The issue in this case is whether Ohio recognizes “battered child syndrome” as a valid topic for expert testimony in the defense of parricide. Expert testimony on battered child syndrome is admissible in Ohio courts when it is relevant and meets the requirements of Evid.R. 702. The defendant, Brian Nemeth, has been diagnosed with battered child syndrome and it is relevant to his defense in a variety of ways. Further, the testimony proffered by the defense on battered child syndrome meets the requirements of Evid.R. 702. Therefore, although the syndrome is not recognized as an independent defense in Ohio, the trial court erred in prohibiting expert testimony on the syndrome in support of a claim of self-defense or as justification for an instruction on a lesser included offense to murder. We, therefore, affirm the decision of the court of appeals.
I
Part of the difficulty we face in addressing this case is the inadequacy of the shorthand labels we have tried to place on the psychological characteristics associated with abused children and other battered persons. In Koss, we adopted the term “battered woman syndrome” as a legal term of art referring to the characteristics and symptoms associated with women who are battered by their spouses or significant others. State v. Koss (1990),
Today we are asked to address what some courts have loosely termed “battered child syndrome.” Unlike battered woman syndrome, the term “battered child syndrome” was long ago adopted as a term of art in the medical community as the label for a set of physical symptoms that provide proof of child abuse. The battered child syndrome has been used for over thirty years in this context and has been accepted by the medical and legal community as a means of proving that a child has been abused. Only recently have attempts been made to expand this label to include a set of psychological symptoms or behavioral effects
Identifying an abused child based solely on a psychological profile, however, is an entirely different matter than recognizing that children who have been abused share a set of characteristic psychological symptoms.
Some experts have tried to incorporate the psychological effects of child abuse under the label of “battered child syndrome”; some distinguish it from the physical syndrome by calling it “child abuse syndrome”; still others address it as a form of posttraumatic stress disorder or acute stress disorder. See Diagnostic and Statistical Manual of Mental Disorders (4 Ed.1994) 424-431 (“DSM-IV”). It has also been labeled as “characterological sequelae of prolonged victimization,” and “traumatic bonding,” for example. See Posttraumatic Stress Disorder: DSM-IV and Beyond (1993) 219-220. Regardless of the label, however, the behaviorál and psychological characteristics which may manifest in abused children have been universally and consistently recognized in the scientific community since at least 1962. See Kempe, Silverman, Steele, Droegemueller & Silver, The-Battered-Child Syndrome (1962), 181 J.Am.Med.Assn. 17, 18-20 (describing the psychological and physiological harm caused by child abuse).
Because the issue has been raised in this case using the term “battered child syndrome” to refer to the psychological and behavioral characteristics of abused children, we will continue to use this label throughout this opinion, recognizing that this encompasses the same characteristics identified under numerous labels and which are set forth most specifically under the diagnostic criteria of posttraumatic stress disorder.
II
The defense in this case did not ask that battered child syndrome be recognized as a new defense or an independent justification for the killing of an abusive
We have previously held that “[t]he Ohio Rules of Evidence establish adequate preconditions for admissibility of expert testimony * * State v. Williams (1983),
Evidence is relevant if it has “any tendency to make the existence of any fact that is of consequence to the determination of the action more probable or less probable than it would be without the evidence.” Evid.R. 401. Evidence that would support a defendant’s explanation of the events at issue and would provide evidence as to his possible state of mind at the time of the incident is clearly relevant to his or her defense. In this case, the testimony on battered child syndrome, which was proffered by the defense, is relevant for at least four separate purposes, including the determination of whether Brian (1) had acted with prior calculation and design as charged in the indictment, (2) had acted with purpose as required for the lesser included offense of murder, (3) had created the confrontation or initiated the aggression, and (4) had an honest belief that he was in imminent danger, a necessary element in the affirmative defense of self-defense.
