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? — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
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?
Center for Cumulative Trauma Studies, Stone Mountain, GA, & Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
,
Department of Psychology, Fayoum University, Fayoum, Egypt
,
Psychology Department, College of Social Sciences, Kuwait University, Kuwait City, Kuwait
,
Counseling Department, T. C. Istanbul Medeniyet University, Istanbul, Turkey
,
Start Point 1, Malmo, Sweden
,
Department of Psychology, The University of Westminster, London, UK
1 Center for Cumulative Trauma Studies, Stone Mountain, GA, & Center for Stress, Trauma and Resiliency, Georgia State University, Atlanta, GA, USA
2 Department of Psychology, Fayoum University, Fayoum, Egypt
3 Psychology Department, College of Social Sciences, Kuwait University, Kuwait City, Kuwait
4 Counseling Department, T. C. Istanbul Medeniyet University, Istanbul, Turkey
5 Start Point 1, Malmo, Sweden
6 Department of Psychology, The University of Westminster, London, UK
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.
KeywordsNon-Linear ModelCumulative Stressors and TraumasExistential Annihilation AnxietiesCentrality of an EventCumulative and Proliferation DynamicsCOVID-19 StressorsContinuous Traumatic Stress Type III Trauma
Aan de Stegge, B. M., Tak, L. M., Rosmalen, J. G. M., & Oude Voshaar, R. C. (2018). Death Anxiety and Its Association with Hypochondriasis and Medically Unexplained Symptoms: A Systematic Review. Journal of Psychosomatic Research, 115, 58-65. https://doi.org/10.1016/j.jpsychores.2018.10.002
Allen, R., Hurvich, M., & Mcguire, H. (2017). Diagnostic Utility of the Hurvich Experience Inventory/50. Psychoanalytic Psychology, 34, 271-278. https://doi.org/10.1037/pap0000067
Berntsen, D., & Rubin, D. C. (2006). The Centrality of Event Scale: A Measure of Integrating a Trauma into One’s Identity and Its Relation to Post-Traumatic Stress Disorder Symptoms. Behaviour Research and Therapy, 44, 219-231. https://doi.org/10.1016/j.brat.2005.01.009
Brabender, V. (2000). Chaos, Group Psychotherapy, and the Future of Uncertainty and Uniqueness. Group, 24, 23-32. https://doi.org/10.1023/A:1007551120290
Burger, J., van der Veen, D. C., Robinaugh, D. J., Quax, R., Riese, H., Schoevers, R. A., & Epskamp, S. (2020). Bridging the Gap between Complexity Science and Clinical Practice by Formalizing Idiographic Theories: A Computational Model of Functional Analysis. BMC Medicine, 18, Article No. 99. https://doi.org/10.1186/s12916-020-01558-1
Caspi, A., Houts, R. M., Belsky, D. W., Goldman-Mellor, S. J., Harrington, H., Israel, S. et al. (2014). The p Factor: One General Psychopathology Factor in the Structure of Psychiatric Disorders? Clinical Psychological Science, 2, 119-137. https://doi.org/10.1177/2167702613497473
Crenshaw, K. W. (2017). On Intersectionality: Essential Writings. The New Press.
