Racial Differences in Posttraumatic Stress Disorder in Military Personnel: Intergenerational Transmission of Trauma as a Theoretical Lens

Various theorists have explored how intergenerational transmission of trauma impacts minority groups. Intergenerational trauma theories suggest that trauma(s) endured by a community have long-standing effects that can be passed on through generations. However, much of the research has focused on indigenous populations or Holocaust survivors despite the historical experiences of the African American community. The minority stress model adds support to intergenerational trauma theories, in that racial minority groups might suffer worse health due to a variety of stressors. Racial minorities are also at greater risk of developing posttraumatic stress disorder (PTSD). Within military populations, PTSD is one of many mental health issues and has been labeled one of the signature injuries of the recent wars in Iraq and Afghanistan. However, the Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for PTSD do not take into account the effects of intergenerational trauma, discrimination, or racism. This article proposes that intergenerational trauma theories and the minority stress model provide explanations for why many studies have found that African American military personnel have higher rates of PTSD compared to their White peers. Indeed, African American military personnel with PTSD might be better understood through more culturally inclusive frameworks (e.g., complex trauma, race-based traumatic stress), because the stressors they experience as racial minorities might exacerbate or lead to symptoms of PTSD.     

‘If I leave home,who will take care of mum?’ Intergenerational transmission of parental trauma through projective identification

Using the construct of projective identification and integrating it with the body of literature on intergenerational transmission of unsymbolized parental trauma, I describe the case of an adult daughter that illustrates intergenerational transmission of unsymbolized parental trauma. It is suggested that the daughter has unconsciously identified with the disavowed feelings of anxiety projected into her by her mother. The daughter’s projective identification of her mother’s unresolved past traumas prevent her from leaving the parental home for the first time, despite being 35 years old. In turn, it is thought that the mother’s unconscious grasping onto her daughter is an attempt to avoid the confrontation of her own unprocessed fears implanted into her by her own mother, thus linking three generations of disavowal. As a way of extending the exiting theory, it is proposed that when there are long-term and inexplicable experiences of anxiety that coalesces around the intergenerational transmission of parental trauma, the term ‘intergenerational transmission of traumatic anxiety’ can be used to describe it.     

Exposure,Resource Loss,and Posttsunami Trauma

This study analyzed whether survivors’ resource loss mediates the effects of exposure on posttsunami trauma. Fourteen months posttsunami, 416 survivors were interviewed from the nine worst-affected habitations of the Nagapattinam district in Tamil Nadu (India). Exposure was measured using a checklist; trauma and resource loss were assessed using inventories. Findings indicate that the indirect effects of tsunami exposure on trauma via resource loss were a more potent predictor than the direct effects of exposure on trauma. Resource loss was a vehicle through which the effects of exposure passed on to posttsunami trauma.     

Spirituality and Trauma: The Role of Clergy in the Treatment of Posttraumatic Stress Disorder

An increased awareness of the spiritual aspects of health and illness has recently led to changes in psychiatry residency training as well as hospital accreditation requirements. The spiritual impact of trauma has been an area of particular interest, as trauma evokes certain existential questions and crises. It is estimated that from 5–11% of trauma survivors will go on to develop posttraumatic stress disorder (PTSD). Given the spiritual challenges of the experience of trauma, patients with PTSD could benefit from spiritual assessment and intervention as part of their overall treatment plan, and clergy can be utilized to perform this. The literature exploring the spiritual impact of trauma and the use of clergy in the treatment of trauma survivors is reviewed. The methods used by three chaplains in a residential treatment program for PTSD at one facility are described and discussed. Both the literature and the experiences of the clergy suggest that exploration of trauma-related existential conflicts in patients with PTSD is beneficial. However, there is a notable dearth of controlled scientific studies evaluating the effectiveness of spiritual interventions with this treatment population. The need for controlled studies to verify the usefulness of spiritual assessment and intervention in patients with PTSD is noted, and a more rigorous analysis of how clergy can best serve this treatment population is encouraged.     

