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Cross-Cultural Assessment of Psychological Trauma and PTSD Cross-Cultural Assessment of Psychological Trauma and PTSD International and Cultural Psychology Series Series Editor: Anthony Marsella, University of Hawaii, Honolulu, Hawaii ASIAN AMERICAN MENTAL HEALTH Assessment Theories and Methods Edited by Karen S. Kurasaki, Sumie Okazaki, and Stanley Sue CROSS-CULTURAL ASSESSMENT OF PSYCHOLOGICAL TRAUMA AND PTSD Edited by John P. Wilson, and Catherine So-kum Tang THE FIVE-FACTOR MODEL OF PERSONALITY ACROSS CULTURES Edited by Robert R. McCrae and Juri Allik FORCED MIGRATION AND MENTAL HEALTH Rethinking the Care of Refugees and Displaced Persons Edited by David Ingleby HANDBOOK OF MULTICULTURAL PERSPECTIVES ON STRESS AND COPING Edited by Paul T.P. Wong and Lilian C.J. Wong INDIGENOUS AND CULTURAL PSYCHOLOGY Understanding People in Context Edited by Uichol Kim, Kuo-Shu Yang, and Kwang-Kuo Hwang LEARNING IN CULTURAL CONTEXT Family, Peers, and School Edited by Ashley Maynard and Mary Martini POVERTY AND PSYCHOLOGY From Global Perspective to Local Practice Edited by Stuart C. Carr and Tod S. Sloan PSYCHOLOGY AND BUDDHISM From Individual to Global Community Edited by Kathleen H. Dockett, G. Rita Dudley-Grant, and C. Peter Bankart SOCIAL CHANGE AND PSYCHOSOCIAL ADAPTATION IN THE PACIFIC ISLANDS Cultures in Transition Edited by Anthony J. Marsella, Ayda Aukahi Austin, and Bruce Grant TRAUMA INTERVENTIONS IN WAR AND PEACE Prevention, Practice, and Policy Edited by Bonnie L. Green, Matthew J. Friedman, Joop T.V.M. de Jong, Susan D. Solomon, Terence M. Keane, John A. Fairbank, Brigid Donelan, and Ellen Frey-Wouters A Continuation Order Plan is available for this series. A continuation order will bring delivery of each new volume immediately upon publication. Volumes are billed only upon actual ship- ment. For further information please contact the publisher. Cross-Cultural Assessment of Psychological Trauma and PTSD Edited by John P. Wilson, Ph.D. Cleveland State University Cleveland, Ohio, USA Catherine So-kum Tang, Ph.D. National University of Singapore Singapore John P. Wilson, Ph.D. Professor Catherine So-kum Tang, Ph.D. Professor of Psychology and Department of Psychology Fulbright Scholar Faculty of Arts and Social Sciences Cleveland State University National University of Singapore Cleveland, Ohio 44115 Singapore 117570 USA [email protected] [email protected] ISBN-13: 978-0-387-70989-5 e-ISBN-13: 978-0-387-70990-1 Library of Congress Control Number: 2007928829 © 2007 Springer Science+Business Media, LLC All rights reserved. This work may not be translated or copied in whole or in part without the written permission of the publisher (Springer Science+Business Media, LLC, 233 Spring Street, New York, NY 10013, USA), except for brief excerpts in connection with reviews or scholarly analysis. Use in connection with any form of information storage and retrieval, electronic adaptation, computer software, or by similar or dissimilar methodology now known or hereafter developed is forbidden. The use in this publication of trade names, trademarks, service marks, and similar terms, even if they are not identified as such, is not to be taken as an expression of opinion as to whether or not they are subject to proprietary rights. Printed on acid-free paper. 987654321 springer.com Foreword By Matthew J. Friedman MD, PhD Executive Director National Center for PTSD US Department of Veterans Affairs It is now well recognized that exposure to a traumatic event may be a defining experience that elicits courage, resourcefulness, and magnificent expressions of the human spirit. On the other hand, such exposure may also precipitate pain, suffering, despair, and chronic psychiatric problems. Furthermore, these two outcomes are not mutually exclusive. People who have performed heroically when confronted by tsunamis, genocidal strife, or abusive violence may also suffer from adverse psychological consequences for decades or a lifetime. The introduction of posttraumatic stress disorder (PTSD) in 1980 into the American Psychiatric Association’s third edition of its Diagnostic and Statistical Manual (DSM-III) has provided scientists and clinicians with a powerful conceptual tool with which to understand human responses to catastrophic events. Since 1980, epidemiologists, anthropologists, and mental health clinicians have understood the importance of trauma to individuals, societies, and cultures. The transformative power of trau- matic events to alter personal and collective trajectories is universal. With this recognition comes the challenge to understand how such posttraumatic transformations are expressed around the globe. Do such reactions exhibit universal (etic) characteristics that are comparable from one cultural milieu to the next? Or are such etic approaches