Johnny Depp/Amber Heard trial, anyone?

[AcronymAllergy]

The goal of expert testimony is not to persuade other experts in mental health, it is to persuade judge/jury. And, if public reaction is anything close to how it was perceived by the trier of fact in this trial, it's was worth every penny charged.

Yep. Or, before trial, to perhaps persuade one side about the strength of the other side's case to make trial seem like a riskier option and/or to induce a larger settlement (for civil cases).

Edit: Although PsyDr makes a good point in that persuasion is the goal from the viewpoint of the attorney (most likely). The goal for the expert being to provide information that is "reliable and helpful" to "help the trier of fact to understand the evidence or to determine a fact in issue."

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[PsyDr]

The goal of expert testimony is not to persuade other experts in mental health, it is to persuade judge/jury. And, if public reaction is anything close to how it was perceived by the trier of fact in this trial, it's was worth every penny charged.

No. No it is not. The goal of the expert witness is to INFORM the trier of fact, not persuade. Persuasion is the job of the attorney.

If you accept persuasion as your job, you're opening the door to being biased, and over stating your opinions.

 

[WisNeuro]

No. No it is not. The goal of the expert witness is to INFORM the trier of fact, not persuade. Persuasion is the job of the attorney.

If you accept persuasion as your job, you're opening the door to being biased, and over stating your opinions.

Technically, I agree with you. The job is to inform. But, the job is to inform in a way that is compelling and easily digestible. The hack opposite us is trying to spin a yarn about the poor claimant who now has catastrophic brain damage due to 5MPH rear-ending incident, which resulted in no LOC and no orthopedic injuries. So, we can provide that information in a very dry, jargon-filled, numbers laden way, or we can make that information relatable. Now, whether we call it informing or persuading, it's the same thing, we're just arguing semantics. As long as we're providing the same evaluation and conclusions based on the data, regardless of who hires us, no worries on my end.

 

[PsyDWannabe]

She stated that forensic work brings in half of her income, however, the majority of her work is clinical as she also does pro bono work. The lawyers tried to go after her for doing primarily forensic work in her practice

Just because an attorney asks a question does not mean the answer is good or bad, it just means the answer is the answer.

 

[lily_pad]

Oh man, yes. I have THOUGHTS.
- I don't like how she diagnosed BPD with only an MMPI-2, and one with an elevated validity profile.
- I also think it's weird to diagnose histrionic in this day and age, and especially comorbid with BPD--BPD would account for histrionic sx, imo.
- Her relationship with the defense team is unethical at worst, bad optics at best
- I like that she used the CAPS-5
- I also like that she said trauma doesn't cause BPD

Can you talk more about trauma not causing BPD? I know it’s a factor but what are the others? (I’m not a psychologist by the way). Is it possible to have BPD without a history of attachment trauma?

 

[smalltownpsych]

Can you talk more about trauma not causing BPD? I know it’s a factor but what are the others? (I’m not a psychologist by the way). Is it possible to have BPD without a history of attachment trauma?

I am not sure what attachment trauma is. Just to clarify, when we are referring to trauma as psychologists we are talking about exposure to “actual or threatened death, serious injury, or sexual violence” which is from the DSM-5. It is good to stick to that definition since we have so few concepts that are that well-defined it does T help to muddy that one up.

When referencing problems with attachment which is one of those aforementioned more challenging to define areas, I often use the term disrupted attachment to encompass the various ways that this process can impact psychological development.

As far as Borderline PD and trauma and attachment problems, the symptoms of BPD do appear to correspond with either of those, but not always therefore we can’t really say trauma causes it or disrupted attachment causes it. We also have cases with trauma or disrupted attachment and not meet criteria for Borderline PD. That didn’t sound clear at all so maybe cara susanna or another poster can say it clearer.

As an example, one of my favorite patients who had early childhood trauma was always very clear that they didn’t meet criteria for Borderline PD although the label was often slapped on them, and they were right, although they had a few of the criteria in the extreme, it was still only 3 or at best 4 of the 9 and the diagnosis requires 5 out of the 9. We talked about the secure bond that they were able to form with people and one very stable people parent in particular despite some of the torment that they experienced as being the likely reason they didn’t meet more criteria. That exceptional ability to form connections with people that was likley a protective factor also being why they were one of my favorites.

 

[cara susanna]

Can you talk more about trauma not causing BPD? I know it’s a factor but what are the others? (I’m not a psychologist by the way). Is it possible to have BPD without a history of attachment trauma?

Sure. So, there's kind of this misconception in (and outside) the field that BPD is a trauma disorder, particularly in response to childhood abuse. Although BPD is often associated with trauma, people can develop BPD without it. One study found that 20-25% of people with BPD don't have an abuse history. BPD is a reaction to pervasive invalidation--which can be abuse but doesn't have to be. One researcher who does a lot of longitudinal studies on BPD told me that a lot of her research shows it's often you just have a kid who's more sensitive to emotions and a parent who doesn't know how to deal with them, and inadvertently makes things worse.

