There is no direct coherence between medical and legal concepts or between medical and legal ways of thinking (Eastman, 1992). As a result, there are often substantial difficulties in translating the findings of one (medicine) into the decisions of the other (law). In order to minimise interdisciplinary confusion, it is necessary for each to have an understanding of the approach of the other. This paper attempts to elucidate the relationship between law and psychiatry as it is played out specifically in personal injury litigation and in relation to civil legal claims for (legal) ‘nervous shock’. It is not confined solely to claims arising out of the development of post-traumatic stress disorder (PTSD) (Eastman, 1995; Napier, 1995), but is applicable to any psychiatric sequelae of events for which legal liability of a defendant can be established. It also offers general comments about the provision of civil psycho-legal assessments, advice and opinion writing (Carson et al, 1993) as a backcloth to its more specific purpose.

The psychiatric sequelae of trauma have been most often discussed in relation to disasters, both natural and man-made, and military conflict. This may sometimes lead psychiatrists to think of posttraumatic stress disorder (PTSD) and other posttraumatic mental illnesses as being somewhat exotic and unusual in general psychiatric practice. In this paper, I propose that PTSD and related disorders are actually common psychiatric problems which require treatment.

During the last decade, direct work with children who have experienced public disaster or private catastrophe, such as abuse, neglect and other intrafamilial crime, has led to the recognition that classifications of post-traumatic stress disorder are relevant to childhood psychopathology. Comorbidity is common. Traumatised children who also are bereaved or dislocated are hindered in mourning and in the capacity to sustain or form attachments. Adult psychopathology often may be linked with unrecognised or underestimated effects of psychological trauma during childhood and adolescence. This paper discusses therapeutic interventions, outlines research hypotheses and provides an introductory bibliography.

Natural disasters occur infrequently in Europe, but the spate of transportation, crowd and other disasters in the late 1980s challenged our collective denial of potential catastrophe. Greater attention is now given also to the frequent small-scale traumatic events which are just as devastating to the many people affected by them, such as violent assaults and road accidents.