Skip to main content

Advertisement

SpringerLink
Log in

Self-Reported Emotional and Behavioral Problems, Family Functioning and Parental Bonding Among Psychiatric Outpatient Adolescent Offspring of Croatian Male Veterans with Partial PTSD

  • Original Paper
  • Published:
Child & Youth Care Forum Aims and scope Submit manuscript

Abstract

Background

Posttraumatic stress disorder (PTSD) in male veterans has been linked with impaired family relationships and psychopathology in their children. Less is known about symptoms in children of veterans with partial PTSD.

Objective

To compare mental health problems, family functioning and parent–child bonding among adolescent offspring of male veterans with no PTSD, partial PTSD and full PTSD, and to examine the relationship between adolescent mental health problems and family factors.

Methods

Consecutive outpatient adolescent offspring (12–18 years) of Croatian male veterans with no PTSD, partial PTSD and full PTSD matched for age, sex, educational level, family income, parental employment, nationality, and residential area reported on emotional and behavioral problems, family functioning and parent–child bonding.

Results

The full PTSD group reported higher levels of total behavior problems, family functioning problems and parental control than the partial PTSD group, which in turn, reported higher levels than the no PTSD group. The partial and full PTSD groups reported comparable levels of emotional and behavioral problems, and parental care. The partial and no PTSD groups did not differ on maternal care, which was significantly higher in these groups than in the full PTSD group. Higher levels of emotional and behavioral symptoms were associated with lower levels of maternal care in the partial PTSD group.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  • Aber, J. L., Gershoff, E. T., Ware, A., & Kotler, J. A. (2004). Estimating the effects of September 11th and other forms of violence on the mental health and social development of New York City’s youth: A matter of context. Applied Developmental Science, 8, 111–129.

    Article  Google Scholar 

  • Achenbach, T. M. (1991). Manual for the youth self report and 1991 profile. Burlington: University of Vermont, Department of Psychiatry.

    Google Scholar 

  • Ahmadzadeh, G. H., & Malekian, A. (2004). Aggression, anxiety, and social development in adolescent children of war veterans with PTSD versus those of non-veterans. Journal of Research in Medical Sciences, 9, 33–36.

    Google Scholar 

  • Banks, D. M., & Weems, C. F. (2014). Family and peer social support and their links to psychological distress among hurricane-exposed minority youth. American Journal of Orthopsychiatry, 84, 341–352.

    Article  PubMed  Google Scholar 

  • Beckham, J. C., Braxton, L. E., Kudler, H. S., Feldman, M. E., Lytle, B. L., & Palmer, S. (1997). Minnesota multiphasic personality inventory profiles of Vietnam combat veterans with posttraumatic stress disorder and their children. Journal of Clinical Psychology, 53, 847–852.

    Article  PubMed  Google Scholar 

  • Blake, D., Weathers, F., Nagy, D., Kaloupek, G., Klauminzer, D., Charney, D., et al. (1990). Clinician-administrated PTSD scale (CAPS). Boston: National Center for Posttraumatic Stress Disorder, Behavioral Sciences Division.

    Google Scholar 

  • Blanchard, E. B., Hickling, E. J., Taylor, A. E., Loos, W. R., & Gerardi, R. J. (1994). Psychological morbidity associated with motor vehicle accidents. Behaviour Research and Therapy, 32, 283–290.

    Article  PubMed  Google Scholar 

  • Bokszczanin, A. (2008). Parental support, family conflict and overprotectiveness: Predicting PTSD symptom levels in adolescents 28 months after a natural disaster. Anxiety Stress and Coping, 21, 325–335.

    Article  Google Scholar 

  • Boričević Maršanić, V., Aukst Margetić, B., Jukić, V., Matko, V., & Grgić, V. (2014a). Self-reported emotional and behavioral symptoms, parent-adolescent bonding and family functioning in clinically referred adolescent offspring of Croatian PTSD war veterans. European Child and Adolesceng Psychiatry, 23, 295–306.

