Skip to main content

The Effects of Societal Violence in War and Post-War Contexts

  • Chapter
  • First Online:
The Palgrave Handbook of Sociocultural Perspectives on Global Mental Health

Abstract

Violent conflict can have devastating and lasting consequences for mental as well as physical health. Posttrauma interventions have been a key focus of the global mental health movement, but have also given rise to an extensive body of literature criticizing the inappropriate transfer of Western psychological assumptions to contexts where they may not be meaningful. This chapter focuses on what has emerged from this debate and argues for building a richer cross-cultural understanding of mental disorder in war and post-war situations by paying attention to the complex interrelations of trauma-focused pathways, psychosocial pathways, and local expressions of distress.

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Chapter
USD 29.95
Price excludes VAT (USA)
  • Available as PDF
  • Read on any device
  • Instant download
  • Own it forever
eBook
USD 299.00
Price excludes VAT (USA)
  • Available as EPUB and PDF
  • Read on any device
  • Instant download
  • Own it forever
Hardcover Book
USD 379.99
Price excludes VAT (USA)
  • Durable hardcover edition
  • Dispatched in 3 to 5 business days
  • Free shipping worldwide - see info

Tax calculation will be finalised at checkout

Purchases are for personal use only

Institutional subscriptions

Similar content being viewed by others

References

  • Abramowitz, S. A. (2010). Trauma and humanitarian translation in Liberia: The tale of open mole. Culture, Medicine and Psychiatry, 34(2), 353–379.

    Article  PubMed  Google Scholar 

  • Almedom, A. M., & Summerfield, D. (2004). Mental well-being in settings of “complex emergency”: An overview. Journal of Biosocial Science, 36(4), 381–388.

    Article  PubMed  Google Scholar 

  • APA. (2013). The diagnostic and statistical manual of mental disorders: DSM-5. Washington: American Psychiatric Association.

    Google Scholar 

  • Atlani, L., & Rousseau, C. (2000). The politics of culture in humanitarian aid to women refugees who have experienced sexual violence. Transcultural Psychiatry, 37(3), 435–449.

    Article  Google Scholar 

  • Banatvala, N., & Zwi, A. B. (2000). Conflict and health: Public health and humanitarian interventions: Developing the evidence base. BMJ: British Medical Journal, 321(7253), 101.

    Article  PubMed  PubMed Central  Google Scholar 

  • Barber, B. (2008). Contrasting portraits of war: Youths’ varied experiences with political violence in Bosnia and Palestine. International Journal of Behavioral Development, 32(4), 298–309.

    Article  Google Scholar 

  • Beiser, M., Turner, R. J., & Ganesan, S. (1989). Catastrophic stress and factors affecting its consequences among Southeast Asian refugees. Social Science and Medicine, 28(3), 183–195.

    Article  PubMed  Google Scholar 

  • Bemme, D., & D’souza, N. (2014). Global mental health and its discontents: An inquiry into the making of global and local scale. Transcultural Psychiatry, 51(6), 850–874.

    Article  PubMed  Google Scholar 

  • Biehl, J., & Locke, P. (2010). Deleuze and the anthropology of becoming. Current Anthropology, 51(3), 317–351.

    Article  Google Scholar 

  • Boehnlein, J. K. (2001). Cultural interpretations of physiological processes in post-traumatic stress disorder and panic disorder. Transcultural Psychiatry, 38(4), 461–467.

    Article  Google Scholar 

  • Collins, P. Y., et al. (2011). Grand challenges in global mental health. Nature, 475(7354), 27–30.

    Article  PubMed  PubMed Central  Google Scholar 

  • Commission of the Social Determinants of Health. (2008). Closing the gap in a generation: Health equity through action on the social determinants of health: Final report of the commission on social determinants of health. Geneva: WHO.

    Google Scholar 

  • Das, V. (1996). Language and body: Transactions in the construction of pain. Daedalus, 125, 67–91.

    Google Scholar 

  • Das, V. (2007). Life and words: Violence and the descent into the ordinary. Berkely: University of California Press.

    Google Scholar 

  • Das, V., & Kleinman, A. (2000). Introduction. In V. Das (Ed.), Violence and subjectivity (pp. 1–18). Berkeley: University of California Press.

    Google Scholar 

  • Davis, D. L., & Joakimsen, L. M. (1997). Nerves as status and nerves as stigma: Idioms of distress and social action in Newfoundland and Northern Norway. Qualitative Health Research, 7(3), 370–390.

