Cultural Scripts of Trauma in East Africa Predicted by Cultural and Intrapersonal Factors: Path Analysis of a New Psychopathological Concept

Cultural factors play a central role in shaping responses to traumatic events. However, most trauma research has been conducted in Western populations, and culturally specific trauma sequelae remain underexplored in other contexts. This study applied the framework of cultural scripts of trauma (CSTs) to examine how cultural values, intrapersonal factors and symptoms of posttraumatic stress disorder (PTSD) and disturbances in self-organization (DSO) are interrelated in an East African context. This cross-sectional study used convenience sampling. Data from East African trauma survivors were analysed using structural equation modelling and path analysis to investigate links among social axioms, general self-efficacy, self-mastery, CSTs, and PTSD and DSO symptoms. Social axioms (social complexity, reward for application and religiosity) predicted growth-related CSTs more strongly than self-efficacy or self-mastery. CSTs such as frame of mind and body-related symptoms were positively associated with PTSD severity. Mediation analyses indicated that CSTs partially explained the association between social axioms and PTSD symptoms. Notably, CSTs such as family stress and cognitive disruption were not linked to PTSD or DSO, suggesting culturally specific trauma responses not captured by current diagnostic criteria. Findings provide empirical support for the CSTs framework in an East African setting. The study highlights the importance of integrating cultural values and culturally specific symptom expressions into trauma assessment and intervention, and advances the development of culturally sensitive models of adaptation to trauma by identifying both unique and cross-cultural dimensions of trauma responses.