    Google Scholar 

  • Boričević Maršanić, V., Aukst Margetić, B., Zečević, I., & Herceg, M. (2014b). The prevalence and psychosocial correlates of suicide attempts among inpatient adolescent offspring of croatian PTSD male war veterans. Child Psychiatry and Human Development, 45, 577–587.

    Article  PubMed  Google Scholar 

  • Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American Psychologist, 32, 513–531.

    Article  Google Scholar 

  • Carlier, I. V., & Gersons, B. P. (1995). Partial posttraumatic stress disorder (PTSD): The issue of psychological scars and the occurrence of PTSD symptoms. Journal of Nervous and Mental Disorders, 183, 107–109.

    Article  Google Scholar 

  • Carrión, V. G., Weems, C. F., Ray, R., & Reiss, A. L. (2002). Towards an empirical definition of pediatric PTSD: The phenomenology of PTSD symptoms in youth. Journal of the American Academy of Child and Adolescent Psychiatry, 41, 166–173.

  • Carty, J., O’Donnell, M. L., & Creamer, M. (2006). Delayed-onset PTSD: A prospective study of injury survivors. Journal of Affective Disorders, 90, 257–261.

    Article  PubMed  Google Scholar 

  • Caselli, L. T., & Motta, R. W. (1995). The effect of PTSD and combat level on Vietnam veterans’ perceptions of child behavior and marital adjustment. Journal of Clinical Psychology, 51, 4–12.

    Article  PubMed  Google Scholar 

  • Cohen, E., Zerach, G., & Solomon, Z. (2011). The implication of combat-induced stress reaction, PTSD, and attachment in parenting among war veterans. Journal of Family Psychology, 25, 688–698.

    Article  PubMed  Google Scholar 

  • Costa, N. M., Weems, C. F., & Pina, A. A. (2009). Hurricane Katrina and youth anxiety: The role of perceived attachment beliefs and parenting behaviors. Journal of Anxiety Disorders, 23, 935–941.

    Article  PubMed  Google Scholar 

  • Cukor, J., Wyka, K., Jayasinghe, N., & Difede, J. (2010). The nature and course of subthreshold PTSD. Journal of Anxiety Disorders, 24, 918–923.

    Article  PubMed  Google Scholar 

  • Davidson, A. C., & Mellor, D. J. (2001). The adjustment of children of Australian Vietnam veterans: Is there evidence for the transgenerational transmission of war-related trauma? Australian and New Zealand Journal of Psychiatry, 35, 345–351.

    Article  PubMed  Google Scholar 

  • Davidson, J., Smith, R., & Kudler, H. (1989). Familial psychiatric illness in chronic posttraumatic stress disorder. Comprehensive Psychiatry, 30, 339–345.

    Article  PubMed  Google Scholar 

  • Dekel, R., Goldblatt, H., Keidar, M., Solomon, Z., & Polliack, M. (2005). Being a spouse of a PTSD veteran. Family Relations, 54, 24–36.

    Article  Google Scholar 

  • Dekel, R., & Solomon, Z. (2006). Secondary traumatization among wives of Israeli POWs. Social Psychiatry and Psychiatric Epidemiology, 41, 27–33.

    Article  PubMed  Google Scholar 

  • Epstein, N. B., Baldwin, L. M., & Bishop, D. S. (1983). The McMaster family assessment device. Journal of Marital and Family Therapy, 9, 171–180.

    Article  Google Scholar 

  • Figley, C. R. (1983). Catastrophes: An overview of family reactions. In C. R. Figley & H. I. McCubin (Eds.), Coping with catastrophe. Stress and the family (Vol. II). New York: Brunner/Mazel.

    Google Scholar 

  • Frančišković, T., Stevanović, A., Jelušić, I., Roganović, B., Klarić, M., & Grković, J. (2007). Secondary traumatization of wives of war veterans with posttraumatic stress disorder. Croatian Medical Journal, 48, 177–184.

