Article Figures & Data
Tables
Characteristic (number responding) Percentage of Group Years in practice (n = 172) <6 21 (36) 6–10 12 (21) 11–20 26 (45) >20 39 (67) Fellow 2 (3) Retaining party (n =176) Defense 27 (47) Prosecution 10 (17) Both equally 44 (78) Does not perform criminal forensic evaluations 19 (34) Retained in a criminal case involving PTSD (n =238) 50 (120) Number of cases involving PTSD (n = 109) 1–5 53 (58) 6–10 17 (18) >10 30 (33) Data are expressed as the percentage of the group of respondents (n).
- Table 2
Reported Characteristics of Criminal Defendants in Respondents' Most Recent Cases Involving PTSD
Combat Exposed Noncombat Exposed Total Combat vs. Noncombat Case occurrences (years ago) (n = 38) (n = 64) (n = 109) χ2 4.53, df = 3, p = .210* <1 34 (13) 42 (27) 41 (45) 1–4 55 (21) 38 (24) 41 (45) 4–10 5 (2) 16 (10) 13 (14) >10 5 (2) 5 (3) 5 (5) Age (n = 35) (n = 59) (n = 100) χ2 = 0.832, df = 2, p = .660* 18–39 69 (24) 61 (36) 64 (64) 40–64 28 (10) 37 (22) 33 (33) >65 3 (1) 2 (1) 3 (3) Gender (n = 36) (n = 64) (n = 106) χ2 = 6.59, df = 1, p = .01† M 97 (35) 78 (50) 85 (90) F 3 (1) 22 (14) 15 (16) Race (n = 37) (n = 63) (n = 106) χ2 = 9.036, df = 1, p = .003† White 83 (31) 63 (40) 71 (75) Black 11 (4) 27 (17) 22 (23) Asian 3 (1) 5 (3) 4 (4) Native American/Alaskan 0 (0) 3 (2) 2 (2) Other 3 (1) 2 (1) 1 (2) Hispanic (n = 33) (n = 65) (n = 107) χ2 = 4.19, df = 1, p = .041† 6 (2) 20 (13) 14 (15) Armed services veteran (n = 37) (n = 64) (n = 103) χ2 = 54.47, df = 1, p < .0001† 89 (33) 14 (9) 42 (43) Charges (n = 37) (n = 61) (n = 107) χ2 = 2.63, df = 2, p = .269* Homicide 30 (11) 42 (26) 40 (43) Other violent 59 (22) 42 (26) 46 (49) Nonviolent 11 (4) 16 (9) 14 (15) Previous legal claims based on PTSD (n = 37) (n = 64) (n = 107) χ2 = 4.11, df = 1, p = .043† Yes 35 (13) 11 (7) 19 (20) No 54 (20) 70 (45) 66 (71) Don't know 11 (4) 19 (12) 15 (16) Combat Exposed Noncombat Exposed Total Combat vs. Noncombat Nature of trauma (n = 38) (n = 62) (n = 104) χ2 = 132.81, df = 4, p = <.0001* Combat 100 (38) 0 37 (38) Accident 0 8 (5) 5 (5) Violence victim 0 37 (23) 25 (26) Witness 0 23 (14) 14 (15) Sexual/physical abuse 0 32 (20) 19 (20) Physically injured by trauma† (n = 36) (n = 43) (n = 79) χ2 = 2.1, df = 1, p = .149 Yes 22 (8) 34 (16) 30 (24) No 78 (28) 66 (27) 70 (55) TBI Sustained (n = 36) (n = 43) (n = 79) χ2 = 8.5, df = 1, p = .0036‡ Yes 17 (6) 9 (4) 13 (10) No 83 (30) 82 (35) 82 (65) Don't know 0 9 (4) 5 (4) Assessment of reliability (n = 38) (n = 58) (n = 98) χ2 = 6.07, df = 2, p = .048* Accurate reporter 76 (29) 52 (30) 60 (59) Exaggerating 13 (5) 26 (15) 22 (21) Malingering 11 (4) 22 (13) 18 (18) Structured assessment of PTSD used§ (n = 38) (n = 58) (n = 100) χ2 = .159, df = 1, p = .69 16 (6) 19 (11) 18 (18) Persons interviewed‖ (n = 36) (n = 58) (n = 94) Family members 44 (16) 36 (21) 39 (37) χ2 = .632, df = 1, p = .427 Spouse/partner 22 (8) 16 (9) 18 (17) χ2 = .674, df = 1, p = .412 Friends 19 (7) 9 (5) 13 (12) χ2 = 2.34, df = 1, p = .126 Witnesses of trauma 6 (2) 16 (9) 12 (11) χ2 = 2.13, df = 1, p = .144 Other¶ 33 (12) 19 (11) 24 (23) χ2 = 2.48, df = 1, p = .115 None 42 (15) 57 (33) 53 (50) χ2 = 2.06, df = 1, p = .151 Documents reviewed‖ (n = 36) (n = 58) (n = 94) Health records 81 (29) 88 (51) 85 (80) χ2 = 0.953, df = 1, p = .329 Criminal records 50 (18) 62 (36) 61 (57) χ2 = 1.32, df = 1, p = .250 Military records 67 (24) 9 (5) 31 (29) χ2 = 35.1, df = 1, p < .0001 Employment records 28 (10) 28 (16) 30 (28) χ2 = .0004, df = 1, p = .984 Other# 67 (24) 64 (37) 65 (61) χ2 = .081, df = 1, p = .777 None 8 (3) 2 (1) 4 (4) χ2 = 2.38, df = 1, p = .155** Data are expressed as the percentage of the group of respondents (n).
