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Self Disclosing Trauma and Post Traumatic Stress Symptoms in Couples: A Longitudinal Study
Abstract
Objective: Most research concerning the implications of self-disclosure on trauma's
aftermath has focused on the salubrious effects disclosure may foster for the primary victim.
However, the manner in which recipients of disclosure are symptomatically affected by it
remains unexamined. Of particular interest are spouses who are often the primary support
providers and are therefore susceptible to secondary traumatization Assessing posttraumatic
stress symptoms (PTSS) and self-disclosure among traumatized veterans and their wives, the
current longitudinal study begins to fill this gap in the literature. Method: 220 couples
consisting of Israeli veterans, of whom 128 were former prisoners of war (ex-POWs) and 92
were combatants, and their wives were examined. PTSS and self-disclosure of both partners
were assessed 30 and 35 years after the war using the PTSD Inventory (PTSD-I; Solomon,
Benbenishty, Neria, & Abramowitz, 1993) and the self-disclosure index (SDI; Miller, Berg,
& Archer, 1983) respectively. Analyses included Pearson intercorrelations analyses and four
stepwise hierarchical multiple regression analyses. Results: Findings indicated that
increments in veterans' disclosure are not only consistently associated with the reduction of
their wives' PTSS, but may also explain and predict some of the change in the wives' PTSS
over time. However, such a longitudinal effect was not evident concerning the veterans'
PTSS. Conclusion: Traumatized ex-POWs' and combatants' self-disclosure within the
marital relationship may contribute to the amelioration of their wives' secondary
traumatization, and thus may be a goal worthwhile pursuing in therapy. However, more
research is needed in order to further understand this relation.
... In these studies, high disclosure was found to be beneficial to relationship adjustment as well as moderated the negative association of PTSS and the other partner's relationship adjustment. We found only one study on disclosure in military couples that implemented a dyadic approach, that is, explored the effects of disclosure (but not deployment-related) by both partners on levels of PTSS of both partners (Stein et al., 2017). This study found that veterans' disclosure was associated with a decrease in spouses', but not veterans', posttraumatic stress over time. ...
... In other words, instead of protecting the partner from distress, concealment was related to more distress in the partner. Notably, no partner effects were found for PTSS, which is contrary to some previous findings (e.g., Stein et al., 2017). Possibly, deployment experiences were related to mental health in ways other than PTSS in the current sample, which may explain the lack of associations between concealment and the other partner's PTSS. ...
... The unexpected null results for disclosure contradict our first hypothesis and differ from most previous findings, which demonstrated a positive relationship with relationship adjustment and a negative relationship with mental health outcomes (e.g., Campbell & Renshaw, 2013). Yet, a few previous studies did report similar results (Stein et al., 2017). There may be several explanations for these null results. ...
Objective: Disclosure of deployment-related experiences among military couples is generally beneficial to mental health and relationship adjustment. Yet, disclosure by the spouse is rarely studied, as are the dyadic associations between disclosure and outcomes in both partners. The present study used a dyadic approach to study the relationship between disclosure or concealment on one hand and mental health and relationship adjustment on the other hand among Israeli military couples. Method: Sixty-three Israel Defense Force (IDF) combat veterans (all male) and their spouses (all female; N = 126) completed self-report questionnaires about disclosure and concealment of deployment-related experiences to their partner; relationship adjustment; depression; and posttraumatic stress symptoms (PTSS). Six Actor–Partner Interdependence Models (APIM) were used for dyadic analysis. Results: We found lower disclosure and higher concealment of deployment-related experiences by veterans compared to spouses. The veteran’s concealment of deployment-related experiences was associated with lower relationship adjustment for both partners and with the veteran’s own higher PTSS. The spouse’s concealment was associated with greater depression for both partners and with the spouse’s own higher PTSS. Neither actor nor partner effects were found for disclosure regarding all three outcomes. Conclusions: Concealment of deployment-related experiences among military couples may have detrimental implications on the mental health and relationship adjustment of both the concealer and their partner. The spouse’s concealment of their experience was as related to mental health and relationship adjustment as the veteran’s concealment. The findings highlight the need to address communication about deployment-related experiences by both partners among military couples.
... PTSD symptom levels or presence of probable PTSD among supportive family members in military samples appeared to be significantly and negatively associated with partner level of education (Dekel et al., 2018;Dekel & Solomon, 2006), employment (Dekel & Solomon, 2006;Frančišković et al., 2007), couple forgiveness when fusion was high (Dekel, 2010), couple forgiveness when detachment was high (Dekel, 2010), survivor self-disclosure (Stein et al., 2017), income (Stein et al., 2017), and survivor's disclosure of trauma details . However, notably, among couples in which one spouse was a holocaust survivor and among couples in which one partner had experienced being a prisoner of war, sharing details of the traumatic event was not significantly associated with partner PTSD symptoms (Lev-Wiesel & Amir, 2001;. ...
... PTSD symptom levels or presence of probable PTSD among supportive family members in military samples appeared to be significantly and negatively associated with partner level of education (Dekel et al., 2018;Dekel & Solomon, 2006), employment (Dekel & Solomon, 2006;Frančišković et al., 2007), couple forgiveness when fusion was high (Dekel, 2010), couple forgiveness when detachment was high (Dekel, 2010), survivor self-disclosure (Stein et al., 2017), income (Stein et al., 2017), and survivor's disclosure of trauma details . However, notably, among couples in which one spouse was a holocaust survivor and among couples in which one partner had experienced being a prisoner of war, sharing details of the traumatic event was not significantly associated with partner PTSD symptoms (Lev-Wiesel & Amir, 2001;. ...
The present narrative review examined quantitative and qualitative research on family members who support survivors of trauma or abuse. Studies included in the present review were found in peer-reviewed journal articles, available in English, published between 1980 and 2019, and focused specifically on the experiences of adult familial supporters of adult trauma and abuse survivors. A search of PsychInfo and Google Scholar identified 136 relevant articles, and analysis of their content generated the following categories: individual-level impacts (i.e., quality of psychological health, burden, secondary traumatic stress, quality of physical health, and positive impacts), interpersonal and environmental level impacts (i.e., quality of relationships with survivors, navigating environment, maltreatment and safety, and social impacts), and other experiences (i.e., social roles, needs, coping strategies, and sociocultural context). Findings indicate that the majority of existing studies examined the experiences of family members of adult survivors of military trauma. Results of the review suggest that family supporters of adult trauma and abuse survivors generally experience physical, emotional, cognitive, behavioral, social, safety, and relational impacts. Implications of review findings and directions for future research are discussed.
