'Malingering' Doctor says Mendiola exaggerated symptoms on psychiatric tests

Published 12:00 am Wednesday, December 2, 2009

By Holly Fesperman Lee

Salisbury Post

After therapist Cynthia Baubach told Laurie Mendiola she didn’t have feelings for her and rejected her advances, “the patient began crying ‘victim,’ ‘harassment,’ ‘abuse,’ as she did with Mr. Helms,” Dr. Barbara Thomas testified Thursday.

Mendiola, a former teacher, is suing former West Rowan Middle School principal Tony Helms and the school board. She says Helms forced her to have an affair with him and school officials knew about the relationship but didn’t do anything.

Thomas owns Salisbury Psychiatric Associates, and Mendiola saw therapists in Thomas’ practice off and on from 2000 to 2005.

Thomas testified that she diagnosed Mendiola with a less severe form of bipolar disorder, post traumatic stress disorder by history and a personality disorder with strong borderline characteristics.

When Thomas questioned Mendiola about her confrontation with Baubach, “as expected, she said Cindy was seducing her in sessions and calling her at home,” Thomas said.

Thomas asked Mendiola why she was still coming to therapy sessions if those things were true and she said Mendiola replied that Cindy was such a great therapist and “I miss her.”

“That’s typical of borderline personality disorder,” Thomas testified.

Thomas testified that she didn’t believe Mendiola’s accusation that Baubach was trying to have a personal relationship with her. She said she knew Baubach’s reputation and the problems Mendiola had.

After Mendiola confronted Baubach, Salisbury Psychiatric Associates decided to terminate the therapy relationship with her.

Ken Soo, attorney for the school board, asked Thomas why that was done.

Thomas testified that Mendiola started coming by the office displaying behaviors that were upsetting to her staff and other patients.

Dr. Arne Newman, the psychiatrist that conducted court- ordered psychiatric testing on Mendiola, also testified that he diagnosed her with borderline personality disorder.

Attorneys for the school board made a motion before the trial started asking a judge to order Mendiola to have psychiatric testing.

That motion was granted because the court found that Mendiola had put her mental health in question. In her lawsuit, Mendiola says she now suffers from post traumatic stress disorder because of her ordeal with Helms.

Newman was accepted as an expert witness in the case.

Newman testified that he gave Mendiola several categories of tests, including a brief academic assessment, a personality inventory and tests for memory, motivation and effort.

Newman explained that he gives the academic evaluation to make sure the person has the basic abilities needed to take the psychological tests.

Mendiola easily met those criteria, Newman said.

Soo asked Newman why he administered memory testing.

Newman replied that the court specified which tests Mendiola would take. He explained that the memory test was chosen because Mendiola said she was having memory problems.

He said he gave Mendiola the word memory test, a fairly simple test that dealt with lists of words.

Newman said he read Mendiola a list of words, asked her to remember several specific words and then asked her to recall them later.

The word memory test is designed to show if someone is having memory problems and is also a good indicator of malingering, he testified.

Soo asked Newman to define malingering.

“Exaggerating or making up of psychological symptoms in order to receive some external gain,” he replied.

Soo asked Newman to testify about his conclusion of Mendiola’s word memory test.

Newman said the test showed a deliberate attempt to appear extremely impaired.

Mendiola’s results fell below scores of mentally retarded 8-year-old girls and those with severe brain damage, he said.

Newman said he administered a visual memory test and again Mendiola scored extremely low.

“Practically speaking, we could not score any lower,” he testified.

“There’s no reason from a depressive perspective the results would be this low,” he said.

Soo asked Newman about his conclusion to the personality test.

Again, Newman testified that the test indicated a deliberate attempt to exaggerate and report excessive symptoms.

Soo provided a copy of the test results for jurors and Newman helped them understand how to interpret the information.

Newman explained several scales on the personality test that help psychiatrists evaluate its validity.

He told jurors if a person’s score on one validity scale approaches 90, the test shouldn’t be interpreted because it’s probably exaggerated. He testified that Mendiola’s scores approached 90 on all validity scales.

Mendiola reported depression as a symptom, and Newman explained her results on the depression scale of the personality test.

