Complex trauma of war captivity: a prospective study of attachment and post-traumatic stress disorder

Zahava Solomon · Rachel Dekel · Mario Mikulincer

138 citations0/0 files storedPsychological Medicine

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Posttraumatic Stress Disorder Research Psychoanalysis and Psychopathology Research Migration, Health and Trauma

Abstract

BACKGROUND: Victims of war captivity sometimes suffer from complex post-traumatic stress disorder (PTSD), a unique form of PTSD that entails various alterations in personality. These alterations may involve changes in attachment orientation. METHOD: The sample comprised two groups of veterans from the 1973 Yom Kippur War: 103 ex-prisoners of war (ex-POWs) and 106 comparable control veterans. They were assessed at two points in time, 18 years and 30 years after the war. RESULTS: Ex-POWs suffered from more post-traumatic symptoms than controls at both measurements points and these symptoms increased only among ex-POWs from Time 1 to Time 2. In addition, both attachment anxiety and attachment avoidance increased with time among ex-POWs, whereas they decreased slightly or remained stable among controls. Finally, the increases in attachment anxiety and avoidance were positively associated with the increase in post-traumatic symptoms among both study groups. Further analyses indicated that early PTSD symptoms predicted later attachment better than early attachment predicted later PTSD symptoms. CONCLUSIONS: The results suggest that: (1) complex traumas are implicated in attachment orientations and PTSD symptoms even many years after captivity; (2) there is an increase in attachment insecurities (anxiety, avoidance) and an increase in PTSD symptoms decades after the captivity; (3) and post-traumatic stress symptoms predict attachment orientations better than attachment orientations predict an increase in PTSD symptoms.

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References

2013Diagnostic and Statistical Manual of Mental Disorders 2012Diagnostic and Statistical Manual of Mental Disorders 1988Diagnostic and Statistical Manual of Mental Disorders 1987Romantic love conceptualized as an attachment process.1987Romantic love conceptualized as an attachment process.2008Attachment in adulthood: structure, dynamics, and change 1998Self-report measurement of adult attachment: An integrative overview.1992Complex PTSD: A syndrome in survivors of prolonged and repeated trauma

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