trauma disorders dates back to the 1860s, though the actual term “Posttraumatic Stress Disorder”
was not coined until the 1970s and did not appear in the DSM until its third edition in 1980.138
Originally, the term “traumatic neurosis” was developed to refer to symptoms of industrial
accidents.139 During the First World War, the concept “shell shock” —later replaced with “war
neuroses” or “functional nervous disorders”140 —described “a form of cognitive and emotional
incapacitation first thought to be produced by the brain-concussive effects of exploding shells.”141
It was later clarified that proximity to an explosion was not relevant to the symptoms of “shell
shock,” rather it was the characteristics of the symptoms, mainly “emotions of extreme and
sudden horror and fright.”142 The 1941 book The Traumatic Neuroses of War noted that the long-term psychological impact of war on veterans often did not occur until after they returned
home.143 After World War II, the “psychiatric casualties” were given the initial diagnosis of
These trauma concepts first began to enter the legal realm in personal injury and criminal
cases.145 Early on, many of the criminal defense cases were unsuccessful because military
veteran-defendants were often required—pursuant to most insanity standards—to “relat[e] the
experience of traumatic stress to a recognized psychiatric disorder in order to fulfill the ‘mental
disease or defect’ criteria.”146 Similarly, in the civil arena, recovery for psychological injuries
was very limited.147 In 1980, inclusion of PTSD in the third edition of the DSM provided
veterans and others with a way to overcome the “diagnostic hurdle.”148 “PTSD provided
psychiatry with a means to classify a psychological injury that developed ‘in normal people . . .
following an extremely traumatic event.’”149 Though the clinical definition of PTSD evolved
from DSM-III to DSM- 5, the basic trauma concept remains a part of legal arguments.
Recognition of PTSD has significantly impacted civil and criminal law.150 Although
judicial skepticism still exists about “whether mental and emotional conditions actually exist,”151
advances in neuroscience have produced more acceptance.152 In civil cases, PTSD has been
raised as a basis for tort claims for intentional or negligent infliction of emotional distress, health
benefits and worker’s compensation.153
138 Deirdre M. Smith, Diagnosing Liability: The Legal History of Posttraumatic Stress Disorder, 84 TEMP. L. REV. 1, 5 (2011) (“John
Erichsen, a British surgeon and academic, is often credited with being the first to apply the term to psychiatric injuries in his book, On
Railway and Other Injuries of the Nervous System, first published in 1866. Erichsen theorized that railway injuries from ‘Jars, Shakes,
Shocks, or Concussions’ to the spinal cord could cause injuries (specifically, lesions) that could have several manifestations, including
‘cerebral’ changes affecting memories, thoughts, temper, and sleep.”).
139 Id. at 7.
140 Id. at 11 (internal quotation marks omitted).
141 Miller, supra note 137, at 355.
142 Smith, supra note 138, at 11 (internal quotation marks omitted).
143 Id. at 13 (referring to and citing ABRAM KARDINER, THE TRAUMATIC NEUROSES OF WAR (1941)).
144 Id. at 14-15 (internal quotation marks omitted).
145 See Miller, supra note 137 (summarizing cases in which veterans were using “shell shock” or “nervous disability,” etc. to explain
behavior); Smith, supra note 138, at 20 (“In practice, traumatic neurosis was not a clinical diagnosis per se, but rather a term generally
reserved to describe psychological injuries in the context of personal injury litigation or claims for industrial and other occupational
146 Miller, supra note 137, at 356.
147 Smith, supra note 138, at 21.
148 Miller, supra note 137, at 356.
149 Smith, supra note 138, at 29 (citation omitted).
150 Betsy J. Grey, Neuroscience, PTSD, and Sentencing Mitigation, 34 CARDOZO L. REV. 53, 58-76 (2012); see also Miller, supra note
137, at 360 (“[I]t is vital that a defense psychological expert witness be able to credibly draw a clear, bright line connecting the effects
of the disorder to the criminal behavior in question.”) (citation omitted).
151 Grey, supra note 150, at 63.
152 Id. at 85.
153 Smith, supra note 138, at 21, 43, 67.