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Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
THEORETICAL MODELS OF VIOLENCE AND TRAUMA: CONCEPTUAL
REVIEWS AND TRAUMA INTERVENTION STRATEGIES
1Leonard C. Orji; 2Iyabode Sadiat-Aliu & 3Iheanyi Valentine Ekechukwu
1University of Agriculture and Environmental Sciences, Umagwo,
Imo State, Department Of Psychology
2Caleb University, Imota Ikorodu, Lagos State. Psychology Department
3Nnamdi Azikiwe University, Awka, Anambra State, Department Of Sociology
Corresponding Author’s Mobile No. 08078615503
EMAIL: drleonardorji@outlook.com
Abstract
The study provides a conceptual review of theoretical models of violence and trauma, with a focus
on trauma intervention strategies. The objectives of the study were to examine the psychosocial
theories of violence, provide a frame work for understanding trauma, describe the sequence of
violence and trauma, explore implications of violence and trauma, highlight the dimensions of
violence and trauma and examine some notable cases of violence and trauma in Nigeria. The study
employed a qualitative research approach, using a review of literature and case studies to analyse
the theorectical models and trauma intervention strategies. The findings reveal that psychosocial
theories of violence provide insights into the factors that contributes to violent behavior, while a
frame work for understanding trauma highlights the complex nature of traumatic experiences and
the need for comprehensive interventions.The study also reveals that violence and trauma have
significant implications for individuals and society, with a range of dimensions that require
attention. Furthermore the study highlights some notable cases of violence and trauma in Nigeria,
including terrorism, political violence, domestic violence and communal conflicts.The study
concludes by emphasizing the importance of trauma intervention strategies in addressing
psychological and social consequences of violence and trauma, and the need for comprehensive
approaches that involve multiple stakeholders.
Keywords: Violence, Trauma, Psychosocial, Trauma management, Posttraumatic Stress
Disorde
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Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
INTRODUCTION
Violence and trauma have their consequential roles on individuals, families and societies at large.
The two terms collectively work hand in glove as ‘cause and effect’ in the life situation of groups
or individuals involved. They can be the origin of a case or as a result of the case at hand. Violence
can be a cause or aftermath of a trauma likewise trauma. They can be commonly experienced by
any child or adult in groups or communities and equally lead to a lasting negative effects as well
as traumatic reactions by the affected individuals.
Violence involves intentional use of physical force or power, threatened or actual against oneself,
another person or against a group or community, that either results in or has a high likelihood of
resulting in injury, death, psychological harm, maladjustment or deprivation (WHO, 2002).
Violence became a public health issue in 1965 when homicide and suicide consistently appeared
on the top list leading cause of death in United States; likewise reaching the epidemic stage in
1980s made it more of a concern to Public health (Centre for Disease Control and Prevention,
2008; 2009).
WHO (2002), divides violence into three broad categories according to who the perpetrators and
victims are of violent acts:
1. Self-directed violence refers to violent acts a person inflicts upon him- or herself, and
includes self-abuse (such as self-mutilation) and suicidal behaviour (including suicidal
thoughts, as well as attempted and completed suicide).
2. Interpersonal violence refers to violence inflicted by another individual or by a small group
of individuals. It can be further divided into two subcategories:
i. Family and intimate partner violence – violence largely between family members and
intimate partners, usually, though not exclusively, taking place in the home. This includes
forms of violence such as child abuse, intimate partner violence and abuse of the elderly.
ii. Community violence – violence between individuals who are unrelated, and who may or
may not know each other, generally taking place outside the home. This includes youth
violence, random acts of violence, rape or sexual assault by strangers, and violence in
institutional settings such as schools, workplaces, prisons and nursing homes.
3. Collective violence can be defined as the instrumental use of violence by people who
identify themselves as members of a group – whether this group is transitory or has a more
permanent identity – against another group or set of individuals, in order to achieve
political, economic or social objectives. This can manifest in a number of forms, such as
genocide, repression, terrorism and organized violent crime.
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Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
Further, these categories were divided into more specific types as:
i. Physical violence as the intentional use of physical force, used with the potential for
causing harm, injury, disability or death. This includes, but is not limited to: scratching,
pushing, shoving, grabbing, biting, choking, shaking, slapping, punching, hitting,
burning, use of a weapon, and use of restraint or one’s body against another person.This
type of violence does not only lead to physical harm, but can also have severe negative
psychological effects – for example, if a child is frequently a victim of physical
violence at home, he or she can suffer from mental health problems and be traumatized
as a consequence of this victimization.
ii. Sexual violence involves a sexual act being committed or attempted against a victim
who has not freely given consent, or who is unable to consent or refuse. This includes,
but is not limited to: forced, alcohol/drug-facilitated or unwanted penetration, sexual
touching, or non-contact acts of a sexual nature. A perpetrator forcing or coercing a
victim to engage in sexual acts with a third party also qualifies as sexual violence.This
type of violence can also lead to physical harm, and in most cases has severe negative
psychological effects too.
iii. Psychological violence (also referred to as emotional or mental abuse) includes verbal
and non-verbal communication used with the intent to harm another person mentally
oremotionally, or to exert control over another person.The impact of psychological
violencecan be just as significant as that of other, more physical forms of violence, as
the perpetratorsubjects the victim to behaviour which may result to some form of
psychological trauma,such as anxiety, depression or post-traumatic stress disorder.
This includes, but is not limited to: expressive aggression (e.g., humiliating and
degrading), coercive control (e.g., limiting access to things or people, and excessive
monitoring of a person’s whereabouts or communications), threats of physical or sexual
violence, control of reproductive or sexual health, exploitation of a person’s
vulnerability (e.g., immigration status or disability). These not only leads to mental
health problems, but also to severe physical problems, such as psychosomatic
disorders.
iv. Neglect, or deprivation, is a type of abuse which occurs when someone has the
responsibility to provide care for an individual who is unable to care for him- or
herself,but fails to do so, therefore depriving them of adequate care. Neglect may
include the failure to provide sufficient supervision, nourishment, or medical care, or
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Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
the failure to fulfil other needs for which the victim cannot provide themselves. Neglect
can lead to many long-term side effects such as: physical injuries, low self-esteem,
attention disorders, violent behaviour, physical and psychological illness, and can even
result death.
Trauma on the other hand, has to do with the emotional response to a terrible event like an accident,
rape, or natural disaster. Immediately after the event, shock and denial are typical. Longer term
reactions include unpredictable emotions, flashbacks, strained relationships, and even physical
symptoms like headaches or nausea (APA, 2022).
