Fields of Combat: Understanding Post-Traumatic Stress Disorderamong Veterans of Iraq and Afghanistan 公开
Finley, Erin Patricia (2009)
Abstract
Abstract Fields of Combat: Understanding Post-Traumatic Stress Disorder among Veterans of Iraq and Afghanistan By Erin P. Finley Post-Traumatic Stress Disorder (PTSD) has received increasing attention as one of the "signature wounds" of the U.S. wars in Iraq and Afghanistan, with more than 75,000 returning veterans newly diagnosed since 2002. Epidemiological and clinical accounts of the disorder have struggled to understand how social and cultural factors may influence veterans' vulnerability to developing PTSD after combat exposure, while anthropological explorations of PTSD have told us little about the personal experience of PTSD, tending to focus instead on a critique of the diagnosis' status as an authoritative biomedical category. The present study addressed these gaps by using both ethnographic and epidemiologic methods to investigate how recent male veterans and their families understand and respond to post-deployment stress and PTSD. Findings consider veterans' experiences of post-deployment stress in the context of key social and cultural variables such as Mexican-American and Euro-American ethnicity, family relations and masculine gender roles, and amid wider understandings of PTSD in clinical and media accounts of the disorder. Living with a diagnosis of PTSD turns out to require navigating multiple and often contradictory fields of social meaning simultaneously, with implications for how veterans make decisions vital to their experience of illness - including coping strategies and efforts toward care-seeking and meaning-making. Retrospectively following veterans across a trajectory of cultural environments and life course events, this dissertation explores how social relations, political economy, and lay and professional notions of illness and gender help to shape veterans' vulnerability and resilience as they work to create post-war lives, often amid profound distress.
Table of Contents
Table of Contents Preface 1 Part I: The Journey Begins -- Personal Histories of Service and Stress Chapter One: Gearing Up 7 A Tradition of Service in San Antonio Chapter Two: War Stories 41 Case Studies of Combat Deployment Chapter Three: Home Again 86 Post-Deployment Stress, Changing Social Relations, and Risk Factors for PTSD Part II: Crisis and Response -- PTSD in Three Cultural Environments Chapter Four: Of Men and Messages 133 Ethnicity, Life Goals, and Family Support Chapter Five: Under Pressure 183 Military Socialization and Stigma Chapter Six: Embattled 222 The Clinic, Part I: The Politics of PTSD in VA Mental Health Care Chapter Seven: Center of the Storm 265 The Clinic, Part II: Therapeutic Interactions
Part III: Navigation -- Deriving a Path for Life and Illness Chapter Eight: Ambivalence 290 PTSD and Perspectives on Veterans in Contemporary America Chapter Nine: Maps 347 Social Experience and Illness Narratives in Treatment-Seeking and Recovery Chapter Ten: Conclusion 396 Recommendations for a Focus on Resilience Appendices i. Appendix A: Theoretical Underpinnings 428 ii. Appendix B: Glossary of Abbreviations 449 iii. Appendix C: List of Tables and Figures 451
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