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A Conceptual Model of Historical Trauma: Implications for Public Health Practice and Research

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Abstract

Historical trauma theory is a relatively new concept in public health. The premise of this theory is that populations historically subjected to long-term, mass trauma-colonialism, slavery, war, genocide-exhibit a higher prevalence of disease even several generations after the original trauma occurred. Understanding how historical trauma might influence the current health status of racial/ethnic populations in the U.S. may provide new directions and insights for eliminating health disparities. This article offers an analysis of the theoretical framework of historical trauma theory and provides a general review of the literature. A conceptual model is introduced illustrating how historical trauma might play a role in disease prevalence and health disparities. Finally, implications for public health practice and research are discussed.
Electronic copy available at: http://ssrn.com/abstract=1350062Electronic copy available at: http://ssrn.com/abstract=1350062
Journal of Health Disparities Research and Practice
Volume 1, Number 1, Fall 2006
©2006 Center for Health Disparities Research
School of Public Health
University of Nevada Las Vegas
93
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R
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JOURNAL OF
A Conceptual Model of Historical Trauma:
Implications for Public Health Practice and Research
Michelle M. Sotero, University of Nevada, Las Vegas
Abstract
Historical trauma theory is a relatively new concept in public
health. The premise of this theory is that populations historically sub-
jected to long-term, mass trauma—colonialism, slavery, war, genocide—
exhibit a higher prevalence of disease even several generations a er the
original trauma occurred. Understanding how historical trauma might
infl uence the current health status of racial/ethnic populations in the
U.S. may provide new directions and insights for eliminating health
disparities. This article off ers an analysis of the theoretical framework of
historical trauma theory and provides a general review of the literature.
A conceptual model is introduced illustrating how historical trauma
might play a role in disease prevalence and health disparities. Finally,
implications for public health practice and research are discussed.
Key Words: historical trauma theory, racial/ethnic health disparities,
minority health, American Indian/Alaskan Native, public health, social
epidemiology
Introduction
Eliminating racial/ethnic health disparities is a key objective in
public health. To that end, modern epidemiology relies primarily on
the biomedical model for understanding the determinants of popula-
tion health. The approach is constrained, however, as McMichael1 has
pointed out, by a preoccupation with proximate risk factors and a focus
on the health of individuals rather than of particular populations. One of
the contributions of social epidemiology has been to expand the search
for causal infl uences on health to social pathways, social transitions and
their institutional contexts.2, 3 As Elder3 has eloquently stated, “lives are
lived in specifi c historical times and places…if historical times and places
change, they change the way people live their lives.”
, pp. 93–108
Electronic copy available at: http://ssrn.com/abstract=1350062Electronic copy available at: http://ssrn.com/abstract=1350062
94 Journal of Health Disparities Research and Practice • Vol. 1, No. 1 • Fall 2006
Historical trauma theory is the embodiment of this sentiment. The
premise is that populations historically subjected to long-term, mass
trauma exhibit a higher prevalence of disease even several generations
a er the original trauma occurred.4–7 Historical trauma theory is a
relatively new concept in public health; thus, empirical evidence
presently off ers weak support for the validity of the theory and its
connection to contemporary health disparities. Yet, for many, the concept
makes intuitive sense. In fact, a large body of interdisciplinary research
seemingly lends support to the theory, making it deserving of further
empirical research.
Understanding how historical trauma infl uences the current
health status of racial/ethnic populations in the U.S. may provide new
directions and insights for eliminating health disparities. This article
off ers an analysis of the theoretical framework of historical trauma
theory and provides a general review of the literature. A conceptual
model is introduced illustrating how historical trauma might play a role
in disease prevalence and health disparities. Finally, implications for
public health practice and research will be discussed.
