Asbestos exposure and posttraumatic stress disorder.
I. N. Perr,
Bull. Amer. Acad. Psychiatry & the Law
21(3): 331-44, 1993.
In 48 cases of claims of psychic injury due to exposure to asbestos, posttraumatic stress disorder
(PTSD) was alleged as a basis for damages in nine (19%). PTSD as currently defined refers to a
specific syndrome following exposure to a life-threatening traumatic event, one outside the general
range of people's experiences such as military combat, floods, earthquakes, bombing, torture, death
camps--events either natural or man-made. The symptoms include reexperiencing of the event with
intrusive thoughts or nightmares of the event, startle reactions, psychic numbing, and survival guilt.
The application of this concept to chronic illness, often of minor degree, is quite inappropriate. The
clinical data in the nine cases reveal no pertinent precipitating event and the lack of a clinical
syndrome compatible with the disorder. The cases also generally reflect no psychiatric impairment,
inadequate medical review, and lack of background history--common characteristics in asbestos
litigation with no disabling pulmonary parenchymal impairment. If the results in this group are
typical, then one must suspect the legitimacy of claims of psychic injury such as post-traumatic stress
disorder from asbestos exposure and at the very least the reasonableness of the experts who provide
input into the medicolegal process.