A psychotically motivated act or an act committed under impaired insight and control of action in the midst of an acute psychosis is the standard for lack of criminal responsibility. There is now increasing evidence that positive symptoms, particularly in the form of hallucinations and delusions, in trauma-related disorders and borderline personality disorder (BPD) are comparable to positive symptoms in psychotic disorders, posing a challenge for differential diagnosis and forensic assessment of the relevance of positive symptoms to insight and self-control. Due to the indistinguishability of the phenomena, there is both a risk of misdiagnosis of a psychotic disorder and also trivialization with the use of or labels. Essential phenomenological differences that may be helpful in forensic assessments are the usually preserved reality testing in trauma-related disorders and BPD, as well as differences in psychopathological symptom constellations. Because of these differences relevant to forensic assessments, it seems useful to distinguish trauma-related disorders and BPD with positive symptoms from psychotic disorders.

中文翻译：

---

创伤相关疾病和边缘性人格障碍中解离阳性症状的法医方面

出于精神病动机的行为或在急性精神病期间在行动的洞察力和控制力受损的情况下实施的行为是缺乏刑事责任的标准。现在越来越多的证据表明，创伤相关疾病和边缘性人格障碍（BPD）中的阳性症状，特别是幻觉和妄想形式，与精神障碍中的阳性症状相当，这对鉴别诊断和法医评估提出了挑战。阳性症状与洞察力和自我控制的相关性。由于这些现象的不可区分性，既存在误诊精神障碍的风险，也存在因使用 或 标签而被轻视的风险。可能有助于法医评估的基本现象学差异是创伤相关疾病和 BPD 中通常保留的现实测试，以及精神病理症状群的差异。由于这些与法医评估相关的差异，区分创伤相关疾病和具有阳性症状的 BPD 与精神障碍似乎很有用。