Trajectories of depression in aging veterans and former prisoners-of-war: The role of social support and hardiness.

OBJECTIVES: Depression is a prevalent outcome of traumatic experiences, such as combat and war captivity. This study explores the heterogeneity of changes over time and assesses the contribution of trauma exposure (combat vs. war captivity), hardiness, and social support for depression trajectories. METHODS: Two groups of Israeli veterans were assessed in 1991, 2003, 2008, and 2015: 149 former prisoners-of-war (ex-POWs) and 107 combat veterans. Protective factors were evaluated in 1991. Group-based trajectory modeling was conducted to identify latent trajectories of change. RESULTS: Four trajectories of "resiliency" (62.8%), "delayed onset" (25.1%), "exacerbation" (6.2%), and "chronicity" (5.9%) were found. The majority of the resilient group were combat veterans whereas the clinical groups consisted primarily of ex-POWs. Lower hardiness and social support were related to more deleterious trajectories. CONCLUSIONS: Spirals of loss involving hardiness and social support, normative experiences, and contextual factors may present explanations for the various depression trajectories.

Far away, so close: The role of self-differentiation in psychopathology among spouses of ex-POWs and comparable combatants.

OBJECTIVE: War captivity entails severe posttraumatic implications for ex-prisoners of war (POWs) and their partners. This study examines the role of self-differentiation in secondary traumatization and dyadic adjustment among ex-POWs' spouses. METHODS: A total of 106 spouses of Israeli ex-POWs and 56 matched spouses of ex-combatants completed self-report questionnaires assessing secondary posttraumatic stress disorder symptoms (SPS), self-differentiation (fusion, cut-off, balanced), general psychiatric distress (GPD), and dyadic adjustment. RESULTS: Ex-POWs' spouses reported lower dyadic adjustment and higher levels of SPS, GPD, and fusion and cut-off differentiation, compared to ex-combatants' spouses. A "mixed" differentiation style characterized by high levels of both fusion and cut-off was associated with particularly high distress levels. Fusion differentiation moderated the association between SPS/GPD and dyadic adjustment. CONCLUSION: Self-differentiation plays an important role in posttraumatic spousal relationships. Women showing unstable differentiation may be particularly vulnerable when living with a veteran. Treatments for posttraumatic couples should target dysregulated interpersonal distance and promote adaptive differentiation.

Suicide among Polish officers during World War II in Oflag II-C Woldenberg.

Although scholars have examined the occurrence of suicide in the concentration camps during World War Two, little has appeared on suicide in prisoner-of-war camps. The present note presents an attempt to document the occurrence of suicide in the Oflag II-C Woldenberg camp in what is now Western Poland, and estimates a suicide rate of between 22.4 to 38.4 per 100,000 per year in the roughly 6,600 prisoners.

[Central Work Camp in Jaworzno (1945-1949) -- epidemiological aspects -- attempt of evaluation]. / Centralny Obóz Pracy w Jaworznie (1945-1949) -- aspekty epidemiologiczne -- próba oceny.

Publication presents the short history of camp hospital which was organised in 1943 Nazi concentration camp Neu-Dachs in Jaworzno. The camp was a branch of Oswiecim concentration camp. Atfer the war damage of the camp, the restoration was begun in 1945. Already in Febraury 1945, in place of German concentration camp, rises Central Work Camp. Several thousands of prisoners of war were placed there. The prisoners of war: Germans, Volksdeutches, Silesians were forced emlpoyed in nearby coal mines. Since 1947 the camp was a place of staying for several thousands Ukrainians who were displaced from eastern part of Poland in "Vistula Operation". Based on available written materials, publication is an attempt to analyse and evaluate: sanitary conditions, prison illnesses, mortality reasons among prisoners, hospital equipment, personel work conditions. The publication gives opportunity to compare conditions of prison hospital under nazi occupation and conditions in the camp which was organised in the same place under Stalin system of terror.

What predicts unremitting suicidal ideation? A prospective examination of the role of subjective age in suicidal ideation among ex-prisoners of war.

OBJECTIVE: Research has demonstrated that traumatic experiences have significant links to suicidal ideation (SI), particularly among older adults. The present study examined SI among older adults with a history of war trauma and the role of perceptions relating to one's age (subjective age) in predicting SI. METHOD: Drawing from a larger longitudinal study, we analyzed data based on interviews with 125 ex-prisoners of war (ex-POWS) from Israel's 1973 Yom Kippur War and a control group of 101 veterans from the same war who did not fall captive (mean age at most recent measurement was 65.05, SDage = 5.29). Participants were interviewed in 2008 (T1) and again in 2015 (T2). RESULTS: Findings revealed significantly higher levels of SI among ex-POWs than evident among controls and significantly higher levels of SI and subjective age among ex-POWs with PTSD. Furthermore, a sequential mediation analysis indicated that among ex-POWs, the path from T1 PTSD symptoms to subsequent SI was mediated by subjective age at T1, and subjective age at T2, after controlling for age, self-rated health, and SI at T1. CONCLUSION: A subset of ex-POWs are exposed to continuous suicidal risk throughout their later life, more than 40 years after the war. Furthermore, an older subjective age mediated these associations, independent of the levels of T1 SI, actual age, and self-rated health. These findings suggest debilitating long-term effects of trauma for SI in later life and their connections to advanced psychological aging. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Decreased Mortality of falciparum Malaria in Anemic Prisoners of War?