↵* Log-linear regression.
↵† Does not include TBI.
↵‡ Chi square test, excluding “don't know” responses.
↵§ SCID, CAPS, and PTSD checklist.
↵‖ Respondents instructed to choose as many categories as applicable.
↵¶ Employer or coworkers, other military personnel, schoolmates, law enforcement, Catholic Archdiocese, prior psychiatric/medical providers, crime witnesses (some categories provided by respondents).
↵# Past litigation records, photographs, school records, workers compensation records, child protective services records, police reports, social security reports, defendant personal writings, jail records, police interrogation videos (some categories provided by respondents).
↵** Fisher's exact test.
Combat Exposed Non-Combat Exposed Total Combat vs. Non-Combat In mental health treatment at time of alleged offense (n = 37) (n = 63) (n = 103) Yes 35 (13) 14 (9) 21 (22) χ2 = 5.088, df = 1, p = .024* Treated with medication† 35 (13) 14 (9) 20 (21) χ2 = 5.08, df = 1, p = .024 Treated with psychotherapy† 16 (6) 3 (2) 8 (8) χ2 = 4.90, df = 1, p = .0270 No 65 (24) 79 (50) 74 (76) Don't know 0 (0) 6 (4) 5 (5) χ2 = 2.45, df = 1, p = .118 Intoxicated at time of alleged offense (n = 37) (n = 63) (n = 106) Yes‡ 43 (16) 38 (24) 39 (41) χ2 = .266, df = 1, p = .606 No 46 (17) 51 (32) 50 (53) Don't know 11 (4) 11 (7) 11 (12) χ2 = .002, df = 1, p = .963 (n = 38) (n = 60) (n = 100) PTSD Diagnosis§ 68 (26) 57 (34) 61 (61) χ2 = .941, df = 1, p = .332 Subthreshold PTSD Diagnosis 5 (2) 8 (5) 7 (7) χ2 = .381, df = 1, p = .565 Other diagnosis‖ (n = 38) (n = 64) (n = 104) Substance abuse 47 (18) 31 (20) 37 (38) χ2 = 2.65, df = 1, p = .104 MDD 21 (8) 17 (11) 19 (20) χ2 = .240, df = 1, p = .628 Psychotic disorder 11 (4) 3 (2) 6 (6) χ2 = 2.40, df = 1, p = .125 Other¶ 47 (18) 42 (27) 43 (45) χ2 = .260, df = 1, p = .610 None 24 (9) 14 (9) 19 (20) χ2 = .192, df = 1, p = .661 Don't know 8 (3) 16 (10) 13 (14) χ2 = 1.28, df = 1, p = .258 Personality disorder (n = 36) (n = 63) (n = 102) Yes 17 (6) 25 (16) 23 (23) χ2 = 2.372, df = 1, p = .124 No 61 (22) 40 (25) 48 (49) Don't know 22 (8) 35 (22) 29 (30) χ2 = 1.75, df = 1, p = .186 Data are expressed as the percentage of the group of respondents (n).
↵* Chi square test performed on “yes” vs. “no” responses; “don't know” responses were excluded.
↵† Respondents instructed to answer as many as applied.
↵‡ Combat exposed: alcohol 38% (14), crystal meth 5% (2). Noncombat exposed: 29% (18), crack cocaine 13% (8). Total: alcohol 30% (32), crack cocaine 8% (8).
↵§ According to DSM-IV-TR PTSD criteria.
↵‖ Respondents instructed to choose as many diagnoses as applied.
↵¶ Other anxiety disorder, dissociative disorder, bipolar affective disorder, attention deficit hyperactivity disorder, pedophilia, intermittent explosive disorder, dysthymic disorder, Tourette's disorder, adjustment disorder, cognitive disorder.
