Sparr L F, Reaves M E, Atkinson R M
Psychiatry Service, Veterans Administration Medical Center, Portland, OR 97207.
Bull Am Acad Psychiatry Law. 1987;15(2):141-62.
Although data are inconclusive, popular perception has linked military combat, posttraumatic stress disorder (PTSD), and criminal behavior. This paper discusses the multifactorial elements of this association that include both conscious and unconscious parameters of psychologic functioning. Testimony on combat-related PTSD has been presented in the courtroom to support veterans' claims of not guilty by reason of insanity (NGRI) and diminished capacity and for consideration during judicial sentencing. Because there is a known connection between the degree of combat involvement and PTSD, verification through collateral sources of the veteran's report of combat experiences is an important component of forensic assessment. The DSM-III-defined diagnosis of PTSD and the presence of a dissociative state have particular relevance in NGRI determinations. In other aspects of the judicial process demonstration of the absolute presence or absence of PTSD is often irrelevant and should be replaced by efforts to establish plausible links between provable combat experiences and the circumstances of the crime.
尽管数据尚无定论,但公众认知已将军事战斗、创伤后应激障碍(PTSD)和犯罪行为联系起来。本文讨论了这种关联的多因素要素,包括心理功能的有意识和无意识参数。与战斗相关的创伤后应激障碍的证词已在法庭上出示,以支持退伍军人因精神错乱而无罪(NGRI)和能力减弱的主张,并在司法量刑时予以考虑。由于战斗参与程度与创伤后应激障碍之间存在已知联系,通过旁证来源核实退伍军人的战斗经历报告是法医评估的重要组成部分。DSM-III定义的创伤后应激障碍诊断和分离状态的存在在NGRI判定中具有特殊相关性。在司法程序的其他方面,证明创伤后应激障碍的绝对存在或不存在往往无关紧要,而应以努力在可证实的战斗经历与犯罪情节之间建立合理联系取而代之。