General information on battered child syndrome would also tend to show that Brian’s behavior was consistent with that of an abused child and would lend support to his testimony that he had been abused both generally and just prior to the küling. See State v. Stowers (1998),
Ill
In addition to the requirement of relevancy, expert testimony must meet the criteria of Evid.R. 702. Rule 702 provides that a witness may testify as an expert if all of the following apply:
“(A) The witness’ testimony either relates to matters beyond the knowledge or experience possessed by lay persons or dispels a misconception common among lay persons;
“(B) The witness is qualified as an expert by specialized knowledge, skill, experience, training, or education regarding the subject matter of the testimony;
“(C) The witness’ testimony is based on reliable scientific, technical, or other specialized information. * * * ”
The first prong of the rule is satisfied in this case. This trial presents precisely the kind of situation in which expert testimony is most necessary. As we recognized in Koss, when we accepted evidence on battered woman syndrome, testimony on the syndrome or psychological effects of abuse is essential to proving the elements of a self-defense claim. Nonconfrontational killings do not fit the general pattern of self-defense. Without expert testimony, a trier of fact may not be able to understand that the defendant at the time of the killing could have had an honest belief that he was in imminent danger of death or great bodily harm. Further, it is difficult for the average person to understand the degree of helplessness an abused child may feel. Thus, expert testimony would also “ ‘help dispel the ordinary lay person’s perception that a [person] in a battering relationship is free to leave at any time.’ ” Koss,
Expert testimony as to the effects of abuse may also help to counter popular misconceptions about the nonreporting of abuse. Prolonged exposure to abuse results in feelings of powerlessness, embarrassment, fear of reprisal, isolation, and low self-esteem. See, generally, footnotes 2 and 3, infra. These effects often prevent a child from seeking help from third parties. The abusive parent also generally becomes adept at concealing the abuse from outsiders. Note, Toffel, Crazy Women, Unharmed Men, and Evil Children: Confronting Myths
Absent corroborating evidence, a trier of fact is likely to believe that the abuse allegations are fabricated in response to the charges levied against the child-defendant. The existence and prevalence of such misconceptions are evident in the transcript of this trial. The prosecution repeatedly stressed that Brian could have left the house again, that he could have gone to his father or grandparents, that he was not in actual imminent danger at the time of the killing, and implying that he must have created the allegations of abuse after the fact because, otherwise, more people would have known about it. Even the trial court judge questioned whether there was corroborating evidence of abuse before granting the state’s motion in limine, excluding testimony on battered child syndrome in connection with a claim of self-defense.
It is the lack of corroborating evidence that makes expert testimony even more crucial in these cases. The defense needs expert testimony to refute the seemingly logical conclusion that serious abuse could not be taking place if no one outside the home was aware of it. Expert testimony is also necessary to dispel the misconception that a nonconfrontational killing cannot satisfy the elements of self-defense, and to counter prosecutorial attacks on the defendant’s credibility based on the nonreporting of abusive incidents. In Koss, we accepted that expert testimony is necessary to explain that the nonreporting of abuse and the failure to retreat from an allegedly abusive environment are not inconsistent with a claim of severe abuse. Surely, if we accept nonreporting and failure to retreat by adults, the reasons for such conduct are even more understandable when a .child is the subject of the abuse.
The second prong of the test has not been challenged. The trial court disallowed any testimony as to battered child syndrome and did not specifically challenge the qualifications of Dr. Eisenberg.
The final requirement for the admission of testimony by experts is whether the testimony is based on reliable scientific, technical, or other specialized information. Dr. Eisenberg’s testimony was based on scientific, technical, or otherwise specialized information. He is a trained psychologist who has specialized training in the behavioral and psychological effects of child abuse. The only question remaining is whether the information supporting his opinion is sufficiently reliable.
IV
Evid.R. 702 does not define “reliability” in the context of admitting expert testimony. “Consistently with the intention to do no more than codify existing
Thus, pursuant to the directives of this court in the Rules of Evidence, and consistent with our previous holding in State v. Williams, scientific opinions need not enjoy “general acceptance” in the relevant scientific community in order to satisfy the reliability requirement of Evid.R. 702. Further, there need not be any agreement in the scientific community regarding the expert’s actual opinion or conclusion. The credibility of the conclusion and the relative weight it should enjoy are determinations left to the trier of fact. See, e.g., State v. Buell (1986),
Prior to the 1994 amendment of Evid.R. 702, the threshold standard of reliability for admission of expert testimony had been stated in a variety of ways. In Koss, the court stated that “battered woman syndrome has gained substantial scientific acceptance to warrant admissibility.” (Emphasis added.) State v. Koss,
Since Pierce, however, Evid.R. 702 was amended, specifically adding the requirement that the information forming the basis of the expert testimony be “reliable.” We have decided only two cases concerned specifically with Evid.R. 702 since the amendment: State v. Stowers,
In Miller, the court designated the following four factors to be considered in evaluating the reliability of scientific evidence: (1) whether the theory or technique has been tested, (2) whether it has been subjected to peer review, (3) whether there is a known or potential rate of error, and (4) whether the methodology has gained general acceptance.
These factors were adopted from Daubert v. Merrell Dow Pharmaceuticals, Inc. (1993),
Relevant evidence based on valid principles will satisfy the threshold reliability standard for the admission of expert testimony. The credibility to be afforded these principles and the expert’s conclusions remain a matter for the trier of fact. The reliability requirement in Evid.R. 702 is a threshold determination that should focus on a particular type of scientific evidence, not the truth or falsity of an alleged scientific fact or truth. “ ‘In other words, the court need not make the initial determination that the expert testimony or the evidence proffered is true before submitting the information to the jury.’ ” State v. Pierce,
V
Though it is not necessary to show general acceptance to pass the threshold of reliability for the admission of expert testimony, the behavioral and psychological effects of prolonged child abuse on the child have been generally accepted in the medical and psychiatric communities and therefore unquestionably meet the requisite level of reliability for admission as the subject of expert testimony.
