Skip to main content
Erschienen in: Social Psychiatry and Psychiatric Epidemiology 2/2013

01.02.2013 | Original Paper

Family cohesion and posttraumatic intrusion and avoidance among war veterans: a 20-year longitudinal study

verfasst von: Gadi Zerach, Zahava Solomon, Danny Horesh, Tsachi Ein-Dor

Erschienen in: Social Psychiatry and Psychiatric Epidemiology | Ausgabe 2/2013

Einloggen, um Zugang zu erhalten

Abstract

Background

The bi-directional relationships between combat-induced posttraumatic symptoms and family relations are yet to be understood. The present study assesses the longitudinal interrelationship of posttraumatic intrusion and avoidance and family cohesion among 208 Israeli combat veterans from the 1982 Lebanon War.

Methods

Two groups of veterans were assessed with self-report questionnaires 1, 3 and 20 years after the war: a combat stress reaction (CSR) group and a matched non-CSR control group.

Results

Latent Trajectories Modeling showed that veterans of the CSR group reported higher intrusion and avoidance than non-CSR veterans at all three points of time. With time, there was a decline in these symptoms in both groups, but the decline was more salient among the CSR group. The latter also reported lower levels of family cohesion. Furthermore, an incline in family cohesion levels was found in both groups over the years. Most importantly, Autoregressive Cross-Lagged Modeling among CSR and non-CSR veterans revealed that CSR veterans’ posttraumatic symptoms in 1983 predicted lower family cohesion in 1985, and lower family cohesion, in turn, predicted posttraumatic symptoms in 2002.