... Disclosure of emotions, especially negative emotions (e.g. fear), was associated with decreases in their own PTSD/PTSS (Stein, Lahav & Solomon, 2017). ...
... Then, the results found that self-disclosure had a signi cant negative predictive effect for PTSD, which is consistent with previous studies (e.g. Schackner, Weiss, Edwards, & Sullivan, 2017;Stein, Lahav, & Solomon, 2017 ) and support the uni ed theory of repression (Erdelyi, 2006), which proposes that the repression of thoughts, feelings, and behaviors is an active process consuming physiological energy. In addition, researchers who are critical of the uni ed theory of repression argued that the most painful events are sometimes the most di cult to repress (Freyd, 2006), attempts to push unwanted thoughts out of awareness often back re, enhancing their accessibility (McNally, 2006). ...
Background: Posttraumatic Stress Disorder (PTSD) is one of the most prevalent psychopathologies experienced by victims following natural disasters. The severity of traumatic experience may be a critical risk factor for the development of PTSD. Nevertheless, other factors may also lead to PTSD. We propose that fear and self-disclosure could be two important factors. Previous studies have examined their unique roles in PTSD, but their combined role in PTSD has been rarely assessed. To fill this gap, the aim of this study was to examine the relationship between severity of traumatic exposure, fear, self-disclosure, and PTSD among victims following flood disaster.
Methods: one hundred ninety-nine participants completed self-report questionnaires. Descriptive statistics were obtained using SPSS 17.0 and Pearson correlation coefficients were calculated to obtain correlations between major variables.
Results: results indicated that severity of traumatic exposure not only had a direct effect on PTSD, but also it had an indirect effect on PTSD via activating victims’ fear. Moreover, self-disclosure played a buffering role between fear and PTSD. However, the role of fear in PTSD may decrease with increases in levels of self-disclosure.
Conclusions: Traumatic exposure had positive predictive effects for PTSD and fear. Self-disclosure had negative predictive effects for PTSD. Fear played a mediating role between severity of traumatic exposure and PTSD, self-disclosure played a moderating role in the relationship between fear and PTSD. Psychological interventions should focus on the regulation of fear and improvement of self-disclosure following traumatic exposure.
... Disclosure of emotions, especially negative emotions (e.g. fear), was associated with decreases in their own PTSD/PTSS (Stein, Lahav & Solomon, 2017). ...
... Then, the results found that self-disclosure had a signi cant negative predictive effect for PTSD, which is consistent with previous studies (e.g. Schackner, Weiss, Edwards, & Sullivan, 2017;Stein, Lahav, & Solomon, 2017 ) and support the uni ed theory of repression (Erdelyi, 2006), which proposes that the repression of thoughts, feelings, and behaviors is an active process consuming physiological energy. In addition, researchers who are critical of the uni ed theory of repression argued that the most painful events are sometimes the most di cult to repress (Freyd, 2006), attempts to push unwanted thoughts out of awareness often back re, enhancing their accessibility (McNally, 2006). ...
Background: Posttraumatic Stress Disorder (PTSD) is one of the most prevalent psychopathologies experienced by victims following natural disasters. The severity of traumatic experience may be a critical risk factor for the development of PTSD. Nevertheless, other factors may also lead to PTSD. We propose that fear and self-disclosure could be two important factors. Previous studies have examined their unique roles in PTSD, but their combined role in PTSD has been rarely assessed. To fill this gap, the aim of this study was to examine the relationship between severity of traumatic exposure, fear, self-disclosure, and PTSD among victims following flood disaster.
Methods: one hundred ninety-nine participants completed self-report questionnaires. Descriptive statistics were obtained using SPSS 17.0 and Pearson correlation coefficients were calculated to obtain correlations between major variables.
Results: results indicated that severity of traumatic exposure not only had a direct effect on PTSD, but also it had an indirect effect on PTSD via activating victims’ fear. Moreover, self-disclosure played a buffering role between fear and PTSD. However, the role of fear in PTSD may decrease with increases in levels of self-disclosure.
Conclusions: Traumatic exposure had positive predictive effects for PTSD and fear. Self-disclosure had negative predictive effects for PTSD. Fear played a mediating role between severity of traumatic exposure and PTSD, self-disclosure played a moderating role in the relationship between fear and PTSD. Psychological interventions should focus on the regulation of fear and improvement of self-disclosure following traumatic exposure.
... When the discloser chooses to talk about a PTE they experienced, it is thought to be beneficial for the mental health of both discloser and recipient. Talking helps others to understand the thoughts and feelings of the victim and provide social support (Stein et al., 2017). However, as Ullman (2011) pointed out, how helpful communication is on PTEs can depend on various factors. ...
Social support plays an important role in children's well-being after experiencing a potentially traumatic event (PTE). One such source of support is the parent-child relationship, specifically by discussing the event. However, current literature provides no consensus on whether parents and children communicate about PTEs, in what way they might communicate and how this affects the child. Hence the goal of the current study is threefold, to explore: (a) whether parents and children communicate about PTEs, (b) what this communication looks like, and (c) how this affects children's well-being. These questions are answered by means of a systematic literature review. Articles were eligible for inclusion if it was an empirical study on communication between parents and children about a PTE that the child (under 18 years) had experienced. Initial searches in electronic databases provided 31,233 articles, of which 26 were deemed eligible for inclusion. Results show that most parents and children have discussed PTEs, but that this may depend on cultural background. What the parent-child communication looks like depends on various factors such as, age of the child, tone, and child's initiation of discussion. Parental post-traumatic stress symptoms seem to negatively impact communication. The results of the impact of communication are less clear-cut, but it seems to have a predominantly positive effect on the child's well-being, depending on parental sensitivity. Clinicians should be watchful for parental symptoms of post-traumatic stress disorder and can focus on promoting parental sensitivity and responsiveness when discussing PTEs with their child or on creating a joint narrative within families.
... This, in turn, causes an increase in negative feelings or a depressive state [31,32], and finally leading to psychiatric disorders such as PTSD, depression, and anxiety. Another post-disaster factor is self-disclosure, which may relieve psychological distress [34,35]. On one hand, by talking with others, people may clarify their psychological states and come to term with events, which in turn could lead them to reframe the meaning of trauma [36]. ...