    PubMed Central  PubMed  Google Scholar 

  • Freudenstein, O., Zohar, A., Apter, A., Shoval, G., Weizman, A., & Zalsman, G. (2011). Parental bonding in severely suicidal adolescent inpatients. European Psychiatry, 26, 504–507.

    Article  PubMed  Google Scholar 

  • Galovski, T., & Lyons, J. A. (2004). Psychological sequelae of combat violence: A review of the impact of PTSD on the veteran’s family and possible interventions. Aggressive and Violent Behavior, 9, 477–501.

    Article  Google Scholar 

  • Gewirtz, A., Forgatch, M., & Wieling, E. (2008). Parenting practices as potential mechanisms for child adjustment following mass trauma. Journal of Marital and Family Therapy, 34, 177–192.

    Article  PubMed  Google Scholar 

  • Guy, W. (1976). Clinical global impressions. In W. Guy (Ed.), Early clinical drug evaluation unit assessment manual for psychopharmacology. Bethesda, MD: National Institute of Mental Health.

    Google Scholar 

  • Hagan, J. F. (2005). Psychosocial implications of disaster and terrorism on children: A guide for the paediatrician. Pediatrics, 116, 787–795.

    Article  PubMed  Google Scholar 

  • Harkness, L. L. (1991). The effect of combat-related PTSD on children. National Center for PTSD Clinical Newsletter, 2, 12–13.

    Google Scholar 

  • Harkness, L. L. (1993). Transgenerational transmission of war-related trauma. In J. P. Wilson & B. Raphael (Eds.), International handbook of traumatic stress syndromes. New York: Plenum.

    Google Scholar 

  • Hathway, S. R., & McKinley, J. C. (1989). Minnesota multiphasic personality inventory (1st ed.). Mineapolis, MN: University of Minnesota.

    Google Scholar 

  • Jacobsen, L. K., Sweeney, C. G., & Racusin, G. R. (1993). Group psychotherapy for children of fathers with PTSD: Evidence of psychopathology emerging in the group process. Journal of Child and Adolescent Group Therapy, 3, 103–120.

    Article  Google Scholar 

  • Jordan, B. K., Marmar, C. R., Fairbank, J. A., Schlenger, W. E., Kulka, R. A., Hough, R. L., & Weiss, D. S. (1992). Problems in families of male Vietnam veterans with posttraumatic stress disorder. Journal of Consulting and Clinical Psychology, 60, 916–926.

    Article  PubMed  Google Scholar 

  • Keane, T. M., Caddell, J. M., & Taylor, K. L. (1988). Mississippi scale for combat-related posttraumatic stress disorder: Three studies in reliability and validity. Journal of Consulting and Clinical Psychology, 56, 85–90.

    Article  PubMed  Google Scholar 

  • Kelley, M. L., Self-Brown, S., Le, B., Bosson, J. V., Hernandez, B. C., & Gordon, A. T. (2010). Predicting posttraumatic stress symptoms in children following Hurricane Katrina: A prospective analysis of the effect of parental distress and parenting practices. Journal of Traumatic Stress, 23, 582–590.

    Article  PubMed Central  PubMed  Google Scholar 

  • Kilic, E. Z., Ozguven, H. D., & Sayil, I. (2003). The psychological effects of parental mental health on children experiencing disaster: The experience of Bolu earthquake in Turkey. Family Process, 42, 485–495.

    Article  PubMed  Google Scholar 

  • Kozarić-Kovačić, D., & Kocijan-Hercigonja, D. (2001). Assessment of post-traumatic stress disorder and comorbidity. Military Medicine, 166, 677–680.

    PubMed  Google Scholar 

  • Laor, N., Wolmer, L., & Cohen, D. J. (2001). Mothers’ functioning and children’s symptoms 5 years after a SCUD missile attack. American Journal of Psychiatry, 158, 1020–1026.