Historical Trauma Theory
Historical trauma theory incorporates and builds upon three
theoretical frameworks in social epidemiology.2 The fi rst is psychosocial
theory, which links disease to both physical and psychological stress
stemming from the social environment. In this framework, psychosocial
stressors not only create susceptibility to disease, but act as a direct
pathogenic mechanism aff ecting biological systems in the body. The
second theoretical framework is political/economic theory, which
addresses the political, economic and structural determinants of health
and disease such as unjust power relations and class inequality. The
third is social/ecological systems theory, which recognizes the multilevel
dynamics and interdependencies of present/past, proximate/distal, and
life course factors in disease causation.1, 2
In understanding how and why certain populations have a higher
burden of disease than others, historical trauma theory provides a
macro-level, temporal framework for examining how the “life course” of
a population exposed to trauma at a particular point in time compares
with that of unexposed populations. Based on a review of the literature,
at least four distinct assumptions underpin this theory: (1) mass trauma
is deliberately and systematically infl icted upon a target population
by a subjugating, dominant population; (2) trauma is not limited to
a single catastrophic event, but continues over an extended period
95
of time; (3) traumatic events reverberate throughout the population,
creating a universal experience of trauma; and (4) the magnitude of the
trauma experience derails the population from its natural, projected
historical course resulting in a legacy of physical, psychological, social
and economic disparities that persists across generations. The three
basic constructs of the theory are the historical trauma experience, the
historical trauma response, and the intergenerational transmission of
historical trauma.4, 8
A Review of the Literature
All trauma experiences are technically historical in nature. Most of
the body of work on psychic trauma has focused on the psychological
eff ects of individuals’ rather than populations’ exposure to traumatic
events.9-11 In 1980, Post-Traumatic Stress Disorder (PTSD) was formally
accepted by the American Psychiatric Association as a diagnosis
describing the severe and long-term eff ects of exposure to traumatic
stressors like combat, sexual assault, child abuse, motor vehicle accidents
or natural disasters.12 Research indicates that individuals diagnosed
with PTSD have elevated odds of behavioral health risks and social
dysfunction.9, 12 Another study found that experiences of chronic trauma
created deep emotional scars aff ecting life-long pa erns of interpersonal
relationships, the ability to master life-skills and role performance.9 More
recently, clinical studies have linked chronic stress associated with PTSD
to physical health. Chronic stress has been linked to impairment of the
nervous system, the hypothalamic–pituitary–adrenal (HPA) axis, and
cardiovascular, metabolic, and immune systems. These impairments
contribute to chronic diseases such as diabetes, hypertension, and
cardiovascular disease.9, 10, 12, 15, 16 The literature also reveals that responses
to deliberate perpetration of mass trauma are very diff erent from those
caused by accident or forces of nature. Trauma as the result of deliberate
intent produces a profound sense of dismay and alienation. Intentional
violence threatens basic assumptions about an orderly, just world and
the intrinsic invulnerability and worthiness of the individual.13, 14
A key feature of historical trauma theory is that the psychological
and emotional consequences of the trauma experience are transmi ed to
subsequent generations through physiological, environmental and social
pathways resulting in an intergenerational cycle of trauma
response.4, 6–8, 17–21
Historical trauma transmission was fi rst conceptualized in the 1960s,
based on studies of persistent trauma among Holocaust survivors and
their families a er World War II.4, 17 Since then, a number of studies
A Conceptual Model of Historical Trauma • Sotero
96 Journal of Health Disparities Research and Practice • Vol. 1, No. 1 • Fall 2006
have found that off spring of Holocaust survivors manifested an array of
trauma response pathology and experienced themselves as “diff erent or
damaged” by their parents’ experiences.4, 15, 17, 21 Though these fi ndings
are not without controversy, disagreement centers primarily around
inadequacies in methodological complexity and study design.4, 17, 22 More
recently, studies in other populations—Palestinian, Russian, Cambodian,
African American and American Indian—have documented that
off spring of parents aff ected by trauma also exhibited various symptoms
of PTSD or “historical trauma response.” These symptoms included
an array of psychological problems such as denial, depersonalization,
isolation, memory loss, nightmares, psychic numbing, hypervigilance,
substance abuse, fi xation on trauma, identifi cation with death, survivor
guilt and unresolved grief.4-8, 17, 20, 23–29
In the last decade, the majority of historical trauma research has
been with American Indian/Alaskan Native (AIAN) populations.
Brave Heart and DeBruyn5 rst published on the concept of historical
trauma in the AIAN population in the mid 1990s. Brave Heart8 defi ned
historical trauma as “the cumulative and collective psychological and
emotional injury sustained over a lifetime and across generations
resulting from massive group trauma experiences.” Faimon30 described
historical trauma experienced by the (American Indian) Dakota nation
as an “indescribable terror and the legacy of terror that remains a er
140 years, as evidenced by repression, dissociation, denial, alcoholism,
depression, doubt, helplessness and devaluation of self and culture.”
She also elaborated on the intergenerational legacy of shame, guilt, and
distrust embedded in collective memory and passed down through
seven generations. The Aboriginal Healing Foundation18 describes
historical trauma as a cluster of traumatic events and as a disease itself.
The symptoms of historical trauma as a disease are the maladaptive
social and behavioral pa erns that were created in response to the
trauma experience, absorbed into the culture and transmi ed as learned
behavior from generation to generation.18
Recently, researchers have begun to identify historical trauma as
a precipitating condition infl uencing racial/ethnic health disparities.
Williams, Neighbors and Jackson31 identifi ed race-related historical
trauma as a large-scale, systems-related macro-stressor that adversely
impacts both the physical and mental health of the aff ected racial/
ethnic group. Walters and Simoni32 described historical trauma from
an indigenous fourth-world context, in which a minority indigenous
population exists in a nation where a colonizing, subordinating majority
holds institutionalized power and privilege. The subordination of
97
indigenous populations and the cumulative eff ects of injustice and
discrimination are characterized as a “soul wound” that impacts
health outcomes for Native people. Duran and Walters33 suggested that
temporal pa erns of exposure to cultural and historical trauma may act
as covariates in HIV/AIDS behavior among AIAN populations. Finally,
Leary7 and Reid, Mims and Higginbo om20 assert that African Americans
have sustained traumatic psychological and emotional injury as a direct
result of slavery, perpetuated by social/institutional inequality, racism
and oppression.