Objectives
The COVID-19 pandemic has caused an increase in psychiatric disorders in college students, particularly posttraumatic stress disorders (PTSD), depression, and anxiety. While existing studies assess the prevalence of these disorders and their predictors, they overlook potential complications caused by comorbidity between these disorders. To fill this gap, this study examined the prevalence of PTSD, depression, anxiety, and their comorbidity to inform targeted intervention for college students during the COVID-19 pandemic.
Design
Self-report questionnaires were used to assess 6,898 college students about six months after the COVID-19 outbreak.
Results
The results found that the prevalence of PTSD, depression, and anxiety were 15.5%, 32.2%, and 32.1% respectively, and the prevalence of comorbid PTSD and depression, comorbid PTSD and anxiety, comorbid depression and anxiety, and comorbid PTSD, depression, and anxiety symptoms were 11.5%, 11.6%, 20.4%, and 9.4% respectively. Moreover, left-behind status, lower economic status, previous trauma experiences, exposure to the pandemic, and rumination were risk factors of psychological distress, but self-disclosure was a protective factor for these disorders.
Conclusion
These results indicate that distinct psychiatric disorders may be comorbid in individuals, and are further influenced by pre-, within-, and post-disaster factors. Furthermore, psychological service targeted at college students should pay attention to comorbid symptoms rather than only symptoms of single disorders.
... Responses are rated on a 6-point Likert scale. Satisfactory external and internal validity was reported with Cronbach's alpha RECOVERY FROM POSTTRAUMATIC STRESS 3 ranging from .93 to .95 (Bachem et al., 2018;Stein et al., 2017). In the present study, Cronbach's alpha was .91. ...
Objective: Much research has been conducted on the clinical course of posttraumatic stress disorder (PTSD), from the perspective of viewing it as a chronic disorder. In the present study, however, we propose viewing PTSD via the recovery paradigm, based on the sociointerpersonal model for understanding posttrauma, which offers a holistic and multidimensional definition of recovery and prognosis (Maercker & Horn, 2013). Specifically, the contribution to recovery of both self-disclosure as a personality trait and self-disclosure of traumatic experiences within the couple relationship were examined. Posttraumatic distress levels and perception of the response following self-disclosure in the couple relationship were examined as mediating variables. Method: The study population included 180 participants between the ages of 20–71 who had been exposed to at least one traumatic event in their lives. Results: The study findings revealed that people with a high propensity for self-disclosure and more self-disclosure in the couple relationship had higher levels of personal recovery. The level of posttraumatic distress mediated the relation between self-disclosure in the couple relationship and the perception of recovery. Only the perception of a positive response following exposure of trauma in the couple relationship was a mediator in the association between self-disclosure of traumatic experiences in the couple relationship and recovery. Conclusions: The study indicates the importance of communication regarding the traumatic event in general, and with reference to the perception of the response to the exposure itself. In addition, the study contributes to broadening the recovery paradigm regarding PTSD.
... In fact, Yang and Ha (2019) found that firefighters' PTG is likely to be promoted if their deliberate ruminations were enhanced after experiencing work-related traumatic events. Although, self-disclosing trauma may prevent post-traumatic stress symptoms (Stein et al., 2017), patient with PTSD can experience PTG if therapists help patients receive positive social responses from listeners and find meaning of life in the self-disclosing process. In addition, these three factors need to be considered when attempting to promote PTG even when applying other clinical methods, and not just for self-disclosure. ...
Background
To explore how self-disclosure leads to post-traumatic growth (PTG) in adults who have experienced traumatic events, this study identified the relationship between self-disclosure and post-traumatic growth in Korean adults. We examined a parallel multiple mediating model for this relationship.
Methods
Participants were 318 Korean male and female adult participants aged 20 years or older who had experienced trauma. We measured deliberate rumination, positive social responses, and the meaning of life as mediating variables.
Results
The results revealed that the study variables positively correlated with PTG. Self-disclosure was positively correlated with deliberate rumination, positive social responses, and meaning of life. In the multiple mediating model, deliberate rumination, positive social responses, and meaning of life mediated the relationship between self-disclosure and PTG.
Conclusion
Self-disclosure, deliberate rumination, positive social responses, and meaning of life play an important role in the growth of adults who have experienced traumatic events. The findings of this study should provide valuable information for future research and for mental health professionals who want to promote the PTG of their clients.
... Unfortunately, this limits crucial insight (a) on the relationship between daily stressors and trauma-related symptoms and maladaptive relational functioning, and (b) into individual and dyadic processes that have helped couples affected by trauma successfully navigate these stressors. Much of extant research have used standardized clinical diagnostic assessments of PTSD to measure the effects of traumatic stress and exposure on couple functioning (e.g., Renshaw et al., 2014;Ruhlmann et al., 2019;Stein et al., 2017). As a result, trauma-based theoretical and clinical conceptualization and intervention stem from a diagnosis of PTSD. ...
Objective: Empirical knowledge about "dual-trauma couples" (DTC), characterized by both partners with a history of trauma exposure and presentation of trauma-related symptoms, is especially deficient. We analyzed DTC partners' qualitative data culled from the Relationship Evaluation Questionnaire (Busby et al., 2001) to ascertain dyadic resiliency processes within dual-trauma couples.
Method: A data-reductive thematic analysis on short-answer responses of reported relational strengths and weaknesses from female (n = 822) and male partners' (n = 831) yielded several processes that provide insight into individual perceptions, behaviors, and past experiences, and dyadic interactions that may foster or hinder effective resilience in DTC.
Results: Participant responses highlighted existing dyadic strengths that fostered effective couple adaptative processes: shared beliefs and goals, mutual collaboration and psychological flexibility, and dyadic connectedness. Barriers to couple resiliency included individual perceptions, behaviors, and past experiences, and dyadic interactions that exacerbated relational instability, emotional unsafety, contentious communication, and difficulties with distress tolerance.
Conclusions: Results promote a balanced conceptualization (i.e., inclusion of both adaptive and maladaptive interactions) of couples affected by trauma exposure. Implications for clinical treatment and several areas for future research are discussed.
... This is consistent with other work showing that the momentary experience of empathy for another indeed involves sharing in their distress or pain [69]. However, other work focused on marital relationships specifically found that self-disclosure is related to positive outcomes for the recipient of the disclosure [70]. There are other contextual factors that may affect how beneficial self-disclosure is for both parties that were not measured in the present study, including the valence of the patient's disclosure and their reasons for disclosing to the caregiver; it may be, for example, that patients tended to self-disclose more negative thoughts and feelings, which in turn could be stressful for caregivers to hear and respond to, thus raising their BP. ...
