Posttraumatic Stress Disorder in Litigation
Guidelines for Forensic Assessment, Second Edition
Edited by Robert I. Simon, M.D.
The terrorist attacks on the World Trade Center in September 2001 turned PTSD into a household word. But posttraumatic stress disorder has been documented throughout history: For example, as long ago as 1666, Samuel Pepys wrote in his diary that he still had night terrors 6 months after the great fire of London. PTSD, officially recognized as a diagnosis by DSM-III in 1980, is only the most recent term used to describe the suffering of trauma victims.
Few could have foreseen its profound impact on litigation. Often dubbed the “black hole” of litigation—where allegations are relatively easy to assert but difficult to defend because the symptoms are subjective—PTSD has deeply influenced civil and criminal law in cases ranging from malpractice and personal injury to sexual harassment and child abuse. It is thus vital for all legal parties involved that forensic examiners perform credible psychiatric and psychological examinations of PTSD claimants.
Intended to add direction and discipline to the forensic assessment of PTSD litigants, this expanded second edition begins with an updated chapter on current and future trends for the role of PTSD in litigation.
- Chapter 2 notes the increasing evidence that exposure to multiple events not only is more common than previously thought but also increases the risk for development of PTSD following the target event.
- Chapter 3 details diagnostic criteria and guidelines for the forensic psychiatric examination of the PTSD claimant.
- Most literature discusses PTSD in adults. Chapter 4 offers a rare perspective on PTSD in children and adolescents, including parental response to the trauma, developmental effects, and delayed onset symptoms.
- Forensic assessment of PTSD claimants is presented in Chapter 5, followed by new chapters on disability determinants (how PTSD impairs occupational functioning) and PTSD in the workplace, where the causal relationship between employment stress and a resulting mental or emotional disorder must be determined.
- Chapter 8 covers guidelines for malingering in PTSD, where the claimant may be motivated by financial gain or by a reduced charge resulting from an insanity defense.
- A new chapter on forensic laboratory testing in PTSD presents the tantalizing potential of psychophysiologic measurement to redeem the PTSD diagnosis from its daunting subjectivity.
This essential collection by 13 U.S. experts sheds important new light on forensic guidelines for effective assessment and diagnosis and determination of disability, serving both plaintiffs and defendants in litigation involving PTSD claims. Mental health and legal professionals, third-party payers, and interested laypersons will welcome this balanced approach to a complex and difficult field.
Foreword. Preface. Introduction. Persistent reexperiences in psychiatry and law: current and future trends for the role of PTSD in litigation. Recent research findings on the diagnosis of PTSD: prevalence, course, comorbidity, and risk. Forensic psychiatric assessment of PTSD claimants. PTSD in children and adolescents: an overview with guidelines for forensic assessment. Forensic psychological assessment in PTSD. Disability determination in PTSD litigation. PTSD in employment litigation. Guidelines for evaluation of malingering in PTSD. Forensic laboratory testing for PTSD. Index.
"With some new chapters and added contributors this essential forensic work has risen to an even higher level of usefulness than its predecessor edition. It admirably achieves its goal of promoting sound, scientific and professional standards for this often-controversial area of litigation. This edition belongs on every forensic shelf."—Thomas G. Gutheil, M.D., Professor of Psychiatry, Harvard Medical School; Co-director, Program in Psychiatry and the Law, Massachusetts Mental Health Center
"If one can improve on a classic, Dr. Simon has done so in the second edition of his Posttraumatic Stress Disorders in Litigation. His initial publication in 1995 served as a major aid for forensic psychiatrists and psychologists. His second edition expands on the problems faced by the forensic assessor by including children, employment situations, disability determinations, and the laboratory corroboration for the diagnosis. PTSD is such a complex and often confusing diagnosis that the establishment of guidelines set by Dr. Simon and elaborated by his colleagues is a most welcome and helpful publication for those of us who conduct forensic psychiatric assessments in civil and criminal litigation."—Robert L. Sadoff, M.D., Clinical Professor of Psychiatry; Director, Center for Studies in Social-Legal Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania
"This book is a welcome update to the first edition and provides readers with a thorough, well balanced, and comprehensive view of forensic assessment of individuals claiming psychiatric difficulty secondary to PTSD. The authors are well known and experienced in their respective fields, and are able to relate important and complicated issues in a relevant, easy to understand manner. This work also provides readers with essential guidelines and encourages a scientific approach for the assessment of these complex legal cases. In their attempt to raise the bar for forensic practitioners, the authors provide an invaluable resource for mental health and legal professionals involved in PTSD evaluation and litigation. An extensive list of references at the end of each chapter also provides the reader with links to further relevant information for those interested in exploring the topic in more depth."—Steven T. Herron, M.D., Doody's Health Science Review, May 2003
Robert I. Simon, M.D., is Clinical Professor of Psychiatry and Director of the Program in Psychiatry and the Law at Georgetown University School of Medicine in Washington, D.C.