Mutuyimana Celestin, Maercker Andreas
Division of Psychopathology and Clinical Intervention, Department of Psychology, Institute of Psychology, University of Zurich, Zurich, Switzerland.
Front Psychol. 2023 Oct 20;14:1206503. doi: 10.3389/fpsyg.2023.1206503. eCollection 2023.
As a new, unifying approach to mapping the cultural expressions of trauma sequelae, cultural scripts of trauma sequelae are empirically investigated here for the first time in a primarily qualitative study. Elements of Cultural Scripts of Trauma (CST) include the typical symptoms and appraisals of changes of those who have experienced traumatic events. These elements refer to the value orientations in the given culture.
To identify post-traumatic cultural scripts' elements and their groupings, as expressed by trauma survivors from the East African population, and to explore the cultural values that serve as a reference to such scripts' elements.
Semi-structured, in-depth interviews were conducted in nine focus groups of trauma survivors and trauma experts. Grounded theory was the basis for the content analysis, and MAXQDA was used for coding and grouping. Semi-quantitative analyses of the frequency of groupings followed.
The study extracted 270 elements of the cultural scripts of trauma. Three stages of cultural scripts' elements were identified including unspeakable, heart wounds and painful scars and growth. The reported elements are only those in the three last stages and they are grouped into six categories, such as cognitive appraisals, worldview, interpersonal relationships, body-related, positive changes and changes in family interest and management, while the elements of the first stages are not codable as the survivors do not yet get the words of their expressions. The cultural values that served as a reference consisted of holding the sadness, Christianity, community reputation, solidarity, social connectedness, social cynicism, and reproductiveness, among others.
This comprehensive study with participants from several countries in East Africa collected a large number of elements of cultural scripts of trauma for this regional area. Notably, these elements were based mostly on man-made traumas, such as the genocide against the Tutsis in Rwanda. Further steps in the CST investigation are subject to future studies, such as a more systematic investigation of the relationship with cultural values and the temporal relationships within the scripts.
作为一种描绘创伤后遗症文化表达的全新统一方法，创伤后遗症文化脚本首次在一项主要为定性研究中接受实证调查。创伤文化脚本（CST）的要素包括经历创伤事件者的典型症状及对变化的评估。这些要素指向特定文化中的价值取向。
识别东非人群中创伤幸存者所表达的创伤后文化脚本要素及其分组，并探究作为此类脚本要素参照的文化价值观。
对九个创伤幸存者和创伤专家焦点小组进行了半结构化深度访谈。扎根理论是内容分析的基础，MAXQDA用于编码和分组。随后对分组频率进行了半定量分析。
该研究提取了270个创伤文化脚本要素。确定了文化脚本要素的三个阶段，包括难以言表、心灵创伤与痛苦伤疤以及成长。报告的要素仅为最后三个阶段的要素，它们被分为六类，如认知评估、世界观、人际关系、身体相关、积极变化以及家庭兴趣与管理方面的变化，而第一阶段的要素无法编码，因为幸存者尚未找到表达这些要素的词汇。作为参照的文化价值观包括承受悲伤、基督教、社区声誉、团结、社会联系、社会犬儒主义以及生殖能力等。
这项针对来自东非多个国家参与者的全面研究为本地区收集了大量创伤文化脚本要素。值得注意的是，这些要素大多基于人为创伤，如卢旺达针对图西族的种族灭绝。CST调查的后续步骤有待未来研究，例如对与文化价值观的关系以及脚本内时间关系进行更系统的调查。
