Most research on persons subjected to physical torture for political reasons has framed this experience as traumatic, with the sequelae approximating the diagnostic criteria of posttraumatic stress disorder. However, responses to checklists, questionnaires, and structured interview schedules may reflect the effect of demand characteristics more than the actual concerns of respondents.
In the first phase of the study I conducted semistructured qualitative interviews with twenty South Africans who were detained for political reasons during the apartheid era. The interviews were transcribed and analysed with the assistance of the Atlas.ti 4.5 program. Results showed that the major concerns expressed by the sample were somatic problems, economic marginalization, nonclinical emotional distress, and dissatisfaction with the present political dispensation in South Africa. Respondents also expressed concerns that reflected symptoms of traumatization, but these were not salient in comparison with the other themes that emerged. The data suggests that a model of trauma and the diagnostic category of posttraumatic stress disorder may be less appropriate than suggested by most of the literature in accounting for the concerns of many South African former political detainees.
The data obtained from this study permits a critique of the hegemony of the psychiatric model of traumatization in conceptualizing the needs of this population, and suggests an alternate perspective that is broader and more inclusive than a psychiatric paradigm. It also discusses the research and possible clinical implications of the results in terms of addressing the needs of former detainees in South Africa.
The data obtained from this study permits a critique of the hegemony of the psychiatric model of traumatization in conceptualizing the needs of this population, and suggests an alternate perspective that is broader and more inclusive than a psychiatric paradigm.
In the second phase of the study the factor structure of former detainees’ current distress associated with having been abused in detention was determined. The qualitative interview data from Phase 1 of the study were used to form the items of the South African Former Detainees’ Distress Scale. In Stage 2 the scale was administered to 148 participants and these data were factor analyzed using principal components analysis with a varimax rotation. Four factors emerged from the analysis: Somatic Problems/ Discontent, Emotional Distress, Lack of Acknowledgement, and Despondency. These factors are discussed in the context of social developments in present day South Africa.
The data suggests that South African former detainees do not experience posttraumatic stress symptoms as a salient feature of their lives. Instead, their concerns are related to the somatic symptoms they continue to experience, the fact that they are not given appropriate recognition for their role in the anti-apartheid struggle by the South African government and society, and the fact that the majority of former detainees have remained poor and unemployed, despite the sacrifices they have made for the country. Psychiatric symptoms related to posttraumatic stress disorder appear to be of secondary concern to most participants.