As a psychologist I have worked with many individuals suffering from PTSD as a result of warfare, trauma, accidents and injuries. In addition, I have provided expert witness consultation and testimony on a variety of personal injury and workplace involved trauma. What is usually the focus of most litigation is the physical and emotional impact on the victim of the trauma or tragedy. What is often missed is the impact on family and the extended emotional, physical and financial costs.
According to The Diagnostic and Statistical Manual (DSM IV), PTSD can develop under the following circumstances: The person has been exposed to a traumatic event in which both of the following have been present:
- The person has experienced, witnessed, or been confronted with an event or events that involve actual or threatened death or serious injury, or a threat to the physical integrity of oneself or others.
- The person’s response involved intense fear, helplessness, or horror.
So one may ask, would a parent’s witnessing of a child’s injuries, surgeries, disfigurement, and rehabilitation constitute “an event that involves actual or threatened death or serious injury or a threat to the physical integrity of oneself or others.” Simply put… yes. One may speculate that the same would hold true if it were a spouse or a sibling of a victim of PTSD.
According to the National Center for PTSD, family members may experience depression, guilt and a sense of hopelessness that their lives will never be the same. This organization also reports that an increase in their drinking, smoking and other unhealthy behaviors may increase as a direct result of intimate involvement with a victim of PTSD. “Survivors (of PTSD) may get into arguments and fights with other people because of the angry or aggressive feelings that are common after a trauma. Also, a person’s constant avoidance of social situations (such as family gatherings) may create hurt feelings or animosity in the survivor’s relationships”. So, if one were to speculate what it would be like to be married to or parented by an individual who is having symptoms of PTSD it is easy to understand that the psychological state of PTSD has a dramatic effect on others besides just the victim him/her self.
One group of trauma victims that has received a great deal of attention is holocaust survivors. Even before the term PTSD became part of the clinical lexicon, it was well established that people who survived years in a concentration camp manifested symptoms that would later be characterized under this label. Research has borne out that the original traumatic event may also be passed down generationally.
A 1998 study by R. Yehuda , et al confirmed that offspring of Holocaust survivor parents with PTSD have a higher lifetime risk for PTSD and report more distress after traumatic events. Thus, along with the exposure to their parents’ traumatic stories and their trauma-related acquired behavioral patterns, these offspring may have a biological vulnerability to traumatic stress. This concept is developed further: “The net result of all this is that we must look at traumatic events as having a ripple effect causing PTSD disposition generationally and through the viewing of others’ trauma (the creation of what might be called ‘secondary victims’).”
In two published studies, family members can develop post-traumatic stress syndrome when they watch their loved ones go through life-threatening illnesses.This is especially true for parents of children with cancer.
So, when determining the costs associated with a case that involves PTSD, one must shift the paradigm to include the far reaching physical, emotional and financial impact to include the individual’s family.