Trauma can occur early to an individual. Early childhood trauma generally refers to the traumatic
experiences that occur to children ages 0-6 and they can experience various types of trauma
including: Natural disasters, sexual abuse, physical abuse, domestic violence, medical injury,
illness, or procedures, community violence, neglect, deprivation, traumatic grief, victim of crime,
kidnapping, accidents, school violence, loss.
Trauma, which may manifest as an acute, chronic or complex in category and can be experienced
directly or indirectly, differs in mode of feelings to people. While some people with traumatic
experience may have clear symptoms of Post Traumatic Stress Disorder (PTSD), many others
could exhibit resilient responses or brief subclinical symptoms or consequences that fall outside
of diagnostic criteria. The impact of trauma can be subtle, insidious, or outrightly destructive.
How an event affects an individual depends on many factors, including characteristics of the
individual, the type and characteristics of the event(s), developmental processes, the meaning of
the trauma, and sociocultural factors (Center for Substance Abuse Treatment (US: 2014).
In a psychological context, a person subjected to trauma may respond in several ways. They may
be in a state of shock, extreme grief, or denial. Apart from the immediate or short-term response,
trauma may also give rise to several longer-term reactions in the form of emotional lability,
flashbacks, impulsiveness, and strained relationships. Besides the psychological symptoms,
trauma can lead to physical symptoms, such as headaches, lethargy, and nausea. Some people may
be affected a lot more than others. Such people may be entrapped in the emotional impact of the
trauma and find it difficult to move on with their lives. Such long-term manifestation of trauma
can lead to a psychological condition called Post-Traumatic Stress Disorder (Allarakha & Pallavi,
2021).
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Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
Objectives of the study
The general objective of this study is to evaluate the role violence and trauma play in human socity
and the burden it leaves on the wellbeing of people and society and how it can be mitigated. Below
are specific objectives of the study:
i. examine the psychological theories of violence
ii. provide framework for understanding of trauma.
iii. describe the sequence of violence and trauma.
iv. explain the implications of violence and trauma.
v. examine notable cases ( in Nigeria) and intervention strategise for trauma.
Psychosocial Theories of Violence
Social Learning Theory of Bandura (1977), believes that people can learn from each other through
observation, imitation and modeling. Bandura explains that children must not be rewarded or
frustrated in order to behave, rather they could learn that behaviour by observing a model doing it.
This explains that violent behaviours that lead to some traumatic experiences are learned from the
environment by the perpetrators. Observational learning is achieved with the five principles;
observation, attention, retention, reproduction and motivation by which when applied would
replicate the learned behaviour or a superior one. These behaviours are copied or replicated as
seen. If an individual happens to be in an environment that practices violent behaviour or use
violence in expressing aggression, this individual could replicate violence when triggered as a way
of expressing the displeasure.It could be learned via exposure or video games. In terms of partner
violence, social learning theory emphasizes that the tendencies of having physical aggression
against one's partner exist because close relatives and friends of the perpetrator approve or engage
in such conduct themselves.
Social learning also occurs through external rewards and punishments and also through the
internalization of group-defined values and expectations. Gang violence, for example, exhibits
many of these social learning processes. Young people who see older, respected people join gangs
and engage in violence also tend to join gangs. Young people often join gangs to obtain social
rewards such as respect, power, and a sense of safety and belongingness as envisaged in cult
activities on campus
Social Exchange Theory of Homans (1958), believes that violence is motivated by the principle of
cost and benefit, through abuse when the reward is greater than the cost. Environmental factors
like family orientation, culture, religion etc. of the perpetrator allows the use of violence in
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Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
expressing and producing the significant reward of social control or power.This theory maintains
that the goal is to gain or maintain control and power over the relationship through abusive
behaviour. The repeated act of violent towards the victim leads them to feel vulnerable and helpless
in the abusive relationship as victims deal with many forms of abuse. The victim develops learned
helplessness and use various coping method to survive the mistreatment even as in Stockholm
syndrome.
The Subculture of ViolenceTheory of Cohen (1972),Cohen proposes that youths as a means of
coping with their particular circumstances and of resisting the dominant values of society develop
a cultural style (violence). They know they cannot do more to change situations but through
resistance they gain subjective satisfaction which can be shown through their lifestyle. They
express their dissatisfaction through riot, demonstrations, hair styles, cloth pattern, music etc.
Cohen argued that these styles are deeply layered in meaning as they indirectly use the means in
expressing their grievances.These individuals use violent behaviour as an approved means of
expression in the environment because they believe it works. Perpetrators of violence and trauma
embark on violence once they are displeased, not satisfied or unfavoured in expressing their
feelings and achieving their goals. Violence like communal clashes, homicide, arson, rape, kidnap,
rituals, etc are powered by this belief.
Psychobiological Theory of Violence; this theory believes that violence occur as a result of
psychobiological and temperamental vulnerabilities and by instinct. It proposes that brain
dysfunction, autonomic functioning, hormones, neuropsychology, and temperament are
contributing factors to violence. It explains the relationship between psychological and behavioral
processes aswell as the underlying physiological mechanisms of these individuals perpetrating
violence. Violence can be as a result of sickness or illness, personality attributes, and the
animalistic response to stimuli for survival.In all these, an individual’s biological makeup or
conditions contribute to violence.
Violence has shown to be a complex phenomenon and it needs to be understood differently by
people in different contexts. People from various countries, cultures, belief systems, etc., have
diverse views on what is called violence or a violent act same with traumatic feelings. It is pertinent
to have a clear understanding of violence and feelings of trauma from the context in which it occurs
and the victims perspective in developing effective prevention and treatment strategies. The right
approach will lead to better understanding in managing.
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Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
Dimensions of Violence
Conflict Triangle theory of Violence by Galton (1969),viewedviolence from three perspectives:
direct/personal violence, indirect/structural violence and symbolic/cultural violence. These he
suggest to be seen as three arms of violence triangle.
i. Direct/personal violence is the violencethe primary committer is known. It is the
obvious among all the dimensions. It encompasses all of the attributes of violence from
threats andpsychological abuse to rape, murder, war, and genocide. It is called direct
or personal because the committers are seen or could be traced in person, hence
personal.
ii. Indirect/structural is the violence where the committer is less obvious. The perpetrators
may be known but subtly covered by the structure that harbors the power of violence
unequally and consequently manifest as unequal chances.Basically, it holds none
responsible of the violence rather the blame is on the structure. This type of violence
shields the perpetrators most times could be as deadly, or deadlier, than direct violence.
