Critical perspectives on research on post-traumatic stress disorder and implications for the South African context

Abstract

This article introduces a special issue of the Journal of Psychology in Africa on post-traumatic stress disorder (PTSD) in Africa and particularly in South Africa and examines the critical debate that has surrounded PTSD research. It begins with an examination of the meaning of the term trauma, and of its specialised use within the clinical context and with respect to the concept of PTSD. The diagnostic approach to the detection of PTSD is presented, criteria in the DSM-IV-TR and the ICD-10 are summarised and differences between the two manuals are discussed. Arguments presented by critics of the concept of PTSD are presented and discussed. These concern the historical evolution of the concept, concerns about the universality of PTSD cross-culturally, and problems arising from understanding human suffering from a narrow medical perspective. It is concluded that while there are dangers in thinking of the sequelae of trauma as a medical/psychiatric problem, and while the alarming rate of traumatic events needs to be addressed at the political, economic and societal level, there is an important place for the provision of assessment and treatment of PTSD within a psychiatric/psychological clinical setting. Keywords: critical theory, diagnosis, post-traumatic stress disorder, South Africa, trauma, traumatic stressJournal of Psychology in Africa 2005, 15(2): 117–124