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“Heroes' invisible wounds of war:” constructions of posttraumatic stress disorder in the text of US federal legislation

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  • Purtle, Jonathan

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.

Suggested Citation

  • Purtle, Jonathan, 2016. "“Heroes' invisible wounds of war:” constructions of posttraumatic stress disorder in the text of US federal legislation," Social Science & Medicine, Elsevier, vol. 149(C), pages 9-16.
    • Handle: RePEc:eee:socmed:v:149:y:2016:i:c:p:9-16
    DOI: 10.1016/j.socscimed.2015.11.039
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    References listed on IDEAS

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    3. Bracken, Patrick J., 2001. "Post-modernity and post-traumatic stress disorder," Social Science & Medicine, Elsevier, vol. 53(6), pages 733-743, September.
    4. Prigerson, H.G. & Maciejewski, P.K. & Rosenheck, R.A., 2002. "Population attributable fractions of psychiatric disorders and behavioral outcomes associated with combat exposure among US men," American Journal of Public Health, American Public Health Association, vol. 92(1), pages 59-63.
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    1. Denneson, Lauren M. & Tompkins, Kyla J. & McDonald, Katie L. & Hoffmire, Claire A. & Britton, Peter C. & Carlson, Kathleen F. & Smolenski, Derek J. & Dobscha, Steven K., 2020. "Gender differences in the development of suicidal behavior among United States military veterans: A national qualitative study," Social Science & Medicine, Elsevier, vol. 260(C).
    2. Lahav, Yael & Stein, Jacob Y. & Hasson, Rachel & Solomon, Zahava, 2020. "Impostorism, subjective age, and perceived health among aging veterans," Social Science & Medicine, Elsevier, vol. 258(C).

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