It is also well recognized in the scientific community that child abuse need not involve excessive or debilitating physical violence to affect the emotional and psychological development of the child. See Comment, Moreno, Killing Daddy: Developing a Self-Defense Strategy for the Abused Child (1989), 137 U.Pa.L.Rev. 1281, 1302. “Child abuse consists of a multitude of nonaccidental physical and psychological traumas to children, in the vast majority of cases, over an extended period of time. Acts of abuse include such bodily violence as beating, squeezing, lacerating, binding, burning, suffocating, poisoning, or exposing to excess heat or cold. Abuse also includes such psychological traumas as. sensory overload with light, sound, stench, aversive taste, itching, pain, or prevention of sleep and verbal overload with insults, accusations, and indoctrination.” Handbook of Clinical Child Psychology (1983) 1220.
The behavioral and psychological effects of child abuse, or battered child syndrome, are most often discussed as a form of posttraumatic stress disorder (“PTSD”). PTSD is an anxiety disorder listed in the DSM-IV, which categorizes universally recognized mental disorders. This specific disorder has been recognized in children at least since 1987 when the DSM-III-R was published. The fourth and most recent edition of the manual specifically notes that PTSD can manifest in children.
This court has already recognized that posttraumatic stress disorder in children is a proper subject for expert testimony. State v. Bidinost (1994),
In addition to this explicit recognition of battered child syndrome, the psychological effects of abuse suffered by battered children are equivalent to the effects of prolonged abuse experienced by abused women and have been recognized as appropriate for expert testimony in the context of battered women. The psychiatric and legal communities have clearly accepted that despite any minor differences in the degree of power differentials between the batterer and the abused, the psychological effects of family violence are legally indistinguishable whether suffered by children or adults.
VI
Several states have allowed the defendant to present expert testimony of a “battered child” or “battered person” syndrome where a child has killed or attempted to kill an abusive family member. See, e.g., State v. Janes (1993),
Still others, while not faced with the issue of expert testimony, have recognized that abused children may exhibit identifiable psychological characteristics that point to a causal connection between the abuse and the killing of the abuser. See, e.g., People v. Cruickshank (1985),
Six states have enacted statutes that allow the presentation of testimony regarding the psychological effects on victims of domestic violence, including children, in cases where the victim of abuse is on trial for acts of violence against the abuser. Tex.Code Crim. Pro. Art. 38.36(b)(2) (1997); Georgia Code 16-3-21(d)(2) (1997); Nevada Rev. Stat. 48.061 (1997); La. Stat. Ann. 404(A)(2) (1997); Cal. Evid.Code 1107 (1997)
VII
While specific legislation may be helpful in defining the parameters of a new defense, such legislative action is not necessary in order for us to determine
Judgment affirmed and cause remanded.
Notes
. Since oral arguments were presented in this case, we have held that the prosecution in a child abuse case may present expert testimony on the characteristic psychological symptoms of a typical abused child as evidence supporting allegations that a particular child has been abused. See State v. Stowers (1998),
. Many other medical sources recognize that PTSD can manifest in children as a result of child abuse. See, e.g., Post-traumatic Stress Disorder: Assessment, Differential Diagnosis and Forensic Evaluation (1990) 28; The Battered Child (4 Ed.1987) 295; Post-Traumatic Stress Disorder in Children (1985) 135-152; Porterfield, Straight Talk About Post-traumatic Stress Disorder (1996) 77; Encyclopedia of Psychiatry, Psychology, and Psychoanalysis (1996) 94; Posttraumatic Stress Disorder: DSM-IV and Beyond, supra, at 215-219; Kaplan and Sadock’s Synopsis of Psychiatry, Behavioral Sciences, and Clinical Psychiatry (7 Ed.1994) 786.
. See, e.g., DSM-IV at 425; Posttraumatic Stress Disorder: DSM-IV and Beyond, supra, at 219-220; State v. Janes (1993),
. While the California statute refers specifically to the admission of expert testimony on battered woman syndrome, it also allows testimony on the “physical, emotional, or mental effects upon the beliefs, perceptions, or behavior of victims of domestic violence” as defined in Cal.Fam.Code 6211; Cal.Evid. Code 1107 (1997). The definition of domestic violence under this Family Code section includes abuse perpetrated against the child of a party and any person related by consanguinity or affinity within the second degree. This would include parental abuse of children. Cal.Fam.Code, Section 6211(f) (West 1998).
. Although the Utah statute does not specifically deal with the admissibility of expert evidence, the House Bill indicates that it is intended to clarify that otherwise competent evidence regarding a victim’s response to patterns of abuse or violence in the parties’ relationship is to be considered by the trier of fact when determining imminence or reasonableness in the act of self-defense. Utah Crim.Code 76-2-402 (Michie 1997); Am.H.B. No. 13, Laws of Utah, Ch. 26, Section 2 (reprinted in Utah Legislative Report 1994, at 18).
