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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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2
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Bertelsen TB, Haugland BSM, Wergeland GJ, Håland ÅT. Parental Early Life Maltreatment and Related Experiences in Treatment of Youth Anxiety Disorder. Child Psychiatry Hum Dev 2023:10.1007/s10578-023-01520-1. [PMID: 36939980 DOI: 10.1007/s10578-023-01520-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 03/21/2023]
Abstract
The role of parents' early life maltreatment (ELM) (e.g. physical, sexual abuse) and related experiences, in relation to offspring anxiety is not well understood. The current study investigated the association between self-reported depression and ELM and related experiences in mothers (n = 79) and fathers (n = 50), and mother-, father-, and youth-reported symptoms of youth anxiety (n = 90). Outcomes were assessed at pre,- and posttreatment and 3-, 6-, and 12-months follow-up. Parental ELM were not associated with pre-treatment differences or differences in outcome of treatment. However ELM related experiences were associated with increased mother-, father-, and youth-rated youth anxiety at pretreatment. Fathers depressive symptoms were found to mediate the relationship between father ELM related experiences and father-rated youth anxiety symptoms. Future research is warranted on parental ELM and depression as factors affecting outcomes of treatment of youth anxiety. Trial registered at: helseforskning.etikkom.no (reg. nr. 2017/1367).
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Affiliation(s)
- Thomas B Bertelsen
- Department of Child and Adolescence Mental Health, Sørlandet Sykehus, Egsveien 100, 4630, Kristiansand, Norway. .,Department of Clinical Child and Adolescent Psychology, Faculty of Psychology, University of Bergen, Bergen, Norway.
| | | | - Gro Janne Wergeland
- Division of Psychiatry, Department of Child and Adolescent Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, Faculty of Medicine, University of Bergen, Bergen, Norway
| | - Åshild Tellefsen Håland
- Department of Child and Adolescence Mental Health, Sørlandet Sykehus, Egsveien 100, 4630, Kristiansand, Norway
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3
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Greeson KW, Crow KMS, Edenfield RC, Easley CA. Inheritance of paternal lifestyles and exposures through sperm DNA methylation. Nat Rev Urol 2023:10.1038/s41585-022-00708-9. [PMID: 36653672 DOI: 10.1038/s41585-022-00708-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/12/2022] [Indexed: 01/19/2023]
Abstract
Many different lifestyle factors and chemicals present in the environment are a threat to the reproductive tracts of humans. The potential for parental preconception exposure to alter gametes and for these alterations to be passed on to offspring and negatively affect embryo growth and development is of concern. The connection between maternal exposures and offspring health is a frequent focus in epidemiological studies, but paternal preconception exposures are much less frequently considered and are also very important determinants of offspring health. Several environmental and lifestyle factors in men have been found to alter sperm epigenetics, which can regulate gene expression during early embryonic development. Epigenetic information is thought to be a mechanism that evolved for organisms to pass on information about their lived experiences to offspring. DNA methylation is a well-studied epigenetic regulator that is sensitive to environmental exposures in somatic cells and sperm. The continuous production of sperm from spermatogonial stem cells throughout a man's adult life and the presence of spermatogonial stem cells outside of the blood-testis barrier makes them susceptible to environmental insults. Furthermore, altered sperm DNA methylation patterns can be maintained throughout development and ultimately result in impairments, which could predispose offspring to disease. Innovations in human stem cell-based spermatogenic models can be used to elucidate the paternal origins of health and disease.
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Affiliation(s)
- Katherine W Greeson
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA.,Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Krista M S Crow
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA.,Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - R Clayton Edenfield
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA.,Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Charles A Easley
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA. .,Regenerative Bioscience Center, University of Georgia, Athens, GA, USA.
