Cultural Factors and Resilience to Trauma

Traumatology | 2024, Vol. 30, No. 1, p. 37-51

The Relationship Between Cultural Variables and Resilience to Psychological Trauma: A Systematic Review of the Literature

Sumithra Raghavan; William Paterson University

Priyadharshiny Sandanapitchai; William Paterson University

The construct of resilience has been of interest to social scientists for several decades, with a range of definitions describing traits, contexts, and processes of growth. Research with trauma-exposed populations suggests that resilience is a common trajectory, but the mechanisms that facilitate resilience are not entirely clear. This is especially the case with cross-cultural populations, and scholars in this area have pointed to the individualistic nature of the concept and the absence of cultural factors in resilience research. These scholars call for a social-ecological view of resilience that incorporates multiple factors, including Indigenous ideologies and systems of meaning-making. This article aims to add to the conversation surrounding the relationship between culture and resilience to psychological trauma. The authors conducted a systematic review of the literature in an effort to identify empirical articles that examined the relationship between culture, resilience, and psychological trauma. Across 3 academic databases and Google Scholar, the authors identified a total of 30 articles that empirically evaluated these variables between 2008 and 2018. Overall, research points to culturally specific values and community and social support to be facilitative of resilience in a range of trauma-exposed populations. The small number of articles is consistent with critiques regarding the absence of culture in empirical assessments of resilience, and the discussion offers suggestions for future research. Overall, the review synthesizes the findings of these articles and offers implications for research and treatment of diverse trauma-exposed populations.

cross-cultural; psychological trauma; resilience; culture

The study of resilience, particularly its interaction with cultural variables, is critical in understanding how individuals recover from psychological trauma. Resilience, the capacity to adapt positively despite significant adversity, has historically been viewed as an individual trait. However, this study challenges that notion by exploring the social-ecological model of resilience, which emphasizes the role of cultural and contextual factors. The current research aims to bridge the gap in resilience literature by systematically reviewing how cultural elements influence resilience in trauma-exposed populations. 

Prior research has shown that resilience, the ability to bounce back from adversity, is influenced by a complex interplay of individual traits, contextual factors, and cultural variables. Werner's landmark study demonstrated that individuals facing significant risk factors could still thrive, highlighting the importance of protective factors such as social support and academic achievement. However, subsequent research has revealed a need for more consensus in defining and operationalizing resilience, leading to varied approaches to studying this construct. While some studies focus on individual traits, others adopt a social-ecological perspective, emphasizing the role of environmental and cultural factors. Scholars like Ungar advocate for a broader understanding of resilience that incorporates cultural values and contexts, challenging the traditional Western-centric view. 

This study utilized a systematic literature review approach to investigate the relationship between culture, trauma, and resilience. Employing a comprehensive search strategy across various databases, articles published between 2008 and 2018 were scrutinized based on predefined inclusion criteria. Mental health, trauma exposure, and resilience were focal points, with trauma defined according to PTSD criteria from the DSM-5. The review encompassed quantitative, qualitative, and mixed methods studies, with data extraction focusing on how culture was defined and assessed and the conceptualization of resilience. 

The findings of the research shed light on the intricate relationship between culture and resilience in trauma-exposed populations. Despite a significant body of literature on resilience to trauma, empirical investigations into the role of cultural factors remain scarce. Cultural values were predominantly assessed through acculturation questionnaires or interview questions, although demographic variables were often used to measure culture. 

The synthesis of findings revealed self-reported associations between cultural or religious values and resilience to trauma. Culture was depicted as providing a context for meaning-making, with narratives reflecting resilience-promoting values such as endurance and family unity. Additionally, specific coping behaviors linked to cultural backgrounds, such as future orientation and self-reliance, were identified. 

Cultural Values as Resilience Factors: Encourage patients to explore and leverage their culturally derived values during therapy sessions. These values can serve as powerful tools for meaning-making and coping with trauma. Ask patients about their cultural backgrounds and traditions, and help them identify aspects that can be sources of strength. Integrating these cultural elements into their recovery plan can provide a strong foundation for building resilience.

Adopt a Social-Ecological Approach: When designing treatment plans, consider the social-ecological model of resilience. This model emphasizes the importance of contextual factors, including cultural values and community support, in fostering resilience. Assess the patient's environment and identify supportive elements that can be enhanced. Collaborate with community resources and involve family members when appropriate to create a supportive network around the patient.

Promote Community Connections: In settings like refugee camps, shelters, or even community centers, facilitate the creation of support networks. Organize group activities that emphasize shared cultural practices and traditions to build a sense of community. Encourage patients to participate in local cultural events or support groups. Promoting these connections can help patients develop a robust support system that enhances their resilience.

Focus on Vulnerable Individuals: Pay special attention to patients who lack family or community support and those struggling to find meaning. These individuals are at higher risk and need targeted interventions. Develop personalized support plans that include finding new sources of social support, such as mentorship programs or peer support groups. Help them identify and cultivate new areas of meaning and purpose to fill these gaps and strengthen their resilience. 

“This review has several noteworthy limitations. First, any systematic review is limited by the search strategy itself. We used the terms culture, resilience, and trauma, expecting they would cast a wide net and we could eliminate further based on content. We also substituted culture with race and ethnicity in an effort to capture related topics that may have been categorized differently. It can be argued that concepts of race and ethnicity themselves are entrenched in a Western system and may have missed articles that review tribal or religious affiliations. We included references to religion and spirituality within items yielded by a “culture” search, but we did not search for those terms independently. Although both the use of broad search terms and examining related terms are common practice in a systematic review (Baumeister, 2013), ultimately if articles are not initially categorized and classified accurately, they will not emerge in a search. Additionally, although terms like culture, spirituality, race, and ethnicity are often used interchangeably, they are unique constructs. Had we focused on spirituality and religious coping, for example, this may have yielded an entirely different set of results. Indeed, these search related criticisms are not unique to our review but does suggest that there may be more studies on this topic than we were able to discover. In contrast, however, the paucity of articles yielded by the search is consistent with criticisms from researchers who repeatedly identified that there is a lack of evidence on the topic of resilience and culture” (p. 47).