Forensic mental health evaluations in the Guantánamo military commissions system: An analysis of all detainee cases from inception to 2018.

Even though the Bush Administration opened the Guantánamo Bay detention facility in 2002 in response to the September 11, 2001 attacks in the United States, little remains known about how forensic mental health evaluations relate to the process of detainees who are charged before military commissions. This article discusses the laws governing Guantánamo's military commissions system and mental health evaluations. Notably, the US government initially treated detainees as "unlawful enemy combatants" who were not protected under the US Constitution and the United Nations Convention Against Torture and Other Forms of Cruel, Inhuman or Degrading Treatment, allowing for the use of "enhanced interrogation techniques." In subsequent legal documents, however, the US government has excluded evidence obtained through torture, as defined by the US Constitution and the United Nations Convention Against Torture. Using open-source document analysis, this article describes the reasons and outcomes of all forensic mental health evaluations from Guantánamo's opening to 2018. Only thirty of 779 detainees (~3.85%) have ever had charges referred against them to the military commissions, and only nine detainees (~1.16%) have ever received forensic mental health evaluations pertaining to their case. Of these nine detainees, six have alleged mental torture while in US custody. This paper shows that leaders in the United States and Europe should consider whether counterterrorism policies that supersede traditional health and human rights complicate the ability of future governments to prosecute cases when successive leaders change laws, a pertinent consideration as North American and European states grapple with the return of foreign fighters.

Deliberate Rumination and Positive Reappraisal as Serial Mediators Between Life Impact and Posttraumatic Growth in Victims of State Terrorism in Chile (1973-1990).

This study examines the role of coping strategies related to positive reappraisal versus other cognitive strategies (deliberate rumination) as mediators between life impact and posttraumatic growth in survivors of the military dictatorship in Chile between 1973 and 1990 (tortured political prisoners and family members of political prisoners executed and missing). Survey data from 251 political violence survivors were analyzed using the SPSS PROCESS macro for bootstrapping indirect effects (Hayes, 2013). Results indicated that positive reappraisal (or reframing) coping mediated the relationship between life impact and posttraumatic growth. A serial multiple mediation model indicates that in the life impact to growth moderation process, rumination must be followed by positive reappraisal to drive this growth. These findings suggest that positive reappraisal of the traumatic experience is essential to achieve growth reports. Implications of these more complex relations are discussed for both counseling interventions and further research.

Trauma and Contemporary Forms of Subjectivity: Contributions of Argentine Psychoanalysis.

This paper offers arguments to justify the relevance of psychoanalysis-psychoanalyses-in present-day Argentina and reflects on the stance taken by psychoanalysts with different theoretical perspectives in the face of the havoc wreaked by state terror (1976-1983). To this end, the author focuses on the pioneers' traits, the significance of the Argentine Psychoanalytic Association in the 1950s and 1960s, and the impact of the departure of the Plataforma Group in 1971. The establishment of the latter opened the way for the development of a psychoanalysis tied to popular movements, sensitive to social conflict, and close to human rights organizations. The author explores both on psychoanalysts' intervention to address the social trauma resulting from the theft of babies during the dictatorship, and on their relationship with Grandmothers of Plaza de Mayo.

Construção do inimigo após o 11 de setembro: os efeitos da identidade do agressor na representação do terrorismo / Construcción del enemigo después del 11 de setiembre: los efectos de la indentidad del agresor en la representación del terrorismo / Enemy construction after 9/11: aggressor identity effect on the representation of terrorism

At the time of the research, there were daily reports in the media regarding terrorist acts. What is it that indeed characterizes an act as being a terrorist one? From a psychosocial perspective, an ambiguous notion of terrorism may legitimate the ingroup/outgroup differentiation that affects intergroup relations. The aim of this research is to understand what people refer to when they talk about terrorism and to study the influence of different variables on the interpretation of some actions such as war or terrorism acts. Results on a sample of 251 University students confirm that the basic criterion for the evaluation of the actions is founded upon the distinction between military or civilian targets (i.e. target effect). However, some subjects use also a criterion based on the aggressor's ethnic-cultural identity (i.e. actor effect).

