• Environmental factors greatly influence emotional, physical, and social well-being. • A fundamental determinant of health ver­ sus illness is the degree of fit between indi­ viduals’ biological, behavioral, and sociocultural needs and the resources avail­ able to them. • Prevention, intervention, and treatment approaches integrate a combination of strategies targeting individual, interperson­ al, and community systems.

To more adequately understand trauma, you must also consider the contexts in which it occurred. Understanding trauma from this angle helps expand the focus beyond individu­ al characteristics and effects to a broader sys­ temic perspective that acknowledges the influences of social interactions, communities, governments, cultures, and so forth, while also examining the possible interactions among those various influences.

Re-enactments Self-harm and self-destructive behaviours Consumption of substances Avoidance

Shame, Gulit, Isolated, Victimised, Anger.

Emotional dysregulation, Numbing - deny that they have any feelings associated with their traumatic experiences and define their reactions as numbness or lack of emotions.

believing that emotional expression is too dangerous or will lead to feeling out of control (e.g., a sense of “losing it” or going crazy).

minimization, avoidance, Dissociation, depersonalization, and derealization, Trauma-induced hallucinations or delusions, Excessive or inappropriate guilt, Cognitive errors, Intrusive thoughts and memories, Triggers and flashbacks

Was the trauma expected or unexpected?

Were the trauma’s effects on the person’s life isolated or pervasive?

Who was responsible for the trauma and was the act intentional?

Was the trauma experienced directly or indirectly

What happened since the trauma?

Psychological meaning of trauma

Disruption of core assumptions and beliefs

Cultural meaning of trauma

Single Event

Multiple Events

Interpersonal Trauma

Developmental traumas.

These groups often share a common identity and history, as well as similar activities and concerns.

It may in­ volve violence in the form of physical or sexual assaults, hate crimes, robberies, workplace or gang-related violence, threats, shootings, or stabbings. eg., school shooting

It also includes actions that attempt to dismantle systemic cultural practices, resources, and identities, such as making boarding school attendance mandato­ry for Native American children or placing them in non-Native foster homes.

Cultural trau­mas are events that, whether intentionally or not, erode the heritage of a culture—as with prejudice, disenfranchisement, and health inequities (e.g., late prenatal care, inability to afford medications, limited access to culturally appropriate health education, vicinity and quality of affordable medical services),

Although the trauma directly affects just one individual, others who know the person and/or are aware of the trauma will likely experience emotional repercussions from the event(s) as well, such as recounting what they said to the person before the event, reacting in disbelief, or thinking that it could just as easily have hap¬pened to them, too.

Genetic, biologi­cal, and psychological makeup and history influence the person’s experience and interpretation of, as well as his or her reactions to trauma.

History of prior psychological trauma. The effects of trauma are cu­mulative; therefore, a later trauma that out­ wardly appears less severe may have more impact upon an individual than a trauma that occurred years earlier. Conversely, individuals who have experienced earlier traumas may have developed effective coping strategies or report positive outcomes as they have learned to adjust to the consequences of the trauma(s). This outcome is often referred to as posttrau­ matic growth or psychological growth.

History of resilience: The ability to thrive beyond the trauma is associated with individual factors as well as situational and contextual factors. There are not only one or two primary factors that make an individual resilient; many factors contribute to the development of resilience. There is little research to indicate that there are specific traits predictive of resilience; instead, it appears that more general characteristics influ­ ence resilience, including neurobiology (Feder, Charney, & Collins, 2011), flexibility in adapt­ ing to change, beliefs prior to trauma, sense of self-efficacy, and ability to experience positive emotions (Bonanno & Mancini, 2011).

History of mental disorders

Gender

Race, ethnicity, and culture

Sexual orientation and gender identity

People who are homeless

Subtle,

Insidious/gradule

Outright destructive.

characteristics of the individual

the type and characteristics of the event(s)

developmental processes,

the meaning of the trauma

sociocultural factors

The characteristics of the trauma and the subsequent traumatic stress reactions can dramatically influence how indi­viduals respond to the environment, relation­ships, interventions, and treatment services, and those same characteristics can also shape the assumptions that clients/consumers make about their world (e.g., their view of others, sense of safety), their future (e.g., hopefulness, fear of a foreshortened future), and themselves (e.g., feeling resilient, feeling incompetent in regulating emotions).

Natural traumatic experiences can directly affect a small number of people, such as a tree falling on a car during a rainstorm, or many people and communities, as with a hurricane. Natural events, often referred to as “acts of God,” are typically unavoidable.

Human-caused traumas are caused by human failure (e.g., technological catastrophes, accidents, malevolence - A malevolent person deliberately tries to cause harm or evil.) or by human design (e.g., war).