“She may have trouble getting out of bed, but when a score is this high you just don’t get out of bed,” he testified.

He went on to say that the symptoms Mendiola reported could be real but they’re exaggerated.

Newman testified that her scores on certain parts of the personality test don’t match her current state and also don’t match her state at the time of her affair with Helms.

During the affair, Mendiola was able to go to her job at school, buy a new house and file a lawsuit.

With the symptoms she was claiming, she wouldn’t have been able to do those things, Newman said.

“I find it very difficult to believe Ms. Mendiola could have functioned over this period of time,” he said.

Soo asked Newman about his diagnosis based on his testing.

“I concluded that she was likely malingering,” he replied.

“There is no psychiatric or logical reason for those memory tests to be as low as they were,” Newman testified.

Soo asked Newman to describe his other diagnosis, borderline personality disorder, for the jury.

Like other doctors that have testified in the trial, he said people with borderline personality disorder are erratic, dramatic and unpredictable.

They are unstable emotionally, have unstable relationships and an unstable sexual identity, he said.

People suffering from the disorder also have a pattern of dangerous, risky behavior.

Newman testified that he reviewed Mendiola’s extensive medical records to make the diagnosis and in his opinion, she met all nine criteria used to diagnose someone with borderline personality disorder.

“People with borderline personality disorder make frantic attempts not to be alone,” he said.

In addition to an affair that ended her marriage, Newman said Mendiola became involved with a man on the Internet who was a drug trafficker. She also became suicidal when her daughter went to to visit her father in Texas, he said.

During the four-hour testing period, Newman said he observed Mendiola happy and joking one minute and then crying the next minute for no apparent reason.

When he reviewed her medical records, Newman testified that he saw where Mendiola reported feeling nothing but indifference.

That symptom is a hallmark of borderline personality disorder; Newman said people with the disorder feel empty inside so they create things on the outside to make themselves feel.

Soo asked Newman to describe how someone with borderline personality disorder would behave in a romantic relationship.

Newman said the person would elevate their partner until they felt crossed and then devalue them immediately.

After reviewing Mendiola’s medical records, Newman said, “I did not believe post traumatic stress disorder was likely in this case.”

Soo asked Newman what, other than Mendiola’s performance on the personality test, led him to diagnose her as malingering.

He talked about her medical records and other psychological tests he administered.

“The whole package suggests that this is a malingered profile.”

During cross-examination, Mendiola’s attorney, B. Ervin Brown, asked Newman if he agreed that borderline personality disorder symptoms are also present in adults who were sexually abused as children.

“They can be,” Newman testified.

Brown asked Newman if he saw sexual abuse in Mendiola’s medical records.

When Mendiola saw Ken Link at Salisbury Psychiatric Associates in 2000, she reported that she thought she had been sexually abused as a child, he said.

Not every person who brings litigation against someone for sexual abuse, Brown asked, is a malinger?

“Correct,” Newman replied.

During follow-up questions, Soo asked Newman if Mendiola’s records supported childhood sexual abuse.

Newman started off by saying that “we will never know for sure” but said he thought it was more likely that her reports of sexual abuse were “iatrogenic.”

He explained what iatrogenic meant by giving the example that someone may hear about a medical condition through their doctor or the media and may claim they have it without knowing for sure.

People who do this are looking for a way to explain their erratic behavior.

Newman explained his opinion.

During the entire time Mendiola was a patient at Salisbury Psychiatric Associates (off and on from 2000 to 2005), she could never remember any of the sexual abuse, she only reported that she thought she was abused.

It was only after she visited Dr. Thomas Hendren and Dr. Stephen Hebert, psychiatrists in Winston-Salem, that Mendiola reported remembering specific events of sexual abuse.

Newman pointed out that this was after the litigation against Helms and the school board started.

Both doctors testified earlier that they diagnosed Mendiola with post traumatic stress disorder and didn’t think she had borderline personality disorder.

Both also said they diagnosed her based only on what she told them and didn’t review her medical records.

As Newman was talking about Mendiola’s reported sexual abuse, she put her head down on the plaintiff’s table and started crying.

Contact Holly Lee at 704-797-7683 or hlee@salisburypost.com