Conclusions

The findings suggest that psychological breakdown on the battlefield is a marker for future family cohesion difficulties. Our results lend further support for the bi-directional mutual effects of posttraumatic symptoms and family cohesion over time.
Literatur
1.
Zurück zum Zitat Combrinck-Graham LA (1985) A developmental model for family systems. Fam Proc 24:139–150CrossRef Combrinck-Graham LA (1985) A developmental model for family systems. Fam Proc 24:139–150CrossRef
2.
Zurück zum Zitat Dekel R, Monson CM (2010) Military related post traumatic stress disorder and family relations: current knowledge and future directions. Aggress Violent Beh 15(4):303–309CrossRef Dekel R, Monson CM (2010) Military related post traumatic stress disorder and family relations: current knowledge and future directions. Aggress Violent Beh 15(4):303–309CrossRef
3.
Zurück zum Zitat Taft CT, Schumm JA, Panuzio J, Proctor SP (2008) An examination of family adjustment among Operation Desert Storm veterans. J Consult Clin Psychol 76:648–659PubMedCrossRef Taft CT, Schumm JA, Panuzio J, Proctor SP (2008) An examination of family adjustment among Operation Desert Storm veterans. J Consult Clin Psychol 76:648–659PubMedCrossRef
4.
Zurück zum Zitat O’Toole BI, Catts SV, Outram S, Pierse KR, Cockburn J (2009) The physical and mental health of Australian Vietnam veterans 3 decades after the war and its relation to military service, combat, and post-traumatic stress disorder. Am J Epidemiol 170:318–330PubMedCrossRef O’Toole BI, Catts SV, Outram S, Pierse KR, Cockburn J (2009) The physical and mental health of Australian Vietnam veterans 3 decades after the war and its relation to military service, combat, and post-traumatic stress disorder. Am J Epidemiol 170:318–330PubMedCrossRef
5.
Zurück zum Zitat American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text rev. American Psychiatric Association, Washington American Psychiatric Association (2000) Diagnostic and Statistical Manual of Mental Disorders, 4th edn, text rev. American Psychiatric Association, Washington
6.
Zurück zum Zitat Solomon Z, Mikulincer M (2006) Trajectories of PTSD: a 20-year longitudinal study. Am J Psych 163:659–666CrossRef Solomon Z, Mikulincer M (2006) Trajectories of PTSD: a 20-year longitudinal study. Am J Psych 163:659–666CrossRef
7.
Zurück zum Zitat Koenen K, Stellman JM, Stellman SD, Sommer JF (2003) Risk factors for course of posttraumatic stress disorder among Vietnam veterans: a 14-Year follow- up of American legionnaires. J Consult Clin Psychol 71:980–986PubMedCrossRef Koenen K, Stellman JM, Stellman SD, Sommer JF (2003) Risk factors for course of posttraumatic stress disorder among Vietnam veterans: a 14-Year follow- up of American legionnaires. J Consult Clin Psychol 71:980–986PubMedCrossRef
8.
Zurück zum Zitat Zeiss RA, Dickman HR (1989) PTSD 40 years later: incidence a person-situation correlates in former POW’s. J Clin Psychol 45:80–87PubMedCrossRef Zeiss RA, Dickman HR (1989) PTSD 40 years later: incidence a person-situation correlates in former POW’s. J Clin Psychol 45:80–87PubMedCrossRef
9.
Zurück zum Zitat Wolfe J, Erickson DJ, Sharkansky EJ, King DW, King LA (1999) Course and predictors of posttraumatic stress disorder among gulf war veterans: a prospective analysis. J Consult Clin Psychol 67:520–528PubMedCrossRef Wolfe J, Erickson DJ, Sharkansky EJ, King DW, King LA (1999) Course and predictors of posttraumatic stress disorder among gulf war veterans: a prospective analysis. J Consult Clin Psychol 67:520–528PubMedCrossRef
10.