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4
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Hartzell G, Stenson AF, van Rooij SJ, Kim YJ, Vance LA, Hinrichs R, Kaslow N, Bradley B, Jovanovic T. Intergenerational effects of maternal PTSD: Roles of parenting stress and child sex. PSYCHOLOGICAL TRAUMA : THEORY, RESEARCH, PRACTICE AND POLICY 2022; 14:1089-1098. [PMID: 31916804 PMCID: PMC7343607 DOI: 10.1037/tra0000542] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
OBJECTIVES Parental posttraumatic stress disorder (PTSD) increases children's risk for emotional and behavioral problems. We examined parenting stress and parenting behavior quality as mediators of the relation between maternal PTSD and problematic child behaviors in a sample at high risk for trauma exposure. We also examined whether child sex moderated this association. METHOD Participants were 141 African American mother-child dyads (children aged 8-12). Mothers reported PTSD severity, parenting stress, and child behavior (externalizing, internalizing, and emotional self-control). Parenting behavior quality (accounting for factors including parental warmth and engagement) was assessed from an observational parent-child interaction task. RESULTS Parenting stress, but not observed parenting behavior quality, mediated the relation between maternal PTSD severity and child behaviors. Child sex moderated this association, such that the effect was stronger for girls. CONCLUSIONS Maternal PTSD may be associated with negative child behavior outcomes, and this relation appears to be mediated by increased parenting stress. Stress-reducing interventions for parents with PTSD could improve child outcomes, especially for girls. (PsycInfo Database Record (c) 2022 APA, all rights reserved).
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Affiliation(s)
- Georgina Hartzell
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Anaïs F. Stenson
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Sanne J.H. van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Ye Ji Kim
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - L. Alexander Vance
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Rebecca Hinrichs
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Nadine Kaslow
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
| | - Bekh Bradley
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
- Atlanta Veteran’s Administration Medical Center
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine
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5
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Hinckley JD, Danielson CK. Elucidating the Neurobiologic Etiology of Comorbid PTSD and Substance Use Disorders. Brain Sci 2022; 12:brainsci12091166. [PMID: 36138902 PMCID: PMC9496654 DOI: 10.3390/brainsci12091166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2022] [Revised: 08/23/2022] [Accepted: 08/29/2022] [Indexed: 11/26/2022] Open
Abstract
Early childhood maltreatment and other traumatic event experiences ("trauma") are common among youth, including those with substance use problems including substance use disorders (SUD). Particularly, interpersonal violence is associated with high rates of comorbidity between posttraumatic stress disorder (PTSD) and SUD, and these comorbid disorders exhibit high levels of overlapping symptomatology. Theoretical models proposed to explain the bidirectional relationship between PTSD and SUD include the self-medication hypothesis and susceptibility hypothesis. In this article, we explore neurobiologic changes associated with trauma, PTSD, and SUD that underly dysregulated stress response. Examining lessons learned from recent translational and clinical research, we propose that further elucidating the neurobiologic etiology of comorbid PTSD and SUD will require a collaborative, interdisciplinary approach, including the integration of preclinical and clinical studies, exploration of biologic markers in clinical studies, and accumulation of larger studies and longitudinal studies with the power to study PTSD and SUD. Such research can transform the field and ultimately reduce high rates and costly impairment of co-occurring PTSD and SUD across the lifespan.
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Affiliation(s)
- Jesse D. Hinckley
- Division of Addiction Science, Treatment & Prevention, Department of Psychiatry, University of Colorado School of Medicine, 1890 N Revere Court, MS-F570, Aurora, CO 80045, USA
- Correspondence:
| | - Carla Kmett Danielson
- National Crime Victims Research & Treatment Center, Department of Psychiatry & Behavioral Sciences, Medical University of South Carolina, 67 President Street, MSC 861, Charleston, SC 29425, USA
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6
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Burenkova OV, Podturkin AA, Naumova OY, Hein S, Li N, Cicchetti D, Luthar SS, Grigorenko EL. Neuroendocrine and autonomic stress systems activity in young adults raised by mothers with mental health and substance abuse problems: A prospective cohort study. Dev Psychobiol 2021; 63:e22213. [PMID: 34813100 PMCID: PMC8650616 DOI: 10.1002/dev.22213] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2021] [Revised: 07/27/2021] [Accepted: 10/26/2021] [Indexed: 11/07/2022]
Abstract
Among the well-known physiological consequences of early adverse environments is dysregulation of the hypothalamic-pituitary-adrenal (HPA) axis. A number of studies demonstrate that negative parenting and living with parents with a history of substance abuse and mental health problems may be associated with HPA axis dysregulation in children. In contrast, studies of more delayed effects in adult offspring, especially prospective, are still scarce. This study was a prospective longitudinal investigation of the association between maternal mental illnesses/substance abuse and maternal negative parenting/parental stress on one side and, on the other side, adult offspring outcomes 10 years later-specifically, we studied the activity of offspring's neuroendocrine (cortisol) and autonomic (heart rate) systems when exposed to a mild psychological stressor. Children of mothers with mental illnesses and/or substance abuse were exposed to more disadvantaged conditions (higher negative parenting and community violence). Despite this, maternal risk groups (having a mother with mental illnesses and/or substance abuse) were not associated with any of the indicators of stress systems activity. Regardless of the risk group, participants with dysregulated HPA axis activity experienced a higher level of negative parenting. Altogether, our study provides evidence that negative parenting may have long-lasting effects on stress-sensitive physiological mechanisms.
