Post-modernity and post-traumatic stress disorder.

The after effects of trauma have assumed a central role in the discourses of psychiatry and psychology in recent years. Most commentators have looked for an explanation of this explosion of interest in trauma, to developments within psychiatry and psychology. However, it is argued here that important cultural changes in the Western world have produced the conditions in which this interest has come about. The advent of post-modernity has witnessed an undermining of social stability and coherence and a systematic weakening of those cultural institutions which provide meaning and order for individuals. Following trauma, the development of the characteristic symptoms of post-traumatic stress disorder (PTSD) is currently understood to arise from a breakdown of meaning within the victim's world. I seek to establish an association between PTSD and the culture of post-modernity. I argue that this connection has important implications with regard to our understanding of the relationship between trauma and culture more generally.

The rehabilitation of child soldiers: defining needs and appropriate responses.

There is growing international concern that large numbers of children are being recruited to military forces in situations of conflict around the globe, despite the fact that there are principles established in international law specifically directed against the use of children as soldiers. It has been assumed that military experience will have negative psychological effects on children, and several projects aimed at the rehabilitation of such children have been developed. We have had opportunities to examine the situation of child soldiers in Uganda, Liberia and Sierra Leone. In this article we draw attention to some of the conceptual and practical problems involved in this rehabilitative work.

The rehabilitation of child soldiers: defining needs and appropriate responses

There is growing international concern that large numbers of children are being recruited to military forces in situations of conflict aroound the globe; desp[ite the fact that there are principles established in international law specifically directed aginst the use of children as soldiers. it has been assumed that military experience will have negative psychological effects on children; and several projects aimed at the rehabilitation of such children have been developed. We have had opportinities to examine the situation of child soldiers in Uganda; Liberia and Sierra leone. In this article we draw attention to some of the conceptual and practical probelms involved in this rehabilitative work

Psychological responses to war and atrocity: the limitations of current concepts.

Because of the prevalence of wars, political violence and other forms of man-made disaster in Third World countries many individuals and communities suffer prolonged and often multiple traumas. In Western psychiatry certain conceptions of the response to violence and trauma have been developed, including the widely used category of post-traumatic stress disorder (PTSD). We argue that because concepts such as PTSD implicitly endorse a Western ontology and value system, their use in non-Western groups should be, atmost, tentative.

Post-empiricism and psychiatry: meaning and methodology in cross-cultural research.

Methodological disputes in psychiatry have usually been framed in terms of a positivist-interpretivist paradigm conflict. While traditional cross-cultural psychiatry does indeed endorse a positivist medical model the author argues that a post-empiricist philosophy of science is best able to 'ground' the 'new' cross-cultural approach.

Helping victims of violence in Uganda.

We report on a project to assist victims of war and violence in Uganda. The original aim of this project, set up by the Medical Foundation for the Care of Victims of Torture, was to establish a centre for the assessment and treatment of torture victims who had suffered during previous regimes in that country. We found, however, that a specialist centre was not the most appropriate response in a country like Uganda. We argue for the need to respect local initiatives and systems of support and against the notion that there is a single model of care which is universally relevant. Following much investigation and involvement with local personnel, we have developed a programme of training and discussion for health workers, and a service to reach the many women who have suffered rape, and whose suffering has continued, largely ignored.

Helping victims of violence in Uganda

We report on a project to assist victims of war and violence in Uganda. The original aim of this project; set up by the Medical Foundation for the Care of Victims of Torture; was to establish a centre for the assessment and treatment of torture victims who had suffered during previous regimes in that country. We found; however; that a specialist centre was not the most appropriate response in a country like Uganda. We argue for the need to respect local initiatives and systems of support and against the notion that there is a single model of care which is universally relevant. Following much investigation and involvement with local personnel; we have developed a programme of training and discussion for health workers; and a service to reach the many women who have suffered rape; and whose suffering has continued; largely ignored

Helping victims of violence in Uganda

We report on a project to assist victims of war and violence in Uganda. The original aim of this project; set up by the Medical Foundation for the Care of Victims of Torture; was to establish a centre for the assessment and treatment of torture victims who had suffered during previous regimes in the country. We found; however; that a specialist centre was not the most appropriate response in a country like Uganda. We argue for the need to respect local initiatives and systems of support; this is against the notion that there is a single model of care which is universally relevant. Following much investigation and involvement with local personnel; we have developed a programme of training and discussion for health workers; and a service to reach the many women who ahve suffered rape; and whose suffering has continued largely ignored

Plasma levels of beta-endorphin in depressed patients with and without pain.

We studied 27 patients who complained of pain, for which no organic basis could be found, and 11 patients without pain. All patients were depressed according to clinical diagnosis and Beck Depression Inventory (BDI) scores. Plasma beta-endorphin levels were found not to differ between the two groups or across other variables. The patients who complained of pain had significantly higher scores on the BDI.