and 2017 identified thought disorders as encompassing poverty of ideas, neologisms, paralogia, word salad, and delusions - all disturbances of thought content and form. Two specific terms have been suggested — content thought disorder (CTD) and formal thought disorder (FTD). CTD has been defined as a thought disturbance characterized by multiple fragmented delusions, and the term thought disorder is often used to refer to an FTD: a disruption of the form of thought. Also known as disorganized thinking, FTD results in disorganized speech and is recognized as a major feature of schizophrenia and other psychoses. Disorganized speech leads to an inference of disorganized thought. Thought disorders include derailment, pressured speech, poverty of speech, tangentiality, verbigeration, and thought blocking. One of the first known cases of thought disorders, or specifically OCD as we know it today, was in 1691. John Moore, who was a bishop, had a speech in front of Queen Mary II, about "religious melancholy."

Malingering is the fabrication, feigning, or exaggeration of physical or psychological symptoms designed to achieve a desired outcome, such as relief from duty or work, avoiding arrest, receiving medication, and mitigating prison sentencing.

<span class="mw-page-title-main">Somatization disorder</span> Mental disorder consisting of clinically significant somatic symptoms

Somatization disorder was a mental and behavioral disorder characterized by recurring, multiple, and current, clinically significant complaints about somatic symptoms. It was recognized in the DSM-IV-TR classification system, but in the latest version DSM-5, it was combined with undifferentiated somatoform disorder to become somatic symptom disorder, a diagnosis which no longer requires a specific number of somatic symptoms. ICD-10, the latest version of the International Statistical Classification of Diseases and Related Health Problems, still includes somatization syndrome.

A factitious disorder is a condition in which a person, without a malingering motive, acts as if they have an illness by deliberately producing, feigning, or exaggerating symptoms, purely to attain a patient's role. People with a factitious disorder may produce symptoms by contaminating urine samples, taking hallucinogens, injecting fecal material to produce abscesses, and similar behaviour.

Ganser syndrome is a rare dissociative disorder characterized by nonsensical or wrong answers to questions and other dissociative symptoms such as fugue, amnesia or conversion disorder, often with visual pseudohallucinations and a decreased state of consciousness. The syndrome has also been called nonsense syndrome, balderdash syndrome, syndrome of approximate answers, hysterical pseudodementia or prison psychosis.

Doctor shopping is the practice of visiting multiple physicians to obtain multiple prescriptions. It is a common practice of people with substance use disorders, suppliers of addictive substances, hypochondriacs or patients of factitious disorder and factitious disorder imposed on another. A doctor who, for a price, will write prescriptions without the formality of a medical exam or diagnosis is known as a "writer" or "writing doctor".

Pathological lying, also known as mythomania and pseudologia fantastica, is a chronic behavior characterized by the habitual or compulsive tendency to lie. It involves a pervasive pattern of intentionally making false statements with the aim of deceiving others, sometimes without a clear or apparent reason. Individuals who engage in pathological lying often claim to be unaware of the motivations behind their lies.

Post-concussion syndrome (PCS), also known as persisting symptoms after concussion, is a set of symptoms that may continue for weeks, months, years after a concussion. PCS is medically classified as a mild traumatic brain injury (TBI). About 35% of people with concussion experience persistent or prolonged symptoms 3 to 6 months after injury. Prolonged concussion is defined as having concussion symptoms for over four weeks following the first accident in youth and for weeks or months in adults.

Factitious disorder imposed on another (FDIA), also known as fabricated or induced illness by carers (FII), and first named as Munchausen syndrome by proxy (MSbP), is a condition in which a caregiver creates the appearance of health problems in another person, typically their child. This may include injuring the child or altering test samples. The caregiver then presents the person as being sick or injured. Permanent injury or death of the victim may occur as a result of the disorder. The behaviour occurs without a specific benefit to the caregiver.

Homicidal ideation is a common medical term for thoughts about homicide. There is a range of homicidal thoughts which spans from vague ideas of revenge to detailed and fully formulated plans without the act itself. Most people who have homicidal ideation do not commit homicide. 50–91% of people surveyed on university grounds in various places in the United States admit to having had a homicidal fantasy. Homicidal ideation is common, accounting for 10–17% of patient presentations to psychiatric facilities in the United States.

