Empirical Limits for the Forensic Assessment of PTSD Litigants
This paper discusses the limits of expert opinion on posttraumatic stress disorder (PTSD) in personal injury claims. The construct of PTSD is hampered by several empirical limitations. Multiple reliable measures of PTSD exist, but have not been evaluated sufficiently within litigating samples and ar...
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| Veröffentlicht in: | Law and human behavior 2005-02, Vol.29 (1), p.121-149 |
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| creator | Koch, William J O'Neill, Melanie Douglas, Kevin S |
| description | This paper discusses the limits of expert opinion on posttraumatic stress disorder (PTSD) in personal injury claims. The construct of PTSD is hampered by several empirical limitations. Multiple reliable measures of PTSD exist, but have not been evaluated sufficiently within litigating samples and are infrequently used by forensic assessors. Common methods for trauma screening appear insensitive. Opinions about causation of PTSD and disability are complicated by retrospective memory biases, as well as the failure of most anxiety disorders to be detected within primary medical care. PTSD appears to have a steep spontaneous remission curve during the first year, but at least 10% of trauma-exposed people suffer chronic distress. Little is known about the course beyond 1 year. Efficacious psychological treatments have been developed for PTSD, but are not in common use limiting claimants' access to rehabilitative treatments. Research on functional disability associated with PTSD is in its infancy, but it seems likely that PTSD will account for only a part of the variance in work disability. We provide suggestions for improving forensic practice, advising the courts about the limitations of forensic opinions, and necessary research. |
| doi_str_mv | 10.1007/s10979-005-1401-7 |
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The construct of PTSD is hampered by several empirical limitations. Multiple reliable measures of PTSD exist, but have not been evaluated sufficiently within litigating samples and are infrequently used by forensic assessors. Common methods for trauma screening appear insensitive. Opinions about causation of PTSD and disability are complicated by retrospective memory biases, as well as the failure of most anxiety disorders to be detected within primary medical care. PTSD appears to have a steep spontaneous remission curve during the first year, but at least 10% of trauma-exposed people suffer chronic distress. Little is known about the course beyond 1 year. Efficacious psychological treatments have been developed for PTSD, but are not in common use limiting claimants' access to rehabilitative treatments. Research on functional disability associated with PTSD is in its infancy, but it seems likely that PTSD will account for only a part of the variance in work disability. We provide suggestions for improving forensic practice, advising the courts about the limitations of forensic opinions, and necessary research.</description><identifier>ISSN: 0147-7307</identifier><identifier>EISSN: 1573-661X</identifier><identifier>DOI: 10.1007/s10979-005-1401-7</identifier><identifier>PMID: 15865334</identifier><language>eng</language><publisher>United States: Springer</publisher><subject>Anxiety disorders ; Depressive disorders ; Disabilities ; Disability Evaluation ; Disorders ; Expert Testimony ; Forensic Assessment ; Forensic Evaluation ; Forensic Psychiatry - methods ; Forensic psychology ; Human ; Humans ; Injuries ; Legal Processes ; Liability, Legal ; Litigation ; Medical treatment ; Mental health ; Physical trauma ; Plaintiffs ; Post traumatic stress disorder ; Posttraumatic Stress Disorder ; Prognosis ; Reproducibility of Results ; Stress Disorders, Post-Traumatic - diagnosis ; Studies ; Symptoms ; Trauma</subject><ispartof>Law and human behavior, 2005-02, Vol.29 (1), p.121-149</ispartof><rights>2005 American Psychology-Law Society/Division 41 of the American Psychological Association</rights><rights>2005 American Psychological Association</rights><rights>Copyright 2005 American Psychology-Law Society/Division 41 of the American Psychological Association</rights><rights>Springer Science + Business Media, Inc. 2005</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-a470t-f4d1dd96a52089f5a479fd5c349411997723e975102e167826bcb1521575fbae3</citedby><cites>FETCH-LOGICAL-a470t-f4d1dd96a52089f5a479fd5c349411997723e975102e167826bcb1521575fbae3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/15865334$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Wiener, Richard L</contributor><creatorcontrib>Koch, William J</creatorcontrib><creatorcontrib>O'Neill, Melanie</creatorcontrib><creatorcontrib>Douglas, Kevin S</creatorcontrib><title>Empirical Limits for the Forensic Assessment of PTSD Litigants</title><title>Law and human behavior</title><addtitle>Law Hum Behav</addtitle><description>This paper discusses the limits of expert opinion on posttraumatic stress disorder (PTSD) in personal injury claims. The construct of PTSD is hampered by several empirical limitations. Multiple reliable measures of PTSD exist, but have not been evaluated sufficiently within litigating samples and are infrequently used by forensic assessors. Common methods for trauma screening appear insensitive. Opinions about causation of PTSD and disability are complicated by retrospective memory biases, as well as the failure of most anxiety disorders to be detected within primary medical care. PTSD appears to have a steep spontaneous remission curve during the first year, but at least 10% of trauma-exposed people suffer chronic distress. Little is known about the course beyond 1 year. Efficacious psychological treatments have been developed for PTSD, but are not in common use limiting claimants' access to rehabilitative treatments. Research on functional disability associated with PTSD is in its infancy, but it seems likely that PTSD will account for only a part of the variance in work disability. We provide suggestions for improving forensic practice, advising the courts about the limitations of forensic opinions, and necessary research.