Massive Traumatic Events and Posttraumatic Stress Disorder

Forensic Psychiatry and Ethical Approaches in Legal Issues, Nursen Turan Yurtsever, Editör, NOVA Science Publishers Inc. , New York, ss.91-110, 2021

Posttraumatic stress disorder (PTSD) is a psychiatric disorder that may

occur in people who have experienced or witnessed a traumatic event such

as a natural disaster, a serious accident, a terrorist act, war/combat, or rape

or who have been threatened with death, sexual violence, or serious injury.

Individuals with PTSD may have impairments in aspects of their

psychological, physical, interpersonal, and occupational lives. PTSD

usually has a chronic course and causes disruptions in the general and

social functioning of the person. PTSD can be both underdiagnosed and

overdiagnosed in clinical settings. There are clear differences in the clinical

approach to PTSD cases and the forensic perspective. The medicolegal

approach is different from the clinical viewpoint. Psychiatrists are

frequently asked for evaluations of traumatic events in civil and criminal

matters. Psychiatrists are asked to evaluate if the traumatic event caused or

contributed to a psychiatric disorder or a functional impairment. They are

also asked to make a distinction between causal and contributing factors.

In addition, the factors that contribute to the person’s current mental state

and functionality should be well reviewed, and a possible malingering

should not be overlooked. This chapter will review the clinical and ethical

implications in evaluating patients with PTSD in a forensic setting.