State Dissociation: Implications for Sleep and Wakefulness, Consciousness, and Culpability - 02/11/11

Doi : 10.1016/j.jsmc.2011.08.002

Mark W. Mahowald, MD ^a,^b,^⁎ , Michel A. Cramer Bornemann, MD ^a,^b, Carlos H. Schenck, MD ^c,^d
^a Department of Neurology, Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415, USA
^b Department of Neurology, University of Minnesota Medical School, Minneapolis, MN, USA
^c Department of Psychiatry, Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415, USA
^d Department of Psychiatry, University of Minnesota Medical School, Minneapolis, MN, USA

Corresponding author. Department of Neurology, Minnesota Regional Sleep Disorders Center, Hennepin County Medical Center, 701 Park Avenue, Minneapolis, MN 55415.

Resumen

Wakefulness and sleep and consciousness and unconsciousness are not all-or-none, mutually exclusive states but rather occur on a broad spectrum with fluid and rapidly changing boundaries, resulting in a wide variety of unusual and often complex and perplexing behaviors. The resulting behaviors may have forensic implications with varying degrees of conscious awareness, intent, and culpability. The neuroscientific basis of these dissociated states will provide fertile areas for discussion between neuroscientists and the legal profession.

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Keywords : Consciousness, State dissociation, Sleepwalking, Sleep terrors, Sleep forensics, Forensic sleep medicine