</description><subject>Anxiety disorders</subject><subject>Depressive disorders</subject><subject>Disabilities</subject><subject>Disability Evaluation</subject><subject>Disorders</subject><subject>Expert Testimony</subject><subject>Forensic Assessment</subject><subject>Forensic Evaluation</subject><subject>Forensic Psychiatry - methods</subject><subject>Forensic psychology</subject><subject>Human</subject><subject>Humans</subject><subject>Injuries</subject><subject>Legal Processes</subject><subject>Liability, Legal</subject><subject>Litigation</subject><subject>Medical treatment</subject><subject>Mental health</subject><subject>Physical trauma</subject><subject>Plaintiffs</subject><subject>Post traumatic stress disorder</subject><subject>Posttraumatic Stress Disorder</subject><subject>Prognosis</subject><subject>Reproducibility of Results</subject><subject>Stress Disorders, Post-Traumatic - 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methods</topic><topic>Forensic psychology</topic><topic>Human</topic><topic>Humans</topic><topic>Injuries</topic><topic>Legal Processes</topic><topic>Liability, Legal</topic><topic>Litigation</topic><topic>Medical treatment</topic><topic>Mental health</topic><topic>Physical trauma</topic><topic>Plaintiffs</topic><topic>Post traumatic stress disorder</topic><topic>Posttraumatic Stress Disorder</topic><topic>Prognosis</topic><topic>Reproducibility of Results</topic><topic>Stress Disorders, Post-Traumatic - diagnosis</topic><topic>Studies</topic><topic>Symptoms</topic><topic>Trauma</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Koch, William J</creatorcontrib><creatorcontrib>O'Neill, Melanie</creatorcontrib><creatorcontrib>Douglas, Kevin S</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Social Sciences Premium Collection</collection><collection>ProQuest Central (Corporate)</collection><collection>ABI/INFORM Collection</collection><collection>ABI/INFORM Global (PDF only)</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>ABI/INFORM Global (Alumni Edition)</collection><collection>Healthcare Administration Database (Alumni)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Psychology Database (Alumni)</collection><collection>Criminal Justice Database (Alumni Edition)</collection><collection>ProQuest Pharma Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ABI/INFORM Collection (Alumni Edition)</collection><collection>Research Library (Alumni Edition)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Social Science Premium Collection</collection><collection>ProQuest Central Essentials</collection><collection>ProQuest Central</collection><collection>Business Premium Collection</collection><collection>Criminology Collection</collection><collection>ProQuest One Community College</collection><collection>ProQuest Central Korea</collection><collection>Business Premium Collection (Alumni)</collection><collection>Health Research Premium Collection</collection><collection>ABI/INFORM Global (Corporate)</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>Research Library Prep</collection><collection>ProQuest Business Collection (Alumni Edition)</collection><collection>ProQuest Business Collection</collection><collection>ProQuest Criminal Justice (Alumni)</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ABI/INFORM Professional Advanced</collection><collection>ABI/INFORM Global</collection><collection>Criminal Justice Database</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Healthcare Administration Database</collection><collection>Medical Database</collection><collection>Psychology Database</collection><collection>Research Library</collection><collection>Research Library (Corporate)</collection><collection>Research Library China</collection><collection>ProQuest One Business</collection><collection>ProQuest One Business (Alumni)</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>ProQuest One Psychology</collection><collection>ABI/INFORM Collection China</collection><collection>ProQuest Central Basic</collection><collection>APA PsycArticles®</collection><collection>MEDLINE - Academic</collection><jtitle>Law and human behavior</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Koch, William J</au><au>O'Neill, Melanie</au><au>Douglas, Kevin S</au><au>Wiener, Richard L</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Empirical Limits for the Forensic Assessment of PTSD Litigants</atitle><jtitle>Law and human behavior</jtitle><addtitle>Law Hum Behav</addtitle><date>2005-02</date><risdate>2005</risdate><volume>29</volume><issue>1</issue><spage>121</spage><epage>149</epage><pages>121-149</pages><issn>0147-7307</issn><eissn>1573-661X</eissn><abstract>This paper discusses the limits of expert opinion on posttraumatic stress disorder (PTSD) in personal injury claims. The construct of PTSD is hampered by several empirical limitations. Multiple reliable measures of PTSD exist, but have not been evaluated sufficiently within litigating samples and are infrequently used by forensic assessors. Common methods for trauma screening appear insensitive. Opinions about causation of PTSD and disability are complicated by retrospective memory biases, as well as the failure of most anxiety disorders to be detected within primary medical care. PTSD appears to have a steep spontaneous remission curve during the first year, but at least 10% of trauma-exposed people suffer chronic distress. Little is known about the course beyond 1 year. Efficacious psychological treatments have been developed for PTSD, but are not in common use limiting claimants' access to rehabilitative treatments. Research on functional disability associated with PTSD is in its infancy, but it seems likely that PTSD will account for only a part of the variance in work disability. We provide suggestions for improving forensic practice, advising the courts about the limitations of forensic opinions, and necessary research.</abstract><cop>United States</cop><pub>Springer</pub><pmid>15865334</pmid><doi>10.1007/s10979-005-1401-7</doi><tpages>29</tpages></addata></record> |
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| subjects | Anxiety disorders Depressive disorders Disabilities Disability Evaluation Disorders Expert Testimony Forensic Assessment Forensic Evaluation Forensic Psychiatry - methods Forensic psychology Human Humans Injuries Legal Processes Liability, Legal Litigation Medical treatment Mental health Physical trauma Plaintiffs Post traumatic stress disorder Posttraumatic Stress Disorder Prognosis Reproducibility of Results Stress Disorders, Post-Traumatic - diagnosis Studies Symptoms Trauma |
| title | Empirical Limits for the Forensic Assessment of PTSD Litigants |
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