Elmore, K. C., & Oyserman, D. (2012). If ‘We’ Can Succeed, ‘I’ Can Too: Identity-Based Motivation and Gender in the Classroom. Contemporary Educational Psychology, 37, 176-185. https://doi.org/10.1016/j.cedpsych.2011.05.003
Finkelhor, D., Ormrod, R. K., & Turner, H. A. (2007). Polyvictimization and Trauma in a National Longitudinal Cohort. Development and Psychopathology, 19, 149-166. https://doi.org/10.1017/S0954579407070083
Franklin, A. J. (1999). Invisibility Syndrome and Racial Identity Development in Psychotherapy and Counseling African American Men. The Counseling Psychologist, 27, 761-793. https://doi.org/10.1177/0011000099276002
Galatzer-Levy, R. M. (2017). Nonlinear Psychoanalysis: Notes from Forty Years of Chaos and Complexity Theory. Routledge. https://doi.org/10.4324/9781315266473
Gehrt, T. B., Berntsen, D., Hoyle, R. H., & Rubin, D. C. (2018). Psychological and Clinical Correlates of the Centrality of Event Scale: A Systematic Review. Clinical Psychology Review, 65, 57-80. https://doi.org/10.1016/j.cpr.2018.07.006
Giacaman, R., Rabaia, Y., Nguyen-Gillham, V., Batniji, R., Punamäki, R. L., & Summerfield, D. (2011). Mental Health, Social Distress and Political Oppression: The Case of the Occupied Palestinian Territory. Global Public Health, 6, 547-559. https://doi.org/10.1080/17441692.2010.528443
Greenberg, J., Simon, L., Pyszczynski, T., Solomon, S., & Chatel, D. (1992). Terror Management and Tolerance: Does Mortality Salience Always Intensify Negative Reactions to Others Who Threaten One’s Worldview? Journal of Personality and Social Psychology, 63, 212-220. https://doi.org/10.1037/0022-3514.63.2.212
Gruber, J., Prinstein, M. J., Clark, L. A., Rottenberg, J., Abramowitz, J. S., Albano, A. M. et al. (2021). Mental Health and Clinical Psychological Science in the Time of COVID-19: Challenges, Opportunities, and a Call to Action. American Psychologist, 76, 409-426. https://doi.org/10.1037/amp0000707
Halfon, S., Çavdar, A., Orsucci, F., Schiepek, G. K., Andreassi, S., Giuliani, A., & de Felice, G. (2016). The Non-Linear Trajectory of Change in Play Profiles of Three Children in Psychodynamic Play Therapy. Frontiers in Psychology, 7, Article No. 1494. https://doi.org/10.3389/fpsyg.2016.01494
Hayes, A. F. (2017). Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression-Based Approach. Guilford Publications.
Heart, B., & DeBruyn, L. M. (1998). The American Indian holocaust: Healing Historical Unresolved Grief. American Indian and Alaska Native Mental Health Research, 8, 56-78. https://doi.org/10.5820/aian.0802.1998.60
Horesh, D., & Brown, A. D. (2020). Traumatic Stress in the Age of COVID-19: A Call to Close Critical Gaps and Adapt to New Realities. Psychological Trauma: Theory, Research, Practice, and Policy, 12, 331-335. https://doi.org/10.1037/tra0000592
Hurvich, M. (2003). The Place of Annihilation Anxieties in Psychoanalytic Theory. Journal of the American Psychoanalytic Association, 51, 579-616. https://doi.org/10.1177/00030651030510020801
Hyland, P., Karatzias, T., Shevlin, M., McElroy, E., Ben-Ezra, M., Cloitre, M., & Brewin, C. R. (2020). Does Requiring Trauma Exposure Affect Rates of ICD-11 PTSD and Complex PTSD? Implications for DSM-5. Psychological Trauma: Theory, Research, Practice, and Policy, 13, 133-141. https://doi.org/10.1037/tra0000908
Kanaan, A., Kira, I., Shuwiekh, H., Kucharska, J., & Al-Huwailah, A. (2019). The Dynamics behind Low Posttraumatic Growth in Victims of Type III Traumas: The Case of Syrians and Palestinians. Traumatology: An International Journal, 26, 205-214. https://doi.org/10.1037/trm0000229
Kashima, E. S., Halloran, M., Yuki, M., & Kashima, Y. (2004). The Effects of Personal and Collective Mortality Salience on Individualism: Comparing Australians and Japanese with Higher and Lower Self-Esteem. Journal of Experimental Social Psychology, 40, 384-392. https://doi.org/10.1016/j.jesp.2003.07.007
Kira, I. (2002). Suicide Terror and Collective Trauma: A Collective Terror Management Paradigm. American Psychological Association. http://psycnet.apa.org/psycextra/316712004-001.pdf&uid=316712004-001&db=PE
Kira, I. (2006). Collective Identity Terror in the Israeli-Palestinian Conflict and Potential Solutions. In J. Kuriansky (Ed.), Terror in the Holy Land, inside the Anguish of Israeli-Palestinian Conflict (pp. 125-130). Praeger.