Background
Cancer impacts both patients and their family caregivers. Evidence suggests that caregiving stress, including the strain of taking on a new role, can elevate the risk of numerous health conditions, including high blood pressure (BP). However, the caregiver’s psychosocial experiences, including their interpersonal relationship with the patient, may buffer some of the negative physiological consequences of caregiving.
Purpose
To examine the influence of psychosocial contextual variables on caregiver ambulatory BP.
Methods
Participants were 81 spouse–caregivers of patients with advanced gastrointestinal or thoracic cancer. For an entire day at home with the patient, caregivers wore an ambulatory BP monitor that took readings at random intervals. Immediately after each BP reading, caregivers reported on physical circumstances (e.g., posture, activity) and psychosocial experiences since the last BP measurement, including affect, caregiver and patient disclosure, and role perceptions (i.e., feeling more like a spouse vs. caregiver). Multilevel modeling was used to examine concurrent and lagged effects of psychosocial variables on systolic and diastolic BP, controlling for momentary posture, activity, negative affect, and time.
Results
Feeling more like a caregiver (vs. spouse) was associated with lower systolic BP at the same time point. Patient disclosure to the caregiver since the previous BP reading was associated with higher diastolic BP. No lagged effects were statistically significant.
Conclusions
Caregivers’ psychosocial experiences can have immediate physiological effects. Future research should examine possible cognitive and behavioral mechanisms of these effects, as well as longer-term effects of caregiver role perceptions and patient disclosure on caregiver psychological and physical health.
... In addition, problematic communication hinders the open exchange of trauma experiences between parents and children. This may mean children make exaggerated guesses about their parents' distress (e.g., Stein et al., 2017) and have an increased probability of ruminating on trauma-related cues. In such cases, parents' marital conflicts may be associated with a lower level of self-differentiation and more psychological inflexibility and rumination among adolescents. ...
Objective:
Various theories have been proposed to elucidate the mechanisms underlying the effect of parental posttraumatic stress symptoms (PTSSs) on their children. However, these theories focused on unique mechanisms for some factors and overlooked the combined role of different factors. This study aimed to construct a broad theoretical framework to comprehensively understand the mechanisms underlying the effect of parents' PTSSs on adolescents. We examined the combined role of parental PTSSs and marital conflict, and adolescents' self-differentiation, psychological inflexibility, and rumination after super typhoon Lekima.
Method:
We used self-report questionnaires to investigate 1,218 parent-adolescent dyads in the area most affected by the disaster 3 months after the typhoon.
Results:
Parents' PTSSs had a direct and positive association with adolescents' PTSSs. We also observed parents' PTSSs had an indirect relationship with adolescents' PTSSs through parental marital conflict and adolescents' self-differentiation, psychological inflexibility, and rumination.
Conclusions:
An effect of PTSSs may be found in the dyadic interaction between parents and their children. Children's psychological and behavioral changes resulting from impaired family relationship functioning exhibited by their posttraumatic parents also play an important role in the interpersonal effect of PTSSs. (PsycInfo Database Record (c) 2021 APA, all rights reserved).
... Regarding the interpersonal dimension, two primary factors are important for fostering PTG among suicide-loss survivors-self-disclosure and social support. Authentic self-disclosure (to at least one significant other) is a prerequisite for a healthy adjustment (Smyth et al., 2012) and buffers against distress in various stressful situations (e.g., Gvion & Levi-Belz, 2018;Stein et al., 2017). Feigelman et al. (2018) demonstrated that high self-disclosure levels concerning a suicide event were significantly associated with diminished grief and mental health difficulties. ...
Suicide-loss survivors often experience personal growth in the aftermath of a loss, depending on their personal and interpersonal characteristics. The current study focuses on the role of self-forgiveness (SF) as a contributing factor, both directly and indirectly, to posttraumatic growth (PTG) among suicide-loss survivors. Israeli suicide-loss survivors (N = 124) completed questionnaires measuring SF and PTG as well as adaptive coping strategies, social support, and self-disclosure. SF positively contributed to PTG, both directly and indirectly, through interpersonal and cognitive processes. These findings highlight the value of actions promoting self-forgiveness, compassion, and acceptance in psychological interventions with suicide-loss survivors.
... On a note of necessary hopefulness, it was shown that the disclosures of the traumatized ex-POWs' and combatants' within the marital relationship may have contributed to the amelioration of their wives' secondary traumatization [21]. The essential influence of the hypothalamic-pituitary-adrenal axis (HPA) in stress-related homeostasis suggests that there is a dysregulation of HPA involvement in the etiopathogenesis of PTSD. ...
Based on attachment theory and a social-cognitive model of posttraumatic stress disorder (PTSD), this study examined the roles of parent–child communication, perceived parental depression, and intrusive rumination in the association between insecure attachment to parents and PTSD among adolescents following the Jiuzhaigou earthquake. In this study, 620 adolescents were recruited to complete self-report questionnaires. The results showed that the direct association between anxious attachment and PTSD was significant, but that between avoidant attachment and PTSD was non-significant. In addition, both anxious and avoidant attachment had indirect associations with PTSD via the mediating effects of parent–child communication openness and problems, perceived parental depression, and intrusive rumination. However, the specific paths between anxious and avoidant attachment and PTSD were different. The findings indicated that insecure attachment among adolescents following the earthquake was predictive for their PTSD, and the mechanisms underlying the association between anxious attachment and PTSD and the association between avoidant attachment and PTSD were distinct. To alleviate PTSD, more attention should be paid to improving the quality of parent–child communication for adolescents with avoidant attachment to parents, and to reducing negative cognition in adolescents with anxious attachment.
