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Culture sensitive assessment   ​

 

 

Topic leader: Andreas Maercker, University of Zurich, Zurich, Switzerland

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CultScript logo.png

​​CultScript

Cultural Scripts of Trauma: Cultural Psychological Factors in Posttraumatic Symptom Development and Expressions

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Project leader Andreas Maercker, University of Zurich, Zurich, Switzerland

 

Project group

Rahel Bachem, David J. Eberle, University of Zurich, Switzerland
Celestin Mutuyimana, Collegium Helveticum, Zurich, Switzerland
Stephen Asatsa, Catholic University of Eastern Africa, Nairobi, Kenia
Carmit Katz, Tel Aviv University, Tel Aviv, Israel
Nino Makhashvili, Jana Javakhishvili, Ana Papava, Ilia State University, Tbilisi, Gerorgia
Jun Wen, Xinyi Yu, Wenli Qiian, Jianping Wang, Beijing Normal University, Beijing, PR China
Jorge Sanabria Leon, Ana Jurado, Andrea Molina, Universidad de Costa Rica, San José, Costa Rica

 

Background & aims

Cultural factors were shown to be particularly relevant for the development and expression of posttraumatic stress. Recently, the concept of cultural scripts of trauma sequelae has been introduced, which proposes that emic elements of traumatic stress may be sequentially linked and specifically associated with cultural factors. Furthermore, a cascade model is proposed, including trauma exposure, demographic characteristics, cultural affiliation, and trauma-related value orientations as influencing factors of cultural trauma development.

Objectives: The purpose of this network project is to investigate cultural psychological factors that contribute to the expression of posttraumatic stress.

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This contribution is timely and enriches the knowledge of trauma and culture. Future publications of this network project will address trauma sequelae from a cultural perspective and provide diagnostic and psychotherapeutic implications.

 

Methods 

The present network project implements a mixed methods approach and will be conducted in 5 different study sites, including Switzerland, Israel, Georgia, China, and East Africa. In sub-study I, the cultural scripts of traumatic stress inventories (CSTI’s) will be developed. These scales provide a pool of trauma sequelae elements for each cultural group. For this purpose, focus groups with trauma survivors and trauma experts will be conducted and analysed using qualitative research methods.

Sub-study II implements a validation analysis of the CSTI’s and the empirical investigation of a cultural cascade model. This quantitative approach will include a larger sample of individuals who experienced traumatic life events.​

Interim Results (September 2026)

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Quantitative Substudy I

At four of the six sites where these studies were initiated, results have now been published:

  • East Africa (Mutuyimana & Maercker, 2023),

  • Switzerland (Bachem et al., 2025),

  • Georgia (Papava et al., 2026), and

  • China (Yu et al., in press).

They revealed that there are culture-specific dominant symptoms of trauma sequelae (a small selection):

- East Africa: Bitterness, distrust, need for care, physical pain

- Switzerland: Self-deprecation, urge to function/overcompensation, emotional overload

- Georgia: Feeling unaccepted, hiding pain/feeling trapped in one’s body, caution in relationships

- China: excessive emotions, self-harm, body-related issues, eating problems.

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Quantitative Substudy II  has so far been successfully conducted in three countries:

  • East Africa (Muytuyimana & Maercker, in press),

  • Switzerland,

  • China (in prep.).

Here, the causal-temporal order of the cultural scripts and their correspondence with cultural values were also examined (East Africa: Wen et al., 2026a). The results were small lists of symptoms—so-called “symptom addenda”—that extend beyond the ICD-11/DSM-5 framework.

A spin-off of this research is the study of Prolonged Grief Disorder using the same research approach: China (Wen et al., 2026b).

 

Research series are currently in preparation in 

  • South Africa

  • Turkey

  • Pakistan.

 

 

Collaborate

Collaborators are Welcome (CAW): Colleagues from all parts of the world are welcome to collaborate with this research consortium and contribute their own ideas.

For more information, please contact: Andreas Maercker

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References

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Mutuyimana, C., & Maercker, A. (2023). Elements of cultural scripts of trauma sequelae among trauma victims in East Africa. Frontiers in Psychology, 14. https://doi.org/10.3389/fpsyg.2023.1206503

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Bachem, R., Mazza, A., Eberle, D. J., & Maercker, A. (2024). A new approach to cultural scripts of trauma sequelae assessment: The sample case of Switzerland. Plos one, 19(4), e0301645.

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Papava, A., Javakhishvili, J. D., Makhashvili, N., Mamuchashvili, K., Eberle, D. J., Bachem, R., Mutuyimana, C., & Maercker, A. (2026). ‘Never let your enemy see you broken’: Cultural trauma script elements in the Republic of Georgia – an international consortium study. European Journal of Psychotraumatology, 17(1), 2668779. https://doi.org/10.1080/20008066.2026.2668779

 

Yu et al. (in press). Qualitative assessment of cultural scripts in post-traumatic experience: The sample case of China. Transcultural Psychiatry

 

Mutuyimana, C., & Maercker, A. (in press) Eastern African Expressions of Suffering: a new Cultural Scripts of Trauma Inventory. PLOSone.

 

Wen, Y., et al. (2026a). Cultural Scripts of Trauma in East Africa Predicted by Cultural and Intrapersonal Factors: Path Analysis of a New Psychopathological Concept. Clinical Psychology & Psychotherapy, 33(1), e70225.

 

Wen, Y., et al. (2026b). Chinese cultural scripts of grief: a qualitative study considering cultural value orientations. Aging & Mental Health, 

https://doi.org/10.1080/13607863.2026.2719937

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