Cumulative Trauma Disorder Scale (CTD): Two Studies

Ibrahim A Kira,Lydia Odenat,Jeffery S Ashby,Linda Lewandowski,Thomas Templin,Alwande Oladele

doi:10.4236/psych.2012.39099

Abstract

Measures that screen for mental health in multiple traumatized populations (e.g., refugees, minorities, mental health patients, prison inmates) lack theoretical clarity that makes it difficult to develop a measure that has robust psychometrics. The paper proposes cumulative trauma disorders (CTD) model and develops a scale that measures the concept and can be used as a general mental health screening tool in such populations. The measure has been tested on two studies: on representative community sample of Iraqi refugees in Michigan and on a clinic sample of refugees. Further, the measure was used on samples of Iraqi refugee and African American adolescents, West Bank and Gaza in Palestinian territories, as well as a mental health screening tool in some centers that screen refugees and torture survivors in US. The measure has been found to have high alpha and test-retest reliability, good construct, concurrent, discriminative and predictive validity in the two main samples and on all the studies and centers that utilized it. The measure can be used as a general mental health screening tool for adult and adolescent in public health settings in different cultures, as well as for refugees, torture survivors, and highly traumatized populations.

Highlights

Advances in trauma theory open the door to new perspectives in assessing and identifying post-cumulative trauma profiles
Cumulative trauma disorders profiles can include sub-models according to the different trauma profiles and their accumulative effects that produce different symptom profiles
The paper proposed the model of cumulative trauma disorder in refugees

Summary

Introduction

There is an intricate divide between three major paradigms in studying traumatic processes: the psychiatric paradigm that focused mostly on the physical survival types of traumatic stress and on post-traumatic stress disorder (PTSD) model (e.g., van der Kolk, Weisaeth, & van der Hart, 1996), the psychoanalytic, and developmental paradigms that focused more on studying the effects of abandonment, early childhood and betrayal traumas (e.g., Bowlby, 1988; Cassidy, & Shaver, 1999; Freyd, DePrince, & Gleaves, 2007), and the intergroup paradigm as evidenced in studying discrimination, genocide, torture and other shared politically motivated micro and macro aggressions (e.g., Pieterse, Todd, Neville, & Carter, 2011; Kira et al, 2008, 2010a; Kira et al, 2010b; Williams, & Mohammed, 2009; Perez, Fortuna, & Alegría, 2008). All the three paradigms found severe physical and mental health consequences for the trauma types that were the focus of their studies. Integrating these three paradigms should help advance trauma theory and research. The second dimension in DBTF describes the level of severity and chronicity

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