PTSD

A Clinical And Forensic Look Into PTSD

Post Traumatic Stress Disorder, or PTSD, is a mental health condition triggered by a traumatic event that is either experienced or witnessed by an individual. The event is perceived as too overwhelming and terrifying, and causes symptoms that affect one’s normal way of life. PTSD is often misdiagnosed or dismissed by healthcare professionals. This is the reason why many people with PTSD are usually untreated. 

Symptoms often vary from person to person, but usually develop immediately after the trauma. However, they can also develop years later. As a result, people are often taken by surprise with smothering and irrational emotions. Consequently, significant problems occur in all areas of life. In addition, they profoundly interfere with our daily activities and peace of mind. PTSD affects people of all ages. 

The Past Revisited

PTSD is characterized by constant and painful memories of the traumatic events of the past. This includes:

  • Intrusive and distressing flashbacks of the traumatic experience
  • Frequent and recurrent nightmares about or relating to the trauma 
  • Paralyzing fear when confronted by a situation similar to the event. These situations are referred to as “triggers” which can be visual or auditory triggers.
  • Reliving and re-experiencing the terrifying ordeal

Emotional and Behavioral Changes

PTSD is also characterized by negative thoughts and emotions that cause negative changes in mood and behavior. This includes:

  • Mood swings, anxiety and depression
  • Feelings of hopelessness and a negative outlook
  • Irrational fear, phobias, and distrust of people
  • Lack of interest in social activities
  • Problems maintaining close and intimate relationships
  • Detachment with friends and family
  • Avoidance of anything that can be a reminder of the trauma
  • No concrete plans for the future 
  • Easily startled and chronic nervousness
  • Irritability and aggression
  • Suicidal thoughts

Physical Changes

  • Insomnia or poor sleeping habits
  • Anorexia and loss of interest in food
  • Inability to focus or concentrate, leading to  poor academic and job performance
  • Chronic aches and pains
  • Medication abuse
  • Substance abuse
  • Lack of energy 
  • Regression in children by bedwetting and tantrums

Not all traumatic experiences lead to PTSD. This depends on many factors such as age, severity of trauma, and coping abilities of the individual. Many associate PTSD with war veterans. However, this condition has expanded in modern times. It is now a worldwide phenomenon that affects millions of people in a variety of ways.

These traumas of the mind and body result in powerful emotional episodes in those with PTSD. Furthermore, these events are usually life threatening and something rare. The rarity of the event creates trauma that enters deeply into the psyche. The events range from accidents, to natural disasters, to wars, witnessing a crime, or being a victim of a crime. 

PTSD in Victims of Crime

PTSDThere is a much higher incidence of PTSD among victims of crime. Moreover, researchers looked at 80 different types of disasters and compared severity of trauma from them. Not surprisingly, mass violence was the most traumatizing of all. Consequently, 67% of people exposed to mass violence developed severe trauma. Natural disasters usually cause a slightly higher amount of trauma (42%) when compared to technological disasters (34%).

According to the PTSD Alliance, the estimated risk of developing PTSD among crime victims are: rape (49%), physical assault (31%), sexual assault (23.7%), shooting and stabbing (15.4%), and witnessing a murder (7.3%). Studies also show very high rates of PTSD among children. As a result, 100% of the victims of parental homicide develop PTSD. In addition, PTSD forms for around 90% of sexually abused children,  77% exposed to shootings, and 35% exposed to community violence.

PTSD in Crime Offenders

PTSD is often used to as an insanity defense for a crime offender. But this is rare, as these types of defenses are difficult to win. Insanity pleas have a high failure rate and account for only 1% of criminal pleas in the United States. Furthermore, out of that 1%, only 25% successfully get an NGRI verdict (Not Guilty by Reason of Insanity). 

An NGRI states that a person cannot be held criminally responsible if the act was committed because of mental disease. Meaning, the offender isn’t of a sound mind during the criminal act. For this reason, PTSD is highly criticized as a defense for crime. However, a few successful cases exist.

The Role of A Forensic Psychologist

Forensic psychologists apply their knowledge to criminal behavior in order to accurately assess a case. Therefore, bridging the gap between psychology and law. It is the application of psychological principles in the legal world. A forensic psychologist evaluates PTSD in offenders and victims. They are highly trained in psychological assessment and forensic evaluations. 

Crimes, disasters, and tragic events do not discriminate. They can happen to anyone. And when they do, the consequences are life changing. Oftentimes, survivors are left to deal with the aftermath on their own. As a result, anxiety, depression and even rates of suicide can increase. If you or a loved one is a victim of crime or a traumatic event, please get help before it is too late. Forensic psychologists can provide counseling and therapy for victims of PTSD. 

