Citation

Hamner MB. J. Law Med. Ethics 2014; 42(2): 155-160.

Affiliation

Professor of Psychiatry and Behavioral Sciences at the Medical University of South Carolina and Medical Director of the PTSD Clinic at the Ralph H. Johnson VA Medical Center in Charleston, S.C.

Copyright

(Copyright © 2014, American Society of Law, Medicine and Ethics, Publisher John Wiley and Sons)

DOI

10.1111/jlme.12131

PMID

25040379

Abstract

PTSD was formalized as a diagnosis by the American Psychiatric Association in 1980 with the publication of the Diagnostic and Statistical Manual of Mental Disorders (DSM), 3rd edition. Since that time, the diagnosis has been widely utilized in the courts including the use in criminal proceedings. PTSD may play a role in the assessment of violent crimes both as a possible contributing factor in the perpetrators as well as a consequence in the victims. There are a number of ethical and clinical considerations in the use of this diagnosis. Importantly, the diagnostic criteria have changed to a degree with subsequent editions of the DSM. This may have an impact on the interpretation of past legal judgments. Moreover, extensive psychiatric comorbidity may complicate the clinical picture, e.g., mood disorders, substance use disorders, or psychosis. The diagnosis of PTSD is still based on clinical, largely subjective criteria, e.g., biological markers are not yet utilized. As such, there may not be consistent agreement about the diagnosis among experts. This paper summarizes some of these relevant issues in adjudicating violent crimes.

Language: en