Editing Post-traumatic stress disorder (section)

== Anthropology ==
{{More citations needed section|date=October 2022}}
[[Cultural anthropology|Cultural]] and [[medical anthropologist]]s have questioned the validity of applying the diagnostic criteria of PTSD cross-culturally.<ref name="Moghimi_2012"/>

Trauma (and resulting PTSD) is often experienced through the outermost limits of suffering, pain and fear. The images and experiences relived through PTSD often defy easy description through language. Therefore, the translation of these experiences from one language to another is problematic, and the primarily Euro-American research on trauma is necessarily limited.<ref>{{cite journal |vauthors=Pillen A |date=2016 |title=Language, Translation, Trauma |journal=[[Annual Review of Anthropology]] |volume=45 |pages=95–111 |doi=10.1146/annurev-anthro-102215-100232|doi-access=free }}</ref> The [[Sapir-Whorf hypothesis]] suggests that people perceive the world differently according to the language they speak: language and the world it exists within reflect back on the perceptions of the speaker.<ref>{{cite journal |vauthors=Skerrett DM |date=2010 |title=Can the Sapir-Whorf hypothesis save the planet? lessons from cross-cultural psychology for critical language policy |journal=[[Current Issues in Language Planning]] |volume=11 |number=4 |pages=331–340 |doi=10.1080/14664208.2010.534236|s2cid=144639205 }}</ref>

For example, ethnopsychology studies in Nepal have found that cultural idioms and concepts related to trauma often do not translate to western terminologies: ''piDaa'' is a term that may align to trauma/suffering, but also people who suffer from ''piDaa'' are considered ''paagal'' (mad) and are subject to negative social stigma, indicating the need for culturally appropriate and carefully tailored support interventions.<ref name="search.ebscohost.com">{{cite journal |vauthors=Kohrt BA, Hrushka DJ |date=2010 |title=Nepali concepts of psychological trauma: the role of idioms of distress, ethnopsychology and ethnophysiology in alleviating suffering and preventing stigma |journal=[[Culture, Medicine and Psychiatry]] |volume=34 |number=2 |pages=322–352 |doi=10.1007/s11013-010-9170-2 |pmid=20309724 |pmc=3819627}}</ref> More generally, different cultures remember traumatic experiences within different linguistic and cultural paradigms. As such, cultural and medical anthropologists have questioned the validity of applying the diagnostic criteria of PTSD cross-culturally, as defined in the Diagnostic and Statistical Manual of Mental Disorders (DSM-III),{{Update inline|date=November 2022|reason=has the DSM-V addressed this issue?}} and constructed through the Euro-American paradigm of psychology.<ref name="Moghimi_2012">{{cite journal |vauthors=Moghimi Y |date=2012 |title=Anthropological discourses on the globalization of posttraumatic stress disorder (PTSD) in post-conflict societies |journal=[[Journal of Psychiatric Practice]] |volume=18 |number=1 |pages=29–37|doi=10.1097/01.pra.0000410985.53970.3b |pmid=22261981 |s2cid=36228060}}</ref>

There remains a dearth of studies into the conceptual frameworks that surround trauma in non-Western cultures.<ref name="Moghimi_2012" /> There is little evidence to suggest therapeutic benefit in synthesizing local idioms of distress into a culturally constructed disorder of the post-Vietnam era, a practice anthropologist believe contributes to category fallacy.{{Clarify|reason=what is category fallacy?|date=September 2022}}<ref name="Moghimi_2012"/> For many cultures there is no single linguistic corollary to PTSD, psychological trauma being a multi-faceted concept with corresponding variances of expression.<ref name="search.ebscohost.com"/>

Designating the effects of trauma as an affliction of the spirit is common in many non-Western cultures where idioms such as "soul loss" and "weak heart" indicate a preference to confer suffering to a spirit-body or heart-body diametric. These idioms reflect the emphasis that collectivist cultures place on healing trauma through familial, cultural and religious activities while avoiding the stigma that accompanies a mind-body approach.<ref name="Moghimi_2012"/> Prescribing PTSD diagnostics within these communities is ineffective and often detrimental.{{Citation needed|date=September 2022}} For trauma that extends beyond the individual, such as the effects of war, anthropologists believe applying the term "social suffering" or "[[cultural bereavement]]" to be more beneficial.<ref>{{cite journal | vauthors = Pedersen D, Tremblay J, Errázuriz C, Gamarra J | title = The sequelae of political violence: assessing trauma, suffering and dislocation in the Peruvian highlands | journal = Social Science & Medicine | volume = 67 | issue = 2 | pages = 205–217 | date = July 2008 | pmid = 18423959 | doi = 10.1016/j.socscimed.2008.03.040 }}</ref>

Every facet of society is affected by conflict; the prolonged exposure to mass violence can lead to a 'continuous suffering' among civilians, soldiers, and bordering countries.<ref name="doi.org">{{cite book |vauthors=Maedel A, Schauer E, Odenwald M, Elbert T |date=2010 |title=Psychological Rehabilitation of Ex-combatants in Non-Western, Post-conflict Settings, Trauma Rehabilitation After War and Conflict |publisher=Springer |location=New York, NY |doi=10.1007/978-1-4419-5722-1_9}}</ref> Entered into the DSM in 1980, clinicians and psychiatrists based the diagnostic criteria for PTSD around American veterans of the Vietnam War.<ref>{{cite journal | vauthors = Crocq MA, Crocq L | title = From shell shock and war neurosis to posttraumatic stress disorder: a history of psychotraumatology | journal = Dialogues in Clinical Neuroscience | volume = 2 | issue = 1 | pages = 47–55 | date = March 2000 | pmid = 22033462 | pmc = 3181586 | doi = 10.31887/DCNS.2000.2.1/macrocq | s2cid = 24931891 }}</ref> Though the DSM gets reviewed and updated regularly, it is unable to fully encompass the disorder due to its Americanization (or Westernization).<ref>{{cite journal | vauthors = Regier DA, Kuhl EA, Kupfer DJ | title = The DSM-5: Classification and criteria changes | journal = World Psychiatry | volume = 12 | issue = 2 | pages = 92–98 | date = June 2013 | pmid = 23737408 | pmc = 3683251 | doi = 10.1002/wps.20050 }}</ref> That is, what may be considered characteristics of PTSD in western society, may not directly translate across to other cultures around the world. Displaced people of the African country Burundi experienced symptoms of depression and anxiety, though few symptoms specific to PTSD were noted.<ref name="Herbert_2010">{{cite book |vauthors=Herbert JD, Forman EM |date=2010 |chapter=Cross-cultural perspectives on posttraumatic stress |title=Clinician's Guide to Posttraumatic Stress Disorder |pages=235–261 |doi=10.1002/9781118269961.ch10|isbn=978-0-470-45095-6 }}</ref>

In a similar review, Sudanese refugees relocated in Uganda were 'concerned with material [effects]' (lack of food, shelter, and healthcare), rather than psychological distress.<ref name="Herbert_2010" /> In this case, many refugees did not present symptoms at all, with a minor few developing anxiety and depression.<ref name="Herbert_2010" /> War-related stresses and traumas will be ingrained in the individual,<ref name="doi.org"/> however they will be affected differently from culture to culture, and the "clear-cut" rubric for diagnosing PTSD does not allow for culturally contextual reactions to take place.{{Citation needed|date=September 2022}}