Kira, I. (2019). Toward an Integrative Theory of Self-Identity and Identity Stressors and Traumas and its Mental Health Dynamic. Psychology, 10, 385-410. https://doi.org/10.4236/psych.2019.104027
Kira, I. (2020). Refugee Status and Identity Development. In S. Hupp, & J. Jewell (Eds.), The Encyclopedia of Child and Adolescent Development (pp. 310-320). Wiley. https://doi.org/10.1002/9781119171492.wecad467
Kira, I. (2021b). The Development-Based Taxonomy of Stressors and Traumas: An Initial Empirical Validation. Psychology, 12, 1575-1614. https://doi.org/10.4236/psych.2021.1210099
Kira, I. A. (2001). Taxonomy of Trauma and Trauma Assessment. Traumatology, 7, 73-86. https://doi.org/10.1177/153476560100700202
Kira, I. A. (2021a). Taxonomy of Stressors and Traumas: An Update of The Development-Based Trauma Framework (DBTF): A Life-Course Perspective on Stress and Trauma. Traumatology, 28, 84-97. https://doi.org/10.1037/trm0000305
Kira, I. A., & Shuwiekh, H. (2021). Discrimination and Mental Health of Christians in Egypt: Coping Trajectories and Perceived Posttraumatic Growth. Mental Health, Religion, and Culture, 24, 1-22. https://doi.org/10.1080/13674676.2020.1832454
Kira, I. A., Al-Ibrahim, B., Aljakoub, J., & Shuwiekh, H. (2022). The Effects of Torture in the Context of COVID-19 and Continuous Type III Trauma’s Variants: The Peri-Post Type III Trauma Mental Health Syndrome in Syrian Torture Survivors. Journal of Loss and Trauma. https://doi.org/10.1080/15325024.2022.2070967
Kira, I. A., Aljakoub, J., Al Ibraheem, B., Shuwiekh, H., & Ashby, J. S. (2022a). The Etiology of Complex PTSD in the COVID-19 and Continuous Traumatic Stressors Era: A Test of Competing and Allied Models. Journal of Loss and Trauma: International Perspectives on Stress & Coping. https://doi.org/10.1080/15325024.2022.2028094
Kira, I. A., Al-Noor, T. H., Al-Bayaty, Y. W., Shuwiekh, H., Ashby, J. S., & Jamil, H. (2022b). Intersected Discrimination through the Lens of COVID-19: The Case Example of Christian Minority in Iraq. American Journal of Orthopsychiatry. https://doi.org/10.1037/ort0000619
Kira, I. A., Ibrahim, E. R., Shuwiekh, H., & Ashby, S. (2021a). Does Intersected Discrimination Underlie the Disproportionate Impact of COVID-19 Infection and Its severity on Minorities? An Example from Jordan. Journal of Loss and Trauma: International Perspectives on Stress & Coping. https://doi.org/10.1080/15325024.2021.1992224
Kira, I. A., Özcan, N. A., Shuwiekh, H., Kucharska, J., Al-Huwailah, A., & Kanaan, A. (2020c). The Compelling Dynamics of “Will to Exist, Live and Survive” on Effecting PTG upon Exposure to Adversities: Is It Mediated, in Part, by Emotional Regulation, Resilience, and Spirituality. Traumatology: An International Journal, 26, 405-419. https://doi.org/10.1037/trm0000263
Kira, I. A., Rice, K., Ashby, J. S., Shuwiekh, H., Al Ibraheem, B., & Aljakoub, J. (2022c). Which Traumas Proliferate and Intensify COVID-19 Stressors? The Differential Role of Pre and Concurrent Continuous Traumatic Stressors and Cumulative Dynamics in Two Communities: USA and Syria. Journal of Loss and Trauma: International Perspectives on Stress & Coping. https://doi.org/10.1080/15325024.2022.2050067
Kira, I. A., Shuwiekh, H. A., Ashby, J. S., Elwakeel, S. A., Alhuwailah, A., Sous, M. S. F. et al. (2021c). The Impact of COVID-19 Traumatic Stressors on Mental Health: Is COVID-19 a New Trauma Type? International Journal of Mental Health and Addiction, 1-20. https://doi.org/10.1007/s11469-021-00577-0
Kira, I. A., Shuwiekh, H., & Kucharska, J. (2017). Screening for Psychopathology Using the Three Factors Model of the Structure of Psychopathology: A Modified Form of GAIN Short Screener. Psychology, 8, 2410-2427. https://doi.org/10.4236/psych.2017.814152
Kira, I. A., Shuwiekh, H., Al Ibraheem, B., & Aljakoub, J. (2019d). Appraisals and Emotion Regulation Mediate the Effects of Identity Salience and Cumulative Stressors and Traumas, on PTG and Mental Health: The Case of Syrian’s IDPs and Refugees. Self and Identity, 18, 284-305. https://doi.org/10.1080/15298868.2018.1451361
Kira, I. A., Shuwiekh, H., Kucharska, J., Fawzi, M., Ashby, J. S., Omidy, A. Z., Abou-Mediene, S., & Lewandowski, L. (2018a). Trauma Proliferation and Stress Generation (TPSG) Dynamics and Their Implications for Clinical Science. American Journal of Orthopsychiatry, 88, 582-596. https://doi.org/10.1037/ort0000304
Kira, I. A., Templin, T., Lewandowski, L., & Shuwiekh, H. (2018b). A Conceptual Model and Measurement of Identity-Based, Existential Annihilation Anxieties (EAA). Psychology, 9, 1306-1328. https://doi.org/10.4236/psych.2018.96080
Kira, I. A., Wroble, N. H. (2016). Trauma: Stress, Coping, and Emerging Treatment Models. In M. M. Amer, & G. H. Awad (Eds.), Handbook of Arab American Psychology (pp. 188-205). Routledge.
