Trauma Research from International Perspectives (TRIP) Lab

Nuwan Jayawickreme, PhD

The Trauma Research from International Perspectives (TRIP) lab focuses on population-level variations in reactions to trauma and chronic stress, with a particular focus on communities affected by intergroup strife. There is evidence of considerable contextal variation in how suffering in such situations is described, disclosed and categorized, which is not surprising when one considers that a complete understanding of a person’s distress - and the best ways of assessing and treating this distress – requires not only an understanding of biology and mind, but also context.

Specific research questions addressed by the TRIP lab include:

Valid measurement of trauma-related variables in Global South contexts

Despite the fact that the field of medical anthropology has accumulated a large body of evidence that conceptualizations of mental health problems and the way that different people from different contexts express their distress vary widely, many researchers and practitioners working with non-Western populations often use measures of psychological distress that were validated only for Western populations. Research from the TRIP lab found that instruments that incorporated local expression of distress – so-called idioms of distress – were superior to translations of measures developed in the West in their ability to identify those who needed assistance. In subsequent studies, the TRIP lab examined the validity of existing measures of depression in post-war Global South settings, and also developed context-specific measures of resilience for Sri Lankan war survivors. In addition, the TRIP lab director, Dr. Nuwan Jayawickreme, co-edited a special issue of Conflict and Health that focused on measurement issues in humanitarian settings. Lastly, Dr. Jayawickreme co-wrote a paper examining broader measurement issues surrounding posttraumatic stress disorder and is currently co-authoring a paper on strategies for improving factor analysis practice.

Identifying causes of post-trauma psychopathology in post-conflict, Global South settings

This line of research has focused on the differential utility of experienced trauma and daily stressors - such as family problems, social problems, economic problems, struggles with fulfilling basic needs, and physical problems – in predicting post-trauma psychopathology in post-war Sri Lanka. There are only scarce resources available for mental health interventions in post-conflict, Global South settings, and the findings of such research can be used by practitioners on the ground to identify those individuals whose trauma/stressor profile suggest they are most at risk for mental illness. The TRIP lab has used network analysis to identify particular constellations of traumas and daily stressors are most associated with psychopathology, association rule learning to identify profiles of specific traumas and stressors that are associated with psychopathology, and structural equation modeling to determine whether different types of daily stressors are associated with psychopathology at different timepoints in a particular conflict.

Examining culture-specific expressions of post-trauma reactions

TRIP lab research on this include a qualitative study examining resilience and posttraumatic growth in Rwandan genocide survivors, a qualitative study examining grief in Sri Lankan war survivors, and an exploratory sequential mixed methods study focused on repetitive thought, also in Sri Lankan war survivors. The lab has also examined the functional utility of the construct personal growth initiative in predicting resilience in Sri Lankan war survivors and Rwandan genocide survivors, and life satisfaction in Sri Lankan war survivors and Rwandan genocide survivors.

Reviews and commentaries on how context impacts mental and physical health

The TRIP lab has conducted a number of literature reviews and commentaries on how context impacts mental and physical health. These include reviews of how context impacts posttraumatic stress disorder, refugee mental health, the experience of pain, and clinical assessment of psychopathology. The lab director, Dr. Nuwan Jayawickreme also co-authored a commentary in Behavioral and Brain Sciences on how network models can be a useful tool to better understand the role context in mental illness.