The PTSD Supremacy: Criterion F in Three Voyager Cases

Abstract

Objective: The aim is to consider whether the courts and experts in their application of Criterion F for posttraumatic stress disorder (PTSD) have applied it consistently in civil claims brought years after the event. Method: Three cases for compensation relating to the Voyager disaster are considered. Results: It appears, from the cases considered in this paper, that while courts consider that Criterion F is crucial in making a diagnosis of PTSD, there are some inconsistencies in terms of understanding and applying this criterion, both by the courts and experts. This may be because of a lack of guidance in psychiatric texts as to how to apply Criterion F. Conclusions: Criterion F is, after the satisfaction of Criterion A(1), arguably the most important of the criteria for PTSD for, while the symptoms referred to in Criteria B–D have been shown to be fairly easy to simulate, it is arguably harder to do this with Criterion F, particularly in cases that arise a long time after the event. It is important therefore that psychiatrists assessing persons so long after an event adhere rigorously to Criterion F, because it is based on facts open to objective corroboration, while criteria B, C and D tend to rely on subjective experiences which are the most sensitive to distortion. Thus, it is to be hoped that if DSM-V is to maintain a criterion of clinically significant distress or impairment in the majority of the disorders described therein, it will provide some assistance as to how this criteria should be applied.