The Legacy of Combat Trauma
The Legacy of Combat Trauma
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战斗创伤的遗产
DOI：
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发表时间：
1998
期刊：
影响因子：
--
通讯作者：
L. Fisher
中科院分区：
文献类型：
--
作者：
Michelle R. Ancharoff;James F. Munroe;L. Fisher
创伤后症状会对创伤幸存者与他人的关系产生深远的影响，其中可能最重要的是家庭成员。幸存者的经历使他们发生了明显的变化。创伤的心理影响在各种幸存者群体中得到了很好的证实（例如，Burgess & Holmstrom，1974; Davis & Friedman，1985; Figley，1978; Foa，Rothbaum，Riggs，&默多克，1992; Kilpatrick，Veronen，& Best，1985; Koopman，Classen，S Laufer，Frey-Wouters，& Gallops，1985; Titchner，Kapp，& Winget，1976）。这些创伤后症状包括（1）通过闪回、噩梦和持续的想法经历创伤;（2）对创伤相关刺激的认知和恐惧回避;（3）易怒、惊吓反应和睡眠障碍的过度觉醒症状（美国精神病学协会，1994）。很容易理解幸存者的反应麻木，社交退缩和易怒，以及偶尔爆发的愤怒，如何使他们难以维持人际关系。反过来，创伤患者的子女可能直接或间接地受到父母创伤后症状的影响。例如，Rosenheck和Nathan（1985）描述了一个患有创伤后应激障碍（PTSD）的退伍军人的孩子，他患有失眠症;头痛;流泪;无助感;害怕被绑架，枪击或杀害;在学校注意力问题;以及类似于他父亲闪回的幻想。这些作者创造了术语继发性创伤来描述这种现象。其他人则将此称为创伤的代际传递（Harkness，1993年）。虽然术语不同，但这些描述的共同点是儿童受到父母创伤后后遗症的影响。尽管有过多的描述性信息，但创伤的代际传递是一个定义不清的经验结构，在专业界也没有得到很好的理解。我们不知道父母的创伤会在多大程度上影响下一代，也不知道有多少代人会受到影响。创伤后应激障碍的最佳预测指标之一是创伤事件的强度和持续时间（Gleser，绿色，& Winget，1981;货车der Kolk，1988）。我们可以推测，儿童继发性创伤的最佳预测因素之一可能是其父母创伤暴露的强度和持续时间。战斗退伍军人是一个受到广泛创伤的群体，因此代表了一个可能代际传播的群体。本章的目标是描述越战老兵的孩子战斗创伤的遗产，并确定通过这些认知，情感和行为模式传递的机制。此外，本章还探讨了如何确定是否、何时以及如何进行干预的问题。
Posttrauma symptoms can have a profound effect on the manner in which a trauma survivor relates to others, including, perhaps most significantly, family members. Survivors are markedly changed by their experiences. The psychological impact of trauma is well established in a variety of survivor populations (e.g., Burgess & Holmstrom, 1974; Davis & Friedman, 1985; Figley, 1978; Foa, Rothbaum, Riggs, & Murdock, 1992; Kilpatrick, Veronen, & Best, 1985; Koopman, Classen, S Laufer, Frey-Wouters, & Gallops, 1985; Titchner, Kapp, & Winget, 1976). These posttrauma symptoms include (1) experiencing the trauma through flashbacks, nightmares, and persistent thoughts; (2) cognitive and phobic avoidance of trauma-related stimuli; (3) hyperarousal symptoms of irritability, startle response, and sleep disturbance (American Psychiatric Association, 1994). It is easy to understand how survivors’ numbing of responsiveness, social withdrawal, and irritability, with episodic outbursts of rage, can make it difficult for them to maintain interpersonal relationships. In turn, children of traumatized patients may be affected directly or indirectly by their parents’ posttrauma symptoms. For example, Rosenheck and Nathan (1985) described a child of a combat veteran with post-traumatic stress disorder (PTSD) as having insomnia; headaches; tearfulness; feelings of helplessness; fears of being kidnapped, shot, or killed; attention problems at school; and fantasies similar to his father’s flashbacks. These authors coined the term secondary traumatization to describe this phenomenon. Others have referred to this as transgenerational transmission of trauma (Harkness, 1993). Although the terminologies differ, common to these descriptions is the notion that children are affected by their parents’ posttrauma sequelae. Despite a plethora of descriptive information, intergenerational transmission of trauma is a poorly defined empirical construct, and one that is not well understood within the professional community. We do not know the extent to which parental trauma affects the next generation or how many generations may be influenced. One of the best predictors for PTSD is the intensity and duration of exposure to traumatic events (Gleser, Green, & Winget, 1981; van der Kolk, 1988). We can speculate that one of the best predictors for secondary trauma in children may be the intensity and duration of trauma exposure of their parents. Combat veterans are a group that has been exposed to extensive trauma and, therefore, represent a population in which intergenerational transmission is likely. The objectives of this chapter are to describe the legacy of combat trauma on the children of Vietnam veterans and identify the mechanisms through which these cognitive, affective, and behavioral patterns are handed down. In addition, this chapter explores issues of how to determine if, when, and how to intervene.
童年接触父母酗酒问题的长期社会心理影响。
DOI：
10.1176/ajp.150.4.608
发表时间：
1993
期刊：
The American journal of psychiatry
影响因子：
--
作者：
Greenfield,SF;Swartz,MS;Landerman,LR;George,LK
通讯作者：
George,LK