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Background: Although peritraumatic dissociation (PD) is viewed as a risk factor for posttraumatic stress disorder (PTSD), prospective studies taking into account other wellknown risk factors for PTSD have been scarce, and the exploration of potential moderators within the relations between PD and PTSD has been lacking. Objective: Filling this gap, this prospective study explored the moderating role of perceived threat within the relations between PD and PTSD, above and beyond age, gender, education, and early trauma-related symptoms. Method: A convenience sample of 200 Israeli civilians filled out self-report questionnaires during the peritraumatic phase (T1) and one to two months after the posttraumatic phase (T2) of being exposed to rocket attacks. Results: The results showed that perceived threat and PD were associated with early traumarelated symptoms and PTSD symptoms. Moreover, perceived threat moderated the relationship between PD and all PTSD symptom clusters apart from avoidance. Conclusions: The present results suggest that the implications of PD are shaped by levels of perceived threat, so that detriments of PD are evident when the trauma is appraised as being highly threatening. Therefore, early interventions that aim to decrease PD may be beneficial in preventing PTSD symptoms of intrusion, hyper arousal, and negative alterations in mood and cognition, for individuals who perceive traumatic events as highly threatening. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Childhood abuse puts individuals at risk for psychopathology and psychiatric symptoms such as posttraumatic stress disorder (PTSD) and anxiety symptoms. At the same time, research has indicated that some survivors report positive transformations in the aftermath of their trauma, known as posttraumatic growth (PTG). Yet the essence of PTG reports is questionable, and some scholars claim that it may reflect maladaptive illusory qualities. Furthermore, according to a recent theoretical model, PTG might be dissociation-based and related to survivors' bonds with their perpetrators. This study aimed to explore these claims by assessing PTG, dissociation, and identification with the aggressor (IWA), as well as PTSD and anxiety symptoms. An online survey was conducted among 597 adult childhood abuse survivors. Study variables were assessed via self-report measures. Analyses indicated positive associations between PTG, dissociation, and IWA. Three distinct profiles were found, reflecting high, medium, and low scores on PTG, dissociation, and IWA. Profile type explained PTSD and anxiety symptoms above and beyond gender, age, and abuse severity. These findings suggest that whereas some childhood abuse survivors might experience a positive transformation subsequent to their trauma, others' PTG reports might reflect dissociative mechanisms and pathological attachments to their perpetrators, and thus might be maladaptive. [ABSTRACT FROM AUTHOR]

The present study sought to examine the relations between a history of childhood sexual abuse (CSA) and sexual motivations and to explore the moderating role of dissociation within these relations. The study was conducted among 889 men and women (ages 18–70). Results indicated a history of CSA was significantly related to higher scores on self-affirmation, coping, partner approval and peer pressure sexual motivations. Interactions between CSA and gender in explaining sexual motivations, were not significant. Among participants with a history of CSA (n = 365), dissociation was significantly related to sexual motivations, so that participants who had dissociation scores above the cutoff (reporting high levels of dissociation) scored higher on intimacy, self-affirmation, coping, and partner approval than did those with a history of CSA who reported low levels of dissociation. Analyzes revealed significant moderating effects for dissociation within the relations between CSA and intimacy, coping, and partner approval sexual motivations. The present study suggests CSA survivors and those who report high levels of dissociation in particular, utilize sex for intimacy, for coping with negative emotions, and for partner approval. Therapists working with CSA survivors should be aware of the potential effects the abuse has on the survivor's reasons to engage in sex. [ABSTRACT FROM AUTHOR]

Despite increasing interest in the mental health of aging veterans, the pathogenic and salutogenic ramifications of war have not been investigated among aging veterans who received decorations of valor. Filling this gap, 73 Israeli decorated veterans (DVs) and 73 non-decorated veterans (n-DVs) (Mage = 68.5) were assessed for posttraumatic stress symptoms (PTSS), depression and anxiety 18 and 45 years after the war, and for posttraumatic growth (PTG) 45 years after the war. Analyses revealed deteriorating posttraumatic avoidance among n-DVs but not among DVs, and significantly lower rates of anxiety and depression and higher rates of PTG among the DVs. These findings suggest that factors related to being a DV may foster resilience to posttraumatic sequelae and are potentially conducive to PTG in later life. Though the study precludes making causal inferences, it serves as a springboard for future investigations into positive mechanisms underlying DVs' relative resilience and growth in later life. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Spouses of former prisoners-of-war (ex-POWs) are at risk for posttraumatic stress symptoms (PTSS) and marital distress. This study assessed the implications of PTSS and self-differentiation for sexual satisfaction among 90 ex-POWs' spouses and 75 matched combatants' spouses from the 1973 Yom Kippur War. Standardized questionnaires were used. Ex-POWs' spouses had elevated PTSS and imbalanced self-differentiation. PTSS were associated with poorer self-differentiation and lower sexual satisfaction. Imbalanced self-differentiation mediated the association between PTSS and sexual satisfaction. The findings imply that PTSS and imbalanced self-differentiation contribute to low sexual satisfaction among spouses of primary trauma survivors. [ABSTRACT FROM AUTHOR]