This is made more confusing by the fact that PTSD can have more complex presentations that *look* like BPD, like emotional and interpersonal dysregulation. But that's why imo a lot of people are misdiagnosed as having BPD when they have PTSD and vice-versa.

I'm talking about DSM-5 criterion A trauma, btw, not attachment issues.

 

[Sanman]

Sure. So, there's kind of this misconception in (and outside) the field that BPD is a trauma disorder, particularly in response to childhood abuse. Although BPD is often associated with trauma, people can develop BPD without it. One study found that 20-25% of people with BPD don't have an abuse history. BPD is a reaction to pervasive invalidation--which can be abuse but doesn't have to be. One researcher who does a lot of longitudinal studies on BPD told me that a lot of her research shows it's often you just have a kid who's more sensitive to emotions and a parent who doesn't know how to deal with them, and inadvertently makes things worse.

This is made more confusing by the fact that PTSD can have more complex presentations that *look* like BPD, like emotional and interpersonal dysregulation. But that's why imo a lot of people are misdiagnosed as having BPD when they have PTSD and vice-versa.

I'm talking about DSM-5 criterion A trauma, btw, not attachment issues.

I really don't understand this part of it because it, kind of, obviously is not a trauma disorder. It is a personality disorder...I mean it is right in the name.

 

[smalltownpsych]

I really don't understand this part of it because it, kind of, obviously is not a trauma disorder. It is a personality disorder...I mean it is right in the name.

I hope you are being facetious. Historically, the naming of something in our field doesn't make it any more or less "real" or valid and it is not like that is how it was in the past and we're so far beyond that now.

 

[Sanman]

I hope you are being facetious. Historically, the naming of something in our field doesn't make it any more or less "real" or valid and it is not like that is how it was in the past and we're so far beyond that now.

I am being slightly facetious, but it is in the name. I don't know that we are so far beyond it now. Tell an insurance company that a DSM dx is not more real or valid than anything else. Pop culture is a different thing.

 

[Therapist4Chnge]

Definitely comes in bursts now and then. But, with the scaling back/retirement of a few people who do IME work here in recent years, I turn down a case at least once a month from just not having time in the frame in which they need the eval. Even after scaling my lower-paying clinical work back. I imagine somewhat location/saturation dependent.

As Wis knows, the challenge is that not all referrals are cases an expert would want. I take on 1-3+ cases per month, but with forensic work, cases settle at a range of stages and often are more stressful bc of changing deadlines and aggressive opposing counsel.

For instance, I recently had 4 cases scheduled in a month, but only one made it through record review, testing, report, and depo; spread out over ~6wk. One settled after a few hours of review and a phone conference. Two others reached reports, but nothing after that. Other months I may see 0-1 cases bc a case settles and another gets pushed back.

The last few months I've had a steady flow of forensic referrals, but it's hard to predict which ones will settle early. I still keep a clinical caseload, which helps balance out the feast or famine nature of forensic work.

 

[alice_in_neuro_wonderland]

Not sure how much of a game changer any of that is in a trial. Frankly Dr. Curry came off as much more articulate and poised than the rebuttal psychologist or Heard's attorneys. When it comes to who lay people will believe, I know where I am putting my money.

I agree that lay people are more likely to blindly believe Dr. Curry, as she is more articulate and probably much more practiced than other members of the teams, but I can definitely hear a bias in her interpretation of Amber's results--one that very much shows she is on Depp's payroll. I also looked up the 3-6 codetype in my MMPI interpretive manual, and her interpretation seems to be very exaggerated to make Amber sound much worse than the manual describes of that codetype. And this is despite the fact that the manual definitely does not hold back or sugarcoat any problematic tendencies picked up by the MMPI. Anyone else concerned by that? Or am I missing something?

 

[WisNeuro]

I agree that lay people are more likely to blindly believe Dr. Curry, as she is more articulate and probably much more practiced than other members of the teams, but I can definitely hear a bias in her interpretation of Amber's results--one that very much shows she is on Depp's payroll. I also looked up the 3-6 codetype in my MMPI interpretive manual, and her interpretation seems to be very exaggerated to make Amber sound much worse than the manual describes of that codetype. And this is despite the fact that the manual definitely does not hold back or sugarcoat any problematic tendencies picked up by the MMPI. Anyone else concerned by that? Or am I missing something?

Haven't watched the testimony. But, we use non manual data for interpretations often. Especially when we have better data depending on the specific situation. So, possible she's basing it off other citations.

 

[deleted1100659]

I agree that lay people are more likely to blindly believe Dr. Curry, as she is more articulate and probably much more practiced than other members of the teams, but I can definitely hear a bias in her interpretation of Amber's results--one that very much shows she is on Depp's payroll. I also looked up the 3-6 codetype in my MMPI interpretive manual, and her interpretation seems to be very exaggerated to make Amber sound much worse than the manual describes of that codetype. And this is despite the fact that the manual definitely does not hold back or sugarcoat any problematic tendencies picked up by the MMPI. Anyone else concerned by that? Or am I missing something?

To be fair, I have no idea of she has histrionic personality disorder, but after watching her testimony and the evidence presented so far, BPD of which the psychologist suggested, doesn't seem impossible by any means.

