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Allbaugh LJ, George G, Klengel T, Profetto A, Marinack L, O'Malley F, Ressler KJ. Children of trauma survivors: Influences of parental posttraumatic stress and child-perceived parenting. J Affect Disord 2024; 354:224-231. [PMID: 38490588 DOI: 10.1016/j.jad.2024.03.067] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Revised: 02/20/2024] [Accepted: 03/09/2024] [Indexed: 03/17/2024]
Abstract
BACKGROUND Research has established a negative association between parental posttraumatic stress symptoms (PTSS), including subthreshold symptoms, and child physical and behavioral health outcomes. Such intergenerational transmission of risk has multiple possible mechanisms, including lack of positive parenting, increased negative parenting, shared environmental and contextual risks, and potential biological components such as shared genetics or even transmission of epigenetic risk. METHOD This study examined 93 parent-child dyads (n = 171 participants total) from a mixed Urban-Suburban US metropolitan area to investigate the relations between parental PTSS and child-perceived parenting and child PTSS. We sought to examine interactions between parental PTSS and parenting on child PTSS. RESULTS We found an association between parent and child PTSS, consistent with prior literature showing increased risk for children of trauma survivors. Interestingly, we found effects of positive parenting on diminished child PTSS symptoms only in parents without PTSS, whereas the effect of positive parenting on buffering child symptoms was absent in parents with PTSS. LIMITATIONS The present findings are tempered by the use of self-report data to assess parent and child PTSS, which is not as reliable as clinician assessment of symptoms. Further, the use of survey data limits what is known about the extent of trauma exposure in parents and children, and different measures were used to assess PTSS in parents and kids, which limits comparability of these reported symptoms. DISCUSSION Limitations notwithstanding, findings suggest joint attention paid to parenting practices and to a parent's recovery, even from subthreshold symptoms of PTSS, as two different but important ways to support trauma survivor parents in their efforts to most optimally parent and protect their children from intergenerational risk.
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Affiliation(s)
- Lucy J Allbaugh
- Department of Psychology, University of Dayton, Dayton, OH, United States of America.
| | - Grace George
- McLean Hospital, Boston, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Torsten Klengel
- McLean Hospital, Boston, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
| | - Alex Profetto
- McLean Hospital, Boston, MA, United States of America
| | - Lucas Marinack
- Department of Psychology, University of Wyoming, Laramie, WY, United States of America
| | - Fiona O'Malley
- Nationwide Children's Hospital, Columbus, OH, United States of America
| | - Kerry J Ressler
- McLean Hospital, Boston, MA, United States of America; Department of Psychiatry, Harvard Medical School, Boston, MA, United States of America
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El Moujabber P, Homsi V, Hallit S, Obeid S. The generation that lived during/participated in the war and the generation that inherited it: association between veterans PTSD and adult offspring's emotional regulation strategies and alexithymia levels. BMC Psychiatry 2023; 23:599. [PMID: 37592206 PMCID: PMC10433638 DOI: 10.1186/s12888-023-05087-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 08/07/2023] [Indexed: 08/19/2023] Open
Abstract
BACKGROUND The long-term repercussions that war can have on both war generations and post-war generations lack in the literature. It is imperative to understand the psychological consequences of the Lebanese Civil War that took place from 1975 to 1990, on the offspring of those who took part in it. Accordingly, the objective of this study was to assess the association between paternal/veterans PTSD and adult offspring's emotional regulation strategies and alexithymia levels, 30 years after the end of war. METHOD A cross-sectional study was carried out between September 2020 and September 2021 on a sample of 75 fathers of Lebanese former veterans and paramilitary veterans and their adult offspring. For the veterans and paramilitary veterans' population, the PTSD Checklist was used to assess post-traumatic stress disorder, and the Combat Exposure Scale (CES) was used to measure the level of combat exposure. For the offspring population, the Emotional Regulation Questionnaire (ERQ) was used to assess emotional regulation strategies and the Toronto Alexithymia Scale (TAS) was used to measure the levels of alexithymia. RESULTS Paternal PTSD (Beta = 10.19) was associated with higher levels of alexithymia in the offspring population. Regarding emotional regulation strategies, results showed that paternal PTSD (Beta = -3.24) was significantly associated with a decrease in the cognitive reappraisal score in the offspring. Also, paternal PTSD (Beta = 4.57) was significantly associated with an increase in expressive suppression score. Additionally, an older father's age (Beta = 1.11) was significantly associated with an increased alexithymia score in the offspring. Moreover, results showed that paternal combat injuries (Beta = -4.24) were significantly associated with a decrease in the alexithymia score in the offspring population and an increase in the expressive suppression score (Beta = 3.28). CONCLUSION This study shows that fathers' traumatic experience of war influences emotion regulation and alexithymia levels in their offspring. Longitudinal studies taking into account the age of the offspring at the time of onset of fathers' symptoms may provide us with additional information to understand the influence of paternal PTSD on the emotional functioning of offspring during different phases of emotional development.
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Affiliation(s)
- Perla El Moujabber
- School of Arts and Sciences, Psychology Department, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon
| | - Vanessa Homsi
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon
| | - Souheil Hallit
- School of Medicine and Medical Sciences, Holy Spirit University of Kaslik, P.O. Box 446, Jounieh, Lebanon.
- Applied Science Research Center, Applied Science Private University, Amman, Jordan.
- Research Department, Psychiatric Hospital of the Cross, Jal Eddib, Lebanon.
| | - Sahar Obeid
- School of Arts and Sciences, Social and Education Sciences Department, Lebanese American University, Jbeil, Lebanon.
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Di Giunta L, Lunetti C, Fiasconaro I, Gliozzo G, Salvo G, Ottaviani C, Aringolo K, Comitale C, Riccioni C, D’Angeli G. COVID-19 Impact on Parental Emotion Socialization and Youth Socioemotional Adjustment in Italy. JOURNAL OF RESEARCH ON ADOLESCENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR RESEARCH ON ADOLESCENCE 2021; 31:657-677. [PMID: 34448309 PMCID: PMC8646882 DOI: 10.1111/jora.12669] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
This study examines the change and associations in parental emotion socialization strategies in response to children's negative emotions and youths' adjustment, comparing before the Covid-19 pandemic hit Italy and since the pandemic began. Participants were convenient cross-sectional/normative (Study 1) and clinical/longitudinal (Study 2) samples of Italian parents whose children were in middle childhood and adolescence. In Study 1, self-reported socialization strategies, youths' maladjustment, and emotion dysregulation increased since the pandemic began. Whereas, in Study 2, socialization strategies and youths' maladjustment decreased since the pandemic started. In both studies, unsupportive parental emotion socialization predicted youths' maladjustment and emotion dysregulation, while supportive parental emotion socialization predicted adaptive emotion regulation. This study advances knowledge about the impact of the Covid-19 pandemic on the family context.