<span class="mw-page-title-main">Occupational burnout</span> Type of occupational stress

According to the World Health Organization (WHO), occupational burnout is a phenomenon resulting from chronic work-related stress, with symptoms characterized by "feelings of energy depletion or exhaustion; increased mental distance from one’s job, or feelings of negativism or cynicism related to one's job; and reduced professional efficacy". While occupational burnout may influence health and can be a reason for people contacting health services, it is not itself classified by the WHO as a medical condition or mental disorder. WHO additionally states that "Burn-out refers specifically to phenomena in the occupational context and should not be applied to describe experiences in other areas of life."

Spiritual crisis is a form of identity crisis where an individual experiences drastic changes to their meaning system typically because of a spontaneous spiritual experience. A spiritual crisis may cause significant disruption in psychological, social, and occupational functioning. Among the spiritual experiences thought to lead to episodes of spiritual crisis or spiritual emergency are psychiatric complications related to existential crisis, mystical experience, near-death experiences, Kundalini syndrome, paranormal experiences, religious ecstasy, or other spiritual practices.

Somatic symptom disorder, also known as somatoform disorder, is defined by one or more chronic physical symptoms that coincide with excessive and maladaptive thoughts, emotions, and behaviors connected to those symptoms. The symptoms are not purposefully produced or feigned, and they may or may not coexist with a known medical ailment. Manifestations of Somatic symptom disorder are variable and symptoms can be widespread, specific, and often fluctuate. Somatic symptom disorder corresponds to the way an individual views and reacts to symptoms as rather than the symptoms themselves. Somatic symptom disorder may develop in those who suffer from an existing chronic illness or medical condition.

Jon Elhai is a professor of clinical psychology at the University of Toledo. Elhai is known for being an expert in the assessment and diagnosis of Posttraumatic stress disorder (PTSD), forensic psychological assessment of PTSD, and detection of fabricated/malingered PTSD; as well as in internet addictions.

The Structured Inventory of Malingered Symptomatology (SIMS) is a 75-item true-false questionnaire intended to measure malingering; that is, intentionally exaggerating or feigning psychiatric symptoms, cognitive impairment, or neurological disorders.

Zack Zdenek Cernovsky was a Canadian psychologist. He was a professor of psychiatry in the Schulich School of Medicine & Dentistry at the University of Western Ontario. He was educated at the University of Berne and the University of Zurich, and taught overseas classes for the University of Maryland before joining the faculty of the University of Western Ontario. His more than 180 scientific publications in psychology and psychiatry deal with topics such as the MMPI, schizophrenia, psychological statistics and research design, sleep disorders, PTSD symptoms in refugees, the frequent psychological polytraumatic symptom pattern encountered in survivors of motor vehicle accidents, and assessments of subjective psychological symptoms of whiplash injury, as a part of medical psychology.

