Adaptation after torture: some thoughts on the long-term effects of surviving a repressive regime.

The long-term problems of refugee survivors of organized violence are considered. A case example is described in order to illustrate the complexity of factors that contribute to the psychological well-being and social adaptation of such a survivor. The limitations of the classic diagnostic approaches are discussed. It is suggested that measures of social function can be more helpful than a description of symptoms, and should be included in the concept of PTSD, in order to increase the usefulness of this diagnosis in relation to severe and chronic trauma.