Goldsmith Rachel E, Martin Christina Gamache, Smith Carly Parnitzke
a Department of Oncological Sciences , Mount Sinai School of Medicine , New York , New York , USA.
J Trauma Dissociation. 2014;15(2):117-32. doi: 10.1080/15299732.2014.871666.
Substantial theoretical, empirical, and clinical work examines trauma as it relates to individual victims and perpetrators. As trauma professionals, it is necessary to acknowledge facets of institutions, cultures, and communities that contribute to trauma and subsequent outcomes. Systemic trauma-contextual features of environments and institutions that give rise to trauma, maintain it, and impact posttraumatic responses-provides a framework for considering the full range of traumatic phenomena. The current issue of the Journal of Trauma & Dissociation is composed of articles that incorporate systemic approaches to trauma. This perspective extends conceptualizations of trauma to consider the influence of environments such as schools and universities, churches and other religious institutions, the military, workplace settings, hospitals, jails, and prisons; agencies and systems such as police, foster care, immigration, federal assistance, disaster management, and the media; conflicts involving war, torture, terrorism, and refugees; dynamics of racism, sexism, discrimination, bullying, and homophobia; and issues pertaining to conceptualizations, measurement, methodology, teaching, and intervention. Although it may be challenging to expand psychological and psychiatric paradigms of trauma, a systemic trauma perspective is necessary on both scientific and ethical grounds. Furthermore, a systemic trauma perspective reflects current approaches in the fields of global health, nursing, social work, and human rights. Empirical investigations and intervention science informed by this paradigm have the potential to advance scientific inquiry, lower the incidence of a broader range of traumatic experiences, and help to alleviate personal and societal suffering.
大量的理论、实证和临床研究探讨了与个体受害者和施害者相关的创伤。作为创伤专业人员，有必要认识到机构、文化和社区中导致创伤及其后续结果的各个方面。环境和机构的系统性创伤背景特征，这些特征引发创伤、维持创伤并影响创伤后反应，为考虑全方位的创伤现象提供了一个框架。《创伤与分离杂志》的当前这期由纳入创伤系统性方法的文章组成。这种观点扩展了创伤的概念化，以考虑学校和大学、教堂及其他宗教机构、军队、工作场所、医院、监狱等环境的影响；警察、寄养、移民、联邦援助、灾害管理和媒体等机构和系统；涉及战争、酷刑、恐怖主义和难民的冲突；种族主义、性别歧视、歧视、欺凌和恐同症的动态；以及与概念化、测量、方法、教学和干预有关的问题。尽管扩展创伤的心理学和精神病学范式可能具有挑战性，但从科学和伦理角度来看，系统性创伤视角是必要的。此外，系统性创伤视角反映了全球卫生、护理、社会工作和人权领域的当前方法。受这一范式影响的实证研究和干预科学有潜力推进科学探究、降低更广泛范围创伤经历的发生率，并有助于减轻个人和社会的痛苦。