No momento da pesquisa, haviam registros diários na mídia sobre ações terroristas. O que de fato caracteriza um ato como sendo terrorista? A partir de uma perspectiva psicossocial, uma noção ambígua de terrorismo pode legitimar a diferenciação de pertencimento ou não ao grupo, que afeta as relações intergrupais. O objetivo dessa pesquisa é entender ao que as pessoas se referem quando falam sobre terrorismo e estudar a influência das diferentes variáveis na interpretação de algumas ações como guerras ou atos terroristas. Resultados de uma amostra de 251 estudantes universitários confirmam que o critério básico para a avaliação destes atos é encontrado na distinção entre alvos civis ou militares (efeito alvo). No entanto, alguns participantes também usaram um critério baseado na identidade étnicacultural do agressor (efeito ator).

n el momento de la investigación, había registros diarios en la prensa sobre acciones terroristas. ¿Lo que de echo caracteriza a un acto como terrorista? A partir de una perspectiva psicosocial, una noción ambigua de terrorismo puede legitimar la diferenciación de pertenecimiento o no al grupo, que afecta a las relaciones intergrupales. El objetivo de esa investigación es entender a lo que las personas se refieren cuando hablan sobre terrorismo y estudiar a la influencia de las diferentes variables en la interpretación de algunas acciones cómo guerras ó actos terroristas. Resultados de una muestra de 251 estudiantes universitarios confirman que lo criterio básico para la evaluación de estos actos es encontrado en la distinción entre dianas civiles o militares (efecto diana). Todavía, algunos participantes también utilizaran un criterio basado en la identidad étnica-cultural del agresor (efecto actor).

Enemy construction after 9/11: aggressor identity effect on the representation of terrorism / Construção do inimigo após o 11 de setembro: os efeitos da identidade do agressor na representação do terrorismo / Construcción del enemigo después del 11 de setiembre: los efectos de la indentidad del agresor en la representación del terrorismo

At the time of the research, there were daily reports in the media regarding terrorist acts. What is it that indeed characterizes an act as being a terrorist one? From a psychosocial perspective, an ambiguous notion of terrorism may legitimate the ingroup/outgroup differentiation that affects intergroup relations. The aim of this research is to understand what people refer to when they talk about terrorism and to study the influence of different variables on the interpretation of some actions such as war or terrorism acts. Results on a sample of 251 University students confirm that the basic criterion for the evaluation of the actions is founded upon the distinction between military or civilian targets (i.e. target effect). However, some subjects use also a criterion based on the aggressor’s ethnic-cultural identity (i.e. actor effect).(AU)

No momento da pesquisa, haviam registros diários na mídia sobre ações terroristas. O que de fato caracteriza um ato como sendo terrorista? A partir de uma perspectiva psicossocial, uma noção ambígua de terrorismo pode legitimar a diferenciação de pertencimento ou não ao grupo, que afeta as relações intergrupais. O objetivo dessa pesquisa é entender ao que as pessoas se referem quando falam sobre terrorismo e estudar a influência das diferentes variáveis na interpretação de algumas ações como guerras ou atos terroristas. Resultados de uma amostra de 251 estudantes universitários confirmam que o critério básico para a avaliação destes atos é encontrado na distinção entre alvos civis ou militares (efeito alvo). No entanto, alguns participantes também usaram um critério baseado na identidade étnicacultural do agressor (efeito ator).(AU)

En el momento de la investigación, había registros diarios en la prensa sobre acciones terroristas. ¿Lo que de echo caracteriza a un acto como terrorista? A partir de una perspectiva psicosocial, una noción ambigua de terrorismo puede legitimar la diferenciación de pertenecimiento o no al grupo, que afecta a las relaciones intergrupales. El objetivo de esa investigación es entender a lo que las personas se refieren cuando hablan sobre terrorismo y estudiar a la influencia de las diferentes variables en la interpretación de algunas acciones cómo guerras ó actos terroristas. Resultados de una muestra de 251 estudiantes universitarios confirman que lo criterio básico para la evaluación de estos actos es encontrado en la distinción entre dianas civiles o militares (efecto diana). Todavía, algunos participantes también utilizaran un criterio basado en la identidad étnica-cultural del agresor (efecto actor).(AU)

Las farc-ep: degradación de la lucha / Are farc-ep a degradation of fight

El presente artículo presenta resultados de una investigación que busca brindar elementos que den cuenta de la validez o sustento y justificación del apelativo de Terrrorista al grupo aramado de las FARC – EP. grupo insurgente alzado en Armas en Colombia y protagonista del conflicto interno en Colombia ya hace más de 45 años No solo es importante ver cuál es el contexto en el que surgen estos calificativos, sino sentar las bases para un estudio riguroso del caso apoyándose en datos que confirmen las tesis aquí planteadas.