The literature on historical trauma is largely theoretical and
qualitative in nature. More quantitative studies are needed to build
on existing work and to connect historical trauma with public health
and disease outcomes. Whitbeck et al.,17 for example, developed a
Historical Loss Scale and a Historical Loss Associated Symptoms Scale
as a measure of historical trauma in American Indian elders. Baker and
Gippenreiter34 conducted a study designed to measure the physical and
mental health eff ects of historical trauma in the grandchildren of victims
of the Stalin Purge of 1937–39.
In addition, the literature on trauma (psychic and historical)
primarily focuses on the psychosocial/psychobiological sequelae of the
trauma experience. Li le is wri en about the physical eff ects resulting
from exposure to mass trauma—injuries, infectious and chronic diseases,
malnutrition—and whether they persist through future generations.
However, a large body of empirical research on the Dutch Famine of
1944 (see the works of M. Susser; A. Ravelli; L. Lumey; and J. McClellan)
and a growing body of research on the fetal origins of disease (see D.
Barker and D. Benyshek) indicate that physical ramifi cations of trauma
exposure can carry over to subsequent generations via genetic mutation,
impairments in gene expression and physiological adaptations.
One of the challenges to quantitative research may be
conceptualizing how events that took place in the distant past aff ect
the present. The literature review did not produce a general conceptual
model illustrating how all of the described elements of historical trauma
interact in a manner that infl uences contemporary health disparities.
A Conceptual Model of Historical Trauma
The conceptual model of historical trauma introduced here a empts
to synthesize the literature and delineate physical, psychological and
social pathways linking historical trauma to disease prevalence and
health disparities (Figure 1).
A Conceptual Model of Historical Trauma • Sotero
98 Journal of Health Disparities Research and Practice • Vol. 1, No. 1 • Fall 2006
Figure 1. Conceptual Model of Historical Trauma
Dominant
Group
Subjugation of
a Population
Segregation/Displacement
(plantation, reservation,
refugee camp, etc.)
Physical/Psychological
Violence
(acute and chronic)
Economic Destruction
(loss of resources,
legal rights)
Cultural Dispossession
(loss of cultural roles,
language, religion, etc.)
First Generation or Primary Generations
Secondary and Subsequent Generations
Trauma Response
Physical Response
> Nutritional stress
> Compromised immune system
> Biochemical abnormalities
> Endocrine impairment
> Adrenal maladaptation
> Gene impairment/expression
Resulting in: malnutrition, diabetes,
hyperglycemia, infectious disease,
heart disease, hypertension, cancer
Psychological Response
> Post-Traumatic Stress Disorder
> Depression
> Panic/Anxiety Disorders
Resulting in:
anger/aggression terror/fear
social isolation grief
shame withdrawal
loss of self-worth numbness
> Increased suicide rate
> Domestic violence
> Unemployment
Resulting in:
breakdown of community/family structures and social
networks, loss of resources, separation from loved ones
> Substance abuse
> Child maltreatment
> Poverty
Resilience
Protective
Factors
Social Response
MASS
TRAUMA
EXPERIENCE
Modes of Intergenerational Transmission
> Physiological
> Genetic
> Environmental
> Psychosocial
> Social/Economic/Political Systems
> Legal and Social Discrimination
Present
Proximate
Individual
Population
Distal Life stage
Life course
Past
influences on
Health Disparities
INTERGENERATI ONAL
TRANSMISSION
99
The model posits that historical trauma originates with the
subjugation of a population by a dominant group. Successful subjugation
requires at least four elements: 18 (1) overwhelming physical and
psychological violence, (2) segregation and/or displacement, (3)
economic deprivation, and (4) cultural dispossession.
The dominant group enforces subjugation through various means
including military force, bio-warfare, national policies of genocide, ethnic
cleansing, incarceration, enslavement, and/or laws that prohibit freedom
of movement, economic development, and cultural expression.4, 5, 18, 19,
24, 32, 35–41 Though overt legitimization of subjugation may be rescinded
over time, its legacy remains in the form of racism, discrimination and
social and economic disadvantage.6, ,7, 20, 31, 32, 42 The universal experience of
subjugation constitutes signifi cant physical and psychological trauma for
the aff ected population.