    Article  PubMed  Google Scholar 

  • Leckman, J. F., Sholomskas, D., Thompson, W. D., Belanger, A., & Weissman, M. M. (1982). Best estimate of lifetime psychiatric diagnosis: A methodological study. Archives of General Psychiatry, 39, 879–883.

    Article  PubMed  Google Scholar 

  • Levendosky, A. A., & Graham-Bermann, S. A. (2000). Behavioral observations of parenting in battered women. Journal of Family Psychology, 14, 80–94.

    Article  PubMed  Google Scholar 

  • Lieberman, A. F., Van Horn, P., & Ozer, E. J. (2005). Preschooler witnesses of marital violence: Predictors and mediators of child behavior problems. Developmental Psychopathology, 17, 385–396.

    Article  Google Scholar 

  • Marshall, R. D., Olfson, M., Hellman, F., Blanco, C., Guardino, M., & Struening, E. L. (2001). Comorbidity, impairment, and suicidality in subthreshold PTSD. American Journal of Psychiatry, 158, 1467–1473.

    Article  PubMed  Google Scholar 

  • McFarlane, A. C. (1987). The relationship between patterns of family interaction and psychiatric disorder in children. Australian and New Zealand Journal of Psychiatry, 21, 383–390.

    Article  PubMed  Google Scholar 

  • Mollica, R. F., Caspi-Yavin, Y., Bollini, P., Truong, T., Tor, S., & Lavelle, J. (1992). The Harvard Trauma Questionnaire. Validating a crosscultural instrument for measuring torture, trauma, and posttraumatic stress disorder in Indochinese refugees. Journal of Nervous and Mental Disorders, 180, 111–116.

    Article  Google Scholar 

  • Norris, F. H., Friedman, M. J., & Watson, P. J. (2002). 60,000 disaster victims speak: Part II. Summary and implications of the disaster mental health research. Psychiatry, 65, 240–260.

    Article  PubMed  Google Scholar 

  • Parker, G., Tupling, H., & Brown, L. B. (1979). A parental bonding instrument. British Journal of Medical Psychology, 52, 1–10.

    Article  Google Scholar 

  • Parsons, J., Kehle, T. J., & Owen, S. V. (1990). Incidence of behavior problems among children of Vietnam veterans. School Psychology International, 11, 253–259.

    Article  Google Scholar 

  • Pat Horenczyk, R. (2003). The impact of ongoing terrorist attacks on the adolescent population in Jerusalem and the Jerusalem area. In M. Caspi (Ed.), Children anxiety as result of the terrorist events. Jerusalem: Israeli Knesset, research and information center.

    Google Scholar 

  • Pat-Horenczyk, R., Peled, O., Miron, T., Brom, D., Villa, Y., & Chemtob, C. (2007). Risk-taking behaviors among Israeli adolescents exposed to recurrent terrorism: Provoking danger under continuous threat? American Journal of Psychiatry, 164, 66–72.

    Article  PubMed  Google Scholar 

  • Pat-Horenczyk, R., Qasrawi, R., Lesack, R., Haj-Yahia, M., Peled, O., Shaheen, M., et al. (2009). Posttraumatic symptoms, functional impairment and coping among adolescents on both sides of the Israeli–Palestinian conflict: A cross-cultural approach. Applied Psychology: An International Review, 58, 688–708.

    Article  Google Scholar 

  • Pfefferbaum, B., Seale, T. W., Brandt, E. N, Jr, Pfefferbaum, R. L., Doughty, D. E., & Rainwater, S. M. (2003). Media exposure in children one hundred miles from a terrorist bombing. Annals of Clinical Psychiatry, 15, 1–8.

    Article  PubMed  Google Scholar 

  • Pfefferbaum, B. J., Weems, C. F., Scott, B. G., Nitiéma, P., Noffsinger, M. A., Pfefferbaum, R. L., et al. (2013). Research methods in child disaster studies: A review of studies generated by the September 11, 2001, Terrorist Attacks; the 2004 Indian Ocean Tsunami; and Hurricane Katrina. Child and Youth Care Forum, 42, 285–337.

