How 'junk science' has put a lot of disorders into the DSM for dubious legal reasons

In 2005, David Feige explained in an article in Slate Magazine how "junk science" has put a lot of disorders into the DSM for dubious legal reasons. "[This syndrome] is part of an ever widening matrix of criminal-justice-related mental-health syndromes whose main goal seems to be to explain away otherwise damaging evidence." This was in the context of a variety of 'expert witnesses' during the Michael Jackson trial, which was taking place at the time.

Here are some bits from that article

Urquiza, called earlier in the trial as an expert witness for the prosecution, testified about something called "child sexual abuse accommodation syndrome," or CSAAS.

He had never examined Mr. Jackson's accuser. He didn't need to.

As it turns out, CSAAS … explains everything.

CSAAS is part of an ever widening matrix of criminal-justice-related mental-health syndromes whose main goal seems to be to explain away otherwise damaging evidence. Rape trauma syndrome (or RTS), battered-woman's syndrome (or BWS), and CSAAS are all examples of this burgeoning field.
Etiologically, all three syndromes are the stepchildren of post-traumatic stress disorder (first diagnostically validated by inclusion in the 1980 version of the psychologist's bible — the Diagnostic and Statistical Manual of Mental Disorders, Third Edition). And, much like their parent, they all share flexible criteria easily applied to … well, pretty much everything.

And that's the whole problem.

Unlike diseases or disorders in which signs (physical phenomena like bruises) or symptoms (subjective complaints like "my elbow hurts") imply a specific cause (you injured your elbow), syndromes (which are also groups of signs and symptoms) may—but don't necessarily—imply a specific cause. As a consequence, although syndromes may sound scientific, their diagnostic value varies wildly.

CSAAS is, simply put, not diagnostic. First named and described in 1983 in an article by Dr. Roland Summit that described five general attributes of child sexual victims (secrecy, helplessness, denial, delayed disclosure, and retraction), Summit himself has conceded the lack of compelling empirical research support for the syndrome. And when lawyers start importing these scientific curiosities into the courtroom, we all have a serious problem.

[...]

CSAAS is a prosecutorial silver bullet and a fabricator's best friend. Every mistake you make is consistent with it; every mistake you don't make further confirms your credibility. No wonder prosecutors rely on it to bolster disintegrating cases. By making credibility tautological, CSAAS makes it nearly impossible to present a defense or attack an incredible witness. To make matters worse, CSAAS testimony is deeply appealing to jurors because of its soothing reassurance that otherwise inexplicable or incredible behavior is merely a manifestation of the actual trauma they all expect to see in a victim.

According to CSAAS experts, not reporting abuse is consistent with suffering from child sexual abuse accommodation syndrome. So is bad behavior, trouble in school, the failure to tell an accurate story, and even the recantation of the entire allegation of abuse. In other words, every criterion usually used by the defense to discredit a witness is actually transubstantiated into evidence that is perfectly consistent with abuse.

And here's the genius: Not exhibiting these signs of CSAAS doesn't mean a child wasn't abused—just that he or she didn't get the syndrome. In other words, a noncredible witness is suffering from the syndrome, but a credible one is merely a credible witness who was legitimately abused.

[...]

Ultimately, though, damage from this pseudoscientific syndrome testimony undermines far more than the fairness of Michael Jackson's trial. By creating the ability to explain away any behavior, syndrome testimony threatens to erode our ability to hold both the alleged victims and the alleged perpetrators to account for their actions. With syndrome testimony we find ourselves in a frictionless world where up is down, falsehood is truth, and there is an excuse for everything.

Ultimately, the problem with the Orwellian world of syndrome testimony is that anything goes, and everyone goes to jail. Don't like my tone? Blame angry author syndrome. Fail to follow my argument? Maybe you have an abstract reasoning deficit disorder. Getting angry? Want to stab me? Fear not, I'm sure a doctor (maybe even Urquiza himself) will be willing to testify that you are simply suffering from overreactive reader's syndrome.

And so it goes