As the model illustrates, primary generations are the direct victims
of subjugation and loss, which threaten their population and economic
and cultural survival. Having witnessed great loss of life and endured
brutality, starvation, and disease, many survivors are plagued with
physical injuries, malnutrition, and high rates of infectious and chronic
diseases.5, 18, 30, 43 Their psychological and emotional responses stem from
experiencing violence, severe stress, pervasive hardship and <relentless>
unremi ing grief at the loss of kin, land, and way of life.5, 13, 18, 37, 39–41, 44
Trauma response in primary generations may include PTSD, depression,
self-destructive behaviors, severe anxiety, guilt, hostility, and chronic
bereavement.9–11, 13 Psychological and emotional disorders may well
translate into physical disease, and vice versa.9, 12
Secondary and subsequent generations are aff ected by the original
trauma through various means. Extreme trauma may lead to subsequent
impairments in the capacity for parenting.4 Physical and emotional
trauma can impair genetic function and expression, which may in turn
aff ect off spring genetically, through in utero biological adaptations,
or environmentally. 4, 11, 18, 45, 46–49 Evidence suggests that disorders such
as mental illness, depression and PTSD can be genetically transmi ed
to secondary and subsequent generations.1, 45, 50 Maternal malnutrition
contributes to poor-quality breast milk and low-birth-weight babies.51
Some studies indicate that maternal care and depressive state are
also major determinants of endocrine and behavioral stress responses
in off spring.50, 52 Further, some evidence suggests that physiological
adaptations made by a fetus in response to in utero stressors are
correlated with a number negative health outcomes throughout life.49
According to Benyshek,46 research shows that Type 2 diabetes in adults
A Conceptual Model of Historical Trauma • Sotero
100 Journal of Health Disparities Research and Practice • Vol. 1, No. 1 • Fall 2006
may be caused by metabolic adaptations of the fetus in response to
maternal malnutrition. The disorder is then propagated throughout
subsequent generations via hyperglycemic pregnancies.46
Maladaptive behaviors and related social problems such as
substance abuse, physical/sexual abuse, and suicide directly traumatize
off spring and are indirectly transmi ed through learned behavior
perpetuating the intergenerational cycle of trauma.4, 53–56 Secondary and
subsequent generations also experience “vicarious traumatization”
through the collective memory, storytelling and oral traditions of the
population. Traumatic events become embedded in the collective,
social memories of the population. Off spring are taught to share
in the ancestral pain of their people and may have strong feelings
of unresolved grief, persecution and distrust.18, 24, 30 They may also
experience original trauma through loss of culture and language, as well
as through proximate, fi rst-hand experiences of discrimination, injustice,
poverty, and social inequality. Such experiences validate their ancestral
knowledge of historical trauma and reinforce the historical trauma
experience and response.24, 31
Finally, the cumulative eff ects of historical trauma on the population,
mitigated to some degree by the existence of resiliency and protective
factors, result in a surfeit of social and physical ills that ultimately lead to
population-specifi c health disparities. Historical trauma has been called
a “disease of time.”18 From this perspective, the poor health status of
aff ected populations can be argued as the result of the accumulation of
disease and social distress across each succeeding generation.
Case Study: Historical Trauma and Health Disparities in the
AIAN Population
Descriptions and details of the subjugation of AIAN people through
colonization, war and genocide have been provided by many authors
and will not be repeated here. (See Stannard, 1992; Thornton, 1987;
Aboriginal Healing Foundation, 2004; and Brave Heart & DeBruyn,
1998). However, to illustrate how historical trauma might infl uence
health disparities, one pertinent historical event will be recounted and
associated with the current health status of the AIAN population.
The introduction of infectious diseases was the single most
devastating impact of the European colonization of the Americas. Known
as virgin soil epidemics, measles and small pox alone decimated over
90% of the indigenous population by some estimates.18 Until the early
1900s, measles and small pox epidemics struck every seven to eleven
101
years, resulting in great loss of life, habitual food scarcity, starvation and
chronic illness.18
Recurrent epidemics meant that the population had li le time to
reproduce fully immune off spring.18 Exposure to infectious disease
compromised cellular immunity, facilitated the spread of viruses and
created susceptibility to other diseases such as tuberculosis, hepatitis and
infl uenza.18, 51, 57 Food scarcity and starvation, a by-product not only of
the epidemics but of government policies, may also have led to metabolic
and behavior adaptations. In a paper titled “Diseases Among Indians,”
published in 1892 in the Weekly Journal of Medicine and Surgery, Dr.
A.B. Holder57 writes, “The buff alo is gone and Government rations or
scant subsistence by their own labor, is the Indians’ present diet. In this
change is found a factor in the causation of consumption and scrofula.”
