Tag Archives: DSM

Expert testimony in criminal court cases

Janeen DeMarte

In my quest to find something good on TV for a half hour or so today, I stumbled across the trial of Jodi Arias just in time to see the expert testimony of Janeen DeMarte, a psychologist working for the prosecution. I must admit that she was very impressive in rebutting all the claims from the expert working for the defense, who claimed that Arias suffered from PTSD. DeMarte was articulate, held herself well in the courtroom, and delivered testimony that is potentially devastating to the claims of the defense.

In DeMarte’s assessment of Arias, she speculated that Arias has Borderline Personality Disorder. Borderlines are known for erratic behavior and seem to have poor emotional control. They are also known to have limited affect (emotional range) and struggle with empathy.

At this point in the trial, the court is trying to determine the state of Arias’ mind during the killing, which will of course help to determine the sentence. As the death penalty is not off the table yet, this is clearly a crucial thing to decide. But this made me realize, even more so, that some disorders are associated with violent behavior whereby the aggressor was not in a ‘right state of mind’ and there are some disorders associated with violent behavior whereby the aggressor was in full control.

This means that whenever the state of mental health is called into question during a criminal court case, the behavior of the prosecution and the defense will become predictably formulaic. You have column A disorders and column B disorders. If you want to argue one way, then you have to pick a column B disorder and rebut diagnoses of any column A disorder. Skeptics argue that you can always find a mental health expert to pick the right diagnoses, depending on what side they are on.

This is where the integrity of mental health experts is really called into question, especially when needing to resist a hurried diagnoses. As DeMarte went through the criteria for PTSD, as presented in the DSM IV, I just kept thinking, “Aren’t many health specialists opposed to the DSM? And if so, how is rebutting this criteria useful?” I can see both the usefulness and the problem with the DSM, but other than considering its utility in diagnosing a patient, it’s clearly also a standard that can be used in court. Would a more dynamic approach to mental health ‘categorization’ provide the same standard and gravitas in a court room?

I long for a day where both law and psychology can keep their integrity and be at peace with one another.

Revisions to Antisocial Personality Disorder (APD) for the DSM V

The DSM-V development website lists a number of proposed revisions for personality disorders from how they initially appeared in the DSM IV. Part of the problem with the DSM IV was that people with a personality disorder were frequently diagnosed with two or more, and as individuals only have one personality the need to recognize a singular personality as dynamic has been recognized.

For more information on how the classification of personality disorders will be different in the DSM V, click here.

The proposed revision of APD does not include recognizing Conduct Disorder (CD) before the age of 15, even though many studies have shown that CD in the pre-pubescent years is a good indicator of APD in adulthood. Although, the revision still includes the need to be 18 or over to have a diagnosis of APD.

For more information on the proposed classification of APD in the DSM V, which should be published in May of 2013, please click here.

Jon Ronson discussing psychopathy and mental illness at TED

This is not a bad TED talk by Jon Ronson. In a fairly humorous 20 minute discussion he points out the follies of the DSM and the Psychopathy Check List. He concludes that our obsession to categorize people within narrow mental illness parameters ends up dehumanizing the patient and can lead to fatal outcomes.