Two studies examined the role of culture on cognitive appraisals of trauma and associated implications for posttraumatic psychological adjustment. Study 2 also investigated the reliability and validity of a new measure assessing public and communal aspects of trauma-associated appraisals (Public and Communal Self Appraisals Measure; PCSAM). Study 1′s non-clinical sample (N = 75) and Study 2′s sample of British and Asian trauma survivors with and without PTSD (N = 95) provided an everyday and trauma memory, completed an Appraisal Inventory, the Posttraumatic Cognitions Inventory and measures of PTSD. Study 2 participants also completed the PCSAM. Conjoined, there were cultural differences in appraisals of everyday and trauma experiences. Nonetheless, there appeared to be cultural similarities in the dysfunctional appraisals of those with PTSD. The PSCAM had good internal consistency, test-retest reliability, convergent validity, and discriminative validity. Findings are discussed in terms of combining cultural models of self with current PTSD models.

Objective: Cognitive appraisals have a central role in the development, maintenance, and treatment of posttraumatic stress disorder (PTSD). Accumulating cross-cultural psychology research has demonstrated that culture affects the way in which an individual cognitively appraises an everyday experience. However, to date, there is little empirical work considering the influence of culture on cognitive appraisals in PTSD and the implications for treatment. The objective of this review article was to consider how culture may impact on the cognitive appraisals central to PTSD.Method: First, we reviewed the role of appraisals in the prominent cognitive models of PTSD. Second, we discussed the cross-culture psychology literature on the influence of culture on appraisals. Third, we considered the impact of culture on trauma-related appraisals and associated clinical implications. Finally, we considered implications for the tailoring of clinical treatment for individuals from diverse cultural backgrounds.Results: It was found that culture influences appraisals; a key psychological process highlighted by cognitive models as predictive of PTSD. In particular, cultural differences in self-understanding influence how individuals appraise experiences in terms of agency, control, mental defeat, and negative independent appraisals of self; appraisals central to PTSD.Conclusions: Empirical work is needed in order to investigate the influence of culture on trauma-related appraisals in the context of PTSD in order to improve theoretical models and clinical approaches. Key Points1 Cognitive appraisals are central to the understanding of posttraumatic stress disorder (PTSD). Crosscultural psychology research has shown culture affects the way in which an individual cognitively appraises an experience. 2 This review article considered how culture may impact on the cognitive appraisals central to the development, maintenance, and treatment of PTSD symptoms. 3 Assessment and treatment implications for individuals from diverse cultural backgrounds were considered.Cognitive factors are one of the best predictors for identifying posttraumatic stress disorder (PTSD) (Kleim, Ehlers, & Glucksman, 2007) and are targeted in evidence-based interventions for PTSD (Resick, 2001).

Appraisals are a key feature in understanding an individual’s experience; this is especially important when the experience is a traumatic one. However, research is diminutive when looking at the interaction between trauma appraisals and culture in relation to posttraumatic stress disorder using qualitative methodologies. This study explored cultural differences in perceptions and appraisals of trauma using three qualitative focus groups with community members (n = 11) from collectivistic cultures who had experienced a traumatic event and three qualitative individual key informant interviews with mental health practitioners (n = 3) routinely working with trauma survivors. Using template analysis, eight emergent themes were highlighted from the data sets [(1) trauma and adjustment; (2) cultural and social roles; (3) traumatised self; (4) relationships; (5) external attribution; (6) future; (7) education; (8) language] that potentially have significant consequences for posttrauma psychological adjustment and recovery. Cumulatively, while a number of themes are similar to that which is emphasised in current literature (e.g. damaged self, negative appraisals of the world, others, future) a number of themes were also resonant and warrant further scrutiny. For instance, the importance and interconnectedness of the group to the individual and the impact trauma has on this; the importance of social roles, cultural appropriateness and violations of cultural values and norms; findings and implications are discussed.

Background:The principles of the Armed Forces Covenant state that Armed Forces Veterans should be at no disadvantage resulting from their service compared with a general adult population. However, despite being at increased risk of experiencing common mental health difficulties, evidence indicates that 82% of Armed Forces Veterans receive no treatment, compared with 63% of the general adult population.Aim:To gain a better appreciation of factors that inform the type of adaptations to cognitive behavioural therapy (CBT) interventions for depression and mainstream service promotion materials to enhance acceptability for Armed Forces Veterans.Method:This is a qualitative study employing a focus group of 12 participants to examine the main impacts of depression on Armed Forces Veterans alongside attitudes towards terminology and visual imagery. Thematic analysis was used to identify themes and sub-themes with rigour established through two researchers independently developing thematic maps to inform a final agreed thematic map.Results:A behavioural activation intervention supporting re-engagement with activities to overcome depression had good levels of acceptability when adapted to reflect an Armed Forces culture. Preferences regarding terminology commonly used within CBT adapted for Armed Forces Veterans were identified. Concerns were expressed with respect to using imagery that emphasized physical rather than mental health difficulties.Conclusions:There is the need to consider the Armed Forces community as a specific institutional culture when developing CBT approaches with potential to enhance engagement, completion and recovery rates. Results have potential to inform the practice of CBT with Armed Forces Veterans and future research.