He further states that food rations furnished by the government were
inconsistent and insuffi cient to maintain health. A er a period of fasting,
the next supply of food rations would arrive and there would be a feast
in which most of the food was consumed. This resulted in a regular
succession of fasts and feasts that “deranges digestion and assimilation
and fi ts the constitution for the invasion of tuberculosis.”57
Though it was only one of many historical tragedies, 6, 18, 58, 59
infectious disease had a devastating impact on the health of American
Indians and Alaskan Natives. One could argue that the population
health of contemporary AIANs never recovered from the extensive
physical, psychological, social and cultural trauma of European
colonization.42 Today, this population has the poorest health status
of any racial/ethnic population in the United States.42 Compared to
the U.S. average, American Indians are 770% more likely to die from
alcoholism, 650% more likely to die from tuberculosis, 420% more likely
to die from diabetes, 280% more likely to die from accidents, 190% more
likely to commit suicide and 52% more likely to die from pneumonia or
infl uenza.42 For some Native populations in the U.S., life expectancy is
lower than every country in the Western Hemisphere, with the exception
of Haiti.60
Implications for Public Health Practice and Research
Pearce61 states that modern epidemiology embraces a paradigm
that “focuses on the individual, blames the victim, and produces
interventions that can be harmful.” Many Native and non-Native allied
public health professionals have begun to change this by developing
intervention programs that integrate theories of historical trauma,
community capacity and community empowerment. 8, 23–25, 33, 55, 62–64
A Conceptual Model of Historical Trauma • Sotero
102 Journal of Health Disparities Research and Practice • Vol. 1, No. 1 • Fall 2006
These programs are designed to be holistic, culturally relevant, and
respectful of indigenous self-understanding of historical trauma and
its impact on community health. Symptoms of historical trauma—like
diabetes, suicide, and domestic violence—are addressed from a diff erent
perspective and through a new paradigm diff erent from traditional
health programs that subscribe to Western belief systems and inherent
dominant culture biases.55, 62 The work pioneered in AIAN communities
provides a model for addressing health disparities in other minority
populations.
Connecting the past with the present is inherent in many cultural
traditions. Historical trauma theory contextualizes “time and place.” It
validates and aligns itself with the experiences and explanatory models
of aff ected populations and recognizes issues of accountability and
agency. It creates an emotional and psychological release from blame
and guilt about health status, empowers individuals and communities to
address the root causes of poor health and allows for capacity building
unique to culture, community and social structure.62
Historical trauma theory is a rich-in-variables framework whose
application to public health is invaluable. More empirical research
is necessary to fully understand, operationalize and validate the
theoretical constructs of historical trauma. More work is also needed
to link measures of historical trauma to health outcomes. The majority
of research on historical trauma has been conducted with American
Indian populations and is largely qualitative. More evaluative research
is needed on the eff ectiveness of intervention programs. More empirical
research is needed to gain a be er understanding of the manifestations
and prevalence of historical trauma among indigenous populations,
as well as the specifi c mechanisms of intergenerational transmission.
Research needs to be conducted in other minority populations in the
U.S. to determine the existence of historical trauma or if there are trauma
response variations dependent on intensity, length and context of
exposure, time passed since exposure, resiliency, protective or cultural
factors. The conceptual model of historical trauma introduced here
is intended to help public health practitioners and researchers gain a
broader perspective of health disparities and aid in the development
of new approaches for improving the health status of racial/ethnic
populations in the United States.
Acknowledgments
Many thanks to Michelle Chino, Ph.D., for making this paper
possible. Her expertise, support and mentorship were invaluable. Special
103
thanks to Roland Sotero for his insightful comments and contributions
and to an anonymous reviewer who took the time to provide an in-depth
critique.
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Michelle M. Sotero, B.A., is a MPH candidate at the University of Nevada, Las
Vegas and a research assistant at the Center for Health Disparities Research,
University of Nevada, Las Vegas.
A Conceptual Model of Historical Trauma • Sotero
... Shared recognition among Blacks and other People of Color shows up immediately as they see themselves depicted, mis-represented and denigrated in public spaces (i.e. workspaces, social media, television, and newsprint; Carlson et al., 2017;Sotero, 2006). Carlson et al. (2017) explain that in order to experience collective trauma through shared recognition, an individual must share a sense of belonging to a group. ...
... In alignment with previous research, this study revealed how shared recognition occurs among Blacks and other People of Color following a race-related incident (Carlson et al., 2017;Sotero, 2006). Findings suggest a collective trauma and/or sense of fear that can occur when race-related discriminatory incidents are either personally or vicariously experienced. ...
Article
This qualitative study explores Black Americans’ social emotional responses after viewing race-related discriminatory content on social media. Perceptions held by fifteen respondents regarding the effects of viewing race-based discriminatory content on social media were evaluated. Three key themes emerged from the findings: 1) Shared recognition as a means of engaging in a collective understanding and identification of race-related discriminatory events; 2) Social emotional responses after engaging with race-related discriminatory and violent content on social media; and 3) Coping as a way to deal with the effects of race-related discriminatory content on social media. Implications for social work practice are discussed.
