Magazine article Clinical Psychiatry News

PTSD Diagnosis Abused in Employment Litigation. (Look to DSM-IV-TR for Criteria)

Magazine article Clinical Psychiatry News

PTSD Diagnosis Abused in Employment Litigation. (Look to DSM-IV-TR for Criteria)

Article excerpt

RANCHO MIRAGE, CALIF. -- "Junk science" has led to widespread misuse of posttraumatic stress disorder diagnoses in employment litigation, a California labor and employment lawyer said at the annual meeting of the American College of Forensic Psychiatry.

"Having an unpleasant boss can't be compared to experiencing the trauma of war," said James J. McDonald Jr., who practices law in Irvine, Calif.

Mr. McDonald cited cases in which employees have claimed they suffered posttraumatic stress disorder (PTSD) after hearing foul language or inappropriate jokes; being fired; or experiencing verbal, sexual, or racial harassment on the job.

Those psychiatrists seeking to counter such claims in court might begin by reading aloud examples of PTSD stressors taken from the DSM-IV-TR, Mr. McDonald suggested.

In addition to military combat, PTSD stressors include being the victim of a violent personal assault, such as a sexual attack or mugging.

Other stressors include being kidnapped, being the victim of a terrorist attack, being held as a prisoner of war, or being the victim of a disaster or a severe automobile accident.

Witnessing the serious injury or unnatural death of another person in the context of violence or a disaster also might lead to PTSD in some, according to DSM-IV-TR.

The DSM-IV-TR makes it clear that a PTSD diagnosis should be reserved for reactions to extraordinarily frightening events that involve actual injury or the threat of death or serious injury, as well as specific and lasting symptoms which include intrusive recollections, avoidant or numbing symptoms, or signs of hyperarousal.

Under such definitions, a teller victimized during a violent bank robbery or a factory worker who witnessed a horrific industrial accident might qualify for a diagnosis of PTSD, Mr. McDonald said.

But an employee unfairly denied a promotion or verbally abused by a boss would not.

Likewise, paramedics, police officers, or firefighters who repeatedly witness alarming scenes of mayhem and death might qualify for "cumulative stressor PTSD." But a person repeatedly subjected to demeaning practical jokes would not.

Mr. McDonald coined the term "Post Traumatic Stress Dishonesty" to describe cases in which employees embellish symptoms and reactions to workplace events in an effort to obtain large damage awards.

He said one such case was Gilbert vs. Daimler-Chrysler Corp., in which a woman -was awarded $21 million after claiming that her life "was and would be completely joyless" and that she would die an untimely death because of depression and PTSD stemming from sexual harassment related to her employment. …

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