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Bachem R, Levin Y, Stein JY, Solomon Z. Families in the Shadow of Traumatic Experiences: Negative World Assumptions and Family Relationships. J Trauma Stress 2021; 34:149-160. [PMID: 33089550 DOI: 10.1002/jts.22603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/01/2019] [Revised: 05/02/2020] [Accepted: 06/12/2020] [Indexed: 11/11/2022]
Abstract
World assumptions (WAs) are cognitive schemas concerning an individual's views of themselves, the world, and others. Although it is well established that WAs are negatively distorted by trauma exposure and strongly associated with posttraumatic psychopathology, the potential impact of WAs on close interpersonal relationships remains largely uninvestigated. The current study explored the implications of veterans' and their spouses' WAs on their marital and parental relationships. Male Israeli veterans (N = 213) from the 1973 Yom Kippur War and their wives were assessed for WAs, marital adjustment, and positive parenting 35-37 years postwar. Analyses included actor-partner interdependence modeling with mediators (APIMem) and were conducted separately for the three domains of WAs: world benevolence, world meaningfulness, and self-worth. The results indicated that both husbands' and wives' lower scores for all domain-specific WA scales were associated with lower scores on measures of marital adjustment and positive parenting. Lower scores for both spouses on scales measuring world benevolence and self-worth were associated with a spillover from lower marital adjustment to lower positive parenting. Finally, associations between one spouse's lower WA scores and the other spouse's spillover from lower marital adjustment to lower positive parenting (i.e., cross-spillover effects) were identified for wives' world benevolence ratings and husbands' self-worth, ds = 0.14-0.72. These results point to the detrimental ramifications of negative WAs on family relationships and the dynamics between the marital and parental family subsystems.
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Affiliation(s)
- Rahel Bachem
- I-Core Research Center for Mass Trauma, Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Yafit Levin
- I-Core Research Center for Mass Trauma, Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Jacob Y Stein
- I-Core Research Center for Mass Trauma, Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
| | - Zahava Solomon
- I-Core Research Center for Mass Trauma, Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel
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Gatta M, Balottin L, Mannarini S, Chesani G, Del col L, Spoto A, Battistella PA. Familial factors relating to alexithymic traits in adolescents with psychiatric disorders. CLIN PSYCHOL-UK 2020. [DOI: 10.1111/cp.12098] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Michela Gatta
- Childhood Adolescence Family Unit, ULSS 16 Padova, Woman and Child Health Department, University of Padova, Padova, Italy,
| | - Laura Balottin
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy,
| | - Stefania Mannarini
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, University of Padova, Padova, Italy,
| | - Giulia Chesani
- Childhood Adolescence Family Unit, ULSS 16 Padova, Woman and Child Health Department, University of Padova, Padova, Italy,
| | - Lara Del col
- Childhood Adolescence Family Unit, ULSS 16 Padova, Woman and Child Health Department, University of Padova, Padova, Italy,
| | - Andrea Spoto
- General Psychology Department, University of Padova, Padova, Italy,
| | - Pier Antonio Battistella
- Childhood Adolescence Family Unit, ULSS 16 Padova, Woman and Child Health Department, University of Padova, Padova, Italy,
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Combat Experience and Posttraumatic Stress Symptoms among Military-Serving Parents: a Meta-Analytic Examination of Associated Offspring and Family Outcomes. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:131-148. [PMID: 29687429 DOI: 10.1007/s10802-018-0427-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
Abstract
In this meta-analysis, we review findings on the relationships between parental combat exposure and PTSD/PTSS in military-serving families and (1) parenting problems, (2) family maladjustment, and (3) offspring problems. We systematically searched for studies in PsycInfo, PsychArticles, Psychology and Behavior Sciences Collection, Published International Literature on Traumatic Stress (PILOTS), and PubMed/Medline as well as conducted manual searches. Search procedures identified 22 eligible studies, including 20 studies examining relationships between parental PTSD/PTSS and parenting, family, and/or offspring outcomes and 8 studies examining relationships between parental combat exposure and parenting, family, and/or offspring outcomes. Random effects meta-analytic models estimated omnibus associations between parental combat exposure/PTSD and pooled Family Difficulties, as well as individual relationships between parental combat exposure and PTSD/PTSS and parenting, family adjustment, and offspring outcomes. Small-to-moderate effect sizes were observed in the omnibus meta-analysis examining relationships between parental PTSD/PTSS and pooled Family Difficulties, and in the meta-analysis examining relationships between parental PTSD/PTSS and parenting problems, between parental PTSD/PTSS and poor family functioning, and between parental PTSD/PTSS and offspring problems. Associations between parental combat exposure and pooled Family Difficulties, as well as between parental combat exposure and parenting problems were smaller in magnitude. PTSD/PTSS among military-serving parents is associated with increased problems in the family environment, including parenting problems, family maladjustment, and offspring problems, whereas combat exposure alone is not as strongly associated with such family difficulties. Moderator analyses are presented and discussed as well. When military-serving parents show psychological symptoms, professionals should consider allocating resources to target broader family issues.
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Lifetime PTSD is associated with impaired emotion recognition in veterans and their offspring. Psychiatry Res 2020; 284:112666. [PMID: 31727441 DOI: 10.1016/j.psychres.2019.112666] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/11/2019] [Revised: 10/28/2019] [Accepted: 10/28/2019] [Indexed: 01/03/2023]
Abstract
PTSD is associated with emotion dysregulation. Studies have found inconsistent impaired facial emotion recognition ability (ERA) in patients with PTSD and intergenerational transmission of PTSD has been reported, although no studies exist regarding ERA. Our objective was to characterise the facial ERA of a group of traumatised war veterans with, and without lifetime PTSD, and also of their respective adult offspring. Sixty-one veterans with, and without lifetime PTSD and 73 offspring were tested for ERA of seven basic facial emotions expressions, 40 years after veterans had been exposed to war-related trauma. Veterans with lifetime PTSD showed impairment of recognition of all emotions, irrespective of the type, when compared with veterans without PTSD. This result was maintained after adjusting for potential confounders-including depressive symptoms. Offspring of veterans with lifetime PTSD also showed impaired recognition of all emotions, including after adjustment for the same variables. Offspring of veterans with lifetime PTSD also showed specific impairment in recognising the emotions of happiness and disgust. These results confirm that PTSD has negative effects with regards to emotion regulation and also on the next generation. This could result in this population being at increased risk of suffering from relationship problems and psychopathology.