Zurück zum Zitat Port LC, Engdahl B, Frazier P (2001) A longitudinal and retrospective study of PTSD among older prisoners of war. Am J Psychiatry 158:1474–1479PubMedCrossRef Port LC, Engdahl B, Frazier P (2001) A longitudinal and retrospective study of PTSD among older prisoners of war. Am J Psychiatry 158:1474–1479PubMedCrossRef
11.
Zurück zum Zitat Orcutt HK, Erickson DJ, Wolfe J (2004) The course of PTSD symptoms among Gulf War veterans: a growth mixture modeling approach. J Trauma Stress 17:195–202PubMedCrossRef Orcutt HK, Erickson DJ, Wolfe J (2004) The course of PTSD symptoms among Gulf War veterans: a growth mixture modeling approach. J Trauma Stress 17:195–202PubMedCrossRef
12.
Zurück zum Zitat Mililiken CS, Auchterlonie JL, Hoge CW (2007) Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA 298(18):2141–2148CrossRef Mililiken CS, Auchterlonie JL, Hoge CW (2007) Longitudinal assessment of mental health problems among active and reserve component soldiers returning from the Iraq war. JAMA 298(18):2141–2148CrossRef
13.
Zurück zum Zitat Erbes CR, Meis LA, Polusny MA, Compton JS (2011) Couple adjustment and posttraumatic stress disorder symptoms in National Guard veterans of the Iraq war. J Fam Psych 25:479–487CrossRef Erbes CR, Meis LA, Polusny MA, Compton JS (2011) Couple adjustment and posttraumatic stress disorder symptoms in National Guard veterans of the Iraq war. J Fam Psych 25:479–487CrossRef
14.
Zurück zum Zitat O’Donnell C, Cook JM, Thompson R, Riley K, Neria Y (2006) Verbal and physical aggression in World War II former prisoners of war: role of posttraumatic stress disorder and depression. J Trauma Stress 19:859–866PubMedCrossRef O’Donnell C, Cook JM, Thompson R, Riley K, Neria Y (2006) Verbal and physical aggression in World War II former prisoners of war: role of posttraumatic stress disorder and depression. J Trauma Stress 19:859–866PubMedCrossRef
15.
Zurück zum Zitat Kulka RA, Schlenger WE, Fairbank JA, Hough RL, Jordan BK, Marmar CR, Weiss DS (1990) Trauma and the Vietnam War Generation. Brunner/Mazel, New York Kulka RA, Schlenger WE, Fairbank JA, Hough RL, Jordan BK, Marmar CR, Weiss DS (1990) Trauma and the Vietnam War Generation. Brunner/Mazel, New York
16.
Zurück zum Zitat Taft CT, Pless AP, Stalans LJ, Koenen KC, King LA, King DW (2005) Risk factors for partner violence among national sample of combat veterans. J Consult Clin Psychol 73:151–159PubMedCrossRef Taft CT, Pless AP, Stalans LJ, Koenen KC, King LA, King DW (2005) Risk factors for partner violence among national sample of combat veterans. J Consult Clin Psychol 73:151–159PubMedCrossRef
17.
Zurück zum Zitat Allen ES, Rhoades GK, Stanley SM, Markman HJ (2010) Hitting home: relationships between recent deployment, posttraumatic stress symptoms, and marital functioning for army couples. J Fam Psychol 24(3):280–288PubMedCrossRef Allen ES, Rhoades GK, Stanley SM, Markman HJ (2010) Hitting home: relationships between recent deployment, posttraumatic stress symptoms, and marital functioning for army couples. J Fam Psychol 24(3):280–288PubMedCrossRef
18.
Zurück zum Zitat Zerach G, Ben-David A, Solomom Z, Heruti R (2010) Posttraumatic symptoms, marital intimacy, dyadic adjustment and sexual satisfaction among ex-prisoners of war. J Sex Med 7:2739–2749PubMedCrossRef Zerach G, Ben-David A, Solomom Z, Heruti R (2010) Posttraumatic symptoms, marital intimacy, dyadic adjustment and sexual satisfaction among ex-prisoners of war. J Sex Med 7:2739–2749PubMedCrossRef
19.
Zurück zum Zitat Renshaw KD, Rodrigues CS, Jones DH (2008) Psychological symptoms and marital satisfaction in spouses of Operation Iraqi Freedom veterans: relationships with spouses’ perception of veterans’ experiences and symptoms. J Fam Psychol 22:586–594PubMedCrossRef Renshaw KD, Rodrigues CS, Jones DH (2008) Psychological symptoms and marital satisfaction in spouses of Operation Iraqi Freedom veterans: relationships with spouses’ perception of veterans’ experiences and symptoms. J Fam Psychol 22:586–594PubMedCrossRef
