PTSD on Trial: Building and Challenging Psychological Injury Evidence in Civil Litigation

Howard J. Friedman, Forensic Neuropsychologist | Forensic Psychiatric Associates, LP

Dr. Howard Friedman conducts psychological and neuropsychological evaluations across clinical and forensic settings, and has qualified as an expert in civil and criminal cases involving psychological injury, traumatic reactions, brain injury, toxic exposure, the impact of drug and alcohol abuse, competency, and psychological functioning relating to mitigation. He has performed forensic evaluations in several states. He has been an independent contractor to fpamed since 2019.

• Education & Credentials

Dr. Friedman received his Ph.D. in psychology from Rutgers University in 1978, then completed a postdoctoral fellowship in neuropharmacology at the University of California, San Francisco, followed by further postdoctoral training in clinical psychology and neuropsychology at the California School of Professional Psychology. He is board certified in neuropsychology by both the American Board of Professional Neuropsychology and the American Board of Clinical Neuropsychology / American Board of Professional Psychology. Licensed in California since 1983, he also holds licenses in New Mexico, Arizona, Texas, Utah, and Hawaii.

• Recognition & Leadership

He served as president of the Northern California Neuropsychology Forum and held several terms as president of the Contra Costa Psychological Association, and he sat for many years on the Board of Directors of the California Psychological Association. He was also president of a mental health practice group of 50 psychiatrists and psychologists providing care for more than 30,000 covered individuals, where he was responsible for clinical case referral and management.

• Professional Involvement

His appointments have centered on psychological assessment: Adjunct Professor and Director of Psychological Assessment Services at The Wright Institute, Director of Psychological Services at Walnut Creek Hospital, and Director of the Progress Assessment System with the California Department of Corrections. He currently serves as Designated Psychologist with the U.S. Department of Energy, a position involving national security related evaluations.

• Experience

In private practice in Walnut Creek, Dr. Friedman has seen more than 11,000 people, and his forensic caseload has concentrated on psychological injury and traumatic reactions, brain injury, toxic exposure, and the effects of drug and alcohol abuse, together with competency and mitigation-related psychological functioning. References are available upon request.

Ayesha Ashai, MD, Forensic Psychiatrist | Forensic Psychiatric Associates, LP

Dr. Ayesha Ashai is a forensic psychiatrist whose forensic areas of interest include psychiatric injury, malpractice, civil and criminal competencies, criminal responsibility, violence and sexual risk assessment, and evaluations related to testamentary capacity and undue influence. She has been qualified as an expert in the field of psychiatry in the Sacramento Superior Court. She has been an independent contractor to fpamed since 2020.

• Education & Credentials

Dr. Ashai received her BA in psychology and Spanish from the University of Michigan in Ann Arbor and attended medical school at Wright State University Boonshoft School of Medicine in Dayton, Ohio. She completed her adult psychiatry residency at the University of Maryland and Sheppard Enoch Pratt Hospital in Baltimore, where she later served as executive chief resident, and then completed a forensic psychiatry fellowship under the leadership of Dr. Charles Scott at the University of California, Davis. She is certified by the American Board of Psychiatry and Neurology in psychiatry with added qualifications in forensic psychiatry, and is licensed to practice medicine in California, Ohio, Pennsylvania, Illinois, and Texas.

• Recognition & Leadership

She serves on the Criminal Behavior Committee and the Cross Cultural Committee of the American Academy of Psychiatry and the Law (AAPL), and has presented on the treatment of psychopathy at AAPL’s national meeting and at local conferences in California. In 2013 she received the Dr. George U. Balis Award for Excellence in Medical Student Education for her work with medical students.

• Professional Involvement

Dr. Ashai is a member of AAPL and an Assistant Clinical Professor at the University of Illinois – School of Medicine. She works as a telepsychiatrist for two outpatient mental health clinics in Ohio and Illinois, and provides treatment for offenders incarcerated at the Winnebago County Jail and, through a therapeutic intervention program, for offenders with serious mental illness released from incarceration.

• Experience

She has performed numerous criminal forensic psychiatric evaluations and has years of experience in the diagnosis and treatment of a broad range of psychiatric disorders across civil and forensic hospitals, emergency rooms, outpatient clinics, and jails. She has specialized experience working with patients who are Muslim, patients with an Indian or Pakistani background, and Hispanic patients. References are available upon request.

SESSION 1 – Building the PTSD Case: What Attorneys Need from Treating and Forensic Experts | 2:30pm – 3:30pm

This session takes attorneys inside the forensic evaluation of PTSD and psychological injury from the perspectives of a forensic neuropsychologist and forensic psychiatrist. Using practical litigation scenarios, the presenters will explain how PTSD diagnoses are established, how experts evaluate causation and functional impairment, and how treating-provider records, forensic interviews, psychological testing, and collateral information are integrated into an expert opinion. Attendees will learn how treating and retained experts serve different roles, what makes an evaluation clinically and forensically defensible, how validity testing affects an opinion, and what attorneys should know before retaining or preparing a PTSD expert.

BREAK | 3:30pm – 3:40pm

SESSION 2 – Challenging PTSD Evidence: Methodology, Differential Diagnosis, and Expert CrossExamination | 3:40pm – 4:40pm

This session examines PTSD evidence from the perspective of experts evaluating and challenging competing opinions. The presenters will walk attorneys through the methodological weaknesses they encounter in forensic PTSD evaluations, including incomplete records review, unsupported causation opinions, inadequate differential diagnosis, deviations from DSM-5-TR criteria, and insufficient attention to symptom validity. Attendees will also learn what a defense expert looks for when reviewing a plaintiff’s evaluation, how experts respond to competing opinions, and which clinical and forensic weaknesses are most likely to matter when an expert’s conclusions are tested at deposition or trial.