The Many faces of Trauma and Recovery around the world: Mapping experiences in Cultural Context (MaTRix)​

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Background

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Cultural and contextual factors both play an important role in shaping individuals’ beliefs, attitudes, and responses to potentially traumatic events (PTEs). While the PTSD construct shows some cross-cultural validity, a growing body of literature also documents culturally specific idioms of distress, symptom constellations and syndromes across trauma sequelae following exposure to PTEs. Multiple studies have also identified the role of cultural factors in explaining large variances in cross-national PTSD prevalence rates and the role of cultural scripts - cultural models that capture dynamic sequences of elements associated with trauma sequelae - in shaping culturally-specific phenomenology and responses to trauma. Despite these cultural and contextual specificities, conceptualisations of trauma and associated approaches to interpreting and treating trauma sequelae, predominantly originate from Western, biomedical models, with few evidence-based treatment options available in low- and middle-income countries (LMICs).

Using an emic-etic approach, the study aims to build on existing evidence-based understanding of the cross-cultural phenomenology of trauma. The resulting evidence will contribute to informing good practice in the development and implementation of efficacious, culturally-driven psychological and/or psychosocial assessment tools and treatments grounded in contextually relevant healing practices.

More specifically, it seeks to understand the types of events that are construed and appraised as traumatic across cultures and how the trauma sequelae, including post-traumatic stress disorder (PTSD) symptomatology, manifest across cultures and contexts. More specifically, the study will explore psychosocial and somatic experiences resulting from exposure to potentially traumatic events (PTEs), their perceived causes, approaches to coping and healing, subjective wellbeing and functioning, and the role of culture, context and identity in shaping these across countries. 

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Aims

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The aim of this project is therefore two-fold.

1. Explore cross-cultural conceptualizations, expressions and experiences of trauma, including individual psychosocial and somatic responses to PTEs and the trauma sequelae, their perceived causes, approaches to coping and healing, subjective wellbeing and functioning, and the role of culture, context and identity in shaping subjective interpretation and the attribution of meaning.

2. Investigate culturally-specific healing and coping strategies, including individual vs collective approaches.

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Methods

The project is currently organized into four Work Packages (WPs) which will be implemented over 2024-2027. 

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WP 1. A systematic review

A systematic review of qualitative research will be undertaken in multiple languages to explore how individuals from low- and middle-income countries subjectively respond to a traumatic event or psychological trauma. All traumatic sequelae following a traumatic event will be considered; a focus will be set on how traumatic events are perceived at individual, familial, and community levels.

Leads:

• Adult populations: Ateka Contractor & Safa Kemal Kaptan

• Children/adolescents populations: Sarah Halligan

Current status:

• The review focusing on adult populations has been registered with OSF and is being initiated

• Collaborators are Welcome (CAW) for children/adolescents only, especially from the Global South / non-Western countries

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WP 2. & 3. Multi-country survey and in-depth qualitative interviews

A pilot study is currently being initiated across nine sites, including Egypt, Lebanon, Qatar, South Africa, Thailand, Turkey, Uganda, Vietnam, and Zambia. Across each site, participants will complete i) a survey composed of both standardized and culturally-specific assessment measures and ii) an in-depth semi-structured qualitative interview. The pilot study will assess the cultural relevance, feasibility and acceptability of the study design and data collection instruments (survey and in-depth interview questionnaire) to inform implementation across a broader range of countries in Phase II of the project.

Leads: 

• Soraya Seedat and Maria Bragesjö​​ (Survey)

• Stéfanie Fréel, Chris Hoeboer and Manasi Sharma (In-Depth Interviews)

Current status:

• A pilot study is being implemented across nine in-country sites

• Collaborators are Welcome (CAW) for scale-up / Phase II, especially from the Global South / non-Western countries

WP 4. Global Expert Focus Groups  

This WP will triangulate findings from WPs 1-3, identifying convergences and divergences in conceptualizations of traumatic experiences and expressions of trauma responses and trauma sequelae across cultures and contexts using a Delphi-like process. Convergences and divergences with standardized, Western assessment instruments and constructs (e.g., PTSD) will be identified to inform the need for, and good practices in developing, culturally-specific assessment measures and treatment approaches.

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Leads:

• Kate Ellis and Sarah Halligan

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Current status:

• not yet initiated; Collaborators are Welcome (CAW), especially from the Global South / non-Western countries

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WP 5. Ethnographic research 

This WP is currently being initiated and will focus on undertaking in-depth, field-based and community-driven research to gain a better understanding of i) manifestations and discourse surrounding experiences of traumatic events, and ii) approaches to healing and coping following exposure to traumatic events. An initial focus will be set on examining non-narrative, collective approaches to healing within conflict and post-conflict settings in the Sahel region, drawing on interdisciplinary conceptual frameworks (i.e., anthropology, psychology, transcultural psychiatry). Regional focus may subsequently be expanded.

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​Leads:

• Jessica Lambert and Stéfanie Fréel

Current status:

• in conceptualization; Collaborators are Welcome (CAW), especially from the Global South / non-Western countries

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Contact

Please contact Stéfanie Fréel or one of the other project leaders for further information.

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