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Affiliation(s)
- Olga V. Burenkova
- Department of Psychology, University of Houston, Houston,
Texas, United States of America
- Department of Psychology, Saint-Petersburg State
University, Saint Petersburg, Russian Federation
| | | | - Oksana Yu. Naumova
- Department of Psychology, University of Houston, Houston,
Texas, United States of America
- Department of Psychology, Saint-Petersburg State
University, Saint Petersburg, Russian Federation
- Human Genetics Laboratory, Vavilov Institute of General
Genetics RAS, Moscow, Russian Federation
| | - Sascha Hein
- Department of Education and Psychology, Free University of
Berlin, Berlin, Germany
| | - Nan Li
- Department of Psychology, University of Houston, Houston,
Texas, United States of America
| | - Dante Cicchetti
- University of Minnesota, Institute of Child Development,
Minneapolis, United States of America
| | - Suniya S. Luthar
- Authentic Connections, Tempe, AZ; Emerita - Teachers
College, Columbia University, New York City, New York, United States of
America
| | - Elena L. Grigorenko
- Department of Psychology, University of Houston, Houston,
Texas, United States of America
- Department of Psychology, Saint-Petersburg State
University, Saint Petersburg, Russian Federation
- Baylor College of Medicine, Houston, Texas, United States
of America
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7
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Ghai M, Kader F. A Review on Epigenetic Inheritance of Experiences in Humans. Biochem Genet 2021; 60:1107-1140. [PMID: 34792705 DOI: 10.1007/s10528-021-10155-7] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2021] [Accepted: 11/04/2021] [Indexed: 12/13/2022]
Abstract
If genetics defines the inheritance of DNA, epigenetics aims to regulate and make it adaptable. Epigenetic alterations include DNA methylation, chromatin remodelling, post-translational modifications of histone proteins and activity of non-coding RNAs. Several studies, especially in animal models, have reported transgenerational inheritance of epigenetic marks. However, evidence of transgenerational inheritance in humans via germline in the absence of any direct exposure to the driving external stimulus remains controversial. Most of the epimutations exist in relation with genetic variants. The present review looks at intergenerational and transgenerational inheritance in humans, (both father and mother) in response to diet, exposure to chemicals, stress, exercise, and disease status. If not transgenerational, at least intergenerational human studies could help to understand early processes of inheritance. In humans, female and male germline development follow separate paths of epigenetic events and both oocyte and sperm possess their own unique epigenomes. While DNA methylation alterations are reset during epigenetic reprogramming, non-coding RNAs via human sperm provide evidence of being reliable carriers for transgenerational inheritance. Human studies reveal that one mechanism of epigenetic inheritance cannot be applied to the complete human genome. Multiple factors including time, type, and tissue of exposure determine if the modified epigenetic mark could be transmissible and till which generation. Population-specific differences should also be taken into consideration while associating inheritance to an environmental exposure. A longitudinal study targeting one environmental factor, but different population groups should be conducted at a specific geographical location to pinpoint heritable epigenetic changes.
