[The relationship between traumatic experiences and dissociative phenomena]. / Het verband tussen belastende ervaringen en dissociatieve verschijnselen.

BACKGROUND: Intuitively we are convinced that there must be a causal relationship between traumatic experiences and dissociation. However, although the theory is both elegant and attractive, the existence of a direct causal link between trauma and dissociation is open to question. Available studies on this theme have methodological shortcomings. AIM: To obtain more insight into the frequency with which psychiatric patients have undergone traumatic experiences and to find out more about the relationship between theses experiences and dissociative phenomena. METHOD: Over a period of two years new outpatients attending psychiatric clinics completed questionnaires about their past life and mental health; in these questionnaires they gave information about traumatic experiences, dissociative phenomena, psychological symptoms and psychological functioning. RESULTS: Only 38 of the 351 patients who completed the questionnaire stated that they had never had any traumatic experiences. A relatively large number of patients mentioned that they had experienced emotional deprivation in their family of origin. The correlation coefficient between traumatic experiences and the scores for dissociative phenomena was 0.30. CONCLUSION: In view of the weak positive correlation between traumatic experiences and dissociative phenomena the hypothesis of a linear causal relationship seems unlikely. It is possible that the relationship is based partly on the poorer general psychological functioning that follows exposure to traumatic experiences.

A cross-national study of posttraumatic stress disorder in Dutch-Australian immigrants.

OBJECTIVE: Studying the rates of posttraumatic stress disorder (PTSD) in people who experienced World War II, but who have subsequently lived in different environments is a way of looking at the impact of recovery environment on PTSD. Immigrants had less support in terms of the social cohesion in their home country, but were not subjected to the same triggers of war-related intrusions. METHOD: Posttraumatic stress disorder was investigated in citizens from the Netherlands who emigrated to Australia in the post-World War II years (n = 251). Immigrants born between 1920 and 1930 (n = 171) were compared with a same-aged group living in Holland (n = 1461) for stressful war experiences and the extent of PTSD. RESULTS: Those who had been exposed to the most severe war stress were overrepresented in the immigrant group. Immigrants with current PTSD more often stated that motives for migration were threat of a third world war, disappointment with Dutch society and personal problems. We were unable to demonstrate specific effects of emigration on the prevalence of current PTSD. CONCLUSIONS: This study suggests that exposure to severe war stress promoted the need to emigrate. The comparable PTSD scores of the groups of war victims living in Australia and the Netherlands support the notion that extreme war stress may be considered the primary determining factor in the development of PTSD, and that actual post-war living circumstances are, in the long term, of subordinate importance.

Reported physical health in resistance veterans from World War II.

Male Dutch Resistance veterans from World War II who reported on chronic diseases were compared with subjects from a population survey. Resistance veterans in general reported significantly more disease. Veterans with symptoms of posttraumatic stress disorder reported more disease than those who had none. Furthermore, 13 specific disease categories were more prevalent in the Resistance veterans than in the general population. In the Resistance veterans total number of reported diseases was significantly correlated with anxiety, depression, and posttraumatic stress disorder. In Resistance veterans weekly tobacco use was comparable to that of the control subjects, but alcohol consumption was significantly less.

Prevalence and course of posttraumatic stress disorder in Dutch veterans of the civilian resistance during World War II: an overview.

This study concerns the prevalence of current and lifetime Posttraumatic Stress Disorder (PTSD) in various groups of officially recognized Veterans of the Dutch civilian Resistance against the Nazi occupation during World War II. In total, 1046 Resistance veterans living in The Netherlands and 52 who immigrated to the United States after the war were examined. Between four and five decades after the end of WW II, between 25 and 50% were suffering from current PTSD. The life-time prevalence is estimated to be substantially higher. The course of PTSD proved highly variable. There had often been a delay of several decades between the end of the war and reoccurrence or first onset of posttraumatic symptoms. The prevalence of PTSD in Resistance veterans who emigrated to the United States was hardly different from that of the veterans still living in The Netherlands.