THE DIFFERENTIAL-DIAGNOSIS OF RITUAL ABUSE ALLEGATIONS

Objective: Because psychiatrists do not have a consistent way to class ify and define the forms of child abuse that may be mistaken for ritua l abuse, the objective of this paper is to create a comprehensive diff erential diagnosis of allegations of ritual abuse. Method: The authors reviewed 60 articles, chapters, and books that contained allegations of ritual abuse or behaviors that might be mistaken for ritual abuse, that were made by patients or caretakers. Results: This paper clarifie s the behaviors that represent or may be mistaken for ritual abuse: Cu lt-based ritual abuse, pseudoritualistic abuse, activities by organize d satanic groups, repetitive psychopathological abuse, sexual abuse by pedophiles, child pornography portraying ritual abuse, distorted memo ry false memory, false report due to a severe mental disorder, pseudol ogia phantastica, adolescent behavior simulating ritual abuse, epidemi c hysteria, deliberate lying, and hoaxes. Conclusions: The differentia l diagnosis of allegations of ritual abuse is important in both clinic al and forensic psychiatry. In some cases, it will not be possible to tell whether a particular allegation is factual or what the underlying mental processes are. It is important to separate the role of the men tal health professional as therapist from the role as an expert witnes s in court.