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Affiliation(s)
- Meenu Ghai
- Discipline of Genetics, School of Life Sciences, Westville Campus, University of KwaZulu-Natal, Private Bag X54001, Durban, KwaZulu Natal, South Africa.
| | - Farzeen Kader
- Discipline of Genetics, School of Life Sciences, Westville Campus, University of KwaZulu-Natal, Private Bag X54001, Durban, KwaZulu Natal, South Africa
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8
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Senehi N, Flykt M, Biringen Z, Laudenslager ML, Watamura SE, Garrett BA, Kominsky TK, Wurster HE, Sarche M. Emotional Availability as a Moderator of Stress for Young Children and Parents in Two Diverse Early Head Start Samples. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2021:10.1007/s11121-021-01307-7. [PMID: 34773574 DOI: 10.1007/s11121-021-01307-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/14/2021] [Indexed: 10/19/2022]
Abstract
Positive parent-child relationship quality is critical for buffering children from the effects of stress on development. It is thus vital to develop interventions that target parent-child relationship quality for families experiencing stress. We examined the moderating role of parent-child relationship quality (as measured by parental emotional availability [EA]) in the intergenerational association between parental adverse childhood experiences (ACEs) and their young children's hair cortisol concentrations (HCCs)-a physiological marker of cumulative hypothalamic pituitary adrenal (HPA)-axis activity. Using data from 127 parent-child dyads collected by two of six ACF-funded Buffering Toxic Stress consortium sites, we tested interaction effects of parental ACEs with parental EA on young children's (Mage = 18.38, SDage = 7.10) HCC. Results revealed curvilinear main effects such that higher parental ACEs were significantly associated with greater HCC and stronger associations occurred at higher levels of parental ACEs. However, this association was moderated by parental EA. Thus, among children with higher parental history of ACEs, children of parents with higher EA had lower HCC compared to children of parents with lower EA. These findings provide support for the risk-buffering and risk-exacerbating role of parent-child relationship quality (e.g., EA) for the transmission of parents' early life adversity on their children's HPA-axis activity, documented here in a racially and ethnically diverse sample of children and parents served by Early Head Start. Findings suggest that intervention and prevention efforts targeting stress response in children of mothers with childhood adversity should also support parents in building an emotionally available relationship with their children.
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Affiliation(s)
- Neda Senehi
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, 31001 E 17th Place, Aurora, CO, USA.
| | - Marjo Flykt
- Faculty of Social Sciences/Psychology, Tampere University, Tampere, Finland
- Faculty of Medicine/Psychology, University of Helsinki, Helsinki, Finland
| | - Zeynep Biringen
- Department of Human Development and Family Services, Colorado State University, Fort Collins, USA
| | - Mark L Laudenslager
- Department of Psychiatry, University of Colorado Anschutz Medical Campus, 31001 E 17th Place, Aurora, CO, USA
| | | | | | | | - Hannah E Wurster
- Department of Human Development and Family Services, Colorado State University, Fort Collins, USA
| | - Michelle Sarche
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, USA
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9
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Stenson AF, van Rooij SJH, Carter SE, Powers A, Jovanovic T. A legacy of fear: Physiological evidence for intergenerational effects of trauma exposure on fear and safety signal learning among African Americans. Behav Brain Res 2020; 402:113017. [PMID: 33197457 DOI: 10.1016/j.bbr.2020.113017] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2020] [Revised: 10/18/2020] [Accepted: 11/10/2020] [Indexed: 12/31/2022]
Abstract
OBJECTIVE To determine the influence of maternal trauma and posttraumatic stress disorder (PTSD) symptoms on children's physiological response to threat and safety signals during a fear conditioning task in trauma-exposed mothers and children. METHOD Participants were African American mother-child dyads (N = 137; children aged 8-13 years). Mothers' trauma history and PTSD symptoms were assessed; Latent Class Analysis (LCA) was conducted from these measures to identify distinct classes. Children reported violence exposure and completed a differential fear conditioning task using fear-potentiated startle (FPS) responses to conditioned danger (CS+) and safety (CS-) signals. RESULTS Four classes of maternal trauma history and PTSD symptoms emerged: 1) Lower Trauma, 2) Moderate Trauma, 3) High Sexual Abuse, and 4) High Trauma and PTSD Symptoms. Children's FPS to CS + and CS- were tested with maternal class as the between-subjects factor. FPS to the danger signal was not significantly different across maternal classes, but FPS to safety (CS-) was significantly higher for the Lower Trauma and High Trauma and PTSD Symptoms classes than either the Moderate Trauma or the High Sexual Abuse classes. CONCLUSIONS Results indicate that maternal trauma impacts children's ability to modulate fear responses in the presence of a safety signal, independent of the children's own trauma exposure. To our knowledge, this is the first study to demonstrate that children's fear inhibition is impacted by maternal trauma exposure. Prior studies have linked fear inhibition to mental health outcomes, highlighting the need to understand intergenerational modulation of fear learning and physiology.