    Article  PubMed Central  PubMed  Google Scholar 

  • Pynoss, R. S., & Eth, S. (1985). Children traumatized by witnessing acts of personal violence: Homicide, rape or suicide behavior. In S. Eth & R. S. Pynoss (Eds.), Post-traumatic stress disorder in children. Washington, DC: American Psychiatric Press.

    Google Scholar 

  • Qouta, S., Punamaki, R. L., & El Sarraj, E. (2008). Child development and mental health in war and military violence: The Palestinian experience. International Journal of Behavioral Development, 32, 310–321.

    Article  Google Scholar 

  • Rosenheck, R., & Fontana, A. (1998). Warrior fathers and warrior sons: Intergenerational aspects of trauma. In Y. Danieli (Ed.), International handbook of multigenerational legacies of trauma (pp. 225–242). New York: Plenum.

    Chapter  Google Scholar 

  • Rosenheck, R., & Nathan, P. (1985). Secondary traumatization in children of Vietnam veterans. Hospital and Community Psychiatry, 36, 538–539.

    PubMed  Google Scholar 

  • Rudan, V., Begovac, I., Szirovicza, L., Filipović, O., & Skočić, M. (2005). The child behavior checklist, teacher report form and youth self report problem scales in a normative sample of Croatian children and adolescents aged 7–18. Collegium Antropologhicum, 29, 17–26.

    Google Scholar 

  • Ruscio, A. M., Weathers, F. W., King, L. A., & King, D. W. (2002). Male war-zone veterans’ perceived relationships with their children: The importance of emotional numbing. Journal of Traumatic Stress, 15, 351–357.

    Article  PubMed  Google Scholar 

  • Scarpa, A., Haden, S. C., & Hurley, J. (2006). Community violence victimization and symptoms of posttraumatic stress disorder: The moderating effects of coping and social support. Journal of Interpersonal Violence, 21, 446–469.

    Article  PubMed  Google Scholar 

  • Scheeringa, M. S., & Zeanah, C. H. (2008). Reconsideration of harm’s way: Onsets and comorbidity patterns of disorders in preschool children and their caregivers following Hurricane Katrina. Journal of Clinical Child and Adolescent Psychology, 37, 508–518.

    Article  PubMed  Google Scholar 

  • Schiff, M., Pat-Horenczyk, R., & Peled, O. (2010). The role of social support for Israeli adolescents continually exposed to terrorism: Protective or compensatory factors? Journal of Child and Adolescent Trauma, 3, 95–108.

    Article  Google Scholar 

  • Solomon, Z., & Lavi, T. (2005). Israeli youth in the second Intifada: PTSD and future orientation. Journal of the American Academy of Child and Adolescent Psychiatry, 44, 1167–1175.

    Article  PubMed  Google Scholar 

  • Stein, B., Jaycox, L., Elliott, M., Collins, R., Berry, S., Marshall, G., et al. (2004). The emotional and behavioral impact of terrorism on children: Results from a national survey. Applied Developmental Psychology, 8, 184–194.

  • Stein, M. B., Walker, J. R., Hazen, A. L., & Forde, D. R. (1997). Full and partial posttraumatic stress disorder: Findings from a community survey. American Journal of Psychiatry, 154, 1114–1119.

    Article  PubMed  Google Scholar 

  • Stein, D., Williamson, D. E., Birmaher, B., Brent, D. A., Kaufman, J., Dahl, R. E., et al. (2000). Parent–child bonding and family functioning in depressed children and children at high risk and low risk for future depression. Journal of American Academy of Child and Adolescent Psychiatry, 39, 1387–1395.

    Article  Google Scholar 

  • Tamplin, A., Goodyear, I. M., & Herbert, J. (1998). Family functioning and parent general health in families of adolescents with major depressive disorder. Journal of Affective Disorders, 48, 1–13.