Violence is an integral part of the very structure of human organizations in social,
political,religious and economic. Structural violence is usually invisible not because it is rare or
concealed, but because it is so ordinary and unremarkable that it tends not to stand out. Such
violence fails to catch our attention to the extent that we accept its presence as a “normal” and
even “natural” part of how we see the world (Afzaal, 2012). Identifying structural violence is by
paying attention to the consequences rather than intents. This is because it shields the committers
while the victims are known.Apparentlythis removes any question pertaining intents of these
committers that are unknown as the Western legal and ethical system are more interested in getting
an offender in direct violence for punishment. Therefore, identifying structural violence is by
focusing on the consequences instead of intents.
iii. Symbolic/cultural violence which was added later by Galton involves using those
aspects of culture that represent or symbolize the individual’s existence in justifying
legally and morally the violence of these perspectives; direct/personal and
indirect/structural violence. The committers of this type of violence based the rationale
of committing the violence on the justification that it is legally acceptable or religiously
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Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
supported. For instance committing murder for the country could be seen as right while for self
is wrong likewise in committing murder for protecting religious rights could be seen as right
for defending the religion but wrong if personal. Afzaal, (2012), identifies that this perspective
changes the clear situation of violence into not violence situation, or having an opaque view of
at least not as violence as assumed thereby changing the reality or fact to unreal, the moral
color from red (wrong) to green (right) and at least to yellow (acceptable).
Galton (1969), used these three perspectives of violence to demonstrate how these violence are
causally connected.Violence of any type has its support on the belief system or culture of the
perpetrators.
Framework for understanding Trauma
Reseachers have developed various theoretical frameworks that can aid the understanding of
trauma in human society. Each framework emphasizes different aspects of traumatic experiences.
Some of those theories are reviewed as follows:
i. Posttraumatic Stress Disorder (PTSD) Framework:This emphasizes the role of
exposure to traumatic events as key factors in the development of PTSD. According
to this framework, traumatic events are outside the range of normal human experience
and can overwhelm an individual’s ability to cope, leading to symptoms such as re-
experiencing the trauma, avoidance, and hyper arousal (APA, 2013).
ii. Polyvagal theory framework: This framework emphasizes the role of autonomic
nervous system in regulating responses to stress and trauma. Traumatic experiences
can dysregulate the autonomic nervous system, leading to chronic states of flight, or
freeze. (Porges, 2011).
iii. Cognitive Behavioural Framework: The emphasizes here is on the role of maladaptive
thoughts and behaviours in maintaining symptoms of trauma. Putting the cognitive
behavioural framework in perspective, those traumatic experiences can lead to negative
beliefs about one’s self, others and the world, which can perpetuate symptoms such as
avoidance and hypervigilance. (Resick, Monson, & Chard, 2016).
iv. Attachment Theory Framework: This theory emphasizes the role of early childhood
experiences in shaping an individual’s capacity to form secure attachment and regulate
emotions.Traumatic experiences can disrupt these processes and lead to difficulties in
forming healthy relationships and regulating emotions (Bolby,1988).
v. Social Constructivist Framework: The focus of this theory is on the social and cultural
context in which traumatic events occur a nd the ways in which they are constructed
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Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
and interpreted by individuals and communities.This theory argues that traumatic events are
not inherently traumatic but become so through their interpretation and meaning within a
particular cultural context.
Dimensions of Trauma
Trauma experiences be it in children, adolescents and adults affects the individual’s wellbeing in
seemingly dimensions of physical, psychological, emotional, spiritual, personal, and professional.
It couldmanifest and be measured byphysical-neglect, emotional-abuse, physical-abuse, sexual-
abuse, and emotional-neglect retrospectively from childhood as they are linked to PTSD
(Bernstein, Stein, Newcomb, Walker, Pogge, Ahluvalia, Zule, 2003).
1. Physical-neglect includes not being provided proper shelter, food, or medical care
2. Emotional-abuse includes being verbally attacked,
3. Physical-abuse includes having one’s body assaulted by another such as being hit or
slapped,
4. Sexual-abuse involves inappropriate touching or rape,
5. Emotional-neglect) parents and family not providing appropriate help or care at appropriate
times.
Recalled childhood trauma especially from sexual and emotional abuse has the susceptibility to
PTSD symptoms and dysregulated drinking (Patock-Peckham, Belton, D'Ardenne, Tein, Bauman
Infurna, et. al., 2020).
There are three main types of trauma: Acute, Chronic, or Complex (Allarakha & Pallavi, 2021).
A. Acute Trauma: It mainly results from a single distressing event, such as an accident, rape,
assault, or natural disaster. The event is extreme enough to threaten the person’s emotional
or physical security. The event creates a lasting impression on the person’s mind. If not
addressed through medical help, it can affect the way the person thinks and behaves. Acute
trauma generally presents in the form of:
1. Excessive anxiety or panic 2. Irritation, 3.Confusion, 4. Inability to have a restful sleep,
5. Feeling of disconnection from the surroundings, 6. Unreasonable lack of trust,
7.Inability to focus on work or studies, 8. Lack of self-care or grooming, 9. Aggressive
behavior
B. Chronic trauma:
It happens when a person is exposed to multiple, long-term, and/or prolonged distressing,
traumatic events over an extended period. Chronic trauma may result from a long-term serious
illness, sexual abuse, domestic violence, bullying, and exposure to extreme situations, such as a
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Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
war. Several events of acute trauma as well as untreated acute trauma may progress into chronic
trauma. The symptoms of chronic trauma often appear after a long time, even years after the event.
The symptoms are deeply distressing and may manifest as labile or unpredictable emotional
outbursts, anxiety, extreme anger, flashbacks, fatigue, body aches, headaches, and nausea. These
individuals may have trust issues, and hence, they do not have stable relationships or jobs. Help
from a qualified psychologist is necessary to make the person recover from the distressing
symptoms.
C. Complex trauma:
It is a result of exposure to varied and multiple traumatic events or experiences. The events are
generally within the context of an interpersonal (between people) relationship. It may give the
person a feeling of being trapped. Complex trauma often has a severe impact on the person’s mind.
It may be seen in individuals who have been victims of childhood abuse, neglect, domestic
violence, family disputes, and other repetitive situations, such as civil unrest. It affects the person’s
overall health, relationships, and performance at work or school.
Whatever be the type of trauma, if a person finds it difficult to recover from the distressing
experiences, they must seek timely psychological help. A qualified psychologist can help the
person with a traumatic experience lead a fulfilling life.
