Criminal Justice Issues

Below are some suggested studies and references that may assist you in working with trauma-affected veterans.  Wherever “($)” appears, the resource is available commercially at the link provided.  To access the study, click on the title and it will take you to the PDF (when available) or the site where the study may be reviewed or purchased.

This compilation of research and references is a work in progress -- suggestions for additions to this page are always welcome and may be sent to postmaster@cvltf.org

 

The entire compilation of research may be found below, or follow these links to access specific sections:

 

CASE LAW

California Penal Code §1170.9

California Penal Code §1170.91

California Penal Code §1001.80

 

Court of Appeals of California, Second District, Division One

The People, Plaintiff and Respondent, v. James L. Williams, Defendant and Appellant

Filed June 23, 2011

 

Court of Appeals of California, Fourth District, Division Three

The People, Plaintiff and Respondent v. Elijah Leigh Ferguson, Defendant and Appellant.

Decided April 30, 2009

 

Supreme Court of the United States

George Porter, Jr. v. Bill McCollum, Attorney General of Florida, Et Al.

Decided November 30, 2009

 

In the United States District Court for the District Of Colorado

United States of America, v. Frederick W. Murphy

Lewis T. Babcock, Judge

Dated January 15, 2008

 

People v. Duncan (App. 3 Dist. 2003) 5 Cal.Rptr.3d 413, 112 Cal.App.4th 744.

Sentencing under statute purporting to provide alternative to probation or imprisonment for Vietnam combat veterans convicted of a felony was a nonexistent sentencing option for defendant who was convicted of gross vehicular manslaughter while intoxicated, even if defendant’s alleged alcoholism was a direct consequence of post-traumatic stress disorder (PTSD) incurred as a result of his service in Vietnam, where there was no federal law which authorized the receipt of defendant to a federal facility for treatment for substance abuse or psychological problems resulting from Vietnam combat service.

 

People v. Abdullah (App. 4 Dist. 1992) 9 Cal.Rptr2d 131, 6 Cal.App.4th 1728, review denied

Condition of sentencing pursuant to state statute allowing Vietnam veterans convicted of state felonies to be committed to federal corrections custody rather than state prison is that federal correctional authorities must be ready, willing, and able to receive defendant for service of his term of incarceration.

Absent federal law authorizing receipt into appropriate federal corrections programs of Vietnam veterans convicted of state felonies, state statute providing for sentence of Vietnam veterans to federal correctional custody in lieu of state prison was illusory and thus, trial court was not required to consider option of alternative federal rehabilitative commitment when sentencing Vietnam veteran.

Statute providing for a placement of Vietnam veterans convicted of state felonies in federal corrections custody rather than state prison required that federal program be part of federal prison system and did not include commitment to local, noncustodial programs.

 

People v. Bruhn (App. 1 Dist. 1989) 259 Cal.Rptr. 6, 210 Cal.App.3d 1195.

Trial court must affirmatively indicate exercise of discretion under this section whenever prima facie showing of eligibility has been made, and intelligent exercise of discretion cannot be inferred from silent record.

Trial court’s summary sentencing of defendant to state prison without considering alternative of commitment to federal facility for treatment for substance abuse or psychological problems resulting from Vietnam combat service required remand for proper exercise of discretion under this section; if on resentencing trial court found that defendant was suitable for alternative placement, court would be required to determine whether defendant was agreeable to such program and whether there was a federal facility authorized to accept him.

Defendant must made initial showing that he served in combat while member of Unites States armed forces and that he suffers from substance abuse or other psychological problems resulting from service to trigger provisions of this section, but, once defendant makes initial showing, trial court must then consider his suitability for federal incarceration for term imposed.

Defendant made sufficient preliminary showing that he was candidate for alternatice placement under this section, thus requiring trial court to consider federal treatment program alternative; record indicated that defendant served combat duty in Vietnam where he used heroin and other drugs, was having difficulty functioning in society following return to United States, at time of offense was homeless, and perpetrated offense to secure basic necessities of life.

 

People v. Ruby (App. 4 Dist. 1988) 251 Cal.Rptr. 339, 204 Cal.App.3d 462, review denied

Record did not show that trial court fully evaluated whether it was appropriate to commit defendant, who was drug-addicted, decorated Vietnam combat veteran, to custody of federal correctional authorities, rather than state prison, in prosecution for unlawfully possessing controlled substance; defendant’s substance abuse has been diagnosed as being causally related to combat experience.

 

People v. Lara (App. 3 Dist. 1984) 202 Cal.Rptr. 262, 155 Cal.App3d 570.

To render judgement providing for convicted Vietnam veteran’s incarceration in custody of federal correctional officials, court must hold evidentiary hearing and insure that appropriate federal program is available to receive defendant, and if so, court should commit defendant directly to custody of federal officials, but if not, court can only commit defendant to state prison with recommendation that director of corrections exercise his statutory discretion to transfer defendant to federal facility.

 

People v. Enriquez (App. 2 Dist. 1984) 205 Cal.Rptr. 238, 159 Cal.App.3d 1.

Defendant convicted of two counts of bank robbery, who showed that he had served two tours of duty in Vietnam, and who argued that robberies were prompted by his narcotics problem, fell far short of showing that he served in combat in Vietnam and that he suffered from a substance abuse as a result of his service, and thus, failed to show that he was entitled to be considered for commitment to custody of federal authorities for incarceration for term imposed.

 

People v. Galvan (App. 5 Dist. 1984) 202 Cal.Rptr. 594, 156 Cal.App.3d 144.

Where appropriate federal program for treatment of Vietnam combat veteran suffering from posttraumatic stress syndrome came into operation after defendant, a Vietnam veteran allegedly suffering from PTSD, was first sentenced, remand was required to give trial court opportunity to obtain recommendation of director of correction or board of prisons terms as to whether defendant’s sentencing and commitment previously ordered should be recalled and to place defendant in new federal program.

 

MILITARY JUSTICE

Reclaiming the Rehabilitative Ethic in Military Justice: The Suspended Punitive Discharge as a Method to Treat Military Offenders With PTSD and TBI and Reduce Recidivism

Major Evan R. Seamone

Summer 2011

Military attorney and author, Major Evan R. Seamone, proposes use of local veterans treatment courts to obtain treatment and preserve VA benefits for active duty wounded warriors facing court-martial charges in new article, “Reclaiming the Rehabilitative Ethic in Military Justice: The Suspended Punitive Discharge as a Method to Treat Military Offenders With PTSD and TBI and Reduce Recidivism,” published by The Military Law Review.

 

Post-Traumatic Stress Disorder & the Military Justice System

Cooke, Peyton. Post-Traumatic Stress Disorder & the Military Justice System (May 13, 2009). Mississippi Law Journal, Vol. 79, No. 3, 2010.

This article, in the main, addresses how the Military Justice system deals -- and ought to deal -- with military members who are suffering from post-traumatic stress disorder (PTSD), and commit crimes. It begins with a thorough overview of PTSD in the current military, and then moves on to analyze the topic through three particular lenses: punishing versus treating military members who suffer from PTSD in light of Retributivst theory; psychotherapist-patient privilege in the military as affected by the recent restructuring of military psychiatry; and how military courts’ own oft-ignored tradition of rights protection affects these issues. The paper concludes provisionally that, due to the nature of military society, the military must both punish and treat its members who commit crimes in order to have the best chance of reintegrating those members into the community; and that, while Department of Defense directives and other military law has arguably eliminated the psychotherapist-patient privilege in the military, military courts have an opportunity to restore and maintain the privilege in light of those courts’ tradition of protecting the interests and rights of military members.

 

POSTTRAUMATIC STRESS

The Correlation Between PTSD and Criminogenic Behaviors In Incarcerated Veterans

Fleming, M., Simpson, M., & Presecan, N. (2013). The Correlation Between PTSD and Criminogenic Behaviors In Incarcerated Veterans. Corrections Forum, 22(6), 37-40.

The article discusses the research study on the characteristics of post-traumatic stress disorder (PTSD) in incarcerated veterans. It highlights the problems associated with the link between PTSD and criminal behaviors, the prevalence of incarcerated veterans, and the link of PTSD with traumatic brain injury. It also explains the treatment options for PTSD.