Kira, I., & Tummala-Narra, P. (2015). Psychotherapy with Refugees: Emerging Paradigm. Journal of Loss and Trauma: International Perspectives on Stress & Coping, 20, 449-467. https://doi.org/10.1080/15325024.2014.949145
Kira, I., Ashby, J. S., Omidy, A. Z., & Lewandowski, L. (2015). Current, Continuous, and Cumulative Trauma-Focused Cognitive Behavior Therapy: A New Model for Trauma Counseling. Journal of Mental Health Counseling, 37, 323-340. https://doi.org/10.17744/mehc.37.4.04
Kira, I., Barger, B., Shuwiekh, H., Kucharska, J., & Al-Huwailah, A. H. (2019a). Cumulative Stressors and Traumas and Suicide: A Non-Linear Cusp Dynamic Systems Model. Psychology, 10, 1999-2018. https://doi.org/10.4236/psych.2019.1015128
Kira, I., Barger, B., Shuwiekh, H., Kucharska, J., & Al-Huwailah, A. (2020a). The Threshold Non-Linear Model for the Effects of Cumulative Stressors and Traumas: A Chained Cusp Catastrophe Analysis. Psychology, 11, 385-403. https://doi.org/10.4236/psych.2020.113025
Kira, I., Clifford, D., Wiencek, P., & Al-Haidar, A. (2001). Iraqi Refugees in Southeast Michigan. First Report, ACCESS Community Health and Research Center.
Kira, I., Fawzi, M., & Fawzi, M. (2013). The Dynamics of Cumulative Trauma and Trauma Types in Adults Patients with Psychiatric Disorders: Two Cross-Cultural Studies. Traumatology: An International Journal, 19, 179-195. https://doi.org/10.1177/1534765612459892
Kira, I., Fawzi, M., Shuwiekh, H., Lewandowski, L., Ashby, J., & Al Ibraheem, B. (2019b). Do Adding Attachment, Oppression, Cumulative, and Proliferation Trauma Dynamics to PTSD Criterion “A” Improves Its Predictive Validity: Toward a Paradigm Shift? Current Psychology, 40, 2665-2679. https://doi.org/10.1007/s12144-019-00206-z
Kira, I., Lewandowski, L., Templin, T., Ramaswamy, V., Ozkan, B., & Mohanesh, J. (2008). Measuring Cumulative Trauma Dose, Types, and Profiles Using a Development-Based Taxonomy of Trauma. Traumatology: International Journal, 14, 62-87. https://doi.org/10.1177/1534765608319324
Kira, I., Özcan, N. A., Shuwiekh, H., Kucharska, J., Al-Huwailah, A., & Kanaan, A. (2020b). The Cross-National Validity and Structural Invariance of the Existential Annihilation Anxiety Scale. Current Psychology, 41, 573-584. https://doi.org/10.1007/s12144-019-00591-5
Kira, I., Shuwiekh, H., Al Ibraheem, B., & Aljakoub, J. (2021b). The Mental and Physical Health Effects of Torture: The Role of Identity Salience as a Pathway to Posttraumatic Growth and Healing: The Case of Syrian Refugees and IDPs. Psychology, 12, 1825-1847. https://doi.org/10.4236/psych.2021.1211110
Kira, I., Shuwiekh, H., Al-Huwailah, A. H., Lewandowski, L., Alawneh, A. W. N., Abou-Mediene, S., Al Ibraheem, B., & Aljakoub, J. (2019c). The Central Role of Social Identity in Oppression, Discrimination, and Social-Structural Violence: Collective Identity Stressors and Traumas, Their Dynamics and Mental Health Impact. Peace and Conflict: Journal of Peace Psychology, 25, 262-268. https://doi.org/10.1037/pac0000363
Kira, I., Shuwiekh, H., Al-Huwailah, A. H., Zidan, T., & Bujold-Bugeaud, M. (2019f). Measuring Interfaith Spirituality: Initial Validation and Psychometrics. Psychology of Religion and Spirituality, 13, 324-339. https://doi.org/10.1037/rel0000242
Kira, I., Shuwiekh, H., Kucharska, J., & Al-Huwailah, A. (2019g). The Integrated Structural and Measurement Models of Existential Annihilation Anxieties (EAA) and Their Potential Contribution to Clinical Science: Two Studies. Psychology, 10, 449-480. https://doi.org/10.4236/psych.2019.104031