This article presents the research results whose aim is to provide elements that report the validity or the support and the justification of the nickname of Terrorist to the FARC - EP group. It is an armed insurgent group in Colombia and main figure of the internal conflict in Colombia for more than 45 years. Not only is it important to see the context in which these nicknames appear, but also to lay the foundations for a rigorous analysis of the case by relying on the data that confirm the theses raised in this study.

Indicios de persuasión coercitiva en el adoctrinamiento de terroristas yihadistas: hacia la radicalización violenta / Evidences of persuasion coercive for indoctrination of jihadists terrorists: towards violent radicalization

En este trabajo se evalúan dos procesos de manipulación psicológica para el adoctrinamiento y la radicalización violenta de un grupo de terroristas yihadistas en España, la persuasión coercitiva y el abuso psicológico grupal. Para ello se ha utilizado la documentación contrastada de una sentencia judicial de la Audiencia Nacional española, sobre los atestados de la “Operación NOVA I, II y III”, la cual permite un análisis fiable de los posibles procesos de manipulación psicológica que se hayan podido aplicar, sobre los miembros de dicho grupo. Se ha analizado la interacción individuo-grupo, las dinámicas grupales generadas, los procesos de interiorización de la ideología extremista violenta y el rol del líder o ideólogo. Los resultados muestran evidencias de la aplicación de procedimientos de reforma de pensamiento, sobre los miembros del mencionado grupo terrorista.

This work analyzes two processes of psychological manipulation for indoctrination and violent radicalization of jihadist terrorists in Spain: coercive persuasion and psychological group abuse. This research is based on the trustworthy information used in findings of the Spanish “Audiencia Nacional” (the Spanish High Court charged with terrorist trials) about the affidavits NOVA Operation I, II, and III. This research facilitates a reliable analysis of the possible processes of psychological manipulation that could have been applied in the terrorist group. The psycho-social approach analyzes the individual-group interaction, group dynamics, the internalization processes of the violent extremist ideology, and the ideologist/leader role.Outcomes showed evidences of thought reform applied on the members of this terrorist group.

The importance of the concepts of disaster, catastrophe, violence, trauma and barbarism in defining posttraumatic stress disorder in clinical practice.

BACKGROUND: Several terms in the scientific literature about posttraumatic stress disorder are used with different meanings in studies conducted by different authors. Words such as trauma, violence, catastrophe, disaster and barbarism are often used vaguely or confusingly, and their meanings change in different articles. The lack of conceptual references for these expressions complicates the organization of literature. Furthermore, the absence of clear concepts may be an obstacle to clinical treatment because the use of these words by the patients does not necessarily point to a diagnosis of posttraumatic stress disorder. DISCUSSION: A critical review of scientific literature showed that stress can be divided in stages to facilitate specific terminological adjustments to the event itself, to the subject-event interaction and to psychological responses. Moreover, it demonstrated that the varying concept of trauma expands into fundamental psychotherapeutic definitions and that the meanings of violence associated with barbarism are an obstacle to resilience. Therefore, this study updates the etymological origins and applications of these words, connects them to the expansions of meanings that can be operated in the clinical care of patients with posttraumatic stress disorder, and analyzes them critically according to the criterion A of DSM-IV and ICD-10. SUMMARY: The terminology in the literature about posttraumatic stress disorder includes a plethora of terms whose meanings are not fully understood, and that, therefore, limit this terminology. The analysis of these terms suggested that the transformation of the concept of trauma led to a broader understanding of this phenomenon in its psychic dimensions, that a barbarian type of violence constitutes an obstacle to resilience, and that the criterion A of the DSM-IV and ICD-10 shows imprecision and conceptual fragilities. METHODS: To develop this debate article, a current specialized literature review was achieved by searching and retrieving the key terms from two major databases: PubMed and PsycINFO. The key terms included "disaster", "catastrophe", "barbarism", "terrorism", "trauma", "psychic trauma" and "violence", also in combination with the terms "PTSD", "concept" and "conceptual aspects". The data were captured specially from review articles. The included studies were those mostly identified by the authors as relevant by the presence of a conceptual approach in any part of the paper. Researches that relied solely on empirical indicators, like psychopathological, neurobiological or pharmacological aspects, were excluded. The focus here was in conceptual aspects, even when some few empirical studies were included. As it was noted a paucity of medical references related to conceptual aspects of these terms, a wider literature needed to be included, including chapters, books and articles proceeded from the Humanities areas. "Interdisciplinary research is needed in this area to include perspectives from a range of different disciplines" once that "to promote public health (...) new dimensions of such interactions and the implications thereof should be pursued in collaboration with researchers from broader areas" 1.