 

Sources:

PTSD and Crime Victimization

Mental Health Issues

Post Traumatic Stress Disorder

Forensic Examinations And PTSD

PTSD Within the Forensic Arena

 

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insanity assessment

Insanity Assessment: When A Guilty Mind Is Absent

THE JUROR STANDS IN THE COURTROOM. Everyone is silent and is seemingly holding their breaths. After a few seconds that lasted more like minutes, the juror declares in a loud voice, “We find the defendant not guilty by reason of insanity”.  Scenes such as this are highly popularized and dramatized in TV shows like Criminal Minds, CSI, or Law And Order. And like any avid fan of crime dramas, we think we know what it means. But do we?

Establishment of Guilt

insanity assessmentIf someone accidentally hits another person with their car, is the driver guilty of a crime? If a person kills in the act of self defense, will that person be held liable for taking a life? What if the perpetrator is mentally insane? What happens when a guilty mind is absent?

There are three elements of a crime, and these elements come together to establish guilt or criminal liability. Every crime involves an act (actus reus), state of mind (mens rea), and causation. Not Guilty by Reason of Insanity (NGRI) revolves around the second element, mens rea. Mens rea is the qualification that a person had the required state of mind during the commission of the crime. Examples of this would be premeditation, recklessness, or negligence. If this qualification is absent, a guilty verdict cannot be found. Under this framework, an NGRI  plea proposes that a defendant is not guilty because of insanity.

Insanity Assessment

Insanity is not just a psychiatric term. It is actually a legal term. In a legal perspective, insanity goes around the premise that the defendant was not of sound mind when a criminal act was committed. However, an NGRI does not apply to every mentally ill defendant. This is because suffering from a mental disorder does not necessarily prove insanity. 

Insanity assessment helps to determine if a person should be granted an NGRI verdict. Contrary to what we see in TV crime shows, insanity pleas have a high failure rate. Only 1% of criminal pleas in the U.S. are NGRI. And within this diminutive percentage, only 25% successfully establish insanity. 

Certain criteria need to be met to validate insanity. And this is no easy feat. The courts rely on the judgement and expertise of a forensic psychologist or psychiatrist in establishing a defendant’s mental state at the time of the crime. These experts use certain guidelines when performing insanity assessment on an individual. They determine legal insanity by applying one or more of the following guidelines:

M’Naghten Rule

insanity assessmentEstablished by the English House of Lords in the 19th century, the M’Naghten Rule determines that a person cannot differentiate between right and wrong when committing the crime. Moreover, the person did not possess the mental capacity to understand the nature and quality of the crime. This rule is also known as the right-or-wrong test. 

The rule was established in 1843 in England following the trial of Daniel M’Naghten, who killed the prime minister’s secretary, thinking he was the prime minister Robert Peel himself. M’Naghten harbored a delusion that the government was conspiring against him. He was acquitted of murder and was institutionalized for the rest of his life.

Durham Rule

The Durham Rule is another insanity assessment tool used to evaluate the validity of an insanity claim. With this rule, a defendant cannot be held criminally responsible for a crime if the act was a result of a mental illness. This rule requires the jury to establish whether or not the defendant suffers from mental illness, and if there exists a causal relationship between the disease and the crime. 

This rule was adopted by the United States Court of Appeals in 1954. It was established following the case of Monte Durham, a 23 year old convicted of housebreaking in 1953. Durham had been in and out of mental institutions prior to his conviction. The Court of Appeals overturned his conviction, giving rise  to this new rule for insanity assessment. 

Irresistible Impulse Test

One problem that arose with the M’Naghten Rule was the establishment of insanity among individuals who understood right from wrong, and yet could not control impulses due to mental illness. The Irresistible Impulse Test addresses this problem. Under its parameters, a defendant may be found not guilty due to the inability to control impulses leading to the commission of a crime. This test is suitable for mental conditions like manias and paraphilias. 

The Model Penal Code

This rule states that an individual is not responsible for a crime where, due to mental disease, he or she did not have the “substantial capacity either to appreciate the criminality of his conduct or to conform his conduct to the requirements of the law.”

The courts adopted this rule in 1972 in an attempt to improve existing frameworks for insanity. It is broader, more comprehensive and encompassing of the complexities involved with insanity assessment. But like the previous rules, it is not without flaws. 

When dealing with an insanity assessment, a forensic psychologist must possess the necessary skills and training for such a critical task. If you want to gain more insight about forensic psychology, check out our post, “Differences Between Therapeutic Psychology and Forensic Psychology”. 

 

Sources:

Forensic Psychologists in Determining Insanity and Competency to Stand Trial

Logical Model of Guilt as a Part of a Structure of Crime

AAPL Practice Guideline for Forensic Psychiatric Evaluation of Defendants Raising the Insanity Defense

Not Guilty by Reason of Insanity

Insanity defense

Not Guilty By Reason of Insanity

What are The Elements of a Crime?

Criminal Law

 

 

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