Competing Constructivisms: The Negotiation of PTSD and Related Stigma Among Post-9/11 Veterans in New York City
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Posttraumatic stress disorder (PTSD) stands as a form of psychopathology that straddles moral and psychiatric domains. Grounded in discrete instances of trauma, PTSD represents an etiological outlier in an era of increased attention to the genetics of mental illness and a prime location for social constructivist analyses of mental illness. This examination of PTSD narratives—as voiced in qualitative interviews and focus groups with 50 veterans of the recent Iraq and Afghanistan wars living in New York City—attends to the processes through which veterans conceive and navigate PTSD symptoms and diagnoses. In so doing we highlight the social constructivist positions undertaken by veterans themselves as they varyingly challenge and internalize symptomology in dialogue with psychiatric definitions and the stigma associated with PTSD. Findings demonstrate the rejection of classic psychopathological etiology—in brain disease, for example—by many veterans as well as the complex balancing of benefit and stigma that veterans undertake when making decisions about presenting to psychiatric clinicians. Drawing on veterans’ accounts, we argue for greater cultural specificity in characterizing the diagnosis-seeking behavior of trauma survivors and a greater appreciation for the contradictions and compromise related to both acceptance and rejection of a mental health diagnosis.
KeywordsPost-traumatic stress Social construction Military veterans
This research was supported by Grants from the National Institute on Alcohol Abuse and Alcoholism (NIAAA; R01 AA020178) and the National Institute on Drug Abuse (NIDA; R01 DA036754-01A1). Points of view expressed in this paper do not necessarily represent the official position of the U.S. Government, NIAAA, NIDA, or NDRI.
Compliance with Ethical Standards
Conflict of interest
None of the authors has received any research grants or other forms of funding or support other than those listed above. All four authors declare that they have no conflicts of interest.
This article does not contain any procedures with animals performed by any of the authors. All procedures performed involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study and all study.
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