Maternal Posttraumatic Stress Disorder Symptoms Research Articles

Examining Associations between Maternal Trauma, Child Attachment Security, and Child Behaviours in Refugee Families

We examined post-traumatic stress disorder (PTSD) and depressive symptoms in refugee mothers and the relationships between maternal trauma, child attachment security, and child internalizing and externalizing behaviours. Results from 36 mothers of children 18–70 months old indicated that while 94.4% of mothers reported experiencing trauma, only 2.8% reported clinically elevated PTSD symptoms. Maternal PTSD symptoms were correlated with child internalizing and externalizing behaviours. Attachment security was negatively correlated with internalizing and externalizing behaviours. Attachment security moderated the relationship between PTSD symptoms and externalizing behaviours; PTSD symptoms predicted externalizing behaviours for children with low attachment security only. This suggests that child attachment security may protect against maternal trauma.

Cumulative stress, PTSD, and emotion dysregulation during pregnancy and epigenetic age acceleration in Hispanic mothers and their newborn infants

ABSTRACT Pregnancy can exacerbate or prompt the onset of stress-related disorders, such as post-traumatic stress disorder (PTSD). PTSD is associated with heightened stress responsivity and emotional dysregulation, as well as increased risk of chronic disorders and mortality. Further, maternal PTSD is associated with gestational epigenetic age acceleration in newborns, implicating the prenatal period as a developmental time period for the transmission of effects across generations. Here, we evaluated the associations between PTSD symptoms, maternal epigenetic age acceleration, and infant gestational epigenetic age acceleration in 89 maternal-neonatal dyads. Trauma-related experiences and PTSD symptoms in mothers were assessed during the third trimester of pregnancy. The MethylationEPIC array was used to generate DNA methylation data from maternal and neonatal saliva samples collected within 24 h of infant birth. Maternal epigenetic age acceleration was calculated using Horvath’s multi-tissue clock, PhenoAge and GrimAge. Gestational epigenetic age was estimated using the Haftorn clock. Maternal cumulative past-year stress (GrimAge: p = 3.23e-04, PhenoAge: p = 9.92e-03), PTSD symptoms (GrimAge: p = 0.019), and difficulties in emotion regulation (GrimAge: p = 0.028) were associated with accelerated epigenetic age in mothers. Maternal PTSD symptoms were associated with lower gestational epigenetic age acceleration in neonates (p = 0.032). Overall, our results suggest that maternal cumulative past-year stress exposure and trauma-related symptoms may increase the risk for age-related problems in mothers and developmental problems in their newborns.

U.S. mothers' appraisals of the race-related events of 2020: Implications for the course of maternal posttraumatic stress disorder symptoms.

For parents of color, publicized racial violence can heighten concerns about their children's safety. The goal of this study was to test whether this form of race-related stress exacerbates maternal posttraumatic stress disorder (PTSD) symptoms over a 4-month period in families of color. Participants included 262 U.S. mothers with a lifetime mental health diagnosis (67.6% non-Hispanic White, 15.6% African-American/Black, 16.8% other family of color). Mothers completed online surveys and open-ended questions, including appraisals of the meaning of the 2020 race-related events (i.e., George Floyd's death, subsequent protests) in relation to their children's future. Open-ended responses were quantified using LIWC15 text analysis for emotion word frequency and thematic coding for perceived implications. In ANCOVA, there were significant racial group differences in appraisals, ds = 0.09-0.57. The responses from mothers of Black children included fewer positive and more negative emotion words than mothers of White children; they also included more perceived negative implications than all other mothers but did not vary on perceived positive implications. In regression analyses, there were significant moderating effects of race/ethnicity in the association between appraisals and PTSD symptom course such that negative appraisals predicted a subsequent increase in PTSD symptoms only for mothers of Black children, βs = .26-.37. Variations in event appraisals were unrelated to PTSD symptom course for other mothers. These findings provide longitudinal support for the link between vicarious racism exposure and PTSD symptoms and highlight one potential form of racism-related stress for parents of Black children.

