Psycholawlogy
Posttraumatic stress disorder (PTSD) is a serious psychological disorder. It can be associated with sexual harassment (SH). PTSD is a very serious harm that some victims of sexual harassment experience and suffer. Its effects cause dysfunction and disability, and, in some circumstances, PTSD can result in permanent harm. A team of psychological science researchers recently reported the results of their examination of the extent to which harassment experiences correlate with PTSD symptoms and whether diagnosable PTSD on the basis of sexual harassment occurs after accounting for prior PTSD, prior sexual abuse, and prior psychological dysfunction.
Persons who claim harm due to sexual harassment may sue for damages specific psychological harms, such as PTSD. This choice, however, can subject the claimant to compulsory mental health examinations under federal and state rules of civil procedure. The authors describe this as “precarious” because “Such examinations are often performed by experts for defense attorneys who may abide by the theory that claims of PTSD from SH are either false or result from an earlier trauma, such as childhood sexual assault, for which the defendant should not be held liable.” The hurdle represents the circumstances surrounding such compulsory examinations. Sexual harassment claimants who have a history of prior trauma or abuse have in some cases been able to avoid the intrusion of the compulsory mental examination by claiming “garden variety” damages. This type of damages concerns humiliation and emotional distress. Generally, “garden variety” damages do not require expert testimony, can be inferred from the circumstances, and are not as severe or compelling as claims for specific psychological harm, like PTSD.
For nearly twenty years, the relationship between SH and PTSD has been the source of controversy in legal and psychological science domains. The controversy concerns two main issues: (1) sexual harassment does not qualify as a stressor which can constitute a traumatic event, or “trigger”, required for the diagnosis of posttraumatic stress disorder; and (2) any claims of PTSD “are either false or the result of traumatic events occurring before the harassment”. A team of researchers addressed issue (2) recently. They “examined the extent to which harassment experiences correlate with PTSD symptoms, and whether diagnosable PTSD on the basis of sexual harassment occurs after accounting for prior traumas, including child sexual abuse (CSA) and adult sexual abuse.”
The study, according to the authors, was the first to control for prior trauma, prior abuse, prior psychological functioning and prior PTSD and show a correlation between sexual harassment and current PTSD regardless of a past history of abuse and dysfunction. The “prior abuse” examined by the researchers has constituted a hurdle, of sorts, in both the legal and mental health domains, for persons claiming they are victims of sexual harassment. This blog post notes in summary format that, as a result of the researchers’ efforts, psychological science has shown that sexual harassment claimants with a history of prior trauma can present specific, compensable claims for PTSD beyond the effects of prior abuse. The results also suggest that these claimants perhaps do not need to limit their damages claims to the less compelling general “garden variety” damages.
The “Hurdle” — Nature of PTSD, Experience of Prior Sexual Trauma, and Sexual Harassment Litigation
The article includes an extensive review of literature about PTSD. A diagnosis of PTSD concerns a number of criteria. The first one, Criterion A, involves 2 parts. The first is that the person receive exposure to a traumatic event. This requirement of “exposure” is unique to the diagnosis of PTSD. This means the person “experiences, witnesses, or confronts (an) event(s) that involves actual or threatened death, injury, or threat to the physical integrity of self or others”. The second part of Criterion A requires that the person’s response involve “fear, helplessness, or horror”. Three other Criteria, B (re-experiencing by intrusive thoughts or dreams, for example), C (avoidance behavior), and D (various forms of hyper-arousal, such as irritability, anger, or hyper-vigilance), must be present in order to satisfy the current diagnostic criteria of the diagnosis under the Diagnostic and Statistical Manual IV-R.
The authors note several studies in which sexual assault has operated as a traumatic stressor associated with the development of PTSD. The literature, the authors report, clearly shows the association of sexual assault as a traumatic stressor. But, whether sexual harassment satisfies the requirement of the traumatic experience criterion has been challenged. The authors indicate that some hold the view that sexual harassment fails to meet the Criterion A because “it is rarely life threatening”. The authors report that three aspects of “moderate to severe forms of sexual harassment”, identified as threats to physical integrity, sexual objectification, and failure of legitimate control to effectively stop the behavior, have been suggested by others as posing threats to physical integrity.
The authors also discussed how past research has shown statistically significant associations, described by them as “strong and consistent”, between sexual harassment and symptoms of PTSD. The past research, however, has been cross-sectional by design. This results in the simultaneous collection of self-reports about harassment, PTSD symptoms, and other trauma. These past studies have not ruled out the possibility that prior sexual trauma or abuse causes PTSD. Also, a line of research associates litigation-related motives to enhance self-reported sexual harassment symptoms and PTSD for purposes of claim settlement and inappropriate interpretation and labeling of workplace behavior have made the task of sorting through causation from former versus current trauma or harassment difficult. Finally, the fact that a substantial percentage of sexual trauma survivors, 35% rape and 23% sexual molestation, according to one report, suffer from PTSD, professionals opposing sexual harassment PTSD claims, both attorneys and their experts, argue that prior trauma rules out any link between sexual harassment and PTSD.
