By Don Vaughn
11 and 20 percent of veterans who served in operations Enduring Freedom
and Iraqi Freedom will experience related symptoms in any given year
and the condition affects a significant number of Gulf War and Vietnam
veterans as well, according to estimates from the National Center for PTSD.
most commonly reported problems associated with PTS include intrusive
memories or nightmares of a traumatic event, feelings such as numbing or
guilt, and symptoms of hyperarousal, such as hypervigilance,
irritability, and sleep problems. Understandably, these symptoms can
have far-reaching effects on a veteran's children, mental health experts
Dr. John A. Fairbank, a psychologist and codirector of the UCLA-Duke University National Center for Child Traumatic Stress,
has been studying the effects of trauma on children for decades. In the
1980s, he was part of a study that interviewed Vietnam veterans and
“We took a look at how the children were doing
from the spouse's perspective,” Fairbank explains. “We compared the
families of veterans who had PTSD with the families of veterans who did
not, and not surprisingly, we found higher rates of reported problems
among the children whose veteran parents had war-related PTSD. There was
a significant difference.”
According to the American Academy of Experts in Traumatic Stress,
a parent's PTS can influence a child in numerous ways, depending on age
and other factors. The three most typical patterns among children are
overidentified child, who experiences secondary traumatization and
might experience some of the same symptoms as the veteran parent;
- the rescuer, who assumes the adult role to compensate for the parent's difficulties; and
- the emotionally uninvolved child, who receives little emotional support from the parent.
These children are more prone to depression, anxiety, and difficulties at school.
parents express symptoms of PTS can influence the relationship they
have with their children, notes Dr. Paula Schnurr, a psychologist and
executive director of the National Center for PTSD.
“One of the
symptoms of PTSD is feeling numb or cut off from the world,” Schnurr
explains. “The extent to which that is communicated to a child can have
the particularly negative effect of distancing the child from the
parent. The child may feel unloved or less connected to the parent in
that circumstance. And that is children across all age ranges.” However,
people vary in the extent to which they feel numbing or how they
communicate, Schnurr adds.
“I've had clinicians tell me about
parents who can communicate with their children but not anyone else,”
Schnurr says. “Their children touch them differently. So it's not a
foregone conclusion that someone who comes back with numbing is going to
be unable to communicate love or have feelings for a child.”
Consequences of anger
common problem is anger, Schnurr notes. “Fortunately, many people with
PTSD don't display significantly angry behaviors, but if they do, I
think there are obvious problems that can emerge,” she reports. “In
extreme cases, anger can really challenge the parent/child
Young people can respond to a parent's PTS symptoms
in a wide variety of ways, experts report. Among toddlers, this might
include regression, such as when a toilet-trained child suddenly refuses
to use the toilet, or engaging in frequent tantrums. Older children
might engage in potentially dangerous behaviors, such as getting into
fights, participating in risky activities, or using alcohol or drugs.
children really try to behave,” says Schnurr. “They over-attribute
their ability to control the situation, so they stay out of mom or dad's
way or try to prevent mom or dad from getting angry. They may also
remove themselves from the situation. Children may also act out because
they are angry themselves. In more extreme cases, they may have trouble
with school work and general acting-out behavior.”
Living in a
household with an emotionally distraught parent can have an adverse
effect on a child's overall quality of life, observes Fairbank.
Sometimes the effects are indirect. For example, a child might do poorly
in school because he or she is kept awake at night by the affected
parent's pacing or because the child is concerned about the parent and
can't concentrate. Similarly, if a parent is frequently angry or
irritable, the child might be reluctant to invite friends over to visit,
resulting in social isolation. “There are lots of ways these things can
affect children's functioning within the family, within school, and
with peers and friends,” confirms Fairbank.
In an effort to better understand how PTS affects young people in childhood and later in life, Fairbank is working with the Millennium Cohort Family Study, which has collected information from nearly 10,000 military families, including active duty servicemembers and veterans.
Millennium Cohort Family Study is specifically designed as a
longitudinal study, and we hope to follow these families for 21 years,”
Fairbank notes. “This project will allow us to look at the impact of
PTSD and other significant war-related health and mental health
conditions and see how the children in the families are doing.”
is research in other areas of trauma, Fairbank says, which suggests
that when children are exposed to trauma at a younger age, the impact
tends to be more complex. “It has a broader range of outcomes, the
younger the person is at the time they are exposed to the trauma,”
Fairbank says. “But what we don't know at this point is how the age of
the child relates to the parent's war-related PTSD. We hope to find that
out through our research.”
According to Dr. Ron Avi Astor, a
psychologist and the Lenore Stein-Wood and William S. Wood Professor of
School Behavioral Health at the University of Southern California in Los
Angeles, two of the most important factors that can influence how a
parent's trauma will affect the rest of the family are family
communication skills and outside support systems.
“From our work,
we see it's not the PTSD alone or even the experience of war alone that
determines the outcome of a child or family,” Astor explains. “While the
military parent is away, the other parent may struggle with the
organization of the household. If they have good support, it's a
nonissue. If they have bad support, it can be disastrous. If you add
PTSD on top of that, without a lot of strong social support, I think
that makes things even more difficult.”
Being a parent with PTS can be extremely difficult. But help is available for those who seek it.
Fairbank recommends a resiliency-based resource known as Project FOCUS.
“It is really focused on talking about deployments before they happen
and upon return, as well as all of the issues that affect children,
spouses, and servicemembers,” Fairbank says. “It does it in a very
Early prep is helpful
preparation for a military parent's deployment and return, and the
issues that might pop up afterward, also can be beneficial, says Astor.
“The more the family can prepare psychologically, socially, and
emotionally and speak openly about it, the better, depending on the age
of the child,” he explains. “Families also need to situate themselves in
a strong, caring, and supportive family and community setting.”
VA is there to help, says Schnurr. It provides a variety of family
services, including education, consultation, and marriage and family
counseling, for immediate family and caregivers. Additionally, many
support programs are in place, including a parenting self-help Web-based course tailored to the needs of veterans and active duty servicemembers facing mental health and reintegration challenges.
VA also has partnered with the UCLA Welcome Back Veterans Family
Resilience Center and the Military Child Education Coalition on pilots
of clinic-based parenting education initiatives.