The individual, the group and the psychology of terrorism.

Northern Ireland lived through a campaign of terrorism for thirty years. This has now ended and substantial progress has been made towards political stability through a long-term peace process. Using his experience as a psychiatrist and psychotherapist, but also as leader of a political party, negotiator in the peace process and subsequently Speaker of the Northern Ireland Assembly, Lord Alderdice explores the psychology of political terrorism. He examines the role of individual and group psychology, the evolution and dissolution of a 'group mind', splitting, and the factors that contribute to division and violence. He describes the frustration of healthy pathways for change, and humiliation, shame and rage as key factors in triggering regression into political violence. Containment, respect and a group psychological process are identified as necessary for evolution towards a more healthy state. It is suggested that application of these Northern Irish insights to the issue of terrorism in other places and especially in the Middle East, may open new and more psychologically sophisticated ways of addressing the problem of terrorism.

Lessons in posttraumatic stress disorder from the past: Venezuela floods and Nairobi bombing.

Identification and treatment of posttraumatic stress disorder (PTSD) are important following a disaster. Insights into how these aims can be achieved may be obtained from previous disasters. This article describes mental health initiatives following the 1999 flooding in Vargas State, Venezuela, and the 1998 U.S. Embassy bombing in Nairobi, Kenya. Following the Vargas State floods, a specialist mental health center devoted to the diagnosis, treatment, and follow-up of PTSD was established. Awareness and acceptance of the clinic was promoted by media campaigns and community-based activities. After 18 months, approximately 5000 people had been screened, of whom 62% were diagnosed with PTSD and treated. Moreover, the clinic's activities had expanded to include treatment of other medical conditions and assistance with nonmedical needs. Following the Nairobi bombing, a mass media campaign was initiated to create awareness of PTSD symptoms and help victims come to terms with their experience. This campaign was found to be well received and helpful. In addition, counselors were trained to support people living or working close to the blast. These examples show that mental health initiatives are feasible after a disaster and highlight a number of issues: (1) The intervention should be tailored to the needs of the target population; (2) Communication should be simple and appropriate; (3) Community-based activities are valuable in promoting awareness and acceptance of mental health initiatives; (4) Reducing the stigma often associated with mental health problems is important; and (5) The mass media can be helpful in promoting awareness of mental health issues following major trauma.

[Fetal and early trauma syndrome-FETS]. / Síndrome del trauma fetal ó temprano-STFT.

This is a new clinical description for cases of children whose parents are among those who have disappeared and were given birth by women held prisoners and subjected to torture, humiliation and abuses. This description is considered a special case of early, and in many cases fetal distress. These children felt horror when they were violently separated from their parents immediately after being born in captivity or in early infancy during the last military dictatorship (1976-1983). Afterwards they were sold by their captors and raised as adoptive or as their own children by the purchasers. The fact that these cases be included in the existing WHO categories contained in CIE-10: Posttraumatic stress disorder, F43.1, is discussed as they show late responses on the part of the victims to situations of torture, terrorism and rape. However, it is clarified that cases in which the aftereffects of severe stress become evident after decades will have to be classified as Persistent personality disorders, after catastrophic experience, F62.0. It is concluded that it is necessary to consider FETS as a new combination of manifestations of the Persistent Personality Disorders due to its specific idiosyncratic characteristics that go beyond the available clinical descriptions, to its own etiophatic equation and to its recognizable pathognomonic identification. Its pathognomonic identification in some cases was useful to detect children with these alienated identity problems (understood as legally neglected and clinically alienated). Propedeutic and treatment aspects are mentioned in conjunction with the peculiarities of a therapy that restores the illegally deprived personality of these children, who nowadays are adults of approximately 25 to 29 years of age. Finally, a metapsychologic discussion is presented, which is about the resilience of the truth and the fact that when it is rejected it returns, thus constituting ethics of the truth.

