Secondary Traumatization Among Adult Offspring of Male Veterans with PTSD: The Role of the Mother-Child Relationship

Background and Purpose: Clinical observations and empirical studies indicate that the consequences of traumatic events are not limited to the victim, but often affect significant others in the victim's environment. The most common term for these effects among family members of war veterans is Secondary Traumatization (Figley, 1986). It describes various difficulties such as distress symptoms, problems in maintaining intimacy, and greater vulnerability to stress. This study examined the long-term consequences of living with a father who suffers from PTSD, as reflected in the offspring's' general levels of distress as well as on their capacity for intimacy. In addition, we examined whether stress responses to terror attacks would be higher among offspring of veterans with PTSD than among members of a control group. Although the literature is limited, it indicates that there is a considerable variance in the reactions of the offspring, which can be partially accounted for by the mother-child relationship (Moore et al., 1990). Thus the last aim of the study was to examine whether a positive relationship with the mother, could lessen the long term effects of living with a father who suffers from PTSD.

Methods: The sample included 46 offspring of Israeli fathers diagnosed with war related chronic PTSD and 46 offspring of fathers who had participated in one of Israel's wars, but did not have PTSD. The two groups were matched by age, gender, education and marital status. Data were collected using structured questionnaires assessing: 1. General mental distress (The Brief Symptom Inventory); 2.Avoidance and intrusive symptoms due to the threat of terror attacks (The Impact of Events Scale); 3. Capacity for intimacy (Intimacy Scale), and 4. Quality of the relationship with the mother (Parental Bonding Instrument).

Findings: MANOVA analyses revealed that adult children of PTSD veterans showed a higher level of psychological distress, a greater impact of terror-related stress as manifested in their higher level of intrusive and avoidance symptoms, and a lower capacity for intimacy than the comparison group. In addition, a positive relationship with the mother moderated the extent of secondary traumatization as was reflected in lower levels of emotional distress, and a higher capacity for intimacy. However, the positive relations with the mother did not alleviate the impact of terror related stress.

Conclusions and Implications: The findings give further validation to the concept of secondary traumatization. They indicate that the consequences of a victim's trauma on his family can manifest both in general mental distress and in specific post traumatic symptoms due to difficulties in coping with threatening situations. In addition it demonstrates the vital role of the mothers in alleviating this distress. The findings of the study reflect the importance of family evaluation for PTSD victims. Besides individual therapy for veterans with PTSD, there is a need for more comprehensive assessment of the families. To improve family relations, it is important to recognize the need for various individual and/or family interventions which take into account the unique situation of each family.