Thanatos and massive psychic trauma: the impact of the death instinct on knowing,remembering, and forgetting

The connection between massive psychic trauma and the concept of the death instinct is explored using the basic assumptions that the death instinct is unleashed through and is in a sense characteristic of traumatic experience, and that the concept of the death instinct is indispensable to the understanding and treatment of trauma. Characteristics of traumatic experience, such as dissolution of the empathic bond, failure to assimilate experience into psychic representation and structure, a tendency to repeat traumatic experience, and a resistance to remembering and knowing, are considered as trauma-induced death instinct derivatives. An initial focus is on the individual, on how death instinct manifestations can be discerned in the survivors of trauma. Next the intergenerational force of trauma is examined; a clinical vignette illustrates how the death instinct acts on and is passed on to the children of survivors. Finally, the cultural or societal aspects of trauma are considered, with an eye to how death instinct derivatives permeate cultural responses (or failures to respond) to trauma. Because trauma causes a profound destructuring and decathexis, it is concluded that the concept of the death instinct is a clinical and theoretical necessity.     

When culture fails: coping with cultural trauma

The research into the phenomenon of cultural trauma is growing as the effects of historical transformations are recognized and analysed. The concept of cultural trauma and the analytic concept of the cultural complex is a suitable theoretical approach for this research. The Lithuanian experience of cultural trauma after the historical shifts indicates the importance of the interplay between societal and individual factors in coping with trauma. Academic psychotraumatological studies carried out at Vilnius University indicate a stronger traumatic experience by people who are survivors of direct political repression and even intergenerational transmission of trauma, but this group also seems to demonstrate an intergenerational transmission of resilience. Paradoxically, from a long‐term perspective, the victims of direct repression seem to have suffered less than the people who accommodated to the regime, and this applies also to their offspring. Analysis in terms of overcoming cultural trauma indicates that society is gradually integrating historic traumatic experiences, although a healthy cultural identity has not yet been restored.     

Exposure,Loss, and Support Predicting the Dimensions of Posttsunami Trauma

This study examined whether exposure, resource loss, and social support predicted the posttsunami trauma of PTSD, depression, negative affect, and physical health problems of the 2004 tsunami survivors. Four hundred sixteen survivors were interviewed in Tamil Nadu (India) 14 months posttsunami. Loss of life followed by loss of property and disaster exposure positively predicted the dimensions of trauma. Survivors having lower social status and income received less material and informational support than their equally affected counterparts, which furthered stress and distress. The survivors’ trauma can be arrested, minimizing the exposure and tangible resource loss, and improving the delivery of social support.     

Ethical Guidelines for Mass Trauma and Complex Humanitarian Emergencies

Issues pertaining to trauma, especially mass trauma and complex humanitarian emergencies, are explored through the lens of ethical counseling guidelines. In mass trauma, particular attention must be paid to the experiences of both survivors and counselors to enhance understanding of ethical best practices and to emphasize the importance of contextual factors in framing effective responses to trauma and humanitarian crises. Recommendations regarding ethical guidelines for counseling practice, clinical involvement, and training are offered.     

Posttraumatic growth in survivors of a natural disaster: the role of social axioms of religiosity,reward for application,and social cynicism

The positive psychology movement has impelled trauma research to focus not only on debilitating aspects of trauma experiences, but also on its positive outcomes such as posttraumatic growth (PTG). We investigated how the social themes of religiosity, reward for application, and social cynicism, as part of the individual’s distal culture, contribute to PTG among natural disaster survivors. We tested a model wherein social axioms of religiosity, reward for application, and social cynicism predict PTG, and their relationships are mediated by adaptive cognitive processing of trauma. The model was tested in a sample of Filipino survivors of typhoon Haiyan using structural equation modeling. The results support the proposed model except for the influence of social cynicism. The findings suggest that generalized beliefs about the social world play an important role in the development of PTG, and must be considered to understand how growth occurs in the aftermath of a traumatic event.     

