February 27, 1940 |
|Institutions||Portland VA Medical Center
Oregon Health & Science University
|Alma mater||Oregon State University BA 1962
University of Oregon PhD 1968
|Known for||Posttraumatic Stress Disorder
Munchausen syndrome by proxy
Loren Pankratz (born February 27, 1940) was a psychologist at the Portland VA Medical Center and professor in the department of psychiatry at Oregon Health & Science University (OHSU). Following his retirement in 1995, he maintained a forensic practice until 2012. He testified across the nation on multiple cases of Munchausen syndrome by proxy, often defending mothers falsely accused of harming their children.
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. He has also published magic history, magic tricks, and mentalism effects in magic trade journals. 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 of Skeptical Inquiry.
Pankratz received his B.A. from Oregon State University in 1962 and his Ph.D. from the University of Oregon in 1968. He is a lifelong resident of Oregon, and his mother and grandparents were pioneers near Mount Hood.
Pankratz has an extensive personal library on the history of deception and mistaken ideas. In 2012, Pankratz constructed a display of historically significant books about quackery at the Oregon Health & Science University Library.
In 1970, Pankratz signed an organ donor card. There are reasons to believe this may be the earliest donor card ever completed, and it is now held in the historical archives of the OHSU library.
In 1971, Pankratz opened a new psychiatry ward at the Portland VA Medical Center. Pankratz was also responsible for psychiatry admissions, which gave him experience with emergency room physicians and procedures. In these settings, he became aware of the array of false information that patients presented to clinicians. Summering in Oregon was the first of his extensive publications on patient deception.
In 1975, Pankratz became consultation psychologist for medical and surgical services where he remained until his early retirement in 1995. He lectured on patient deception at grand rounds in nearly every hospital specialty. "The purpose of checking a veteran's story, of course, is not directed at catching lies but at identifying and treating the proper problem."
Pankratz was appointed professor in the psychiatry department at Oregon Health Sciences University (now Oregon Health & Science University) in 1989. In an undoubtedly[who?] unique position for a psychologist, Pankratz was appointed chair of the promotion and tenure committee of the department of psychiatry. He held that position for eight years, selected by two psychiatry department chairmen. After retirement, now clinical professor, he became part of the teaching faculty of the forensic fellowship program in the department of psychiatry.
As a reviewer for the American Journal of Psychiatry, Pankratz vetted potential publications on Posttraumatic Stress Disorder in which some authors "merely gathered evidence for what they believed was true about symptoms and the underlying trauma." Careful studies show that patients can sincerely report events and symptoms that are significantly discrepant from underlying facts. Moreover, both children and adults, it turns out, are amazingly resilient in the long run to trauma. The label of Posttraumatic Stress Disorder in Pankratz's opinion, should be reserved for those with a significant psychiatric condition based on an abnormal response to a documented trauma. He discovered that many aspiring authors did not check outside facts, and patients told therapists what they wanted to hear.
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. This work pioneered attention to what is now recognized as a serious health problem. His article was the first to define "drug seeking behavior" and recommend management strategies.
In 1993, Pankratz was appointed to the scientific and professional advisory board of the False Memory Syndrome Foundation. He has written about the lack of documented evidence for repressed memory and the resistance in acknowledging this professional blunder.
Munchausen syndrome by proxy
Pankratz's articles on Munchausen syndrome by proxy were among the first to identify the problem of false accusations associated with the diagnosis. Early in his forensic career, Pankratz was surprised to discover mothers accused of Munchausen syndrome by proxy (MBP) merely because they were advocating for their children with developmental disorders. In most cases 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". 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."
After a highly 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.
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 states that the book showcases "many dramatic examples of creating illusions of illness."
Pankratz and psychiatrist Landy Sparr wrote the first paper describing factitious Posttraumatic Stress Disorder after it appeared in the psychiatric diagnostic manual. They showed that the stories of trauma always require external verification, a perpetual theme in the writings of Pankratz.
Pankratz showed that forced-choice testing was a new strategy for the assessment of malingering related to any sensory deficit. These papers and the one on memory testing have all been cited over 100 times. A couple of years later Pankratz expanded forced-choice testing to assess malingering on neuropsychological assessment. From this seminal work, a flood of tests have incorporated his conceptual strategy.