Síndrome del trauma fetal o temprano STFT / Fetal and early trauma syndrome - FETS

Nueva descripción clínica para los caso de hijos de desaparecidos y de nacidos en cautiverio de madres bajo torturas, vejaciones y abusos como una forma especial de sufrimiento temprano, y en muchos casos fetal. Estos niños padecieron el horro, al ser separados violentamente de sus padres a la mas tierna edad, o inmediatamente después de su nacimiento en cautiverio, vendidos por sus captores y criados como adoptados o propios por los adquirentes durante la última dictadura militar (1976-83) Se discute su posible inclusión en las categorías vigentes del CIE-10 de la OMS: Trastornos de estrés postraumático F43.1, pues incluyen Las respuestas tardías o diferidas a situaciones de ser victimas de torturas, terrorismo y violación. Pero se aclara que en el caso de que las secuelas de un estrés devastador, se manifiesten después de década, habrá que codificar como Trastorno persistente de la personalidad, tras experiencia catastrófica F62.0. Se concluye con la necesidad de postular el STFT como un nuevo cuadro de los Trastornos Persistentes de la Personalidad, por sus características idiosincrásicas específicas que desbordan las descripciones clínicas disponibles que tiene ecuación etio-patológica propia y una identificación protognomónica reconocible, que en algunos casos sirvió para detectar a niños con problemas de identidad enajenada (vale entender como jurídicamente sustraída clínicamente alienada). Se mencionan aspectos propedéuticos y de tratamiento en conjunción con las particularidades de una terapéutica que restaure la personalidad privada ilegalmente en estos niños, hoy adultos de 25 a 29 años. Finalmente se realiza una discusión meta-psicológica sobre la resiliencia de la verdad, que cuando se la rechaza, retorna constituyéndose así como una, ética de la verdad (AU)

Síndrome del trauma fetal o temprano STFT / Fetal and early trauma syndrome - FETS

Nueva descripción clínica para los caso de hijos de desaparecidos y de nacidos en cautiverio de madres bajo torturas, vejaciones y abusos como una forma especial de sufrimiento temprano, y en muchos casos fetal. Estos niños padecieron el horro, al ser separados violentamente de sus padres a la mas tierna edad, o inmediatamente después de su nacimiento en cautiverio, vendidos por sus captores y criados como adoptados o propios por los adquirentes durante la última dictadura militar (1976-83) Se discute su posible inclusión en las categorías vigentes del CIE-10 de la OMS: Trastornos de estrés postraumático F43.1, pues incluyen Las respuestas tardías o diferidas a situaciones de ser victimas de torturas, terrorismo y violación. Pero se aclara que en el caso de que las secuelas de un estrés devastador, se manifiesten después de década, habrá que codificar como Trastorno persistente de la personalidad, tras experiencia catastrófica F62.0. Se concluye con la necesidad de postular el STFT como un nuevo cuadro de los Trastornos Persistentes de la Personalidad, por sus características idiosincrásicas específicas que desbordan las descripciones clínicas disponibles que tiene ecuación etio-patológica propia y una identificación protognomónica reconocible, que en algunos casos sirvió para detectar a niños con problemas de identidad enajenada (vale entender como jurídicamente sustraída clínicamente alienada). Se mencionan aspectos propedéuticos y de tratamiento en conjunción con las particularidades de una terapéutica que restaure la personalidad privada ilegalmente en estos niños, hoy adultos de 25 a 29 años. Finalmente se realiza una discusión meta-psicológica sobre la resiliencia de la verdad, que cuando se la rechaza, retorna constituyéndose así como una, ética de la verdad

20 Years is not long enough.

The author presents some Latin American sociopolitical vicissitudes exemplified by Argentina, where she lives and where she trained and practices as a psychoanalyst. The exposition is based on the impact that her experience with two patients, Ana and Juana, had on her, and is presented in the form of clinical vignettes. The author reflects clinically and technically on the transference and countertransference and on the ways in which self-analysis enabled her to distinguish between the countertransference related to the patient and that related to the psychoanalyst. Finally, the author discusses the traumatic effects of 'the human condition', 'social violence' and 'Evil', referring specifically to the 'repetitive trauma' individuals experience under the globalization of terror and to the use of mechanisms of disavowal that result in serious splitting. The author confronts the reader with totalitarian terror as something that attacks and destroys the main constitutive characteristic of human beings, namely, their ability to think, remarking that H. Arendt is the one who speaks about 'radical evil' as 'the banality of Evil'. The author addresses the question of whether by tempering aggression and organizing levels of symbolization 'words' might prevent the emergence of 'pure jouissance' and be more powerful and significant than violence, overriding it.

Una modelación de las variables que explican el impacto de los eventos terroristas en el comportamiento humano / A modeling of the variables that explain the impact of terrorist events on human behavior

El impacto de los eventos terroristas sobre el comportamiento humano, se ha estado explicando a partir de seis variables: (1) Situación de Incertidumbre, (2) Creencias Precautorias, (3) Sentido de Comunidad, (4) Percepción de Riesgos, (5) Motivos de Atribución y (6) Comportamiento Heurístico. Se modela la relación causal entre estas seis variables.

