Transgenerational trauma in a post-conflict setting: Effects on offspring PTSS/PTSD and offspring vulnerability in Cambodian families

Assessing transgenerational trauma transmission: development and psychometric properties of the Historical Intergenerational Trauma Transmission Questionnaire (HITT-Q)

ABSTRACTObjective/Background: Despite increasing attention on transgenerational trauma, currently no comprehensive model and measure exists to be applied on various populations. This study represents the first step in the validation of such a model and a related scale. The Historical Intergenerational Trauma Questionnaire (HITT-Q) assesses family and offspring self-reported vulnerability and resilience, as well as offspring historical moral injury and current levels of insidious trauma.Method: We developed the HITT-Q based on the cross-population model (HITT model; [Starrs, C. & Békés, V. (2024). Historical and transgenerational trauma: A conceptual framework. Traumatology. In Press]) which incorporates key findings in existing population specific studies. For initial validation of the model and its measurement, Holocaust survivors' offspring (N = 1104) completed the HITT-Q, measures of current mental health symptoms (PTSD, C-PTSD, anxiety, and depression), and a resilience scale.Results: In line with the HITT model, confirmatory factor analyses supported a 12-factor solution with the following factors under theorized dimensions: I. Family Vulnerability: (1) Dysregulated and Trauma-related Communication; (2)Trauma-influenced Parenting, (3) Fear; (4) Distress; II. (5) Family Resilience, III. Offspring Vulnerability: (6) Escape; (7) Heightened Responsibility; (8) Trauma-related distress; IV. Offspring Resilience: (9) Coping; (10) Belonging; (11) Values; V. (12) Historical Moral injury. The 12-factor model showed acceptable to good internal validity, and comparison with an existing measure of transgenerational Holocaust trauma indicated good concurrent validity. Finally, the HITT-Q demonstrated predictive validity for mental health symptoms and current resilience.Conclusions: The current study represents the first step in validating the HITT-Q as a comprehensive measure of historical intergenerational vulnerability and resilience. Our findings provide strong support for the underlying model, and suggest that the HITT-Q represents a valuable scale for both research and historical trauma-informed care.

In the shadow of dissidence: exploring the experiences of descendants of Czechoslovakian dissidents

Introduction

The Communist Party's reign in Czechoslovakia (1948-1989) saw the persecution of thousands of individuals. The State Security campaign "Asanace" (meaning "sanitation") was conducted to expel critics of the regime from the country using psychological and physical terror. Although stories of dissidents are frequently presented in public spaces, little is known about the experiences of their children.

Methods

To address this gap, we conducted interpretative phenomenological analyses of semi-structured in-depth interviews with five adult descendants of Czechoslovakian dissidents.

Results

Our analyses revealed that while participants appreciated and were inspired by their parents' dissident activities, they tend to distance themselves from it in order not to live in their parents' shadow. Furthermore, for them, the "Asanace" campaign primarily meant emigration, which in turn affected their sense of self and (national) identity dispersion. Consequently, they experienced feelings of being uprooted and different. Furthermore, they faced challenges acculturating. However, they also recognized their resilience as being rooted in their migration experience and the legacy of their parents' dissidence.

Discussion

By highlighting intergenerational differences and the impact of family legacy on individuals' strengths and weaknesses, this study contributes to our understanding of the psychological consequences of living in, escaping from and adjusting to life beyond oppressive regimes.

Bedside to bench: the outlook for psychedelic research

There has recently been a resurgence of interest in psychedelic compounds based on studies demonstrating their potential therapeutic applications in treating post-traumatic stress disorder, substance abuse disorders, and treatment-resistant depression. Despite promising efficacy observed in some clinical trials, the full range of biological effects and mechanism(s) of action of these compounds have yet to be fully established. Indeed, most studies to date have focused on assessing the psychological mechanisms of psychedelics, often neglecting the non-psychological modes of action. However, it is important to understand that psychedelics may mediate their therapeutic effects through multi-faceted mechanisms, such as the modulation of brain network activity, neuronal plasticity, neuroendocrine function, glial cell regulation, epigenetic processes, and the gut-brain axis. This review provides a framework supporting the implementation of a multi-faceted approach, incorporating in silico, in vitro and in vivo modeling, to aid in the comprehensive understanding of the physiological effects of psychedelics and their potential for clinical application beyond the treatment of psychiatric disorders. We also provide an overview of the literature supporting the potential utility of psychedelics for the treatment of brain injury (e.g., stroke and traumatic brain injury), neurodegenerative diseases (e.g., Parkinson's and Alzheimer's diseases), and gut-brain axis dysfunction associated with psychiatric disorders (e.g., generalized anxiety disorder and major depressive disorder). To move the field forward, we outline advantageous experimental frameworks to explore these and other novel applications for psychedelics.