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Affiliation(s)
- Anaïs F Stenson
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States.
| | - Sanne J H van Rooij
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Sierra E Carter
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Abigail Powers
- Department of Psychiatry and Behavioral Sciences, Emory University, Atlanta, GA, United States
| | - Tanja Jovanovic
- Department of Psychiatry and Behavioral Neurosciences, Wayne State University, Detroit, MI, United States
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10
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Grefe CN, Brown EJ, Lang C, Sharma-Patel K. Implementation of a Trauma-Specific, Evidence-Informed Treatment for Adolescents: Two Cases Highlighting How to and How Not to Integrate. COGNITIVE AND BEHAVIORAL PRACTICE 2020. [DOI: 10.1016/j.cbpra.2019.07.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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11
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Bhattacharya S, Fontaine A, MacCallum PE, Drover J, Blundell J. Stress Across Generations: DNA Methylation as a Potential Mechanism Underlying Intergenerational Effects of Stress in Both Post-traumatic Stress Disorder and Pre-clinical Predator Stress Rodent Models. Front Behav Neurosci 2019; 13:113. [PMID: 31191267 PMCID: PMC6547031 DOI: 10.3389/fnbeh.2019.00113] [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: 12/06/2018] [Accepted: 05/07/2019] [Indexed: 12/12/2022] Open
Abstract
Although most humans will experience some type of traumatic event in their lifetime only a small set of individuals will go on to develop post-traumatic stress disorder (PTSD). Differences in sex, age, trauma type, and comorbidity, along with many other elements, contribute to the heterogenous manifestation of this disorder. Nonetheless, aberrant hypothalamus-pituitary-adrenal (HPA) axis activity, especially in terms of cortisol and glucocorticoid receptor (GR) alterations, has been postulated as a tenable factor in the etiology and pathophysiology of PTSD. Moreover, emerging data suggests that the harmful effects of traumatic stress to the HPA axis in PTSD can also propagate into future generations, making offspring more prone to psychopathologies. Predator stress models provide an ethical and ethologically relevant way to investigate tentative mechanisms that are thought to underlie this phenomenon. In this review article, we discuss findings from human and laboratory predator stress studies that suggest changes to DNA methylation germane to GRs may underlie the generational effects of trauma transmission. Understanding mechanisms that promote stress-induced psychopathology will represent a major advance in the field and may lead to novel treatments for such devastating, and often treatment-resistant trauma and stress-disorders.
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Affiliation(s)
- Sriya Bhattacharya
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Audrey Fontaine
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada.,Institut des Systèmes Intelligents et de Robotique (ISIR), Université Pierre et Marie Curie, Sorbonne Universités, Paris, France
| | - Phillip E MacCallum
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - James Drover
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
| | - Jacqueline Blundell
- Department of Psychology, Memorial University of Newfoundland, St. John's, NL, Canada
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12
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Koszycki D, Taljaard M, Bielajew C, Gow RM, Bradwejn J. Stress reactivity in healthy child offspring of parents with anxiety disorders. Psychiatry Res 2019; 272:756-764. [PMID: 30832196 DOI: 10.1016/j.psychres.2018.12.171] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2018] [Revised: 12/09/2018] [Accepted: 12/30/2018] [Indexed: 11/26/2022]
Abstract
Several studies suggest that anxiety disorders (AD) involve dysregulation of the autonomic nervous system (ANS) and hypothalamic-pituitary (HPA) axis. However, it is unknown if alterations in these biological systems are premorbid markers of AD risk or a state-dependent feature of anxiety. This study examined ANS and HPA-axis response to a laboratory stressor in healthy child offspring of parents with (n = 55) and without (n = 98) a history of AD. High frequency heart rate variability (HF-HRV) was assessed during sitting and standing baseline conditions and during a speech task where participants remained standing. Salivary cortisol was measured at baseline and at 15, 30, 45 and 60 min post-speech. Subjective anxiety was assessed with a visual analogue scale. Children of parents with AD displayed reduced HRV and a blunted cortisol response to the speech task compared to children of non-anxious parents. No risk group effect was found for anxiety ratings. These preliminary data suggest that healthy children of anxious parents exhibit altered stress reactivity to an acute laboratory stressor. Further research is needed to confirm findings and identify mechanisms that may account for altered self-regulation processes to a stressor in children at familial risk for AD.
