International Journal of Environmental Research and Public Health Post-Traumatic Stress Disorder and Urban Violence: An Anthropological Study (original) (raw)
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Post-traumatic stress disorder and urban violence: An anthropological study
The study aimed to understand how "distress" is experienced by patients with Post-Traumatic Stress Disorder (PTSD) in the social-cultural context of São Paulo, Brazil, an urban environment marked by social inequality and high levels of violence. A qualitative study was conducted between 2008 and 2010 with PTSD patients (F43.1, ICD-10, 1997) who had been victims of robberies and kidnappings in São Paulo. Dense ethnographic observations were carried out, as well as in-depth semi-structured interviews with ten adult patients. The analysis method used was based on anthropology. The results show that it is particularly important to distinguish between perceptions of different forms of the experience of social suffering and perceptions of health and illness held by victims and biomedical experts. The cause of PTSD is more often associated with the personal problems of the victim than with the specific traumatic event. The distress described in terms of what is considered a "normal" reaction to violence and what is considered a symptom of PTSD. The findings indicate that the diagnostic of PTSD can be understood in relation to the different contexts within a culture. The ethnographic approach serves not only to illuminate individual suffering but also the social suffering experienced by the residents of São Paulo.
Relationship Between PTSD and Brazilian Urban Violence
Comprehensive Guide to Post-Traumatic Stress Disorder, 2015
The diagnostic of PTSD can be understood in relation to different contexts and different cultures. Different levels of specific understanding are therefore considered within populations where suffering is identified and legitimized. The purpose of this chapter is to seek to understand the context in which "distress" is experienced by victims of urban violence diagnosed with posttraumatic stress disorder (PTSD) and to understand the victims' requests for help and their perception of PTSD in this context. The analysis focuses on São Paulo, in particular, a major metropolitan area of Brazil marked by social inequality, where violence frequently erupts. There are few studies on PTSD in Brazil, but the literature on violence and crime is well established, showing the complexity and comprehensiveness of this subject in the country. The discussion developed in this chapter is articulated with the help of important theoretical studies on violence in Brazil and empirical data from an anthropological study carried out on PTSD patients living in São Paulo.
BMC Psychiatry, 2022
Background Adolescents in low-resource urban settings in Brazil are often exposed to high levels of trauma that can result in post-traumatic stress disorder (PTSD). However, preliminary evidence indicates that PTSD tends to be under-reported in Brazilian health services, despite the high prevalence of trauma. Additionally, little is known about the perceived applicability among clinicians of the new ICD-11 diagnosis of complex PTSD (CPTSD), despite its potential relevance for contexts of chronic trauma. The current study investigated local understandings of PTSD and CPTSD among health professionals working with adolescents in violent neighbourhoods of São Paulo city. Methods Semi-structured interviews were conducted with 58 health professionals working at both the primary care and specialized mental health levels in two areas of São Paulo city with high levels of community violence. Results Most participants knew about PTSD, but most did not know about CPTSD. There were mixed views ...
2022
This paper details two ongoing pilot studies exploring the perspectives of a group of indigenous Brazilian students and a group of dwellers in a Brazilian favela, who have experienced and continue to experience trauma. The paper explores the difference in perspectives, values, and trauma as experienced by these communities, when seen through the lens of colonial psychology and seeks to contribute to a dialogue within psychology that promotes critical psychology and dialogue.
BMC Psychiatry, 2020
BackgroundThroughout the world, millions of people living in deprived urban environments with frequent experiences of violence are mentally distressed. There is little evidence about which characteristics of people living in such environments are associated with lower or higher levels of mental distress and how they may cope with experiences of violence.Methods/DesignThis study is part of the research project ‘Building the Barricades’ (ES/S000720/1 ESRC-AHRC GCRF Mental Health 2017), which uses a mixed-method approach. Quantitative and qualitative studies will be conducted in 16 favelas in the area of Maré in Rio de Janeiro, Brazil. The quantitative study consists of a survey of 1200 randomly selected adults living in Maré and of 200 individuals who frequent the open-use drug sites. The survey will assess sociodemographic characteristics, experiences of different forms of violence, physical and mental health status (including drug use) and active participation in cultural consumption and production. In the qualitative study we will conduct 60 in-depth interviews and 8 focus groups of participants selected from respondents to the survey to assess in more detail their experiences of violence and coping strategies. In order to analyze the quantitative data we will use descriptive statistics and explore associations in uni- and multi-variable analyses. Qualitative data will be subjected to thematic analysis.DiscussionThis is an exploratory study to identify characteristics and coping strategies that appear to help people to overcome experiences of violence in deprived areas without developing mental distress. The findings could inform policies to reduce mental distress and improve the quality of life of people living in urban areas affected by violence.