20.
Zurück zum Zitat Riggs DS, Byrne CA, Weathers FW, Litz BT (1998) The quality of the intimate relationships of male Vietnam veterans: problems associated with posttraumatic stress disorder. J Trauma Stress 11:87–101PubMedCrossRef Riggs DS, Byrne CA, Weathers FW, Litz BT (1998) The quality of the intimate relationships of male Vietnam veterans: problems associated with posttraumatic stress disorder. J Trauma Stress 11:87–101PubMedCrossRef
21.
Zurück zum Zitat Hendrix CC, Jurich A, Schumm WR (1995) Long-term impact of Vietnam war service on family environment and satisfaction. Fam Soc 76:498–506 Hendrix CC, Jurich A, Schumm WR (1995) Long-term impact of Vietnam war service on family environment and satisfaction. Fam Soc 76:498–506
22.
Zurück zum Zitat Sutker PB, Davis JM, Uddo M, Ditta SR (1995) War zone stress, personal resources, and PTSD in Persian Gulf War returnees. J Abnorm Psychol 104:444–452PubMedCrossRef Sutker PB, Davis JM, Uddo M, Ditta SR (1995) War zone stress, personal resources, and PTSD in Persian Gulf War returnees. J Abnorm Psychol 104:444–452PubMedCrossRef
23.
Zurück zum Zitat Solomon Z, Mikulincer M, Freid B, Wosner Y (1987) Family characteristic and posttraumatic stress disorder: a follow-up of Israeli combat stress reaction casualties. Fam Proc 26:383–394CrossRef Solomon Z, Mikulincer M, Freid B, Wosner Y (1987) Family characteristic and posttraumatic stress disorder: a follow-up of Israeli combat stress reaction casualties. Fam Proc 26:383–394CrossRef
24.
Zurück zum Zitat Galovski T, Lyons JA (2004) Psychological sequelae of combat violence: a review of the impact of PTSD on veteran’s family and possible interventions. Aggress Violent Beh 9:477–501CrossRef Galovski T, Lyons JA (2004) Psychological sequelae of combat violence: a review of the impact of PTSD on veteran’s family and possible interventions. Aggress Violent Beh 9:477–501CrossRef
25.
Zurück zum Zitat King DW, King LA, Foy DW, Keane TM, Fairbank JA (1999) Posttraumatic stress disorder in a national sample of female and male Vietnam veterans: Risk factors, war-zone stressors, and resilience-recovery variables. J Abnorm Psychol 108:164–170PubMedCrossRef King DW, King LA, Foy DW, Keane TM, Fairbank JA (1999) Posttraumatic stress disorder in a national sample of female and male Vietnam veterans: Risk factors, war-zone stressors, and resilience-recovery variables. J Abnorm Psychol 108:164–170PubMedCrossRef
26.
Zurück zum Zitat Vogt D, Smith B, Elwy R, Martin J, Schultz M, Drainoni M, Eisen S (2011) Predeployment, deployment, and postdeployment risk factors for posttraumatic stress symptomatology in female and male OEF/OIF veterans. J Abnorm Psych 120:819–831CrossRef Vogt D, Smith B, Elwy R, Martin J, Schultz M, Drainoni M, Eisen S (2011) Predeployment, deployment, and postdeployment risk factors for posttraumatic stress symptomatology in female and male OEF/OIF veterans. J Abnorm Psych 120:819–831CrossRef
27.
Zurück zum Zitat Hosek JR, Kavanagh J, Miller L (2006) How deployments affect service members. The RAND Corporation, Santa Monica Hosek JR, Kavanagh J, Miller L (2006) How deployments affect service members. The RAND Corporation, Santa Monica
28.
Zurück zum Zitat Warner CH, Appenzeller GN, Warner CM, Grieger T (2009) Psychological effects of deployments of military families. Psycihat Ann 39:56–63CrossRef Warner CH, Appenzeller GN, Warner CM, Grieger T (2009) Psychological effects of deployments of military families. Psycihat Ann 39:56–63CrossRef
29.
