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Case 1:20-cr-00330-PAE Document 424-3 Filed 11/08/21 Page 19 of 29 Pathways to False Allegations 113 psychotic disorder, psychotic disorder due to a general medical condition, substance-induced psychotic disorder, and psychotic disorder not otherwise specified. Each of these disorders is known to cause gross impairment in functioning. The DSM-IV-TR (American Psychiatric Association, 2000) details com- mon delusions that may be pervasive in individuals with delusional disorder. Other psychotic disorders may be associated with these delusional themes as well. Erotomatic delusions involve irrational, unsubstantiated, or impossible claims that some person is in love with the delusional individual. The individual may claim that a movie star or superior at work is secretly in love with him or her and that there is a spiritual tie between them. Another delusional theme of interest is the persecutory type. This delu- sional theme is characterized by irrational, unsubstantiated, or impossible claims that the individual has been wronged and that some injustice has taken place. Frequent appeals to the court system are common in which the individual attempts to persecute the central person in the delusion. Mixed types of delusions involve delusions in which no one type predominates. A mixed erotomatic and persecutory type might be the type of delusion that would lead to a false allegation of sexual assault. However, delusions can be complex and difficult to categorize, even when they are sexual in nature. Studies investigating the content of delusions have found delusions that are sexual in nature are not uncommon and are occur more often in women than in men (Galdos & van Os, 1995; Meloy, 1989). Some cases of sexual delusions have been documented. In one case, Rosenthal and McGuinness (1986), two psychiatric nurses, wrote about a client with delusions cen- tered on sex. “When her hydrotherapist offered her a backrub one day, she exclaimed, ‘Don’t touch me! I am not your homosexual lover’’(p. 149). These delusions may lead a person to claim adamantly that sexual relations or events occurred that may be impossible or highly improbable. Dissociation Dissociation is “the lack of the normal integration of thoughts, feel- ings, and experiences into the stream of consciousness and memory” (Berstein & Putnam, 1986). According to the DSM-IV-TR (American Psychiatric Association, 2000), dissociation involves a disruption or splitting off of memory, personality, identity, consciousness, or general perceptions of the self and surroundings; it can be recurring, gradual, or transient. Currently, there is some controversy concerning the function, antecedents and etiology of dissociation (Candel, Merckelbach, & Kuijpers, 2003). Dissociative tendencies have been thought to exist as a stable trait in some individuals (Waller, Putnam, & Carlson, 1996), though most research has looked only at dissociation in relation to traumatic expe- riences. Much of the focus on the relationship between trauma and dissociation may be the result of earlier studies that found a relationship DOJ-OGR- 00006287