Childhood sexual abuse (CSA) poses a risk for sexual revictimization. Additionally, according to theory CSA may lead to identification with the aggressor, expressed by adopting the perpetrator's experience concerning the abuse; identifying with the perpetrator's aggression; replacing one's agency with that of the perpetrator; and becoming hyper-sensitive to the perpetrator. Although clinical impressions suggest that identification with the aggressor underlies reenactment of trauma, this linkage between identification with the aggressor and sexual revictimization remains largely uninvestigated. This study assessed (a) the relationship between identification with the aggressor (total score and four subscales) and sexual revictimization; (b) the unique associations between identification with the aggressor (total score and four subscales) and sexual revictimization, above and beyond chronicity of abuse and PTSD symptoms. Participants were Israeli women students who reported a history of CSA (n = 174). Analyses indicated significant correlations between two subscales of identification with the aggressor – replacing one's agency with that of the perpetrator and becoming hyper-sensitive to the perpetrator – and sexual revictimization. These subscales of identification with the aggressor were associated with sexual revictimization, above and beyond the effects of chronicity of the abuse and PTSD symptoms. Nevertheless, these associations were in opposite directions – while replacing one's agency with that of the perpetrator was related with higher occurrence of sexual revictimization, becoming hyper-sensitive to the perpetrator was related with lower levels of revictimization. These results imply that identification with the aggressor may serve as a multifaceted phenomenon in the context of sexual revictimization, comprised of both adaptive and maladaptive aspects. [ABSTRACT FROM AUTHOR]

Living with veterans who suffer from post-traumatic stress disorder (PTSD) is associated with elevated distress in spouses. Moreover, military spouses are at an elevated risk for domestic abuse, which might exacerbate their plight. Forgiveness is posited to have a healing effect for individuals, both in general as well as in the context of marital relations. Yet, the outcomes of forgiveness under conditions of ongoing abuse are not well understood. The current study fills this gap. Military spouses (n = 245) were assessed 30 (T1) and 38 (T2) years after the 1973 Yom-Kippur War. Abuse inflicted upon the spouses, spouses' forgiveness, spouses' distress (self-rated health and psychiatric symptomatology) and veterans' PTSD symptoms were assessed. Domestic abuse was associated with spouses' distress beyond the effect of the veterans' PTSD. Furthermore, domestic abuse moderated the associations between forgiveness and distress. Whereas forgiveness predicted reduced distress among spouses who reported a lower frequency of domestic abuse, its effects were non-significant among spouses who reported a higher frequency of domestic abuse. Results imply that the protective effect of forgiveness dissolves in the face of an elevated frequency of ongoing abuse and that promoting forgiveness as a part of psychotherapy for individuals who undergo abuse might be ineffective. [ABSTRACT FROM AUTHOR]

Spouses of traumatized war veterans might suffer from distress following indirect exposure to combat and direct exposure to domestic abuse. Yet the effect of this twofold trauma exposure is far from being fully understood. Theory views attachment security as a personal resource mitigating adversity, whereas attachment insecurities intensify distress. Nevertheless, there are mixed results concerning the effects of attachment in the aftermath of trauma. Furthermore, the role of trauma exposure levels regarding the effects of attachment remains largely uninvestigated. Filling these gaps, this study assessed female military spouses 30 (T1) and 38 (T2) years after the 1973 Yom Kippur War. Direct (domestic abuse) and indirect (veteran partners’ posttraumatic stress symptoms) trauma exposure, attachment, depression, and anxiety were assessed. Findings indicated an interaction between the trauma types in predicting spouses’ anxiety. Domestic abuse moderated the relations between attachment and distress. Although attachment anxiety had nonsignificant effects on anxiety among low-level domestic abuse sufferers, it predicted elevated anxiety among high-level domestic abuse sufferers. Furthermore, while attachment avoidance predicted elevated distress among low-level domestic abuse sufferers, its effects dissolved or became positive in nature among high-level domestic abuse sufferers. Discussion focuses on evolutionary explanations of the functions of attachment under different conditions of threat. [ABSTRACT FROM AUTHOR]

