Beyond Trauma‐Focused Psychiatric Epidemiology: Bridging Research and Practice With War‐Affected Populations

American Journal of Orthopsychiatry (Impact Factor: 1.6). 09/2006; 76(4):409 - 422. DOI: 10.1037/0002-9432.76.4.409
Source: PubMed

ABSTRACT This article examines the centrality of trauma-focused psychiatric epidemiology (TFPE) in research with war-affected populations. The authors question the utility of the dominant focus on posttraumatic stress disorder and other disorders of Western psychiatry, and they identify a set of critical research foci related to mental health work with communities affected by political violence. Core assumptions of TFPE and its roots in logical positivism and the biomedical model of contemporary psychiatry are explored. The authors suggest that an alternative framework—social constructivism—can serve as a bridge between researchers and practitioners by helping to refocus research efforts in ways that are conceptually and methodologically more attuned to the needs of war-affected communities and those working to address their mental health needs.

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    ABSTRACT: Introduction Political violence is a global phenomenon, especially in low- to middle-income countries. This phenomenon increasingly involves civilians. This situation is a priority in collective health, as it produces multiple and complex effects on physical and mental health, and human and social ecosystems. The objective of this article is to present the main tendencies that coexist in research and practice on the understanding of the effects of political violence on mental health. The biomedical approach of psychiatric trauma and the wider perspective of social sciences, which incorporate the collective dimension of these effects, are also taken into account. Methods Review of research determines the relationship with political violence / collective violence and mental health in international databases and national documentation centers, academics and NGOs within the last decade of the twentieth century, and the first of this century under the headings of trauma, war, armed conflict and political violence. Results The limitations of general explanations of psychiatric trauma in understanding the complex effects of political violence on mental health are shown. The constructs that incorporate social and collective dimensions increase this comprehension of these effects and knowledge of mental health, both conceptually as methodologically. Conclusions In a political violence context it urgent to change attitudes about mental health. It is a way to overcome the biomedical, individualistic, and short term epidemiology, and to remove medication from mental health. This means acknowledging that people who experience the effects of political violence effects are not sick. They are powerful people who can transform and produce the life they dream of.
    Revista Colombiana de Psiquiatría. 09/2013; 42(3):276–282.
  • Source
    The Lancet Global Health. 05/2014; 2(5):e249–e250.

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May 16, 2014