Toxic Stress: Linking Historical Trauma to the Contemporary Health of American Indians and Alaska Natives

Abstract

The legacy of historical trauma continues to plague Indigenous populations throughout the world. This theoretical dissertation describes how biology (neurodevelopment, neurobiology and endocrinology) and culture (inter-generationally learned behaviors) are intricately intertwined in the development of dysfunctional coping behaviors that contribute to stress-related chronic diseases (heart disease, obesity, type II diabetes mellitus, depression, neurodegenerative disorders and memory impairment) in some individuals. The primary impact of the many episodes of historically traumatic genocide has been post-traumatic stress disorder (PTSD) and the onset of dysregulation of the hypothalamic-pituitary-adrenal axis (HPA-axis). PTSD has had a profound impact on relationships and behaviors, while dysregulation of the HPA-axis is associated with pathophysiology. It is well documented that historical trauma has caused a cultural disconnect from traditional wellness and healing practices. Despite incredible resiliency, the result of this legacy has been a genesis of intergenerational, dysfunctional, coping strategies that have become subtly engrained in a viscous cycle of self-perpetuating, self-inflicting, dysfunctional behaviors that have been carried forward into the next generation as "toxic stress" - in the form of childhood abuse, domestic violence, interpersonal violence, and substance abuse. With time, the association to the initial traumatic assault erodes, leaving behind, collectively, a fragmented society that, in many places, has become the basis for a "cultural crisis". The approach presented in this dissertation is founded upon: 1) cultural acquisition theories that describe how existing cultural constructs and traditions are internalized by children and repeated throughout a life-time into the next generation; and 2) understanding the interaction of the autonomic nervous system (specifically, the HPA-axis and its activation by stress) and the neocortex, the basis for higher psychological processes associated with learning and cultural acquisition. This dissertation offers an explanation for the continued impact of historically traumatic events on the contemporary health and wellness of American Indian and Alaska Native people. It is hoped that this approach leads to specific intervention and prevention measures that are culturally relevant in addressing pathophysiology, cognitive-behavioral issues and the collective cultural changes that have ensued as a result of historical trauma.