PTSD in Court III: Malingering, assessment, and the law

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Abstract

This journal's third article on PTSD in Court focuses especially on the topic's “court” component. It first considers the topic of malingering, including in terms of its definition, certainties, and uncertainties. As with other areas of the study of psychological injury and law, generally, and PTSD (posttraumatic stress disorder), specifically, malingering is a contentious area not only definitionally but also empirically, in terms of establishing its base rate in the index populations assessed in the field. Both current research and re-analysis of past research indicates that the malingering prevalence rate at issue is more like 15 ± 15% as opposed to 40 ± 10%. As for psychological tests used to assess PTSD, some of the better ones include the TSI-2 (Trauma Symptom Inventory, Second Edition; Briere, 2011), the MMPI-2-RF (Minnesota Multiphasic Personality Inventory, Second Edition, Restructured Form; Ben-Porath & Tellegen, 2008/2011), and the CAPS-5 (The Clinician-Administered PTSD Scale for DSM-5; Weathers, Blake, Schnurr, Kaloupek, Marx, & Keane, 2013b). Assessors need to know their own possible biases, the applicable laws (e.g., the Daubert trilogy), and how to write court-admissible reports. Overall conclusions reflect a moderate approach that navigates the territory between the extreme plaintiff or defense allegiances one frequently encounters in this area of forensic practice.

Section snippets

Précis of the third article of the three on PTSD in Court

The third article of the three in the journal for court purposes on PTSD (posttraumatic stress disorder) deals with legal aspects and court, in particular (for the first two articles in the series, refer to Young, 2016a, Young, 2017). It starts with a comprehensive review of malingering, by considering the different approaches to its definition and the different rates attributed to its prevalence. Some of the complications in determining the base rate of malingering concern differing

Existing tools

Frueh, Elhai, Grubaugh, and Ford (2012) have noted the value of structured interviews in firmly establishing the diagnosis of PTSD. Structured interviews are preferred because they allow for more detailed inquiry and clarification than self-report instruments. An example of a structured interview for PTSD is the PTSD module of the SCID.

As for other interview approaches, there are ones that also have adequate psychometric properties relative to the DSM-5 PTSD symptoms. The PCL-5 (Weathers et

Admissibility

Admissibility to court and related venues is informed by cases that have specified the parameters of good science compared to poor or junk science. The decision of the Supreme Court of the United States in Daubert (Daubert v. Merrell Dow Pharmaceuticals, Inc., 1993), in particular, serves that function in forensic cases. It specifies, among other things, that admissibility of evidence to court shall be evaluated by triers of fact (judges, juries) according to the criteria of falsifiability,

Conclusions to the article

An interim summary on this third article in the series of three in the journal on the topic of PTSD in Court, which is on malingering, assessment and testing, and the law, includes the following. Malingering is a pervasive concern in forensic disability and related assessments for court and other similar venues. Partly depending on which side of the so-called “adversarial divide” one works, it is the backdrop that might be considered in most every case either as quite possible or quite

Summary

The present series of three articles on PTSD in Court is divided into three major parts: (a) an introduction, including on PTSD in the DSM-5 (e.g., entry trauma criterion, symptoms, clusters, limitations); (b) a description on biological contributions and causality related to PTSD, with cautions about bio-exuberance in court and reaching the material contributions test; and (c) forensic and legal considerations, especially on its testing, malingering, and biases. Mainly, this series of three

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