Posttraumatic Suffering as a Source of Transformation: A Clinical Perspective

The author's goal was to explore the historical, political, and social forces that have played a major role in the acceptance of the idea of trauma as a cause of the specific symptoms of posttraumatic stress disorder (PTSD) and to discuss the impact that current research findings have had on some of the initial conceptualizations of the disorder. The conceptual origins of PTSD are described, and the literature on the prevalence, longitudinal course, phenomenology, and neurobiology of PTSD is reviewed. Paradoxically, there are a series of findings that support the idea that PTSD is a distinct diagnostic entity, but these are different from those originally developed from psychosocial theory and stress research. PTSD has been a controversial diagnosis and is again at a vulnerable point. It is imperative that the field address how current findings challenge the original conceptualizations of this disorder so that the next generation of conceptual issues can be formulated.

This study examines the number and types of war traumas children face growing up in a war-torn country and the relation of such traumatic experiences to their psychosocial development. A sample of 224 Lebanese children (10-16 years old) were interviewed using measures of war exposure, mental health symptoms, adaptational outcomes, and Post-Traumatic Stress Disorder (PTSD). The number and type of children's war traumas varied meaningfully in number and type by their age, gender, father's occupational status, and mother's educational level. As predicted, the number of war traumas experienced by a child was positively related to PTSD symptoms; and various types of war traumas were differentially related to PTSD, mental health symptoms, and adaptational outcomes. For example, children who were exposed to multiple war traumas, were bereaved, became victims of violent acts, witnessed violent acts, and/or were exposed to shelling or combat exhibited more PTSD symptoms. Children who were separated from parents reported more depressive symptoms and children who experience bereavement and were not displaced reported more planful behavior. Lastly, children who were separated from parents and who witnessed violent acts reported more prosocial behavior. Implications for program interventions and directions for future research on the effects of war on the psychosocial development of children are explored.