Spousal Perception of Primary Terror Victims’ Coping Strategies and Secondary Trauma

A Causal Model of Children's Vicarious Traumatization

Children may be vicariously traumatized from learning about the trauma of family and friends. To date, a causal model of children's vicarious traumatization has not been empirically validated in the literature. This paper fills the gap in the literature by reporting on the direct effect of vicarious trauma on children independent of caregiving impairment. Data for the study came from the National Survey of Children's Exposure to Violence I (NATSCEV I). This unique dataset features two indicators of vicarious trauma exposure: (1) family victimization and (2) community violence. Hierarchical multiple regression was conducted in order to control for nuisance variables such as caregiver impairment, defined as the degree of warmth or hostility; time elapsed since the trauma occurred and the study taking place; and other trauma exposure (i.e. direct and witnessed trauma). As expected, the study found evidence of a direct and positive relationship between learning about the trauma of close friends and family and children's trauma symptomatology. Both adolescents and young children were found to be vulnerable to experience vicarious traumatization, with gender and ethnicity being contributing factors. Chronological age was not found to be significant in children's vicarious traumatization. These findings support the causal model of vicarious traumatization. They demonstrate that children may be traumatized by exposure to the trauma material of others above and beyond the influence of caregiver impairment. As such, attention should be given to interventions, practices, and policies that intervene in the lives of children exposed to violence.

Outcomes of Mental Health Screening for United Kingdom Nationals Affected by the 2015-2016 Terrorist Attacks in Tunisia, Paris, and Brussels

Following several terrorist attacks in 2015 and 2016, a national program was set up to identify and support residents of England whose mental health had been affected. We report the outcomes of the program's screening and assessment components. Questionnaires and information about the program were mailed to 483 people and 49 families known to the police. Individuals who screened positive on an assessment for posttraumatic stress disorder, anxiety, depression, increased smoking, or problematic alcohol consumption were offered clinical assessment and referred to an appropriate National Health Service (NHS) service, if required. Of the 195 eligible people who returned our questionnaires, 179 (91.8%) screened positive on one or more measure. Following clinical assessment, 78 adults and three children were referred for treatment. The program was broadly successful in facilitating access to services. However, most people who had been directly exposed to the attacks did not participate and data protection issues limited communication with those who were affected. Further discussion of data protection concerns may help future programs operate more efficiently.

Concern and death anxiety during an ongoing terror wave: The moderating role of direct vs. indirect exposure

The current study examined whether emotional concern over one's security situation is connected with death anxiety during an ongoing terror wave, and whether type of exposure (media exposure vs. contact with witnesses) moderates this connection. A total of 345 individuals, aged 18-70, were sampled during an ongoing wave of terror in Israel and filled out scales measuring death anxiety, concern over security situation, and type of exposure. Results indicated that increased concern was connected with enhanced death anxiety. Moreover, this connection was more pronounced among individuals exposed to the events through the media, in comparison with individuals who had first-hand contact with witnesses.

Survivor-spouse dissociation and posttraumatic stress disorder: Personal and dyad relationships

This study examined the relationships between dissociation and posttraumatic stress disorder (PTSD) symptoms among injured survivors of terror attacks and their spouses (N = 210), specifically exploring survivor-spouse dyadic associations. Structural equation modeling and the actor-partner interdependence model were used to test the bidirectional dyadic association of both the survivors' and the spouses' dissociation with PTSD symptoms. The results demonstrated a positive association both between the survivors' trait dissociation and PTSD symptoms and between the spouses' trait dissociation and their PTSD symptoms. However, no significant associations were found at the bidirectional level. Taken together, our findings shed new light on the role of trait dissociation in PTSD. Although trait dissociation is associated with higher PTSD symptoms for both survivors and their spouses, its role may be limited in the bidirectional partner context. Theoretical and clinical implications of the findings are discussed.

