Cultural Differences in Trauma Appraisals and Implications for the development and maintenance of post-traumatic stress disorder (PTSD)

Engelbrecht, Alberta (2013) Cultural Differences in Trauma Appraisals and Implications for the development and maintenance of post-traumatic stress disorder (PTSD). Doctoral thesis, University of East Anglia.

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Abstract

There is an urgent need to improve our understanding of the influence of culture on the onset and maintenance of post-traumatic stress disorder (PTSD). Substantial evidence indicates that appraisals and self-concept, both of which are central to the understanding and treatment of PTSD are found to differ across cultures. This thesis therefore investigated the influence of cultural variation in self-construal on a) trauma appraisals, b) posttrauma self-concept and c) posttrauma psychological adjustment.
The thesis was comprised of three parts with a total of seven studies; the methodology adopted a questionnaire and interviewing approach on British and Asian participants. Part 1 and 2 explored the objectives in a non-clinical sample (n = 75; n = 14; parts 1 and 2 respectively). Part 3 examines the objectives in a clinically relevant sample of trauma survivors with and without PTSD (n = 95).
In relation to trauma appraisals, the thesis’ findings relay that there are cultural differences in trauma appraisals, including a significant cultural difference in perceived personal control for those with PTSD compared to trauma survivors without PTSD. However, appraisals of those with PTSD tended to be similar, suggesting cultural similarities in trauma appraisals for clinical groups. Second, the Public and Communal Self Appraisal Measure (PCSAM) which measures collectivistic type cognitions was developed and demonstrated good internal consistency, test-retest reliability, convergent validity, and discriminative validity. This measure further demonstrated collective self-appraisals to also play a significant role in PTSD development and/or maintenance, suggesting both independent and interdependent self-construal are impacted and damaged by trauma. Findings in relation to post-trauma self-concept (i.e. traumatized and trauma-centered self-concept) suggest a pan-cultural relationship to PTSD. Additionally, an ambivalent post-trauma self-concept was found to directly impact British trauma survivors but not Asian. However, when mediated by trauma-related appraisals, self-ambivalence was found to indirectly influence PTSD for the Asian and British groups. Finally, the influence of cultural variation in self-construal on post-trauma psychological adjustment, and theoretical and clinical implications of the thesis are discussed. Limitations and future directions are considered.

Item Type: Thesis (Doctoral)
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Mia Reeves
Date Deposited: 17 Oct 2014 11:25
Last Modified: 17 Oct 2014 11:25
URI: https://ueaeprints.uea.ac.uk/id/eprint/50545
DOI:

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