Intergenerational Transmission of Trauma in WTC Responders with PTSD

Details

• Personal Author:
  Cheslack-Postava KR ; Cycowicz YM ; Rodriguez Moreno D
• Description:
  A parent's experience of trauma has been shown to impact the psychological well-being of their children even when the children themselves were not directly exposed to the traumatic event. Research on the Intergenerational Transmission of Trauma (ITT) has demonstrated behavioral, cognitive, and emotional difficulties in offspring of traumatized parents, including hypervigilance, nightmares, difficulties in interpersonal functioning, deficits in academic performance, along with mood and other psychiatric disorders. Studies examining the effects of trauma transmission from parents with post-traumatic stress disorder (PTSD), reported high rates of PTSD in their offspring. However, there is still debate regarding how the proposed pathways of ITT explain the increased risk for impaired psychological well-being in children of parents exposed to trauma. The burden of ITT has not received appropriate research consideration in children of World Trade Center Responders (WTC-R) given earlier reports of behavioral, psychological and health problems among these children, and evidence suggests that these difficulties and disorders persist beyond the childhood years. This study addressed this gap by establishing a new cohort of persons who were younger than 18 years of age at the time of the 9/11 terror attack, and whose parents developed PTSD after being exposed through their occupation to the terror attack and its aftermath. We have assessed the psychological wellbeing and risk factors of this cohort using an online battery and examined the possible pathways of ITT. Our study included WTC responders that were at the 9/11 site either as police or recovery workers, and who developed PTSD as a result of their exposure to the attack. In addition, the responders who were invited to the study were those who at the time of the 9/11 attack, had children younger than 18 years old. Only those families in which both the parents and at least one now-adult children agreed to participate were included in the study. A total of 176 parents and 270 of their now-adult children completed the study. They all completed an online survey which included demographic questions, brief assessment of current mental health, past trauma exposures, questions about current physical health, their social support and cognitive functioning. Our data showed a positive change in demographic characteristics between the WTC-R parents and their now-adult children. The children had more years of education and a greater income compared to their parents. Our study also showed that the parents' exposure to the acute 9/11 trauma not only impairs their own mental health but it also put their children at risk to develop mental health disorders. Indeed, the rate of probable mental disorders are high among both parents and offspring. Specifically, we found that both WTC-R parents and their offspring have high rates of depression (31.82 % and 21.85%), anxiety (24.43% and 25.19%), panic (30.6% and 27.40%), and AUD (8.52% and 17.1%). In addition, we found that over 10% of the now-adult children had Covid-19 like-PTSD (compared to only 4.56% among the parents). The transmission of mental health disorders from parents to children probably depends on many factors. Our study found that certain characteristics of parents or their children are more likely to enable such transmission. For example, children who have depression are more likely to have parents who have depression, and children with PTSD are more likely to have parents with panic disorder. When the WTC-R who was exposed to trauma is a mother, her children are more likely to have depression and anxiety disorder. If the now-adult child is a daughter then she is more likely to have PTSD and panic disorder, but less likely to have Alcohol use disorder. Children's own life experiences and trauma also play an important role in their mental health and with increased trauma experiences we found more panic disorder and alcohol use disorder among offspring. Furthermore, the effect of Covid-19 on the now-adult children was higher than in their parents, and was associated with PTSD, anxiety and panic disorders. A more hopeful finding in our study points to an important way to reduce the risk of mental health disorders in children of trauma exposed parents. In our study of WTC responder parents, we found that having social support made the children more resilient and they showed less depression, anxiety, and alcohol use disorders. It appears that having interactions with other people in the child's environment can mitigate the effect of parents' mental health on their children. It could be that the social support provides other behavioral models from which they learn that lead them to have better mental health. In summary, our study demonstrates that transmission of trauma from parents to offspring is not limited to PTSD symptoms. Psychopathology of the parents following the 9/11 trauma poses a risk for their children to develop their own mental health pathology, and this is more acute for females. Our findings about social support suggest that environment could reduce this risk and change the course of life for these children. Our study shows the importance of understanding the pathways of trauma transmission across generations. Future studies replicating and extending our research are necessary to formulate effective interventions that could teach resilience in the face of mass disasters. [Description provided by NIOSH]
• Subjects:
  Mental Health Nervous System Occupational Health Safety September 11 Terrorist Attacks Stress Disorders, Post-Traumatic
• Keywords:
  Children Cognitive Function Mental Health Post-traumatic Stress Disorder Psychological Effects PTSD Traumatic Incident Stress Well-being World Trade Center WTC
• Series:
  Grant Final Reports
• Publisher:
  National Institute for Occupational Safety and Health
• Document Type:
  Text
• Funding:
  Cooperative Agreement
• Genre:
  Final Cooperative Agreement Report
• Place as Subject:
  New York ; OSHA Region 2
• CIO:
  National Institute for Occupational Safety and Health (NIOSH)
• Division:
  OEP - Office of Extramural Programs
• Topic:
  Workplace Safety & Health
• Location:
  North America
• Pages in Document:
  1-14
• NIOSHTIC Number:
  nn:20069519
• Citation:
  Atlanta, GA: U.S. Department of Health and Human Services, Public Health Service, Centers for Disease Control and Prevention, National Institute for Occupational Safety and Health, U01-OH-012065, 2023 Oct; :1-14
• Contact Point Address:
  Yael M. Cycowicz, PhD, New York State Psychiatric Institute DBA Research Foundation for Mental Hygiene, Inc, 1051 Riverside Drive, New York, NY 10032-1007
• Email:
  Yael.Cycowicz@nyspi.columbia.edu
• Federal Fiscal Year:
  2024
• Performing Organization:
  New York State Psychiatric Institute DBA Research Foundation for Mental Hygiene, Inc
• Peer Reviewed:
  False
• Start Date:
  20200701
• Source Full Name:
  National Institute for Occupational Safety and Health
• End Date:
  20210630
• Collection(s):
  National Institute for Occupational Safety and Health
• Main Document Checksum:
  urn:sha-512:d215fea284a5738c1574fca0bc84a262e96a1a1c4ec058b1fe12cd9b0253f155d7903f5f6c16e7178e2086022865b913c27e98d713fe3bda0aa6a8798fca1cab
• Download URL:
  https://stacks.cdc.gov/view/cdc/219233/cdc_219233_DS1.pdf
• File Type:
  [PDF - 1.38 MB ]