Over the years, there are records of improvement of trauma care where experiences gotten from
warfare, medical research, technological advancements in imaging and critical care, and the swift
transfer of trauma victims to appropriate centres for definitive management, leading to improved
trauma survival (Lendrum & Lockey, 2013). Records of significantly improved and organized
regional trauma care system manifested in the definitive care, mortality and morbidity rates from
the US and UK(Okereke, Zahoor & Ramadan, 2022). While many different trauma systems seem
to be developed in various countries by the slow adaptation of existing hospital systems; the trauma
system is structured around the initial pre-hospital management and triage, in-hospital care, and
rehabilitation (associated with teaching and research) of trauma victims within a defined
geographic area and integrated into a regional public health system. The seeming increase of
violence and trauma in Nigeria due to the high occurrence of events of such lately pose the need
in having a formal trauma system in Nigeria.This involves emergency services (EMS), dispatch
and pre-arrival instructions, EMS field triage and transport (ground or air), trauma system hospital,
an inter-hospital transfer (ground or air), trauma centre and team activation, operating room or
interventional radiology, intensive care unit (ICU), general care and early rehabilitation, outpatient
or inpatient rehabilitation, home and follow-up care, injury epidemiology and prevention
(Okereke, Zahoor & Ramadan, 2022).
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Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
Sequence of Violence and Trauma
Violence and trauma seemingly have been proved to having high connection in manifesting
psychological disorders. In sequence of violence, individual reactions manifest among the
individual victims. Some people have immediate reactions, whilst for others reactions are delayed
and might occur after a period of time. There might be concerns of how it feels even how other
close relatives feel in their reaction to violence. Acknowledging the normalcy in reacting with
different emotions as being triggered by such difficult events is therapeutic. However, people’s
reactions to violence depend on the individual, but there are reactions which are more common,
especially if the person is or has been subjected to repeated violence.
In the same vein, Centre for Substance Abuse Treatment (2014), identifies that sequence of
traumatic reactions in the aftermath of trauma as quite complicated and affected by the victims’
experiences. They begin to seek help of natural supports and healers, trying different coping and
life skills, seeking help and advice from immediate family, and the responses of the larger
community in which they live. Although reactions range in severity, even the most acute responses
are natural responses to manage trauma. They are not a sign of psychopathology. Coping styles
vary from action oriented to reflective and from emotionally expressive to reticent. Clinically, a
response style is less important than the degree to which coping efforts successfully allow one to
continue necessary activities, regulate emotions, sustain self-esteem, and maintain and enjoy
interpersonal contacts. Indeed, a past error in traumatic stress psychology, particularly regarding
group or mass traumas, was the assumption that all survivors need to express emotions associated
with trauma and talk about the trauma; more recent research indicates that survivors who choose
not to process their trauma are just as psychologically healthy as those who do. The most recent
psychological debriefing approaches emphasize respecting the individual’s style of coping and not
valuing one type over another.
Initial reactions to trauma can include exhaustion, confusion, sadness, anxiety, agitation,
numbness, dissociation, confusion, physical arousal, and blunted affect. Most responses are normal
in that they affect most survivors and are socially acceptable, psychologically effective, and self-
limited. Indicators of more severe responses include continuous distress without periods of relative
calm or rest, severe dissociation symptoms, and intense intrusive recollections that continue
despite a return to safety.
Apparently, these individuals with the distressing feelings of violence and trauma have diverse
ways in understanding and expressing them as pains or symptoms. Hence, psychologists advise
that considerations should be made on conceptualizing and interpreting these feelings from the
individual's cultural perspective.
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Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
Specifically, the violence and traumatic events experience by these individuals although cut across
cultural boundaries, the context should be understood and explained using their cultural lens. The
interpretations, preventions and treatments have to be made via the culture of the affected
individuals. Understanding violence and trauma therefore involves both universal and contextual
overtone. The contextual meaning then gives meaning to the events that made these individuals
victims of the violence and trauma. It prepares the victims reactions to the events, and decide
approaches to apply in managing or handling the feelings as it pertains to their everyday affairs.
Integration of both the universal and the contextual understanding in approaching violence and
trauma seems beneficial as it gives those affected the best possible chance of survival in the future
(Adimula & Ijere, 2018). This article equally addresses the consequential similitudes and
peculiarities of violence and traumatic events on the victims. That the approaches can help towards
gaining insight into the conceptualization of violence and trauma in Nigerian context or culture
and its psychological impacts as experienced by Nigerians.
Implications of Violence
Violence-induced injuries have been associated with greater inflammation and higher sympathetic
nervous system activation, worse posttraumatic stress disorder (PTSD) and depression outcomes,
and poorer social-environmental outcomes, such as lower socioeconomic status, higher exposure
to community violence, and lower rates of returning to work (National Academies of Sciences,
2018).
Violence has been recorded to be among the leading cause of death in the world as it accounts for
more than 1.6 million deaths each year. Public health experts stipulates that the statistics are just
the tip of the iceberg with the majority of violent acts being committed behind closed doors and
going largely unreported. This report aims to shed light on these acts. In addition to the deaths,
millions of people are left injured as a result of violence and suffer from physical, sexual,
reproductive and mental health problems, (WHO, 2002). The violence caused deaths majorly occur
in low-to-middle-income countries with internal conflicts (Rutherford, Zwi, Grove, & Butchart ,
2007).
The economic costs of violence include the direct costs of medical, policing and legal services,
and the indirect costs of lost earnings and productivity, lost investments in human capital, life
insurance costs and reduced quality of life. Estimates of costs across countries vary widely due to
the use of different methodologies, including the measurement of productivity losses via foregone
wages and income, which tends to undervalue losses in low income countries (Rutherford, Zwi,
Grove & Butchart, 2007). Etc.
Experiencing violence can range from feelings of grief, shame and guilt for what has happened to
them, to feelings of anger and powerlessness. Seemingly, physical responses as headaches,
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Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
stomach aches, sleeping difficulties, eating disorders and exhaustion can be among the feelings.
Intellectual capacity can also be impaired and the affected person may become confused and suffer
memory loss. It may also cause a loss of trust, changes in sexual behaviour or feelings of loneliness
and alienation.It is established that being subjected to violence and having lived with extreme
stress can lead to post traumatic stress disorder (PTSD) and fatigue.
Among Nigerian civilian population, violent injuries are on the increase, almost approaching an
epidemic level. This is attributable to the rising violent crime rate as a result of hardship, high level
of unemployment, political crisis, religious and ethnic conflicts, police brutality and high incidence
of armed robbery (Chukwuneke & Anyanechi, 2012). Sexual violence and vicarious trauma have
been identified among the symptoms of posttraumatic stress disorder among Nigerian youths
(Ilesanmi & Eboiyehi, 2012).