 

Forensic Validity of a PTSD Diagnosis

Claudia Baker, MSW, MPH and Cessie Alfonso, LCSW

National Center for PTSD

Many types of civil and criminal court cases and litigation involve claims of Posttraumatic Stress Disorder. The diagnostic validity of these claims can impact directly upon the defense, plaintiff, or prosecutorial legal strategies, depending upon the nature of use in the case. It is important, therefore, for attorneys and others involved in the legal system to be able to assess the validity of PTSD evaluations and diagnoses. Although only an expert in PTSD can complete an in-depth review of the diagnostic methodology used in a case, it is helpful if those conducting initial reviews know some basic facts about PTSD and what constitutes a sound diagnosis.

 

Department of the Army: Policy Guidance on the Assessment and Treatment of Post-Traumatic Stress Disorder (PTSD)

 

PTSD as a Criminal Defense: A Review of Case Law

Berger, O., McNiel, D., & Binder, R. (2012). PTSD as a criminal defense: a review of case law. The Journal Of The American Academy Of Psychiatry And The Law, 40(4), 509-521.

Posttraumatic stress disorder (PTSD) has been offered as a basis for criminal defenses, including insanity, unconsciousness, self-defense, diminished capacity, and sentencing mitigation. Examination of case law (e.g., appellate decisions) involving PTSD reveals that when offered as a criminal defense, PTSD has received mixed treatment in the judicial system. Courts have often recognized testimony about PTSD as scientifically reliable. In addition, PTSD has been recognized by appellate courts in U.S. jurisdictions as a valid basis for insanity, unconsciousness, and self-defense. However, the courts have not always found the presentation of PTSD testimony to be relevant, admissible, or compelling in such cases, particularly when expert testimony failed to show how PTSD met the standard for the given defense. In cases that did not meet the standard for one of the complete defenses, PTSD has been presented as a partial defense or mitigating circumstance, again with mixed success.

 

PTSD and the Law: An update

PTSD Research Quarterly: Advancing Science and Promoting Understanding of Traumatic Stress

National Center for PTSD

Jim McGuire, PhD & Sean Clarke, JD

2011

 

Reinvigorating Actus Reus: The Case for Involuntary Actions by Veterans with Post-Traumatic Stress Disorder

Melissa Hamilton, Reinvigorating Actus Reus: The Case for Involuntary Actions by Veterans with Post-Traumatic Stress Disorder, 16 Berkeley J. Crim. L. 340 (2011).

In common law, criminal culpability rests on two basic foundations of criminal intent, or mens rea, and a voluntary act, which comprises the actus reus. While much of the litigation in criminal cases concerns assigning the appropriate mens rea concept to the particular defendant’s mental state, relatively little debate focuses on the element of actus reus. Indeed, case law and commentators generally have devoted scant attention to fleshing out the voluntary act concept despite the historical consensus of both utilitarians and retributivists that one should not be considered morally or legally culpable for his or her involuntary actions. This paper conceptualizes an overall need to reinvigorate the actus reus requirement as a fundamental principal of criminal culpability. It does so by employing a contemporary problem facing the criminal justice system of combat veterans with Post-Traumatic Stress Disorder (PTSD) who commit acts of unlawful violence, including homicide, either in reflexive actions or during dissociative states triggered by re-experiencing combat-related stresses. While the veterans are often convicted of criminal offenses, studies on PTSD substantively support an argument that such violence may actually be conceptualized as automatism and, therefore, should not qualify as voluntary acts justifying criminal culpability. For example, mental health professionals describe PTSD as a neuropsychiatric disorder that involves hypervigilance, and hyperreactivity. Modern combat training is a likely correlate with its emphasis on muscle memory and reflexive responsiveness in the use of lethal weapons, which are adaptive, survival behaviors in the field of battle. The relationship to automatism is also evident in that PTSD is not merely a cognitive disorder as studies have shown PTSD-related alterations to brain structure and function and neurophysiological performance. Thus, this contemporary problem of PTSD in veterans due to wartime service provides a fresh perspective on which to reconsider the importance of the voluntary act requirement of criminal law.

 

Post-Traumatic Stress Disorder in the Criminal Justice System: From Vietnam to Iraq and Afghanistan

Marcia G. Shein

September 2010

 

Exit Wounds: Current Issues Pertaining to Combat-Related PTSD of Relevance to the Legal System

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Tramontin, M. (2010). Exit Wounds: Current Issues Pertaining to Combat-Related PTSD of Relevance to the Legal System.Developments In Mental Health Law, 29(1), 23-47.

Written for those in the mental health and legal communities dealing with war veterans embroiled in the criminal justice system, this Article presents an overview of current issues pertaining to the diagnosis, assessment, and treatment of combat-related post-traumatic stress disorder (PTSD). The objective is to provide information that can assist the legal system when addressing PTSD-related issues of combat veterans charged with crimes, with a specific focus on those returning from Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). As part of this discussion, insights from clinical practice for assessing and treating combat veterans are offered and considered in light of state of the art trends from the complex and evolving field of traumatic stress studies. [ABSTRACT FROM AUTHOR]

 

Studies’ Estimates of PTSD Prevalence Rates for Returning Service Members Vary Widely

Rajeev Ramchand, Terry L. Schell, Benjamin R. Karney, Karen Chan Osilla, Rachel M. Burns, Leah B. Caldarone

RAND Corporation 2010

Summarizes analyses of existing posttraumatic stress disorder (PTSD) studies for war zone veterans, finding that the prevalence estimates vary widely and are linked to the use of different PTSD diagnostic definitions and divergent study samples.

 

Disparate Prevalence Estimates of PTSD Among Service Members Who Served in Iraq and Afghanistan: Possible Explanations

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Ramchand, R., Schell, T. L., Karney, B. R., Osilla, K., Burns, R. M., & Caldarone, L. (2010). Disparate prevalence estimates of PTSD among service members who served in Iraq and Afghanistan: Possible explanations. Journal Of Traumatic Stress, 23(1), 59-68. doi:10.1002/jts.20486

The authors reviewed 29 studies that provide prevalence estimates of posttraumatic stress disorder (PTSD) among service members previously deployed to Operations Enduring and Iraqi Freedom and their non-U.S. military counterparts. Studies vary widely, particularly in their representativeness and the way PTSD is defined. Among previously deployed personnel not seeking treatment, most prevalence estimates range from 5 to 20%. Prevalence estimates are generally higher among those seeking treatment: As many as 50% of veterans seeking treatment screen positive for PTSD, though much fewer receive a PTSD diagnosis. Combat exposure is the only correlate consistently associated with PTSD. When evaluating PTSD prevalence estimates among this population, researchers and policymakers should carefully consider the method used to define PTSD and the population the study sample represents.

 

Posttraumatic Stress Disorder and Criminal Responsibility

Friel, A., White, T., & Hull, A. (2008). Posttraumatic stress disorder and criminal responsibility. Journal of Forensic Psychiatry & Psychology, 19(1), 64-85. doi:10.1080/14789940701594736

There has been an increased interest in the relationship between posttraumatic stress disorder (PTSD) and violence, and in the factors that mediate their linkage. PTSD is a common, often underdiagnosed, condition with high levels of psychiatric comorbidity. It often has poor outcomes, with many cases becoming chronic, leading to substantial costs both to the individual and society as a whole. In this paper we report on the literature on PTSD, its diagnosis, assessment, and treatment. The difficulties encountered when assessing PTSD – the subjective nature of the symptoms, the risk of malingering, and the possibility of secondary gain – have been highlighted. Assessment and treatment in forensic settings is further complicated by the possibility of perpetrator PTSD. We have reviewed the prevalence of PTSD with particular reference to offender and forensic populations. The association between PTSD and violence, its relevance across the spectrum of criminal responsibility, and relevant case law are explored.

 

Combat Veterans, Mental Health Issues, and the Death Penalty: Addressing the Impact of Post-Traumatic Stress Disorder and Traumatic Brain Injury

Anthony E. Giardino

May 2009

More than 1.5 million Americans have participated in combat operations in Iraq and Afghanistan over the past seven years. Some of these veterans have subsequently committed capital crimes and found themselves in our nation’s criminal justice system. This Essay argues that combat veterans suffering from post-traumatic stress disorder or traumatic brain injury at the time of their offenses should not be subject to the death penalty. Offering mitigating evidence regarding military training, post-traumatic stress disorder, and traumatic brain injury presents one means that combat veterans may use to argue for their lives during the sentencing phase of their trials. Alternatively, Atkins v. Virginia and Roper v. Simmons offer a framework for establishing a legislatively or judicially created categorical exclusion for these offenders, exempting them from the death penalty as a matter of law. By understanding how combat service and service-related injuries affect the personal culpability of these offenders, the legal system can avoid the consequences of sentencing to death America's mentally wounded warriors, ensuring that only the worst offenders are subject to the ultimate punishment.

