Cultural Diversity in Trauma Response

The topic of cultural diversity in trauma response has been dominated by mainstream conceptualizations of culture in the United States. In trauma psychology, the term culture is usually relegated to notions of race, non-Western cultures, socioeconomic status, or the so-called special populations (children, adolescents, the elderly, LGBT populations, members of religion sects, etc.). Research studies that address cultural variables in traumatology mainly focus on these groups' differential rates of response and exposure to trauma, differences in risk for psychopathology, vulnerabilities, and responsiveness to treatment.

It has been determined that culture is a crucial factor in understanding the development, maintenance, and treatment of posttraumatic stress disorder (PTSD). However, individuals' values, beliefs, cultural idioms of distress, cultural factors related to the psychosocial environment, and dimensions of power and privilege are frequently ignored in trauma research protocols and trauma treatments. Proponents of the cultural and anthropological perspective bring into question whether responses to trauma and suffering, in particular the diagnosis of PTSD, constitute a universal reaction to human suffering.

A second line of inquiry—namely, the biomedical model and neuroscience research on PTSD and psychological trauma, argues that while only a very small percentage of people develop PTSD when faced with extreme stress, trauma can elicit similar psychological and physiological reactions among those exposed to it. In other words, trauma is understood as a universal experience. Proponents of this approach claim that neurobiological underpinnings of the trauma response are well established. Symptoms of PTSD are believed to be a failure of the stress-regulating neurobiological systems to exposure to severe stressors. Newer developments in neuroscience have linked these neurobiological changes to mechanisms of learning and extinction as well as arousal. Most recently, neurobiological research has focused on understanding the mechanisms that underlie the predisposition to develop PTSD.

A third perspective proposes an integration of neurobiological responses to trauma with the sociopolitical, cultural, and historical context in which trauma occurs. Its main focus of inquiry is a cultural analysis of that context. In other words, it suggests that the ways we respond to trauma are determined not only by neurobiology but also by individual and collective agendas that surround trauma. As a result, conceptualizations on the “appropriate” ways to deal with trauma are relative.

The following sections describe in detail the different approaches to understanding cultural variations in the trauma response.