Maternal stress and mental health before pregnancy and offspring diurnal cortisol in early childhood.

The current study investigates whether prepregnancy maternal posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, and stress predict children's cortisol diurnal slopes and cortisol awakening responses (CARs) adjusting for relevant variables. Mothers were enrolled after delivering a baby and followed through their subsequent pregnancy with 5 years of longitudinal data on their subsequent child. This prospective design allowed assessment of PTSD symptoms, depressive symptoms, and perceived stress prior to pregnancy. Children provided three saliva samples per day on three consecutive days at two timepoints in early childhood (M age=3.7 years, SD=0.38; M age=5.04 years, SD=0.43). Mothers' PTSD symptoms prior to pregnancy were significantly associated with flatter child diurnal cortisol slopes at 4 and 5 years, but not with child CAR. Findings at the age of 4 years, but not 5 years, remained statistically significant after adjustment for maternal socioeconomic status, race/ethnicity, child age, and other covariates. In contrast, maternal prepregnancy depressive symptoms and perceived stress did not significantly predict cortisol slopes or CAR. Results suggest that maternal prepregnancy PTSD symptoms may contribute to variation in early childhood physiology. This study extends earlier work demonstrating risk of adverse outcomes among children whose mothers experienced trauma but associations cannot be disentangled from effects of prenatal mental health of mothers on children's early childhood.

Mode of birth and development of maternal postnatal post-traumatic stress disorder: A mixed-methods systematic review and meta-analysis.

Post-traumatic stress disorder (PTSD) affects approximately 3% of women in the postnatal period, but less is known about risk factors for PTSD than other postnatal mental illnesses. This review aimed to analyze the literature on the impact of mode of birth on postnatal PTSD. Searches were undertaken of CINAHL, the Cochrane Library, MEDLINE, PsycINFO, and Scopus for studies investigating the link between mode of birth and postnatal PTSD in high-resource countries from January 1990 to February 2021. Quantitative and qualitative data were collected and synthesized. Meta-analysis was performed with four of the studies, and the rest were analyzed narratively. Twelve quantitative studies, presenting data on 5567 women, and two qualitative studies, with 92 women, were included in the review. Most studies found a significant relationship between mode of birth and maternal PTSD symptoms. Meta-analysis found cesarean birth was more closely associated with PTSD than vaginal delivery (VD) (P= 0.005), emergency cesarean birth (EmCB) more than elective cesarean birth (ElCB) (P< 0.001), instrumental vaginal delivery (IVD) more than spontaneous vaginal delivery (SVD) (P< 0.001), and EmCB more than SVD (P< 0.001). Women who developed PTSD after EmCB felt less in control and less supported than those who did not develop it after the same procedure. Request for repeat ElCB appeared more common among women with pre-existing postnatal PTSD, but this may subsequently leave them feeling dissatisfied and their fears of childbirth unresolved. Modes of birth involving emergency intervention may be risk factors for the development of postnatal PTSD. Ensuring that women feel supported and in control during emergency obstetric interventions may mediate against this risk.

Preconception maternal posttraumatic stress and child negative affectivity: Prospectively evaluating the intergenerational impact of trauma.

The developmental origins of psychopathology begin before birth and perhaps even prior to conception. Understanding the intergenerational transmission of psychopathological risk is critical to identify sensitive windows for prevention and early intervention. Prior research demonstrates that maternal trauma history, typically assessed retrospectively, has adverse consequences for child socioemotional development. However, very few prospective studies of preconception trauma exist, and the role of preconception symptoms of posttraumatic stress disorder (PTSD) remains unknown. The current study prospectively evaluates whether maternal preconception PTSD symptoms predict early childhood negative affectivity, a key dimension of temperament and predictor of later psychopathology. One hundred and eighteen women were recruited following a birth and prior to conception of the study child and were followed until the study child was 3-5 years old. Higher maternal PTSD symptoms prior to conception predicted greater child negative affectivity, adjusting for concurrent maternal depressive symptoms and sociodemographic covariates. In exploratory analyses, we found that neither maternal prenatal nor postpartum depressive symptoms or perceived stress mediated this association. These findings add to a limited prospective literature, highlighting the importance of assessing the mental health of women prior to conception and providing interventions that can disrupt the intergenerational sequelae of trauma.