Intergenerational transmission: The individuation process and the capacity for intimacy of adult children of holocaust survivors

This article deals with the intergenerational processes of adult children of Holocaust surviors. By exploring their level of individuation from the parental family and their capacity for intimacy with spouses, the research findings reveal that: Adult children of survivors are emotionally more interconnected to their parents than are their counterparts (using the MIS). Adult children of survivors have a lower intimacy capacity with their spouses in comparison with the control group. These findings are explained from an intergenerational perspective regarding a post-traumatic population.Received PhD from University of Wisconsin-Madison. Current research in the individuation process throughout adulthood, and the post-traumatic effect of Holocaust survivors.     

Influence of affective distractors on working memory capacity in relation to symptoms of posttraumatic stress disorder

Symptoms evoked in individuals with posttraumatic stress disorder (PTSD) when processing trauma‐relevant material arguably impair higher order cognitive functions. An example is working memory capacity (WMC), which has been shown to be disrupted by affective distractors. However, it is unknown whether this association varies across different types of PTSD symptoms. This study explored the association between WMC performed in affective (relative to neutral) contexts in relation to different symptoms of PTSD (avoidance, re‐experiencing, hyperarousal). Motor vehicle accident survivors with PTSD and without PTSD completed a delayed‐match‐to‐sample task including trauma‐related, neutral, and scrambled distractors in the interval between the presentation of the memoranda and the recognition target. The results showed that there was support for an indirect pathway between PTSD diagnosis and WMC performed in affective (versus neutral) contexts through re‐experiencing and avoidance symptoms. The findings suggest that avoidance symptoms in particular may benefit from interventions directed at improving WMC.     

Survivor Insight: A Study of Family,Friend, and Community Response to Interpersonal Violence

The purpose of this study was to examine the perspectives of survivors of trauma concerning their family, friend, and community responses to their trauma. Using a community-based, participatory action framework, a measure was developed and distributed to 351 randomly drawn survivors of interpersonal violence. The majority of participants indicated that they were never or rarely helped or protected at the time they first experienced the trauma. Several significant correlations were found between participants’ perceptions of their own healing and the responses of people in their lives. Many respondents also indicated that people do not know how to help survivors heal and that the general public does not understand how trauma affects people. The results are discussed within the framework of developing supports for trauma survivors that include trauma-informed family, friends, and community. Questions for further research and implications for professional practice and trauma-informed communities are discussed.     

Los Degradados: Out,down, dead: Transmitted and inflicted trauma as encountered in the analysis of a 6‐year‐old girl1

The author presents the analysis of a precocious traumatized little girl, which reveals the ways in which historical trauma is transmitted and intrafamilial trauma is both disguised and represented. The play as it evolves is seen to simultaneously communicate what the child struggles with and to resolutely try to hide what has actually happened. Analyst and child together participate in play which utilizes displacement, enactment and interactive enactment, the latter play mode being the very hallmark of profound traumatic experience. Carlotta, the child, helps the analyst to follow her quest for meaning making even as the interaction between them adheres to and departs from the deepening pentimenti of traumatic experience, which needs to be unraveled and reconstructed in order that her own developmental progression can be rejoined. The analysis facilitates Carlotta's capacity to play in a more unfettered fashion and to assist her family's recovery as well.     

Transgenerational processes and the trauma of sexual abuse

The process of the unconscious transmission of trauma between generations has been written about within the psychoanalytic field since Freud. the concept was further developed by psychoanalysts in their work with second generation survivors of the Holocaust. the particular characteristic is that it is a transmission that takes place silently and in secret, but actively. It is especially found in families where there is an inhibition against thinking. It is suggested in this paper that the concept could be usefully considered in families where a parent is a survivor of child sexual abuse but has kept the trauma a secret. Clinical examples illustrate how children in such families may carry the unconscious dynamics which can emerge into consciousness through symptomatology in the child.     

