http://www.fpamed.com | Since its introduction into psychiatric discourse in the post-Vietnam era, PTSD has become a controversial but important part of forensic psychology. While the exact criteria for establishing a diagnosis of PTSD continues to evolve, it is still true that defendants who are able to establish past sympathetic trauma and subsequent affliction with PTSD are more likely to be sympathetic to juries, and thus see more positive outcomes at their trials.

1. P T S D a n d t h e L a w :
WHAT IT IS, WHAT IT ISN'T, AND ITS
NEWEST ROLE IN THE COURTROOM

2. WHAT IS PTSD?
The term "PTSD" (Post-Traumatic
Stress Disorder) was introduced
into psychological discourse in
the post-Vietnam era. The
diagnosis of PTSD was created to
describe the variety of damaging
psychological effects seen in
soldiers due to their long-term
and continued exposure to
trauma during the war. In the
decades since the diagnosis'
introduction, it has become a
part of the common lexicon.

3. UNDERSTANDING PTSD
The most common understanding of PTSD is that it causes
sufferers of a traumatic experience or experiences to constantly re-remember
and re-experience the fear of harm or death that they
felt during the inciting incident(s).
PTSD is most commonly associated with the trauma experienced
by soldiers deployed in armed conflict. According to current
estimates by the National Center for PTSD:
• 11% of veterans of the conflict in Afghanistan, and
• 20% of veterans of the Iraq War suffer from PTSD

4. PTSD IN
LEGAL DEFENSE
In the legal world, PTSD most often comes
up as part of a defense against criminal
charges. It is most commonly used as part
of one of the following defense strategies:
• Insanity
• Diminished capacity
• A mitigating factor during sentencing
That said, PTSD is not only legally relevant
in criminal cases. It will sometimes also be
brought up as a mitigating factor in civil
cases such as mass tort claims, or in family
court cases such as child custody disputes.

5. EXPERT WITNESSES AND PTSD
Research has consistently shown that if a psychiatric expert witness is
able to show that a defendant has suffered from past trauma and
subsequently establish a diagnosis of PTSD, that diagnosis can make a
significant difference in the outcome of the trial. This is especially true
in the case of veterans suffering from PTSD. Time and time again,
studies have shown that juries are more lenient on veterans whom they
believe to be suffering from PTSD, and that soldiers convicted of a
crime are likely to receive a lighter sentence.

6. HOW PTSD
DOES NOT
WORK AS
PART OF A
LEGAL
DEFENSE
In order for a diagnosis of PTSD to have a
beneficial effect on a legal defense strategy, it
is best if the defense team can logically
connect the PTSD diagnosis and its effects
with the alleged criminal act. Additionally,
juries and courtrooms are not sympathetic to
claims of PTSD caused by the commission of
criminal acts or the inflicting of trauma.
An example of PTSD backfiring as
part of a defense strategy is the Jodi
Arias murder trial, during which the
jury rejected the defendant's claims
that committing the murder she was
charged with had caused her to suffer
from PTSD. In order to be an effective
part of a defense, the defendant must
be shown to suffer from PTSD
because of trauma inflicted on them,
not as a side effect of trauma that they
themselves have inflicted.

7. THE CHANGING DEFINITION OF PTSD
While the broad definition of PTSD has remained consistent since the
1970s, the American Psychiatric Association (APA) has made some
changes to the exact guidelines on how the disorder is diagnosed. The
most recent change came in 2013, when the APA published the latest
edition of their Diagnostic and Statistical Manual of Mental Disorders
(also know as the DSM-5).
The criteria for diagnosing PTSD in this newest edition differ from the
previous ones found in DSM-4, and have generated some controversy
among academics, psychologists, and prosecutors.

8. PTSD AS DEFINED IN DSM-5
The most significant changes to the criteria for diagnosing
PTSD made in DSM-5 are:
• The addition of a fourth major symptom cluster. In the
newest update, the "avoidance/numbing" cluster found in
DSM-IV has been split in two: "avoidance" and
"persistent negative changes in cognitions and mood."
• The broadening of a pre-existing cluster, "changes in
arousal and reactivity," to include additional symptoms
such as angry outbursts, irritability, and self-destructive
or reckless behavior.
• Lower diagnostic thresholds for children and
adolescents.
• The addition of a new subtype of PTSD for children ages
six and younger.

9. THE DSM-5 CONTROVERSY
There has been some criticism of the DSM-5 updates to PTSD; most of it
suggesting that the new criteria is overly broad. Criminal prosecutors in
particular have been skeptical of the changes, claiming that it is now easier
than ever for expert witness testimony to establish PTSD, which will lead to
an increase in the number of defendants who use it as a part of their
criminal defense.
While the current application of PTSD in criminal defenses may be
controversial, the wide spread acceptance of PTSD as a legitimate medical
condition means that it will continue to be used as a part of legal defenses,
and that it will most likely continue to be regarded as a legitimate
extenuating circumstance by juries.

10. Forensic Psychiatric Associates
Medical Corporation (fpamed) is a
group of psychiatric and
psychological experts who provide
support to defense attorneys,
prosecutors, and civil plaintiffs
nationwide. Fpamed provides
reports, consultations, and expert
testimony on matters of mental
health and the legal system, with
the aim of presenting complex
psychological and behavioral
analysis to the court in an
understandable, evidence-based
manner. For more information, call
(415) 388-8040 or visit
www.fpamed.com.