Literature has suggested that auditory hallucinations might be prevalent in the general population and could be linked to the experience of trauma. This prospective study examines the prevalence of auditory hallucinations in trauma survivors and its association with posttraumatic stress disorder (PTSD) symptoms, over time. Former prisoners of war (ex-POWs) from the 1973 Yom Kippur War (n = 99) with and without PTSD and comparable veterans (n = 103) were assessed twice, in 1991 (T1) and 2003 (T2) in regard to auditory hallucinations and PTSD symptoms. Findings indicated that ex-POWs who suffered from PTSD reported higher levels of auditory hallucinations at T2 as well as increased hallucinations over time, compared to ex-POWs without PTSD and combatants who did not endure captivity. The relation between PTSD and auditory hallucinations was unidirectional, so that the PTSD overall score at T1 predicted an increase in auditory hallucinations between T1 and T2, but not vice versa. Assessing the role of PTSD clusters in predicting hallucinations revealed that intrusion symptoms had a unique contribution, compared to avoidance and hyperarousal symptoms. The findings suggest that auditory hallucinations might be a consequence of the posttraumatic reaction among veterans. [ABSTRACT FROM PUBLISHER]

Objective: Most research concerning the implications of self-disclosure on trauma’s aftermath has focused on the salubrious effects disclosure may foster for the primary victim. However, the manner in which recipients of disclosure are symptomatically affected by it remains unexamined. Of particular interest are spouses who are often the primary support providers and are therefore susceptible to secondary traumatization. Assessing posttraumatic stress symptoms (PTSS) and self-disclosure among traumatized veterans and their wives, the current longitudinal study begins to fill this gap in the literature.Method: A total of 220 couples consisting of Israeli veterans, of whom 128 were former prisoners of war (ex-POWs) and 92 were combatants, and their wives were examined. PTSS and self-disclosure of both partners were assessed 30 and 35 years after the war using the Posttraumatic Stress Disorder Inventory (PTSD-I; Solomon et al., 1993) and the Self-Disclosure Index (SDI; Miller, Berg, & Archer, 1983), respectively. Analyses included Pearson intercorrelations analyses and four stepwise hierarchical multiple regression analyses.Results: Findings indicated that increments in veterans’ disclosure are not only consistently associated with the reduction of their wives’ PTSS but may also explain and predict some of the change in the wives’ PTSS over time. However, such a longitudinal effect was not evident concerning the veterans’ PTSS.Conclusion: Traumatized ex-POWs’ and combatants’ self-disclosure within the marital relationship may contribute to the amelioration of their wives’ secondary traumatization, and thus may be a goal worth pursuing in therapy. However, more research is needed to further understand this relation. [ABSTRACT FROM PUBLISHER]

Objective: The controversy regarding the nature of posttraumatic growth (PTG) includes two main competing claims: one which argues that PTG reflects authentic positive changes and the other which argues that PTG reflects illusionary defenses. The former also suggests that PTG evolves from shattered world assumptions (WAs) and that the co-occurrence of high PTG and negative WAs among trauma survivors reflects reconstruction of an integrative belief system. The present study aimed to test these claims by investigating, for the first time, the mediating role of dissociation in the relation between PTG and WAs. Method: Former prisoners of war (ex-POWs; n = 158) and comparable controls (n = 106) were assessed 38 years after the Yom Kippur War. Results: Ex-POWs endorsed more negative WAs and higher PTG and dissociation compared to controls. Ex-POWs with posttraumatic stress disorder (PTSD) endorsed negative WAs and a higher magnitude of PTG and dissociation, compared to both ex-POWs without PTSD and controls. WAs were negatively correlated with dissociation and positively correlated with PTG. PTG was positively correlated with dissociation. Moreover, dissociation fully mediated the association between WAs and PTG. Conclusion: These findings imply that PTG might reflect illusory defenses and raise questions regarding the integration between the co-occurrence of high PTG and negative WAs among trauma survivors. [ABSTRACT FROM AUTHOR]

The aim of the present study was to examine the directionality of the association between post-traumatic stress symptoms (PTSS) and attachment insecurities across time among indirect trauma survivors. Wives of former prisoners of war (ex-POWs), with and without post-traumatic stress disorder (PTSD), and comparable controls were assessed 30 (T1) and 38 (T2) years after the Yom Kippur War. As expected, wives of ex-POWs endorsed higher PTSS compared to wives of controls. Wives of ex-POWs with PTSD endorsed higher PTSS and higher attachment avoidance compared to wives of ex-POWs without PTSD and controls. There were significant associations between PTSS and attachment insecurities. Contrary to the hypothesis, the relationship between PTSS and attachment insecurities among wives of ex-POWs was unidirectional, with attachment anxiety at T1 predicting PTSS at T2, and not vice versa. Results indicate that attachment anxiety might act as a risk factor for secondary traumatic reactions. [ABSTRACT FROM PUBLISHER]

