Although post-traumatic stress disorder (PTSD) is now constituted by a set of characteristic symptoms, its roots lie in Post-Vietnam Syndrome, a label generated by a Vietnam-era advocacy movement that focused not on symptoms but on war's traumatic context. When Post-Vietnam Syndrome was subsumed into the abstract, individualistic, symptom-centered language of DSM-III and rendered as PTSD, it not only lost this focus on context but also neglected the experiences of veterans who suffer from things done or witnessed, not primarily from what was done to them, in war. This agent-related trauma has been rediscovered in contemporary work on moral injury, but moral injury too is increasingly subjected to the hegemony of the symptom. Focusing on symptoms, however, unhelpfully pathologizes and individualizes trauma, neglects traumatic context, and legitimates problematic therapeutic approaches. Trauma researchers and clinicians should decenter the language of symptoms and focus instead on context and on alternative accounts of trauma.

中文翻译：

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挑战症状的霸权：恢复创伤后应激障碍和道德伤害的背景

尽管创伤后应激障碍 (PTSD) 现在由一系列特征性症状构成，但其根源在于后越南综合症，这是越南时代倡导运动产生的标签，该运动不关注症状，而是关注战争的创伤背景。当后越南综合症被纳入 DSM-III 的抽象的、个人主义的、以症状为中心的语言中并被渲染为 PTSD 时，它不仅失去了对背景的关注，而且还忽视了经历过或目睹的事情的退伍军人的经历，而不是主要来自战争中对他们所做的事情。这种与代理相关的创伤在当代关于道德伤害的工作中被重新发现，但道德伤害也越来越多地受到症状的支配。然而，专注于症状无益地将创伤病理化和个性化，忽视了创伤背景，并使有问题的治疗方法合法化。创伤研究人员和临床医生应该分散症状的语言，转而关注背景和创伤的其他解释。