Clinically relevant historical trauma sequelae: A systematic review

OBJECTIVES

The purpose of this systematic review (SR) was to present the current state of research on historical trauma, and the topics closely related to its semantic space that include intergenerational trauma, collective trauma, and extended cultural bodily and mental responses, in order to identify gaps in the literature that need to be addressed.

METHODS

A search of empirical studies from 1990 to 2022 was performed via Scopus, Web of Science, MEDLINE, EBSCOhost-PsychInfo, and Embase, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist.

RESULTS

The initial search yielded 1012 studies, 52 of which were included in the current review. The results show that the historical trauma concept has a high potential for new research in the field of Global Mental Health. Gaps in the literature were identified, including a lack of standard features of historical trauma, and assessments of historical trauma in additional contexts than its original fields of application with Indigenous Americans.

CONCLUSION

Although the introduction of the concept of historical trauma was intended to fill the gap of trauma-related difficulties not covered by the criteria of post-traumatic stress disorder (PTSD), this concept needs further scientific refinement.

The Impact of Parent Torture and Family Functioning on Youth Adjustment in War-Affected Families: A Path Analysis Describing Intergenerational Trauma and the Family System

The direct exposure to physical or psychological trauma from torture or war leads to well-documented individual health consequences. Less understood are the inclusive and intergenerational effects of war trauma on family systems and youth adjustment. The purpose was to examine mechanisms in war-affected families that explained the significant emotional and behavioral consequences of intergenerational trauma in youth through the use of multiple methods. Quantitative assessments of maternal and paternal caregivers and youth characterized associations between parent torture, parent mental health distress, parent physical health problems, family functioning, and youth adjustment. Narrative statements further contextualized processes through which the trauma of a parent impacted youth and family systems. The research was conducted in partnership with local, refugee-serving community-based organizations. The study sample included parents and youth in 96 Karen families, originating from Burma in Southeast Asia, who had been resettled to the United States through the U.S. Refugee Admissions Program. Path analysis results indicated that parent torture (β = -0.173) had statistically significant negative direct effects on youth adjustment. Parent torture had a negative indirect effect on youth adjustment through the mental health (β = -0.345) and physical health problems of parents (β = -0.305), and youth gender (β = 0.126) and trauma exposure of youth (β = -0.048). Family functioning type demonstrated a positive direct effect on youth adjustment (β = 0.449). Family type had an indirect effect on youth adjustment through youth gender (β = 0.142), youth trauma exposure (β = -0.165), parent physical health problems (β = -0.202), and parent mental health (β = 0.509). The current study developed and tested the first model of intergenerational trauma's effects on the adjustment of Karen refugee youth. Results emphasize that individual recovery from torture must be accompanied by adjunct interventions focused on family systems and youth adjustment, to holistically address intergenerational sequala of trauma.

Intergenerational Communication about Historical Trauma in Asian American Families

Little is known about how Asian American families, as well as other racially marginalized families, communicate about ethnic and racial group histories, particularly regarding historical trauma. Unlike personal trauma, historical trauma refers to distressing or life-threatening events which members of a group with a shared social identity experience together and pass on to their descendants. It has been studied in a variety of groups and contexts, notably in Holocaust survivors and their families and in Native American communities. The concept has seen limited application to Asian American groups, despite its relevance to their unique and shared lived experiences. For instance, the majority of Asian Americans have immigrated from countries across Asia that have been profoundly affected by war and political upheaval in the past century. Research on historical trauma among Asian Americans has focused primarily on refugees who fled the US wars in Southeast Asia, with some research on Japanese Americans who were incarcerated during World War II. Historical trauma related to other major events, such as the India/Pakistan Partition, the Chinese Civil War and Cultural Revolution, the Korean War, and the Sri Lankan Civil War, have not been examined among Asian Americans. A lack of recognition of these historical traumas within families and communities, as well as in the psychological literature, may mask important pre-migration history effects on Asian American families across generations. In this paper, we consider how historical trauma impacts Asian American individuals, families, and communities. We also examine the role of intergenerational communication in historical trauma and in Asian American families and communities. Finally, we discuss historical trauma among Asian Americans within the framework of radical healing, particularly how intergenerational communication about historical trauma can raise critical consciousness, facilitate ethnic-racial identity development, and reinforce ethnic-racial socialization.

