Posttraumatic stress disorder in tort actions: forensic minefield.
L. F. Sparr and J. K. Boehnlein,
Bull. Amer. Acad. Psychiatry & the Law
18(3): 283-302, 1990.
The authors discuss posttraumatic stress disorder (PTSD) as a basis for personal injury litigation.
Three case examples raise issues related to: (1) the controversy surrounding expansion of tort
liability, (2) the courtroom use of psychiatric nomenclature as represented in the DSM (e.g., PTSD),
and (3) ethical concerns regarding psychiatric expert witnesses. Psychiatrists became easy targets
when problems related to personal injury "stress" cases developed. A careful analysis, however,
demonstrates that the issues are complex and multifaceted. For example, tort liability expansion was
primarily instituted to compel a greater provision of liability insurance, not to reward stress claims.
The increasing use of psychiatry's DSM in the courtroom has occurred despite explicit precautions
against forensic application. Finally, the need for psychiatric expert witnesses has increased because
courts have gradually usurped some psychiatric clinical prerogatives and because there has been a
trend toward greater consideration of emotional pain and suffering. Although psychiatric expert
witnesses have not been beyond reproach, critics have attempted to impeach the entire psychiatric
profession for the questionable actions of the minority. The authors provide a detailed analysis of
current problems, offer suggestions for improvement, and provide an educational counterpoint to the
"hysterical invective" that often greets psychiatric testimony. [References: 77]