Extreme Example of “The Hurdle” of Prior Sexual Abuse & Sexual Harassment Claims – Katt v. City of New York
The authors cite to several sexual harassment cases which included a claim for damages for PTSD reviewed by another reviewer, the author of a 2007 article. This particular reviewer, part of a group, regarded psychological damages alleged from current harassment to be caused by former trauma more than the current harassment. In Katt v. City of New York, 151 F.Supp.2d 313 (S.D.N.Y. 2001) (see case), Ms. Katt had been previously diagnosed with a psychological disturbance and other trauma in the past, and had suffered abuse from a domestic partner.
The New York Police Department employed Ms. Katt as a civilian employee. Lieutenant Anthony DePalma supervised Katt. The research study authors describe the precinct’s work environment as “rowdy” and “with lots of sexual innuendo and horseplay”. Also, Ms. Katt’s police officer supervisor “continually rubbed up against her, sat on her lap [the District Court opinion describes DePalma as a “large man, muscular, and over 6 feet tall” and Katt as “petite”], touched the back of her neck with his tongue, and squirted a water pistol at her when she was wearing a white t-shirt, among other degrading sexualized gestures.” “DePalma made repeated sexual overtures and physical contact with Katt, including questioning whether he could ‘put his ‘throbbing manroot’ into the ‘wet recesses’ of her ‘femininity’”, report the investigators in their review of the legal and psychological background of the issues surrounding “prior abuse” and PTSD.
The victim Ms. Katt had gastrointestinal disturbances, vomiting, and headaches. She suffered nightmares and flashbacks. A psychologist diagnosed Katt as having PTSD and testified that the harassment was the likely cause. This was “despite the fact that she had experienced psychological disturbances and other trauma in the past.” A psychologist expert for the defense disagreed. This expert opined that “Katt had been previously diagnosed with Schizotypal Personality Disorder and that this along with abuse she experienced from a domestic partner in 1992 led to her inability to separate fantasy from fact and her inability to establish intimacy with men.”
The authors mention other reviewers who, like the other, argue that if PTSD is presented as an emotional damage claim in a sexual harassment case, then any prior sexual abuse is the likely cause. Since over 20% of persons who have either been raped or been sexually molested suffer from PTSD in the lives, compared to less than 2% of the population, “defense lawyers and their experts argue that evidence of prior abuse should rule out the alleged causal connection between sexual harassment and PTSD.” Other reviewers noted by the authors have argue for a contrary view. Two studies noted showed a near zero correlation between prior abuse and sexual harassment and no difference in the form or degree of emotional distress, including PTSD, experienced by sexual harassment victims who had prior history compared to those who did not.
The above sets the stage for the important research questions addressed by the investigators in this post’s review article.
Research Questions – Sexual Harassment and PTSD
The investigators empirically examined associations between sexual harassment experience and PTSD by examining three questions:
-
What specific sexual harassing experiences are associated with threshold symptoms of PTSD?
-
After controlling for prior sexual abuse or sexual assault or other forms of trauma, and other past psychological disturbances, does the association between sexual harassment and PTSD persist?
-
Does prior PTSD exacerbate any possible relations between sexual harassment and current PTSD symptoms?
Research Participants, Measures, and Procedures
A unique group constituted the research participants. A two-wave panel of 445 women who had obtained protective orders to protect themselves from domestic violence. The researchers asked sexual harassment experiences questions only of women who had worked during the period between the baseline interview and the follow up interview. These women were not involved in litigation over sexual harassment.
The investigators measured PTSD by the participants’ responses to items taken from a standard interview, the Diagnostic Interview Schedule (DIS). The research team used this measure to gather data about Criterion A type stressors as well as the symptoms of PTSD. Responses to a 53-item self-report inventory of psychological symptoms (including symptom dimensions of somatization, obsessive compulsive, interpersonal sensitivity, depression, anxiety, and others), The Brief Symptom Inventory, Global Severity Index (BSIGSI), helped the researchers measure past psychological distress. In addition to past psychological distress, the investigators measured interpersonal violence by The Conflict Tactics Scales, using separate scales for nonsexual and sexual violence. They examined child abuse experiences under a separate format, regarding both nonsexual and sexual abuse. A final measure, items adapted from versions of the Sexual Experiences Questionnaire, enabled the researchers to gather data about study participants’ sexual harassment experiences which followed the baseline interview. The responses to these items provided the investigators information about the participants’ experiences of gender harassment, e.g. dirty jokes, to unwanted sexual attention, e.g. staring at breasts, to sexual coercion, e.g. fear of retaliation if did not do something sexual.
The investigators recruited the study’s participants from several court jurisdictions. The women had recently obtained court protective orders against a male intimate partner following a court hearing. Under controlled conditions, the study participants provided a baseline interview and then a follow-up interview approximately twelve months later. In general, the women participants “experienced high levels of trauma, victimization, and psychological dysfunction.”
