The POW wife. A psychiatric appraisal

Long-Term Consequences of War Captivity in Military Veterans

Numerous studies on the health and functioning of veterans and former prisoners of war have shown that the experience of war captivity is one of the most difficult human experiences. Captivity is often characterized by extremely difficult and inhumane conditions, as well as exposure to various forms of both psychological and physical abuse. Such traumatic experiences can lead to serious psychological consequences that can last for years, even decades after release from captivity. The aim of this paper is to present a brief overview of research that points to the specifics of wartime captivity and the long-term psychological consequences in veterans of former camp detainees, as well as the consequences suffered by their families and factors that, apart from the intensity of the trauma, contribute to the emergence and persistence of psychological disorders. From the presented research, it can be concluded that former prisoners of the camp represent an extremely vulnerable group of the social community and require long-term appropriate treatment, while the needs of veterans' families should not be neglected, with the necessity of including spouses and children in psychological and psychosocial treatments.

Keeping a healthy distance: Self-differentiation and perceived health among ex-prisoners-of-war's wives

OBJECTIVE

War captivity may affect spouses of former-prisoners-of-war (ex-POWs) in many ways, including posttraumatic stress symptoms (PTSS) and somatic difficulties manifested in negative perceived health. This is generally known as secondary traumatization. Theory suggests that development of secondary traumatization occurs through the relationship with the primary trauma survivor Figley (1986) , thus implying that the ability to keep balanced emotional distance in the relationship may play a pivotal role. Notwithstanding, the contribution of self-differentiation to secondary somatic disturbances remains largely uninvestigated. The current study fills this gap.

METHODS

Ex-POWs' wives (n=143) and control former-combatants' wives (n=102), were assessed prospectively 30 (T1) and 38 (T2) years after the 1973 Yom Kippur War. Self-differentiation and PTSS were assessed at both time-points, while perceived health measures were assessed at T2.

RESULTS

Wives of ex-POWs endorsed higher PTSS, lower self-differentiation and negative perceived health, compared to control wives. Indirect exposure to war captivity was related to low self-differentiation and elevated PTSS, which predicted negative perceived health. Furthermore, self-differentiation characterized by fusion-with-others fully mediated the relation between indirect exposure to war captivity and perceived health, beyond the effects of PTSS as a mechanism.

CONCLUSION

Results suggest that tendencies towards fusion-with-others within the marital relationship, act as a risk factor not only for psychological distress but also for somatic distress among secondary trauma survivors. Hence, clinical interventions may seek to improve indirect trauma survivor's self-differentiation capacities, thus potentially facilitating the prevention of secondary somatic distress.

Suicidal Ideation Among Wives of Former Prisoners of War: A Longitudinal Dyadic Study

OBJECTIVES

The associations between posttraumatic stress disorder (PTSD) and suicidal ideation (SI) among ex-prisoners of war (ex-POWs) has recently been exemplified. Several studies have revealed the toll of war captivity in the secondary traumatization (ST) of ex-POWs' wives. This study aimed to assess SI among ex-POWs' wives and the longitudinal associations between their husbands' PTSD and their own ST.

METHOD

A sample of 233 Israeli couples (142 ex-POW couples and a comparison group of 91 veteran couples) completed self-report measures of PTSD symptoms, SI, and depression at two time points: T1 (2003) and T2 (2008), 30 and 37 years after the 1973 Yom Kippur War.

RESULTS

Among control wives, although not among ex-POWs' wives, the more ST symptoms they reported, the higher their level of SI. Furthermore, for both research groups, husbands' PTSD and wives' ST were positively associated with their own levels of SI, respectively. Autoregressive cross-legged (ARCL) analysis demonstrated that SI at T1 predicted ST at T2 among control wives but not among ex-POWs' wives. Surprisingly, an actor-partner interdependence modeling (APIM) analysis revealed, only among ex-POWs' couples, that the more the husbands suffered from PTSD and SI, the more moderate the increase of the wives' SI was between T1 and T2, thus, leading to better outcomes in terms of the wives' SI.

CONCLUSIONS

Ex-POWs' posttraumatic distress is longitudinally related to their spouses' ST and SI. Clinical implications of these findings of the relations between captivity trauma and suicidality for veteran couples are discussed.

Secondary traumatization and self-rated health among wives of former prisoners of war: The moderating role of marital adjustment

We investigated the relationships between secondary traumatization, marital adjustment, and self-rated health among wives of former prisoners of war. Participants were Israeli wives of former prisoners of war ( N = 116) and a matched control group of wives of combat veterans ( N = 56). Wives of former prisoners of war reported worse self-rated health compared to the control group of wives of combat veterans. Wives of former prisoners of war also reported higher levels of secondary traumatization, and marital adjustment moderated the relationship between wives’ secondary traumatization and their general health. The experience of living with former prisoners of war who might also suffer from posttraumatic stress disorder is associated with wives’ own psychological and self-rated health outcomes.

The Woes of Waiting Wives: Psychosocial Battle at Homefront

Few studies on stress have been carried out in soldiers and other paramilitary forces deployed in operational situations because of the security concerns, practical difficulties of conducting combat psychiatric studies and various other reasons. Studies on their families, who safeguard the family interests, during the period of absence of soldiers, have been even fewer. Significant contributions of researchers in this field were reviewed and suitably interpreted. Analysis revealed various types of stress and the multiple coping methods being practiced. It also highlighted various preventive and remedial measures being undertaken by waiting wives and their children. There is a need to understand and address the psychosocial issues of these families.

Differentiation of the self and posttraumatic symptomatology among ex-POWs and their wives

War captivity is a highly traumatic experience which sometimes has deleterious effects on both ex-POWs and their wives. This study examined the relationships between posttraumatic stress disorder (PTSD) symptoms and differentiation among male ex-prisoners of war (ex-POWs; n = 103), their wives (n = 82), and comparable controls. Results show that ex-POWs and their wives endorsed more PTSD symptoms than controls. Ex-POWs endorsed more cut-off and fusion than controls, while their wives endorsed only more fusion than control wives. Finally, the relationship between differentiation and PTSD was found to be stronger among ex-POW couples than among control couples. The unique characteristics of war captivity and the relationships between avoidance symptoms and cut-off were suggested as possible explanations.