 

Aggression Among Combat Veterans: Relationships With Combat Exposure and Symptoms of Posttraumatic Stress Disorder, Dysphoria, and Anxiety Severity of Posttraumatic Stress Disorder and Involvement with the Criminal Justice System

Taft, C., Vogt, D., Marshall, A., Panuzio, J., & Niles, B. (2007). Aggression among combat veterans: relationships with combat exposure and symptoms of posttraumatic stress disorder, dysphoria, and anxiety. Journal Of Traumatic Stress, 20(2), 135-145.

Prior research has revealed heightened aggressive behavior among veterans with PTSD. This study tested a model examining the interrelationships among combat exposure, posttraumatic stress disorder (PTSD) symptoms, dysphoric symptoms, and anxiety symptoms in predicting aggressive behavior in a sample of 265 male combat veterans seeking diagnostic assessment of PTSD. Combat exposure was indirectly associated with aggression primarily through its relationship with PTSD symptoms. Symptoms of PTSD were directly related to aggression, and indirectly related to aggression through dysphoric symptoms. Results highlight the role of PTSD symptoms and dysphoric symptoms with respect to aggressive behavior among this population, and suggest the relevance of aggression theory to the study of combat veterans.

 

Posttraumatic Intrusion, Avoidance, and Social Functioning: A 20-Year Longitudinal Study

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Solomon, Z., & Mikulincer, M. (2007). Posttraumatic intrusion, avoidance, and social functioning: A 20-year longitudinal study. Journal Of Consulting And Clinical Psychology, 75(2), 316-324. doi:10.1037/0022-006X.75.2.316

The study assesses posttraumatic intrusion, avoidance, and social functioning among 214 Israeli combat veterans from the first Lebanon War with and without combat stress reaction (CSR) 1, 2, 3, and 20 years after the war. CSR veterans reported higher intrusion and avoidance than did non-CSR veterans. With time, there was a decline in these symptoms. In addition, intrusion and avoidance were associated with problems in social functioning on a given year, and they longitudinally predicted social dysfunction 2, 3, and 20 years after the war. CSR veterans presented stronger temporal covariations between intrusion-avoidance and social functioning. The findings suggest that CSR is a marker for future psychopathology and point to the role of avoidance in social dysfunction. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)

 

Post-traumatic Stress Disorder and the Casual Link to Crime: A Looming National Tragedy

Daniel, D. L. (2008). Post-traumatic Stress Disorder and the Casual Link to Crime: A Looming National Tragedy. US Army, US Army Combined Arms Center. doi:10.1037/e614642009-001

The purpose of this paper is to investigate if there is a correlation between PTSD and criminal behavior in soldiers that have been incarcerated after returning from the GWOT and to determine the obligations of the U.S. government/DoD to prevent, treat, and/or mitigate the problem. This study includes data collected, examined and analyzed from three primary sources. First, an existing study on PTSD and criminal behavior by James J. Collins and Susan L. Bailey which examines the correlation between PTSD and criminal behavior primarily in 1140 nonveteran North Carolina inmates. This study is included to establish whether a general causal link exists between PTSD and an incidence of violent criminal behavior. Next, statistical data compiled by the Bureau of Justice Statistics (BJS) section of the Office of Justice Programs, U.S. Department of Justice (DoJ) is analyzed for trends in incarceration rates among veterans in Federal and State correctional facilities. The BJS data is included to examine whether the incarceration rates of veterans for violent criminal offenses has peaked during and after periods of war. Finally, this study will look closely at aggregate exempt inmate data recently compiled by the administrative and mental health staff of the United States Disciplinary Barracks, Fort Leavenworth, Kansas (USDB). The data from the USDB is part of an ongoing survey of the inmates (n=440) to determine the incidence of PTSD and mental health disorders within the prisoner population for treatment purposes and program analysis. This paper explores the history of PTSD in previous conflicts, the characteristics of the disorder and briefly discusses current treatment approaches. The data presented, particularly the initial results of the current USDB survey, strongly supports the current hypothesis that there is a correlation between PTSD and criminal behavior in soldiers that have been incarcerated after returning from the GWOT. As such the final contribution of this paper is to offer some brief recommendations on what our national leaders should do to prevent or mitigate the impending problem in our society of more veterans involved in violent criminal behavior. (PsycEXTRA Database Record (c) 2013 APA, all rights reserved)

 

Attorneys as First-Responders: Recognizing the Destructive Nature of Posttraumatic Stress Disorder on the Combat Veteran’s Legal Decision-Making Process

Captain Evan R. Seamone

Winter 2009

 

The Veterans’ Lawyer as Counselor: Using Therapeutic Jurisprudence to Enhance Client Counseling For Combat Veterans with Posttraumatic Stress Disorder

Captain Evan R. Seamone

Winter 2009

 

PTSD Symptoms, Demographic Characteristics, and Functional Status Among Veterans Treated in VA Primary Care Clinics

($)

Magruder, K. M., Frueh, B. C., Knapp, R. G., Johnson, M. R., Vaughan, J. A., Carson, T. C., Powell, D. A. and Hebert, R. (2004), PTSD symptoms, demographic characteristics, and functional status among veterans treated in VA primary care clinics. Journal of Traumatic Stress, 17: 293–301. doi: 10.1023/B:JOTS.0000038477.47249.c8

We hypothesized that PTSD symptomatology would have an inverse relationship with functional status and would vary as a function of sociodemographic variables. Primary care patients (N = 513) at two VA Medical Centers were randomly selected and recruited to participate. After adjustment for other demographic variables. PTSD symptom levels were significantly related to age (younger patients had more severe symptoms), employment status (disabled persons had higher symptom levels), war zone experience, and clinic location. PTSD symptomatology was inversely related to mental and physical functioning, even after control for potential confounding. These findings have implications for screening and service delivery in VA primary care clinics, and support the more general finding in the literature that PTSD is associated with impaired functioning.

 

Does Early Psychological Intervention Promote Recovery From Posttraumatic Stress?

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Richard J. McNally, Richard A. Bryant, and Anke Ehlers

November 2003

In the wake of the terrorist attacks at the World Trade Center, more than 9,000 counselors went to New York City to offer aid to rescue workers, families, and direct victims of the violence of September 11, 2001. These mental health professionals assumed that many New Yorkers were at high risk for developing posttraumatic stress disorder (PTSD), and they hoped that their interventions would mitigate psychological distress and prevent the emergence of this syndrome. Typically developing in response to horrific, life-threatening events, such as combat, rape, and earthquakes, PTSD is characterized by reexperiencing symptoms (e.g., intrusive recollections of the trauma, nightmares), emotional numbing and avoidance of reminders of the trauma, and hyperarousal (e.g., exaggerated startle, difficulty sleeping). People vary widely in their vulnerability for developing PTSD in the wake of trauma. For example, higher cognitive ability and strong social support buffer people against PTSD, whereas a family or personal history of emotional disorder heightens risk, as does negative appraisal of one's stress reactions (e.g., as a sign of personal weakness) and dissociation during the trauma (e.g., feeling unreal or experiencing time slowing down). However, the vast majority of trauma survivors recover from initial posttrauma reactions without professional help. Accordingly, the efficacy of interventions designed to mitigate acute distress and prevent long-term psychopathology, such as PTSD, needs to be evaluated against the effects of natural recovery. The need for controlled evaluations of early interventions has only recently been widely acknowledged.

Psychological debriefing—the most widely used method—has undergone increasing empirical scrutiny, and the results have been disappointing. Although the majority of debriefed survivors describe the experience as helpful, there is no convincing evidence that debriefing reduces the incidence of PTSD, and some controlled studies suggest that it may impede natural recovery from trauma. Most studies show that individuals who receive debriefing fare no better than those who do not receive debriefing. Methodological limitations have complicated interpretation of the data, and an intense controversy has developed regarding how best to help people in the immediate wake of trauma.

Recent published recommendations suggest that individuals providing crisis intervention in the immediate aftermath of the event should carefully assess trauma survivors' needs and offer support as necessary, without forcing survivors to disclose their personal thoughts and feelings about the event. Providing information about the trauma and its consequences is also important. However, research evaluating the efficacy of such “psychological first aid” is needed.

Some researchers have developed early interventions to treat individuals who are already showing marked stress symptoms, and have tested methods of identifying those at risk for chronic PTSD. The single most important indicator of subsequent risk for chronic PTSD appears to be the severity or number of posttrauma symptoms from about 1 to 2 weeks after the event onward (provided that the event is over and that there is no ongoing threat).

