Skip to main content
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 3
  • Cited by
    This chapter has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Ferrández San Miguel, María 2018. Towards a Theoretical Approach to the Literature of Resilience. Orbis Litterarum, Vol. 73, Issue. 2, p. 146.

    周, 方方 2018. Trauma and Sociopolitical Context in Paul Auster’s Leviathan. World Literature Studies, Vol. 06, Issue. 03, p. 107.

    Hinton, Devon E. and Kirmayer, Laurence J. 2013. Local responses to trauma: Symptom, affect, and healing. Transcultural Psychiatry, Vol. 50, Issue. 5, p. 607.

  • Print publication year: 2007
  • Online publication date: July 2009

12 - Adaptation, Ecosocial Safety Signals, and the Trajectory of PTSD



In recent years, Western concepts of psychological trauma have come under increasing challenge, particularly from a transcultural perspective (see Silove, 1999a). The evolving critique is based on several loosely interrelated assertions (Summerfield, 1999): that the psychiatric category posttraumatic stress disorder (PTSD) has its roots in the historical and social imperatives of the 1970s when there was a need to vindicate and advocate for Vietnam combat veterans returning to a hostile public reception in the USA; that, in turn, the medicalization of PTSD spawned a self-sustaining and self-serving trauma counseling industry; and that the consequences, intentional or otherwise, have been to encourage a culture of victimization, compensation seeking, and unrealistic expectations. Concerns have been raised, in particular, about the proliferation of psychological debriefing after disasters, in spite of mounting evidence that indiscriminate interventions of that type may be ineffective, and in some cases injurious, to natural recovery (Raphael & Wilson, 2000). The added concern is that the professional appropriation of psychological trauma may undermine communal support mechanisms that traditionally provided comfort to survivors.

Such concerns are particularly relevant to conflict-affected countries that lack the resources and skills to apply best practice treatments for PTSD. Issues of feasibility and affordability make it impossible to offer best practice interventions (whether pharmacological or cognitive behavioral) on a mass scale to the large portion of trauma-affected populations meeting criteria for PTSD soon after major humanitarian disasters.

Recommend this book

Email your librarian or administrator to recommend adding this book to your organisation's collection.