Violence and crime as commonly used together has a strong link. In order not to confuse them
some types of crime are violent as per definition (such as armed crime or contact crimes, including
murder, assault and rape), while other crimes involve no direct violence at all (such as tax evasion
or illicit drug use). Similarly, not all types of violence are criminal, such as the previously
mentioned structural violence, or many forms of psychological violence (WHO, 2002).
Specifically, not every violence case is a criminally related case likewise not every crime is violent.
Consequently, the needs to separate between violence and crime as they commonly arebut should
be on check for they can lead to each other.For instance illicit use of drugs may not be a violent
act but it can be used when perpetrating violent crimes or after (those offenses that involve use of
force or threat of force like armed robbery, rape, homicide, suicide etc).
Implications of Trauma
Exposure to traumatic events causes Post-Traumatic Stress Disorder (PTSD). In the previous
versions of DSM it was classified as an anxiety disorder, subsequently reclassified as a “trauma
and stressor related disorder” in DSM-5 (American Psychiatric Association (APA), 2013).
PTSD is estimated to affect about 2% of Western world population although, estimates are
considerably higher amongst specific risk groups such as first responders, soldiers, and populations
affected by war and political violence (Berger et al., 2012; Breslau, 2009; Muldoon &
Downes, 2007). Nigeria has no clear-cut records of PTSD but records showed the prevalence
ranges between 2.7% and 66.7%(Sekoni, Mall & Christofides, 2021). Sexual abuse in childhood,
past year intimate partner violence and anxiety were significantly associated with higher PTSD
scores among female urban slum dwellers in Western Nigeria (Sekoni, Mall, & Christofides,
2021).
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Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
Diagnosing PTSD demands the symptoms that arise because of a trauma be severe, prolonged and
interfere with social and/or occupational functioning (Muldoon, et al, 2019).PTSD is characterized
by the presence of multiple persistent symptoms across four symptom clusters. Symptoms from
all four clusters must be present to warrant diagnosis (APA, 2013). These comprise (1) intrusion
symptoms (e.g., flashbacks, nightmares), (2) persistent avoidance of stimuli associated with the
trauma (e.g., avoiding “trigger” situations), (3) negative alterations in cognition and mood
associated with the traumatic event (e.g., guilt, difficulty concentrating), and (4) alterations in
arousal and reactivity that are associated with the traumatic event (e.g., difficulty sleeping;
APA, 2013). Trauma has been linked to affect brain development. Researchers have shown that
trauma has a negative effect on the children’s brain particularly because of their rapidly developing
brain.
Experiencing traumatic episodes by a child exposes the child’s brain into a heightened state of
stress that activatessecretions of fear-related hormones (Chen, Miller, Kobor, & Cole, 2011;
Delima &Vimpani, 2011; Nemeroff, 2016). Obviously, stress has been accepted to being part of
normal life but when a child faces chronic trauma especially of abuse and neglect from childhood,
the child’s brain remains heightenedin that pattern and consequently, can change the emotional,
behavioral and cognitive functioning of the child in survival.The Adverse Childhood Experiences
Study (ACEs) underscores the impact of trauma on physical and mental health over time and
reported that the greater the number of ACEs the greater the risk for the following problems later
in life including alcoholism, depression, multiple sexual partners, suicide attempts, smoking and
liver disease among other negative health related issues (UNICEF, 2019; Meeker, O'Connor, Kelly
Hodgeman, Scheel-Jones & Berbary, 2021).
Trauma-induced changes to the brain can result in varying degrees of cognitive impairment and
emotional dysregulation that can lead to a host of problems, including difficulty with attention and
focus, learning disabilities, low self-esteem, impaired social skills, and sleep disturbances
(Nemeroff, 2016). Since trauma exposure has been linked to a significantly increased risk of
developing several mental and behavioral health issues including posttraumatic stress disorder,
depression, anxiety, bipolar disorder, and substance use disorders—it is important for practitioners
to be aware of steps they can take to help minimize the neurological effects of child abuse and
neglect and promote healthy brain development (Shonkoff, 2011).
Also, persistence of childhood trauma as insecurity widens in Nigeria particularly Northeast and
part of the Northwest has been recorded (Ibrahim, 2021) Etc. Omigbodun, Bakare & Yusuf (2008),
identified traumatic experiences to be having dire consequences for the mental health of young
persons. Among Nigerian women, traumatic experiences include the barbaric genital mutilation
also known as female circumcision, gender driven poverty; polygamy; work place sexual
harassments; domestic violence, limited social or religious sanctions, lack of social support,
cultural norm of widowhood, wife rape, social perception of women as property owned by father
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Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
then the husband, not being able to inherit lands from their birth families which is categorized as
social trauma (Adimula & Ijere, 2018). This includes other conditions led by being internally
displaced by Boko haram, herders’ crises as well as communal clashes and flooding.
Annually, the worldwide record oftraumatic injuries affect about5.8 million people and identified
as the leading cause of lost years of life, estimated to result in 500 years of lost productivity
annually per 100,000 population (Celso,Tepas,Langland-Orban,Tepas,Langland Pracht, Papa,
Lottenberg & Flintl, 2006; Gupta, Wong, Nepal, Shrestha, Kushner,Nwomeh & Wren, 2015).Also
exposure to trauma is pervasive in societies worldwide and is associated with substantial costs to
the individual society, making it a significant global public health concern (Magruder, McLaughlin
& Elmore Borbon, 2017).
Public health has identified Low-Middle-Income Countries (LMIC) like Nigeria of being affected
by traumatic injuries where industrialization and urbanization without concurrent developments in
the health systems have caused a shift in disease epidemiology towards more chronic illnesses and
acute traumatic injuries. The unexpected high population movement in LMIC leads to unequally
higher death rates from trauma than countries with higher-income. Sub-Saharan Africa (SSA)
records more than 50% of all injuries asLMICs account for 90% of the global trauma morbidity
and mortality rates. Trauma kills 68 people per 100,000 in SSA, compared to 6.4 people per
100,000 in higher-income European countries (Ekenze, Anyanwu & Chukwumam, 2009). The
most significant factor of disparity in mortality rates between LMICs and high income countries
is the variation in wealth distribution and healthcare funding. Another factor that precipitates the
dwindling outcomes of LMIC is the unfair sharing of resources as the major cities have the highly
skilled personnel and medical facilities, depriving the rural populace from these high-level
services.
Early traumatic experience may increase risk of substance use disorders (SUDs) because of
attempts to self-medicate or to dampen mood symptoms associated with a dysregulated biological
stress response.
