ISTSS Logo
 
Home > Public Resources > Trauma Blog > 2016 - September > All in the Family: Examining secondary traumatization in the families of Vietnam Veterans

All in the Family: Examining secondary traumatization in the families of Vietnam Veterans

September 2, 2016

The traumatic effects of war experience on Vietnam veterans have been repeatedly studied and widely discussed over the past few decades. However, research on secondary traumatization, the transmission of distress from trauma victims to others in close proximity, has been limited (Kulka et al., 1990; Dohrenwend et al., 2013; Figley, 1983). While the psychological toll of traumatic stress on Vietnam veterans has become a larger part of the conversation, it is important to acknowledge that their family members faced difficulties as well, particularly those that may have been indirectly affected by veterans’ traumatic experiences.

Our study focuses on the wives/partners and children of 115 clinically interviewed male Vietnam veterans, a subsample from the National Vietnam Veterans Readjustment Study (NVVRS) who had one or more children aged 6-16 (Kulka et al., 1988). Traumatization is defined as having experienced DSM-III-R lifetime war-related posttraumatic stress disorder (PTSD), especially as having such PTSD currently at the time of the survey. The wives/partners were interviewed about their own possible demoralization – helplessness, hopelessness, depressed mood, dread, anxiety, low self-esteem and psychophysiological disturbances – as measured by the Demoralization Scale of the Psychiatric Epidemiology Research Interview (PERI) (Dohrenwend, 1980). They also completed the Child Behavior Checklist (CBCL) assessing internalizing (e.g. anxious/depressive) and externalizing (e.g. aggressive) behaviors (Achenbach, 1991; Achenbach & Ruffle, 2000). Veteran risk factors (i.e. pre-war vulnerability, exposure to war-zone stressors, and participation in harm to civilians or prisoners) and alcoholism with onset during or after their service in Vietnam were examined in addition to PTSD in order to detect which factors were associated with secondary traumatization in the veterans’ wives/partners and children (Dohrenwend et al., 2013).

We found direct evidence of secondary traumatization in the boys’ internalizing behaviors. Veterans’ current PTSD is associated with demoralization in their wives/partners, which in turn is associated with behavior problems in their daughters. Wife/partner demoralization is also associated with current alcoholism in the veterans. These associations are independent of other veteran risk factors.

Compared to the national sample norms outlined by Achenbach and Rescorla (2001), this sample is not unusually problematic despite evidence of secondary traumatization in our study. Nonetheless, our findings have important implications regarding the potential causes of secondary traumatization in the family members of combat veterans. Further research is necessary to clarify why the effects of secondary traumatization are so different for boys and girls.

Female veterans interviewed were too few to include in the sample used here, but their service as combat soldiers in recent years, as well as their continued service as nurses subject to traumatic experiences associated with treating the wounded, provide opportunities to study the possible direct and indirect effects of war-related trauma in women. War-time circumstances and societal changes are an important factor to consider when examining veterans’ families. Future studies should examine secondary traumatization in new generations of veterans and their families, and compare their findings with those reported here. By refining our understanding of the breadth, duration and intensity of secondary traumatization, we can hope to more adequately prevent indirect traumatization and provide care for veterans’ spouses, partners and children.
 

Reference Article 

Yager, T. J., Gerszberg, N., & Dohrenwend, B. P. (2016). Secondary Traumatization in Vietnam Veterans’ Families. Journal of Traumatic Stress, 29(4), 349-355. doi: 10.1002/jts.22115

Author biographies

Nicole Gerszberg, a recent graduate of Wesleyan University, has been conducting research on the families of Vietnam veterans alongside Dr. Dohrenwend and Dr. Yager since 2009. She has also conducted research on traumatic stress through the Cognitive Affective Personality Science Laboratory at Wesleyan University and assisted with research on low mood through the Laboratory for Affective and Translational Neuroscience at McLean Hospital.

Bruce P. Dohrenwend, PhD, holds the following positions: Professor of Social Science, Department of Psychiatry, Columbia University; Professor of Epidemiology, Mailman School of Public Health, Columbia University; and Chief of Research, Division of Social Psychiatry, New York State Psychiatric Institute. His research has been concerned with the role of adversity and stress and various types of psychopathology. In recent years, he has focused on war-related PTSD in U.S. veterans who fought in Vietnam.

Thomas Yager, PhD, is an Associate Research Scientist at the Mailman School of Public Health, Columbia University. He has studied the effects of traumatic events on the mental health of Vietnam veterans and others, much of this work in collaboration with Bruce Dohrenwend. He has also studied changing community in an Irish village. 

Discussion Questions

  • How do we distinguish primary and secondary traumatization?
  • How is secondary traumatization manifest in the family members of Vietnam veterans?
  • How do female and male children’s behaviors differ in relation to their father’s PTSD? 

References

Achenbach, T. M. (1991). Manual for the Child Behavior Checklist/4-18 and 1991 profile. Burlington: University of Vermont, Department of Psychiatry.

Achenbach, T.M., & Ruffle, T.M. (2000).  The Child Behavior Checklist and related forms for assessing behavioral/emotional problems and competencies.  Pediatrics in Review, 21(1), 265-271doi:10.1542/pir.21-8-265

Dohrenwend, B.P., Shrout, P.E., Egri, G., & Mendelsohn, F.S. (1980).  Non-specific psychological distress and other dimensions of psychopathology: Measures for use in the general population. Archives of General Psychiatry 37, 1229-1236. doi:10.1001/archpsyc.1980.01780240027003

Dohrenwend, B.P., Yager, T.J., Wall, M.M., & Adams, B.G. (2013).  The roles of combat exposure, personal vulnerability, and involvement in harm to civilians or prisoners in Vietnam war-related posttraumatic stress disorder, Clinical Psychological Science, 1, pp. 223-238. doi:10.1177/2167702612469355

Figley, C.R. (1983).  Catastrophes: An overview of family reactions.  In C.R. Figley, & H.I. McCubin (Eds.), Coping with catastrophe: Stress and the Family, Vol. II, 3-20.  Bruner/Mazel.

Kulka, R.A., Schlenger, W.E., Fairbank, J.A., Hough, R.L., Jordan, B.K., Marmar, C.R., et al. (1988).  National Vietnam Veterans Readjustment Study (NVVRS): Description, current status, and initial PTSD prevalence estimates. Washington, DC: Veterans Administration.

Kulka, R.A., Schlenger, W.E., Fairbank, J.A., Hough, R.L., Jordan, B.K., Marmar, C.R., et al. (1990).  Trauma and the Vietnam war generation: Report of findings from the National Vietnam Veterans Readjustment Study. New York: Brunner/Mazel