Cognitive-behavioral treatments differ from crisis intervention (e.g., debriefing) in that they are delivered weeks or months after the trauma, and therefore constitute a form of psychotherapy, not immediate emotional first aid. Several controlled trials suggest that certain cognitive-behavioral therapy methods may reduce the incidence of PTSD among people exposed to traumatic events. These methods are more effective than either supportive counseling or no intervention.

In this monograph, we review risk factors for PTSD, research on psychological debriefing, recent recommendations for crisis intervention and the identification of individuals at risk of chronic PTSD, and research on early interventions based on cognitive-behavioral therapy. We close by placing the controversy regarding early aid for trauma survivors in its social, political, and economic context.

 

 

Posttraumatic stress disorder: diagnosis and epidemiology, comorbidity and social consequences, biology and treatment.

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Brunello, N.; Davidson, J.; Deahl, M.; et al. 2001. Postraumatic Stress Disorder: Diagnostic and Epidemiology, Comorbidity and Social Consequences, Biology and Treatment. Neuropsychobiology 43:150–162.

Epidemiological studies clearly indicate that posttraumatic stress disorder (PTSD) is becoming a major health concern worldwide even if still poorly recognized and not well treated. PTSD commonly co-occurs with other psychiatric disorders, and several symptoms overlap with major depressive disorders, anxiety disorders and substance abuse; this may contribute to diagnostic confusion and underdiagnosis. This anxiety disorder provokes significant occupational, psychiatric, medical and psychosocial disability, and its consequences are enormously costly, not only to the survivors and their families, but also to the health care system and society. Work impairment associated with PTSD is very similar to the amount of work impairment associated with major depression. The pathophysiology of PTSD is multifactorial and involves dysregulation of the serotonergic as well as the noradrenergic system. A rational therapeutic approach should normalize the specific psychobiological alterations associated with PTSD. This can be achieved through the use of antidepressant drugs, mainly of those that potentiate serotonergic mechanisms. Recent double-blind placebo-controlled studies report the efficacy of selective serotonin reuptake inhibitors. Several cognitive-behavioral and psychosocial treatments have also been reported to be efficacious and could be considered when treating PTSD patients.

 

 

 

Aggression and Its Correlates in Vietnam Veterans with and Without Chronic Post-Traumatic Stress Disorder

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Lasko, N.B., Guruits, T.V., Kuhne, A.A., Orr, S.P., & Pitman, R.K. (1994). Aggression and its correlates in Vietnam veterans with and without chronic post-traumatic stress disorder. Comprehensive Psychiatry, 35, 373-381.

This study measured self-reported aggression, hostility, and anger in Vietnam combat veterans with (n = 27) and without (n = 15) posttraumatic stress disorder (PTSD). On the Buss-Durkee Hostility Inventory, Past Feelings and Acts of Violence Scale, Episodic Dyscontrol Scale, and State-Trait Anger Expression Inventory (STAXI), PTSD subjects scored significantly higher than non-PTSD subjects, whose scores fell in the range reported for normative, noncombat populations. The PTSD versus non-PTSD group differences were not explained by combat exposure, which did not correlate significantly with the psychometric aggression measures. These findings suggest that increased aggression in war veterans is more appropriately regarded as a property of PTSD, rather than a direct consequence of military combat. The association between compromised neurologic and neuropsychologic status and the psychometric measures was modest and explained little of the group differences.

 

Paying the Price for Vietnam: Post-traumatic Stress Disorder and Criminal Behavior

Erlinder, C. P. (1984). Paying the price for Vietnam: Post-traumatic Stress Disorder and criminal behavior. Boston College Law Review, 25(2). 305-347.

 

The Vietnam Veteran on Trial: The Relation of Post-Traumatic Stress Disorder to Criminal Behavior

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Wilson, J. P., & Zigelbaum, S. D. (1983). The Vietnam Veteran on Trial: The Relation of Post-Traumatic Stress Disorder to Criminal Behavior. Behavioral Sciences & The Law, 1(3), 69-83.

The purpose of this paper is to conceptualize the relationship of Post-Traumatic Stress Disorder (PTSD) in Vietnam veterans to criminal behavior. A conceptual framework is discussed which proposes that the disposition to criminal behavior is determined by whether or not the veteran enters into the survivor mode of functioning as a behavioral defense mechanism against the disorder. It is hypothesized that there exists a relationship between the severity of PTSD and the tendency to commit illegal acts. The Vietnam Era Stress Inventory (Wilson and Krauss, 1980) was used to assess PTSD among a volunteer national sample of Vietnam combat veterans (N = 114) participating in the Veterans Administration's counseling program known as Operation Outreach. The results strongly supported the hypothesis and indicated that combat role variables, exposure to stressors in Vietnam and the severity of PTSD were significantly correlated with criminal acts. [ABSTRACT FROM AUTHOR]

 

TRAUMATIC BRAIN INJURY

Traumatic Brain Injury — Football, Warfare, and Long-Term Effect

DeKosky, S., Ikonomovic, M., & Gandy, S. (2010). Traumatic brain injury: football, warfare, and long-term effects. Minnesota Medicine, 93(12), 46-47.

Public awareness of the consequences of traumatic brain injury caused by participation in sports, vehicular crashes, and modern warfare has increased in recent years. This article describes what is currently understood about the pathogenesis of traumatic brain injury and goals for research that could lead to better understanding.

 

Combat Veterans, Mental Health Issues, and the Death Penalty: Addressing the Impact of Post-Traumatic Stress Disorder and Traumatic Brain Injury

Anthony E. Giardino

May 2009

More than 1.5 million Americans have participated in combat operations in Iraq and Afghanistan over the past seven years. Some of these veterans have subsequently committed capital crimes and found themselves in our nation’s criminal justice system. This Essay argues that combat veterans suffering from post-traumatic stress disorder or traumatic brain injury at the time of their offenses should not be subject to the death penalty. Offering mitigating evidence regarding military training, post-traumatic stress disorder, and traumatic brain injury presents one means that combat veterans may use to argue for their lives during the sentencing phase of their trials. Alternatively, Atkins v. Virginia and Roper v. Simmons offer a framework for establishing a legislatively or judicially created categorical exclusion for these offenders, exempting them from the death penalty as a matter of law. By understanding how combat service and service-related injuries affect the personal culpability of these offenders, the legal system can avoid the consequences of sentencing to death America's mentally wounded warriors, ensuring that only the worst offenders are subject to the ultimate punishment.

 

VETERANS AS DEFENDANTS

 

Echoes of War: The Combat Veteran in Criminal Court

Brockton D.  Hunter

July 2014

Just as PTSD is a natural side effect of war, research also reveals veteran-committed crime waves in the wake of every major American conflict, particularly Vietnam. Even today, 40 years after that war, hundreds of thousands of psychologically injured Vietnam veterans are incarcerated, chronically addicted and/or homeless across our country. This session will explore the history of PTSD and its ties to criminal behavior. It will then explore the ways in which America and its criminal justice system can learn lessons from history and avoid mistakes made with past generations of troubled returning war veterans.

 

Prospective Prediction of Functional Difficulties Among Recently Separated Veterans

Larson, G. E., & Norman, S. B. (2014). Prospective prediction of functional difficulties among recently separated Veterans. Journal Of Rehabilitation Research & Development, 51(3), 415-427. doi:10.1682/JRRD.2013.06.0135

Reports of functional problems are common among Veterans who served post-9/11 (more than 25% report functional difficulties in at least one domain). However, little prospective work has examined the risk and protective factors for functional difficulties among Veterans. In a sample of recently separated Marines, we used stepwise logistic and multiple regressions to identify predictors of functional impairment, including work-related problems, financial problems, unlawful behavior, activity limitations due to mental health symptoms, and perceived difficulty reintegrating into civilian life. Posttraumatic stress disorder symptoms assessed both before and after military separation significantly predicted functional difficulties across all domains except unlawful behavior. Certain outcomes, such as unlawful behavior and activity limitations due to mental health symptoms, were predicted by other or additional predictors. Although several forms of functioning were examined, the list was not exhaustive. The results highlight a number of areas where targeted interventions may facilitate the reintegration of military servicemembers into civilian life. [ABSTRACT FROM AUTHOR]

 

The Correlation Between PTSD and Criminogenic Behaviors In Incarcerated Veterans

Fleming, M., Simpson, M., & Presecan, N. (2013). The Correlation Between PTSD and Criminogenic Behaviors In Incarcerated Veterans. Corrections Forum, 22(6), 37-40.

