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Eastern African expressions of suffering: A new Cultural Scripts of Trauma Inventory

بیان‌های رنج در شرق آفریقا: ابزار جدید سنجهٔ الگوهای فرهنگی آسیب روانی

Célestin Mutuyimana, And re as Maercker

PLoS ONE 2026 Vol. 21(9), pp. e0358482
https://doi.org/10.1371/journal.pone.0358482

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چکیده

Introduction Many people who have experienced trauma feel that PTSD criteria do not describe their experiences. They report culturally specific symptoms, in our new theory referred to as Cultural Scripts of Trauma, yet no study has systematically mapped these experiences or developed tools to measure them. Objectives This study aims to map cultural scripts of trauma suffering and to develop and validate the Cultural Scripts of Trauma Inventory (CSTI) across Eastern African countries, including Rwanda, Uganda, Tanzania, and Kenya. Methods A qualitative study involving 115 participants across nine focus groups of trauma survivors and experts was conducted to map the main cultural scripts of trauma experiences and generate initial pool of items. This was followed by a quantitative validation study involving 1,208 participants from Rwanda, Uganda, Tanzania, and Kenya. In an online survey, participants completed the pre-CSTI and additional measures for convergent and divergent validity, such as the International Trauma Questionnaire, Clinical Aspects of Historical Trauma, Purpose in Life Questionnaire, Subjective Vitality, and General Self-Efficacy. Results The results yield 71 Cultural Scripts of Trauma Sufferings (CSTs). The confirmatory factor analysis confirms 15 most relevant CSTs regrouped in five factors such as cognitive, body related, frame of mind, meaning disruption and family stress demonstrating excellent model fit. Those constitute 15 item-inventory that showed strong overall reliability and validity. Additionally, the model exhibited configural, metric, and partial scalar invariance, confirming its consistency across various groups. Conclusion This study is advancing culturally informed diagnosis and treatment of post traumatic sequelae by identification of culturally specific post trauma suffering and development and validation of CSTI in East African countries. It provides clinicians and researchers with a resource to adopt a model of beyond and including PTSD by offering a deeper understanding of post-traumatic stress in diverse cultural contexts.

چکیده به فارسی

مقدمه: بسیاری از افرادی که تجربه آسیب روانی داشته‌اند، احساس می‌کنند ملاک‌های اختلال استرس پس از سانحه (PTSD) تجارب آن‌ها را توصیف نمی‌کند. آن‌ها نشانه‌های خاص فرهنگی را گزارش می‌کنند که در نظریه جدید ما به عنوان «الگوهای فرهنگی آسیب روانی» نامیده می‌شود، اما تاکنون هیچ مطالعه‌ای به طور نظام‌مند این تجارب را ترسیم نکرده یا ابزارهایی برای سنجش آن‌ها توسعه نداده است. اهداف: هدف این پژوهش، ترسیم الگوهای فرهنگی رنج آسیب روانی و توسعه و اعتباریابی ابزار سنجهٔ الگوهای فرهنگی آسیب روانی (CSTI) در کشورهای شرق آفریقا از جمله رواندا، اوگاندا، تانزانیا و کنیا است. روش‌ها: مطالعه‌ای کیفی با مشارکت ۱۱۵ نفر در قالب ۹ گروه متمرکز از بازماندگان آسیب و خبرگان به منظور ترسیم الگوهای اصلی تجارب آسیب روانی و تولید بانک اولیه گویه‌ها انجام شد. سپس مطالعه‌ای کمی جهت اعتباریابی با مشارکت ۱۲۰۸ نفر از رواندا، اوگاندا، تانزانیا و کنیا صورت گرفت. در یک نظرسنجی آنلاین، شرکت‌کنندگان نسخه اولیه CSTI و ابزارهای تکمیلی برای سنجش روایی همگرا و واگرا، از جمله پرسشنامه بین‌المللی آسیب روانی، جنبه‌های بالینی آسیب تاریخی، پرسشنامه هدفمندی در زندگی، سرزندگی ذهنی و خودکارآمدی عمومی را تکمیل کردند. نتایج: نتایج منجر به شناسایی ۷۱ الگوی فرهنگی رنج آسیب روانی (CST) شد. تحلیل عاملی تأییدی، ۱۵ الگوی فرهنگی مهم‌تر را در پنج عامل شامل شناختی، بدنی، وضعیت ذهنی، اختلال معنایی و استرس خانوادگی با برازش عالی مدل تأیید کرد. این عوامل، ابزار ۱۵ گویه‌ای را تشکیل می‌دهند که از پایایی و روایی کلی قوی برخوردار است. افزون بر این، مدل از نظر پیکربندی، سنجش و بخشی از مقیاس، ناوریانس را نشان داد و ثبات آن را در گروه‌های مختلف تأیید کرد. نتیجه‌گیری: این مطالعه با شناسایی رنج‌های خاص فرهنگی پس از آسیب و توسعه و اعتباریابی CSTI در کشورهای شرق آفریقا، به تشخیص و درمان مبتنی بر فرهنگ پیامدهای پس از آسیب کمک می‌کند. این ابزار منبعی برای درمانگران و پژوهشگران فراهم می‌کند تا مدلی فراتر و شامل PTSD را با درک عمیق‌تر از استرس پس از سانحه در زمینه‌های فرهنگی متنوع اتخاذ کنند.

