James J. Peters Veterans Affairs Medical Center.
Psychol Trauma. 2018 Jan;10(1):22-29. doi: 10.1037/tra0000302.
There is a growing literature on the intergenerational transmission of trauma, representing approaches across psychodynamic, family systems, epidemiological, sociological, and biological levels of analysis. Embitterment has been proposed as a response to severe, but normative, stressful events, different from the life-threatening trauma that precedes posttraumatic stress disorder (PTSD).
This article reviews the potential applicability of the construct of embitterment to trauma and intergenerational effects through (a) a historical review of the intergenerational transmission of trauma literature, (b) a discussion of embitterment versus PTSD, (c) a brief review of theories of mechanisms of transmission, and (d) a discussion of biological findings and their interpretation.
Mechanisms of intergenerational transmission of trauma, which may include psychodynamic processes, vicarious trauma, learning and modeling, parenting and family environment, and biological influences, are reviewed. Survivor coping and resilience, and specifically the presence of PTSD, has emerged as an important moderator of parental trauma effects on the second generation. A table comparing posttraumatic embitterment disorder and PTSD is provided.
The discussion emphasizes the importance of construing biological findings as flexible adaptations to stressors rather than deterministic indicators of damage, the relevance of context in interpreting such findings, and the role of community-level processes for healing. (PsycINFO Database Record
创伤的代际传递方面的文献日益增多,代表了精神分析、家庭系统、流行病学、社会学和生物学分析层面的方法。痛苦被认为是对严重但正常的压力事件的一种反应,与创伤后应激障碍(PTSD)之前的危及生命的创伤不同。
本文通过(a)对创伤和代际影响的代际传递文献进行历史回顾,(b)讨论痛苦与 PTSD 的区别,(c)简要回顾传播机制的理论,以及(d)讨论生物学发现及其解释,来审查痛苦这一结构在创伤和代际效应中的潜在适用性。
本文回顾了创伤的代际传递机制,其中可能包括心理动力学过程、替代性创伤、学习和模仿、养育和家庭环境以及生物学影响。幸存者的应对和适应能力,特别是 PTSD 的存在,已成为父母创伤对第二代影响的重要调节因素。还提供了一个比较创伤后痛苦障碍和 PTSD 的表格。
讨论强调了将生物学发现理解为对压力源的灵活适应而不是损伤的确定性指标的重要性,解释此类发现的背景的相关性,以及社区层面的愈合过程的作用。