Maternal History of Adverse Experiences and Posttraumatic Stress Disorder Symptoms Impact Toddlers' Early Socioemotional Wellbeing: The Benefits of Infant Mental Health-Home Visiting.

BackgroundThe present study examined the efficacy of the Michigan Model of Infant Mental Health-Home Visiting (IMH-HV) infant mental health treatment to promote the socioemotional wellbeing of infants and young children. Science illuminates the role of parental “co-regulation” of infant emotion as a pathway to young children’s capacity for self-regulation. The synchrony of parent–infant interaction begins to shape the infant’s own nascent regulatory capacities. Parents with a history of childhood adversity, such as maltreatment or witnessing family violence, and who struggle with symptoms of post-traumatic stress may have greater challenges in co-regulating their infant, thus increasing the risk of their children exhibiting social and emotional problems such as anxiety, aggression, and depression. Early intervention that targets the infant–parent relationship may help buffer the effect of parental risk on child outcomes.MethodsParticipants were 58 mother–infant/toddler dyads enrolled in a longitudinal randomized control trial testing the efficacy of the relationship-based IMH-HV treatment model. Families were eligible based on child age (<24 months at enrollment) and endorsement of at least two of four socio-demographic factors commonly endorsed in community mental health settings: elevated depression symptoms, three or more Adverse Childhood Experiences (ACEs) parenting stress, and/or child behavior or development concerns. This study included dyads whose children were born at the time of study enrollment and completed 12-month post-baseline follow-up visits. Parents reported on their own history of ACEs and current posttraumatic stress disorder (PTSD) symptoms, as well as their toddler’s socioemotional development (e.g., empathy, prosocial skills, aggression, anxiety, prolonged tantrums).ResultsMaternal ACEs predicted more toddler emotional problems through their effect on maternal PTSD symptoms. Parents who received IMH-HV treatment reported more positive toddler socioemotional wellbeing at follow-up relative to the control condition. The most positive socioemotional outcomes were for toddlers of mothers with low to moderate PTSD symptoms who received IMH-HV treatment.ConclusionResults indicate the efficacy of IMH-HV services in promoting more optimal child socioemotional wellbeing even when mothers reported mild to moderate PTSD symptoms. Results also highlight the need to assess parental trauma when infants and young children present with socioemotional difficulties.

Associations Between Maternal Post-traumatic Stress Disorder and Traumatic Events With Child Psychopathology: Results From a Prospective Longitudinal Study.

Introduction: Exposure to interpersonal violence (IPV) can lead to post-traumatic stress disorder (PTSD) in mothers, and in turn adversely affect the mother-child relationship during early development, as well as the mental health of their children. Our objectives are to assess: (1) the association of maternal IPV-PTSD to child psychopathology, (2) the association of maternal IPV independently of PTSD to child psychopathology, and (3) the relationship between child exposure to violence to the psychopathology of these children.Methods: We used data from the longitudinal Geneva Early Childhood Stress Project. The sample included 64 children [mean age at Phase 1 = 2.4 (1.0–3.7) years] of mothers with or without IPV-PTSD. Data on mothers was collected during Phase 1, using the Clinical Administered PTSD Scale (CAPS), the Brief Physical and Sexual Abuse Questionnaire (BPSAQ) and the Conflict Tactics Scale (CTS2). Modules of a semi-structured diagnostic interview, and the Violence Exposure Scale were used to collect information on child at Phase 2, when children were older [mean age = 7.02 (4.7–10)].Results: A higher CAPS score in mothers when children were toddler-age was associated with an increased risk of symptoms of attention deficit/hyperactivity disorder (ADHD; β = 0.33, p = 0.014) and PTSD in school-age children. The association between maternal IPV-PTSD and child PTSD (β = 0.48, p < 0.001) symptoms remained significant after adjustment for potential confounders. Among children, exposure to violence was associated with an increased risk of symptoms of generalized anxiety (β = 0.37, p = 0.006), major depressive (β = 0.24, p = 0.039), ADHD (β = 0.27, p = 0.040), PTSD (β = 0.52, p < 0.001), conduct (β = 0.58, p = 0.003) and oppositional defiant (β = 0.34, p = 0.032) disorders.Conclusion: Our longitudinal findings suggest that maternal IPV-PTSD during the period of child development exert an influence on the development of psychopathology in school-aged children. Mothers' IPV was associated with child psychopathology, independently of PTSD. Child lifetime exposure to violence had an additional impact on the development of psychopathology. Careful evaluation of maternal life-events is essential during early childhood to reduce the risk for the development of child psychopathology. Early efforts to curb exposure to violence in children and early intervention are both needed to reduce further risk for intergenerational transmission of trauma, violence, and related psychopathology.