ترجمه‌ی خودکار برای آشنایی سریع؛ برای نقل و ارجاع، متن اصلی ملاک است.

موضوع‌ها و کلیدواژه‌ها

اختلال استرس پس از سانحهخودکارآمدیدرمانConfirmatory factor analysisConvergent validitycultural competenceCultural diversityFocus groupPsychological traumaPsychometricsScripting language

ارجاع

Mutuyimana, C., & Maercker, A. R. A. (2026). Eastern African expressions of suffering: A new Cultural Scripts of Trauma Inventory. PLoS ONE, 21(9), e0358482. https://doi.org/10.1371/journal.pone.0358482

(Mutuyimana & Maercker, 2026)

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  1. با احترام و بدون توهین، تحقیر، برچسب‌زنی یا حمله‌ی شخصی با دیگران گفتگو کنید.
  2. از نوشتن هرگونه اطلاعات هویتی یا قابل‌شناسایی مراجعان، بیماران یا اشخاص ثالث، از جمله نام، شماره‌ی تماس، تصویر، نشانی، محل کار یا جزئیات منحصربه‌فرد پرونده خودداری کنید.
  3. اگر درباره‌ی یک تجربه‌ی بالینی سؤال می‌کنید، اطلاعات را تا حد ممکن بی‌نام و کلی بیان کنید تا امکان شناسایی فرد وجود نداشته باشد.
  4. این بخش برای یادگیری و گفت‌وگوی علمی است و جایگزین ارزیابی، تشخیص، مشاوره یا روان‌درمانی شخصی نیست.
  5. در شرایط بحران یا خطر آسیب به خود یا دیگران، به این بخش اتکا نکنید و برای دریافت کمک فوری با اورژانس اجتماعی ۱۲۳ یا صدای مشاور بهزیستی ۱۴۸۰ تماس بگیرید.
  6. انتشار تبلیغات، معرفی خدمات شخصی، شماره‌ی تلفن، شناسه‌ی شبکه‌های اجتماعی، پیوند تبلیغاتی یا درخواست جذب مراجع در این بخش مجاز نیست.
  7. در بیان ادعاهای علمی، به‌ویژه درباره‌ی اثربخشی درمان‌ها، تشخیص یا یافته‌های پژوهشی، تا حد امکان نام منبع معتبر، مقاله یا راهنمای علمی را ذکر کنید.
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  9. پاسخ‌هایی که کارشناسان فکر بنیان می‌دهند با برچسب «پاسخ فکر بنیان» یا «کارشناس فکر بنیان» نمایش داده می‌شوند و سایر نوشته‌ها بیانگر نظر کاربران هستند.
  10. گزارش نوشته‌ی نامناسب: اگر نوشته‌ای حاوی نقض محرمانگی، محتوای آسیب‌زا، توهین، تبلیغ یا تخلف از این قوانین است، گزینه‌ی «گزارش» را انتخاب کنید تا تیم سایت بررسی کند.

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