Family Hardiness and Social Support as Predictors of Post-Traumatic Stress Disorder
Jovanovic, Aleksandar A., Aleksandric, Branimir V., Dunjic, Dusan, Todorovic, Vladimir S., Psychiatry, Psychology and Law
In this study we examined the influence of post-traumatic psychosocial variables on the pathogenesis of post-traumatic stress disorder (PTSD). The referential framework of the study is based on the integration of the medical model of PTSD contained in the DSM classification system and McCubbin's systemic-orientated psychosocial model of family and social functioning. The research covered 120 subjects--victims of the civil, religious and national conflicts in the territory of the former Yugoslavia in the 1990s--divided into two study groups of 60 as a target and a comparison group. All the subjects were Orthodox Serbs. The target group consisted of 60 subjects, patients from the Institute of Psychiatry of the Clinical Centre of Serbia in Belgrade with PTSD of war genesis according to the criteria of the DSM-III-R without previous psychiatric treatment. The comparison group consisted of 60 subjects who had been exposed to the effect of stress agents of catastrophic intensity of war genesis and who had previously not shown any psychiatric disorder or been treated psychiatrically. The research variables were gender, age, marital status, refugee status, war military service, Family Hardiness Index (FHI), Family Inventory of Life Events (FILE) and Social Support Index (SSI). In the equation of logistical regression low family hardiness (FHI), weaker social support (SSI) and positive marital status (on the border of statistical significance) were separated as significant predictors of PTSD. This study confirms the significance of post traumatic environmental factors as predictors of PTSD.
The civil, religious and national war in the former Yugoslavia in the 1990s created an enormous endemic peak of psychiatric disorders induced by war-related stress (Cucic, Bjegovic, & Djokic, 1994; Weine, Becker, Vojvoda, et al., 1998). According to WHO assessments, the number of psychotraumatised persons in the war zone in the territory of the former Yugoslavia amounted to about 4 million (of the 20 million total number of population), which means that the mental health of at least 800,000 people (20% of the exposed), who needed psychosocial and psychiatric health treatment for grave traumatic stress reactions (World Health Organization, 1994), was threatened with the symptoms of completely or partially developed post-traumatic stress disorder (PTSD)
It is well known that PTSD, as a major form of trauma-induced psychiatric disorder, is more certain, graver and longer-lasting when it appears as a consequence of human destructiveness. In relation to other stress-agents, the stress-agents of human design are more likely to cause intensive fear, horror and the feeling of helplessness in their victims as is the case with post-traumatic disorders of war genesis (Lifton, 1967; Bailly, Jaffe, & Pagella, 1988; Rasmussen, 1990; Orner, 1992; Horowitz, 1994). The open nosological question of determining psychotraumatic disorders demands much more than study of the interaction between the so-called initial stress-agents with psychotrauma and causally connected psychotraumatic disorders (Brett, 1996; Kleinman, 1998; Saporta & Van Der Kolk, 1992). For a long time special attention in the research into PTSD has been directed at the study of relevant psychosocial variables (Davidson, Smith, & Kudler, 1989; Solomon, Waysman, Levy, et al., 1992; Yehuda, Halligan, & Bierer, 2001). PTSD, like other psychiatric disorders, does not come about in a vacuum. Regardless of whether the social environment causes or supports the continuance of a disorder, the patient is always in pathogenic or favourable interaction with significant persons from his or her social environment, primarily with family members (Williams & Williams, 1985; Solomon, Mikulincer, Freid, & Wosner, 1987; Walsh, 1998; McCubbin & McCubbin, 1991; Lie, 2002).
Aims of the Study
In this study we examined the influence of family variables on the pathogenesis of PTSD. …