Secondary traumatization describes the phenomenon whereby those in proximity to trauma survivors develop psychological symptoms similar to those experienced by the direct survivor. The current study examined secondary trauma (ST) and generalized distress symptoms (general psychiatric symptomatology, functional disability, and self-rated health) in wives of former prisoners of war (ex-POWs). The study compared wives of Israeli ex-POWs from the 1973 Yom Kippur War with wives of a matched control group of non-POW Yom Kippur War combat veterans (CVs). The wives also were divided into groups based on their husbands' current posttraumatic stress disorder (PTSD) status and PTSD trajectory (i.e., chronic, delayed), and their outcomes were compared with resilient CVs. We found that wives of ex-POWs with PTSD reported higher ST and generalized distress than wives of ex-POWs and non-POW CVs without PTSD. Wives of ex-POWs with chronic PTSD reported the highest levels of functional disability. We also found that the relationships between husbands' prior captivity, and wives' ST and general psychiatric symptomatology were fully mediated by the husbands' PTSD symptoms. These findings indicate that it is exposure to a partner with PTSD that leads to overall ST and other distress symptoms, and not simply to a trauma survivor. Furthermore, the more severe their husbands' PTSD, the more wives are at risk for ST and general psychiatric symptomatology. Wives of partners with PTSD should therefore be considered high-risk groups for ST and distress that may require targeted interventions. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
This is the book that started an are of research and practice of compassion fatigue, secondary traumatic stress and stress reactions, vicarious trauma, and most recently compassion fatigue resilience
Presents an "Opener Scale" that measures the tendency to elicit intimate disclosure from others. Data from 740 undergraduates provided evidence for the scale's validity and reliability. In a face-to-face dyadic interaction between strangers in a laboratory study, 55 undergraduate women who scored either high or low on the Opener Scale were paired with other women who scored either high or low on a self-disclosure index. Low disclosers revealed more to high openers than to low openers. However, high disclosers were equally intimate with both types of partner. In a field study with 54 sorority women, acquaintances and friends were more willing to disclose to high openers than to low openers. High openers were more liked than low openers in the latter study only. It is suggested that high openers were able to elicit more disclosure because of their greater receptiveness and attentiveness and use of more follow-up questions. (44 ref) (PsycINFO Database Record (c) 2006 APA, all rights reserved).
Open communication postdeployment has been encouraged for military couples (Allen, Rhoades, Stanley, & Markman, 2011), as trauma symptoms have been found to influence military couples' marital satisfaction and relationship functioning. Limited research has investigated whether trauma disclosure moderates the association between trauma symptoms and relationship quality. The current study included data from 50 Army couples. Based on a multiple-group actor-partner-interdependence model (APIM), we found that higher levels of trauma symptoms were associated with lower relationship quality for the actors ( themselves) and their partners. In addition, trauma disclosure moderated the relationship between partners. Implications for future research with larger samples are discussed.
The overarching goal of the current study was to determine the impact of talking interpersonally over time on emerging adults' individual and relational health. Using an expressive writing study design (see Frattaroli, 2006), we assessed the degree to which psychological health improved over time for college students who told and listened to stories about friends' current difficulties in comparison with tellers in control conditions. We also investigated the effects on tellers' and listeners' perceptions of each other's communication competence, communicated perspective-taking, and the degree to which each threatened the other's face during the interaction over time to better understand the interpersonal communication complexities associated with talking about difficulty over time. After completing prestudy questionnaires, 49 friend pairs engaged in three interpersonal interactions over the course of 1 week wherein one talked about and one listened to a story of difficulty (treatment) or daily events (control). All participants completed a poststudy questionnaire 3 weeks later. Tellers' negative affect decreased over time for participants exposed to the treatment group, although life satisfaction increased and positive affect decreased across time for participants regardless of condition. Perceptions of friends' communication abilities decreased significantly over time for tellers. The current study contributes to the literature on expressive writing and social support by shedding light on the interpersonal implications of talking about difficulty, the often-overlooked effects of disclosure on listeners, and the health effects of talking about problems on college students' health.
Loneliness holds detrimental ramifications for health and well-being. Nevertheless, loneliness references in the literature addressing combat-related trauma are few. Consequentially, the qualities and characteristics of such experiences in these posttraumatic realities remain uninvestigated empirically. In the current qualitative study we began filling this gap in the literature. We utilized thematic content analysis of life-stories of 19 combat veterans and 7 ex-POWs that have given testimony at the Israel Trauma Center for Victims of Terror and War (NATAL). Our findings suggest that the loneliness in the contexts at hand is primarily characterized by a sense of experiential isolation, rather than social, emotional, or existential. This is the sensation that due to the extraordinary nature of traumatic experiences the fulfillment of needs such as empathy and intersubjectivity may be unattainable. Integrating our findings with existing interdisciplinary literature regarding social sharing, trauma, and loneliness, we discuss implications for clinical interventions and further research. (PsycINFO Database Record
(c) 2015 APA, all rights reserved).
Although secondary traumatization has been extensively studied, gender difference in susceptibility has received limited attention. This study addressed the issue by a meta-analysis of published findings on male and female persons in close, extended relationships with trauma victims, namely, their spouses, parents, children, and therapists. The analysis included peer-reviewed studies, written in English and published between 1990 and January 2012. Twelve studies reporting 17 findings on 1,623 subjects were identified. All the studies showed females' higher susceptibility to secondary traumatization, with a mean effect size of 0.48 (95% CI [0.35, 0.60]). Moderator analysis revealed that studies conducted in the United States reported lower gender discrepancies than studies conducted elsewhere. The consistent finding that females are considerably more susceptible to secondary traumatization than males means that professionals must be made aware of the special vulnerability of girls and women and help them adopt ways of caring for the traumatized family member or clients while maintaining their own psychological boundaries. (PsycINFO Database Record (c) 2014 APA, all rights reserved).
This review demonstrates that an individualist view of emotion and regulation is untenable. First, I question the plausibility of a developmental shift away from social interdependency in emotion regulation. Second, I show that there are multiple reasons for emotional experiences in adults to elicit a process of social sharing of emotion, and I review the supporting evidence. Third, I look at effects that emotion sharing entails at the interpersonal and at the collective levels. Fourth, I examine the contribution of emotional sharing to emotion regulation together with the relevant empirical evidence. Finally, the various functions that the social sharing of emotion fulfills are reviewed and the relevance of the social sharing of emotion for emotion scientists is discussed.
Whereas disclosing traumatic events to others can reduce autonomic nervous system activity and reap positive health benefits for the discloser, the physiological consequences for the listener are less clear. It was predicted that listening to the disclosure of trauma would be stressful, resulting in increases in the listeners' anxiety and skin conductance level (SCL). SCL and heart rate (HR) were recorded while 66 listeners watched a 1- to 2-hr videotaped interview of 1 of 33 Holocaust survivors disclosing their World War II experiences. The simultaneous physiological measurements of the Holocaust disclosers and subject listeners were averaged into 1-min blocks and correlated with each other. Of the significant SCL correlations between the disclosers and listeners, 70% were from listeners who evidenced SCL patterns that fluctuated in an inverse pattern to the disclosers. Those listeners who evidenced SCL patterns corresponding to the disclosers were more likely to have high scores on the Epstein Feelings Inventory and report experiencing similar emotions as the disclosers. Results suggest a fundamental distinction between disclosing traumatic experiences and listening to them. Implications for social support are discussed.
Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods, offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Talking about a difficult event may reduce discloser distress, but it may increase it in the listener. This essay offers a model that assesses some antecedent and interactional variables proposed to be involved with listening and connected with listeners' negative distress. Based on 82 reports of interactions with close relational others, levels of negative distress correlated positively with the amount of responsibility people felt for the other and time reported listening to the others' disclosure. Those who reported validating the other also reported more negative distress than did those who said their response style was to give advice. This article offers possible modifications to the model based in these results.
Men are a unique population to work with in psychotherapy, but what does research indicate about how masculinity relates to therapeutic issues? Summarizing research on masculinity's relationship to a range of presenting issues, this article organizes and discusses the findings according to masculinity "scripts" that clinicians are likely to recognize when working with male clients. The article then addresses how masculinity is also associated with less help seeking and with negative attitudes toward psychological help seeking. This irony, that traditional masculinity scripts contribute to men's presenting concerns and act as barriers to help seeking, is then addressed through recommendations for training and practice that incorporate a sociocultural context into working with men. (PsycINFO Database Record (c) 2012 APA, all rights reserved)
Previous research has shown that receiving social support in the face of negative events (i.e., enacted support) is sometimes correlated with positive outcomes, sometimes unrelated to outcomes, and sometimes associated with negative outcomes. However, people's perception that they have high-quality support available to them when they have a stressor (i.e., perceived support) is consistently and strongly associated with better health, well-being, and relationship functioning. However, both enacted and perceived support available in response to positive event disclosures are consistently associated with positive outcomes. In 2 studies, we examined why enacted support for negative events has such a spotty record and compared it with enacted support for positive events; a third study examined how support for positive events may be a major contributor to perceived availability of effective support for negative events. The results showed that providing responsive support to negative events is particularly difficult; received support for negative events disclosures (but not positive event disclosures) involves substantial drawbacks and risks, especially when that support is not responsive to the recipient's needs; and that enacted support for positive events was a better predictor of later perceptions of the quality of available support for stressors than enacted support for negative events. Findings are discussed in terms of implications for the social support literature and how positive relationship processes influence health and well-being, not only directly but also indirectly by providing critical information regarding the availability of others if a problem occurs. (PsycINFO Database Record (c) 2012 APA, all rights reserved).
Although war captivity is a potent pathogen for psychiatric illness, little is known about the long-term trajectories of post-traumatic stress disorder (PTSD) among ex-prisoners of wars (ex-POWs). This study aimed to assess the long-term trajectories of PTSD and their predictors following war captivity. One hundred and sixty four Israeli ex-POWs and 185 comparable combatants from the 1973 Yom Kippur War were followed over 35 years, with three follow-ups (1991, 2003, 2008). Ex-POWs reported higher PTSD rates than controls at all three assessments. Four trajectories of PTSD were identified: chronic PTSD, delayed PTSD, recovery and resilience. The majority of POWs reported delayed PTSD, while the majority of controls were classified as resilient. While PTSD rates remained relatively stable over time among controls, a steep increase in rates was observed among POWs between 1991 and 2003, followed by stabilization in rates between 2003 and 2008. Finally, subjective experience of captivity was the variable that best distinguished between the resilience and PTSD groups of ex-POWs, followed by participation in previous wars and negative life events during childhood. War captivity carries long-lasting psychiatric implications, even decades after release. Aging processes, as well as unique stressors that exist in Israel, may account for the elevated PTSD rates found here.
This article proposes that not only disclosure but also secrecy should have a beneficial effect on satisfaction in close relationships. Disclosure and secrecy are determined by dispositional characteristics of relationship partners and by the unique relationship context in which they occur. Dispositional and contextual measures of disclosure and secrecy were included in a correlational study among married participants to answer the following questions: (1) do dispositional measures of disclosure and secrecy predict marital satisfaction? and (2) do contextual measures of disclosure and secrecy predict marital satisfaction? In addition, it examined to what extent dispositional measures of disclosure and secrecy predict communicative behavior between partners. Results showed that dispositional measures contributed only marginally to marital satisfaction, while contextual measures strongly contributed to marital satisfaction. Contextual disclosure and secrecy independently contributed to marital satisfaction. Dispositional measures failed to predict communicative behavior between partners. These findings suggest that both disclosure and secrecy are powerful mechanisms in marital relationships and that it is the process that occurs when partners interact with each other, rather than the characteristics of either or both, that affects marital satisfaction.
This paper argues for a substantial re-conceptualization of coping. The strong focus on emotional distress as the marker of coping efforts has masked the importance of social functions, processes and outcomes in coping with life stress, particularly the role of communal coping. Communal coping is a cooperative problem-solving process salient in coping with both individual and collective stressors. It involves the appraisal of a stressor as `our' issue and cooperative action to address it. Beyond its important role in coping, communal coping is endemic to notions of social integration, interdependence and close relationships, and may underlie the resilience of families and other social units dealing with stressful life events. The authors present a framework that distinguishes communal coping from other individual and social coping processes. We also provide an analysis of benefits and costs of communal coping, a discussion of key factors in its utilization, and suggestions for further research on the functioning of communal coping in contemporary society.
A meta-analysis of 205 studies involving 23,702 Ss was conducted to determine whether there are sex differences in self-disclosure. Across these studies, women disclosed slightly more than men (d = .18). This effect size was not homogeneous across studies. Several moderator variables were found. Sex of target and the interaction effect of relationship to target and measure of self-disclosure moderated the effect of sex on self-disclosure. Sex differences in self-disclosure were significantly greater to female and same-sex partners than to opposite-sex or male partners. When the target had a relationship with the discloser (i.e., friend, parent, or spouse), women disclosed more than men regardless of whether self-disclosure was measured by self-report or observation. When the target was a stranger, men reported that they disclosed similarly to women; however, studies using observational measures of self-disclosure found that women disclosed more than men.
The PTSD Inventory, a self-report diagnostic questionnaire based on DSM-III criteria, was revised to meet the more recent DSM-III-R criteria. This study examined the validity of the revised inventory relative to a structured clinical interview (SCID) and the Impact of Events Scale (IES). Results showed a high degree of concordance between the instruments, supporting the use of the more standardized, easy to administer and economical PTSD Inventory.