... 128). African Americans who have experienced historical traumas like slavery and discrimination tend to show a higher incidence of disease even decades after the original trauma occurred (Quinn, 2018;Sotero, 2006). Specifically, in the explanation of the Post Traumatic Slave Syndrome, DeGruy (2001) suggests that the hundreds of years African Americans spent enslaved has resulted in a legacy of debt-pain-and trauma that is similar to the effect of historical trauma, i.e., delinquency and criminality. ...
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Early life adversity has long been associated with the onset and course of criminal behavior and juvenile justice involvement. Nevertheless, there is a paucity of research on the differential experiences of early life trauma and trauma symptomology among justice involved youth of color who are ubiquitously overrepresented in the juvenile justice system (JJS). Conventional trauma instruments used in the JJS may yield limited cultural relevance or applicability to racially minoritized justice involved youth as they rarely capture concepts of race-based trauma. While research has explored the relative effects of racial trauma above and beyond other traumatic experiences among minoritized youth in the JJS, differential trauma experiences and differential effects between trauma and delinquency among racial groups have not been extensively explored. Conducting multivariate analysis of variance with appropriate post hoc tests and bivariate correlations, the results revealed significant mean differences between racial groups on experiences of early life trauma via conventional trauma instruments; white youth reported higher rates of trauma events including cumulative trauma, relative to black and Hispanic youth, but had similar rates of trauma symptoms relative to black youth. Furthermore, while there were no racial group differences on reports of delinquency, there were vastly different trauma-based risk correlates by racial group; white youth had several trauma indicators associated with delinquency, whereas black and Hispanic youth had no associations. Results suggest conventional trauma instruments have limited cultural and racial relevancy for minoritized justice involved youth. Implications are identified for intersectional youth participatory action approaches to instrument development centered on discovering raced-based traumatic stress among racially minoritized justice involved youth.
... Estrada outlines that this trauma is expressed as symptoms of depression, selfdestructive behavior, substance abuse, identification with ancestral pain, fixation to trauma, somatic symptoms, anxiety, guilt, and chronic bereavement. Sotero (2006) developed a three-stage conceptual model of historical trauma. First, a dominant group subjugates a population, resulting in segregation and displacement, physical and psychological violence, economic destruction, and cultural dispossession. ...
Thesis
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This study of Elena Poniatowska's La noche de Tlateloco is based on a cognitive poetic approach to explore readers' perceptions of the work. It affirms both the historical veracity and literary ingenuity of the text by highlighting literary elements and asserting that they strengthen rather than weaken readers' historical understanding of the censured collective trauma. This study applies theories of readers' literary perceptions to investigate the work as a sensorially immersive experience. It analyzes the emotional atmospheres in "Ganar la calle" and "La noche de Tlatelolco" by highlighting cognitive qualities of emotions within the text. It then postulates that the creative presentation of La noche draws readers' attention to historical silences and immerses them into parts of the past often overlooked by conventional historiography. Hold for signature page. We will help you place your unsigned signature page here. Only unsigned copies are uploaded to ensure that a person's signature is not released on the internet.
Chapter
A large body of research has demonstrated that experiencing abuse by an intimate partner is associated with a wide range of mental health consequences. Some are the direct results of violence, others are related to the traumatic psychophysiological effects of ongoing abuse. Less well researched, however, are the ways that people who abuse their partners engage in coercive tactics related to their partner’s mental health or substance use as part of a broader pattern of abuse and control – tactics known as mental health and substance use coercion. For survivors of ongoing Intimate Partner Violence (IPV), responding to trauma raises another set of concerns, particularly when the trauma is unremitting, and symptoms reflect a response to ongoing danger and coercive control. At the same time, many survivors experience multiple types of trauma over the course of their lives, including structural violence and marginalization. While more research is needed on IPV-specific treatment interventions, evidence indicates that interventions that are adapted to meet the specific needs of survivors of IPV are most effective. This chapter provides an overview of the impact of IPV on survivors’ mental health and a framework for treatment in the context of IPV, including IPV-specific treatment strategies and suggestions for incorporating an IPV- and trauma-informed approach.
Chapter
Exposure to adverse or traumatic events in childhood has been linked to a host of negative and lasting effects on health and well-being throughout the life course (Anda et al. Eur Arch Psychiatry Clin Neurosci, 256(3):174–186, 2006). Students who are suffering from the effects of trauma may experience alterations in their thinking, mood, or patterns of reactivity that may contribute to or compound academic difficulties. A student’s behavior may escalate quickly to violence due to profound physiological dysregulation, and/or they may subsequently experience harsh or punitive consequences for their maladaptive behaviors that are re-traumatizing, and may lead to further distress. Both outcomes may jeopardize the safety of the student and those around them. How school personnel respond to trauma-exposed students can decrease the compounding effects of trauma, and can create a safer school experience for everyone (Rivard et al. Ther Community, 26(1):83–96, 2005). This chapter will provide a framework for how trauma-informed care (TIC) can create a culture of safety that can decrease violence in schools. Drawing on emerging data from trauma systems transformation projects and the empirical literature, this chapter will explore the tenets and assumptions of trauma-informed care, propose intervention, and data strategies for integration of trauma-informed care into a Multi-tiered Systems of Support model, and provide essential elements of a data-driven, trauma-informed approach to reducing trauma and violence in schools. Case examples are provided to illustrate concepts.