 

[cara susanna]

I agree that lay people are more likely to blindly believe Dr. Curry, as she is more articulate and probably much more practiced than other members of the teams, but I can definitely hear a bias in her interpretation of Amber's results--one that very much shows she is on Depp's payroll. I also looked up the 3-6 codetype in my MMPI interpretive manual, and her interpretation seems to be very exaggerated to make Amber sound much worse than the manual describes of that codetype. And this is despite the fact that the manual definitely does not hold back or sugarcoat any problematic tendencies picked up by the MMPI. Anyone else concerned by that? Or am I missing something?

No, I agree, especially if no scales were elevated above 65. I also want to know why she thought the CAPS-5 responses were exaggerated--imo invalidity on the CAPS-5 is hard to determine. The other psychologist (Dr. Hughes? it's probably a good thing I can't for sure remember her name anymore) also argued that some responses were not coded as trauma-related when they were. Man I just really want to see that raw data, especially the PAI.

 

[alice_in_neuro_wonderland]

No, I agree, especially if no scales were elevated above 65. I also want to know why she thought the CAPS-5 responses were exaggerated--imo invalidity on the CAPS-5 is hard to determine. The other psychologist (Dr. Hughes? it's probably a good thing I can't for sure remember her name anymore) also argued that some responses were not coded as trauma-related when they were. Man I just really want to see that raw data, especially the PAI.

Me too! I want to see the whole report from both of them so bad haha. But it’d probably just make me feel even more annoyed with the bias issues.

 

[alice_in_neuro_wonderland]

Haven't watched the testimony. But, we use non manual data for interpretations often. Especially when we have better data depending on the specific situation. So, possible she's basing it off other citations.

Interesting, and good to know. I’ve only ever been taught to use the manuals, but I am pretty early on in my training (about to start internship soon).

 

[WisNeuro]

Interesting, and good to know. I’ve only ever been taught to use the manuals, but I am pretty early on in my training (about to start internship soon).

Manuals are always the starting point. But, often the norms are inadequate, or they haven't been examined in certain populations. And, that's where using the broader literature can help.

 

[allantois]

Decided to do some digging into this gem of a lawyer.

Elaine Charlson Bredehoft - Charlson Bredehoft Cohen Brown & Nadelhaft, P.C.

Ms. Bredehoft, a native of Northern Minnesota, has been successfully trying cases in state and federal courts in Virginia and the District of Columbia since 1984. Ms. Bredehoft has been consistently recognized in publications as one of the Best Lawyers in Virginia, Washington, D.C. & Baltimore...

cbcblaw.com

The cases she touts on her page:

• Tyler v. Molchon (Fairfax Cir. Ct. 2000) ($1.3 million verdict for wrongful death “suicide by cop” against psychiatrist who prematurely released decedent, upheld by Virginia Supreme Court, 2001)
• Johnson v. Kaiser Permanente (Fairfax Cir. Ct. 1993) ($950,000 verdict for emotional distress of grandmother misdiagnosed with AIDS).

 

[MAClinician]

So many nuggets that McDonalds is calling

 

[AbnormalPsych]

That guy is annoying as hell. I just skipped around, here's some favorite moments:

Q: "What was your baseline for assessing cognitive impairment?" ... A: "his processing speed was not slow, I've seen him do commercials"
Q: "During your deposition what were the circumstances in which you decided to call Mr Depp an idiot?"
Q: "You're not claiming to be a better actor than Mr. Depp?"" ... A: "I have no idea what an actor does!"
"Let me ask you about pirate stuff"
Q: "And you derived this without talking to him?" ...Q: "no i've never talked to him"

 

[neurotic_cow]

That guy is annoying as hell. I just skipped around, here's some favorite moments:

Q: "What was your baseline for assessing cognitive impairment?" ... A: "his processing speed was not slow, I've seen him do commercials"
Q: "During your deposition what were the circumstances in which you decided to call Mr Depp an idiot?"
Q: "You're not claiming to be a better actor than Mr. Depp?"" ... A: "I have no idea what an actor does!"
"Let me ask you about pirate stuff"
Q: "And you derived this without talking to him?" ...Q: "no i've never talked to him"

I couldn't watch more than 30 seconds of it without wanting to rip my hair out.

 

[calimich]

Yeah, I also saw that clip and then tuned in to see more of the train wreck.
The questioning about the earpiece was also entertaining.
Q- “do you know if Marlon Brando used an earpiece?”

“Marlon Brando? Isn’t he dead? So no, he doesn’t use an earpiece.”
“Oh, you meant when he was alive?”
“I know absolutely nothing about acting!”

 

[allantois]

This is how I imagine some posters in this thread would testify 😂

Also, everyone is gonna think our mental health system is a mess throwing around PD diagnoses left and right

 

[cara susanna]

Apparently the dude is now getting review bombed (same happened with Dr. Hughes, I think)

Depp fans are flooding a psychiatrist's page with negative reviews after Amber Heard's team called him as a witness

David Spiegel's WebMD page is now filled with one-star reviews — many posted Monday, including several that directly mentioned the Depp-Heard trial.

www.insider.com