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Wickersham A, Leightley D, Archer M, Fear NT. The association between paternal psychopathology and adolescent depression and anxiety: A systematic review. J Adolesc 2020; 79:232-246. [PMID: 31986478 DOI: 10.1016/j.adolescence.2020.01.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2018] [Revised: 12/13/2019] [Accepted: 01/12/2020] [Indexed: 12/30/2022]
Abstract
INTRODUCTION Paternal psychopathology is associated with various adolescent outcomes. With emotional disorders presenting a significant public health concern in the adolescent age group, the aim of this systematic review was to synthesize evidence on the relationship between paternal mental health and adolescent anxiety or depression. METHODS PubMed, Web of Science, Embase, Ovid MEDLINE, Global Health, and PsycINFO were searched for articles which primarily aimed to investigate the relationship between paternal mental health (exposure) and adolescent anxiety or depression (outcome). Articles were assessed for risk of bias, and findings are presented in a narrative synthesis. The protocol is registered on PROSPERO (CRD42018094076). RESULTS Findings from the fourteen included studies indicated that paternal depression is associated with adolescent depression and anxiety. Findings relating to other paternal mental health disorders were inconclusive. Results largely suggested that adolescent depression and anxiety is equally associated with paternal and maternal mental health. The included studies were mostly cross-sectional, and the quality of included studies was mixed. Attempts to focus on the 11-17 year age range were hampered by the variability of age ranges included in studies. CONCLUSIONS Further longitudinal research is needed to clarify the association between paternal mental health disorders other than depression, and adolescent anxiety or depression. Mechanisms in this relationship should also be further explored, and could be informed by existing models on younger children.
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Affiliation(s)
- Alice Wickersham
- King's Centre for Military Health Research, King's College London, United Kingdom; Department of Psychological Medicine, King's College London, United Kingdom; South London and Maudsley NHS Foundation Trust, United Kingdom.
| | - Daniel Leightley
- King's Centre for Military Health Research, King's College London, United Kingdom
| | - Marc Archer
- King's Centre for Military Health Research, King's College London, United Kingdom
| | - Nicola T Fear
- King's Centre for Military Health Research and Academic Department of Military Mental Health, King's College London, United Kingdom
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Aloni R, Mikulincer M, Zerach G, Solomon Z. The intergenerational sequelae of war captivity: the impact of a self-amplifying cycle of PTSD and attachment insecurities on offspring's attachment orientations. Eur J Psychotraumatol 2020; 11:1741859. [PMID: 32363009 PMCID: PMC7178882 DOI: 10.1080/20008198.2020.1741859] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2019] [Revised: 03/04/2020] [Accepted: 03/04/2020] [Indexed: 11/04/2022] Open
Abstract
Background: War captivity is one of the most severe human-made traumatic events which lead to self-amplifying cycle of post-traumatic stress disorder (PTSD) symptoms and attachment insecurities. Solid evidence in the literature pointed out on the intergenerational transmission of PTSD symptoms. However, no research has been conducted on the intergenerational transmission of attachment insecurities and the effect of the self-amplifying cycle among former prisoners of war (ex-POWs) and their offspring attachment insecurities. Objective: This research aims to explore the intergenerational impact of a self-amplifying cycle of PTSD and attachment insecurities among ex-POWs on their offspring's attachment orientations. Method: We sampled dyads of Israeli ex-POWs of the Yom Kippur war and their adult offspring (ex-POW group) (n = 80) as well as dyads of Israeli veterans who fought in the Yom Kippur war, but were never held captive, and their adult offspring (control group) (n = 40). Veterans reported on PTSD severity and attachment orientations (anxiety, avoidance). Offspring reported on attachment orientations. We conducted (a) hierarchical regressions to predict offspring attachment orientations as a function of veterans' attachment orientations, and (b) moderated mediation analyses examining the role of veterans' PTSD in the intergenerational transmission of attachment orientations. Results: Ex-POWs' attachment anxiety was associated with offspring's reports of higher attachment anxiety and avoidance, and this intergenerational transmission of attachment was mediated by ex-POWs' PTSD severity. These effects were not significant in the control group. Conclusions: Decades after the war end, the intergenerational sequelae of war captivity are evident by the impact of the self-amplifying cycle of PTSD and attachment insecurities among ex-POWs and their offspring's attachment insecurities. Therefore, it is imperative for clinicians to recognize the intergenerational transmission and to focus not only on the trauma but also on the traumatized person's attachment injuries and the shattering of core beliefs about the world, self, and others, in the context of attachment-based therapies.
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Affiliation(s)
- Roy Aloni
- School of Social Work, Ariel University, Tel-Aviv, Israel
| | - Mario Mikulincer
- School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Gadi Zerach
- Department of Behavioral Sciences and Psychology, Ariel University, Ariel, Israel
| | - Zahava Solomon
- School of Social Work, Ariel University, Tel-Aviv, Israel
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10
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Mutuyimana C, Sezibera V, Nsabimana E, Mugabo L, Cassady C, Musanabaganwa C, Kayiteshonga Y. PTSD prevalence among resident mothers and their offspring in Rwanda 25 years after the 1994 genocide against the Tutsi. BMC Psychol 2019; 7:84. [PMID: 31856892 PMCID: PMC6923965 DOI: 10.1186/s40359-019-0362-4] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2019] [Accepted: 12/04/2019] [Indexed: 11/10/2022] Open
Abstract
Background The 1994 Genocide against the Tutsi was a major traumatic event affecting nearly all Rwandans. Significant psychological sequels continue to occur in the population 25 years after, with a high prevalence of posttraumatic stress disorder (PTSD) found in women. Three groups are typically designated with regard to the Genocide against the Tutsi: those who were targeted and categorized as genocide “survivors,” those who were in the country during the genocide and were the “non-targeted” group, and those who were outside of the country, referred to as the “1959 returnees.” Each group experienced various traumatic events during and in the aftermath of the genocide. Offspring of the designated groups, currently exhibit symptoms of PTSD disregarding of being born in the years following the genocide. A number of studies have described the prevalence of PTSD in the general adult population. There is a lack of research comparing the prevalence of PTSD in women and their offspring among these three target groups, therefore, this study aimed to bridge the gap. Methods We conducted a comparative cross-sectional study with a sample of 432 mothers and 432 children in three categories: genocide survivors, in country non-targeted and 1959 returnees. Participant ages for children were between 14 to 22 years and for mothers, between the ages of 32 to 87 years. The UCLA-PTSD DSM-5, PTSD Check list-5 and Life events Checklist-5 were translated from English to Kinyarwanda and were used to assess exposure to trauma and the prevalence of PTSD symptoms in Rwandan mothers and their offspring. Results Key Results yield a PTSD rate of 18.8, 6.2, 5.2% within survivors, in country non-targeted, and returnees respectively with an average PTSD rate of 43.8% for parents, and 16.5% for offspring. Conclusion PTSD among the mothers’ groups and their offspring have been found, specifically in the offspring of genocide survivors. Considering these adolescents were not born at the time of the 1994 Genocide against the Tutsi, the results suggest future studies should explore the precipitating factors contributing to the PTSD symptoms within this specific group.
