Post-Traumatic Stress Disorder: Ethical and Legal Relevance to the Criminal Justice System

Abstract

Post-Traumatic Stress Disorder is a major public health concern in both civilian and military populations, across race, age, gender, and socio-economic status. While PTSD has been around for centuries by some name or another, its definition and description also continue to evolve. Within the last few years, the American Psychological Association has published the 5th edition of the Diagnostic and Statistical Manual of Mental Disorders, which includes some major changes in the diagnostic criteria for PTSD. Recent data on epidemiology, etiological theories, and empirically supported methods of treatment, as well as implications for legal processes and criminal justice system personnel, are discussed.

Concerns Over Divergent Approaches in the Diagnostics of Posttraumatic Stress Disorder

“…There is a marked incongruence between the ICD-11 12 proposed criteria and DSM-5 11 (specifically the absence of the criteria related to the negative alterations in cognitions and mood) that were key new inclusions in DSM- 5,11 yet absent in the proposed ICD-11.…”

“…Since its inclusion in the Diagnostic and Statistical Manual of Mental Disorders, third edition (DSM-III), 1 there has been an ongoing debate about the veracity, the neurobiology, and legal status of the disorder. [2][3][4][5][6] As a consequence, the clinical utility of the definition has been subject to competing interests from insurance companies, victim's groups, and policy makers. Also, there is no other mental health diagnosis in which the causation is directly linked to the diagnosis; a status that has particular ramifications in compensation settings.…”

Biomarkers for PTSD Susceptibility and Resilience, Ethical Issues

“…Today, ethical studies and discussions on biomarker research in trauma-related mental disorders including PTSD are rather sparse. Where they do exist, the scientific reports seem to mostly focus on research-related ethical questions (Jain et al 2011), on questions that arise when treating PTSD patients (Yang et al 2017), and on ethical issues relevant for the criminal justice system (Soltis et al 2014). However, biomedical research on PTSD susceptibility and resilience furthermore raises ethical questions in the context of prevention that have been largely underrepresented in the scientific literature.…”

Concept Analysis of Posttraumatic Stress Disorder

“…The DSM-IV put more emphasis on the perception of an event as compared to the DSM-III by acknowledging that the threat of a traumatic event was on par with the experience of a traumatic event in terms of possible psychological effect (Soltis, Acierno, Gros, Yoder, & Tuerk, 2014). Still, the definition of a traumatic event has been viewed as too narrow, failing to take into account how individuals interpret the event (Mitchell, Clegg, & Furniss, 2006).…”