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Objectives Unambiguously, Nigeria is off-track in achieving the health-related SDGs. Consequentially, this study aligns with SDG 3 which calls for “ good health and wellbeing for people by ensuring healthy lives and promoting wellbeing for all at all ages” . This article examines the combined effect of health expenditure and other key macro-economic factors on health indices such as maternal and newborn and child mortality in Nigeria. Contrary to existing literature, we formulated a model that predicts the level of macro-economic determinants needed to achieve the SDG targets for maternal and newborn and child mortality in Nigeria by 2030. Methodology The study used Autoregressive Distributed Lag (ARDL), which is usually used for large T models. The study period spans from 1995 to 2020. Results We found a significant negative relationship between health outcomes and macro-economic determinants namely, household consumption, total health expenditure, and gross fixed capital while we determined a significant positive relationship between health outcomes and unemployment. Our findings are further supported by out-of-sample forecast results suggesting a reduction in unemployment to 1.84 percent and an increase in health expenditure, gross fixed capital, household consumption, control of corruption to 1,818.87 billon (naira), 94.46 billion (naira), 3.2 percent, and −4.2 percent respectively to achieve SDG health targets in Nigeria by 2030. Policy implication The outcome of this result will give the Nigerian government and stakeholders a deeper understanding of the workings of the macro-economic factors, concerning health performance and will help position Nigeria, and other SSA countries by extension, toward reducing maternal mortality to 70 per 100,000 and newborn and child mortality to 25 per 1,000 births by 2030. The African leaders should consider passing into law the need for improvement in macro-economic factors for better health in Africa. We also recommend that the Nigerian government should steadily increase health expenditure to reach and move beyond the forecast level for improvement in maternal and infant mortality, given the present low and unimpressive funding for the health sector in the country.
Chapter
This chapter considers how educators can and should pay attention to the spatial implications of issues impacting educators and schools. Drawing attention to critical and racialized geographies, this chapter provides examples of how we might think spatially and expand our roles as citizen teachers. If we are to alter relations of power and engage in place-making, we need to have the analytic tools to understand how community issues percolate into schools. This chapter introduces the school and the district to map out particular relationships that shape the narration of these stories and examples.KeywordsCritical geographiesRacialized geographiesSettler colonialismPlace-makingWhite supremacy
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Black American women are disproportionately exposed to adversities that may have an intergenerational impact on mental health. The present study examined whether maternal exposure to adversity and epigenetic age acceleration (EAA; a biomarker of stress exposure) predicts the socioemotional health of her offspring. During pregnancy, 180 Black American women self-reported experiences of childhood adversity and marginalization-related adversity (i.e., racial discrimination and gendered racial stress) and provided a blood sample for epigenetic assessment. At a three-year follow-up visit, women reported their offspring's emotional reactivity (an early indicator of psychopathology) via the CBCL/1.5-5. After adjusting for maternal education and offspring sex, results indicated that greater maternal experiences of childhood trauma (β = 0.21, SE(β) = 0.01; p = 0.01) and racial discrimination (β = 0.14, SE(β) = 0.07; p = 0.049) predicted greater offspring emotional reactivity, as did maternal EAA (β = 0.17, SE(β) = 0.09, p = 0.046). Our findings suggest that maternal EAA could serve as an early biomarker for intergenerational risk conferred by maternal adversity, and that 'maternal adversity' must be defined more broadly to include social marginalization, particularly for Black Americans.
Book
In this extraordinary new text, an international array of scholars explore the enduring legacy of such social shocks as war, genocide, slavery, tyranny, crime, and disease. Among the cases addressed are - instances of genocide in Turkey, Cambodia, and Russia - the plight of the families of Holocaust survivors, atomic bomb survivors in Japan, and even the children of Nazis - the long-term effects associated with the Vietnam War and the war in Yugoslavia - and the psychology arising from the legacy of slavery in America.