The article discusses the research study on the characteristics of post-traumatic stress disorder (PTSD) in incarcerated veterans. It highlights the problems associated with the link between PTSD and criminal behaviors, the prevalence of incarcerated veterans, and the link of PTSD with traumatic brain injury. It also explains the treatment options for PTSD.

 

Internal Anger and External Expressions of Aggression in OEF/OIF Veterans

Renshaw, K. D., & Kiddie, N. S. (2012). Internal anger and external expressions of aggression in OEF/OIF veterans. Military Psychology, 24(3), 221-235. doi:10.1080/08995605.2012.678197

National Guard/Reserve service members (n = 143) deployed to Operations Enduring/Iraqi Freedom completed measures of anger/aggression, coping, and PTSD. Regressions and path analyses revealed that PTSD and avoidant coping both contributed to elevated anger. Furthermore, PTSD exerted indirect effects on verbal and physical aggression via anger, with direct effects only on physical aggression. Younger age was unrelated to anger but directly related to greater verbal and physical aggression. These results contribute to a more comprehensive understanding of risk for aggression in veterans of recent conflicts; however, the generalizability is limited by sample characteristics (all National Guard/Reserve, mostly White, married, religious). (PsycINFO Database Record (c) 2014 APA, all rights reserved) (journal abstract)

 

Criminal Justice Involvement, Trauma, and Negative Affect in Iraq and Afghanistan War Era Veterans

Elbogen, E. B., Johnson, S. C., Newton, V. M., Straits-Troster, K., Vasterling, J. J., Wagner, H., & Beckham, J. C. (2012). Criminal justice involvement, trauma, and negative affect in Iraq and Afghanistan war era veterans. Journal Of Consulting And Clinical Psychology, 80(6), 1097-1102. doi:10.1037/a0029967

Objective: Although criminal behavior in veterans has been cited as a growing problem, little is known about why some veterans are at increased risk for arrest. Theories of criminal behavior postulate that people who have been exposed to stressful environments or traumatic events and who report negative affect such as anger and irritability are at increased risk of antisocial conduct. Method: We hypothesized veterans with posttraumatic stress disorder (PTSD) or traumatic brain injury (TBI) who report anger/irritability would show higher rates of criminal arrests. To test this, we examined data in a national survey of N = 1,388 Iraq and Afghanistan war era veterans. Results: We found that 9% of respondents reported arrests since returning home from military service. Most arrests were associated with nonviolent criminal behavior resulting in incarceration for less than 2 weeks. Unadjusted bivariate analyses revealed that veterans with probable PTSD or TBI who reported anger/irritability were more likely to be arrested than were other veterans. In multivariate analyses, arrests were found to be significantly related to younger age, male gender, having witnessed family violence, prior history of arrest, alcohol/drug misuse, and PTSD with high anger/irritability but were not significantly related to combat exposure or TBI. Conclusions: Findings show that a subset of veterans with PTSD and negative affect may be at increased risk of criminal arrest. Because arrests were more strongly linked to substance abuse and criminal history, clinicians should also consider non-PTSD factors when evaluating and treating veterans with criminal justice involvement. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)

 

Military Suicides: Those We Might Yet Save

Penny Coleman

January 24, 2012

 

Prosecutor Pretrial Attitudes and Plea-Bargaining Behavior Toward Veterans With Posttraumatic Stress Disorder

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Wilson, J., Brodsky, S. L., Neal, T. S., & Cramer, R. J. (2011). Prosecutor pretrial attitudes and plea-bargaining behavior toward veterans with posttraumatic stress disorder. Psychological Services, 8(4), 319-331. doi:10.1037/a0025330

Prosecutors are handling increasing numbers of criminal cases concerning veterans from the wars in Iraq and Afghanistan who suffer from posttraumatic stress disorder (PTSD). How these prosecutors handle such cases may reflect their attitudes toward veterans or offenders with PTSD. In turn, their attitudes may affect perceptions of blameworthiness, as well as negotiations about sentencing during the pretrial stage. The present study investigated the effect of a defendant's military experience and mental health status (i.e., PTSD) on prosecutors' offers at the pretrial stage and their ratings of the defendant's blameworthiness. Prosecutors' offers were more lenient to stress-disordered veterans; specifically, they were offered more diversion programs as compared with veterans without PTSD and to other offenders with PTSD. Prosecutors also perceived veterans and those with PTSD as less criminally culpable; they also empathized and identified more with veterans and those with PTSD than nonveterans and offenders without PTSD. (PsycINFO Database Record (c) 2013 APA, all rights reserved) (journal abstract)

 

Keeping Veterans with PTSD out of the Justice System

Keeping Veterans with PTSD out of the Justice System. (2010). Keeping Veterans with PTSD out of the Justice System, 2. doi:10.1037/e553532011-001

This report discusses how in recent years, programs have been developed to keep war Veterans with mental health problems from being put in jail or prison. The programs aim to assist Veterans who become involved in the justice system to get treatment for mental health problems that may exist. This includes the numbers of Veterans returning from Afghanistan and Iraq. (PsycEXTRA Database Record (c) 2013 APA, all rights reserved)

 

Exit Wounds: Current Issues Pertaining to Combat-Related PTSD of Relevance to the Legal System

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Tramontin, M. (2010). Exit Wounds: Current Issues Pertaining to Combat-Related PTSD of Relevance to the Legal System.Developments In Mental Health Law, 29(1), 23-47.

Written for those in the mental health and legal communities dealing with war veterans embroiled in the criminal justice system, this Article presents an overview of current issues pertaining to the diagnosis, assessment, and treatment of combat-related post-traumatic stress disorder (PTSD). The objective is to provide information that can assist the legal system when addressing PTSD-related issues of combat veterans charged with crimes, with a specific focus on those returning from Operations Enduring Freedom and Iraqi Freedom (OEF/OIF). As part of this discussion, insights from clinical practice for assessing and treating combat veterans are offered and considered in light of state of the art trends from the complex and evolving field of traumatic stress studies. [ABSTRACT FROM AUTHOR]

 

Last Stand? The Criminal Responsibility of War Veterans Returning from Iraq and Afghanistan with Posttraumatic Stress Disorder

Hafemeister, Thomas L. and Stockey, Nicole A., Last Stand? The Criminal Responsibility of War Veterans Returning from Iraq and Afghanistan with Post-Traumatic Stress Disorder (March 4, 2010). Indiana Law Journal, Vol. 85, No. 1, p. 87, 2010; Virginia Public Law and Legal Theory Research Paper No. 2009-06.

As more psychologically-scarred troops return from combat in Iraq and Afghanistan, society's focus on and concern for these troops and their psychological disorders has increased. With this increase and with associated studies confirming the validity of the Post-Traumatic Stress Disorder (PTSD) diagnosis and the genuine impact of PTSD on the behavior of war veterans, greater weight may be given to the premise that PTSD is a mental disorder that provides grounds for a "mental status defense", such as insanity, a lack of mens rea, or self-defense. Although considerable impediments remain, given the current political climate, Iraq and Afghanistan War veterans are in a better position to succeed in these defenses than Vietnam War veterans were a generation ago. This Article explores the prevalence and impact of PTSD, particularly in war veterans, the relevance of this disorder to the criminal justice system, and the likely evolution of related mental status defenses as Iraq and Afghanistan War veterans return from combat.

 

Veterans’ Courts and Criminal Responsibility: A Problem Solving History & Approach to the Liminality of Combat Trauma

Holbrook, Justin G. (2010). Veterans’ Courts and Criminal Responsibility: A Problem Solving History & Approach to the Liminality of Combat Trauma. Social Science Research Network. Retrieved from http://ssrn.com/abstract=1706829

In September 2010, a federal judge dismissed a criminal case involving a veteran accused of assaulting a federal police officer to allow the case to be heard by the Buffalo Veterans Treatment Court, a division of Buffalo City Court. For those involved in veterans’ advocacy and treatment, the case is significant for a number of reasons. First, it is the first criminal case nationwide to be transferred from federal court to a local veterans treatment court where the goal is to treat - rather than simply punish - those facing the liminal effects of military combat. Second, the case reignites the still unsettled controversy over whether problem-solving courts generally, and veterans courts specifically, unfairly shift the focus of justice away from the retributive interests of victims to the rehabilitative interests of perpetrators. Third, the case serves as a signal reminder to all justice system stakeholders, including parties, judges, attorneys, and treatment professionals, of the potential benefits of sidestepping courtroom adversity in favor of a coordinated effort that seeks to ameliorate victim concerns while advancing treatment opportunities for veterans suffering from combat-related trauma. This chapter explores these issues in light of the history of combat-related trauma and the development of veterans’ treatment courts around the country.