Understanding Trauma
  • Online ISBN: 9780511500008
  • Book DOI:
Please enter your name
Please enter a valid email address
Who would you like to send this to *
Basoglu, M., Jaranson, J., Mollica, R., & Kastrup, M. (2001). Torture and mental health: A researcher overview. In Gerrity, E., Keane, T., & Tuma, F. (Eds.), The mental health consequences of torture (pp. 35–65). New York: Plenum.
Jong, J. T., & Komproe, I. H. (2002). Closing the gap between psychiatric epidemiology and mental health in post-conflict situations. Lancet, 359(9320), 1793–1794.
Jong, J. T., Komproe, I. H., VanOmmeren, M. Ommeren, M., ElMasri, M. Masri, M., Araya, M., Khaled, N., et al. (2001). Lifetime events and posttraumatic stress disorder in 4 postconflict settings. Journal of the American Medical Association, 286(5), 555–562.
Jong, K., Mulhern, M., Ford, N., Kam, S., & Kleber, R. (2000). The trauma of war in Sierra Leone. Lancet, 355(9220), 2067–2068.
Ekblad, S., & Jaranson, J. (2004). Psychosocial rehabilitation. In Wilson, J. & Drozdek, B. (Eds.), Broken spirits (pp. 609–636). New York: Brunner/Routledge.
Galletly, C., Clark, C. R., McFarlane, A. C., & Weber, D. L. (2001). Working memory in posttraumatic stress disorder – an event-related potential study. Journal of Traumatic Stress, 14(2), 295–309.
Modvig, J., Pagaduan-Lopez, J., Rodenburg, J., Salud, C. M., Cabigon, R. V., & Panelo, C. I. (2000). Torture and trauma in post-conflict East Timor. Lancet, 356(9243), 1763.
Mollica, R. F., Donelan, K., Tor, S., Lavelle, J., Elias, C., Frankel, M., et al. (1993). The effect of trauma and confinement on functional health and mental health status of Cambodians living in Thailand-Cambodia border camps. Journal of the American Medical Association, 270(5), 581–586.
Mollica, R. F., McInnes, K., Pham, T., SmithFawzi, M. C. Fawzi, M. C., Murphy, E., & Lin, L. (1998). The dose-effect relationships between torture and psychiatric symptoms in Vietnamese ex-political detainees and a comparison group. Journal of Nervous and Mental Disease, 186(9), 543–553.
Mollica, R. F., McInnes, K., Sarajlic, N., Lavelle, J., Sarajlic, I., & Massagli, M. P. (1999). Disability associated with psychiatric comorbidity and health status in Bosnian refugees living in Croatia. Journal of the American Medical Association, 282(5), 433–439.
Momartin, S., Silove, D., Manicavasagar, V., & Steel, Z. (2003). Dimensions of trauma associated with posttraumatic stress disorder (PTSD) caseness, severity and functional impairment: A study of Bosnian refugees resettled in Australia. Social Science & Medicine, 57(5), 775–781.
Momartin, S., Silove, D., Manicavasagar, V., & Steel, Z. (2004). Comorbidity of PTSD and depression: Associations with trauma exposure, symptom severity and functional impairment in Bosnian refugees resettled in Australia. Journal of Affective Disorders, 80(2–3), 231–238.
Raphael, B., & Wilson, J. (2000). Introduction and overview: Key issues in the conceptualization of debriefing. In Raphael, B. & Wilson, J. (Eds.), Psychological debriefing theory, practice and evidence (pp. 1–17). Cambridge, UK: Cambridge University Press.
Silove, D. (1998). Is posttraumatic stress disorder an overlearned survival response? An evolutionary-learning hypothesis. Psychiatry, 61(2), 181–190.
Silove, D. (1999a). The psychosocial effects of torture, mass human rights violations, and refugee trauma: Toward an integrated conceptual framework. Journal of Nervous and Mental Disease, 187(4), 200–207.
Silove, D. (1999b). Health and human rights of the East Timorese. Lancet, 353(9169), 2067.
Silove, D. (2002). The asylum debacle in Australia: A challenge for psychiatry. Australian and New Zealand Journal of Psychiatry, 36(3), 290–296.
Silove, D. (2004). The global challenge of asylum. In Wilson, J. P. & Drozdek, B. (Eds.), Broken spirits (pp. 13–32). New York: Brunner-Routledge.
Silove, D., Coello, M., Tang, K., Aroche, J., Soares, M., Lingam, R., et al. (2002). Towards a researcher-advocacy model for asylum seekers: A pilot study amongst East Timorese living in Australia. Transcultural Psychiatry, 39(4), 452–468.
Silove, D., Ekblad, S., & Mollica, R. (2000). The rights of the severely mentally ill in post-conflict societies. Lancet, 355(9214), 1548–1549.
Silove, D., Manicavasagar, V., Baker, K., Mausiri, M., Soares, M., Carvalho, F., et al. (2004). Indices of social risk among first attenders of an emergency mental health service in post-conflict East Timor: An exploratory investigation. Australian and New Zealand Journal of Psychiatry, 38(11–12), 929–932.
Silove, D., Sinnerbrink, I., Field, A., Manicavasagar, V., & Steel, Z. (1997). Anxiety, depression and PTSD in asylum-seekers: Associations with pre-migration trauma and post-migration stressors. British Journal of Psychiatry, 170, 351–357.
Silove, D., Steel, Z., & Watters, C. (2000). Policies of deterrence and the mental health of asylum seekers. Journal of the American Medical Association, 284(5), 604–611.
Steel, Z., Momartin, S., Bateman, C., Hafshejani, A., Silove, D. M., Everson, N., et al. (2004). Psychiatric status of asylum seeker families held for a protracted period in a remote detention centre in Australia. Australian and New Zealand Journal of Public Health, 28(6), 527–536.
Steel, Z., Silove, D., Phan, T., & Bauman, A. (2002). Long-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: A population-based study. Lancet, 360(9339), 1056–1062.
Summerfield, D. (1999). A critique of seven assumptions behind psychological trauma programmes in war-affected areas. Social Science & Medicine, 48(10), 1449–1462.
Turner, S. W., Bowie, C., Dunn, G., Shapo, L., & Yule, W. (2003). Mental health of Kosovan Albanian refugees in the UK. British Journal of Psychiatry, 182, 444–448.
Yehuda, R. (2002). Post-traumatic stress disorder. New England Journal of Medicine, 346(2), 108–114.
Zwi, A. B., & Silove, D. (2002). Hearing the voices: Mental health services in East Timor. Lancet, 360(Suppl.), s45–46.