Posttraumatic growth, social acknowledgment as survivors, and sense of coherence in former German child soldiers of World War II.

OBJECTIVES To examine posttraumatic growth (PTG) and its predictors social acknowledgment as survivors, sense of coherence (SOC), trauma severity, and further factors in former child soldiers more than 60 years after deployment. DESIGN Cross-sectional. SETTING University-based geropsychiatric center in Germany. PARTICIPANTS One hundred three former German child soldiers of World War II, mean age 78 years in which 96% experienced at least one war trauma. MEASUREMENT Subjects completed the Posttraumatic Growth Inventory, Social Acknowledgment Questionnaire (SAQ), and SOC Scale. Trauma exposure and posttraumatic stress disorder (PTSD) symptoms were assessed by the Posttraumatic Diagnostic Scale. Depression, anxiety, and somatization were assessed using the Brief Symptom Inventory. RESULTS Number of traumas, recognition by significant others, and general disapproval as facets of social acknowledgment as a survivor, and meaningfulness as a dimension of SOC correlated significantly with PTG. In a multiple hierarchical regression analysis, recognition as a survivor by significant others (SAQ) and meaningfulness (SOC) remained the only significant predictors of PTG. CONCLUSION Social acknowledgment as a survivor by significant others and the belief that the world is meaningful are among the most important factors contributing to PTG. Further research should investigate whether treatments of PTSD in people who experienced war traumas recently or many years ago might benefit from a focus on the belief system and the role of family and social support.