 

Correlates of Anger and Hostility in Iraq and Afghanistan War Veterans

Elbogen, E., Wagner, H., Fuller, S., Calhoun, P., Kinneer, P., & Beckham, J. (2010). Correlates of anger and hostility in Iraq and Afghanistan war veterans. The American Journal Of Psychiatry, 167(9), 1051-1058. doi:10.1176/appi.ajp.2010.09050739

Objective: As troops return from Iraq and Afghanistan to civilian life, clinicians are starting to grapple with how best to detect those at risk of postdeployment adjustment problems. Data reveal the presence of mental health problems in these soldiers, including posttraumatic stress disorder (PTSD), head injury, and alcohol abuse. Each of these conditions has been associated with elevated anger and hostility in veterans from previous conflicts. The authors sought to identify variables empirically related to anger and hostility in Iraq and Afghanistan veterans. Method: A total of 676 veterans who served since September 11, 2001, and who volunteered to participate in research studies were interviewed with instruments designed to collect information on psychiatric symptoms, health, and possible postdeployment adjustment issues. The primary outcome measures were variables measuring aggressive impulses or urges, difficulty managing anger, and perceived problems controlling violent behavior. Results: The three outcome measures were each significantly associated with PTSD hyperarousal symptoms. Other PTSD symptoms were less strongly and less consistently linked to anger and hostility. Traumatic brain injury and alcohol misuse were related to the outcome variables in bivariate but not multivariate analyses. Distinct sets of demographic, historical, and military-related variables were associated with the different facets of anger and hostility measured. Conclusions: The results underscore the need to tailor interventions individually to address anger and hostility effectively and to develop theoretically sophisticated, evidence-based knowledge to identify service members at risk of problematic postdeployment adjustment.

 

Antidepressant Drug Effects and Depression Severity: A Patient-Level Meta-analysis

Fournier, J. C., DeRubeis, R. J., Hollon, S. D., Dimidjian, S., Amsterdam, J. D., Shelton, R. C., & Fawcett, J. (2010). Antidepressant drug effects and depression severity: A patient-level meta-analysis. JAMA: Journal Of The American Medical Association, 303(1), 47-53. doi:10.1001/jama.2009.1943

Context: Antidepressant medications represent the best established treatment for major depressive disorder, but there is little evidence that they have a specific pharmacological effect relative to pill placebo for patients with less severe depression. Objective: To estimate the relative benefit of medication vs placebo across a wide range of initial symptom severity in patients diagnosed with depression. Data Sources: PubMed, PsycINFO, and the Cochrane Library databases were searched from January 1980 through March 2009, along with references from meta-analyses and reviews. Study Selection: Randomized placebo-controlled trials of antidepressants approved by the Food and Drug Administration in the treatment of major or minor depressive disorder were selected. Studies were included if their authors provided the requisite original data, they comprised adult outpatients, they included a medication vs placebo comparison for at least 6 weeks, they did not exclude patients on the basis of a placebo washout period, and they used the Hamilton Depression Rating Scale (HDRS). Data from 6 studies (718 patients) were included. Data Extraction: Individual patient-level data were obtained from study authors. Results: Medication vs placebo differences varied substantially as a function of baseline severity. Among patients with HDRS scores below 23, Cohen d effect sizes for the difference between medication and placebo were estimated to be less than 0.20 (a standard definition of a small effect). Estimates of the magnitude of the superiority of medication over placebo increased with increases in baseline depression severity and crossed the threshold defined by the National Institute for Clinical Excellence for a clinically significant difference at a baseline HDRS score of 25. Conclusions: The magnitude of benefit of antidepressant medication compared with placebo increases with severity of depression symptoms and may be minimal or nonexistent, on average, in patients with mild or moderate symptoms. For patients with very severe depression, the benefit of medications over placebo is substantial. (PsycINFO Database Record (c) 2012 APA, all rights reserved)

 

Post-Traumatic Stress Disorder in the Criminal Justice System: From Vietnam to Iraq and Afghanistan

Marcia G. Shein

September 2010

 

Mental Health and Other Risk Factors for Jail Incarceration among Male Veterans

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Greenberg, G., & Rosenheck, R. (2009). Mental health and other risk factors for jail incarceration among male veterans. The Psychiatric Quarterly, 80(1), 41-53. doi:10.1007/s11126-009-9092-8

Data derived from the 2002 Survey of Inmates in Local Jails and the 2000 National Survey of Veterans show that having mental health problems in addition to such sociodemographic characteristics as being a member of a minority group, not being married, having less education, and being younger are risk factors for incarceration among veterans, as they are for the general population. As in previous studies veterans who served during the Vietnam Era and to an even greater extent, those who served in the early years of the All Volunteer Force were at greater risk of incarceration than veterans from the most recent period of the AVF, after controlling for age and other factors.

 

Combat Veterans, Mental Health Issues, and the Death Penalty: Addressing the Impact of Post-Traumatic Stress Disorder and Traumatic Brain Injury

Anthony E. Giardino

May 2009

More than 1.5 million Americans have participated in combat operations in Iraq and Afghanistan over the past seven years. Some of these veterans have subsequently committed capital crimes and found themselves in our nation’s criminal justice system. This Essay argues that combat veterans suffering from post-traumatic stress disorder or traumatic brain injury at the time of their offenses should not be subject to the death penalty. Offering mitigating evidence regarding military training, post-traumatic stress disorder, and traumatic brain injury presents one means that combat veterans may use to argue for their lives during the sentencing phase of their trials. Alternatively, Atkins v. Virginia and Roper v. Simmons offer a framework for establishing a legislatively or judicially created categorical exclusion for these offenders, exempting them from the death penalty as a matter of law. By understanding how combat service and service-related injuries affect the personal culpability of these offenders, the legal system can avoid the consequences of sentencing to death America's mentally wounded warriors, ensuring that only the worst offenders are subject to the ultimate punishment.

 

Posttraumatic Stress Disorder and Criminal Responsibility

Friel, A., White, T., & Hull, A. (2008). Posttraumatic stress disorder and criminal responsibility. Journal of Forensic Psychiatry & Psychology, 19(1), 64-85. doi:10.1080/14789940701594736

There has been an increased interest in the relationship between posttraumatic stress disorder (PTSD) and violence, and in the factors that mediate their linkage. PTSD is a common, often underdiagnosed, condition with high levels of psychiatric comorbidity. It often has poor outcomes, with many cases becoming chronic, leading to substantial costs both to the individual and society as a whole. In this paper we report on the literature on PTSD, its diagnosis, assessment, and treatment. The difficulties encountered when assessing PTSD – the subjective nature of the symptoms, the risk of malingering, and the possibility of secondary gain – have been highlighted. Assessment and treatment in forensic settings is further complicated by the possibility of perpetrator PTSD. We have reviewed the prevalence of PTSD with particular reference to offender and forensic populations. The association between PTSD and violence, its relevance across the spectrum of criminal responsibility, and relevant case law are explored.

 

Early Intervention for Trauma: Where Are We and Where Do We Need to Go? A Commentary

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Litz, B. T. (2008), Early intervention for trauma: Where are we and where do we need to go? A commentary. Journal of Traumatic Stress, 21: 503–506. doi: 10.1002/jts.20373

In this commentary, the author underscores the importance of early intervention for trauma and describes the challenges that lie ahead for researchers, decision makers, and care providers. The author also provides a review of where things stand, briefly reviews psychological first aid strategies, and underscores where we need to go from here. Although the field has advanced considerably in the last decade or so, and there are compelling trials underway, there is much work that needs to be done, especially in terms of effectiveness and the task of integrating early intervention into various work cultures, such as the military.