Zurück zum Zitat Figley CR (1983) Catastrophes: An overview of family reactions. In: Figley CR, Hamilton IM (eds) Stress and the Family, II: Coping with Catastrophe. Brunner/Mazel, New York, pp 3–36 Figley CR (1983) Catastrophes: An overview of family reactions. In: Figley CR, Hamilton IM (eds) Stress and the Family, II: Coping with Catastrophe. Brunner/Mazel, New York, pp 3–36
30.
Zurück zum Zitat Silver SM, Iacono C (1986) Symptom group and family patterns of Vietnam veterans with Post-traumatic strees disorders. In: Figley CR (ed) Trauma and its wake, II: Traumatic stress, theory, research, and intervention. Brunner/Mazel, New York, pp 78–96 Silver SM, Iacono C (1986) Symptom group and family patterns of Vietnam veterans with Post-traumatic strees disorders. In: Figley CR (ed) Trauma and its wake, II: Traumatic stress, theory, research, and intervention. Brunner/Mazel, New York, pp 78–96
31.
Zurück zum Zitat Nelson-Goff BS, Smith DB (2005) Systemic traumatic stress: the couple adaptation to traumatic stress model. J Marital Fam Ther 31(2):145–157CrossRef Nelson-Goff BS, Smith DB (2005) Systemic traumatic stress: the couple adaptation to traumatic stress model. J Marital Fam Ther 31(2):145–157CrossRef
32.
Zurück zum Zitat Benotsch EG, Brailey K, Vasterling JJ, Uddo M, Constans JI, Sutker PB (2000) War Zone stress, personal and environmental resources, and PTSD symptoms in Gulf War Veterans: a longitudinal perspective. J Abnorm Psychol 109:205–213PubMedCrossRef Benotsch EG, Brailey K, Vasterling JJ, Uddo M, Constans JI, Sutker PB (2000) War Zone stress, personal and environmental resources, and PTSD symptoms in Gulf War Veterans: a longitudinal perspective. J Abnorm Psychol 109:205–213PubMedCrossRef
33.
Zurück zum Zitat Evans L, Cowlishaw S, Hopwood M (2009) Family functioning predicts outcomes for veterans in treatment for chronic posttraumatic stress disorder. J Fam Psychol 23(4):531–539PubMedCrossRef Evans L, Cowlishaw S, Hopwood M (2009) Family functioning predicts outcomes for veterans in treatment for chronic posttraumatic stress disorder. J Fam Psychol 23(4):531–539PubMedCrossRef
34.
Zurück zum Zitat Whisman MA, Uebelacker LA, Bruce ML (2006) Longitudinal association between marital dissatisfaction and alcohol use disorders in a community sample. J Fam Psychol 20(1):164–167PubMedCrossRef Whisman MA, Uebelacker LA, Bruce ML (2006) Longitudinal association between marital dissatisfaction and alcohol use disorders in a community sample. J Fam Psychol 20(1):164–167PubMedCrossRef
35.
Zurück zum Zitat Horowitz M, Wilner N, Alvarez W (1979) Impact of Event Scale: a measure of subjective stress. Psychosom Med 41:209–218PubMed Horowitz M, Wilner N, Alvarez W (1979) Impact of Event Scale: a measure of subjective stress. Psychosom Med 41:209–218PubMed
36.
Zurück zum Zitat Schwartwald J, Solomon Z, Weisenberg M, Mikulincer M (1987) Validation of Impact of Event Scale for psychological sequelae of combat. J Consult Clin Psychol 55:251–256CrossRef Schwartwald J, Solomon Z, Weisenberg M, Mikulincer M (1987) Validation of Impact of Event Scale for psychological sequelae of combat. J Consult Clin Psychol 55:251–256CrossRef
37.
Zurück zum Zitat Horowitz MJ (1976) Stress Response Syndromes. Jason Aronson, New York Horowitz MJ (1976) Stress Response Syndromes. Jason Aronson, New York
38.
Zurück zum Zitat Horowitz M (1982) Stress response syndromes and their treatment. In: Goldberger L, Breznitz S (eds) Handbook of stress: Theoretical and Clinical Aspects. Free Press, New York, pp 711–732 Horowitz M (1982) Stress response syndromes and their treatment. In: Goldberger L, Breznitz S (eds) Handbook of stress: Theoretical and Clinical Aspects. Free Press, New York, pp 711–732
39.