Secondary Traumatization in Mental Health Professionals: A Systematic Review of Gender Findings

The issue of gender is largely ignored in studies of secondary traumatization (STS). This article addresses the question of gender differences in susceptibility to STS among clinicians who treat traumatized clients. It does so by systematically reviewing the very limited body of published findings on this subject to date. These are 10 published studies that measure STS by post-traumatic stress disorder (PTSD) symptomatology and 4 studies that measure it using Stamm's Professionals Quality of Life Survey (ProQOL), which queries PTSD symptomatology along with other difficulties that may arise in helping traumatized clients. Almost all the studies based on PTSD symptomatology show greater female susceptibility. Although the pattern is less clear in the ProQOL studies, the article argues that the research to date does not really show mixed findings, as is repeatedly claimed, but greater susceptibility among female clinicians. It also points out that the findings do not mean that male clinicians are unaffected by their traumatized clients and notes the various manifestations of their distress reported in the reviewed studies. The article offers a variety of explanations for the heightened female susceptibility.

Humor and Trauma-Related Psychopathology Among Survivors of Terror Attacks and Their Spouses

The goal of this study was to examine the bidirectional relationships between humor and trauma-related psychopathology (posttraumatic stress disorder [PTSD], depression, and anxiety symptoms) among 105 dyads consisting of Israelis who were injured during terror attacks and their spouses (N = 210). An actor-partner interdependence model (APIM) was applied as part of a structural equation modeling (SEM) analysis aimed at examining the associations between the use of different styles of humor and trauma-related psychopathology. Consistent with our hypotheses, results suggested that benign styles of humor were associated with survivors' lower levels of trauma-related symptoms (actor effects) and also had a buffering effect for the spouse (partner effects). More specifically, the use of self-enhancing humor by survivors was negatively associated with spousal symptoms and the use of affiliative humor by spouses was negatively associated with psychopathology symptoms reported by survivors. The results of this study shed light on the role that benign humor may play in coping with traumatic events while taking into account the dyadic relationships among survivors and their spouses. Theoretical and clinical implications of the findings are discussed.

Female receptivity and secondary traumatization in the family

This paper addresses the question of gendered receptivity to Secondary Traumatic Syndrome (STS) in the family. Unlike other manifestations of distress in the family, where gender comparisons are a matter of course, very few such comparisons are made in studies of STS. Review of the findings of 12 studies, the only studies, to date, that provide data enabling the comparison of STS in males and females, shows that females in the family, whether daughters, wives, or mothers, are consistently more likely than the males, whether sons, husbands, or fathers, to experience the Posttraumatic Stress Disorder (PTSD) symptoms of a traumatized family member without having experienced the traumatic event itself. This pattern pertains to whether the event that precipitated the primary trauma was a collective or individual trauma and whether the STS sufferer was a child or adult or living or not living with the PTSD casualty. The Discussion points out that gender is an important factor in the development of STS, whether in interaction with role, beyond role, or both.

The bidirectional dyadic association between tendency to forgive, self-esteem, social support, and PTSD symptoms among terror-attack survivors and their spouses

This study examined the dyadic association of terror attack survivors’ and spouses’ internal resources, tendency to forgive (self, others,and situational forgiveness), self-esteem, and the external resource of social support, as associated with victims’ and spouses’ posttraumatic stress disorder (PTSD) symptoms, using the actor–partner interdependence model. Based on lists by the One Family organization in Israel, 108 couples participated in the study. The study results demonstrate that in the dyad relationship, survivors’ tenden cyto forgive others and social support relate both to survivors’ decreased levels of PTSD symptom severity (β = −.20, p = .021;β =−.55 p < .001) and spouses’ decreased levels of PTSD symptom severity (β =−.21, p = .015; β =−.27, p = . 004), whereas spouses’ self-esteem relates to both spouses’ and survivors’ decreased levels of PTSD symptom severity (β =−.57, p < .001; β =−.14, p = .041).The findings underscore the role of the survivor–spouse unit by highlighting the dyad relationship of internal and external resources as associated with both survivors’ and spouses’ PTSD symptoms. Theoretical and clinical implications of the findings are discussed.