    Article  Google Scholar 

  • De Jong, J., Komproe, I., & Van Ommeren, M. (2003) Common mental disorders in postconflict settings. Lancet, 361(9375), 2128–2130.

    Google Scholar 

  • De Jong, K., Kleber, R. J., & Puratic, V. (2003). Mental Health Programs in areas of armed conflict: The Médecins Sans Frontières counselling centers in Bosnia-Hercegovina. Intervention, 1, 14–32.

    Google Scholar 

  • Demyttenaere, K., et al. (2004). Prevalence, severity, and unmet need for treatment of mental disorders in the World Health Organization World Mental Health Surveys. Journal of the American Medical Association, 291(21), 2581–90.

    Google Scholar 

  • Desjarlais, R., Eisenberg, L., Good, B., & Kleinman, A. (1995). World mental health: Problems and priorities in low-income countries. Oxford University Press.

    Google Scholar 

  • Desjarlais, R., & Kleinman, A. (1997). Violence and well-being. Social Science and Medicine, 45(8), 1143–1145.

    Article  PubMed  Google Scholar 

  • Eggerman, M., & Panter-Brick, C. (2010). Suffering, hope, and entrapment: Resilience and cultural values in Afghanistan. Social Science and Medicine, 71(1), 71–83.

    Article  PubMed  PubMed Central  Google Scholar 

  • Farhood, L., Zurayk, H., Chaya, M., Saadeh, F., Meshefedjian, G., & Sidani, T. (1993). The impact of war on the physical and mental health of the family: The Lebanese experience. Social Science and Medicine, 36(12), 1555–1567.

    Google Scholar 

  • Farmer, P., (2004). An anthropology of structural violence. Current Anthropology, 45(3), 305–325.

    Article  Google Scholar 

  • Fassin, D., & Rechtman, R. (2009). The empire of trauma: An inquiry into the condition of victimhood. Princeton: Princeton University Press.

    Google Scholar 

  • Feldman, A. (1995). Ethnographic states of emergency. In C. Nordstrom & A. Robben (Eds.), Fieldwork under fire: Contemporary studies of violence and survival (pp. 224–252). Berkeley: University of California Press.

    Google Scholar 

  • Galtung, J. (1985). Twenty-five years of peace research: Ten challenges and some responses. Journal of Peace Research, 22(2), 141–158.

    Article  Google Scholar 

  • Good, B. J. (1977). The heart of what’s the matter. The semantics of illness in Iran. Culture, Medicine and Psychiatry, 1(1), 25–58.

    Article  PubMed  Google Scholar 

  • Hagengimana, A., & Hinton, D. (2009). Ihahamuka, a Rwandan syndrome of response to the genocide: Blocked flow, spirit assault, and shortness of breath. In D. E. Hinton & B. J. Good (Eds.), Culture and panic disorder (pp. 205–229). Stanford: Stanford University Press.

    Google Scholar 

  • Hautzinger, S., & Scandlyn, J. (2014). Beyond post-traumatic stress: Homefront struggles with the wars on terror. Walnut Creek: Left Coast Press.

    Google Scholar 

  • Henry, D. (2006). Violence and the body: Somatic expressions of trauma and vulnerability during war. Medical Anthropology Quarterly, 20(3), 379–398.

    Article  PubMed  Google Scholar 

  • Hinton, D. E., & Lewis-Fernández, R. (2010). Idioms of distress among trauma survivors: Subtypes and clinical utility. Culture, Medicine and Psychiatry, 34(2), 209–218.

    Article  PubMed  Google Scholar 

  • Hinton, D. E., Pich, V., Marques, L., Nickerson, A., & Pollack, M. H. (2010). Khyâl attacks: A key idiom of distress among traumatized Cambodia refugees. Culture, Medicine and Psychiatry, 34(2), 244–278.

    Article  PubMed  Google Scholar 

  • Hollifield, M., et al. (2002). Measuring trauma and health status in refugees: A critical review. JAMA, 288(5), 611–621.

    Article  PubMed  Google Scholar 

  • James, E. C. (2010). Democratic insecurities: Violence, trauma, and intervention in Haiti. Berkeley: University of California Press.

    Google Scholar 

  • Jenkins, J. H. (1998). The medical anthropology of political violence: A cultural and feminist agenda. Medical Anthropology Quarterly, 12(1), 122–131.

    Article  PubMed  Google Scholar 

  • Kienzler, H. (2008). Debating war-trauma and PTSD in an interdisciplinary arena. Social Science & Medicine, 67(2), 218–227

    Google Scholar 

  • Kienzler, H. (2010). The differential impact of war and trauma on Kosovar Albanian women living in post-war Kosova. Canada: McGill University.