Maternal History of Child Sexual Abuse and Maladaptive Outcomes in Sexually Abused Children: The Role of Maternal Mental Health.

The effects of child sexual abuse (CSA) have been found to surpass generations as maternal history of CSA is associated with increased difficulties in sexually abused children. However, little is known about the mechanisms underlying this association. The present study aimed to test maternal mental health symptoms including psychological distress, post-traumatic stress disorder (PTSD) symptoms, and dissociation as mediators of the relationship between maternal CSA and children’s internalizing, externalizing, and dissociation symptoms in a large sample of sexually abused children. A total of 997 sexually abused children aged 3-14 years old and their mothers were recruited at five specialized intervention centers offering services to sexually abused children and their families. The children were divided into two groups depending on their mothers’ self-reported history of CSA. Mothers completed a series of questionnaires assessing their mental health and children’s functioning. Maternal history of CSA was associated with increased maternal psychological distress, PTSD symptoms, and dissociation following children’s disclosure of CSA. In turn, maternal psychological distress and maternal dissociation were associated with increased child internalizing, externalizing, and dissociation symptoms. Maternal PTSD symptoms were associated with child internalizing symptoms. Maternal mental health difficulties mediated the association between maternal CSA and sexually abused children’s maladaptive outcomes. Clinicians should assess for possible history of CSA in mothers of sexually abused children and determine how best to support them to cope with the aftermaths of their child’s disclosure and with their own traumatic past.

A legacy of fear: Physiological evidence for intergenerational effects of trauma exposure on fear and safety signal learning among African Americans

ObjectiveTo 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. MethodParticipants 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. ResultsFour 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. ConclusionsResults 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.

A Pilot and Feasibility Randomized Controlled Trial of Dyadic Exposure Therapy and Dyadic Client-Centered Therapy for Posttraumatic Preschool Children and Their Caregivers

Treatment protocols for preschoolers with posttraumatic stress disorder (PTSD), especially following single trauma and medical trauma exposure, are sparse. The co-occurring severity of caregivers’ and children’s posttraumatic symptoms is a robust finding. Consequently, treatment that focuses both on children’s and caregivers’ PTSD symptoms directly is important. The study aims were to evaluate the feasibility of dyadic exposure therapy (DET) and supportive dyadic client-centered therapy (DCCT) and to perform a preliminary analysis of the degree of change in DET and DCCT. Twelve preschoolers (M = 49.25 months, SD = 13.84) with PTSD, their 12 mothers and 9 of their fathers, were randomly assigned to 15 sessions of DET (n = 6) or DCCT (n = 6). All participants completed their respective interventions. Only DET yielded significant improvements on mother-rated measures of child and maternal PTSD symptoms and appraisals. Therapy focused on child-caregiver PTSD symptoms directly may ameliorate the bidirectional effects of symptomatic responses within the traumatized dyad.

