A clinical and forensic psychologist hired by actor Johnny Depp's legal team diagnosed his ex-wife Amber Heard with borderline personality disorder and histrionic personality disorder in court proceedings this week.
Dr Shannon Curry also testified at the Fairfax County Circuit Court that, in her professional opinion, she does not believe that Ms Heard suffers from Post-Traumatic Stress Disorder (PTSD).
Mr Depp, 58, is suing Ms Heard, 36, for libel over an opinion piece she wrote in the Washington Post that doesn't name him but in which she referred to herself as a "public figure representing domestic abuse".
He is seeking a payout of $US50 million ($70 million) for damage to his reputation. Ms Heard is countersuing for $US100 million, alleging Mr Depp smeared her by calling her a liar.
Mr Depp has testified that he's the one who was a victim of domestic violence in their relationship.
Behind disorders mentioned in court
Dr Curry told the court that borderline personality disorder is a disorder of contradictions, where someone can come across as being very charming. But, she said, it's also a disorder of instability, driven by an underlying terror of abandonment.
"When somebody is afraid of being abandoned by their partner — or by anybody else in their environment — and they have this disorder, they'll make desperate attempts to prevent that from happening," she said.
She said those desperate attempts could involve physical aggression.
"Over time, the anger, the explosive anger that they show when somebody is needing space or when somebody's really not doing anything wrong – because a lot of times they read into things that they perceive as being a slight to them or being somebody intending to harm them that actually isn't happening – they'll exaggerate it and they'll explode, they'll react in this heightened manner that is just exhausting for their partners," she explained in court.
Dr Curry also said borderline personality disorder could be a predictive factor for women who implement violence against their partners, and a common tactic might be physically assaulting that partner and then getting harmed themselves.
She said that people with borderline personality disorder can go from one extreme to another in how they see their partners.
Dr Curry described histrionic personality disorder as belonging to the same cluster of mental illnesses.
"With histrionic personality disorder, what you're going to see is extreme discomfort with not being the centre of attention, extreme efforts to be the centre of attention and when they feel that they're not the centre of attention, you will see some strange things — making up stories to try to get attention, often taking on a victim or princess role," she explained.
Dr Curry told the court Ms Heard does not have PTSD.
"She initially said, 'Yes, I have that', to 19 of the 20 symptoms.
"That's not typical, even of somebody with the most-disabling form of PTSD.
"When we eventually sort of dialled it down, she had three remaining symptoms."
She said that, according to the notes she reviewed, some of these symptoms were present before Ms Heard started dating Mr Depp.
Dr Curry said she reached her diagnoses after reviewing Ms Heard's treatment records and spending 12 hours with Ms Heard, during which she carried out diagnostic testing.
She said she was not asked to provide a psychological evaluation of Mr Depp.
How common is it for psychologists to diagnose defendants in US judicial system?
Dr Lenore Walker is a clinical and forensic psychologist based in Florida. She spoke to the ABC about the work she does generally and how forensic psychology works within the court system in the United States, but did not speak specifically about the Johnny Depp and Amber Heard case.
On many occasions, Dr Walker — who coined the term "battered woman syndrome" — has interviewed people involved in court cases to provide diagnoses. On some occasions, she'll be hired by an attorney and, in other cases, by the court.
She said that, particularly in the early days, she might have spent up to two days interviewing someone.
"I would not make a diagnosis unless I actually spent time with the person," she said.
In coming up with a diagnosis, Dr Walker reviews a variety of documents — such as prior medical history, school records if dealing with children, how someone functions on their job if they have a head injury, police records — and she might interview witnesses as well to get a clearer picture.
She's had some high-profile clients. Dr Walker was a forensic consultant in the 1995 OJ Simpson trial, saying it was the first time she can recall an entire trial being televised, minute by minute, from start to finish.
"I also did evaluate OJ for the attorneys at that time, and was prepared to testify, but they never called me because the whole issue of domestic violence began to unravel, I guess, for the prosecution," she explained.
Dr Walker said that, sometimes, justice was not served well in high-profile cases when people rushed to take one side or the other.
Can defendants refuse psychological testing?
Dr Stephen Diamond is a clinical and forensic psychologist based in Los Angeles and has testified in court many times, in both civil and criminal cases.
He said that defendants, legally and ethically, have the right to refuse diagnostic testing unless there's a court order compelling them to do so.
Dr Diamond said that evaluations were often kept separate from treatment to ensure objectivity.
"When you're treating a patient, you have a therapeutic relationship with them," he said, "and that can bias your evaluation."
Dr Diamond stressed to the ABC that he had no involvement in the Johnny Depp and Amber Heard case and was only commenting generally.
He said patients sometimes gravitated towards the concept of PTSD, but there are very specific kinds of diagnostic criteria for a PTSD diagnosis to be given.
"Technically speaking, and clinically speaking, PTSD should really only be used as a diagnosis when there has been a threat to one's life as part of the trauma, or one has witnessed someone be murdered or killed or tortured or something like that," Dr Diamond said.
He said that providing diagnoses was not an exact science.
"Because you can have five different psychologists and psychiatrists evaluate the same patient, and they may come up with five different diagnoses."
Could there be a conflict of interest in this case?
Under questioning from Ms Heard's attorney, Dr Curry told the court she was interviewed over dinner at Mr Depp's home by his legal team before she was hired. Mr Depp was present.
"And the dinner lasted approximately three to four hours, correct?" Ms Heard's attorney, Elaine Bredehoft, asked.
"Yes – the interview," Dr Curry replied.
"And it included drinks, correct?" Ms Bredehoft asked.
"Yes, dinner and I believe drinks were served," Dr Curry replied.
Dr Diamond said a legal team had the right to interview a prospective expert witness but, he said, doing so over dinner and drinks could potentially lead to a conflict of interest and the bias might not even be conscious.
"I wouldn't be comfortable with it," he said, "and I don't think it's common."
As Dr Curry gave her testimony, Ms Heard could be seen taking notes.
Ms Heard is expected to take the stand for the first time as early as Monday, US time.