    Google Scholar 

  • Kienzler, H. (2012). The social life of psychiatric practice: Trauma in postwar Kosova. Medical Anthropology, 31(3), 266–282.

    Article  PubMed  Google Scholar 

  • Kienzler, H., & Pedersen, D. (2012). Strange but common bedfellows: The relationship between humanitarians and the military in developing psychosocial interventions for civilian populations affected by armed conflict. Transcultural Psychiatry, 49(3-4), 492–518.

    Article  PubMed  Google Scholar 

  • Kleinman, A. (1997). Writing at the margin: Discourse between anthropology and medicine. Berkeley: University of California Press.

    Book  Google Scholar 

  • Kleinman, A., Das, V., & Lock, M. M. (1997). Social suffering. Berkeley: University of California Press.

    Google Scholar 

  • Lock, M. (1993). Cultivating the body: Anthropology and epistemologies of bodily practice and knowledge. Annual Review of Anthropology, 22, 133–155.

    Article  Google Scholar 

  • Locke, P. A. (2009). City of survivors trauma, grief, and getting by in post-war Sarajevo. Princeton University Press: Princeton.

    Google Scholar 

  • Locke, P. (2012). Appropriating trauma: Legacies of humanitarian psychiatry in postwar Bosnia-Herzegovina. Intergraph: Journal of Dialogic Anthropology, 3(2).

    Google Scholar 

  • Lopez, S. R., & Guarnaccia, P. J. (2000). Cultural psychopathology: Uncovering the social world of mental illness. Annual Review of Psychology, 51(1), 571–598.

    Article  PubMed  Google Scholar 

  • Lyons, J. A. (1991). Strategies for assessing the potential for positive adjustment following trauma. Journal of Traumatic Stress, 3, 93–111.

    Article  Google Scholar 

  • McNally, R.J. (2003). Progress and controversy in the study of posttraumatic stress disorder. Annual Review of Psychology, 54, 229–252

    Google Scholar 

  • Miller, K. E., & Rasmussen, A. (2010). War exposure, daily stressors, and mental health in conflict and post-conflict settings: Bridging the divide between trauma-focused and psychosocial frameworks. Social Science & Medicine, 70(1), 7–16.

    Article  Google Scholar 

  • Neuner, F., et al. (2004). Psychological trauma and evidence for enhanced vulnerability for posttraumatic stress disorder through previous trauma among West Nile refugees. BMC Psychiatry, 4(1), 34.

    Article  PubMed  PubMed Central  Google Scholar 

  • Nichter, M. (1981). Idioms of distress: Alternatives in the expression of psychosocial distress. A case from south India. Culture, Medicine and Psychiatry, 5, 379–408.

    Article  PubMed  Google Scholar 

  • Nichter, M. (2010). Idioms of distress revisited. Culture, Medicine and Psychiatry, 34(2), 401–416.

    Article  PubMed  Google Scholar 

  • Nordstrom, C. (2004). The tomorrow of violence. In N. Whitehead (Ed.), Violence (pp. 223–242). Santa Fe: School of American Research Press.

    Google Scholar 

  • Olujic, M. B. (1998). Embodiment of terror: Gendered violence in peacetime and wartime in Croatia and Bosnia-Herzegovina. Medical Anthropology Quarterly, 12(1), 31–50.

    Article  PubMed  Google Scholar 

  • Panter-Brick, C., et al. (2011). Mental health and childhood adversities: A longitudinal study in Kabul, Afghanistan. Journal of the American Academy of Child and Adolescent Psychiatry, 50(4), 349–363.

    Article  PubMed  PubMed Central  Google Scholar 

  • Patel, V., Boyce, N., Collins, P.Y., Saxena, S., & Horton, R. (2011). A renewed agenda for global mental health. The Lancet, 378(9801), 1441–1442.

    Google Scholar 

  • Paton, D., & Violanti, J. (2006). Vulnerability to traumatic stress: Personal, organisational and contextual influences. In J. Violanti & D. Paton (Eds.), Who gets PTSD? Issues of posttraumatic stress vulnerability. Springfield: Charles C. Thomas Publisher, LTD.

    Google Scholar 

  • Pedersen, D. (2002). Political violence, ethnic conflict, and contemporary wars: Broad implications for health and social wellbeing. Social Science and Medicine, 55(2), 175–190.

    Article  PubMed  Google Scholar 

  • Pedersen, D., & Kienzler, H. (2015). Exploring pathways of distress and mental disorders: The case of the highland Quechua populations in the Peruvian Andes. In D. Hinton & B. Good (Eds.), Culture and PTSD: trauma in global and historical perspective (pp. 240–274). Philadelphia: University of Pennsylvania Press.

