A psychiatry expert witness advises on a case involving an abuse victim who suffered mental harm after police released her attacker. Plaintiff was attacked by her ex-boyfriend when he barged into her home. He stabbed her repeatedly in the hand. He also terrorized her daughter and mother. The attacker was taken to jail but released a short time later. Despite assurances from police that plaintiff would be alerted upon his release, no notification was made. He returned to the home and terrorized the family again. Plaintiff alleges that she has had to move three times to prevent the man from locating them.
Question(s) For Expert Witness
- 1. Did the attack cause psychological problems?
- 2. What symptoms and diagnostic criteria support your conclusion?
Expert Witness Response
It is my opinion, to a reasonable degree of medical and psychiatric certainty, that plaintiff suffers from Post-Traumatic Stress Disorder (PTSD) resulting from multiple physical attacks by her ex-boyfriend, that included stabbing her in the hand as she tried to get away from his attacks. She continues to live in constant fear that he will discover where they are now residing and return to harm them. The medical criteria for this diagnosis, after a careful evaluation, are satisfied. Additionally, this diagnosis is a proximate result of the incident in question.
Plaintiff experienced a life-threatening physical attack. During this attack on herself and her family, plaintiff felt she was unable to protect them or herself adequately and felt intense fear and helplessness. She has re-experienced the trauma with recurrent intrusive recollections of the incidents, as well as nightmares of being stabbed and “fighting for my life.” These nightmares occur 2-3 times a week at this time, but she experienced them more frequently initially.
While watching a television program similar to what she had experienced, she experienced a traumatic re-activation of her symptoms. This re-activation resulted in worsening of her anxiety and creating a depressed mood. I used the Burns Depression and Anxiety Inventories and Beck’s Depression Inventory to assist in ascertaining the symptoms of Anxiety and Depression.
Plaintiff has decreased her participation in activities that she enjoyed at one time; she does not like being around the people she once wanted to be around and states she doesn’t feel the joy of being with a group anymore. She states she tries to avoid going to places where she might be asked about the incident, she has also quit school because of a lack of interest in pursuing her studies. She no longer feels optimistic about her future, and she states she has continuous feelings of doom and not being able to fulfill her dreams. She has difficulty getting to sleep at night and is often up late into the night because of her inability to sleep. She has difficulty concentrating and has been and finds herself withdrawing from others due do her inability to “keep up with the conversation,” this tends to add to her feelings of hopelessness.
Her symptoms have lasted more than one month. This has caused significant impairment in her occupational, educational, and social functioning.
Plaintiff has a history of depression and has been treated in the past with medication. She has a history of prior traumas that include domestic violence, both physical and emotional abuse. Research indicates that although a minority of individuals develops PTSD from a given traumatic episode, those with a history of prior traumas or pre-existing anxiety or depressive disorders are more vulnerable to developing PTSD from a life-threatening trauma than those without this history.