Therapeutic implications of counselling psychologists’ responses to client trauma: An interpretative phenomenological analysis

The past two decades have seen a surge of interest in the impact of working with trauma survivors on therapists’ psychological well-being. Existing literature assumes that therapists’ strong subjective responses to traumatic material adversely influence the therapeutic process. However, this has not yet been directly researched. Nine counselling psychologists were interviewed regarding the clinical impact of their responses to the disclosure of traumatic material. Interpretative Phenomenological Analysis showed that significant challenges are experienced in the use of self in therapy with trauma survivors, including making sense of horrific human actions, negotiating complex interpersonal dynamics and responding to ethical dilemmas in therapy. Results emphasised the importance that therapists attached to the development of their therapeutic use of self in therapy with trauma survivors, the value of learning from others and reaching a place of acceptance and hope when working with trauma survivors. Finally, specific training and development implications are proposed.     

Client‐centred group therapy for survivors of interpersonal trauma: A pilot investigation

Group therapy for trauma survivors provides an opportunity to share experiences with others in a supportive environment. Client‐centred groups have received very little attention as a way of working with traumatised people. Such groups promise to promote psychological growth following trauma. In this paper we present pilot data from a client‐centred group of six survivors of interpersonal violence who were experiencing complex posttraumatic stress reactions. Results suggested that those who perceived the presence of empathic listening within the group therapy sessions benefited from the group, showing greater positive changes. Clinical implications for working with trauma survivors, methodological considerations and directions for future research are discussed.     

Intergenerational Transmission of Trauma-Related Distress: Maternal Betrayal Trauma,Parenting Attitudes,and Behaviors

The purpose of this study was to elucidate mechanisms involved in the intergenerational transmission of trauma-related distress. This study investigated whether betrayal trauma (BT; abuse by a person close to the victim) and specific parenting attitudes and behaviors among mothers with child abuse histories predicted internalizing and externalizing symptoms in their children. Mothers and children (ages 7–11) were recruited for a project on parenting and stress (N = 72). Maternal betrayal trauma predicted both internalizing (β = 0.33, p < .01) and externalizing symptoms (β = 0.25, p < .05) even when controlling for mothers’ trauma-related symptoms. Negative attitudes toward limit setting predicted externalizing symptoms (β = ?0.33, p < .05). Poorer communication (β = ?0.39, p < .05) but higher parenting satisfaction (β = 0.38, p < .01) predicted internalizing symptoms. These findings demonstrate the importance of assessing maternal trauma and parenting characteristics as part of interventions with symptomatic children.     

Intergenerational Transmission of Trauma: The Mediating Role of Parenting Styles on Toddlers' DSM-Related Symptoms

Although the intergenerational transmission of trauma has been well documented, the pathways by which trauma symptoms are passed between parents and children remain unclear. This study examined the mediating role of parenting styles in the transmission of maternal trauma to children. Participants were a sample of 105 mothers of toddlers (18–30 months old). Mothers who had experienced interpersonal trauma were more likely to have an authoritarian parenting style, including verbal hostility, physical coercion, and low nurturance. Verbal hostility especially predicted more prevalent and increasing toddler symptoms associated with affective, hyperactive, and oppositional defiant disorders. Thus, the verbal hostility component of authoritarian parenting could serve as a major intergenerational pathway between maternal trauma and early child symptoms.     

Asian Trauma Survivors: Immigration, Identity, Loss, and Recovery

Psychological trauma in Asian American communities has been increasingly visible in recent years. This paper examines the impact of several variables, including migration, interdependence of the Asian family structure, and acculturation on the experience of trauma. Case illustrations are discussed to illustrate the interplay of cultural ideology, family dynamics, and intrapsychic experiences in the lives of many Asian and Asian American trauma survivors. Psychotherapeutic issues are explored from cultural and psychodynamic perspectives.