A critical re-reading of post-traumatic stress disorder
term in 1980 in association with major stressors, including concentration-camp experiences, torture, bombings and natural disaster, they subsumed previous diagnostic categories including post-torture syndrome and rape-trauma syndrome under PTSD. Therefore, this apparently contemporary illness discourse for survivors of political violence is neither altogether new, nor recent. What is perhaps 'new' is the extent to which it has been popularised within Western culture, and the extent to which psychologists, psychiatrists and other mental-health workers have convinced international agencies, including the United Nations, of the importance of incorporating mental-health work within the rapid and long-term responses to war, natural disasters and other 'exceptionally difficult circumstances' .
Posttraumatic stress disorder among adolescents in Brazil: a cross-sectional study
BMC Psychiatry
Background The frequency of trauma and different types of violence exposure in urban areas and their effects on the mental health of adolescents in developing countries are poorly investigated. Most information about traumatized young people comes from war scenarios or disasters. This study aimed to determine the prevalence of PTSD in trauma-exposed students in a low-resource city of the state of Rio de Janeiro, Brazil. The effects of sociodemographic and individual and family factors in the development of PTSD were also investigated. Methods Through multi-stage cluster sampling, 862 adolescents (Mage = 15 years old, 65% female) from public and private schools in the city of São Gonçalo were selected for the study. Self-rating structured questionnaires were applied to assess sociodemographic profile, exposure to physical and psychological violence (family, school, community), sexual abuse, social support, social functional impairment, resilience, and posttraumatic stress disorder. T...
PTSD: An Evaluation of the Western Framework and its Global Limitations
The main focus of this paper is to address the limitations of applying the current framework of Post-Traumatic Stress Disorder (PTSD) to trauma-stricken populations worldwide. To do so, the literature contributed by authors of assorted professional backgrounds is reviewed to reveal a convergence of ideas that challenges the underlying assumptions under which PTSD functions. Among these assumptions are the Western ethnocentrism and the biomedical purviews from which PTSD is viewed. The analysis begins at discussing the formation of PTSD within a culture of post-modernism. Afterwards, the notion of universalism is assessed and challenged. Subsequently, qualitative methods are presented to foster cultural competence. Additionally, the paper calls for paradigm shifts to focus less on distress and more on resilience. As a result, the paper does not advocate for the dismissal of the theory of PTSD but rather endeavors to shed light on the inherent biases that affect the effectiveness of its diagnosis and treatments in non-Western contexts where the manifestation of trauma is not uniform. Keywords: PTSD, trauma, post-modernism, universalism, resilience, ethnocentrism
Trauma and disasters in social and cultural context
Principles of Social …, 2010
In recent years, disaster psychiatry and psychology have emerged as distinct areas of study with textbooks, journals and societies devoted to research and discussion of clinical and social issues. This development of the field has accompanied recognition that trauma and disasters may be associated with particular types of mental health problems requiring culturally informed interventions at both individual and community levels. Posttraumatic stress disorder (PTSD) is at the center of trauma theory. Biological mechanisms are important for understanding the causes and chronicity of PTSD, the dynamics of triggering and re-experiencing, and the effectiveness of exposure therapy as a treatment, but PTSD involves additional cognitive and social mechanisms mediated by the personal and cultural meaning of traumatic events. The impact of trauma and disasters depends crucially on broader social, economic and political contexts. Culture influences the individual and collective experience of trauma at many levels: the perception and interpretation of events as threatening or traumatic; modes of expressing and explaining distress; coping responses and adaptation; patterns of help-seeking and treatment response. Most importantly, culture gives meaning to the traumatic event itself allowing individuals, families and communities to make sense of violence and adversity in ways that may moderate or amplify their impact.