Cross-Examining Psychiatrists

ISSUES IN FORENSIC PSYCHOLOGY
Cross-Examining Psychiatrists

Before they undertake their formal training in psychiatry, psychiatrists complete the same medical education as other physicians. It is rare, however, that psychiatrists physically examine patients, or obtain laboratory studies (blood tests, CAT scans, etc), to support their opinions in legal matters.
Neither psychiatric education nor training prepares psychiatrists to undertake psychological testing. Without objective data available to them via psychological testing, psychiatrists are typically reduced to relying on their clinical judgments.
Clinical judgment, however, is notoriously speculative. There can be enormous variations in the clinical judgments of two or more psychiatrists evaluating the same person.
In legally related evaluations, psychiatrists typically rely on DSM-IV diagnoses. Absent psychological test data, diagnostic opinions are more reliable when obtained from structured interviews that are standardized. Nevertheless, psychiatrists rarely use structured interviews when assessing people.
Psychiatric evaluations for legal purposes often involve questions of malingering and impression management. Impression management refers to people putting forth deliberate efforts to create favorable impressions of themselves. Unlike clinical judgment, psychological testing can identify efforts at malingering and impression management.
The relevant research demonstrates that clinical judgment fails when attempting to identify deception. Psychiatrists who claim that their clinical judgment allows them to identify impression management and malingering have resorted to entirely unsubstantiated claims.
Without objective data to support their opinions in legally related evaluations, psychiatrists are quite vulnerable to well-prepared cross-examination.

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