Some Notable Cases of Violence and Trauma in Nigeria
1. Boko Haram Insurgency: Nigeria is currently facing a serious security challenge due to the
activities of the Boko Haram terrorist group. The group has been responsible for numerous
violent attacks, including suicide bombings, kidnappings, and mass killings. The insurgency has
caused a great deal of trauma and suffering for the people of Nigeria, particularly those in the
northeastern part of the country where the group is most active.
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Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
2. Police Brutality: The #EndSARS protests in Nigeria in 2020 brought to light the issue of police
brutality in the country. Many young Nigerians have experienced violence and trauma at the
hands of the police, often leading to long-term psychological effects.
3. Conflict in the Middle Belt: The Middle Belt region of Nigeria has experienced ongoing
conflict between farmers and herders, leading to numerous incidents of violence and
displacement. The trauma experienced by those caught up in the conflict can have significant
long-term effects on their mental health.
4. Gender-Based Violence: Nigeria has a high prevalence of gender-based violence, including
domestic violence, rape, and sexual assault. Victims of such violence often experience trauma
that can last for years, affecting their mental health and well-being.
5. Communal Clashes: Nigeria has also experienced communal clashes between different ethnic
and religious groups, leading to significant loss of life and displacement. The trauma
experienced by those affected by these clashes can be long-lasting and have a profound effect
on their mental health.
Rsearch Method
The major strategy in collection data for this study was a secondary data approach. Two relevant
strategies delineated for the data collection include:
Annotation: Where key quotes emanating from original works were edited and presented to
suffice issues raised in the study. Other annotations written by other scholars and editors relevant
to our conceptualization.Author abstracts were also searched and reviewed for relevant ideas
concerning our study.
Data based searches: Abstracts and information relevant to the study were sought for through the
following data base searches: Sociofile: Sociological abstracts; Public affairs information services;
pubmed search base.
The Role of Intervention in trauma cases.
Intervention refers to the action taken to address or mitigate the effects of a traumatic event. In
the context of trauma, intervention can take many forms, including medical treatment to address
physical injuries, psychological couselling to address emotional trauma, and support services to
help individuals cope with the aftermat of a traumatic event. The goal of trauma intervention is to
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Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
help individuals recover from the effects of the traumatic event and to promote their overall
wellbeing and functioning. Effective intervention can help individuals process their emotion ,
develop coping skills and rebuild their sense of safety and security. It can also help to prevent the
development of long term psychological disoreders, such as Post Traumatic Stress Disoders
(PTSD). There are many different approaches to trauma intervention, including eye movement
desensitization reprocessing,narrative exposure therapy, somatic experiencing, cognitive behavior
technique, brain spotting, etc.The specific approach used will depend on the individual’s needs
and the severity of their symtoms.
Eye Movement Diseensitisation Reprocessing ( EMDR) was developed by Frances Shappiro
(1989) and consist of eight phases for the treatment of PTSD. The eight stages according to
Hooman (2005) include:History taking, client preparation, assessment, desensitization,
installation, body scan, closure and reevaluation of treatment effect, the core is stage four in which
stress experience has to be processed.Bilateral stimulation is used here as in other methods.
Some studies (for e.g. Barth, Stoffers & Beugel,2003; Sack, Lempa, & Lemprecht, 2001) have
confirmed the effectiveness of PTSD, also the international Society for trauma and traumatic stress
(ISTSS) classified the method as effective and reliable in the treatment of ptsd as well as WHO in
2013 ( Foa, Keane & Friedman, 2000).
Narative Exposure Therapy ( NET) as captured by Scauer, Neuner & Elbert, (2011) was
developed within the field as part of the new Neuro scientific theories. The fundamental element
in this method relates to interpersonal sharing of the experience ( recalled and newly actualized
emotions, thoughts, facts and feelings) from the autobiographical memory available information
is retrieved (Neuner, Schauer & Elbert, 2009). The therapist is needed to help the traumatized in
overcoming speechlessness that often go along with traumatized people. The effectiveness and
feasibility of NET has been demonstrated in several studies (for e.g. Schaal, Elbert & Neuner,
2008; Nuener, Schauer, Karunakara, Klaschik, Robert & Elbert, 2004).
Another approach is the Somatic Experiencing (SE) of Levine, ( 1997). This method is body
oriented and based on biological functioning. The focus of this approach is on the biological
residue of trauma and pattern by which the body response to threat and fear. According to Levine
PTSD occurs as a result of incomplete defense-response and cross genre survival strategy. SE has
the following objectives.; to affect the regulation of stimuli; to reduce excessive and inappropriate
reaction in the nervous system and finally the restructuring of inappropriate cognitive
interpretations or reviews. Several studies have also shown promising outcome with the
application of the somatic experiencing to traumatic experiences for e.g. ( Leitch, 2007; Leitch,
Van Slyke & Allen, 2009).
Cognitive Behavioural Therapy ( CBT): This type of therapy has consistently been found to be
the most effective treatment of PTSD both in the short and long term. CBT for PTSD is trauma
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Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
focused which means that the trauma events are the center of the treatment. It focuses on
restructuring the faulty thinking pattern of the individuals passing through traumatic experiences
or events. This approach like other psychological techniques takes between 30 – 40 sessions within
a period of 6 – 9 months ( Benkert, Hautzanger & Graft- Morgenstern, 2008).
Brain Spotting is a recent development in the treatment of persons with post traumatic stress
disorder.This method is expected to provide a reduced period of treatment sessions (1-3 sessions).
Brain spotting builds on EMDR and SE (which has been described above), however it also has
connections with neuropsychology (Corrigan & Grand, 2013). One can aptly define this method
as a neuropsychological tool which aid in the discoverey of neuro physiological sources of
emotional or physical discomfort, truama dissociation and myriads of symptoms by processing
them and engendering the expected change. In demonstrating its effectiveness in the management
of traumatic experiences a study was conducted by (Grand, 2011).
With the aim of providing a complete resolution of blocked arousal in the brain and body as this
oftentimes return to traumatic experiences with the individual, showing eye movements, either
with both or one eye, the socalled brain spots are identified. This method combines other treatment
methods like EMDR as developed by Shapiro (2001) and SE as developed by Levine (1997). It
is therefore refered to as a Dual Model of affect regulation. Beyond the Psychotherapy methods
described above. A combination of pharmacotherapy and psychotherapy provide a faster recoverey
pt for victims of trauma. The role of serotine reuptake in stress management have been studied.
(Tucker et al., 2001). Studies demonstrating the efficacies of pharmacotherapy are well noted for
e.g as provided by (Kampthammer, 2011).
In summary, intervention can play a critical role in helping individuals recover from the effects of
traumatic experiences and can help to promote their overall well-being and functioning.