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Affiliation(s)
- Diana Koszycki
- University of Ottawa, Ottawa, Ontario, Canada; Institut du savoir Montfort, Ottawa, Ontario, Canada; University of Ottawa Brain and Mind Research Institute, Ottawa, Ontario, Canada.
| | | | | | - Robert M Gow
- University of Ottawa, Ottawa, Ontario, Canada; Children's Hospital of Eastern Ontario, Ottawa, Ontario, Canada
| | - Jacques Bradwejn
- University of Ottawa, Ottawa, Ontario, Canada; Institut du savoir Montfort, Ottawa, Ontario, Canada
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13
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Yehuda R, Lehrner A. Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms. World Psychiatry 2018; 17:243-257. [PMID: 30192087 PMCID: PMC6127768 DOI: 10.1002/wps.20568] [Citation(s) in RCA: 194] [Impact Index Per Article: 32.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/13/2018] [Revised: 06/13/2018] [Accepted: 06/13/2018] [Indexed: 12/18/2022] Open
Abstract
This paper reviews the research evidence concerning the intergenerational transmission of trauma effects and the possible role of epigenetic mechanisms in this transmission. Two broad categories of epigenetically mediated effects are highlighted. The first involves developmentally programmed effects. These can result from the influence of the offspring's early environmental exposures, including postnatal maternal care as well as in utero exposure reflecting maternal stress during pregnancy. The second includes epigenetic changes associated with a preconception trauma in parents that may affect the germline, and impact fetoplacental interactions. Several factors, such as sex-specific epigenetic effects following trauma exposure and parental developmental stage at the time of exposure, explain different effects of maternal and paternal trauma. The most compelling work to date has been done in animal models, where the opportunity for controlled designs enables clear interpretations of transmissible effects. Given the paucity of human studies and the methodological challenges in conducting such studies, it is not possible to attribute intergenerational effects in humans to a single set of biological or other determinants at this time. Elucidating the role of epigenetic mechanisms in intergenerational effects through prospective, multi-generational studies may ultimately yield a cogent understanding of how individual, cultural and societal experiences permeate our biology.
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Affiliation(s)
- Rachel Yehuda
- James J. Peters Bronx Veterans Affairs Hospital, Bronx, NY, USA
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Amy Lehrner
- James J. Peters Bronx Veterans Affairs Hospital, Bronx, NY, USA
- Departments of Psychiatry and Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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14
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Davis EP, Hankin BL, Swales DA, Hoffman MC. An experimental test of the fetal programming hypothesis: Can we reduce child ontogenetic vulnerability to psychopathology by decreasing maternal depression? Dev Psychopathol 2018; 30:787-806. [PMID: 30068416 PMCID: PMC7040571 DOI: 10.1017/s0954579418000470] [Citation(s) in RCA: 53] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Maternal depression is one of the most common prenatal complications, and prenatal maternal depression predicts many child psychopathologies. Here, we apply the fetal programming hypothesis as an organizational framework to address the possibility that fetal exposure to maternal depressive symptoms during pregnancy affects fetal development of vulnerabilities and risk mechanisms, which enhance risk for subsequent psychopathology. We consider four candidate pathways through which maternal prenatal depression may affect the propensity of offspring to develop later psychopathology across the life span: brain development, physiological stress regulation (hypothalamic-pituitary-adrenocortical axis), negative emotionality, and cognitive (effortful) control. The majority of past research has been correlational, so potential causal conclusions have been limited. We describe an ongoing experimental test of the fetal programming influence of prenatal maternal depressive symptoms using a randomized controlled trial design. In this randomized controlled trial, interpersonal psychotherapy is compared to enhanced usual care among distressed pregnant women to evaluate whether reducing prenatal maternal depressive symptoms has a salutary impact on child ontogenetic vulnerabilities and thereby reduces offspring's risk for emergence of later psychopathology.
