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

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

Jonathan Purtle
Social science & medicine (1982), v 149, pp 9-16
Jan 2016
PMID: 26689630

Abstract

Policy design theory Posttraumatic stress disorder Public policy Qualitative document analysis United States
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. •Public policies contribute to the social construction of mental health problems.•A qualitative content analysis of US federal PTSD legislation was conducted.•War-related language and imagery constructed PTSD as a military-specific problem.•Military-specific constructions of PTSD do not reflect the disorder's epidemiology.•Military-specific constructions could inhibit civilian access to PTSD treatment.

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Web of Science research areas
Public, Environmental & Occupational Health
Social Sciences, Biomedical
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