asmagill

Etiology of indecent exposure

6 posts in this topic

62 years old gentleman (age was not given in the scenario) was brought into a/e due to concerns of his wife after he was exposing himself ( urinating in the back garden) and a female neighbour saw him doing so. Task was to explore the aetiology.

Struggled a lot re aetiology , explored index event ,bio-psychosocial reasons of his presentation but could not get much from him. He was retired police officer who denied any past forensic Hx,no substance misuse,no past psych Hx etc. he only reported of mild attention/concentration problem while playing darts. I wonder if anyone could find etiology from him?? 

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i tried to rule out dementia as well, there was no change in personality , no problem with memory and no Hx OF INAPPROPRIATE BEHAVIOUR IN PAST THOUGH  IN NEXT STATION WIFE GAVE PAST HX OF ALLEGED SEXUAL ABUSE OF GRANDDAUGHTER BUT RE ETIOLOGY HE DID NOT GIVE MUCH INFO

 

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Can anyone shed some light on this staion and how to approach it ?

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This station is actually quite tricky and a bit complicated .

i think various etiological factors ( if station demands etiology) which need to be explored here are as follows 

Dementia related disinhibition ( which I think u explored clearly )

LD 

head injury/ trauma resulting in change in behavior and personality 

alcohol and other substance misuse ( u did that as well)

Stress ----which could be an important factor in sudden/ drastic  change in behavior 

Late onset psychosis 

childhood sexual abuse 

And of course one will be going through past forensic hx ,past hx of any such events etc 

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Also ABC is a must. Antecedant, Behaviour, Consequence. 

Ongoing risk to the women and children is another thing to be established in both stations especially the second. 

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