In Journal of the American Medical Association (JAMA), Pankratz published an article on the assessment and treatment of "geezers". The Los Angeles Times, in a review of the article, says 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 goes on to quote the 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.'"
- "CSI Fellows and Staff". CFI. Retrieved 2012-08-14.
- Hunter, Eva. "Program director nurtures severely handicapped children". Catholic Sentinel. Retrieved 2012-05-22.
- Grover, Stuart. "Stuart Grover Accepts 2004 NDOA Professional Achievement Award". The Collins Group. Retrieved 2012-05-22.
- "The Literature of Quackery: Amusement and Understanding". Oregon Health & Science University. Retrieved 2012-05-22.
- "Donor Card". Retrieved 9/8/2012.
- Pankratz, Loren; Lipkin (1978). "'The Transient Patient in a Psychiatric Ward: Summering in Oregon". Journal of Operational Psychiatry 9: 42–47.
- Pankratz, Loren; James Jackson (29 December 1994). Habitually Wandering Patients. The New England Journal of Medicine. Retrieved 2012-05-22.
- Pankratz, Loren (May–June 2003). "More hazards: Hypnosis, airplanes, and strongly held beliefs". Skeptical Inquirer Magazine. Retrieved 2012-05-22.
- Southwick, S.M. "Consistency of memory for combat-related traumatic events in veterans of Operation Desert Storm". American Journal of Psychiatry. Retrieved 2012-07-24.
- Bowman, Marilyn (1997). "Individual differences in posttraumatic response: Problems with the adversity-distress connection". Erlbaum.
- Pankratz, Loren; David Hickman; Shirley Toth (October 1989). "The Identification and Management of Drug-Seeking Behavior in a Medical Center". Elsevier. pp. 115–118. Retrieved 2012-05-22.
- "The FMSF Scientific and Professional Advisory Board - Profiles". False Memory Syndrome Foundation. Retrieved 2012-05-22.
- Pankratz, Loren (January 2006). "Persistent Problems With the Munchausen Syndrome by Proxy Label". Journal of the American Academy of Psychiatry and the Law: 90–95. Retrieved 2012-05-22.
- Pankratz, Loren (2006). "Persistent Problems With the Munchausen Syndrome by Proxy Label". The Journal of Psychiatry & Law 34 (1). Retrieved 2012-05-23.
- Pankratz, Loren (Fall 2010). "Persistent problems with the "separation test" in Munchausen syndrome by proxy". The Journal of Psychiatry & Law. Retrieved 2012-05-22.
- Weintraub, Pamela. "Munchausen: Unusual Suspects". Psychology Today. Retrieved 2012-05-22.
- Kane, Karen (26 March 2012). "Expert declares accused parents 'normal'". Pittsburgh Post-Gazette. Retrieved 2012-05-22.
- "Skeptic's Toolbox Awards - 2". Retrieved 2012-08-12.
- Resnick, Phillip (February 1999). "Patients Who Deceive: Assessment and Management of Risk in Providing Health Care and Financial Benefits". Psychiatric Services. Retrieved 2012-05-22.
- Sparr, L.; Loren Pankratz (1983). Factitious Posttraumatic Stress Disorder. American Journal of Psychiatry. pp. 1016–1019. Retrieved 2012-05-22.
- Pankratz, Loren; Stephen A. Fausti; Steve Peed (1975). "Case Study: A Forced-Choice Technique to Evaluate Deafness in the Hysterical or Malingering Patient". Journal of Consulting and Clinical Psychology 43 (3): 421–422. doi:10.1037/h0076722. Retrieved 2012-05-22.
- Pankratz, Loren (1979). "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.47.1.225. Retrieved 2012-05-22.
- 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: 367–372. doi:10.2466/pms.19184.108.40.2067. Retrieved 2012-05-22.
- 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. Retrieved 2012-05-22.
- 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.
- Media related to Loren Pankratz at Wikimedia Commons
- The Skeptic's Toolbox
- What Gives a Liar Away? - Oregonians for Rationality