Civil Law and Psychological Injury
This domain tests psychiatric injury claims in tort and employment settings: whether a recognised condition exists, whether the defendant caused it, and whether policy controls bar recovery.
Elements and causation
Claimants must prove a recognised psychiatric condition, not mere distress, together with duty, breach, causation and damage. Causation is but-for, with material contribution where multiple factors operate. The eggshell skull rule means the defendant takes the claimant as found, but the harm must still be a reasonably foreseeable type.
Primary and secondary victims
England and Wales distinguishes primary victims, who were at risk of physical harm and need only foreseeability of physical injury (Page v Smith, 1996), from secondary victims, who must satisfy Alcock v Chief Constable of South Yorkshire (1991): close tie of love and affection, proximity in time and space, direct perception with unaided senses, and a sudden shocking event.
Diagnosis
DSM-5-TR PTSD requires exposure to actual or threatened death, serious injury or sexual violence, then intrusion, avoidance, negative cognition and mood, and arousal symptoms, lasting over one month with impairment. Acute stress disorder covers three days to one month. CAPS-5 is the structured interview; PCL-5 and IES-R are screens. Differential diagnosis must exclude mild traumatic brain injury, chronic pain, depression and feigned symptoms.
Worked example
A mother is telephoned an hour after her daughter's fatal accident. Despite the close tie, she fails the proximity and direct-perception limbs under Alcock, so her secondary-victim claim fails absent different policy controls.
Traps
Diagnosing PTSD without a qualifying criterion A event; using 'compensation neurosis' as a clinical entity; attributing all symptoms to the index event when pre-existing vulnerability is documented; treating malingering as a diagnosis rather than a differential consideration.