Culture, traumatic stress and PTSD

Ideas about what is ‘normal’ or ‘expected’ behaviour evolve throughout history and vary in different cultures and geographical regions. As a result, the meaning and implications of mental disorder also vary across space and time. For example, in certain cultures, communicating with the spirits of ancestors is considered a sign of a divine connection and the gift of discernment, while in others, it may be considered abnormal, unacceptable and even pathological.

This contextual variation is also relevant for how psychological distress is interpreted and managed (Phillips, 2009). Distress can be defined as the transient and culturally sanctioned response to a specific stressor, which usually subsides as the stressor is removed or as the individual adapts to that stressor. However, if the experienced distress far exceeds what is culturally appropriate respective to the magnitude of the stressor, the distress may be perceived as pathological and as a symptom of a mental disorder.

Assessing the ‘normalcy’ and appropriateness of responses to stress is challenging, however, as it requires detailed information about the context and the local cultural norms. Clinical assessment and diagnostic tools are sometimes critiqued for their failure to consider the influence of environment, social context, cultural values and beliefs, class, race, and gender in how patient problems are experienced, communicated and addressed. As a result, the extent to which Western psychiatric assessment and diagnosis structures capture the experience, meaning and the impact of the distress in diverse individuals and communities has been questioned.

References

^{Phillips, M. R. (2009). Is distress a symptom of mental disorders, a marker of impairment, both or neither? World Psychiatry, 8(2), 91-92. Retrieved from https://pubmed.ncbi.nlm.nih.gov/19516930/}