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For four hundred years-from the first Spanish assaults against the Arawak people of Hispaniola in the 1490s to the US Army's massacre of Sioux Indians at Wounded Knee in the 1890s-the indigenous inhabitants of North and South America endured an unending firestorm of violence. During that time the native population of the Western Hemisphere declined by as many as 100 million people. Indeed, as historian David E. Stannard argues in this stunning new book, the European and white American destruction of the native peoples of the Americas was the most massive act of genocide in the history of the world. Stannard begins with a portrait of the enormous richness and diversity of life in the Americas prior to Columbus's fateful voyage in 1492. He then follows the path of genocide from the Indies to Mexico and Central and South America, then north to Florida, Virginia, and New England, and finally out across the Great Plains and Southwest to California and the North Pacific Coast. Stannard reveals that wherever Europeans or white Americans went, the native people were caught between imported plagues and barbarous atrocities, typically resulting in the annihilation of 95 percent of their populations. What kind of people, he asks, do such horrendous things to others? His highly provocative answer: Christians. Digging deeply into ancient European and Christian attitudes toward sex, race, and war, he finds the cultural ground well prepared by the end of the Middle Ages for the centuries-long genocide campaign that Europeans and their descendants launched-and in places continue to wage-against the New World's original inhabitants. Advancing a thesis that is sure to create much controversy, Stannard contends that the perpetrators of the American Holocaust drew on the same ideological wellspring as did the later architects of the Nazi Holocaust. It is an ideology that remains dangerously alive today, he adds, and one that in recent years has surfaced in American justifications for large-scale military intervention in Southeast Asia and the Middle East. At once sweeping in scope and meticulously detailed, American Holocaust is a work of impassioned scholarship that is certain to ignite intense historical and moral debate.
Chapter
This chapter describes a preliminary research project jointly undertaken during the winter of 1993–1994 by a Russian psychologist and an American social worker. The authors first met during KGB’s presentation of Bowen Family Systems Theory (BFST) at Moscow State University in 1989. During frequent meetings in subsequent years in the United States and Russia, the authors shared their thoughts about the enormous political and societal upheaval occurring in Russia in the 1990s. The wider context of Russian history in the 20th-century and its impact on contemporary events, on the functioning of families over several generations, and on the functioning of individuals living through turbulent times was central to these discussions.
Article
OBJECTIVE: To determine the prevalence of psychological morbidity among Palestinian children living in the southern Bethlehem District of the West Bank during July 2000. METHODS: We undertook a descriptive study using the Rutter A2 (parent) Scale to determine psychological morbidity. This questionnaire comprises 31 questions that were answered by a parent of the 206 subject children (ages 6 to 13 years). We selected subjects based on a multistage, randomized selection of 8 Palestinian villages and their households in the southern region of Bethlehem, West Bank. We used the Gaza Socioeconomic Adversities Questionnaire to determine differences in economic status among families. RESULTS: For all families interviewed, the father was employed, none were receiving financial assistance, and all but 1 owned their own house. The results of the Rutter A2 Scale revealed a rate of psychological morbidity ("caseness") of 42.3% among Palestinian children. The rate for boys was 46.3% and for girls, 37.8%. CONCLUSIONS: The prevalence of psychological morbidity among Palestinian children in the West Bank was significantly higher (factor of 2; chi2 = 23.26, df 1, P < 0.001), relative to the level of psychological morbidity determined independently for children in Gaza during 2000. We predict that these rates will have increased substantially owing to the escalated violence that began in this region 2 months after we conducted our study. We further predict that children in Israeli settlements in the West Bank will also exhibit elevated levels of psychological morbidity, relative to their counterparts in Israel.
Article
Objective: To investigate possible multigenerational influences on birthweight. Design: Data from the longitudinal study of one week's births in 1958 up to the age of 23 years, the British National Child Development Study, were utilized. These provide socio-biological information on the parents of the cohort, on the cohort members from birth onwards, and on the pregnancies and the birthweight of any babies born to the cohort members. Main outcome measure: The main outcome was the birthweight of babies born to the cohort members, for whom complete intergenerational data were available for 1638 firstborn. Multiple regression modelling was used to investigate any associations between their birthweight and characteristics of their parents and grandparents. Results: Significant positive associations were found between babies' birthweight and parental birthweight but not gestational age. For the babies born to female cohort members additional findings included associations between their birthweight and the height of the maternal grandmother and the social class of the maternal grandfather, even after adjustment for such strong predictors of birthweight as maternal weight, smoking habit in pregnancy and baby's sex and birth order. Conclusion: These results thus offer support for a multigenerational influence on birthweight passed through the maternal line.
Article
Psychological responses and mental health of 174 Palestinian women living in the occupied West-Bank and the Gaza Strip were studied through a stress model. Thirty-five Palestinian women living in Israel proper who had not been exposed to military occupation were interviewed as a comparison group. The stress process studied consists of women's appraisal of threat and the importance of the stressors in their lives, the estimation of their own resources to cope with stress, actual coping modes, and mental health outcomes. Women living under military occupation tended to appraise their environment as highly threatening and their experiences as strain-producing. At the same time they believed they had sufficient assets, especially collective and ideological resources, to deal with the stressors. This tendency was particularly evident among victims of political violence. Women strongly exposed to hardships of military occupation tended to employ more social and political activity and less inactive and ...