Meta-analyses were conducted on 14 separate risk factors for posttraumatic stress disorder (PTSD), and the moderating effects of various sample and study characteristics, including civilian/military status, were examined. Three categories of risk factor emerged: Factors such as gender, age at trauma, and race that predicted PTSD in some populations but not in others; factors such as education, previous trauma, and general childhood adversity that predicted PTSD more consistently but to a varying extent according to the populations studied and the methods used; and factors such as psychiatric history, reported childhood abuse, and family psychiatric history that had more uniform predictive effects. Individually, the effect size of all the risk factors was modest, but factors operating during or after the trauma, such as trauma severity, lack of social support, and additional life stress, had somewhat stronger effects than pretrauma factors.
Two classes of modern missing data procedures, maximum likelihood (ML) and multiple imputation (MI), tend to yield similar results when implemented in comparable ways. In either approach, it is possible to include auxiliary variables solely for the purpose of improving the missing data procedure. A simulation was presented to assess the potential costs and benefits of a restrictive strategy, which makes minimal use of auxiliary variables, versus an inclusive strategy, which makes liberal use of such variables. The simulation showed that the inclusive strategy is to be greatly preferred. With an inclusive strategy not only is there a reduced chance of inadvertently omitting an important cause of missingness, there is also the possibility of noticeable gains in terms of increased efficiency and reduced bias, with only minor costs. As implemented in currently available software, the ML approach tends to encourage the use of a restrictive strategy, whereas the MI approach makes it relatively simple to use an inclusive strategy.
Disclosing information, thoughts, and feelings about personal and meaningful topics (experimental disclosure) is purported to have various health and psychological consequences (e.g., J. W. Pennebaker, 1993). Although the results of 2 small meta-analyses (P. G. Frisina, J. C. Borod, & S. J. Lepore, 2004; J. M. Smyth, 1998) suggest that experimental disclosure has a positive and significant effect, both used a fixed effects approach, limiting generalizability. Also, a plethora of studies on experimental disclosure have been completed that were not included in the previous analyses. One hundred forty-six randomized studies of experimental disclosure were collected and included in the present meta-analysis. Results of random effects analyses indicate that experimental disclosure is effective, with a positive and significant average r-effect size of .075. In addition, a number of moderators were identified.
The challenges of peacekeeping place individuals at risk for the development of significant psychological distress (e.g., B. T. Litz, S. Orsillo, M. Freidman, P. Ehlich, & A. Batres, 1997). Self‐disclosure has been shown to ameliorate psychological distress following exposure to potentially traumatic events (J. W. Pennebaker & K. D. Harber, 1993). Sharing, or self‐disclosure of deployment‐related experiences, was the focus of this study and was hypothesized to be associated with adaptation. As part of a larger investigation, 426 U.S. military personnel who served as peacekeepers in Somalia were administered a comprehensive psychosocial questionnaire that included measures of exposure to negative and potentially traumatic experiences, reception at homecoming, self‐disclosure, and PTSD symptom severity. The results indicate that adjustment to peacekeeping is significantly related to self‐disclosure, especially to supportive significant others.
Using a qualitative method research design, participants were classified into one of two groups based on their self-reported disclosure of their deployment experiences to their spouse: low disclosure (n = 16) or high disclosure (n = 55). The high disclosure group participants reported primarily positive functioning themes: support and active connecting, communication, relationship resources, and cohesion, as well as relationship distress. The low disclosure group participants reported more mixed results: impaired communication, support and connecting, and understanding. In general, the results indicate the importance of communication as a key component of coping with deployment experiences for both soldiers and spouses.
This study examined relationships between self-disclosure and marital satisfaction. On self-report measures, husbands' disclosure to wives was positively related to, and predictive of, husbands' marital satisfaction; wives' disclosure to husbands was a positive predictor of husbands' marital satisfaction; wives' disclosure to husbands was positively related to, and predictive of, wives' marital satisfaction; and the amount of discrepancy between disclosure of husbands and wives was negatively related to, and a negative predictor of, husbands' marital satisfaction. Behaviorally, the duration of time that husbands spent disclosing to wives was a negative predictor of husbands' and wives' marital satisfaction.
Virtually all discussions and applications of statistical mediation analysis have been based on the condition that the independent variable is dichotomous or continuous, even though investigators frequently are interested in testing mediation hypotheses involving a multicategorical independent variable (such as two or more experimental conditions relative to a control group). We provide a tutorial illustrating an approach to estimation of and inference about direct, indirect, and total effects in statistical mediation analysis with a multicategorical independent variable. The approach is mathematically equivalent to analysis of (co)variance and reproduces the observed and adjusted group means while also generating effects having simple interpretations. Supplementary material available online includes extensions to this approach and Mplus, SPSS, and SAS code that implements it.
Building on knowledge from research focusing on "vicarious traumatization" or "compassion fatigue" on therapists and others who work with victims of trauma, this study focused on researchers. The article reports the results of an exploratory, qualitative study of eighteen interviewers of Holocaust survivors from four different Holocaust research projects using a survey instrument and several open-ended questions. The results indicate that there were more positive than negative impacts on the researchers. Positive impacts include: increased appreciation for the resilience and strength of survivors; a greater appreciation for one's life; a stronger Jewish identity; and a greater sense of justice. Negative impacts include only one case of what could be viewed as vicarious traumatization or compassion fatigue. Other negative impacts on the interviewers were: difficulty in listening to the traumatic narratives, increased fear and vulnerability as a Jew, and a general sadness about the dark side of humanity. However, in all cases these negative impacts were mitigated by the positive benefits the interviewer respondents felt they gained from doing this work. The latter part of the paper discusses how interviewers coped with the traumatic material and the implications for future research.
This study combines the fever model with communication privacy management to examine the conditions under which military wives are likely to disclose their family stressors or engage in protective buffering with their deployed husbands. Military wives (N =105) whose husbands were deployed and who had at least one child completed a web-based survey about the communication of family stressors during deployment. Protective buffering was associated with negative health symptoms, and disclosure was related to marital satisfaction. Wives' perceptions that their husbands were in dangerous situations as well as their perceptions that husbands were supportive of their disclosures were both related to protective buffering and disclosure.