    Google Scholar 

  • Pedersen, D., Kienzler, H., & Gamarra, J. (2010). Llaki and nakary: Idioms of distress and suffering among the highland Quechua in the Peruvian Andes. Culture, Medicine and Psychiatry, 34(2), 279–300.

    Article  PubMed  Google Scholar 

  • Redfield, P. (2013). Life in crisis: The ethical journey of doctors without borders. Berkeley: University of California Press.

    Google Scholar 

  • Rousseau, C., Drapeau, A., & Rahimi, S. (2003). The complexity of trauma response: A 4-year follow-up of adolescent Cambodian refugees. Child Abuse & Neglect, 27(11), 1277–1290.

    Article  Google Scholar 

  • Sapkota, R. P., Gurung, D., Neupane, D., Shah, S.K., Kienzler, H., & Kirmayer, L.J. (2014). A village possessed by “witches”: A mixed-methods case–Control study of possession and common mental disorders in rural Nepal. Culture, Medicine and Psychiatry, 38(4), 642–668.

    Google Scholar 

  • Summerfield, D. (1999). A critique of seven assumptions behind psychological trauma programmes in war-affected areas. Social Science and Medicine, 48(10), 1449–1462.

    Article  PubMed  Google Scholar 

  • Taylor, C.C. (2002). The Cultural Face of Terror in the Rwandan Genocide. In A.L. Hinton (Ed.), Annihilating Difference: The Anthropology of Genocide (pp.137–178). Berkeley: University of California Press.

    Google Scholar 

  • Tol, W. A., Kohrt, B., Jordans, M., Thapa, S., Pettigrew, J., Upadhaya, N., & De Jong, J. (2010). Political violence and mental health: A multi-disciplinary review of the literature on Nepal. Social Science & Medicine, 70(1), 35–44.

    Google Scholar 

  • Tol, W. A., Barbui, C., Galappatti, A., Silove, D., Betancourt, T., Souza, R., Golaz, A., & Van Ommeren, M. (2011). Mental health and psychosocial support in humanitarian settings: Linking practice and research. The Lancet, 378(9802), 1581–1591.

    Google Scholar 

  • Tousignant, M., Habimana, E., Biron, C., Malo, C., Sidoli-LeBlanc, E., & Bendris, N. (1999). The Quebec Adolescent Refugee Project: Psychopathology and family variables in a sample from 35 nations. Journal of the American Academy of Child and Adolescent Psychiatry, 38(11), 1426–1432.

    Google Scholar 

  • Turpin, J. (1998). Many faces: Women confronting war. In A. Lorentzen & J. Turpin (Eds.), The women and war reader. New York: New York University Press.

    Google Scholar 

  • Ungar, M. (2011). Community resilience for youth and families: Facilitative physical and social capital in contexts of adversity. Children and Youth Services Review, 33(9), 1742–1748.

    Article  Google Scholar 

  • Ventevogel, P., Jordans, M., Reis, R., & De Jong, J. (2013). Madness or sadness? Local concepts of mental illness in four conflict-affected African communities. Conflict and Health, 7(3), 1–16.

    Google Scholar 

  • Ware, N. C., & Kleinman, A. (1992). Culture and somatic experience: The social course of illness in neurasthenia and chronic fatigue syndrome. Psychosomatic Medicine, 54(5), 546–560.

    Article  PubMed  Google Scholar 

  • Whitehead, N. L. (2004). Introduction: Cultures, conflicts, and the poetics of violent practice. In N. Whitehead (Ed.), Violence (pp. 25–54). Santa Fe: School of American Research Press.

    Google Scholar 

  • Wilkinson, R. G. (1996). Unhealthy societies: From inequality to well-being. Psychology Press.

    Google Scholar 

  • World Health Organization. (2003). Mental health in emergencies. Mental health and social aspects of health of populations exposed to extreme stressors. Geneva: WHO.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Editor information

Editors and Affiliations

Copyright information

© 2017 The Author(s)

About this chapter

Cite this chapter

Kienzler, H., Locke, P. (2017). The Effects of Societal Violence in War and Post-War Contexts. In: White, R., Jain, S., Orr, D., Read, U. (eds) The Palgrave Handbook of Sociocultural Perspectives on Global Mental Health. Palgrave Macmillan, London. https://doi.org/10.1057/978-1-137-39510-8_14

Download citation

Publish with us

Policies and ethics