Objective: War captivity includes a unique constellation of simultaneous somatic and interpersonal assaults. This raises questions about the link between attachment and somatic complaints among ex–prisoners of war (ex-POWs). Although the attachment literature assumes that attachment affects somatic complaints and not vice versa, to date no empirical studies assess the association between the two variables over time. In this article we prospectively examine the association between attachment and somatic complaints over time among ex-POWs and comparable veterans. Method: The current study included two groups of male Israeli veterans of the 1973 Yom Kippur War: ex-POWs and comparable veterans who were not taken captive. Both groups were assessed via self-report measures at three times: T1 (1991), T2 (2003), and T3 (2008)—18, 30, and 35 years after the war, respectively. Results: Ex-POWs reported higher levels of somatic complaints and attachment insecurities. These levels increased over time compared to combatant veterans. Moreover, while there was a unidirectional influence of somatic complaints on attachment security over time among combatant veterans, this relationship was bidirectional among ex-POWs. Conclusions: The present study suggests that the combined physical and interpersonal assaults experienced during captivity have adverse effects on combatants and on attachment security, even three decades later. More important, in ex-POWs the relationship between these domains appears to be interactive and mutual, with one reinforcing the other, and vice versa. [ABSTRACT FROM AUTHOR]

Objective: The current study aimed to investigate (a) "secondary" posttraumatic growth (PTG) in wives of former prisoners of war (ex-POWs) and its association to husbands' captivity, husbands' posttraumatic stress disorder (PTSD), and husbands' PTSD trajectories; and (b) the bidirectional relationships over time between wives' posttraumatic stress symptoms (PTSS) and PTG. Method: The study compared 116 wives of Israeli ex-POWs from the 1973 Yom Kippur War with 56 wives of a matched control group of non-POW combat veterans. Wives were divided into groups according to husbands' captivity status, husbands' PTSD status, and husbands' PTSD trajectories; and ANOVAs and MANOVAs were conducted to assess group differences in PTSS and PTG, both cross-sectionally and longitudinally. Autoregressive cross-lag modeling was also used to assess bidirectional relationships between wives' PTSS and PTG over time. Results: Wives of ex-POWs with PTSD reported significantly higher PTG compared with wives of ex-POWs without PTSD and wives of controls. While PTG and PTSS remained stable over time, importantly, the Time 1 (T1) level of PTG predicted avoidance symptoms at Time 2 (T2); the higher the wives' PTG at T1, the higher their avoidance symptoms at T2, but not vice versa. Conclusions: These findings support the notion that "secondary PTG" exists. They also strengthen the theory that growth and distress can co-occur. Finally, the finding that PTG predicted subsequent avoidance symptoms suggests that PTG does not prevent the future development of distress. [ABSTRACT FROM AUTHOR]

Background:It is well documented that comorbid post-traumatic stress disorder (PTSD) in chronic pain is associated with a more severe symptom profile with respect to pain, disability and psychological distress. However, very few intervention studies exist targeting both PTSD and pain. The current study is the first randomized controlled trial evaluating the effect of the body-oriented trauma approach of Somatic Experiencing (SE) for comorbid PTSD and low back pain. Although the method is well recognized by clinicians and widely used, SE still needs to be tested in a randomized clinical trial in comparison with an active control group. Objective:The aim of the current study was to compare the effect of an SE intervention in addition to treatment-as-usual (TAU) for patients with chronic low back pain and comorbid PTSD compared to TAU alone. Method:The study was a two-group randomized controlled clinical trial. A cohort of patients (n = 1045) referred to a large Danish spine centre between February 2013 and October 2014 were screened for PTSD and randomized to either TAU (4–12 sessions of supervised exercises for low back pain) or TAU plus SE (6–12 sessions). In total, 91 patients fulfilled the inclusion criteria and volunteered to participate in the study. Treatment effects were evaluated by self-report questionnaires comparing baseline measures with 12-month follow-up measures. Results:The additional SE intervention significantly reduced the number of PTSD symptoms compared with TAU alone, corresponding to a large effect size. Also, fear of movement was significantly reduced (moderate effect size). Both groups achieved a large reduction in pain-catastrophizing, disability and pain. Conclusions:A brief additional SE intervention was found to have a significant effect on PTSD and fear of movement compared to TAU alone. However, the overall effect of SE was less than expected and the clinical importance of the effects can be questioned. [ABSTRACT FROM AUTHOR]