Psychology
2013. Vol.4, No.4, 396-409
Published Online April 2013 in SciRes (http://www.scirp.org/journal/psych) DOI:10.4236/psych.2013.44057
Advances in Continuous Traumatic Stress Theory: Traumatogenic
Dynamics and Consequences of Intergroup Conflict: The
Palestinian Adolescents Case
Ibrahim A. Kira
1*
, Jeffrey S. Ashby
2
, Linda Lewandowski
3
,
Abdul Wahhab Nasser Alawneh
4
, Jamal Mohanesh
5
, Lydia Odenat
6
1
Center for Cumulative Trauma Studies, Stone Mountain, USA
2
Georgia State University, Atlanta, USA
3
University of Massachusetts, Amherst, USA
4
Arab and Middle East Resource Center, Dearborn, USA
5
ACCESS Community Health and Research Center, Dearborn, USA
6
Emory University, Atlanta, USA
Email:
*
kiraaref@aol.com
Received January 21
st
, 2013; revised February 25
th
, 2013; accepted March 21
st
, 2013
Copyright © 2013 Ibrahim A. Kira et al. This is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
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 re-
lated 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 adoles-
cents. The relevance of these results to peace, social and clinical psychology was discussed.
Keywords: DBTF Trauma Framework; Type III trauma; Stress Generation; Stress Proliferation;
Collective Annihilation Anxiety
Toward a Theory of Continuous Traumatic
Stress
Researchers and theorists (e.g., Turner, Wheaton, & Lloyd,
1995) typically identify three types of stressors: traumatic stress,
life events or “ordinary stress”, and chronic stress. Typically
the focus of clinical, social and political psychology is more on
stressors that have the potential of generating psychological and
social pathology and inter-group conflicts rather than the more
inconsequential ordinary life stressors. While the literature ge-
nerally identifies stressors in these ways, there is a rift in the
theory and study of stress. There are two competing but related
paradigms including the stress, appraisal, and coping theory
that originated initially from the physiological and sociological
literature (e.g. Selye, 1956; Lazarus, 1999; Lazarus & Folkman,
1984; Everly & Lating, 2002) and the theory of traumatic stress
that originated mostly from psychiatric, psychological, and psy-
cho-political literature (e.g., van der Kolk, Weisaeth, & van der
Hart, 1996; Cassidy & Shaver, 1999; Freyd, DePrince, & Glea-
ves, 2007; Herman, 1992; Bryant-Davis & Ocampo, 2005).
Further, within the theory of traumatic stress there is a divide
between three major paradigms in studying traumatic processes:
the psychiatric paradigm that focused mostly on the physical
survival types of traumatic stress that threaten the “physical
integrity”, or risk of serious injury or death, to self or others,
and on the resulted post-traumatic stress disorder (PTSD) sym-
ptoms (e.g., Green, 1995; Rothschild, 2000), the psychoanalytic,
and developmental paradigms that focused more on studying
the effects of abandonment, child maltreatment and other betra-
yal traumas in early childhood (e.g., Bowlby, 1988; Cassidy &
Shaver, 1999; Freyd, DePrince, & Gleaves, 2007), and the inter-
group paradigm as evidenced in studying discrimination, geno-
cide, holocaust, torture and other shared politically motivated
micro and macro aggressions (e.g., Bryant-Davis & Ocampo,
2005; Sue, 2010; for analysis of discrimination as a trauma, see
Helms, Nicolas, & Green, 2010, for meta-analysis of the effects
of discrimination , see Pascoe & Richman, 2009).
There are at least three potential problems with the current
status of trauma theory and research. The first is its fragmenta-
*
Corresponding author.
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