Far away, so close: The role of self-differentiation in psychopathology among spouses of ex-POWs and comparable combatants

J Clin Psychol. 2020 Oct;76(10):1904-1922. doi: 10.1002/jclp.22965. Epub 2020 May 26.

Abstract

Objective: War captivity entails severe posttraumatic implications for ex-prisoners of war (POWs) and their partners. This study examines the role of self-differentiation in secondary traumatization and dyadic adjustment among ex-POWs' spouses.

Methods: A total of 106 spouses of Israeli ex-POWs and 56 matched spouses of ex-combatants completed self-report questionnaires assessing secondary posttraumatic stress disorder symptoms (SPS), self-differentiation (fusion, cut-off, balanced), general psychiatric distress (GPD), and dyadic adjustment.

Results: Ex-POWs' spouses reported lower dyadic adjustment and higher levels of SPS, GPD, and fusion and cut-off differentiation, compared to ex-combatants' spouses. A "mixed" differentiation style characterized by high levels of both fusion and cut-off was associated with particularly high distress levels. Fusion differentiation moderated the association between SPS/GPD and dyadic adjustment.

Conclusion: Self-differentiation plays an important role in posttraumatic spousal relationships. Women showing unstable differentiation may be particularly vulnerable when living with a veteran. Treatments for posttraumatic couples should target dysregulated interpersonal distance and promote adaptive differentiation.

Keywords: PTSD; secondary traumatization; self-differentiation; spouses; war captivity.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Compassion Fatigue / psychology*
  • Emotional Adjustment
  • Female
  • Humans
  • Interpersonal Relations*
  • Israel
  • Male
  • Middle Aged
  • Prisoners of War / psychology*
  • Prisoners of War / statistics & numerical data
  • Self Concept*
  • Self Report
  • Spouses / psychology*
  • Spouses / statistics & numerical data
  • Stress Disorders, Post-Traumatic / psychology