another exam- ple of a western scientific imperialism that fails to assign proper weight to culture-specific (emic) idioms of distress? PTSD has become a battleground on which the etic–emic controversy has raged (Osterman and de Jong, in press). Although I believe that these two perspectives are complementary, others have complained that PTSD is actually a Euro-American culture-bound syndrome that does not apply v vi Foreword to traditional cultures (Summerfield, 2004). Whereas it is indisputable that PTSD has been detected around the world in both industrialized and developing societies (Green et al., 2003; Marsella et al., 1996; Osterman & de Jong), it remains an open question whether PTSD is the best idiom of distress from one culture to the next. The horrific wars and genocidal events of recent years have produced new opportunities for integrating different cultural models of traumatic stress with empirically based approaches to diagnosis and treatment. It is clear that Western conceptual and clinical approaches that focus primarily on individual psychopathology must be expanded to incorporate collec- tive cultural, psychosocial, and historical considerations. This book provides an excellent framework within which to consider the complex overlapping of culture, trauma, behavioral reactions, and collective consequences within a global context. It is a significant step forward toward standardizing the understanding of PTSD during an era of rapid globalization throughout the world. In short, it is a significant achievement that provides a provocative, scholarly, and comprehensive synthesis that should be mandatory reading for both the scientific and humanitarian communities. Green, B. L., Friedman, M. J., de Jong, J., et al. (Eds.). (2003). Trauma interventions in war and peace: Prevention, practice, and policy. Amsterdam: Kluwer/Plenum. Marsella, A. J., Friedman, M. J., Gerrity, E. T., & Scurfield, R. M. (Eds). (1996). Ethnocultural aspects of post-traumatic stress disorder: Issues, research and clinical applications. Washington, DC: American Psychological Association. Osterman, J. E., & de Jong, J. T. V. M. (in press). Cultural issues. In M. J. Friedman, T. M. Keane, & P. A. Resick (Eds.), PTSD, science & practice: A comprehensive handbook. New York: Guilford. Summerfield, D. A. (2004). Cross-cultural perspectives on the medicalization of human suf- fering. In G. M. Rosen (Ed.), Posttraumatic stress disorder: Issues and controversies (pp. 233–245). Chichester, England: Wiley. Preface By John P. Wilson This book attempts to break new ground in the field of traumatology. As the field has advanced in its scientific knowledge, it has also become more globalized in nature as this body of scientific and clinical information has been utilized in nearly all parts of the world, especially in situations of disaster (e.g., 2004 Tsunami; Hurricane Katrina), wars (e.g., Iraq, Bosnia), political oppression and genocide (e.g., Darfur, Sudan), and to other types of traumatic events. Therefore, there is a need for a reference work that extends beyond the limitations of Western methods of assessing and understanding psychic trauma. It is our hope that this book and its suc- cessors will begin a process that eventually will lead to integrative global knowledge of how to employ culturally sensitive ways to understand psychological reactions to traumatic life experiences for culturally and ethnically diverse populations. The book is organized into three parts. Part I focuses on theoretical and cultural considerations in the cross-cultural assessment of psycho- logical trauma and posttraumatic stress disorder (PTSD). There are six chapters in this section. Part II concerns assessment methods and contains four chapters. Part III examines trauma and cultural adaptation in six unique chapters. In Chap. 1, John P. Wilson presents a broad conceptual overview of culture, trauma, and the assessment of posttraumatic syndromes in a global context. He raises issues regarding the importance of the field of traumatology to create an agenda for the development of culturally sen- sitive assessment processes and procedures. In a similar way, he presents 21 core questions for understanding culture, trauma, and posttraumatic syndromes. Wilson also suggests by looking at mythology, universal themes of the relationship between traumatic life experiences and pat- terns of posttraumatic adaptation can be evaluated from literature and its reflection of human struggles across different cultures throughout time in human history. vii viii Preface In Chap. 2, Lisa Tsoi Hoshmand presents a rich chapter on the under- standing and assessment of trauma and its aftermath from a cultural–- ecological perspective. As she notes, “the definition of trauma entails the cultural and ecological
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