PTSD and Ethnic Violence

To the Editor: Sociopolitical forces may cause, shape, or worsen psychiatric disorders (1). Such disorders are encountered more frequently in refugees and torture victims who seek asylum in the United States. A social climate of intolerance toward ethnic minorities and other socially disenfranchised groups in the U.S. is being increasingly documented (2).

A dramatic example of social intolerance is the incident in River City, California, in which illegal immigrants were beaten by members of the U.S. Border Patrol (3). Such incidents may result in psychiatric morbidity even among those who experienced no direct physical trauma from the event. This report describes and discusses such a case.

Mr. C is a 49-year-old single Mexican-American Vietnam veteran who was admitted to a psychiatric hospital for worsening of his posttraumatic stress disorder (PTSD) symptoms after watching the River City incident on TV. He stated that the violence he witnessed reminded him of experiences in Vietnam and triggered feelings of irritability, resentment, helplessness, and fear. He began to isolate himself and was unable to leave his house for fear that he would be mistaken for an illegal immigrant, taken to jail, and sent to Mexico by the Immigration and Naturalization Service.

Mr. C served in Vietnam in 1968, but he considered himself an outsider because he was never fully accepted by his peers, who frequently reminded him of his physical resemblance to the Vietcong. He witnessed many traumatic events and was wounded by friendly fire.

Mr. C's case illustrates the impact of a sociopolitical event on symptoms of PTSD. His disorder was shaped by the historical context of the Vietnam war, including a military environment that fostered a general mistrust of the government among alienated ethnic minorities. His sense of rejection was further compounded by having been wounded by one of his peers.

Witnessing the River City incident on television triggered Mr. C's decompensation because the violence of the beatings reenacted his conflicts over government as aggressor and himself as victim. To him, the Border Patrol represented the government, a body designed to protect national sovereignty but also an aggressor toward people of Mexican origin. Mr. C also identified with the victims—outsiders with whom he shared a similar ethnicity and physiognomy—and thus felt vulnerable to the attack.

Cases such as Mr. C's may become more prevalent as racist movements grow and violent acts ensue. The impact of these societal developments is likely to be negative. Clinicians need to be attuned to this new reality and to take an active role in recognizing and evaluating the psychiatric effects.

Dr. Dassori is assistant professor of psychiatry and Dr. Silva is associate professor of psychiatry at the University of Texas Health Science Center at San Antonio.