 

Profile of 100 Incarcerated Veterans: Alameda County, California - 2012

 

Veterans in State and Federal Prison, 2004

Noonan, M. E., & Mumola, C. J. (2007). Veterans in State and Federal Prison, 2004. Veterans In State And Federal Prison, 2004, 1-16. doi:10.1037/e640312007-001

Reports on veterans who are inmates in state and federal prisons. Demographic characteristics, offense types, co-occurring substance use and mental health problems are addressed. Data in this report were based on personal interviews with prisoners, conducted through the Survey of Inmates in State and Federal Correctional Facilities, 2004. Conducted every 5 or 6 years since 1974 (Federal facilities were added for the first time in 1991), the inmate surveys are the only national source of detailed information on criminal offenders, including special populations such as military veterans. (PsycEXTRA Database Record (c) 2013 APA, all rights reserved)

 

Veterans in Prison or Jail

Bureau of Justice Statistics Special Report

January 2000

 

Medication Madness: How Psychiatric Drugs Cause Violence, Suicide, and Crime

Dr. Peter Breggin

September 13, 2009

 

Post-traumatic Stress Disorder and the Casual Link to Crime: A Looming National Tragedy

Daniel, D. L. (2008). Post-traumatic Stress Disorder and the Casual Link to Crime: A Looming National Tragedy. US Army, US Army Combined Arms Center. doi:10.1037/e614642009-001

The purpose of this paper is to investigate if there is a correlation between PTSD and criminal behavior in soldiers that have been incarcerated after returning from the GWOT and to determine the obligations of the U.S. government/DoD to prevent, treat, and/or mitigate the problem. This study includes data collected, examined and analyzed from three primary sources. First, an existing study on PTSD and criminal behavior by James J. Collins and Susan L. Bailey which examines the correlation between PTSD and criminal behavior primarily in 1140 nonveteran North Carolina inmates. This study is included to establish whether a general causal link exists between PTSD and an incidence of violent criminal behavior. Next, statistical data compiled by the Bureau of Justice Statistics (BJS) section of the Office of Justice Programs, U.S. Department of Justice (DoJ) is analyzed for trends in incarceration rates among veterans in Federal and State correctional facilities. The BJS data is included to examine whether the incarceration rates of veterans for violent criminal offenses has peaked during and after periods of war. Finally, this study will look closely at aggregate exempt inmate data recently compiled by the administrative and mental health staff of the United States Disciplinary Barracks, Fort Leavenworth, Kansas (USDB). The data from the USDB is part of an ongoing survey of the inmates (n=440) to determine the incidence of PTSD and mental health disorders within the prisoner population for treatment purposes and program analysis. This paper explores the history of PTSD in previous conflicts, the characteristics of the disorder and briefly discusses current treatment approaches. The data presented, particularly the initial results of the current USDB survey, strongly supports the current hypothesis that there is a correlation between PTSD and criminal behavior in soldiers that have been incarcerated after returning from the GWOT. As such the final contribution of this paper is to offer some brief recommendations on what our national leaders should do to prevent or mitigate the impending problem in our society of more veterans involved in violent criminal behavior. (PsycEXTRA Database Record (c) 2013 APA, all rights reserved)

 

Attorneys as First-Responders: Recognizing the Destructive Nature of Posttraumatic Stress Disorder on the Combat Veteran’s Legal Decision-Making Process

Captain Evan R. Seamone

Winter 2009

 

The Veterans’ Lawyer as Counselor: Using Therapeutic Jurisprudence to Enhance Client Counseling For Combat Veterans with Posttraumatic Stress Disorder

Captain Evan R. Seamone

Winter 2009

 

Aggression Among Combat Veterans: Relationships With Combat Exposure and Symptoms of Posttraumatic Stress Disorder, Dysphoria, and Anxiety Severity of Posttraumatic Stress Disorder and Involvement with the Criminal Justice System

Taft, C., Vogt, D., Marshall, A., Panuzio, J., & Niles, B. (2007). Aggression among combat veterans: relationships with combat exposure and symptoms of posttraumatic stress disorder, dysphoria, and anxiety. Journal Of Traumatic Stress, 20(2), 135-145.

Prior research has revealed heightened aggressive behavior among veterans with PTSD. This study tested a model examining the interrelationships among combat exposure, posttraumatic stress disorder (PTSD) symptoms, dysphoric symptoms, and anxiety symptoms in predicting aggressive behavior in a sample of 265 male combat veterans seeking diagnostic assessment of PTSD. Combat exposure was indirectly associated with aggression primarily through its relationship with PTSD symptoms. Symptoms of PTSD were directly related to aggression, and indirectly related to aggression through dysphoric symptoms. Results highlight the role of PTSD symptoms and dysphoric symptoms with respect to aggressive behavior among this population, and suggest the relevance of aggression theory to the study of combat veterans.

 

Severity of Posttraumatic Stress Disorder and Involvement with the Criminal Justice System

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Calhoun, P. S., Malesky Jr., L., Bosworth, H. B., & Beckham, J. C. (2004). Severity of Posttraumatic Stress Disorder and Involvement with the Criminal Justice System. Journal Of Trauma Practice, 3(3), 1-16. doi:10.1300/J189v03n03_01

Two hundred and forty-one Vietnam combat veterans with chronic posttraumatic stress disorder (PTSD) completed measures of PTSD symptom severity, combat exposure, depression, hostility, interpersonal violence, substance abuse, and arrest history. The majority of veterans with PTSD (63%) reported being arrested at least once after returning from Vietnam. Logistic regression analyses indicated that PTSD severity was positively correlated with arrest history even when other variables associated with criminal behavior were taken into account. Recommendations for evaluation and treatment of individuals with PTSD who are at risk of becoming involved with the criminal justice system are discussed. [ABSTRACT FROM AUTHOR]

 

Aggression and Its Correlates in Vietnam Veterans with and Without Chronic Post-Traumatic Stress Disorder

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Lasko, N.B., Guruits, T.V., Kuhne, A.A., Orr, S.P., & Pitman, R.K. (1994). Aggression and its correlates in Vietnam veterans with and without chronic post-traumatic stress disorder. Comprehensive Psychiatry, 35, 373-381.

This study measured self-reported aggression, hostility, and anger in Vietnam combat veterans with (n = 27) and without (n = 15) posttraumatic stress disorder (PTSD). On the Buss-Durkee Hostility Inventory, Past Feelings and Acts of Violence Scale, Episodic Dyscontrol Scale, and State-Trait Anger Expression Inventory (STAXI), PTSD subjects scored significantly higher than non-PTSD subjects, whose scores fell in the range reported for normative, noncombat populations. The PTSD versus non-PTSD group differences were not explained by combat exposure, which did not correlate significantly with the psychometric aggression measures. These findings suggest that increased aggression in war veterans is more appropriately regarded as a property of PTSD, rather than a direct consequence of military combat. The association between compromised neurologic and neuropsychologic status and the psychometric measures was modest and explained little of the group differences.

 

The “Vietnam Syndrome’’ Defense: A “G.I. Bill of Criminal Rights”?

Samuel Pyeatt Menefee

February 1985

 

Paying the Price for Vietnam: Post-traumatic Stress Disorder and Criminal Behavior

Erlinder, C. P. (1984). Paying the price for Vietnam: Post-traumatic Stress Disorder and criminal behavior. Boston College Law Review, 25(2). 305-347.

 

The Vietnam Veteran on Trial: The Relation of Post-Traumatic Stress Disorder to Criminal Behavior

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Wilson, J. P., & Zigelbaum, S. D. (1983). The Vietnam Veteran on Trial: The Relation of Post-Traumatic Stress Disorder to Criminal Behavior. Behavioral Sciences & The Law, 1(3), 69-83.

The purpose of this paper is to conceptualize the relationship of Post-Traumatic Stress Disorder (PTSD) in Vietnam veterans to criminal behavior. A conceptual framework is discussed which proposes that the disposition to criminal behavior is determined by whether or not the veteran enters into the survivor mode of functioning as a behavioral defense mechanism against the disorder. It is hypothesized that there exists a relationship between the severity of PTSD and the tendency to commit illegal acts. The Vietnam Era Stress Inventory (Wilson and Krauss, 1980) was used to assess PTSD among a volunteer national sample of Vietnam combat veterans (N = 114) participating in the Veterans Administration's counseling program known as Operation Outreach. The results strongly supported the hypothesis and indicated that combat role variables, exposure to stressors in Vietnam and the severity of PTSD were significantly correlated with criminal acts. [ABSTRACT FROM AUTHOR]

 

FAMILY ISSUES AND DOMESTIC VIOLENCE

Returning from the War Zone A Guide for Families of Military Members

September 2010

 

Domestic Violence, PTSD and Brain Injury:  Military and Civilian Challenges

Part 1

Part 2

Deborah D. Tucker for the National Center on Domestic and Sexual Violence (NCDSV)

2009

This two-part article written by the director of the NCDSV explores the military and civilian challenges presented by domestic violence and behavior that is more often associated with PTSD or TBI, whether attributable to experiences in a military setting or some other influence, such as being a victim of child abuse or sexual assault or from brain injury impacting the impulse control of the sufferer. Ms. Tucker offers recommendations for lawyers and judges as well as resources for intervention with the offender and support for the victims.

