As with the identification and labelling of many mental health problems, the adoption of PTSD within DSM can be said to arise from contemporaneous social and political contexts: specifically the return to the United States of many war-affected veterans from Vietnam (Scott, 1993). The specific circumstances of the recognition of PTSD within DSM-III have led several commentators to discuss it in terms of social construction (e.g., Summerfield, 2001). The current review argues that the orientation of theory and research aimed at understanding PTSD has been particularly informed by Western individualistic constructions of social phenomena. Our review calls for a blending of approaches to understanding post-traumatic stress by considering the social structures and contexts in which it is expressed and in particular by considering how a group-level analysis can inform incidence, diagnosis, and expression of post-traumatic symptoms.