This study presents a new short scale for measuring cumulative trauma dose, types, and profiles that is based on the APA (American Psychological Association) trauma Group (currently division 56) definition of trauma and a new, two-way development-based taxonomy of trauma. The new measure was tested using a sample of 501 Iraqi refugees who are one of the most traumatized groups. The following six salient factors were found: collective identity, family, personal identity, interdependence or secondary, man-made or nature-made survival, and abandonment types of traumas. The study provided evidence of adequate reliability; construct, convergent, divergent and predictive validity of the new scale and provided partial confirmation of the validity of the development-based taxonomy of traumas. A new method was introduced to measure trauma types and profiles and their differential association with different symptom configurations and health disorders. The newly developed measure can be used in clinical trauma-informed settings and in research.

A review of the theory of trauma as a special case of stress response theory, two different classifications/taxonomies of traumas emerge. Each taxonomy describes a different dimension of the traumatic event. The first taxonomy, areas of individual functioning, includes five types: Attachment trauma, autonomy or identity trauma, interdependence trauma, achievement or self-actualization trauma, and survival trauma. The second classification is based on experiential objective external criteria and includes two main categories: Factitious or trauma-like and real traumatic events. The first happens in one step transmission from one to one or more persons. The second get transmitted in multiple steps or cross-generationally. Traumas can get transmitted cross generationally in two venues: through family or collectively. Collective transmission of traumas happens in two contexts: historical and social structural. Direct traumas (person-made), on the other hand, is divided into two types: Simple (type I) and complex (type II, and type III). While type I is a single blow, type II is a unit of repeated and connected series of blows. Type III is the additive effect of the sequence of all direct, indirect, and factitious traumatic events on one or more of the different areas of functioning across life span. The latter section of the paper describes a Trauma Assessment Matrix to help identify the accumulation of traumatic events and its potentially additive effects in one or more of the five areas of functioning. The treatment implications are addressed.

The goal of this paper is to advance the theory of chronic and traumatic stressors that have been identified as type III traumas in the trauma developmentally-based framework (DBTF) and use it to investigate the mental and physical health effects of such traumas on impacted individuals and groups. Participants were 438 Palestinian adolescents from the West Bank who had been exposed to a number of types of trauma including chronic intergroup violence. The age of participants in the sample ranged from 12 to 19 with a mean of 15.66 and SD of 1.43. The sample included 54.6% males, 52.3% resided in cities, 44.4% resided in villages, while 3.2% resided in refugee camps. The study utilized a measure for cumulative traumas that is based on the DBTF and measures of post-traumatic stress disorder (PTSD), cumulative trauma related disorders (CTD), depression, anxiety, collective annihilation anxiety (AA), identity salience, and fear of death. The results of partial correlation and path analyses indicated that continuous traumatic stress was a significant predictor of mental health. The analyses also indicated that poverty predicted identity salience and AA that mediated their negative effects on physical and mental health of Palestinian adolescents. The relevance of these results to peace, social and clinical psychology was discussed.

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Developments in the theories of identity, culture, and traumatology enrich our cross-cultural understanding of mental health dynamics, case conceptualization, and developing effective intervention models to help victims of complex and cumulative traumas especially in different cultures and minority populations. Identity traumas, along with preidentity and nonidentity traumas, contribute to forming cultures. On the other hand, cultures may contribute to delivering some types of culture- and social-made serious traumatic conditions that can be transferred cross-generationally, such as poverty and caste systems. Most current interventions are designed to help with single trauma and ignore the cumulative trauma dynamics as well the collective identity and culture-specific traumas. This understanding entails revising our culturally limited and single-trauma-based interventions to help clients who belong to different cultures or to minority victims of culture- and social-made traumas as well as those who are victims of cumulative traumas. Multisystemic, multimodal, multicomponent flexible and fiddle therapy models emerged as potentially more effective in the treatment of disorders resulting from cumulative and identity traumas. They are more ecologically valid and culturally competent. Specific models of multisystemic, multimodal therapies— the wraparound psychosocial rehabilitation approach, for torture survivors, and the summer day and after-school treatment, for child victims of cumulative traumas—are discussed.