Range and specificity of war-related trauma to posttraumatic stress; depression and general health perception: displaced former World War II children in late life.

摘要

BACKGROUND: Dose-response relation of war experiences and posttraumatic stress, depression and poor health functioning in late life is well documented in war-affected populations. The influence of differing trauma types experienced by war-affected population in the study of dose-response relation of war trauma and psychological maladaptation in late life has not been investigated. We examined a subgroup of displaced elders and investigated whether specific trauma types were associated with differential health outcomes. METHODS: From representative practitioner lists, matched groups of former displaced and non-displaced World War II children were assigned, yielding a total sample of 417 participants (response rate 50%). Measurement encompassed a self-report survey including the Impact of Event Scale-Revised, the Patient Health Questionnaire and the Harvard Trauma Questionnaire. RESULTS: Consistent dose-relation between war-related experiences and posttraumatic stress or depressive symptoms in late life was found for both, displaced and non-displaced elders, whereas a gradient for poor health perception was only found in displaced people. Trauma types derived from principal component analysis showed differential associations with health outcomes. Human Right Violations emerged as risk factor for posttraumatic stress symptoms and Deprivation & Threat to Life as risk factor for depressive symptoms. Poor self-rated health was associated with multiple trauma types. LIMITATIONS: Non-random recruitment, retrospective design and use of self-report. CONCLUSIONS: Posttraumatic stress and depression are associated with war-related experiences more than 60 years after World War II. Results suggest that different trauma types lead to unique variants of syndrome configurations, which may result from different etiological factors.