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Polar Histogram Visualization of Acute Stress Disorder Scale Scores for Comprehensive Clinical Assessment

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DSM-5 and posttraumatic stress disorder.

Andrew P Levin¹, Stuart B Kleinman², John S Adler²

¹Dr. Levin is Medical Director, Westchester Jewish Community Services, Hartsdale, NY, and Assistant Clinical Professor of Psychiatry, Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY. Dr. Kleinman is Associate Clinical Professor of Psychiatry, Columbia University College of Physicians and Surgeons, and Adjunct Professor of Law, Brooklyn Law School, Brooklyn, NY. Mr. Adler is a shareholder with Littler Mendelson, PC, in its San Diego, CA office. aplevin2@cs.com.

The Journal of the American Academy of Psychiatry and the Law

|July 3, 2014

Summary

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) updated posttraumatic stress disorder (PTSD) criteria, impacting diagnosis prevalence and forensic assessments. These changes refine criteria for PTSD, affecting legal and clinical evaluations.

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Area of Science:

Psychiatry
Psychology
Forensic Science

Background:

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) introduced significant revisions to posttraumatic stress disorder (PTSD) diagnostic criteria.
These changes include elaborations on gatekeeper criteria, a new stressor category, expanded symptom counts, and a novel PTSD subtype.

Purpose of the Study:

To analyze the rationale behind the DSM-5 PTSD criteria revisions.
To assess the impact of these changes on PTSD diagnosis prevalence in clinical settings.
To explore the implications of the updated criteria for forensic assessments and legal evaluations.

Main Methods:

Review and analysis of the DSM-5 criteria for posttraumatic stress disorder.
Examination of existing clinical studies to evaluate prevalence shifts.
Exploration of potential impacts on forensic methodologies, including malingering detection, criminal responsibility, witness reliability, civil claims, and disability eligibility.

Main Results:

The DSM-5 revisions introduce nuanced changes to PTSD diagnosis, potentially altering prevalence rates.
The updated criteria have broad implications for forensic assessments, affecting malingering detection and legal interpretations.
Forensic applications span criminal responsibility, witness reliability, civil litigation, and disability claims.

Conclusions:

The DSM-5 revisions represent a significant evolution in defining and diagnosing PTSD.
These changes necessitate a re-evaluation of forensic assessment practices and legal standards related to PTSD.
Understanding the impact of the DSM-5 criteria is crucial for accurate clinical and legal evaluations.