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Affiliation(s)
- Celestin Mutuyimana
- Centre for Mental Health, University of Rwanda, Kigali, Rwanda. .,Hope and Homes for Children, Salisbury, UK.
| | | | | | - Lambert Mugabo
- Centre for Mental Health, University of Rwanda, Kigali, Rwanda
| | - Cindi Cassady
- Department of Clinical Psychology, University of Kibungo, Kibungo, Rwanda
| | | | - Yvonne Kayiteshonga
- Mental Health Division, Rwanda Biomedical Centre, Ministry of Health, Kigali, Rwanda
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Batchelor V, Pang TY. HPA axis regulation and stress response is subject to intergenerational modification by paternal trauma and stress. Gen Comp Endocrinol 2019; 280:47-53. [PMID: 30981703 DOI: 10.1016/j.ygcen.2019.04.010] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2018] [Revised: 04/08/2019] [Accepted: 04/09/2019] [Indexed: 12/20/2022]
Abstract
There is increasing evidence that one's risk for psychiatric disturbances and metabolic syndromes is influenced by their parents' own health history, lifestyle and living environment. For example, paternal high fat diet is strongly linked to neuroendocrine dysregulation in offspring and increased risk for diabetes. The potential intergenerational impact of paternal stress has only just begun to emerge, with the initial evidence suggestive of greater risk for anxiety-related disorders. The hypothalamic-pituitary-adrenal (HPA)-axis is a key neuroendocrine signalling system involved in physiological homeostasis and stress response. In individuals, dysregulation of this system is closely associated with behavioral deficits and mood disorders. Various preclinical models of paternal stress have demonstrated robust behavioral shifts but little is known about the intergenerational modification of HPA axis function. This review will present evidence drawn from a range of laboratory mouse and rat models that the intergenerational influence of paternal stress on offspring behavioral phenotypes involve some level of HPA axis dysregulation. It makes the case that further investigations to comprehensively profile HPA axis function in offspring generations is warranted.
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Affiliation(s)
- Vicky Batchelor
- Department of Anatomy & Neuroscience, University of Melbourne, VIC 3010, Australia; Florey Institute of Neurosciences and Mental Health, University of Melbourne, VIC 3010, Australia
| | - Terence Y Pang
- Department of Anatomy & Neuroscience, University of Melbourne, VIC 3010, Australia; Florey Institute of Neurosciences and Mental Health, University of Melbourne, VIC 3010, Australia.
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Honda Y, Fujiwara T, Yagi J, Homma H, Mashiko H, Nagao K, Okuyama M, Ono-Kihara M, Kihara M. Long-Term Impact of Parental Post-Traumatic Stress Disorder Symptoms on Mental Health of Their Offspring After the Great East Japan Earthquake. Front Psychiatry 2019; 10:496. [PMID: 31404309 PMCID: PMC6675868 DOI: 10.3389/fpsyt.2019.00496] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2018] [Accepted: 06/24/2019] [Indexed: 12/02/2022] Open
Abstract
Longitudinal studies of the long-term psychological impact of the Great East Japan Earthquake (GEJE) on parents and their children have been limited. The current study aimed to monitor parents' post-traumatic stress disorder (PTSD) symptoms and behavioral problems among their children over time and to analyze their long-term associations among the survivors of the GEJE. We used data from the GEJE Follow-up for Children study, which recruited 4- to 6-year-old children and those children's parents immediately after the GEJE in March 2011, with ongoing follow-up. Children's total, internalizing, and externalizing behavioral problems were assessed using the Child Behavior Checklist (CBCL), and parental probable PTSD was assessed using the Impact of Event Scale-R (IES-R), in 2012 (baseline) and 2014 (follow-up). Parental PTSD symptoms and children's behavioral problems declined slightly over time, and both showed a significant correlation between the surveys (r = 0.55-0.77, P < 0.001). The association between parental PTSD symptoms and children's behavioral problems was investigated using multivariate logistic regression analysis adjusting for baseline children's behavioral problems and other potential confounders. Cross-sectionally, while no significant association was detected in 2012, all types of children's behavioral problems exhibited significant positive associations with parental PTSD symptoms in multiple logistic regression analysis adjusted odds ratio (AOR) = 3.03, 3.30, and 5.34 for total, internalizing, and externalizing behavior problems, respectively. Maternal educational attainment level (higher than high school education) showed a significant negative association with children's total and externalizing behavioral problems (AOR = 0.30 and 0.13, respectively) in 2014. Longitudinally, parental PTSD symptoms in 2012 showed a significant association with children's internalizing behavioral problems in 2014 after adjusting for children's behavioral problems in 2012 and parental PTSD symptoms in 2014 (AOR = 4.62). These results suggest that the effect of the GEJE on parental PTSD symptoms and children's behavioral problems was long-term, lasting for at least 3 years. These possibilities should be carefully considered in mental health support for parents and their offspring in areas affected by the GEJE.
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Affiliation(s)
- Yukiko Honda
- Division of Advanced Preventive Medical Sciences, Graduate School of Biomedical Sciences, Nagasaki University, Nagasaki, Japan
- Faculty of Advanced Science and Technology, Kumamoto University, Kumamoto, Japan
- Department of Global Health and Socio-epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
- Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
| | - Takeo Fujiwara
- Department of Social Medicine, National Research Institute for Child Health and Development, Tokyo, Japan
- Department of Global Health Promotion, Tokyo Medical and Dental University, Tokyo, Japan
| | - Junko Yagi
- Department of Psychiatry, Iwate Medical University, Iwate, Japan
| | | | | | | | - Makiko Okuyama
- Department of Psychosocial Medicine, National Center for Child Health and Development, Tokyo, Japan
| | - Masako Ono-Kihara
- Department of Global Health and Socio-epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Masahiro Kihara
- Department of Global Health and Socio-epidemiology, School of Public Health, Graduate School of Medicine, Kyoto University, Kyoto, Japan
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Mannarini S, Balottin L, Palmieri A, Carotenuto F. Emotion Regulation and Parental Bonding in Families of Adolescents With Internalizing and Externalizing Symptoms. Front Psychol 2018; 9:1493. [PMID: 30174638 PMCID: PMC6107795 DOI: 10.3389/fpsyg.2018.01493] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2018] [Accepted: 07/30/2018] [Indexed: 12/04/2022] Open
Abstract
Parental bonding and emotional regulation, while important to explain difficulties that may arise in child development, have mainly been studied at an individual level. The present study aims to examine alexithymia and parental bonding in families of adolescents with psychiatric disorders through different generations. The sample included a total of 102 adolescent patients with psychiatric disorders and their parents. In order to take a family level approach, a Latent Class Analysis was used to identify the latent relationships among alexithymia (Toronto Alexithymia Scale), perceived parental bonding (Parental Bonding Instrument) and the presence of adolescent internalizing or externalizing psychiatric symptoms (Youth Self-Report). Families of internalizing and externalizing adolescents present different and specific patterns of emotional regulation and parenting. High levels of adolescent alexithymia, along with a neglectful parenting style perceived by the adolescent and the father as well, characterized the families of patients with internalizing symptoms. On the other hand, in the families with externalizing adolescents, it was mainly the mother to remember an affectionless control parental style. These results suggest the existence of an intergenerational transmission of specific parental bonding, which may influence the emotional regulation and therefore the manifestation of psychiatric symptoms.
