Tuesday, February 28, 2017

Posttraumatic Stress Disorder - Cross-Examining Psych Doctors, Tip #66


A Posttraumatic Stress Disorder (PTSD) is commonly diagnosed in medical-legal evaluations. This disorder is diagnosed correctly when an individual has been exposed to an extreme life-threatening traumatic stressor that has led to the development of a set of characteristic signs and/or symptoms. Such traumatic events include, but are not limited to, military combat, violent personal assault, being kidnapped, being taken hostage, terrorists attack, torture, incarceration as a prisoner of war, natural or man-made disasters, severe automobile accidents or being diagnosed with a life threatening illness.
More help for cross-examining psych doctors can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Check out my blog (http://drleckart.blogspot.com). 

DrLeckartWETC@gmail.com, (844) 444-8898

Friday, February 24, 2017

Severe With Psychotic Features - Cross-Examining Psych Doctors, Tip #65




The modifier or specifier “Severe With Psychotic Features” may be used when diagnosing a Major Depressive Disorder if the individual presents with delusions and/or hallucinations.  Typically, the content of those delusions and/or hallucinations is mood-congruent, which means that their content is consistent with themes of depression found in the patient’s narrative.  When you have a psych report, you should look for information where the doctor reported that the individual complained of hallucinations and/or delusions.  You should also look for information in the doctor’s Mental Status Examination where they may have commented on observing hallucinations and/or delusions during their face-to-face interview with the patient.  When the doctor has failed to put that information into their report there is no data to support their use of the modifier or specifier of “Severe With Psychotic Features.”

More help for cross-examining psych doctors can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Check out my blog (http://drleckart.blogspot.com). 

DrLeckartWETC@gmail.com, (844) 444-8898

Apricots™ help prepare a brief for the court - Cross-Examining Psych Doctors, TIp #64


An Apricot™ contains information about the significant flaws in a psych report in a clearly written work product privileged report.  An Apricot™ is written in jargon-free language.  In situations where discovery has closed or the psych doctor will not be cross-examined, an Apricot™ contains all the psychological information needed to prepare a brief for the court if the attorney decides that they wish to petition to have the court throw out the doctor’s report.


More help for cross-examining psych doctors can be found at my website (www.drleckartwetc.com) and in my book Psychological Evaluations In Litigation: A Practical Guide for Attorneys and Insurance Adjusters

Check out my blog (http://drleckart.blogspot.com). 

DrLeckartWETC@gmail.com, (844) 444-8898

Monday, February 13, 2017

Use of the Epworth Sleepiness Scale, Tip #63



The Epworth Sleepiness Scale is a self-report instrument that asks the test-taker to rate themselves on a 4-point scale describing their impression of the likelihood of their “dozing or sleeping” under eight circumstances such as sitting and reading, watching television, lying down in the afternoon or stopped in traffic for a few minutes.  The test-taker can receive a total score of between 0 and 24, with a higher score indicating that they believe they are more likely to fall asleep or doze under the stated circumstances.  It is advised tha a score greater than 10 indicates that the test-taker should consider whether they are obtaining adequate sleep or need to see a sleep specialist.   Unfortunately, there are no validity scales included in the test to determine whether the test-taker is completely the items in an honest and frank manner and therefore the test is completely useless for medical-legal evaluations.

Sentence Completion Tests, Tip #62



Sentence Completion Tests are instruments in which the individual is given the first part of a sentence that they are asked to complete in any manner in which they deem appropriate.  The doctor then “interprets” what they feel is the meaning of the individual’s productions.  Unfortunately, there are absolutely no standards for interpreting the results of Sentence Completion Tests, resulting in a situation in which this type of test has absolutely no validity or reliability with regard to assessing psychopathology.  Clearly, Sentence Completion Tests have no known use in medical-legal evaluations.

Own the Diagnostic and Statistical Manual of Mental Disorders (DSM), Tip #61



The most current version of the Diagnostic and Statistical Manual of Mental Disorders (DSM), the DSM-5, was published by the American Psychiatric Association in 2013.  The DSM-IV-TR was published in 2000.  Before that, the DSM-IV was published in 1994.  Moreover, when you are reading a psych report, find the area in the report where the doctor stated which version of the DSM they used in arriving at their diagnostic conclusions.  It is also strongly recommended that you take a copy of the DSM to the cross-examination and display that manual in a prominent position.  As of this writing, some electronic copies of the DSM are available on the Internet for as little as $0.99.