This review of the literature reveals that veterans' posttraumatic stress disorder (PTSD) following exposure to combat violence affects veterans' familial relationships and the psychological adjustment of family members. Previous study within other trauma populations has conceptualized the negative impact of an individual's traumatic stress on his/her family members as “secondary traumatization.” This review examines the processes by which secondary traumatization occurs within combat veterans' families. Research has identified PTSD as mediating the effect of veterans' combat experience on the family. Veterans' numbing/arousal symptoms are especially predictive of family distress; while, to a lesser extent, veterans' anger is also associated with troubled family relationships and secondary traumatization among family members. Empirical modeling of additional factors involved in secondary traumatization is needed. Marital/family interventions have largely focused on improving relationships and reducing veterans' symptoms, rather than targeting improvements in the psychological well-being of the spouse and children. Interventions directly addressing the needs of significant others, especially spouses, are advocated. The potential for increased effectiveness of PTSD interventions and possible cost-savings attained by improving relationships and reducing caregiver burden are also discussed.
: Individuals who have experienced traumatic events often share their experiences in story form. This sharing has consequences for both storytellers and listeners. Understanding the experience of both members of the listener-storyteller dyad is of value to nurses who are often the listener within the nurse-patient dyad.
: The aim of this study was to illuminate the experiences of the listener and the storyteller when a traumatic event is shared within the dyad.
: The phenomenon was explored using an interpretive phenomenological approach. Participants consisted of 12 dyads, each with a storyteller and a listener. The storytellers were individuals who had been involved in U.S. Airways Flight 1549 when it crash-landed in the Hudson River in January 2009. Each storyteller identified a listener who had listened to them share their story of this event, dubbed The Miracle on the Hudson. In-depth interviews were conducted with each storyteller and each listener.
: Five essential themes emerged from the data: Theme 1, The Story Has a Purpose; Theme 2, The Story as a Whole May Continue to Change as Different Parts Are Revealed; Theme 3, The Story Is Experienced Physically, Mentally,Emotionally, and Spiritually; Theme 4, Imagining the "What" as well as the "What If"; and Theme 5, The Nature of the Relationship Colors the Experience of the Listener and the Storyteller. Roy's Adaptation Model of Nursing was found to be applicable to the findings of this study.
: For the participants in this study, the experience of sharing a traumatic event involved facts, feelings, and images. The story evolved as it was remembered, told, and listened to in a nonlinear, multifaceted way. The listener and the storyteller collaborated, adapted, and responded physically, mentally, emotionally, and spiritually.
Statistical procedures for missing data have vastly improved, yet misconception and unsound practice still abound. The authors frame the missing-data problem, review methods, offer advice, and raise issues that remain unresolved. They clear up common misunderstandings regarding the missing at random (MAR) concept. They summarize the evidence against older procedures and, with few exceptions, discourage their use. They present, in both technical and practical language, 2 general approaches that come highly recommended: maximum likelihood (ML) and Bayesian multiple imputation (MI). Newer developments are discussed, including some for dealing with missing data that are not MAR. Although not yet in the mainstream, these procedures may eventually extend the ML and MI methods that currently represent the state of the art.
The challenges of peacekeeping place individuals at risk for the development of significant psychological distress (e.g., B. T. Litz, S. Orsillo, M. Freidman, P. Ehlich, & A. Batres, 1997). Self-disclosure has been shown to ameliorate psychological distress following exposure to potentially traumatic events (J. W. Pennebaker & K. D. Harber, 1993). Sharing, or self-disclosure of deployment-related experiences, was the focus of this study and was hypothesized to be associated with adaptation. As part of a larger investigation, 426 U.S. military personnel who served as peacekeepers in Somalia were administered a comprehensive psychosocial questionnaire that included measures of exposure to negative and potentially traumatic experiences, reception at homecoming, self-disclosure, and PTSD symptom severity. The results indicate that adjustment to peacekeeping is significantly related to self-disclosure, especially to supportive significant others.
Post-traumatic stress (PTS) is a significant clinical problem in the general population. However, only a portion of those exposed to trauma develop PTS. Patterns of emotional self-disclosure have the potential to explain some of the individual differences in the development and continuation of symptoms. In this study, the authors investigated the links between emotional self-disclosure, as measured by the Emotional Self-Disclosure Scale (ESDS; W. E. Snell, R. S. Miller, & S. S. Belk, 1988). and a post-trauma psychological state, as measured by the Trauma Symptom Inventory (TSI; J. Briere, 1995). Their results showed that, in general, men engaged in less emotional self-disclosure than did women, and as TSI scores increased, the men were significantly less willing to disclose emotions of happiness. For women, as TSI scores increased they were significantly more willing to engage in talk about emotions related to anxiety but less willing to talk about emotions related to fear. The authors considered these data within current understandings of the role of emotional self-disclosure in the processing of traumatic experiences.
Marriage is a ubiquitous social status that consistently is linked to health. Despite this, there has been very little theory development or related research on the extent to which couple members are jointly motivated to and actively engage in health-enhancing behaviors. In this paper we propose an integrative model, based on interdependence theory and communal coping perspectives, that explicitly considers dyadic processes as determinants of couple behavior. Our integrated model applies these constructs to consider how couple dynamics might influence adoption of risk-reducing health habits. Accordingly, we suggest that the couple's interdependence can transform motivation from doing what is in the best interest of the self (person-centered), to doing even selfless actions that are best for the continuation of the relationship (relationship-centered). In turn, this transformation can lead to enhanced motivation for the couple to cope communally or act cooperatively in adopting health-enhancing behavior change. Implications for research related to couples and health behavior change are also highlighted.
The aim of the study is to examine secondary traumatization of wives of former prisoners of war (POWs) as manifested in posttraumatic stress disorder (PTSD) symptoms, additional psychiatric symptoms, and marital adjustment. In addition, it assessed the role of several contributors to the wives' secondary traumatization: the husband's PTSD, the level of his verbal and physical aggression, and the wife's level of self-disclosure.
The study compared three groups of Israeli wives: wives of POWs with PTSD (N=18), wives of POWs without PTSD, (N=64), and a control group of wives of veterans without PTSD (N=72).
The highest level of distress in all measures was endorsed by the wives of POWs with PTSD. Moreover, in addition to husband's PTSD and captivity, both the man's aggression and the wife's self-disclosure played a role in the wife's level of distress.
The findings show that the husbands' PTSD was more strongly associated with the wives' secondary traumatization than their captivity.
Diagnostic and statistical manual of mental disorders
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders
(5th ed.). Washington, DC: American Psychiatric
Publishing.