• Karl V Umbrasas.
• Center for Forensic Behavioral Sciences, Walter Reed National Military Medical Center, Bethesda, MD.
• Mil Med. 2020 Feb 12; 185 (1-2): 92-96.

IntroductionThis retrospective study evaluated the prevalence of posttraumatic stress disorder (PTSD) diagnosis among military servicemembers referred for Sanity Boards (n = 229), which is a military evaluation for competence to stand trial (CST) and criminal responsibility (CR). This study further explored the degree to which PTSD was considered a "severe mental disease or defect," the degree to which PTSD was associated with an opinion of not criminally responsible (NCR), and the degree to which PTSD was associated with incompetence to stand trial (IST).Material And MethodsCompleted Sanity Board evaluations were the source of data. This study used an empirical approach to reviewing the Sanity Boards.ResultsSanity Boards diagnosed 13.1% of referrals with PTSD. Of those diagnosed with PTSD, no participants (0%) were opined to meet criteria for incompetence to stand trial (IST), 30% were opined to meet the insanity criteria of "severe mental disease or defect," and one person (0.4%) was found not criminally responsible (NCR) based on PTSD. In the single case in which the person was recommended as NCR based on PTSD, the criminal behavior was deemed to be related to dissociation.ConclusionsPTSD is often considered a "severe mental disease or defect" during Sanity Board evaluations, which differs from the legal standard for "severe mental disease or defect" used by the military justice system. Forensic practitioners consulting with the military justice system acknowledge that PTSD is a "severe mental disease or defect" often, but they rarely opine that PTSD renders a servicemember NCR. In the rare instance where PTSD was opined to render a servicemember NCR, the symptom of dissociation caused an inability to appreciate the nature and quality or wrongfulness of the action.Published by Oxford University Press on behalf of the Association of Military Surgeons of the United States 2019. This work is written by (a) US Government employee(s) and is in the public domain in the US.

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