Kira, I., Templin, T., Lewandowski, L., Ashby, J. S., Oladele, A., & Odenat, L. (2012b). Cumulative Trauma Disorder Scale: Two Studies. Psychology, 3, 643-656. https://doi.org/10.4236/psych.2012.39099
Kira, I., Templin, T., Lewandowski, L., Clifford, D., Wiencek, E., Hammad, A., Al-Haidar, A., & Mohanesh, J. (2006). The Effects of Torture: Two Community Studies. Peace and Conflict: Journal of Peace Psychology, 12, 205-228. https://doi.org/10.1207/s15327949pac1203_1
Kira, I., Templin, T., Lewandowski, L., Ramaswamy, V., Bulent, O., Mohanesh, J., & Abdulkhaleq, H. (2012a). Collective and Personal Annihilation Anxiety: Measuring Annihilation Anxiety AA. Psychology, 3, 90-99. https://doi.org/10.4236/psych.2012.31015
Laceulle, O. M., Vollebergh, W. A. M., & Ormel, J. (2015). The Structure of Psychopathologyin Adolescence: Replication of a General Psychopathology Factor in the TRAILS Study. Clinical Psychological Science, 3, 850-860. https://doi.org/10.1177/2167702614560750
Leyro, T. M., Zvolensky, M. J., & Bernstein, A. (2010). Distress Tolerance and Psychopathological Symptoms and Disorders: A Review of the Empirical Literature among Adults. Psychological Bulletin, 136, 576-600. https://doi.org/10.1037/a0019712
Lorant, V., Kunst, A. E., Huisman, M., Costa, G., & Mackenbach, J. (2005). Socio-Economic Inequalities in Suicide: A European Comparative Study. The British Journal of Psychiatry, 187, 49-54. https://doi.org/10.1192/bjp.187.1.49
Lowe, S. R., Raker, E. J., Arcaya, M. C., Zacher, M. L., Waters, M. C., & Rhodes, J. E. (2020). A Life-Course Model of Trauma Exposure and Mental Health among Low-Income Survivors of Hurricane Katrina. Journal of Traumatic Stress, 33, 950-961. https://doi.org/10.1002/jts.22581
Maxwell, S. E., & Cole, D. A. (2007). Bias in Cross-Sectional Analyses of Longitudinal Mediation. Psychological Methods, 12, 23-44. https://doi.org/10.1037/1082-989X.12.1.23
McLaughlin, K. A., Breslau, J., Green, J. G., Lakoma, M. D., Sampson, N. A., Zaslavsky, A. M., & Kessler, R. C. (2011). Childhood Socioeconomic Status and the Onset, Persistence, and Severity of DSM-IV Mental Disorders in a US National Sample. Social Science & Medicine, 73, 1088-1096. https://doi.org/10.1016/j.socscimed.2011.06.011
Mossakowski, K. N. (2003). Coping with Perceived Discrimination: Does Ethnic Identity Protect Mental Health? Journal of Health and Social Behavior, 44, 318-331. https://doi.org/10.2307/1519782
Murray, L. K., Cohen, J. A., & Mannarino, A. P. (2013). Trauma-Focused Cognitive Behavioral Therapy for Youth Who Experience Continuous Traumatic Exposure. Peace and Conflict: Journal of Peace Psychology, 19, 180-195. https://doi.org/10.1037/a0032533
Oldfield, J., Humphrey, N., & Hebron, J. (2015). Cumulative Risk Effects for the Development of Behaviour Difficulties in Children and Adolescents with Special Educational Needs and Disabilities. Research in Developmental Disabilities, 41-42, 66-75. https://doi.org/10.1016/j.ridd.2015.05.010
Petros, P. (2003). Non-linearity in Clinical Practice. Journal of Evaluation in Clinical Practice, 9, 171-178. https://doi.org/10.1046/j.1365-2753.2003.00344.x
Post, R. M., Weiss, S. R. B., & Smith, M. A. (1995). Sensitization and Kindling: Implications for the Evolving Neural Substrates of Post-Traumatic Stress Disorder. In M. J. Friedman, D. S. Charney, & A. Y. Deutch (Eds.), Neurobiological and Clinical Consequences of Stress: From Normal Adaptation to Post-Traumatic Stress Disorder (pp. 203-224). Lippincott Williams & Wilkins.
