Forensic Assessment of PTSD Via DSM-5 Versus ICD-11 Criteria: Implications for Current Practice and Future Research
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Forensic Assessment of PTSD Via DSM-5 Versus ICD-11 Criteria: Implications for Current Practice and Future Research Patricia K. Kerig 1
&
Michaela M. Mozley 1 & Lucybel Mendez 1
Received: 24 September 2020 / Accepted: 1 November 2020 / Published online: 4 December 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Recognition of the high prevalence of trauma exposure and posttraumatic stress symptoms among adult and youth offenders has inspired calls for justice systems to engage in trauma-informed practices, particularly with regard to the assessment of trauma histories and posttraumatic reactions in legal contexts. Accordingly, skills in trauma assessment have become essential professional competencies for those conducting psychological evaluations in the justice system. However, there are a number of challenges to effective practice, including the existence of two distinctly different sets of diagnostic criteria for posttraumatic stress disorder (PTSD) in the DSM-5 versus ICD-11; controversies over whether separate diagnostic entities comprising complex PTSD and developmental trauma disorder are valid; limitations of the existing measures for assessing and diagnosing the disorder(s); difficulties with differential diagnosis of overlapping disorders and detection of malingering; and limited attention to cultural, ethnic, and racial diversity in the idioms and expressions of posttraumatic stress reactions. The present article reviews these challenges and offers recommendations for future research and clinical practice. Keywords Trauma . PTSD . Complex PTSD . Diagnosis . Assessment
Trauma exposure and posttraumatic stress reactions comprise forms of psychological injury that are very relevant to forensic contexts (Young, 2016). Approximately 75% of incarcerated adults report histories of trauma exposure, with even higher rates among women in the justice system, many of whom have experienced sexual assault in childhood or adulthood (see Allely & Allely, 2020). Among adolescent offenders, studies including large-scale samples find that between 80 and 98% report a history of trauma exposure, with rates of clinically significant posttraumatic stress symptoms (PTSS) found in approximately 30% of boys and 50% of girls (Kerig & Becker, 2012). Accordingly, it is not surprising that a disproportionately large number of justice-involved adults and youth meet criteria for a diagnosis of posttraumatic stress disorder (PTSD), especially among girls and women (Goff, Rose, Rose, & Purves, 2007; Kerig & Becker, 2012). Moreover, a wealth of research attests to the negative short- and long-
* Patricia K. Kerig [email protected] 1
Department of Psychology, University of Utah, Salt Lake City, UT, USA
term effects of trauma exposure and PTSS on behavioral and emotional health, particularly in regard to an increased likelihood of offending and recidivism among adults (Taylor et al., 2020) and adolescents (Becker & Kerig, 2011; Kerig & Becker, 2015). For example, prospective longitudinal research show
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