Answers to the Research Questions – Sexual Harassment and PTSD
The data obtained and analyses performed by the investigators resulted in the following answers the research questions:
-
What specific sexual harassing experiences are associated with threshold symptoms of PTSD? The investigators placed the participants into four (4) categories, each category reflected increasing levels of severity, based upon their sexual harassment experiences. Of the four groups, the members of two groups, one whose members experienced both gender harassment and unwanted sexual attentions, and the other, whose members experienced gender harassment, unwanted sexual attentions, and sexual coercion, had PTSD diagnoses which increased steadily with the severity of sexual harassment. The analyses showed that moderate to severe experiences of sexual harassment result in sizeable increases in diagnosable PTSD. The first two categories, one with no sexually harassing experiences, and the second, whose respondents experienced gender harassment only, had no increases.
-
After controlling for prior sexual abuse or sexual assault or other forms of trauma, and other past psychological disturbances, does the association between sexual harassment and PTSD persist? The answer is “Yes”. As a result of the statistical analyses performed by the investigators, they concluded that “unwanted social-sexual experiences in the workplace (sexual harassment) significantly predicted PTSD beyond the effects of prior abuse, prior victimization, and prior psychological distress.:
-
Does prior PTSD exacerbate any possible relations between sexual harassment and current PTSD symptoms? The investigators reported “Past PTSD did not meaningfully alter the associations between sexual harassment and current PTSD.”
Why Is This Study Important?
According to the authors, many studies have established correlations between PTSD and sexual harassment. A very significant “first” occurred with this study according to these investigators. Their study was the first to rule out the explanation that the correlation between sexual harassment and PTSD was related to prior histories of trauma. In other words, experiencing sexual harassment was independently associated with PTSD symptoms regardless of a past history of abuse or dysfunction. According to these researchers, “this study sheds doubt on the assumption that claims of PTSD should be dismissed if evidence of prior trauma or prior psychological dysfunction is produced.” This research is important because the findings lend credibility to claims of emotional and psychological damages due to sexual harassment. For victims, such as those like Ms. Katt, as discussed above, who desire to make legal claims, this study removes the hurdle of prior abuse or trauma and prior psychological dysfunction.
The phrase “garden variety damages”, as discussed in this post, is very relevant in the sexual harassment claim context. The Missouri Supreme Court in the case State ex rel. Dean v. Cunningham, 182 S.W.3d 561 (Mo. banc 2006) see case issued an opinion which discusses that concept in a context closely related to the “hurdle” of prior abuse discussed in this post’s research article. Considering Missouri law, the Supreme Court ruled that a sexual harassment claimant who asserts a claim for “garden variety” emotional distress does not open up past medical or psychological history to the probing inquiries of the civil litigation discovery process. In other words, “garden variety” emotional distress damages are not a claim for specific emotional damage or injury and therefore do not place the mental or physical condition of the victim in controversy. There will be no discovery and no compulsory mental health examinations in such claims. The Court discussed how such claims are “only for such emotional distress and humiliation that an ordinary person would experience under the circumstances or that may be inferred from the circumstances”. While the choice to not pursue damages for specific emotional harms does shield the claimant from the inquiry into prior abuse or medical and psychological history, in defending a claim for “garden variety damages”, the organization or individual defendant may show that the claimant’s “emotional distress and humiliation were not so severe as to require medical or physical consultation or treatment”. Removing the hurdle of “prior abuse”, however, leaves a legal tightrope, of sorts, to cross in these claims.
The investigators conclude their article with two important points: (1) severe sexual harassment may produce significant levels of of PTSD symptoms for which victims of should be adequately compensated; (2) the merits of a case and personal considerations guide a person’s decision to claim “garden variety” or specific damages, “but the fear that prior damages will invalidate a claim of specific PTSD damages should be set aside.”
Source: Stockdale MS, Logan TK, & Weston R (2009). Sexual harassment and posttraumatic stress disorder: damages beyond prior abuse. Law and human behavior, 33 (5), 405-18 PMID: 19115099. The lead author of this research report article, Margaret (Peggy) Stockdale, Ph.D, is Professor of Psychology and Chair, Department of Psychology, at Indiana University – Purdue University, Indianapolis, (author webpage).
Thank you for visiting Psycholawlogy (web page). Please let me know if you have any questions or comments or if you would like a copy of the article or any case mentioned in this post. You can contact me through my web page at Adlitem Solutions web page or email me directly to dan@adlitemsolutions.com. Adlitem Solutions provides organization development consulting services to professional services and law firms. Through its lead consultant, Dan DeFoe JD MS, a lawyer with 20+ years of experience as a trial attorney and who also has a MS degree in organizational development psychology, Adlitem Solutions can assist your organization so that it can identify, develop, and implement strategies, processes, and procedures to provide a work environment with supportive peers and supervisors in which employees can effectively cope with and combat sexual harassment. With Adlitem Solutions, the intervention targets for sexual harassment and other organizational growth and development opportunities include: people, projects, and practices. No employee should have to work in the type of environment as described in Katt v. City of New York.