The impact of terrorist events on human behavior has been explained based on six variables: (1) Uncertainty Situation, (2) Precautionary Beliefs, (3) Sense of Community, (4) Perception of Risks, (5) ) Reasons for Attribution and (6) Heuristic Behavior. The causal relationship between these six variables is modeled.

Psychosocial assessment for victims of violence in Peru: the importance of local participation.

This paper describes a pilot study assessing the psychosocial impact of political violence in the Peruvian Andes, utilizing a collaborative approach with local professionals and communities. The study team prioritized dialogue and information exchange with the local professional community and villagers participating in the assessment in order to raise awareness of psychosocial issues and provide education and support. Participation in the pilot study had positive therapeutic effects for villagers, and inspired ongoing discussion groups to address psychosocial problems in communities. This paper also describes a psychosocial assessment strategy utilizing qualitative methods and an adaptation of the Harvard Trauma Questionnaire in collaboration with Andean villagers. Usefulness and limitations of the data will be reviewed, in terms of cultural and context relevance, usefulness for informing interventions, and comparisons with ethnographic methodologies and other survey instruments.

[Survey of attitudes to air travel after terrorist events of September 2001]. / Informe sobre actitudes hacia viajar en avión posteriores a los atentados terroristas del 11 de septiembre de 2001.

An opportunistic questionnaire study of peoples attitudes to, commercial flying and their behavioural responses after the events of September 11 2001 in the USA. Cohorts drawn from people attending a series of educational lectures, a specific leisure time activity and a travel health clinic 6 months after the disasters. More people appeared to worry about air travel 6 months after Sept 11 2001 than in reports prior to this date and the worried seem to experience a greater intensity of anxiety.

Protección de la salud mental en situaciones de desastres y emergencias / Protection of mental health in situations disaster and emergencies

Los efectos de los desastres sobre la salud se manifiestan tanto en lo físico, lo mental y lo social. Tradicionalmente, se ha brindado una atención más detallada solo a los aspectos físicos y sociales. Los programas de salud en las emergencias se han dirigido básicamente a la atención médica inmediata, al problema de las enfermedades transmisibles, agua y saneamiento ambiental, así como los daños a la infraestructura sanitaria. Afortunadamente, en los últimos años, se ha comenzado a prestar atención al componente psicosocial, que siempre está presente en estastragedias humanas, pero dimensionando lo psicosocial en un sentido amplio que abarca no solo la enfermedad psíquica, sino también otra gama de problemas como la aflicción, el duelo, las conductas violentas y el consumo excesivo de sustancias adictivas. Esta guía responde a la preocupación e inquietud creciente mostrada por los gobiernos, organizaciones no gubernamentales y la comunidad internacional en responder mejor al impacto de los desastres y emergencias en la salud mental de la población. Se ha abordado el tema tratando de elimi-nar muchos de los estigmas que aún existen ­incluso entre profesionales de la salud­ sobre las enfermedades mentales y otros problemas de la conducta humana. Además de los desastres provocados por amenazas naturales, también los efectos generados por la violencia social masiva y las guerras han provocado un gran impacto sobre la salud mental de las personas que han tenido que huir presas del miedo, han sufrido heridas y mutilaciones, la muerte de seres queridos, y graves pérdidas económicas. Igualmente, la salud mental se veafectada como resultado de los desplazamientos de grandes grupos humanos, de la vida encampamentos, o del hacinamiento en suburbios de muy difíciles condiciones sanitarias y económicas. En estas circunstancias las necesidades de atención psicosocial son especialmente altas debido al estrés al que la población está sometida y a los traumas específicos de grupos con mayor vulnerabilidad. En este contexto, son muchos los países de América Latina y el Caribe que además presentan una baja capacidad de respuesta a los problemas de salud mental en situaciones de emergencia.

Trauma in war and political persecution: expanding the concept.

A contextual understanding of the concept of trauma is proposed through a study of its meaning in a Latin American context facing war and political repression. This article explores the contributions of narrative and liberation psychology to understanding politically based trauma. It critiques the relationship between the concept of trauma and the diagnosis of posttraumatic stress disorder. It analyzes how Colombian human rights activists make sense of the political persecution and trauma in their work. The author argues that the kind of experiences that these activists have endured go beyond the category of stress and can best be understood as traumatic within the context of the current medium-intensity war in Colombia.