Modern clinical trials have suggested that anemia protects against malaria mortality. Military records of the Second World War in Asia were examined to see if there was support for this hypothesis. When relatively well-nourished Imperial Japanese Navy sailors captured on Nauru (n = 799) were imprisoned on the Fauro Islands, 26% died from falciparum malaria. Similarly treated but very malnourished colocated Imperial Army soldiers experienced low stable malaria mortality. One-fifth of previously healthy Australian Army soldiers (n = 252) retreating from New Britain died largely because of malaria in April 1942. Malnourished prisoners of war, who were as a group very anemic, both Australian Army soldiers in Thailand and Japanese Army soldiers in Papua New Guinea, had high malaria rates but very low (< 3%) mortality rates. Malaria immunity does not adequately explain this dichotomy, suggesting that severe nutritional deprivation may be protective against malaria mortality possibly because of iron-deficiency anemia.

One 'knows': self-rated health and telomere length among ex-prisoners of war.

OBJECTIVE: Ill-health and early mortality are amongst the most significant ramifications of trauma. Furthermore, trauma alters the subjective perception and experience of the body. The aim of this study is to examine the extent to which deteriorations in perceived health among traumatised individuals are associated with cellular health as manifested in telomere length. METHODS: Specifically, 88 former prisoners of war (ex-POWs) evaluated their health (self-rated health; SRH) at 18 (T1), 35 (T2) and 42 (T3) years after the war, and were assessed for telomere length at T3. Health behaviour, BMI, morbidity and PTSD were also examined at T3. RESULTS: The findings demonstrated that SRH was cross-sectionally correlated with telomere length. Furthermore, a significant sequential indirect effect was found, in which worse SRH in T1 was associated with shorter telomere length at T3, through worse SRH at T2 and at T3. CONCLUSIONS: These findings demonstrate that long-term deteriorations in the subjective evaluations of health are implicated in actual cellular health among individuals exposed to trauma.

Gender differences in posttraumatic stress symptoms among former prisoners of wars' adult offspring.

OBJECTIVES: The lifetime risk for posttraumatic stress disorder (PTSD) and PTSD symptoms (PTSS) among primary and secondary female victims is known to be higher than for male. This study assessed gender differences in PTSS among former prisoners of war's (ex-POWs) adult offspring and the associations with their fathers' and mothers' PTSS and the parental bonding with them. DESIGN: A correlative study. METHODS: A sample of 79 Israeli father-mother-offspring ex-POW triads from the 1973 Yom Kippur War completed self-report measures. Fathers were assessed in 2008, mothers were assessed in 2011 and their adult offspring took part in 2014. RESULTS: Sons of ex-POWs reported higher levels of PTSS as compared to daughters of ex-POWs. However, fathers' PTSS was positively related to daughters' PTSS, but not significantly related to sons' PTSS. Daughters' PTSS were also associated with both parents' lower care and higher overprotection, while sons' PTSS were associated only with fathers' lower care and higher overprotection. CONCLUSIONS: Among adult offspring of ex-POWs, sons are at greater risk for psychological distress in the form of PTSS. Nevertheless, the intergenerational transmission of captivity-related PTSS from both fathers and spouses to their offspring is more prominent among daughters of ex-POWs.

Guilt as a mediator between depressive symptoms and subjective age: A 17-year longitudinal study of Israeli ex-prisoners of war.

This longitudinal study assesses the trajectories of depressive symptoms and subjective age and the mediating role of guilt in the association between them. Two groups of aging Israeli combat veterans (M age = 57), 128 ex-prisoners of war (ex-POWs), and 106 comparable combat veterans (controls), were assessed at 3 times: 18 (Time 1 [T1]), 30 (Time 2 [T2]), and 35 (Time 3 [T3]) years after the war. They filled out self-report questionnaires on depression, guilt, and subjective age. Results revealed that significantly more ex-POWs had chronic or delayed clinical levels of depressive symptoms than did controls and that chronic and delayed depressive symptoms were associated with a higher subjective age at T3. Furthermore, the path between depressive symptoms at T1 for predicting subjective age at T3 was fully explained by levels of guilt-distress at T2. Although the mediation effect was found in both study groups, it was significantly stronger among ex-POWs than among controls. These findings suggest that not only is depression a long-term sequela of traumatic stress, it is also a risk factor for psychological aging among war veterans. Furthermore, guilt-distress appears to play an important role in advancing subjective age, especially among ex-POWs. (PsycINFO Database Record

Coping strategies of former prisoners of war mediate the intergenerational transmission of posttraumatic stress symptoms.

