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Post-traumatic Stress Disorder and the Legal System: The Jodi Arias Defense

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Many of us are familiar with the case of Jodi Arias, who is on trial for murder.

She admits to shooting her boyfriend, Travis Alexander, stabbing him multiple times and slashing his throat from ear to ear. Arias claims to have little or no memory of the murder. A defense-retained psychologist testified Jodi was suffering from Post-Traumatic Stress Disorder which arose from the murder itself.

Although I have never examined Ms. Arias, nor reviewed any of the documents submitted as evidence in the trial, I am disturbed by this tactic.

This diagnostic assertion is ludicrous on face-value because PTSD and the claim of not remembering a traumatic event are mutually exclusive.

In fact, Post-Traumatic Stress Disorder applies when a person remembers too much of a trauma. Intrusive thoughts and recollections (flashbacks) of the incident are played over and over in the victim's mind. Recurrent nightmares awaken the person in a state of terror. In essence, the signs and symptoms of PTSD preclude the person from being unable to remember the trauma. The disorder involves "over-remembering" the event.

In addition, for PTSD to be properly diagnosed, the victim must experience the trauma with fear of imminent death or threat of severe harm to self or others. Stressors which may evoke the disorder include forcible rapes; violent muggings; wartime combat; witnessing others being killed, maimed or tortured; tsunamis; plane crashes; and similar horrific occurrences.

As a forensic psychiatrist, I have examined many patients who survived catastrophic incidents, including more than 300 survivors of the 9/11 attack at the World Trade Center. However, during other consultations, I've encountered some people claiming to suffer from PTSD following situations that would never evoke the disorder. Whether it was tripping and falling on a sidewalk, or a fender-bender car accident not even requiring a trip to the emergency room, the flagrant misuse of the diagnosis has earned it the dubious distinction of being the most abused and misapplied diagnosis in the psychiatric-legal lexicon.

The Arias case demonstrates a larger issue. The claim of PTSD seeps into courtroom proceedings far too frequently because the disorder primarily involves symptoms, with relatively few (if any) objective signs. And, the word stress is a loaded concept presented to juries, often in a distorted way that trivializes real PTSD.

Post-Traumatic Stress Disorder is a serious psychiatric condition caused by an overwhelming psychic stressor, rendering the victim unable to stop reliving the sense of helplessness, terror and impending annihilation. There is absolutely nothing about the Jodi Arias defense that even remotely approaches rendering an honest diagnosis of PTSD.

It's time for the courts to require rigorous criteria be applied to this diagnosis before allowing more specious psychiatric claims to be presented to juries.