Do South African Former Detainees Experience Post-Traumatic Stress? Circumventing the Demand Characteristics of Psychological Assessment

Abstract

Most research on persons subjected to physical or psychological torture for political reasons has framed this experience as traumatic, with the sequelae approximating the diagnostic criteria of post-traumatic stress disorder (PTSD). Yet, critiques of the trauma model have called attention to the fact that PTSD represents a Western conceptualization of the concerns of persons who have survived stressful experiences. In order to determine whether symptoms of traumatization are salient psychiatric phenomena for South African former detainees, semi-structured qualitative interviews were conducted with 20 respondents who were detained and tortured for political reasons during the apartheid era. Interviews were transcribed and analysed for thematic content using a grounded theory approach. Results showed that although the main concerns expressed were unrelated to traumatization, participants also indicated that they experienced symptoms of post-traumatic stress. These data suggest that although too great a focus on traumatic responses may be misplaced, it remains important to consider the possibility that former detainees may exhibit symptoms of this nature. Consequently, critiques of the trauma discourse as a Western phenomenon need to be tempered with evidence of the lived reality of psychological sequelae experienced by this population.

Keywords

political detainees post-traumatic stress disorder

Get full access to this article

View all access options for this article.

References

American Psychiatric Association . (2002). Diagnostic and statistical manual of mental disorders (4th ed., text revision: DSM-IV-TR). Washington, DC: American Psychiatric Association .

Bjorklund, D. F. , Cassel, W. S. , Bjorklund, B. R. , Brown, R. D. , Park, C. L. , Ernst, K. , & Owen, F. A. (2000). Social demand characteristics in children’s and adults’ eyewitness memory and suggestibility: The effect of different interviewers on free recall and recognition . Applied Cognitive Psychology, 14, 421–433 .

Bouwer, C. , & Stein, D. J. (1998). Survivors of torture presenting at an anxiety disorders clinic: Symptomatology and pharmacotherapy . Journal of Nervous and Mental Disease, 186, 316–318 .

Bracken, P. J. , Giller, J. E. , & Summerfield, D. (1995). Psychological responses to war and atrocity: The limitations of current concepts . Social Science & Medicine, 40, 1073–1082 .

Bulhan, H. A. (1985). Franz Fanon and the psychology of oppression. New York: Plenum Press .

Comer, R. J. (2000). Abnormal psychology (4th ed.). New York: Von Holtzbrinck .

De Jong, K. , Mulhern, M. , Ford, N. , Van der Kam, S. , & Kleber, R. (2000). The trauma of war in Sierra Leone . Lancet, 355, 2067–2068 .

Durrheim, K. (2002). Research design. In M. Terre Blanche & K. Durrheim (Eds.), Research in practice: Applied methods for the social sciences (pp. 29–53). Cape Town: University of Cape Town Press .

Foster, D. , Davis, D. , & Sandler, D. (1987). Detention and torture in South Africa: Psychological, legal and historical studies. New York: St. Martin’s Press .

10.

Kagee, A. (2004). Present concerns of survivors of human rights violations in South Africa. Social Science & Medicine, submitted.

11.

Kleinman, A. (1986). Social origins of distress and disease: Depression, neurasthenia, and pain in modern China. New Haven, CT: Yale University Press .

12.

Kleinman, A. (1987). Anthropology and psychiatry: The role of culture in cross cultural research on illness . British Journal of Psychiatry, 151, 447–454 .

13.

McFarlane, A. C. (1997). Post-traumatic stress disorder: The importance of clinical objectivity and systematic research . Medical Journal of Australia, 166, 88–90 .

14.

Pillay, B. J. (2000). Providing mental health services to survivors: A Kwa Zulu-Natal perspective . Ethnicity and Health, 5, 269–272 .

15.

Sarraj, E. E. , Punamaki, R. L. , Salmi, S. , & Summerfield, D. (1996). Experiences of torture and ill-treatmentand post-traumatic stress disorder symptoms among Palestinian political prisoners . Journal of Traumatic Stress, 9, 595–606 .

16.

Simpson, M. (1993). Traumatic stress and the bruising of the soul: The effects of torture and coercive interrogation. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes (pp. 667–684). New York: Plenum Press .

17.

Solomons, K. (1989). The dynamics of post-traumatic stress disorder in South African political detainees . American Journal of Psychotherapy, XLIII, 208–217 .

18.

Somnier, F. E. , & Genefke, I. K. (1986). Psychotherapy for victims of torture . British Journal of Psychiatry, 149, 323–329 .

19.

Strauss, A. L. (1987). Qualitative analysis for social sciences. New York: Cambridge University Press .

20.

Struwig, F. W. , & Stead, G. B. (2001). Planning, designing, and reporting research. Cape Town: Maskew Miller Longman .

21.

Summerfield, D. (1999). A critique of seven assumptions behind psychological trauma programmes in war-affected areas . Social Science & Medicine, 48, 1449–1462 .

22.

Summerfield, D. (2001). The invention of post-traumatic stress disorder and the social usefulness of a psychiatric category . Student British Medical Journal, 9, 61–64 .