Page 229 - Creating Spiritual and Psychological Resilience

198 Creating Spiritual and Psychological Resilence

and were inversely related to age at the time of prior trauma. Their results
underscore the importance of providing long-term disaster assistance to
immigrants with prior trauma (see Mollica, McInnes, Poole, & Tor, 1998,
in the context of cumulative trauma in particular).
Similar findings are reported in children and adolescents with PTSD;
for example, in Kenya (Pfefferbaum et al., 2003), particularly in the con-
text of cumulative stress or multiple or prolonged stressors/traumata such
as in Sri Lanka, where children were exposed to family violence, war, and
the tsunami (Catani, Jacob, Schauer, Kohila, & Neuner, 2008; Schauer,
Catani, Ruf, & Elbert, 2006). This was also evident in Native American
adolescents in substance abuse treatment (Deters, Novina, Fickenscher,
& Beals, 2006), and Cuban children and adolescents after release from a
refugee camp (Rothe et al., 2002).
The literature invokes both psychological (Breslau & Anthony, 2007;
Johnsen, Eid, Laberg, & Thayer, 2002; Moinzadeh, 1998; Solomon &
Prager, 1992) and biological (e.g., Yehuda, Morris, Labinsky, Zamelman, &
Schmeidler, 2007) mechanisms to explain the process of retraumatization.
Moreover, these seem to operate both within the directly traumatized gen-
eration for a lifetime, and multigenerationally—between the traumatized
generation and generations to come. Within the directly traumatized
generation, Solomon and Prager (1992) found that the sense of a previous
similar experience did not affect the response of the non-Holocaust sur-
vivors to the first Gulf war, while it amplified the distress of the survivors.
Furthermore, the first neurobiological study of Holocaust survivors pro-
vides evidence that the biological abnormalities in younger PTSD patients
persist in elderly survivors (Yehuda, Southwick, Nussbaum, Wahby, Giller,
& Manson, 1990; see also van Kammen et al., 1990).
Regarding intergenerational retraumatization, Solomon found that
children of survivors of the Nazi Holocaust who failed to cope during
the Lebanon war suffered deeper and more intense distress than those
who are not children of survivors (see also Rosenheck and Fontana, 1998,
on Vietnam veterans in the United States, and Nader, 1998, on children
exposed to a violent event). Yehuda et al. (1998) demonstrated empirically
that offspring of Holocaust survivors appear to have a similar neuroendo-
crine status to that of Holocaust survivors with PTSD, and that they may
be more psychologically and biologically vulnerable to stress and trauma
than controls. Concluding that the “intergenerational syndrome” may
have a phenomenology and neurobiology similar to that of PTSD, Yehuda
et al. (1998) also found that low cortisol levels in offspring of Holocaust
survivors are associated with their tendency to indicate distress about