 

VETERANS TREATMENT COURTS

Veterans Treatment Courts: Analysis and Recommendations

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Frederick, A. (2014). Veterans Treatment Courts: Analysis and Recommendations. Law & Psychology Review, 38211-230.

This note examines the creation of veterans treatment courts, a type of problem-solving court specifically for veterans, as a response to the increasing number of incarcerated veterans in the United States. Specifically, this note explores the history and development of veterans treatment courts, the operation and key components of the program, and the impact of applying its methodology. It also identifies and responds to the common criticisms of the system. Finally, this note concludes by providing recommendations for applying the mentor aspect of the program to other problem-solving courts. [ABSTRACT FROM AUTHOR]

 

An inventory of VA involvement in Veterans courts, dockets and tracks

Jim McGuire, PhD; Sean Clark, JD; Jessica Blue-Howells, LCSW; Cedric Coe, MAFO

VA Veterans Justice Programs

February 7, 2013

 

Catch, Treat, and Release: Veteran Treatment Courts Address the Challenges of Returning Home.

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Slattery, M., Dugger, M. T., Lamb, T. A., & Williams, L. (2013). Catch, Treat, and Release: Veteran Treatment Courts Address the Challenges of Returning Home. Substance Use & Misuse, 48(10), 922-932. doi:10.3109/10826084.2013.797468

After a decade of war, there is a great need for treatment and alternatives to incarceration for justice-involved veterans. U.S. military service members are returning from combat with substantial mental health challenges, which increase the potential for justice involvement. Veteran Treatment Courts are starting across the nation to meet this need for therapeutic justice. These problem solving courts provide access to treatment and motivation for engagement. Preliminary evidence from a Substance Abuse and Mental Health Services Administration-funded evaluation suggests that significant improvements in posttraumatic stress disorder and substance use are just a few of the positive outcomes that these courts may help veterans achieve. [ABSTRACT FROM AUTHOR]

 

Critical concerns in Iraq/Afghanistan war veteran-forensic interface: Veterans treatment court as diversion in rural communities.

Smee, D. E., McGuire, J., Garrick, T., Sreenivasan, S., Dow, D., & Woehl, D. (2013). Critical concerns in Iraq/Afghanistan war veteran-forensic interface: Veterans treatment court as diversion in rural communities. Journal Of The American Academy Of Psychiatry And The Law, 41(2), 256-262.

The veteran-forensic interface is an emerging area of relevance to forensic clinicians assessing or treating returning Iraq and Afghanistan war veterans facing criminal sanctions. Veterans’ Treatment Court (VTC) represents a recent diversion mechanism for low-level offenses that is based on a collaborative justice model. Thirty-nine percent of veterans who served in Iraq or Afghanistan and receiving VA services reside in rural areas. Rural veterans facing criminal justice charges may be at a disadvantage due to limited access to forensic psychiatrists with relevant expertise in providing veterans services for diversion. Therefore, widening the pool of forensic clinicians who have such expertise, as well as knowledge of the signature wounds of the wars as related to aggression and reckless behavior is necessary. This article presents an overview of VTCs and discusses the role of forensic clinicians as stakeholders in this process.

 

Veterans Courts: Early Outcomes and Key Indicators for Success

Holbrook, J. & Anderson, S. (2011). Veterans Courts: Early outcomes and key indicators for success. Social Science Research Network. Retrieved from http://ssrn.com/abstract=1912655

The growing trend within the judicial, treatment, and advocacy communities toward specialized courts for military veterans raises important questions about the effectiveness of such courts in rehabilitating veterans. Both principally and practically, veterans courts observers may take opposing positions regarding the appropriateness and effectiveness of placing veterans in a specialized, treatment-based court program simply because of their military service. This chapter explores these challenging issues in two parts. First, we undertake a discussion of first principle concerns related to veterans courts by reviewing research studies examining the link between veterans and criminal misconduct. The return of 1.6 million veterans from the wars in Iraq and Afghanistan has re-ignited the still unsettled controversy over whether veterans suffering from combat trauma are more likely than their non-veteran counterparts to commit criminal misconduct after returning home. While firm conclusions may be difficult (and unpopular) to draw, the issue warrants attention in any serious discussion about the merits and best practices of veterans court programs. Second, we present early findings from an assessment we conducted of the practices, procedures, and participant populations of certain veterans courts operating as of March 2011. Of the 53 courts invited to participate, 14 provided a response by completing either an online or paper survey. Of these, seven submitted sample policies and procedures, participant contracts, plea agreements, and mentor guidelines for our review. Drawing on these courts’ common practices and procedures, we identify key operational components courts should consider in implementing veterans court programs. We also conclude that veterans court outcomes, at least at present, appear at least as favorable as those of other specialized treatment courts.

 

The Battle on the Home Front: Special Courts Turn to Vets to Help Other Vets

William H. McMichael

November 2011

 

Veterans’ Courts and Criminal Responsibility: A Problem Solving History & Approach to the Liminality of Combat Trauma

Holbrook, Justin G. (2010). Veterans’ Courts and Criminal Responsibility: A Problem Solving History & Approach to the Liminality of Combat Trauma. Social Science Research Network. Retrieved from http://ssrn.com/abstract=1706829

In September 2010, a federal judge dismissed a criminal case involving a veteran accused of assaulting a federal police officer to allow the case to be heard by the Buffalo Veterans Treatment Court, a division of Buffalo City Court. For those involved in veterans’ advocacy and treatment, the case is significant for a number of reasons. First, it is the first criminal case nationwide to be transferred from federal court to a local veterans treatment court where the goal is to treat - rather than simply punish - those facing the liminal effects of military combat. Second, the case reignites the still unsettled controversy over whether problem-solving courts generally, and veterans courts specifically, unfairly shift the focus of justice away from the retributive interests of victims to the rehabilitative interests of perpetrators. Third, the case serves as a signal reminder to all justice system stakeholders, including parties, judges, attorneys, and treatment professionals, of the potential benefits of sidestepping courtroom adversity in favor of a coordinated effort that seeks to ameliorate victim concerns while advancing treatment opportunities for veterans suffering from combat-related trauma. This chapter explores these issues in light of the history of combat-related trauma and the development of veterans’ treatment courts around the country.

 

Coming Home: Accommodating the Special Needs of Military Veterans to the Criminal Justice System

Hawkins, M. D. (2010). Coming Home: Accommodating the Special Needs of Military Veterans to the Criminal Justice System. Ohio State Journal Of Criminal Law, 7(2), 563-573.

Large numbers of Iraq and Afghanistan war veterans are returning home with serious mental and emotional problems. In response to their impact on the criminal justice system, several jurisdictions have established veterans courts. Patterned after the early intervention and intensive supervision protocols of drug courts, these courts are designed to address the particular needs of these veterans. Focusing on nonviolent offenses and relying on a treatment rather than punishment model, early reports suggest the efforts are working to address the profound stress many veterans have experienced and the difficult adjustment to civilian life they face when returning home. [ABSTRACT FROM AUTHOR]

 

Should Problem Solving Courts be Solution-Focused Courts?

King, Michael S., Should Problem Solving Courts be Solution-Focused Courts? (December 13, 2010). Revista Juridica Universidad de Puerto Rico, Forthcoming; Monash University Faculty of Law Legal Studies Research Paper No. 2010/15.

Drug courts, family violence courts, mental health courts, community courts and variations of these courts have commonly been considered to be problem-solving courts. Implicit in the concept of and literature on these courts is the idea that it is the court that solves participants’ problems, often with the assistance of a multi-disciplinary team. However behavioral science research suggests that positive behavioural change involves the individual’s own internal processes and actions, albeit often assisted by treatment and support services. Rather than seeking to solve participants’ problems, these courts should be taking a solution-focused approach, supporting participants’ own change processes and facilitating their involvement with treatment and support agencies as needed. Such an approach avoids coercion and paternalism, promotes participant involvement in decision making and problem-solving concerning their rehabilitation, uses persuasion and motivational interviewing techniques where appropriate and supports participant self-efficacy. This approach is more likely to promote long-lasting behavioral change than a problem-solving approach. However further research is needed concerning the efficacy of particular judicial processes in these courts.