Zurück zum Zitat Sundin EC, Horowitz MJ (2002) Impact of Event Scale: psychometric properties. Br J Psychiatry 180:205–209PubMedCrossRef Sundin EC, Horowitz MJ (2002) Impact of Event Scale: psychometric properties. Br J Psychiatry 180:205–209PubMedCrossRef
40.
Zurück zum Zitat Moos RH, Moos BS (1986) Family Environment Scale Manual, 2nd edn. Consulting Psychologists Press, Palo Alto Moos RH, Moos BS (1986) Family Environment Scale Manual, 2nd edn. Consulting Psychologists Press, Palo Alto
41.
Zurück zum Zitat Olson DH (1999) Circumplex model of marital and family systems. In: Walsh F (ed) Normal Family Processes, 2nd edn. Guilford Press, New York Olson DH (1999) Circumplex model of marital and family systems. In: Walsh F (ed) Normal Family Processes, 2nd edn. Guilford Press, New York
42.
Zurück zum Zitat Bollen KA, Curran PJ (2006) Latent Curve Models. A Structural Equation Perspective. Wiley-Interscience, Hoboken Bollen KA, Curran PJ (2006) Latent Curve Models. A Structural Equation Perspective. Wiley-Interscience, Hoboken
43.
Zurück zum Zitat Bentler PM, Wu EJ (1995) EQS for Windows User’s Guide. Multivariate Software, Encino Bentler PM, Wu EJ (1995) EQS for Windows User’s Guide. Multivariate Software, Encino
44.
Zurück zum Zitat Anderson TW (1960) Some stochastic process models for intelligence test scores. In: Arrow KJ, Karlin K, Suppes P (eds) Mathematical Methods in the Social Sciences. Stanford University Press, Stanford Anderson TW (1960) Some stochastic process models for intelligence test scores. In: Arrow KJ, Karlin K, Suppes P (eds) Mathematical Methods in the Social Sciences. Stanford University Press, Stanford
45.
Zurück zum Zitat Nash WP (2007) Combat/operational stress adaptations and injuries. In: Figley CR, Nash WP (eds) Combat Stress Injury: Theory, Research, and Management. Routledge, New York, pp 33–64 Nash WP (2007) Combat/operational stress adaptations and injuries. In: Figley CR, Nash WP (eds) Combat Stress Injury: Theory, Research, and Management. Routledge, New York, pp 33–64
46.
Zurück zum Zitat Creamer M, Burgess P, Pattison P (1992) Reaction to trauma: a cognitive processing model. J Abnorm Psychol 101:452–459PubMedCrossRef Creamer M, Burgess P, Pattison P (1992) Reaction to trauma: a cognitive processing model. J Abnorm Psychol 101:452–459PubMedCrossRef
47.
Zurück zum Zitat Horowitz MJ (1997) Stress Response Syndromes, 3rd edn. Jason Aronson, New York Horowitz MJ (1997) Stress Response Syndromes, 3rd edn. Jason Aronson, New York
48.
Zurück zum Zitat Sundin EC, Horowitz MJ (2003) Horowitz’s impact of Event Scale evaluation of 20 years of use. Psychosom Med 65:870–876PubMedCrossRef Sundin EC, Horowitz MJ (2003) Horowitz’s impact of Event Scale evaluation of 20 years of use. Psychosom Med 65:870–876PubMedCrossRef
49.
Zurück zum Zitat Ehlers A, Clark DM (2000) A cognitive model of Posttraumatic stress disorder. Behav Res Ther 38:319–345PubMedCrossRef Ehlers A, Clark DM (2000) A cognitive model of Posttraumatic stress disorder. Behav Res Ther 38:319–345PubMedCrossRef
50.
Zurück zum Zitat Hackmann A, Ehlers A, Speckens A, Clark DM (2004) Characteristics and content of intrusive memories in PTSD and their changes with treatment. J Trauma Stress 17:231–240PubMedCrossRef Hackmann A, Ehlers A, Speckens A, Clark DM (2004) Characteristics and content of intrusive memories in PTSD and their changes with treatment. J Trauma Stress 17:231–240PubMedCrossRef
51.
Zurück zum Zitat Koren D, Arnon I, Klein E (2001) Long term course of chronic posttraumatic stress disorder in traffic accident victims: a three-year prospective follow-up study. Beh Res Ther 39:1449–1458CrossRef Koren D, Arnon I, Klein E (2001) Long term course of chronic posttraumatic stress disorder in traffic accident victims: a three-year prospective follow-up study. Beh Res Ther 39:1449–1458CrossRef