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Affiliation(s)
- Stefania Mannarini
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Laura Balottin
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Arianna Palmieri
- Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
| | - Francesco Carotenuto
- Interdepartmental Center for Family Research, Department of Philosophy, Sociology, Education, and Applied Psychology, Section of Applied Psychology, University of Padova, Padova, Italy
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Lang AJ, Gartstein MA. Intergenerational transmission of traumatization: Theoretical framework and implications for prevention. J Trauma Dissociation 2018; 19:162-175. [PMID: 28509617 DOI: 10.1080/15299732.2017.1329773] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Intergenerational transmission of traumatization (ITT) occurs when traumatized parents have offspring with increased risk for emotional and behavioral problems. Although fetal exposure to the maternal biological milieu is known to be one factor in ITT, PTSD-driven parent-child interactions represent an additional important and potentially modifiable contributor. The Perinatal Interactional Model of ITT presented herein proposes that PTSD leads to social learning and suboptimal parent-child interactions, which undermine child regulatory capacity and increase distress, largely explaining poor social-emotional outcomes for offspring of parents with PTSD. Psychosocial intervention, particularly when delivered early in pregnancy, holds the possibility of disrupting ITT.
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Affiliation(s)
- Ariel J Lang
- a VA San Diego Center of Excellence for Stress and Mental Health (CESAMH) , University of California San Diego , San Diego , California , USA
| | - Maria A Gartstein
- b Department of Psychology , Washington State University , Pullman , Washington , USA
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Zerach G, Solomon Z. Gender differences in posttraumatic stress symptoms among former prisoners of wars’ adult offspring. ANXIETY STRESS AND COPING 2017; 31:21-31. [DOI: 10.1080/10615806.2017.1368835] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gadi Zerach
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Zahava Solomon
- Bob Shapell School of Social Work and I-Core Research Center for Mass Trauma, Tel Aviv University, Tel Aviv, Israel
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Zhou X, Levin Y, Stein JY, Zerach G, Solomon Z. Couple Forgiveness and its Moderating Role in the Intergenerational Transmission of Veterans' Posttraumatic Stress Symptoms. JOURNAL OF MARITAL AND FAMILY THERAPY 2017; 43:410-421. [PMID: 27859442 DOI: 10.1111/jmft.12200] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/06/2023]
Abstract
This study examined the moderating effect couple forgiveness (as perceived by the wives/mothers) may have on the intergenerational transmission of posttraumatic stress symptoms (PTSS) among families of combat veterans and former prisoners of war (ex-POWs). The sample included 123 (79 ex-POWs and 44 control combatants) Israeli father-mother-adult offspring triads. Self-report measures were administered at 2008 to veterans, at 2010-2011 to wives, and at 2013-2014 to offspring. The findings indicated that ex-POWs' PTSS were positively related to their offspring's PTSS, while couple forgiveness buffered this effect, particularly, and detrimentally, when couple forgiveness was low. These findings imply that apprehending the quality of the forgiving atmosphere within the marital relationship may be important for understanding the apparatus of intergenerational transmissions of trauma.
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Fisher SD. Paternal Mental Health: Why Is It Relevant? Am J Lifestyle Med 2017; 11:200-211. [PMID: 30202331 PMCID: PMC6125083 DOI: 10.1177/1559827616629895] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 11/02/2015] [Accepted: 01/11/2016] [Indexed: 01/23/2023] Open
Abstract
Father's mental health is an emerging area of interest that is beginning to be recognized in research, and to a lesser extent in clinical practice and society. Fathers are part of a parenting dyad with 2 partners who are responsible for their children's emotional development. Similar to mothers, the risk for mental health problems increases once a male becomes a father, but there is limited research examining this issue. The purpose of this review is to present the available literature on father's mental health and its effect on child emotional health through various mechanisms. In general, father's mental health was found to be related to increased child internalizing and externalizing behaviors, but each disorder had different risk factors, and a unique effect on parenting behaviors and the child's emotional health. The most developed paternal mental health literature is focused on depression. However, key conceptual and methodological problems exist that may limit our understanding of paternal depression. Additionally, the focus on paternal depression may not accurately represent the largest risk for paternal psychopathology and the resultant child mental health outcomes because men have an increased likelihood of displaying externalizing behaviors. Implications for research, clinical practice, and policy are discussed.
