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[Indirect traumatization of spouses of Dutch war victims]
I Bramsen1, I E Reuling, H M van der Ploeg
1Afd. Medische Psychologie, Vrije Universiteit Amsterdam.
Objective:
To determine the specific problems experienced by spouses of Dutch war victims.
Design:
Cross-sectional written questionnaire investigation.
Method:
A written questionnaire was sent to 382 supporters of a foundation for spouses of war victims (Stichting Partners van Oorlogsgetroffenen (SPO)). This organization facilitates contact between fellow sufferers. The questionnaire incorporated elements from the 'Symptom checklist'-90, the 'Impact of event scale', and the 'Maudsley marital questionnaire'. The data obtained were compared to those from previous investigations. The first of these was among 346 spouses of veterans, members of a veteran organization (Bond van Nederlandse Militaire Oorlogs- en Dienstslachtoffers), who were subdivided into two groups, married to veterans with post-traumatic stress disorder (PTSS) (n = 76) and married to veterans without PTSS (n = 264). The second was with 555 women who had participated in a study, carried out in 1992, concerning the long-term effects of severe war experiences among elderly Dutch people.
Results:
The response rate was 161/382 (42%). The spouses experienced a high burden of care. All of their symptoms were significantly more severe than in the two comparison groups, but equalled those in the partners of veterans with PTSS, with the exception of the quality of the partner relation. This was significantly less than in the partners of veterans with PTSS. In particular, the spouses reported having problems with the war victim being uncommunicative, emotionally numb, sad, and irritable. Spouses themselves also reported posttraumatic reactions such as re-experiencing and avoidance that could not be explained by their own exposure to war and violence.
Conclusion:
The results confirm the theory that by their close contact with the war victim spouses are indirectly traumatized. It is recommended that the physician who has traumatized patients in his or her practice actively inquiries as to whether the spouse can cope with the situation and to what extent.