Conclusion and Recommendation
Violence and trauma have been x-rayed above and depicted as being very unhealthy to any
individual or society, hence people are advised to regulate their emotions which in most instances
remain at the spur of violence and trauma.Both have also become a public health concern that
should attract the attention of the government. The Nigerian society and citizens have been under
increasing perpetual violence with its attendant traumatic experiences. It is therefore
recommended as follows:
i. Government should set up agencies to handle the epidemiology of violence and trauma
with a view to studying their root causes and nipping them in the bud before they
excalate.
ii. Violence and trauma should be formally incoporrated into our education curriculum.
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iii. Trauma treatment should be given priority at the primary care level, considering its
public and mental health implications.
iv. Government should engage experts for e.g psychologist, media practioners, sociologist
in mitigating the rate of violence and incidences of trauma among the citizenry
v. That trauma managers should ensure the use of psychotherapy and pharmacotherapy
where appropriate and based on severity to achieve faster and more enduring recovery
in trauma cases.
REFERENCES
Adimula, R. A. & Ijere, I. N. (2018), Psycho-social traumatic events among women in Nigeria
Madridge Journal of AIDS: 2638-1958
Afzaal, A. (2012). The violence triangle. https://ahmedafzaal.com/2012/02/20/the-violence-
triangle/
Allarakha, S.. & Uttekar, P. S. .(2021). What are the three types of trauma? Retrieved from
https://www.medicinenet.com/what_are_the_3_types_of_trauma/article.htm on 18/08/2022
American Psychiatric Association (APA). (2013). Diagnostic and statistical manual of mental
disorders (DSM-5®). USA: American Psychiatric Pub.
Barth, J., Stoffers, J. & Bengel, J. (2003). Efficacy of EMDR in patients with PTSD. A meta-
analytic review of randomized controlled trials. Paper presented at the European conference
on traumatic stress, Berlin, Germany, May.
Benkert, O., Hautzinger, M. & Graf-Morgenstern, M. (2008). Psycho-pharmacological guide for
psychologists and psychotherapists. Heideberg: Springer- Verlag.
Berger, W., Coutinho, E. S. F., Figueira, I., Marques-Portella, C., Luz, M. P., Neylan, T.
C., Mendlowicz, M. V. (2012). Rescuers at risk: A systematic review and meta-regression
analysis of the worldwide current prevalence and correlates of PTSD in rescue
workers. Social Psychatry and Psychiatric Epidemiology, 47, 1001–1011.
Bernstein D. P., Stein, J. A., Newcomb, M. D., Walker, E., Pogge, D., Ahluvalia, T., Zule W.
(2003). Development and validation of a brief screening version of the childhood trauma
questionnaire. Child Abuse & Neglect. 27(2), 169–190.
20
Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
Boko Haram insurgency. Council on Foreign Relations.
https://www.cfr.org/backgrounder/boko-haram-insurgency.
Bolby, J. (1988). A secure base: Parent-child attachemnet and healthy human development.
Basic Books.
Breslau, N. (2009). The epidemiology of trauma, PTSD, and other posttrauma disorders. Trauma,
Violence, & Abuse, 10, 198–210.
Celso, B., Tepas, J., Langland-Orban, B., Pracht, E., Papa, L., Lottenberg, L., & Flint, L. (2006).
A systematic review and meta-analysis comparing outcome of severely injured patients
treated in trauma centers following the establishment of trauma systems, J Trauma. 60, 371–
378.
Center for Substance Abuse Treatment (US: 2014). Trauma-Informed Care in Behavioral Health
Services. Rockville (MD): Substance Abuse and Mental Health Services Administration
(US). (Treatment Improvement Protocol (TIP) Series, No. 57.) Chapter 3, Understanding the
Impact of Trauma. Available from: https://www.ncbi.nlm.nih.gov/books/NBK207191/
Centers for Disease Control and Prevention (2008). Leading causes of death. National Center for
Health Statistics. 1900-1998. http:// www.cdc.gov/nchs/data/dvs/lead1900_98.pdf.
Centers for Disease Control and Prevention (2009). Web-based Injury Statistics Query and
Reporting System (WISQARS).National Center for Injury Prevention and
Control.http://www.cdc.gov/ncipc/wisqars.
Chen, E., Miller, G. E., Kobor, M. S., & Cole, S. W. (2011). Maternal warmth buffers the effects
of low early-life socioeconomic status on pro-inflammatory signaling in adulthood.
Molecular Psychiatry, 16(7), 729–737.
Cherry, K. (2020). Five important concepts in Social Psychology.
https://www.verywellmind.com/things-you-should-know-about-social-psychology-
2795903
Chukwuneke, F, & Anyanechi, C. (2012). Violent injuries in Nigeria: increasing occurrence but
low priority on preventive measures. Injury Prevention 18(Suppl 1):A141.4-A142.
Cohen, P. (1972). Sub-cultural Conflict and Working Class Community. Working Papers in
Cultural Studies. No.2. Birmingham: University of Birmingham.
Corrigan, F. & Grand, D. ( 2013). Brain spotting: Recruiting the midbrain for accessing and
Healing sensiromotor memories of traumatic activation. Medical Hypotheses , 80, 759 - 766
Delima, J., & Vimpani, G. (2011). The neurobiological effects of childhood maltreatment. Family
Matters, 89, 42–52.
21
Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
Ekenze, S. O., Anyanwu K. K., Chukwumam D. O. (2009). Childhood trauma in Owerri (south
eastern) Nigeria. http://www.ncbi.nlm.nih.gov/pubmed/19485155. NigerJ.Med. 18,9–83.
End SARS Movement. Human Rights Watch. https://www.hrw.org/tag/end-sars-movement.
Foa, E. B., Keane, T. M. & Friedman, M. J. (2000). Effective treatment for PTSD:Practice
guidelines of the international society for traumatic stress studies. New York: Guilford
press.
Galtung, J. (1969). "Violence, Peace and Peace Research". Journal of Peace Research. 6 (3), 167–
191.
Gender-Based Violence in Nigeria. United Nations Population Fund.
https://nigeria.unfpa.org/en/topics/gender-based-violence-nigeria.
Grand, D. (2011). Brain spotting: A new dual regulation model for the psychotherapeutic process.
Trauma and Violence, 3,276-285
Gupta S, Wong E. G., Nepal, S., Shrestha, S., Kushner, A. L, Nwomeh, B. C., & Wren, S. M.
(2015). Injury prevalence and causality in developing nations. Results from a countrywide
population-based survey in Nepal. Surgery, 157:843–849.
