"Heroes' invisible wounds of war:" constructions of posttraumatic stress disorder in the text of US federal legislation. (January 2016)

• Record Type: Journal Article
• Authors: Purtle, Jonathan
• Is Part Of: Social science & medicine. Volume 149(2016)
• Page Start: 9
• Page End: 16
• Publication Date: 2016-01
• Subjects: United States -- Posttraumatic stress disorder -- Policy design theory -- Qualitative document analysis -- Public policy; Social medicine -- Periodicals; Medical anthropology -- Periodicals; Public health -- Periodicals; Psychology -- Periodicals; Medicine -- Periodicals; Medicine -- Periodicals; Médecine sociale -- Périodiques; Anthropologie médicale -- Périodiques; Santé publique -- Périodiques; Psychologie -- Périodiques; Médecine -- Périodiques; Electronic journals; 362.105
• DOI: 10.1016/j.socscimed.2015.11.039
• Languages: English
• ISSNs: 0277-9536

Abstract

Abstract: Public policies contribute to the social construction of mental health problems. In this study, I use social constructivist theories of policy design and the methodology of ethnographic content analysis to qualitatively explore how posttraumatic stress disorder (PTSD) has been constructed as a problem in US federal legislation. I analyzed the text of 166 bills introduced between 1989 and 2009 and found that PTSD has been constructed as a problem unique to combat exposures and military populations. These constructions were produced through combat-related language and imagery (e.g., wounds, war, heroism), narratives describing PTSD as a military-specific phenomenon, and reinforced by the absence of PTSD in trauma-focused legislation targeting civilians. These constructions do not reflect the epidemiology of PTSD—the vast majority of people who develop the disorder have not experienced combat and many non-combat traumas (e.g., sexual assault) carry higher PTSD risk—and might constrain public and political discourse about the disorder and reify sociocultural barriers to the access of mental health services. Highlights: Public policies contribute to the social construction of mental health problems. A qualitative content analysis of US federal PTSD legislation was conducted. War-related language and imagery constructed PTSD as a military-specific problem. Military-specific constructions of PTSD do not reflect the disorder's epidemiology. Military-specific constructions could inhibit civilian access to PTSD treatment.