Cumulative Trauma

The term cumulative trauma has been operation-alized in a number of ways in the literature. The diversity of conceptualizations stems from both theoretical and methodological differences in attempts to explore the construct (see Scott-Storey, 2011, for a complete review). However, the consistent hypothesis associated with the term cumulative trauma is that as the number of traumas accumulates, there is a concomitant increase in the trauma-related symptomatology. A similar concept has been described in the medical literature, with the description of conditions that are exacerbated by repeated injury over time. Although the two literatures have not been directly linked, researchers in both the mental and physical health fields have verified the detrimental effects of repeated trauma exposure.

Mental health researchers have documented the prevalence of a range of types of traumatic experiences with greater levels of methodological rigor in the research conducted after 1990. Most research on the cumulative impacts of trauma has focused on women's experiences of a range of types of interpersonal abuse; however, there has been some parallel research in the literature examining exposure to combat experiences. This entry will draw from the research on the impacts of interpersonal abuse on women's health.

The evidence of the frequency of women's exposure to potentially traumatic events has been accompanied by increased knowledge about the considerable range of psychological outcomes that may follow trauma exposure. As methodology in the field of trauma research has become more sophisticated, investigators have become aware that questions about the effects of trauma exposure and associated symptomatology are not easily answered. While an appreciable number of individuals experience trauma-related symptoms, evidence also suggests that in many cases individuals do not have long-term problems associated with exposure to potentially traumatic events. Furthermore, even among those who experience trauma-related difficulties, there is a wide variability in both the severity and types of sequelae associated with the trauma exposure. Moreover, researchers have increasingly become aware of the importance of investigating [Page 187]both physical and psychological symptoms associated with repeated abuse exposure. Individual variability in response to abuse has led to attempts to identify both mediators and moderators associated with the range of outcomes following trauma exposure. This research has enhanced our understanding not only of trauma-related distress but also of factors associated with resiliency. It is in this scientific context that the growing interest in cumulative trauma has advanced.