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Affiliation(s)
- Sheehan D. Fisher
- Department of Psychiatry and Behavioral Science, Feinberg School of Medicine, Northwestern University, Chicago, Illinois
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Zerach G, Kanat-Maymon Y. The Role of Fathers’ Posttraumatic Stress Symptoms and Dyadic Adjustment in the Intergeneration Transmission of Captivity Trauma. JOURNAL OF LOSS & TRAUMA 2017. [DOI: 10.1080/15325024.2017.1310497] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Affiliation(s)
- Gadi Zerach
- Department of Behavioral Sciences, Ariel University, Ariel, Israel
| | - Yaniv Kanat-Maymon
- The School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
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Selimbasic Z, Sinanovic O, Avdibegovic E, Brkic M, Hamidovic J. Behavioral Problems and Emotional Difficulties at Children and Early Adolescents of the Veterans of War with Post-Traumatic Stress Disorder. Med Arch 2017; 71:56-61. [PMID: 28428676 PMCID: PMC5364795 DOI: 10.5455/medarh.2017.71.56-61] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Behavioral problems and emotional difficulties at children of the veterans of war with post-traumatic stress disorder (PTSD) have not been researched entirely. In our country, which has a lot of persons suffering from some psychological traumas, this trauma seems to continue. AIM The aim of this study was to determine the exposure, manifestations of behavioral problems and emotional difficulties at children and early adolescents, whose fathers were the veterans of war demonstrating post-traumatic stress disorder symptoms. RESPONDENTS AND METHODS The analyzed group comprised 120 school age children (10-15 years of age), whose parents/fathers were the veterans of war. The children were divided into two groups, and each group into the following two age sub-groups: 10-12 (children) and 13-15 (early adolescents) according to PTSD presence at their fathers - veterans of war. PTSD symptoms at fathers, veterans of war, were assessed using the Harvard Trauma Questionnaire-Bosnia and Herzegovina version and MKB-10 - audit of criteria. To assess the behavioral problems of children, the Child Behavior Checklist for parents was used, and to evaluate the neuroticism at children Hanes-Scale of neuroticism-extraversion was used while the depression level was evaluated using the Depression self-rating scale (DSRS). To analyze the obtained results, SPSS 17 program was used. The value p <0. 05 is considered significant. RESULTS Children of fathers, the veterans of war, demonstrating the PTSD symptoms show more problems in activity, social and school conduct as well as in symptoms of behavioral problems compared to the children whose fathers do not demonstrate the PTSD symptoms (p<0. 001). Children of the war veterans demonstrating the symptoms of the post-traumatic stress disorder show significant difference at neuroticism sub-scales (p<0.001). Negative correlation between PTSD and activity, social and school conduct has been determined (p <0. 01), while positive correlation was determined between PTSD of war veterans with symptoms and neuroticism at children (p <0. 01). Depression symptoms are found at 17.5% children, while 28.3% are in the risky group and the girls demonstrate higher depression level. CONCLUSION Children and early adolescents of fathers - veterans of war with post-traumatic stress disorder show significant differences in competencies, behavior, emotional difficulties and neuroticism. Significant correlation was found between psychopathology of parents - fathers the veterans of war and their children. Impact of psychological conditions of fathers - the veterans of war with post-traumatic stress disorder to children is strong and they represent a significant risky group for development of mental disorders.
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Affiliation(s)
- Zihnet Selimbasic
- Clinic for Psychiatry, University Clinical Centre, University in Tuzla, Bosnia and Herzegovina
- Faculty of Medicine, University in Tuzla, Tuzla, Bosnia and Herzegovina
| | - Osman Sinanovic
- Clinic for Neurology, University Clinical Centre, University in Tuzla, Bosnia and Herzegovina
- Faculty of Medicine, University in Tuzla, Tuzla, Bosnia and Herzegovina
| | - Esmina Avdibegovic
- Clinic for Psychiatry, University Clinical Centre, University in Tuzla, Bosnia and Herzegovina
- Faculty of Medicine, University in Tuzla, Tuzla, Bosnia and Herzegovina
| | - Maja Brkic
- Clinic for Psychiatry, University Clinical Centre, University in Tuzla, Bosnia and Herzegovina
| | - Jasmin Hamidovic
- Clinic for Psychiatry, University Clinical Centre, University in Tuzla, Bosnia and Herzegovina
- Faculty of Medicine, University in Tuzla, Tuzla, Bosnia and Herzegovina
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King N, Smith A. Exploring the impact of parental post-traumatic stress disorder on military family children: A review of the literature. NURSE EDUCATION TODAY 2016; 47:29-36. [PMID: 27189880 DOI: 10.1016/j.nedt.2016.04.018] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2015] [Revised: 03/26/2016] [Accepted: 04/20/2016] [Indexed: 06/05/2023]
Abstract
OBJECTIVES The number of UK service personnel who have a diagnosis of PTSD is unclear, but there has been a recent increase in referrals to services for PTSD symptomology. It is imperative to understand the impact this may have on the children of affected service families. This review of literature aimed to explore and provide insight into the experiences of services children whose parent has a diagnosis of PTSD. DESIGN A comprehensive review of the literature. DATA SOURCES Online databases CINAHL, MEDLINE, psychARTICLES, The Psychology and Behavioural Sciences Collection and PILOTS were searched. REVIEW METHODS The studies were chosen in keeping with a specified inclusion and exclusion criteria. The literature was critically analysed and key themes identified through the strategy of thematic analysis. RESULTS Five studies met the inclusion criteria. Three key themes were identified from the five articles; secondary traumatisation; impact on the child's mental health; and impact on the child's adult relationships. CONCLUSION The findings highlighted the prevalence of secondary traumatisation and a potential negative impact on the child's mental health and relationships. However, literature used in the review was conducted in countries outside of the UK, therefore the comparison of results may be compromised. This review identifies the paucity of research on this topic and highlights the need for UK based research to be carried out in this area.
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Affiliation(s)
- Natalie King
- Ridgewood Centre, Surrey and Borders Partnership NHS Trust, Frimley, Surrey GU16 9QE, United Kingdom
| | - Alison Smith
- School of Health Sciences, Stag Hill Campus, University of Surrey, Guildford, Surrey GU2 7AX, United Kingdom
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van Ee E, Kleber RJ, Jongmans MJ. Relational Patterns Between Caregivers With PTSD and Their Nonexposed Children: A Review. TRAUMA, VIOLENCE & ABUSE 2016; 17:186-203. [PMID: 25964276 DOI: 10.1177/1524838015584355] [Citation(s) in RCA: 72] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The question as to whether or not children can be affected by the traumatization of their parents has been the topic of a long-standing debate. This article provides a critical review of 72 research studies on traumatized parents with symptoms of posttraumatic stress disorder (PTSD), the parent-child interaction, and the impact on their nonexposed child (0-18 years). The evidence suggests that traumatization can cause parenting limitations, and these limitations can disrupt the development of the young child. From the studies reviewed several patterns emerged: Relational patterns of traumatized parents who are observed to be emotionally less available and who perceive their children more negatively than parents without symptoms of PTSD; relational patterns of children who at a young age are easily deregulated or distressed and at an older age are reported to face more difficulties in their psychosocial development than children of parents without symptoms of PTSD; and relational patterns that show remarkable similarities to relational patterns between depressed or anxious parents and their children. Mechanisms such as mentalization, attachment, physiological factors, and the cycle of abuse offer a valuable perspective to further our understanding of the relational patterns. This article builds on previous work by discussing the emerged patterns between traumatized parents and their nonexposed children from a relational and transactional perspective.
