A Critical Outlook on Stress and Trauma Field in the Era of COVID-19 and Beyond: The Linear and Non-Linear Effects of Cumulative Stressors and Traumas on Psychopathology: Are They Mostly Mediated by the Centrality of Events and Existential Anxieties?

Abstract

Objective: The study aimed to clarify and refine the conceptual framework of cumulative stressors and trauma (CST) dynamics, its relationships to the centrality of an event to an identity (COE), and the existential annihilation anxieties (EAA), and psychopathology. The study aimed to propose and test a model in which CST affects psychopathology directly and to a greater extent indirectly through COE and the four different types of identity-based EAA (personal/psychic identity, collective identity, physical identity, and status identity EAA). Further, the study aimed to replicate the previous finding that the non-linear model of CST’s effects on internalizing, externalizing, and thought disorders (the psychopathology three major factors) explains more variance than the linear model. Method: Using path analysis, PROCESS mediation analysis, curve estimation regression, on a combined sample (N = 1566) from Egypt (N = 490), Turkey (N = 420), Kuwait (N = 300), Syria (N = 179), and the UK (N = 177), we tested the study assumptions. Results: Status identity EAA and the other types of EAA related to different identities and COE mediated the major part of CST impact on psychopathology; with “status identity, EAA” had the strongest effect size. The non-linear model of the impact of CST’s cumulative dynamics on psychopathology, internalizing, externalizing, thought disorders, and physical health accounted for much more variance than the linear model. Conclusions: Results supported the proposed framework. The implications of these results for a paradigm shift in understanding stress and traumatization dynamics that go beyond the current linear approach with the sole focus on a single past stressor or traumatic stressor were discussed.