Group Project for Holocaust Survivors and their Children.
Department of Psychiatry, Geisel School of Medicine at Dartmouth.
Psychol Trauma. 2017 Aug;9(Suppl 1):98-106. doi: 10.1037/tra0000192. Epub 2016 Sep 19.
Because findings on the mental health status of Holocaust survivors' offspring have been inconsistent, we aimed to identify factors that place some offspring at greater risk for developing mood or anxiety disorders.
Using a web-based survey and structured clinical interviews with adult children of survivors, we attempted to predict disorders from offspring's circumstances, perceptions of parents' posttrauma adaptational styles, and self-reported reparative adaptational impacts. Posttrauma adaptational styles encompass intrafamilial and interpersonal psychological, social and behavioral coping, mastery, and defense mechanisms used by each parent. Reparative adaptational impacts reflect the offspring's self-reported insecurity about their own competence, reparative protectiveness, need for control, obsession with the Holocaust, defensive psychosocial constriction, and immature dependency.
Of the disorders studied, generalized anxiety disorder was most frequent, followed by major depressive episode and posttraumatic stress disorder (PTSD). Only 2 variables independently predicted these disorders: participants' age and reparative adaptational impacts. Parents' styles were correlated with the presence of disorder, but had no effect when the child's reparative impacts were controlled. The age effect was consistent with epidemiologic research showing lower prevalence of psychological disorder in older cohorts. The severity of participants' reparative impacts was unequivocally the most important (OR = 5.3) or at least the most proximal precursor to the development of psychological disorders. When reparative impacts were low, frequency of disorder was low (8%); when reparative impacts were high, frequency of disorder was high (46%).
Reparative adaptational impacts could guide clinicians in treating children of survivors. (PsycINFO Database Record
由于有关大屠杀幸存者后代心理健康状况的研究结果并不一致，我们旨在确定哪些因素会使一些后代更易患情绪或焦虑障碍。
我们使用基于网络的调查和对幸存者成年子女的结构化临床访谈，试图从后代的情况、父母创伤后适应方式的感知以及自我报告的修复适应影响来预测障碍。创伤后适应方式包括父母双方在家庭内和人际间使用的心理、社会和行为应对、掌握和防御机制。修复适应影响反映了子女对自身能力、修复保护、控制需求、对大屠杀的痴迷、防御性心理社会限制以及不成熟的依赖的自我报告的不安全感。
在所研究的障碍中，广泛性焦虑障碍最常见，其次是重性抑郁发作和创伤后应激障碍（PTSD）。只有 2 个变量独立预测了这些障碍：参与者的年龄和修复适应影响。父母的风格与障碍的存在相关，但在控制了孩子的修复影响时，没有影响。年龄效应与流行病学研究一致，即年龄较大的队列中心理障碍的患病率较低。参与者修复影响的严重程度无疑是最重要的（OR=5.3），或者至少是心理障碍发展的最直接前兆。当修复影响较低时，障碍的频率较低（8%）；当修复影响较高时，障碍的频率较高（46%）。
修复适应影响可以指导临床医生治疗幸存者的子女。