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Affiliation(s)
- Elisa van Ee
- Reinier van Arkel, Psychotraumacentrum Zuid Nederland, Den Bosch, the Netherlands
| | - Rolf J Kleber
- Clinical and Health Psychology, Utrecht University, Utrecht, the Netherlands
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Zerach G, Kanat-Maymon Y, Aloni R, Solomon Z. The role of fathers' psychopathology in the intergenerational transmission of captivity trauma: A twenty three-year longitudinal study. J Affect Disord 2016; 190:84-92. [PMID: 26480215 DOI: 10.1016/j.jad.2015.09.072] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2015] [Revised: 09/02/2015] [Accepted: 09/15/2015] [Indexed: 10/22/2022]
Abstract
BACKGROUND The aversive impact of combat and parents' combat-induced posttraumatic stress disorder (PTSD) on young children has been examined in a few studies. However, the long-term toll of war captivity on the secondary traumatization (ST) of adult offspring remains unknown. This study aimed to assess the longitudinal associations between former prisoners of war (ex-POWs), PTSD, depressive symptoms and their adult offsprings ST. METHOD A sample of 134 Israeli father-child dyads (80 ex-POWs dyads and a comparison group of 44 veterans'dyads) completed self-report measures. The fathers participated in three waves of measurements following the Yom Kippur War (T1: 1991, T2: 2003, and T3: 2008), while the offspring took part in T4 (2013). RESULTS Offspring of ex-POWs with PTSD at T3 reported more ST symptoms than offspring of ex-POWs without PTSD and controls. Ex-POWs' PTSD hyper-arousal symptom cluster at T3 was positively related to offsprings ST avoidance symptom cluster. Offspring of ex-POWs with chronic and delayed PTSD trajectories reported more ST symptoms than offspring of ex-POWS and controls with resilient trajectories. Ex-POWs' PTSD and depression symptoms at T1, T2 and T3 mediated the link between war captivity (groups) and offsprings ST in T4. LIMITATIONS The use of self-report measures that did not cover the entire span of 40 years since the war, might may bias the results. CONCLUSIONS The intergenerational transmission of captivity related trauma following the Yom Kippur War was exemplified. ST symptoms among ex-POWs' adult offspring are closely related to their father' PTSD and related depressive symptom comorbidity.
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Affiliation(s)
- Gadi Zerach
- Department of Behavioral Sciences, Ariel University, Ariel, Israel.
| | - Yaniv Kanat-Maymon
- The School of Psychology, Interdisciplinary Center Herzliya, Herzliya, Israel
| | - Roy Aloni
- Bob Shapell School of Social Work, Tel Aviv University, I-Core Research Center for Mass Trauma, Tel Aviv, Israel
| | - Zahava Solomon
- Bob Shapell School of Social Work, Tel Aviv University, I-Core Research Center for Mass Trauma, Tel Aviv, Israel
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Zerach G, Solomon Z. A Relational Model for the Intergenerational Transmission of Captivity Trauma: A 23-Year Longitudinal Study. Psychiatry 2016; 79:297-316. [PMID: 27880620 DOI: 10.1080/00332747.2016.1142775] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
OBJECTIVES The aversive, long-term toll of war captivity and fathers' combat-induced posttraumatic stress disorder (PTSD) on adult offspring's secondary traumatization (ST) has been recently exemplified. However, the study of potential mechanisms of the intergenerational transmission of trauma to offspring is still lacking. This prospective study aimed to assess the role of fathers' PTSD symptoms (PTSS), paternal parenting, and adult offspring's attachment insecurities in adult offspring's PTSS. METHOD A sample of 124 Israeli father-child dyads (80 ex-POW dyads and a comparison group of 44 veteran dyads) completed self-report measures. The fathers participated in three waves of measurements following the Yom Kippur War (T1: 1991, T2: 2003, T3: 2008), while the offspring took part in T4 (2013). RESULTS Offspring of ex-POWs with PTSD at T3 reported more PTSS and higher levels of attachment insecurities than offspring of ex-POWs without PTSD and controls at T4. Fathers' proximity to the children and sensitivity to the children's needs were negatively related. Offspring's attachment insecurities were positively related to offspring's PTSS. Importantly, serial multiple mediation model results show that war captivity increased the level of the fathers' PTSD at T2 and T3, which in turn decreased the level of the fathers' parenting at T3, and thereby increased the level of offspring's attachment avoidance at T4, which by its own merit was related to higher levels of adult offspring's PTSS. CONCLUSIONS The mechanisms of the intergenerational transmission of captivity-related trauma of veterans' PTSD and paternal parenting, through offspring's attachment insecurities and offspring's PTSS, was exemplified.
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Shahini M, Rescorla L, Wancata J, Ahmeti A. Mental health problems in Kosovar adolescents: results from a national mental health survey. NEUROPSYCHIATRIE : KLINIK, DIAGNOSTIK, THERAPIE UND REHABILITATION : ORGAN DER GESELLSCHAFT ÖSTERREICHISCHER NERVENÄRZTE UND PSYCHIATER 2015; 29:125-32. [PMID: 26290137 DOI: 10.1007/s40211-015-0155-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/30/2015] [Accepted: 08/05/2015] [Indexed: 11/25/2022]
Abstract
PURPOSE Our purpose was to determine the effects of gender and age on Kosovar YSR scores and the prevalence of self-reported behavioral/emotional problems in Kosovar adolescents based on scores above a cutpoint. METHODS Participants were 1351 adolescents recruited from secondary schools in seven regions of Kosova who completed the Youth Self-Report. RESULTS The oldest adolescents had the highest scores on many YSR scales. Although Kosova's mean problems scores were not elevated relative to international norms, the percentage of adolescents scoring in the deviant range (borderline + clinical) was much higher than expected for almost all YSR problem scales, including Total Problems (31.2%), Internalizing (40.8%), and Externalizing (23.4%). The 23% prevalence of elevated scores on Stress Problems was triple the expected 7% prevalence based on a 93rd percentile cutpoint. CONCLUSION Results revealed much higher prevalence of psychopathology than would be expected based on international norms, with 25-40% of Kosovar adolescents scoring in the deviant range on YSR scales, Thus, our research indicates a need for expanding psychiatry services to meet the pressing mental health needs of Kosovar adolescents as well as the importance of considering mental health problems in their social context.
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Affiliation(s)
- Mimoza Shahini
- Child and Adolescent Psychiatry, University Clinical Center of Kosova, 10000, Prishtine, Kosove.
| | - Leslie Rescorla
- Department of Psychology, Bryn Mawr College, 101 N. Merion, Avenue, 19010, Bryn Mawr, PA, USA
| | - Johannes Wancata
- Klinische Abteilung für Sozialpsychiatrie, Univ.-Klinik für Psychiatrie und Psychotherapie, Medizinische Universität Wien, Allgemeines Krankenhaus der Stadt Wien, Währinger Gürtel 18-20, 1090, Vienna, Austria
| | - Adelina Ahmeti
- Child and Adolescent Psychiatry, University Clinical Center of Kosova, 10000, Prishtine, Kosove.