Combat Exposed Noncombat Exposed Total Combat vs. Noncombat Retaining agent (n = 38) (n = 63) (n = 107) χ2 = 1.179, df = 2, p = .56* Defense 50 (19) 53 (34) 53 (57) Court 40 (15) 30 (19) 33 (35) Prosecution 11 (4) 16 (10) 14 (15) Defense claim† (n = 35) (n = 59) (n = 97) Not guilty by reason of insanity 49 (17) 25 (15) 34 (33) χ2 = 5.24, df = 1, p = .022 Diminished responsibility 37 (13) 44 (26) 41 (40) χ2 = .434, df = 1, p = .510 Other legal claims† (n = 28) (n = 48) (n = 79) Mitigation 86 (24) 77 (37) 80 (63) χ2 = .832, df = 1, p = .362 Incompetent to stand trial 4 (1) 16 (8) 11 (9) χ2 = 2.90 df = 1, p = .0883 Other‡ 18 (5) 15 (7) 18 (14) χ2 = .143, df = 1, p = .706 Stages psychiatric evidence introduced† (n = 37) (n = 62) (n = 107) Pretrial 68 (25) 66 (41) 67 (72) χ2 = .022, df = 1, p = .883 Trial 41 (15) 36 (22) 37 (40) χ2 = .253, df = 1, p = .615 Sentencing 30 (11) 40 (25) 36 (38) χ2 = .608, df = 1, p = .436 Expert's opinion on legal claim (n = 37) (n = 58) (n = 98) Valid 60 (22) 47 (27) 50 (49) χ2 = 1.510, df = 1, p = .220 Invalid 40 (15) 53 (31) 50 (49) Opposing expert retained (n = 37) (n = 60) (n = 101) Yes 24 (9) 38 (23) 34 (34) χ2 = 2.03, df = 1, p = .154 No 35 (13) 25 (15) 29 (29) Don't know 22 (8) 23 (14) 23 (23) χ2 = .0382, df = 1, p = .845 Not applicable 19 (7) 13 (8) 15 (15) χ2 = .546, df = 1, p = .460 Agreement between opposing experts (n = 9) (n = 23) (n = 34) PTSD present Yes 89 (8) 26 (6) 41 (14) χ2 = 6.801, df = 1, p = .014§ No 11 (1) 48 (11) 41 (14) Don't know 0 (0) 26 (6) 18 (6) χ2 = 2.89, df = 1, p = .0891 Legal claim Yes 56 (5) 35 (8) 41 (14) χ2 = 1.16, df = 1, p = .282 No 33 (3) 39 (9) 38 (13) Don't know 11 (1) 26 (6) 21 (7) χ2 = .849, df = 1, p = .357 - Table 6
Legal Outcomes Reported by Respondents Regarding the Most Recent Criminal Case Involving PTSD as a Legal Claim
Combat Exposed % (n) Noncombat Exposed % (n) Total % (n) Combat vs. Noncombat Went to trial (n = 37) (n = 64) (n = 108) Yes 32 (12) 41 (26) 39 (42) χ2 = .400, df = 1, p = .527 No 41 (15) 38 (24) 37 (40) Unknown 27 (10) 22 (14) 24 (26) χ2 = .344, df = 1, p = .558 Type of trial (n = 12) (n = 26) (n = 41) Judge 17 (2) 39 (10) 29 (12) χ2 = 2.25, df = 1, p = .134 Jury 83 (10) 53 (14) 66 (27) Don't know 0 (0) 8 (2) 5 (2) χ2 = .974, df = 1, p = .324 Outcome* (n = 36) (n = 56) (n = 95) NGRI 11 (4) 5 (3) 7 (7) χ2 = 1.02, df = 1, p = .313 Lesser charge 19 (7) 27 (15) 23 (22) χ2 = .775, df = 1, p = .379 Guilty 38 (14) 39 (22) 40 (38) χ2 = .009, df = 1, p = .924 GBMI 3 (1) 0 1 (1) χ2 = 1.56, df = 1, p = .212 Charges dismissed 8 (3) 4 (2) 5 (5) χ2 = .952, df = 1, p = .329 Innocence 0 (0) 2 (1) 1 (1) χ2 = .660, df = 1, p = .416 Don't know 21 (8) 23 (13) 23 (22) χ2 = .012, df = 1, p = .912 Mitigation (n = 36) (n = 55) (n = 94) Yes 39 (14) 25 (14) 30 (28) χ2 = 3.05, df = 1, p = .081 No 14 (5) 27 (15) 22 (21) Don't know 33 (12) 36 (20) 35 (33) χ2 = .035, df = 1, p = .851 Not applicable† 14 (5) 11 (6) 13 (12)
