This study presents a new short scale for measuring cumulative trauma dose, types, and profiles that is based on the APA (American Psychological Association) trauma Group (currently division 56) definition of trauma and a new, two-way development-based taxonomy of trauma. The new measure was tested using a sample of 501 Iraqi refugees who are one of the most traumatized groups. The following six salient factors were found: collective identity, family, personal identity, interdependence or secondary, man-made or nature-made survival, and abandonment types of traumas. The study provided evidence of adequate reliability; construct, convergent, divergent and predictive validity of the new scale and provided partial confirmation of the validity of the development-based taxonomy of traumas. A new method was introduced to measure trauma types and profiles and their differential association with different symptom configurations and health disorders. The newly developed measure can be used in clinical trauma-informed settings and in research.

A review of the theory of trauma as a special case of stress response theory, two different classifications/taxonomies of traumas emerge. Each taxonomy describes a different dimension of the traumatic event. The first taxonomy, areas of individual functioning, includes five types: Attachment trauma, autonomy or identity trauma, interdependence trauma, achievement or self-actualization trauma, and survival trauma. The second classification is based on experiential objective external criteria and includes two main categories: Factitious or trauma-like and real traumatic events. The first happens in one step transmission from one to one or more persons. The second get transmitted in multiple steps or cross-generationally. Traumas can get transmitted cross generationally in two venues: through family or collectively. Collective transmission of traumas happens in two contexts: historical and social structural. Direct traumas (person-made), on the other hand, is divided into two types: Simple (type I) and complex (type II, and type III). While type I is a single blow, type II is a unit of repeated and connected series of blows. Type III is the additive effect of the sequence of all direct, indirect, and factitious traumatic events on one or more of the different areas of functioning across life span. The latter section of the paper describes a Trauma Assessment Matrix to help identify the accumulation of traumatic events and its potentially additive effects in one or more of the five areas of functioning. The treatment implications are addressed.

The goal of this paper is to advance the theory of chronic and traumatic stressors that have been identified as type III traumas in the trauma developmentally-based framework (DBTF) and use it to investigate the mental and physical health effects of such traumas on impacted individuals and groups. Participants were 438 Palestinian adolescents from the West Bank who had been exposed to a number of types of trauma including chronic intergroup violence. The age of participants in the sample ranged from 12 to 19 with a mean of 15.66 and SD of 1.43. The sample included 54.6% males, 52.3% resided in cities, 44.4% resided in villages, while 3.2% resided in refugee camps. The study utilized a measure for cumulative traumas that is based on the DBTF and measures of post-traumatic stress disorder (PTSD), cumulative trauma related disorders (CTD), depression, anxiety, collective annihilation anxiety (AA), identity salience, and fear of death. The results of partial correlation and path analyses indicated that continuous traumatic stress was a significant predictor of mental health. The analyses also indicated that poverty predicted identity salience and AA that mediated their negative effects on physical and mental health of Palestinian adolescents. The relevance of these results to peace, social and clinical psychology was discussed.

No abstract

Developments in the theories of identity, culture, and traumatology enrich our cross-cultural understanding of mental health dynamics, case conceptualization, and developing effective intervention models to help victims of complex and cumulative traumas especially in different cultures and minority populations. Identity traumas, along with preidentity and nonidentity traumas, contribute to forming cultures. On the other hand, cultures may contribute to delivering some types of culture- and social-made serious traumatic conditions that can be transferred cross-generationally, such as poverty and caste systems. Most current interventions are designed to help with single trauma and ignore the cumulative trauma dynamics as well the collective identity and culture-specific traumas. This understanding entails revising our culturally limited and single-trauma-based interventions to help clients who belong to different cultures or to minority victims of culture- and social-made traumas as well as those who are victims of cumulative traumas. Multisystemic, multimodal, multicomponent flexible and fiddle therapy models emerged as potentially more effective in the treatment of disorders resulting from cumulative and identity traumas. They are more ecologically valid and culturally competent. Specific models of multisystemic, multimodal therapies— the wraparound psychosocial rehabilitation approach, for torture survivors, and the summer day and after-school treatment, for child victims of cumulative traumas—are discussed.

There is an intricate divide between three major paradigms in studying traumatic processes: the psychiatric paradigm that focused mostly on the survival types of traumatic stress and on posttraumatic stress disorder (PTSD) model (e.g., van der Kolk, Weisaeth, & van der Hart,1996), the psychoanalytic, and developmental paradigms that focused more on studying the effects of abandonment, child maltreatment, and other betrayal traumas in early childhood (e.g., Bowlby, 1988; Cassidy, & Shaver, 1999; Freyd, DePrince, & Gleaves, 2007), and the intergroup paradigm as evidenced in studying discrimination, genocide, torture, and other shared politically motivated micro and macro aggressions (e.g., for theoretical analysis of discrimination as a trauma, see Helms, Nicolas, & Green, 2010). Until recently, the three paradigms and their perspective theories and research, while some times overlap; have developed along relatively independent lines. In the first paradigm, trauma is defined as an event that involves actual or threatened death or serious injury or a threat to the physical integrity of self or others (American Psychiatric Association, 2004), and has potential of leading to PTSD symptoms. In the second and third paradigms, trauma is mostly a process that can be triggered by internal or external events that threaten the person's physical, personal, or social identities and this/her basic autonomy or dependence needs and have potential of yielding different symptoms that may include PTSD, and other syndromes(and not only PTSD). American Psychological Association APA trauma group's (currently APA division 56) definition of trauma as "A process that leads to the disorganization of a core sense of self and world and leaves an indelible mark on one's world views that psychological disorders often follow upon exposure to" represents this approach. In the second paradigm traumatization process is mostly triggered by the caregiver failing to satisfy her/his natural XXX10.1177/1534765612459892TraumatologyKira et al.

Trauma developmental theory identifies gender discrimination (GD) as a type of persistent, ongoing trauma that has the potential for serious, negative effects on mental health. This study was conducted to examine the potential role of GD in the development of cumulative trauma disorders (CTD) and symptoms of posttraumatic stress disorder (PTSD) as well as the role of GD in mediating the effects of other traumas on these disorders. The sample included 160 female torture survivors from more than 30 countries. Measures of PTSD, CTD, and types of trauma exposure were acquired as part of a larger study on refugee torture survivors. Structural equation modeling was used to test several plausible models for the direct and indirect effects of GD on PTSD and CTD, within the context of other trauma exposure. Results suggest that GD mediates the effects of identity traumas on CTD and PTSD. GD also had direct effects on CTD, including relationships with dissociation, suicidality, and deficits in executive function. GD did not appear to directly influence the development of PTSD. The implications of these results for assessment and treatment of women's trauma-related disorders as well as strategies for their prevention are discussed.

The goal of the 2 studies discussed in this article was to explore how persons who have undergone torture and other general trauma differ from persons who have undergone only general trauma and to compare the effects of torture to other kinds of traumas. The studies were conducted in 2001 and 2003. Contrary to our hypotheses, we found that although tortured individuals have a significantly higher trauma dose, they are more resilient, are more socioculturally adjusted, have more posttraumatic growth, and practice their religion more. They are more tolerant of differences in religion, race, and culture, and feel more supported. However, they are less healthy physically than individuals in the community who were not tortured. We used theories of attribution, identity trauma, and cumulative trauma to understand the results. Recommendations for counseling and therapy are discussed.