Overview



Post-traumatic Stress Disorder (PTSD) is a psychological disorder that affects individuals who have been exposed (both first hand and second hand) to some sort of traumatic/adverse situation. Its symptoms consist of: hypervigilance, uncontrollable outbursts of anger, inability to concentrate, recurrent visions or dreams about events experienced, sporadic sleeping patterns, and disabilities in acculturating with other members of society (Turnbull 1998). The disorder is known to affect populations who are victims of natural disasters, experience/witness violence, and endure the hardships of war.


Health Impact



According to the American Psychiatric Association’s DSM-IV (2000), PTSD is diagnosed by exposure to trauma, with subsequent intrusive recollections of the experience, avoidance and symptoms of hyper-arousal, such as heightened vigilance and trouble sleeping. Reactions to trauma are defined in psychobiological terms – arousal, avoidance, and repetition. However, individuals who go face trauma develop altered understandings of themselves and their lives (Hinton & Lewis-Fernandez 2010; Kienzler 2008; Polusny et al. 2011). Moreover, how these changes affect them in their daily function is of key importance in understanding the impact that PTSD has on differing populations. Issues of reacculturation, familial integration, social awareness, substance abuse, depression, violent tendencies with loved ones, and the inability to express their traumatic experiences have lasting consequences which not only affect the health of the individual, but also the family and friends associated with the person.

In clinical terms, post-traumatic stress disorder is often conceived as an individual disorder – a mental health problem. In anthropological terms, PTSD has a cascade of effects that create behavioral and social dynamics which can increase, or decrease, the impact of trauma, hyper-vigilance, and arousal over time. How these effects play out for an individual and his/her loved ones is important to take into consideration, especially when children are within the household and bear witness to it.

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More often than not, individuals who suffer from PTSD are known to have associations with depression, anxiety disorders, prolonged bouts of social dislocation, and the inability to decipher exactly what the recurring recollections of trauma played out within their minds mean. The embodiment of such trauma differs from individual to individual due to the cultural specific meanings of stress and identity within the trauma experienced. Differentiations in cultural embodiment of trauma as well as stress have required clinicians to reshape the way in which they address PTSD from one patient to the next.

Of notable mention is Erin Finley (medical anthropologist) and Allan Young (medical anthropologist). Finley’s work encompasses ethnographic explanatory models of PTSD within the U. S. Veteran population. In her book entitled, Fields of Combat: Understanding PTSD Among Veterans of Iraq and Afghanistan, Dr. Finley interviewed 60 veterans who all interpreted PTSD in a distinct way. Though their symptoms were somewhat similar, the way in which they embodied and expressed symptoms was tailored by their understanding of stress and identity both within the military institution as well as the social structures that influence civilian interpretation of military duties. Allan Young’s book entitled, The Harmony of Illusions: Inventing Post-traumatic Stress Disorder, dives into the critical foundations of understanding traumatic memory and the cultural, social, and biological components that affect the construction PTSD. His text is a pillar for understanding the architecture of fear and the symbolic meaning that trauma has on both a cultural level as well as a biological level.

The perpetuation and development of PTSD is as much a cultural phenomenon as it as a chronic medical issue. Given the multiple influences that induce the onset of PTSD, there are several considerations beyond a strictly clinical inventory that must be accounted for and considered in order to produce a holistic approach that can understand why traumatic events cause long-term psycho-emotional damage. Navigating differences in culture and the impact that fear architecture has on the mind-body dichotomy is of paramount importance when grasping the complexities of cross-cultural embodiment of trauma (Kohrt & Harper 2008).

Such influences affect not only military-specific PTSD but all classifications of PTSD (natural disaster survivors, rape victims, car accident survivors, etc). Through more ethnographic exposure, better understandings of cross cultural perceptions of PTSD are becoming understood and useful for the medical community.

PTSD Multimedia




Watch a video on PTSD!



Read about overdiagnosis of PTSD within the military on Neuron Culture Science Blog!


Further Reading



Eggerman, M., Brick-Panter, C. 2010. Suffering, hope, and entrapment: Resilience and cultural values in Afghanistan. Social Science and Medicine 71 (1): 71-83.

Finley, Erin. 2012. War and Dislocation: A Neuroanthropological Model of Trauma among American Veterans with Combat PTSD. In D. Lende & G. Downey, Eds., The Encultured Brain: An Introduction to Neuroanthropology. Pp. 263-290. Cambridge, MA: MIT Press.

Gottman, J.M., Gottman, J.S., Atkins, C. 2011. The Comprehensive Soldier Fitness Program: Family skills component. American Psychologist 66(1): 52-57.

Jobson, L. & O'Kearney, R. 2008. Cultural differences in personal identity in post-traumatic stress disorder. British Journal of Clinical Psychology 47(1): 95–109.

Litz, B.T., Schlenger, W.E. 2009. PTSD in Service Members and New Veterans of the Iraq and Afghanistan Wars: A Bibliography and Critique. PTSD Research Quarterly 20(1): 2-7.

Yehuda, R., Bierer, L. 2009. The Relevance of Epigenetics to PTSD: Implications for the DSM-V. Journal of Traumatic Stress 22(5): 427-434.


References



Collura, G., Lende, D. (in press). Post-traumatic Stress Disorder and Neuroanthropology: Stopping PTSD Before it Begins. Annals of Anthropology.
Finley, E. (2011). Fields of Combat: Understanding PTSD Among Veterans of Iraq and Afghanistan. Cornell University Press, New York.

Hinton, D. & Lewis-Fernando, R. (2010) Idioms of distress among trauma survivors: Subtypes and clinical utility. Culture, Medicine and Psychiatry 34(2): 209-218.

Kienzler, H. (2008) Debating war-trauma and post-traumatic stress disorder (PTSD) in an interdisciplinary arena. Social Science and Medicine 67(2): 218-227.

Kohrt, B., Harper, I. (2008) Navigating Diagnoses: Understanding Mind–Body Relations, Mental Health, and Stigma in Nepal. Culture, Medicine, & Psychiatry 32 (4): 462-491.

Polusny, M., Erbes, C., Murdoch, M., Arbisi, P., Thuras, P., Rath, M. (2011) Prospective risk factors for new-onset post-traumatic stress disorder in National Guard soldiers deployed to Iraq. Psychological Medicine 41: 687-698.

Turnbull, G.J. (1998) A review of post-traumatic stress disorder. Part I: Historical development and classification. Injury 29(2): 87-91.