References

  1. 1 2 3 Pankratz, Loren. What Gives a Liar Away? - Oregonians for Rationality
  2. 1 2 Kane, Karen (26 March 2012). "Expert declares accused parents 'normal'". Pittsburgh Post-Gazette . Retrieved 2015-02-27.
  3. 1 2 Weintraub, Pamela. "Munchausen: Unusual Suspects". Psychology Today . Retrieved 2012-05-22.
  4. ↑ "CSI Fellows and Staff". CFI . Retrieved 2012-08-14.
  5. ↑ Global Climate Change and Human Health. Am Cncl on Science, Health.
  6. ↑ "The Literature of Quackery: Amusement and Understanding". Oregon Health & Science University . Retrieved 2012-05-22.
  7. ↑ Pankratz, Loren; Lipkin (1978). "The Transient Patient in a Psychiatric Ward: Summering in Oregon". Journal of Operational Psychiatry. 9: 42–47.
  8. ↑ Pankratz, Loren; James Jackson (29 December 1994). "Habitually Wandering Patients". The New England Journal of Medicine . 331 (26): 1752–1755. doi: 10.1056/NEJM199412293312606 . PMID   7984197.
  9. 1 2 3 4 5 Pankratz, Loren (May–June 2003). "More hazards: Hypnosis, airplanes, and strongly held beliefs". Skeptical Inquirer . Retrieved 2012-05-22.
  10. ↑ [ dead link ] "The FMSF Scientific and Professional Advisory Board - Profiles". False Memory Syndrome Foundation. Archived from the original on 2012-05-12. Retrieved 2012-05-22.
  11. ↑ [ non-primary source needed ]Pankratz, Loren; David Hickman; Shirley Toth (October 1989). "The Identification and Management of Drug-Seeking Behavior in a Medical Center". Drug and Alcohol Dependence. Elsevier. 24 (2): 115–118. doi:10.1016/0376-8716(89)90073-2. PMID   2571491.
  12. ↑ "Munchausen syndrome: Symptoms, Treatment & Definition".
  13. ↑ Pankratz, Loren (January 2006). "Persistent Problems With the Munchausen Syndrome by Proxy Label". Journal of the American Academy of Psychiatry and the Law . 34 (1): 90–95. PMID   16585239. Archived from the original on 2016-02-03. Retrieved 2012-05-22.
  14. ↑ Pankratz, Loren (2006). "Persistent Problems With the Munchausen Syndrome by Proxy Label" (PDF). The Journal of Psychiatry & Law. 34 (1): 90–5. PMID   16585239. Archived from the original (PDF) on 2014-04-19. Retrieved 2012-05-23.
  15. ↑ Pankratz, Loren (Fall 2010). "Persistent problems with the "separation test" in Munchausen syndrome by proxy" (PDF). The Journal of Psychiatry & Law. 38 (3): 307–323. doi:10.1177/009318531003800305. S2CID   75617802. Archived from the original (PDF) on 2014-04-19. Retrieved 2012-05-22.
  16. ↑ "Skeptic's Toolbox Awards - 2". youtube. Retrieved 2012-08-12.
  17. ↑ [ dead link ]Resnick, Phillip (February 1999). "Patients Who Deceive: Assessment and Management of Risk in Providing Health Care and Financial Benefits" (PDF). Psychiatric Services . Retrieved 2012-05-22.[ permanent dead link ]
  18. ↑ [ dead link ]Sparr, L.; Loren Pankratz (1983). "Factitious Posttraumatic Stress Disorder". American Journal of Psychiatry . 140 (8): 1016–1019. doi:10.1176/ajp.140.8.1016. PMID   6869583 . Retrieved 2012-05-22.
  19. ↑ Pankratz, Loren; Stephen A. Fausti; Steve Peed (1975). "Case Study: A Forced-Choice Technique to Evaluate Deafness in the Hysterical or Malingering Patient" (PDF). Journal of Consulting and Clinical Psychology . 43 (3): 421–422. doi:10.1037/h0076722. PMID   1159132 . Retrieved 2012-05-22.
  20. ↑ Pankratz, Loren (1979). "Symptom validity testing and symptom retraining: Procedures for the Assessment and Treatment of Functional Sensory Deficits". Journal of Consulting and Clinical Psychology. 47 (2): 409–410. doi:10.1037/0022-006X.47.2.409. PMID   469093.
  21. ↑ Pankratz, Loren (1983). "'A New Technique for the Assessment and Modification of Feigned Memory Deficit. Perceptual and Motor Skills". Journal of Consulting and Clinical Psychology. 57 (2): 367–372. doi:10.2466/pms.1983.57.2.367. PMID   6634318. S2CID   44912439.
  22. ↑ Pankratz, Loren; Lial Kofoed (1988-02-26). "The Assessment and Treatment of Geezers". Journal of the American Medical Association . 259 (8): 1228–1229. doi:10.1001/jama.259.8.1228. PMID   3339822 . Retrieved 2012-05-22.[ dead link ]
  23. ↑ Parachin, Allan (1988-02-26). "Old Men Need Respect, Too--Giving the Geezer His Due : 'The geezer emerged from adverse circumstances with a fierce independence blazed from solving problems". Los Angeles Times . Retrieved 2012-05-22.
  24. ↑ Mysteries and Secrets Revealed: From Oracles at Delphi to Spiritualism in America. Prometeus. 2021. ISBN   978-1633886681.
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