Schauer, M., & Schauer, E. (2010). Trauma-Focused Public Mental-Health Interventions: A Paradigm Shift in Humanitarian Assistance and Aid Work. In E. Martz (Ed.), Trauma Rehabilitation after War and Conflict (pp. 389-428). Springer. https://doi.org/10.1007/978-1-4419-5722-1_16
Skapinakis, P., Weich, S., Lewis, G., Singleton, N., & Araya, R. (2006). Socio-Economic Position and Common Mental Disorders: Longitudinal Study in the General Population in the UK. The British Journal of Psychiatry, 189, 109-117. https://doi.org/10.1192/bjp.bp.105.014449
Smith, T. B., & Silva, L. (2011). Ethnic Identity and Personal Well-Being of People of Color: A Meta-Analysis. Journal of Counseling Psychology, 58, 42-60. https://doi.org/10.1037/a0021528
Stein, M. B., Jang, K. L., Taylor, S., Vernon, P. A., & Livesley, W. J. (2002). Genetic and Environmental Influences on Trauma Exposure and Posttraumatic Stress Disorder Symptoms: A Twin Study. American Journal of Psychiatry, 159, 1675-1681. https://doi.org/10.1176/appi.ajp.159.10.1675
Stets, J. E., & Burke, P. J. (2000). Identity Theory and Social Identity Theory. Social Psychology Quarterly, 63, 224-237. https://doi.org/10.2307/2695870
Suliman, S., Mkabile, S. G., Fincham, D. S., Ahmed, R., Stein, D. J., & Seedat, S. (2009). Cumulative Effect of Multiple Trauma on Symptoms of Posttraumatic Stress Disorder, Anxiety, and Depression in Adolescents. Comprehensive Psychiatry, 50, 121-127. https://doi.org/10.1016/j.comppsych.2008.06.006
Van Geert, P. (1998). We Almost Had a Great Future behind Us: The Contribution of Non-Linear Dynamics to Developmental-Science-in-the-Making. Developmental Science, 1, 143-159. https://doi.org/10.1111/1467-7687.00020
Wamser-Nanney, R., Howell, K. H., Schwartz, L. E., & Hasselle, A. J. (2018). The Moderating Role of Trauma Type on the Relationship between Event Centrality of the Traumatic Experience and Mental Health Outcomes. Psychological Trauma: Theory, Research, Practice, and Policy, 10, 499-507. https://doi.org/10.1037/tra0000344
Williams, D. R., Yu, Y., Jackson, J. S., & Anderson, N. B. (1997). Racial Differences in Physical and Mental Health: Socioeconomic Status, Stress, and Discrimination. Journal of Health Psychology, 2, 335-351. https://doi.org/10.1177/135910539700200305
Willy, C., Neugebauer, E. A., & Gerngroß, H. (2003). The Concept of Nonlinearity in Complex Systems. European Journal of Trauma, 29, 11-22. https://doi.org/10.1007/s00068-003-1248-x
Yair, G. (2014). Israeli Existential Anxiety: Cultural Trauma and the Constitution of National Character. Social Identities, 20, 346-362. https://doi.org/10.1080/13504630.2014.1002390
Yehuda, R., Kahana, B., Schmeidler, J., Southwick, S. M., Wilson, S., & Giller, E. L. (1995). Impact of Cumulative Lifetime Trauma and Recent Stress on Current Posttraumatic Stress Disorder Symptoms in Holocaust Survivors. The American Journal of Psychiatry, 152, 1815-1818. https://doi.org/10.1176/ajp.152.12.1815
Zeeman, E. C. (1976). Catastrophe Theory. Scientific American, 234, 65-83. https://doi.org/10.1038/scientificamerican0476-65