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Boričević Maršanić V, Aukst Margetić B, Ožanić Bulić S, Đuretić I, Kniewald H, Jukić T, Paradžik L. Non-suicidal self-injury among psychiatric outpatient adolescent offspring of Croatian posttraumatic stress disorder male war veterans: Prevalence and psychosocial correlates. Int J Soc Psychiatry 2015; 61:265-74. [PMID: 25008331 DOI: 10.1177/0020764014541248] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND The children of male veterans with combat-related posttraumatic stress disorder (PTSD) are at particularly high risk of emotional and behavioral problems. However, no studies have examined non-suicidal self-injury (NSSI) in this population of youth. AIMS To determine the prevalence and psychosocial correlates of lifetime NSSI in a sample of psychiatric outpatient adolescent offspring of Croatian PTSD male veterans. METHOD Consecutive outpatient adolescent offspring of Croatian male PTSD veterans, aged 12 to 18 years, were assessed on the Deliberate Self Harm Inventory, the Youth Self-Report, the Family Assessment Device, the Parental Bonding Instrument and the Demographics Questionnaire. RESULTS Of the whole sample, 52.7% of adolescents reported NSSI at least once during their lifetime. Lifetime NSSI was significantly associated with internalizing symptoms (adjusted odds ratio (OR) = 2.14; 95% confidence interval (CI): 1.04-4.42, p = .040), poor family functioning (adjusted OR = 6.54; 95% CI: 2.02-21.22, p = .002), lower maternal and paternal care (adjusted OR = 0.47; 95% CI: 0.40-0.56, p = .000 and adjusted OR = 0.82; 95% CI: 0.73-0.91, p = .000, respectively) and higher paternal control (adjusted OR = 1.84; 95% CI: 1.59-2.14, p = .000) in multivariate analysis. No association was found between lifetime NSSI and any of the socio-demographic variables. CONCLUSION NSSI is a significant clinical problem in outpatient adolescent offspring of PTSD male veterans, which may be influenced by clinical and family factors. Interventions aimed at reducing internalizing symptoms and improving family functioning and parental behaviors are needed in the treatment of adolescent offspring of male PTSD veterans engaging in NSSI.
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Affiliation(s)
| | | | - Suzana Ožanić Bulić
- Department of Dermatology, University Hospital Center Sestre Milosrdnice, Zagreb, Croatia
| | - Irena Đuretić
- Psychiatric Hospital for Children and Adolescents, Zagreb, Croatia
| | - Hrvoje Kniewald
- Department of Pediatrics, University Hospital Center Zagreb, Zagreb, Croatia
| | - Tatjana Jukić
- Neuropsychiatric Hospital Dr. I. Barbot, Popovača, Croatia
| | - Ljubica Paradžik
- Psychiatric Hospital for Children and Adolescents, Zagreb, Croatia
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Impact of parents' wartime military deployment and injury on young children's safety and mental health. J Am Acad Child Adolesc Psychiatry 2015; 54:294-301. [PMID: 25791146 DOI: 10.1016/j.jaac.2014.12.017] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Revised: 12/03/2014] [Accepted: 12/29/2014] [Indexed: 11/23/2022]
Abstract
OBJECTIVE Children are at risk for adverse outcomes during parental military deployments. We aim to determine the impact of parental deployment and combat injury on young children's postdeployment mental health, injuries, and maltreatment. METHOD This is a population-based, retrospective cohort study of young children of active duty military parents during fiscal years (FY) 2006 to 2007, a high deployment period. A total of 487,460 children, 3 to 8 years of age, who received Military Health System care, were included. The relative rates of mental health, injury, and child maltreatment visits of children whose parents deployed and children of combat-injured parents were compared to children unexposed to parental deployment. RESULTS Of the included children, 58,479 (12%) had a parent deploy, and 5,405 (1%) had a parent injured during deployment. Relative to children whose parents did not deploy, children of deployed and combat-injured parents, respectively, had additional visits for mental health diagnoses (incidence rate ratio [IRR] = 1.09 [95% CI = 1.02-1.17], IRR = 1.67 [95% CI = 1.47-1.89]), injuries (IRR = 1.07 [95% CI = 1.04-1.09], IRR = 1.24 [95% CI = 1.17-1.32]), and child maltreatment (IRR = 1.21 [95% CI = 1.11-1.32], IRR 2.30 = [95% CI 2.02-2.61]) postdeployment. CONCLUSION Young children of deployed and combat-injured military parents have more postdeployment visits for mental health, injuries, and child maltreatment. Mental health problems, injuries, and maltreatment after a parent's return from deployment are amplified in children of combat-injured parents. Increased preventive and intervention services are needed for young children as parents return from deployments. Child health and mental health providers are crucial to effective identification of these at-risk children to ensure effective care provision.
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Self-Reported Emotional and Behavioral Problems, Family Functioning and Parental Bonding Among Psychiatric Outpatient Adolescent Offspring of Croatian Male Veterans with Partial PTSD. CHILD & YOUTH CARE FORUM 2015. [DOI: 10.1007/s10566-015-9299-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Boričević Maršanić V, Margetić BA, Zečević I, Herceg M. The prevalence and psychosocial correlates of suicide attempts among inpatient adolescent offspring of Croatian PTSD male war veterans. Child Psychiatry Hum Dev 2014; 45:577-87. [PMID: 24338268 DOI: 10.1007/s10578-013-0426-2] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Despite evidence that children of male war veterans with combat-related posttraumatic stress disorder (PTSD) are at particularly high risk for behavior problems, very little is currently known about suicidal behaviors in this population of youth. This study aimed to examine the prevalence and psychosocial correlates of suicide attempts among psychiatrically hospitalized adolescent offspring of Croatian male PTSD veterans. Participants were psychiatric inpatients, ages 12-18 years. Self-report questionnaires assessed demographics, suicide attempts, psychopathology, parenting style, and family functioning. The prevalence of suicide attempts was 61.5% (65.2% for girls and 58.0% for boys). Internalizing symptoms, family dysfunction, lower levels of maternal and paternal care, and paternal overcontrol were significantly associated with suicide attempts. Our findings suggest that suicide attempts are common among inpatient adolescent offspring of male PTSD veterans and that interventions targeting both adolescent psychopathology and family relationships are needed for adolescents who have attempted suicide.
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Zerach G, Aloni R. Secondary traumatization among former prisoners of wars' adult children: the mediating role of parental bonding. ANXIETY STRESS AND COPING 2014; 28:162-78. [DOI: 10.1080/10615806.2014.923097] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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