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Affiliation(s)
- Elysia Poggi Davis
- Department of Psychology, University of Denver, Denver, Colorado
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine California
| | - Benjamin L. Hankin
- Department of Psychology, University of Illinois, Urbana Champaign, Illinois
| | | | - M. Camille Hoffman
- University of Colorado School of Medicine, Departments of Obstetrics and Gynecology and Psychiatry, Aurora, CO
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15
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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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16
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Walker FR, Pfingst K, Carnevali L, Sgoifo A, Nalivaiko E. In the search for integrative biomarker of resilience to psychological stress. Neurosci Biobehav Rev 2017; 74:310-320. [DOI: 10.1016/j.neubiorev.2016.05.003] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2015] [Revised: 04/26/2016] [Accepted: 05/06/2016] [Indexed: 12/20/2022]
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17
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Western High-Fat Diet Consumption during Adolescence Increases Susceptibility to Traumatic Stress while Selectively Disrupting Hippocampal and Ventricular Volumes. eNeuro 2016; 3:eN-NWR-0125-16. [PMID: 27844058 PMCID: PMC5099604 DOI: 10.1523/eneuro.0125-16.2016] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2016] [Revised: 09/23/2016] [Accepted: 10/26/2016] [Indexed: 11/29/2022] Open
Abstract
Psychological trauma and obesity co-occur frequently and have been identified as major risk factors for psychiatric disorders. Surprisingly, preclinical studies examining how obesity disrupts the ability of the brain to cope with psychological trauma are lacking. The objective of this study was to determine whether an obesogenic Western-like high-fat diet (WD) predisposes rats to post-traumatic stress responsivity. Adolescent Lewis rats (postnatal day 28) were fed ad libitum for 8 weeks with either the experimental WD diet (41.4% kcal from fat) or the control diet (16.5% kcal from fat). We modeled psychological trauma by exposing young adult rats to a cat odor threat. The elevated plus maze and the open field test revealed increased psychological trauma-induced anxiety-like behaviors in the rats that consumed the WD when compared with control animals 1 week after undergoing traumatic stress (p < 0.05). Magnetic resonance imaging showed significant hippocampal atrophy (20% reduction) and lateral ventricular enlargement (50% increase) in the animals fed the WD when compared with controls. These volumetric abnormalities were associated with behavioral indices of anxiety, increased leptin and FK506-binding protein 51 (FKBP51) levels, and reduced hippocampal blood vessel density. We found asymmetric structural vulnerabilities to the WD, particularly the ventral and left hippocampus and lateral ventricle. This study highlights how WD consumption during adolescence impacts key substrates implicated in post-traumatic stress disorder. Understanding how consumption of a WD affects the developmental trajectories of the stress neurocircuitry is critical, as stress susceptibility imposes a marked vulnerability to neuropsychiatric disorders.
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18
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Liu K, Ruggero CJ, Goldstein B, Klein DN, Perlman G, Broderick J, Kotov R. Elevated cortisol in healthy female adolescent offspring of mothers with posttraumatic stress disorder. J Anxiety Disord 2016; 40:37-43. [PMID: 27088877 PMCID: PMC4964788 DOI: 10.1016/j.janxdis.2016.04.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 04/01/2016] [Accepted: 04/04/2016] [Indexed: 01/04/2023]
Abstract
Offspring with maternal PTSD are at increased risk of developing PTSD themselves. Alterations in the hypothalamic-pituitary-adrenal (HPA) axis may play a role and have been noted in offspring, although evidence is mostly from adult offspring with PTSD symptoms themselves. The present study of adolescent girls (N=472) and their mothers (n=18 with lifetime PTSD versus n=454 with no PTSD) sought to determine whether healthy, non-affected offspring of mothers with PTSD would exhibit altered HPA axis function. Saliva samples were collected from the adolescent girls at waking, 30min after waking, and 8 pm on 3 consecutive days. Offspring whose mothers were diagnosed with PTSD demonstrated higher cortisol awakening response (CAR; Cohen's d=0.58) and greater total cortisol output (Cohen's d=0.62). In this preliminary study, higher cortisol levels during adolescence among offspring of mothers with PTSD may index a vulnerability in these at-risk youth.
