The role of intrusion, avoidance, and cognitive coping strategies more than 50 years after war VIVIAN KRAAIJ & NADIA GARNEFSKI Department of Clinical and Health Psychology, Leiden University, Leiden, The Netherlands (Received 21 January 2003; revised 21 August 2003; accepted 6 June 2005) Abstract The relationships between war events, cognitive coping strategies, posttraumatic stress reactions, and depressive symptoms were examined in 248 people who experienced war 50 years ago. The findings suggest that people who experienced war events that indicate a more severe involvement in war suffered from more depressive symptoms. War events that might be experienced by many people in the community appeared not to be related to depression scores. The occurrence of intrusion and avoidance appeared to be related to depressive symptoms. When cognitive coping strategies were included in the analysis, intrusion and avoidance no longer were significant. However, cognitive coping strategies, such as positive reappraisal, positive refocusing, rumination, acceptance, and self- blame, were significantly related to depressive symptoms. Intervention programs should pay attention to these cognitive coping strategies. Keywords: War, intrusion, avoidance, cognitive coping, depression Some people who have experienced traumatic events during wartime have emotional or psychiatric problems, such as posttraumatic stress disorder or depression, more than 50 years later (Nadler & Ben-Shushan, 1989; Hovens, op den Velde, Falger, Schouten, de Groen, & van Duijn, 1992; Op den Velde et al., 1993, 1996; Bramsen, 1995; Bramsen, Klaarenbeek, & van der Ploeg, 1995a; Lee, Vaillant, Torrey, & Elder, 1995; Bramsen & van der Ploeg, 1999). Events experienced during war, such as seeing many people being killed, destruction of house or neighborhood due to bombing, serious illness, being in danger of losing one’s life, maltreatment and torture by the occupier, have all been found to be related to psychopathology (Beal, 1995; Bramsen, Klaarenbeek, & van der Ploeg, 1995b). It has been suggested that people who have been exposed to a greater amount of war experiences suffer even higher levels of distress (Bramsen et al., 1995b). Various theories have been developed to offer insight into the nature of pathological reactions to traumatic events. Several theories, such as those developed by Horowitz (1976), Creamer (Creamer, Burgess, & Pattison, 1992; Creamer, 1995), and Janoff- Bulman (1985, 1989, 1992), propose that people have a set of preexisting beliefs and Correspondence: Vivian Kraaij, Leiden University, Department of Clinical and Health Psychology, P.O. Box 9555, 2300 RB Leiden, The Netherlands. Tel:  /31 71 5273736. Fax:  /31 71 5273619. E-mail: Kraaij@fsw. LeidenUniv.nl ISSN 1061-5806 print/ISSN 1477-2205 online # 2006 Taylor & Francis DOI: 10.1080/10615800500412449 Anxiety, Stress, and Coping, March 2006; 19(1): 1  /14