Advocating for a Collaborative Research Approach on Transgenerational Transmission of Trauma

Since Myers (1915) coined the term 'shell shock' to define the prolonged suffering of soldiers returning from the Great War, the psychological and physical result of distressing experiences, known as trauma, has been of academic interest. Transgenerational transmission of trauma effects has been recorded, demonstrating that on some level, the exposure to trauma of one generation can impact individuals of a subsequent generation (Yehuda & Lehrner, 2018). Observational studies on children of holocaust survivors formed the basis of this trajectory of research (Rakoff, 1966), and eventually this phenomenon became referred to as the transgenerational transmission of trauma (TTT). Since then, TTT has been observed in several contexts, including within families who have experienced high rates historical trauma (O'Neill et al., 2016), within regions high-frequencies of historical war and terrorism (Yehuda & Lehrner, 2018) and those who have undergone famine (Ahmed, 2010). This report aims to outline several pathways (biological, psychological, and sociological) by which trauma may be transmitted across generations. Moreover, it discusses several methods of trauma assessment and the related challenges and benefits. Lastly, this report advocates a biopsychosocial approach - an interdisciplinary model using the interplay of biological, psychological, and social-environmental factors - to research TTT. By promoting the benefits of such an interdisciplinary approach we attempt to break up silos between disciplines and encourage collaboration between academics from various backgrounds researching this topic to better serve individuals impacted by TTT.

Mechanisms Explaining the Relationship Between Maternal Torture Exposure and Youth Adjustment In Resettled Refugees: A Pilot Examination of Generational Trauma Through Moderated Mediation

The intergenerational effects of trauma resulting from torture and war are complex and multi-faceted and have important implications for the family system. The current study aimed to identify key relationships between refugee maternal caregiver exposure to torture, mental health, and physical health with maternal-reported youth adjustment. Ninety-six Karen maternal caregivers originating from Burma and resettled in the United States participated in a cross-sectional, explanatory mixed methods study. Maternal mental health distress was found to mediate the relationship betweenmaternal torture experiences and youth adjustment, R² = .357. Physical health problems was found to moderate the degree to which mental health distress mediated the relationship between torture and war trauma experiences and youth adjustment, R² = .409. The current study is significant in that it enhances our mechanistic understanding of factors relevant to the intergenerational effects of trauma within families where maternal caregivers experienced trauma from torture and/or war.

Direct and indirect psychological impacts of shark-bite events

OBJECTIVE

Shark bites are rare, with intense media exposure. There are no known studies of the psychological impacts of this specific type of traumatic event. This is the first study that describes those directly and indirectly affected, and evaluates the prevalence of post-traumatic stress disorder (PTSD) and related risk factors.

METHODS

In total, 124 members of an Australian shark-bite peer-support group were invited to complete an online survey assessing demographic, event, media and psychological factors. Response rate was 48% ( n = 60, 63% male, 44 ± 14 years). Retrospective and current measures of PTSD (PTSD Checklist for DSM-5 [PCL-5]) and suicidality (Suicidal Ideation Attributes Scale [SIDAS-5]) were used.

RESULTS

Post-event PTSD was prevalent in this sample ( n = 16/59, 27.1%, 95% confidence interval [CI] = [15.4, 38.8]), but less so currently ( n = 2/55, 3.6%, 95% CI = [0.0, 8.7]). In addition, nine ( n = 9/59, 15.3%, 95% CI = [5.8, 24.7]) had subthreshold, but highly symptomatic, syndromes post event. There was no association of PTSD with direct/indirect bite involvement, gender, or prior trauma. Two respondents were at risk of suicidal behaviour. PTSD was commonly reported by those without a partner (odds ratio [OR] = 5.91, 95% CI = [1.52, 22.99], p = 0.01) or with two friends or fewer to rely on (OR = 5.83, 95% CI = [1.62, 21.01], p = 0.01). PTSD was more likely in those with a negative media experience ( n = 34/52, 65.4%, OR = 11.90, 95% CI = [1.42, 100.04], p = 0.02) and 61.5% ( n = 32/52) of respondents reported media coverage lasting months or years. In multivariate modelling, negative media impact, relationship status and friendships were independently associated with PTSD and explained much of the variance in PTSD ( F_4,41 = 10.94, p < 0.0001, r² = 0.52).

CONCLUSION

Nearly one-third of members of an Australian shark-bite peer-support group report post-event PTSD, and one-quarter of these were not present at the time of the event. Findings support interventions targeting negative media impact, similar to media reporting guidelines for suicide, and enhancing social support.