    Article  PubMed  Google Scholar 

  • Thabet, A. A. M., & Vostanis, P. (2002). Emotional problems in Palestinian children living in a war zone: A crosssectional study. Lancet, 359, 1801–1804.

    Article  PubMed  Google Scholar 

  • Weems, C. F., & Overstreet, S. (2008). Child and adolescent mental health research in the context of Hurricane Katrina: An ecological-needs-based perspective and introduction to the special section. Journal of Clinical Child and Adolescent Psychology, 37, 487–494.

    Article  PubMed  Google Scholar 

  • Weems, C. F., Pina, A. A., Costa, N. M., Watts, S. E., Taylor, L. K., & Cannon, M. F. (2007). Pre disaster trait anxiety and negative affect predict posttraumatic stress in youth after Hurricane Katrina. Journal of Consulting and Clinical Psychology, 75, 154–159.

    Article  PubMed  Google Scholar 

  • Weich, S., Patterson, J., Shaw, R., & Stewart-Brown, S. (2009). Family relationships in childhood and common psychiatric disorders in later life: Systematic review of prospective studies. British Journal of Psychiatry, 194, 392–398.

    Article  PubMed  Google Scholar 

  • Weiss, D. S., Marmar, C. R., Schlenger, W. E., Fairbank, J. A., Jordan, B. K., & Hough, R. L. (1992). The prevalence of lifetime and partial post-traumatic stress disorder in Vietnam theater veterans. Journal of Traumatic Stress, 5, 365–376.

    Article  Google Scholar 

  • World Health Organization. (2003). International statistical classification of diseases and related health problems, 10th revision. Geneva: World Health Organization.

    Google Scholar 

  • Wyman, P. A., Cowen, E. L., Work, W. C., & Parker, G. R. (1991). Developmental and family milieu correlates of resilience in urban children who have experienced major life stress. American Journal of Community Psychology, 19(3), 405–426.

    PubMed  Google Scholar 

  • Zalihic, A., Zalihic, D., & Pivic, G. (2008). Influence of posttraumatic stress disorder of the fathers on other family members. Bosnian Journal of Basic Medical Sciencies, 8, 20–26.

    Google Scholar 

Download references

Acknowledgments

This research received no specific grant from any funding agency in the public, commercial or non-for-profit sectors.

Conflict of interest

The authors declare that there is no conflict of interest.

Author information

Authors and Affiliations

  1. Institute of Public Health, “Dr. A. Štampar”, Mirogojska 16, Zagreb, Croatia

    Iris Sarajlić Vuković

  2. Psychiatric Hospital for Children and Adolescents, Kukuljevićeva 11, Zagreb, Croatia

    Vlatka Boričević Maršanić & Ljubica Paradžik

  3. Department of Psychiatry, University Hospital Center Zagreb, Kišpatićeva 12, Zagreb, Croatia

    Branka Aukst Margetić

  4. Psychiatric Hospital Vrapče, Bolnička cesta 32, Zagreb, Croatia

    Domagoj Vidović

  5. Child Protection Center of Zagreb, Đorđićeva 26, Zagreb, Croatia

    Gordana Buljan Flander

Authors
  1. Iris Sarajlić Vuković
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Vlatka Boričević Maršanić
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Branka Aukst Margetić
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ljubica Paradžik
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Domagoj Vidović
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Gordana Buljan Flander
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Vlatka Boričević Maršanić.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Sarajlić Vuković, I., Boričević Maršanić, V., Aukst Margetić, B. et al. Self-Reported Emotional and Behavioral Problems, Family Functioning and Parental Bonding Among Psychiatric Outpatient Adolescent Offspring of Croatian Male Veterans with Partial PTSD. Child Youth Care Forum 44, 655–669 (2015). https://doi.org/10.1007/s10566-015-9299-9

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s10566-015-9299-9

Keywords

Search

Navigation