Hofman, A.,(2005). EMDR in the treatment of psycho traumatic stress syndrome. Stuttgart:
Theome
Homans, G. C. (1958). Social Behaviour as Exchange. American Journal of Sociology 63, (6) 597-
606
Ibrahim, B. Z, (2021). Childhood trauma persists as insecurity widens. Retrieved from
https://humanglemedia.com/childhood-trauma-persists-as-insecurity-widens-in-nigeria/ on
12/08/2022.
Ilesanmi, O. O & Eboiyehi, F.A (2012). Sexual violence and vicarious trauma: a case studyugvb
Gender and Behaviour 10 (1).
Kampfhammer, H.D. (2011). Adjustment disorder, acute and post traumatic stress disorder in H.J.
Moller, G. Laux, & H. P. Kampfhammer (Eds.), psychiatry, psychosomatic medice,
psychotherapy (pp. 605-679). Berlin, Heidelberg: Springer- verlag.
Leitch, L. M. (2007). Somatic Experiencing treatment with tsunami survivors in Thailand
Broadening the scope of early intervention. Traumatology, 13, 11 - 20
Leitch, L. M., Vanslyke, Y., & Allen, M. (2009). Somatic experiencing treatment with social
services workers following hurricanes Katrina and Rita. Social Work, 54 (1), 9-18.
Lendrum, R. A & Lockey D. J. (2013). Trauma system development.Anaesthesia; 68 (1), 30–39.
22
Leonard C. Orji, IyabodeSadiat-Aliu & Iheanyi Valentine Ekechukwu
Levine, P. A. (1997). Waking the tiger. Berkely, CA: North Alantic Books.
Magruder K. M, McLaughlin K. A & Elmore Borbon D. L. (2017). Trauma is a public health issue.
European Journal of Psychotraumatology, 98(1).
Meeker E.C., O'Connor B.C., Kelly L.M., Hodgeman D.D., Scheel-Jones A.H., Berbary C. (2021).
The impact of adverse childhood experiences on adolescent health risk indicators in a
community sample. Psychol Trauma. 13(3), 302-312.
Muldoon, O. T., & Downes, C. (2007). Social identification and post-traumatic stress symptoms
in post-conflict Northern Ireland. The British Journal of Psychiatry, 191, 146–149.
Muldoon, S. Alexander, H., Catherine, H., Tegan, C., Michelle, K. & Jolanda, J. (2019) . The
social psychology of responses to trauma: Social identity pathways associated with
divergent traumatic responses, European Review of Social Psychology, 30 (1), 311-348.
Nemeroff, C. B. (2016). Paradise lost: The neurobiological and clinical consequences of child
abuse and neglect. Neuron, 89(5), 892–909.
Neuner, F., Schauer,M. & Elbert, T. ( 2009). Narrative Exposure. In Maercker A. (eds).Post
traumatic stress disorder (pp.301 – 318). Heidelberg: Springer.
Neuner, F., Schauer,M., Karunakara, U., Klaschik, C., Robert, C., & Elbert, T. ( 2004).
Psychological trauma and evidence for enhanced vulnerability for PTSD through previous
trauma in West Nile refugees. BMC Psychiatry, 4(1), 34.
Nigeria's Middle Belt crisis: Violence and displacement." Al Jazeera.
https://www.aljazeera.com/news/2018/6/25/nigerias-middle-belt-crisis-violence-and-
displacement.
Omigbodun O, Bakare K, Yusuf B. (2008). Traumatic events and depressive symptoms among
youth in Southwest Nigeria: a qualitative analysis. 20(3), 243-53.
Patock-Peckham, J. A., Belton, D. A., D'Ardenne, K., Tein, J.Y., Bauman, D. C., Infurna, F. J.,
Sanabria, F., Curtis, J., Morgan-Lopez, A. A., & McClure, S. M. (2020). Dimensions of
childhood trauma and their direct and indirect links to PTSD, impaired control over
drinking, and alcohol-related-problems. Addictive Behaviors Reports, 12.
Porges, S.W. (2011).The Polyvagal Theory:Neurophysiological foundations of emotion,
attachement, communication, and self- regulation. Norton.
Resick, P.A., Monson, C. M., & Chard, K .M. (2016). Cognitive processing therapy for PTSD: A
comprehensive manual. Guilford Press.
Rutherford, A., Zwi, A. B., Grove, N. J., Butchart, A. (2007). Violence: A priority for public
health? (part 2). Journal of Epidemiological Community Health. 61(9), 764-70
23
Contemporary Journal of Applied Psychology (CJAP) Vol. 8, N0. 1 June 2023
Sack, M., Lempa, W., Lamprecht, F.(2001). Study quality and effect sizes – a meta analysis of
EMDR treatment for PTSD. Psychotherapy, Psychosomatic Medical Psychology, 51 (9-
10), 350 – 355.
Schaal, S., Elbert, T. & Nuener, F.(2009). Narrative exposure therapy vs Group interpersonal
Psychotherapy a controlled clinical trial with orphaned survivors of the Rwandan genocide.
Psychotherapy and Psychosomatics, 78, 208 – 306.
Schauer, M., Neuner, F. & Elbert, T. (2011). Narrative Exposure Therapy (NET). A short term
intervention for traumatic stress disorders. Cambridge / Gottinger: Hogrefe & Huber
Publishers.
Sekoni, O., Mall, S. & Christofides, N. (2021). Prevalence and factors associated with PTSD
among female urban slum dwellers in Ibadan, Nigeria: a cross-sectional study. BMC Public
Health 21.
Shapiro, F. (2001). Eye movement dissensitisation and reprocessing: Basic principles, protocols
and procedures (2nd ed. ) New York: Guilford Press.
Shonkoff, J. (2011). Protecting brains, not simply stimulating minds. Science, 333 (6045), 982–
983.
Tucker, P., Zanineli, R., Yehuda, R., Ruggiero, L., Dillingham, K. & Pitts, C.D. (2001). Paroxetine
in the treatment of chronic post traumatic stress disorder: Results of a placebo – controlled,
flexible dosage trial. Journal of Clinical Psychiatry, 62, 860 – 968.
UNICEF, (2019).Adverse Childhood Experiences (ACE) Study Research on Adverse Childhood
Experiences in Serbia. UNICEF Serbia Belgrade.
Waters, H., Hyder, A., & Rajkotia, (2004). The economic dimensions of interpersonal violence.
Geneva: Department of Injuries and Violence Prevention, World Health Organization,
World Health Organization, (2002). New WHO report presents more complete picture of global
violence. htps://www.who.int/news/item/03-10-2002-first-ever-global-report-on-violence-
and-health-released on 18/08/2022