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Affiliation(s)
- Keke Liu
- Department of Psychology, University of North Texas, Denton, TX 76203, United States.
| | - Camilo J. Ruggero
- Department of Psychology, University of North Texas, Denton, TX 76203, United States of America
| | - Brandon Goldstein
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United Sates of America
| | - Daniel N. Klein
- Department of Psychology, Stony Brook University, Stony Brook, NY 11794, United Sates of America
| | - Greg Perlman
- Department of Psychiatry, Stony Brook University, Stony Brook, NY 11794, United States of America
| | - Joan Broderick
- Center for Self-Report Science, University of Southern California, Los Angeles, CA 90089, United States of America
| | - Roman Kotov
- Department of Psychiatry, Stony Brook University, Stony Brook, NY 11794, United States of America
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Brown BT, Graham PL, Bonello R, Pollard H. A biopsychosocial approach to primary hypothyroidism: treatment and harms data from a randomized controlled trial. Chiropr Man Therap 2015; 23:24. [PMID: 26301086 PMCID: PMC4545871 DOI: 10.1186/s12998-015-0068-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2014] [Accepted: 07/23/2015] [Indexed: 12/26/2022] Open
Abstract
BACKGROUND Hypothyroidism is a common endocrine condition. There is evidence to suggest that, for a proportion of sufferers, the standard medical treatment does not completely reverse the constitutional and neuropsychiatric symptoms brought about by this condition. The management of hypothyroidism follows a biomedical model with little consideration given to alternative management approaches. There exists anecdotal evidence and case reports supporting the use of a biopsychosocial-based intervention called Neuro-Emotional Technique (NET) for this population. The aim of this study was to explore the potential short-medium term clinical efficacy and safety of NET for individuals with primary hypothyroidism.DesignPlacebo-controlled, blinded, parallel groups, randomized trial. METHODS Ninety adults with a diagnosis of primary hypothyroidism were recruited from Sydney, Australia. Blinded participants were randomized to either the NET or placebo group and received ten intervention sessions over a six week period. The primary outcome involved the measurement of states of depression using the DASS-42 questionnaire. Secondary outcomes included thyroid function, thyroid autoimmunity testing, SF-36v2 questionnaire, resting heart rate and temperature measurement. Outcomes were obtained at baseline, seven weeks and six months. Questionnaires were completed at the private clinics, and serum measures were obtained and analysed at commercial pathology company locations. Heart rate and temperature were also measured daily by participants. Linear mixed-effects models were used to analyse the continuous outcomes. Unadjusted odds ratios with 95% confidence intervals were calculated for the binary outcomes. RESULTS Participants were randomly allocated to the NET (n=44) and placebo (n=46) groups. A proportion of the sample displayed neuropsychiatric disturbances and alterations in quality of life measures at baseline. There were no statistically significant or clinically relevant changes in the primary or secondary outcomes between the NET and placebo groups at time seven weeks or six months. There were a few short-lived minor adverse events reported in both the NET and placebo groups that coincided with the application of the intervention. CONCLUSIONS The application of the NET intervention appears to be safe, but did not confer any clinical benefit to the participants in this study and is unlikely to be of therapeutic use in a hypothyroid population. CLINICAL TRIALS REGISTRATION NUMBER Australian and New Zealand Clinical Trials Registry Number: 12607000040460.
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Affiliation(s)
- Benjamin T. Brown
- />Department of Chiropractic, Macquarie University, Balaclava Road, North Ryde, 2109 NSW Australia
| | - Petra L. Graham
- />Department of Statistics, Macquarie University, Balaclava Road, North Ryde, 2109 NSW Australia
| | - Rod Bonello
- />School of Health Professions - Murdoch University, 90 South Street, Murdoch, 6150 WA Australia
| | - Henry Pollard
- />Private Practice, 84 Kingsway, Cronulla, 2230 NSW Australia
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