Psychological Injury and Law: An Integrative Model

This article briefly reviews the literature on three areas of psychological injury, post-traumatic stress disorder, chronic pain, and traumatic brain injury, preparatory to presentation of an integrated biopsychosocial and forensic model of multifactorial causality. The model is the first in the field to (a) cover in one model the three types of psychological injury, (b) while including a full range of causality factors relevant to forensic psychology (such as pre-event, event-, post-event, and unrelated factors), and (c) while addressing the relevance of biopsychological and stress as a cohering factors in all conditions. (d) The model emphasizes the importance of individual differences, for example, in causality of symptom presentation. (e) The model acknowledges that in individual evaluations, psychologists need to consider threats to validity, response biases, and possible malingering, and verify whether pre-event factors fully explain post-event presentation.     

Reye's syndrome. A diagnosis occasionally first made at medicolegal autopsy.

Reye's syndrome, a condition characterized pathologically by cerebral edema and fatty change of the liver, has been described extensively in the medical literature as a disease manifested clinically by encephalopathy and coma. This is a report of five cases of Reye's syndrome occurring as sudden, unexpected deaths outside of the hospital. In each of these cases, there is a vague history of a previous viral illness. A history of aspirin intake is inconstant. Each child either had no significant past illnesses or there was a history of repeated upper respiratory infections. The classic progression of signs and symptoms usually described for Reye's syndrome, where vomiting usually precedes encephalopathy and coma, was not present in any of the cases. Results of autopsies showed the characteristic findings for Reye's syndrome, and additional tests showed no other explanation for the deaths. This manifestation of the disease is seldom described in medical literature, but it may be encountered occasionally by the medical examiner.