52.
Zurück zum Zitat Solomon Z, Zur-Noah S, Horesh D, Zerach G, Keinan G (2008) Contribution of stressful life events throughout the life cycle to combat-induced psychopathology. J Trauma Stress 21:318–325PubMedCrossRef Solomon Z, Zur-Noah S, Horesh D, Zerach G, Keinan G (2008) Contribution of stressful life events throughout the life cycle to combat-induced psychopathology. J Trauma Stress 21:318–325PubMedCrossRef
53.
Zurück zum Zitat Boss P, Couden BA (2002) Ambiguous loss from chronic physical illness: clinical interventions with individuals, couples, and families. J Clin Psychol 58:1351–1360PubMedCrossRef Boss P, Couden BA (2002) Ambiguous loss from chronic physical illness: clinical interventions with individuals, couples, and families. J Clin Psychol 58:1351–1360PubMedCrossRef
54.
Zurück zum Zitat Beckham JC, Moore SD, Reynolds V (2000) Interpersonal hostility and violence in Vietnam combat veterans with chronic posttraumatic stress disorder: a review of theoretical models and empirical evidence. Aggress Violent Beh 5:451–466CrossRef Beckham JC, Moore SD, Reynolds V (2000) Interpersonal hostility and violence in Vietnam combat veterans with chronic posttraumatic stress disorder: a review of theoretical models and empirical evidence. Aggress Violent Beh 5:451–466CrossRef
55.
Zurück zum Zitat Solomon Z (1988) The effect of combat-related posttraumatic stress disorder on the family. Psychiatry 51:323–329PubMed Solomon Z (1988) The effect of combat-related posttraumatic stress disorder on the family. Psychiatry 51:323–329PubMed
56.
Zurück zum Zitat Harkness LL (1993) Transgenerational transmission of war- related trauma. In: Wilson JP, Raphael B (eds) International Handbook of Traumatic Stress Syndromes. Plenum, New York, pp 635–641CrossRef Harkness LL (1993) Transgenerational transmission of war- related trauma. In: Wilson JP, Raphael B (eds) International Handbook of Traumatic Stress Syndromes. Plenum, New York, pp 635–641CrossRef
57.
Zurück zum Zitat American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association, Washington American Psychiatric Association (1994) Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Association, Washington
58.
Zurück zum Zitat Weiss S, Marmar CR (1997) The Impact of Event Scale-Revised. In: Wilson JP, Keane TM (eds) Assessing psychological trauma and PTSD: A handbook for practitioners. Guilford Press, New York, pp 399–411 Weiss S, Marmar CR (1997) The Impact of Event Scale-Revised. In: Wilson JP, Keane TM (eds) Assessing psychological trauma and PTSD: A handbook for practitioners. Guilford Press, New York, pp 399–411
59.
Zurück zum Zitat Sherman MD, Zanotti DK, Jones DE (2005) Key elements in couple’s therapy with veterans with combat-related posttraumatic stress disorder. Prof Psychol Res Prac 36:626–633CrossRef Sherman MD, Zanotti DK, Jones DE (2005) Key elements in couple’s therapy with veterans with combat-related posttraumatic stress disorder. Prof Psychol Res Prac 36:626–633CrossRef
Metadaten
Titel
Family cohesion and posttraumatic intrusion and avoidance among war veterans: a 20-year longitudinal study
verfasst von
Gadi Zerach
Zahava Solomon
Danny Horesh
Tsachi Ein-Dor
Publikationsdatum
01.02.2013
Verlag
Springer-Verlag
Erschienen in
Social Psychiatry and Psychiatric Epidemiology / Ausgabe 2/2013
Print ISSN: 0933-7954
Elektronische ISSN: 1433-9285
DOI
https://doi.org/10.1007/s00127-012-0541-6

Weitere Artikel der Ausgabe 2/2013

Social Psychiatry and Psychiatric Epidemiology 2/2013 Zur Ausgabe

Update Psychiatrie

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.