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The Ravages of War Related PTSD Spread to Partners and Children of US Soldiers

The heartbreaking story of a family's secondary trauma.

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"It says here," Brannan says, her eyes narrowing incredulously, "that you spit on somebody today."

"Yes ma'am," Katie admits, lowering her voice and her eyes guiltily.

"Katie Vines." Brannan was born here in Alabama, so that's drawled. "Wah did you do that?"

Her schoolmate said something mean. Maybe. Katie doesn't sound sure, or like she remembers exactly. One thing she's positive of: "She just made me…so. MAD." Brannan asks Katie to name some of the alternatives. "Walk away, get the teacher, yes ma'am, no ma'am," Katie dutifully responds to the prompts. She looks disappointed in herself. Her eyebrows are heavily creased when she shakes her head and says quietly again, "I was so mad."

Brannan and Katie's teacher have conferenced about Katie's behavior many times. Brannan's not surprised she's picked up overreacting and yelling—you don't have to be at the Vines residence for too long to hear Caleb hollering from his room, where he sometimes hides for 18, 20 hours at a time, and certainly not if you're there during his nightmares, which Katie is. "She mirrors…she just mirrors" her dad's behavior, Brannan says. She can't get Katie to stop picking at the sores on her legs, sores she digs into her own skin with anxious little fingers. She is not, according to Brannan, "a normal, carefree six-year-old."

Different studies of the children of  American World War II, Korea, and Vietnam vets with PTSD have turned up different results: "45 percent" of kids  in one small study "reported significant PTSD signs"; "83 percent reported elevated hostility scores." Other studies have found a  "higher rate of psychiatric treatment""more dysfunctional social and emotional behavior""difficulties in establishing and maintaining friendships." The symptoms were similar to what those researchers had seen before, in perhaps the most analyzed and important population in the field of secondary traumatization: the children of Holocaust survivors.

But then in 2003, a team of Dutch and Israeli researchers  meta-analyzed 31 of the papers on Holocaust survivors' families, and concluded—to the fury of some clinicians—that when more rigorous controls were applied, there was no evidence for the intergenerational transmission of trauma.

I asked the lead scientist, Marinus van IJzendoorn of Leiden University, what might account for other studies' finding of secondary trauma in vets' spouses or kids. He said he's never analyzed those studies, and wonders if the results would hold up to a meta-analysis. But: "Suppose that there is a second-generation effect in veterans, there are a few differences that are quite significant" from children of Holocaust survivors that "might account for difference in coping mechanisms and resources." Holocaust survivors "had more resources and networks, wider family members and community to support them to adapt to their new circumstances after a war." They were not, in other words, expected to man up and get over it.

We await the results of the 20-year, 10,000-family-strong study of impacts on Iraq and Afghanistan veterans' kin, the largest of its kind ever conducted, that just got under way. Meanwhile, René Robi­chaux, social-work programs manager for US Army Medical Command, concedes that "in a family system, every member of that system is going to be impacted, most often in a negative way, by mental-health issues." That was the impetus for the Marriage and Family Therapy Program, which since 2005 has added 70 therapists to military installations around the country. Mostly what the program provides is couples' counseling. Children are "usually not" treated, but when necessary referred to child psychiatrists—of which the Army has 31. Meanwhile, the Child, Adolescent and Family Behavioral Health Office has trained hundreds of counselors in schools with Army children in and around bases to try to identify and treat coping and behavioral problems early on. "We're better than we were," Robi­chaux says. "But we still have a ways to go."

 
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