PT - JOURNAL ARTICLE AU - Robert A. Prentky AU - Anna I. Coward AU - Adeena M. Gabriel TI - Commentary: Muddy Diagnostic Waters in the SVP Courtroom DP - 2008 Dec 01 TA - Journal of the American Academy of Psychiatry and the Law Online PG - 455--458 VI - 36 IP - 4 4099 - http://jaapl.org/content/36/4/455.short 4100 - http://jaapl.org/content/36/4/455.full SO - J Am Acad Psychiatry Law2008 Dec 01; 36 AB - In this brief commentary, we address several of the points raised by Drs. First and Halon on the abuses of DSM diagnoses (APA, 2000) in civil commitment hearings of sex offenders. We discuss each of the elements in the three‐step process proposed by First and Halon for reforming the diagnosis of paraphilias in SVP proceedings, paying particular attention to the role of volitional impairment. Both in spirit and in substance, we fundamentally agree with First and Halon, concluding that the misuse of science, inclusive of the misuse of the DSM, in the SVP courtroom is a variation of pretextuality. We commend First and Halon for drawing attention to a serious problem, one that undermines the integrity of the legal system in general and the SVP adjudicatory process in particular. We conclude with a warning that without firmer control from the courts, expert opinions will remain opaque and of questionable probative value.