Posttraumatic stress disorder and criminal responsibility

Abstract

There has been an increased interest in the relationship between posttraumatic stress disorder (PTSD) and violence, and in the factors that mediate their linkage. PTSD is a common, often underdiagnosed, condition with high levels of psychiatric comorbidity. It often has poor outcomes, with many cases becoming chronic, leading to substantial costs both to the individual and society as a whole. In this paper we report on the literature on PTSD, its diagnosis, assessment, and treatment. The difficulties encountered when assessing PTSD – the subjective nature of the symptoms, the risk of malingering, and the possibility of secondary gain – have been highlighted. Assessment and treatment in forensic settings is further complicated by the possibility of perpetrator PTSD. We have reviewed the prevalence of PTSD with particular reference to offender and forensic populations. The association between PTSD and violence, its relevance across the spectrum of criminal responsibility, and relevant case law are explored.

Keywords:

• Posttraumatic stress disorder
• post-traumatic stress disorder
• forensic psychiatry
• criminal responsibility
• diminished responsibility
• insanity