Opinion ID: 600354
Heading Depth: 3
Heading Rank: 1

Heading: General Acceptance of Psychiatry and Dependent Personality Disorder

Text: 46 The district court and panel majority rely heavily on Bright, which was decided nearly eighteen years ago. Since 1975, however, psychiatry, like virtually all fields of medicine, has expanded its boundaries of knowledge considerably, while becoming increasingly sophisticated in its understanding of mental diseases, defects and disorders. Indeed, eleven years after Bright, this Circuit wrote, [i]t cannot be gainsaid that psychiatry enjoys general acceptance in the field of medicine. United States v. McBride, 786 F.2d 45, 51 (2d Cir.1986) (citing Ake v. Oklahoma, 470 U.S. 68, 81, 105 S.Ct. 1087, 1095, 84 L.Ed.2d 53 (1985)). As the boundaries of medical knowledge expand, so too must the boundaries of admissible medical evidence. 47 Like the panel majority, I believe the mental disorder allegedly suffered by DiDomenico was substantially similar to the mental condition that allegedly afflicted the defendant in Bright. Unlike the panel majority, however, I do not believe that Dr. Grove intended merely to place a newfangled clinical label on DiDomenico's condition. Rather, Dr. Grove was prepared to testify concerning the effect of a medical condition which, in the years since Bright, has been the subject of considerable research 2 and is now sufficiently well-established to justify inclusion in the standard reference work of psychiatric diagnosis: the Diagnostic and Statistical Manual of Mental Disorders, Third Edition, Revised (hereinafter DSM-III-R). 48 Dependent Personality Disorder is listed and defined in DSM-III-R, a publication which is, according to Dr. Grove, the most respected, standard text on the subject. J.App. at 235. The process by which a disorder qualifies for listing and description in DSM-III-R is rigorous and requires stringent peer review. See DSM-III-R at xix-xxii, xxix (These diagnostic criteria and the DSM-III-R classification of mental disorders reflect a consensus of current formulations of evolving knowledge in our field....). DSM-III-R disorders have gained general acceptance in the academic and clinical psychiatric communities. 3 Furthermore, there is a growing literature on the treatment of Dependent Personality Disorder. See e.g., 3 American Psychiatric Association, Treatments of Psychiatric Disorders: A Task Force Report of the American Psychiatric Association 2762-70 (1989). Accordingly, the diagnosis which Dr. Grove was prepared to offer was based on a well-established mental disorder and represented neither junk science 4 nor scientific speculation beyond the boundaries of current knowledge. 49 The Second Circuit has examined whether expert testimony concerning the presence of an objectively ascertainable organic brain injury may be excluded by the trial judge. The Court ruled that the trial judge erred in not admitting this testimony, noting that, 50 [a]lthough a district court may exclude psychiatric testimony which merely offers an opinion about the defendant's capacity to form the mental state required to commit the offense charged, without suggesting the presence of a mental disease or defect, the psychiatrist here was prepared to testify that McBride suffered such organic impairment. We believe that, for purposes of determining admissibility, this evidence was highly relevant to a critical fact in issue, namely, appellant's state of mind, and, therefore, was admissible under Fed.R.Evid. 702. 51 United States v. McBride, 786 F.2d 45, 50 (2d Cir.1986) (citations omitted). The question, then, is whether the logic of McBride should be extended to situations where the alleged mental disease or defect is not based on an objectively ascertainable organic brain injury, but rather on an admittedly subjective determination by a psychiatrist, using established diagnostic criteria, that an individual suffers from a mental disorder. I believe that when, as in the present case, a diagnosis is based upon criteria that are sufficiently well-established to justify inclusion in a widely accepted medical manual, such as DSM-III-R, that diagnosis belongs in the courtroom pursuant to Rule 702 every bit as much as evidence of an organic brain injury. 5 52 Of particular relevance to this appeal, Dependent Personality Disorder was not listed in the second edition of the Diagnostic and Statistical Manual of Mental Disorders, which was current when the Bright court wrote, appellant asks us to go beyond the boundaries of conventional psychiatric opinion testimony. We think the testimony offered was not sufficiently grounded in scientific support to make us reach or, indeed, cross the present frontier of admissibility. 6 517 F.2d at 586. 53 When the frontiers of scientific knowledge change, that which is admissible as expert testimony must change as well. At the time of Bright, Dependent Personality Disorder was not recognized by the standard treatise of psychiatric diagnosis. Over time, with further research and peer review, Dependent Personality Disorder has now gained acceptance within the psychiatric profession, which, in turn, enjoys general acceptance in the field of medicine. United States v. McBride, 786 F.2d at 51. The testimony proffered by Dr. Grove was, in the words of the Bright court sufficiently grounded in scientific support and did not go beyond the boundaries of current knowledge. United States v. Bright, 517 F.2d at 586. 54