Causality in criminal forensic and in civil disability cases: Legal and psychological comparison

Imaging of musculoskeletal injury: timing estimation and medico-legal issues

Musculoskeletal imaging plays a pivotal role in the evaluation of trauma, with applications spanning medical, forensic, and insurance contexts. Precisely dating musculoskeletal injuries is vital for reconstructing the timeline of events leading to trauma and verifying their accuracy. In forensic medicine, radiologists are frequently called upon by law enforcement and insurance companies to estimate the age of such injuries. This review aims to provide an overview of musculoskeletal imaging findings that can be used in medico-legal issues related to trauma to reach a comprehensive understanding of the causal relationship between the traumatic event and the clinical findings, with a particular focus on assessing causality, timing estimation and post-traumatic injury and impairment. Imaging plays a pivotal role in the precise and comprehensive evaluation of musculoskeletal traumatic injuries, with applications extending from immediate clinical care to legal and insurance considerations. Through various imaging modalities, it is possible to estimate the time elapsed since the injury and assess the impact of any pre-existing conditions. Effective collaboration between the forensic physician and the radiologist is essential to accurately determine the causal link between the injurious event and the resulting damage. This interdisciplinary approach ensures appropriate compensation and addresses the complex forensic aspects involved.

PTSD in Court II: Risk factors, endophenotypes, and biological underpinnings in PTSD

The second article in the series of three for the journal on "PTSD in Court" especially concerns the biological bases that have been found to be associated with PTSD (posttraumatic stress disorder). The cohering concepts in this section relate to risk factors; candidate genes; polygenetics; "gene×environment" interactions; epigenetics; endophenotypes; biomarkers; and connective networks both structurally and functionally (in terms of intrinsic connectivity networks, ICNs, including the DMN, SN, and CEN; that is, default mode, salience, and central executive networks, respectively). Risk factors related to PTSD include pre-event, event- and post-event ones. Some of the genes related to PTSD include: FKBP5, 5-HTTLPR, and COMT (which are, respectively, FK506-binding protein 5 gene, serotonin-transporter linked polymorphic region, catechol-O-methyl-transferase). These genetic findings give an estimate of 30% for the genetic influence on PTSD. The typical brain regions involved in PTSD include the amygdala, hippocampus, and prefrontal cortex, along with the insula. Causal models of behavior are multifactorial and biopsychosocial, and these types of models apply to PTSD, as well. The paper presents a multilevel systems model of psychopathology, including PTSD, which involves three levels - a top-down psychological construct one, a bottom-up symptom connection one, and a middle one involving symptom appraisal. Legally, causality refers to the event at issue needing to meet the bar of being materially contributory to the outcome. Finally, this section of the article reviews empirically-supported therapies for PTSD and the dangers of not receiving treatment for it.

Psychiatric/Psychological Injury and Law: Introduction

This special issue on psychiatric/psychological injury and law covers major developments in the field, and illustrates the complexities for mental health professionals in dealing with psychiatric/psychological injuries in court. The articles vary in the range of topics covered, and include ones on posttraumatic stress disorder, other trauma reactions, dissociation, disability, pain, and traumatic brain injury, in particular but also new areas, such as the effects of early penile injury. Work in the area of psychiatric/psychological injury and law needs to be scientifically-informed, comprehensive, and impartial, and the series of articles to follow will help workers in the area meet this standard.