OBJECTIVES: Certain coping strategies, characterized by emotional coping or disengagement/ avoidance, have been linked to posttraumatic stress disorder (PTSD) and PTSD symptoms (PTSS). However, the role of primary trauma victims' coping strategies in the intergenerational transmission of PTSS is still lacking. This prospective study assessed the mediating role of former prisoners of war's (ex-POWs) coping strategies in the associations between ex-POWs' PTSS and their adult offspring's secondary PTSS in relation to their fathers' captivity and psychiatric symptomatology. DESIGN: A correlational, prospective study. METHOD: A sample from the 1973 Yom Kippur War composed of 79 Israeli ex-POW father-offspring dyads completed self-report measures. Fathers were assessed in 2001 and 2008, and their adult offspring participated in 2014. RESULTS: ex-POWs' problem-focused coping strategies of active coping and planning, as well as disengagement-oriented coping strategies of alcohol and substance use and venting of emotions, were negatively associated with offspring's PTSS and psychiatric symptomatology. Importantly, ex-POWs' venting of emotions mediated the link between ex-POWs' PTSS and their offspring's secondary PTSS. CONCLUSIONS: Ex-POWs with PTSS might expose their offspring to dysregulated mood, behaviors, and cognitions. Special awareness should be given to the venting of emotions coping style as possible mechanism for the intergenerational transmission of captivity-related PTSS.

The Implication of Combat Stress and PTSD Trajectories in Metabolic Syndrome and Elevated C-Reactive Protein Levels: A Longitudinal Study.

OBJECTIVE: This study sheds light on the importance of long-term follow-up of trauma survivors, posttraumatic stress disorder (PTSD) trajectories, and early detection of health risk factors in trauma survivors. The present study prospectively assessed the following over 23 years: (1) the association of psychological and physiologic stress during captivity with elevated C-reactive protein (CRP) levels and metabolic syndrome (MetS), which includes hypertension; elevated levels of insulin, triglycerides, and fasting glucose; decreased levels of high-density lipoprotein cholesterol; and obesity and (2) the implication of PTSD trajectories in elevated CRP levels and MetS. METHODS: Measurements were taken in 1991, 2003, 2008, and 2015. Participants were 116 Israeli combat veterans of the 1973 Yom Kippur War (of these, 101 were former prisoners of war [ex-POWs] and 15 were comparable controls). The medical assessments relevant for this study were body mass index, fasting blood glucose levels, and diabetes, blood pressure or a diagnosis of hypertension, high-density lipoprotein cholesterol and triglyceride levels, and medication intake. In addition, the PTSD Inventory was used to assess PTSD symptoms and trajectories over time according to DSM-IV-TR PTSD criteria. RESULTS: Captivity-in particular, the captivity stressors of weight loss, physical suffering, psychological suffering, and humiliation-was implicated in both elevated CRP levels and MetS, significantly so with elevated CRP levels (P = .01, R² = 0.33). Captivity-induced PTSD, in particular chronic and delayed PTSD trajectories, was associated with elevated CRP levels and MetS, significantly so for MetS (P = .05). CONCLUSIONS: Monitoring inflammation using markers like CRP level in trauma survivors can be beneficial, particularly if PTSD is chronic or delayed. Clinicians treating trauma survivors should raise awareness of the importance of such measures in light of long-term health vulnerabilities.

Secondary traumatization among former prisoners of wars' adult children: the mediating role of parental bonding.

BACKGROUND AND OBJECTIVES: The aversive impact of combat and parents' combat-induced posttraumatic stress disorder (PTSD) on young children has been examined in a few studies. However, the long-term toll of war captivity on secondary traumatization (ST) and the parental bonding of adult children remain unknown. This study examined ST symptoms and parental bonding among adult children of former prisoners of war (ex-POWs' children) that were compared to adult children of comparable veterans (controls' children). Furthermore, we examined the mediating role of parental bonding and exposure to stress in the association between group and ST symptoms. DESIGN: A correlative, cross-sectional study. METHODS: Participants were Israeli ex-POWs' children (N = 98) and controls' children (N = 90), whose fathers fought in the 1973 Yom Kippur War. All participants completed a battery of self-reported questionnaires. RESULTS: Ex-POWs' children reported a higher number of ST symptoms and lower levels of fathers' care, as compared to controls' children. Importantly, exposure to stress stemming from fathers' behaviors and fathers' care was found to mediate the association between research group and ST. CONCLUSIONS: Forty years after the war ended, the experience of living with ex-POWs is associated with ex-POWs' children psychological outcome.