Maternal prenatal depression, PTSD, and problematic parenting: the mediating role of maternal perceptions of infant emotion

ABSTRACT Background: Perinatal illness is alarmingly common and has negative effects on maternal and infant well-being. Depression and posttraumatic stress disorder (PTSD), specifically, are characterised by negative views of the self and others, which may impact a mother’s perceptions of herself and her child. Objective: This study examined the relationship between depression and PTSD symptoms, maternal perceptions of infant emotions, and parenting behaviours. Methods: 120 pregnant, mostly low-income women and their infants (after birth) participated in a longitudinal study. Maternal depression and PTSD symptoms were assessed during pregnancy and 1 year postpartum; maternal perceptions of infant emotions and parenting quality were assessed at 1 year. Results: Correlation analyses revealed significant, negative associations between prenatal (but not postnatal) psychiatric symptoms and positive perceptions of infant emotions, as well as between positive perceptions of infant emotions and negative parenting. Results also revealed significant indirect effects of prenatal depressive and PTSD symptoms on negative parenting via perceptions of infant emotion (95% CIs:.0013 –.0200 and.0008 –.0083, respectively). Conclusion: Findings highlight that mothers should be routinely screened for psychiatric symptoms during the perinatal period, and perceptions of infant emotions may be an important target for parent-infant mental health interventions.

Adverse childhood experiences, posttraumatic stress, and FKBP5 methylation patterns in postpartum women and their newborn infants

BackgroundGenetic variation and epigenetic mechanisms involving the stress-related gene FKBP5 have been implicated in the intergenerational transmission of trauma-related effects in adult offspring of trauma-exposed caregivers, but these processes have not been fully explored in postpartum women and their newborn infants. MethodsWomen recruited from a prenatal care clinic during their third trimester of pregnancy (N = 114) completed a battery of instruments assessing adverse childhood experiences (ACEs), adversity in adulthood, posttraumatic stress disorder (PTSD) symptoms, negative emotional state, and emotion dysregulation. FKBP5 rs1360780 genotype and intron 7 methylation were derived from saliva collected from postpartum mothers and their newborn infants within 24 h of delivery. ResultsAllele-specific associations of methylation with maternal ACEs and prenatal trauma-related symptoms were evident; however, relations differed between mothers and newborns. In mothers carrying the stress sensitive T-allele (CT and TT genotypes), maternal FKBP5 methylation negatively correlated with threat-based ACEs and maternal PTSD symptoms during pregnancy, but not deprivation-based ACEs. In infants homozygous for the C allele (CC genotype), infant FKBP5 methylation positively correlated with maternal threat-based ACEs and prenatal PTSD symptom severity, but not deprivation-based ACEs or adversity in adulthood. ConclusionsOur results provide evidence that links maternal threat-based ACEs and trauma-related symptoms during pregnancy with allele-specific epigenetic patterns in postpartum women and their newborn infants. These findings provide mechanistic insight into the potential intergenerational impact of ACEs and the effect of maternal PTSD symptoms during pregnancy.

Trajectories of maternal symptoms of posttraumatic stress disorder predict long-term mental health of children following the Wenchuan earthquake in China: A 10-year follow-up study

Background: Maternal psychopathology can be an important factor associated with psychological adjustment of children. However, there is limited research on long-term impacts of maternal posttraumatic stress disorder (PTSD) on children's mental health. This study examined how PTSD trajectories of women exposed to the 2008 Wenchuan earthquake in China predicted their children's mental health symptoms 10 years after the earthquake. Methods: 410 dyads of mothers and their adolescent children who exposed to the Wenchuan earthquake were investigated at 12 and 18 months post-earthquake. While the mothers completed measures of earthquake exposure and PTSD symptoms, the children completed measures of earthquake exposure, PTSD, depression and anxiety symptoms. In the 10-year follow up, 257 out of the 410 children completed measures of PTSD, depression and anxiety symptoms. Data were analyzed using linear regression. Results: Four trajectories of maternal PTSD symptoms were identified: (a) chronic (9.5%); (b) resilient (66.3%); (c) delayed (7.6%); and (d) recovery (16.6%); More importantly, the findings demonstrated that children whose mothers experienced chronic PTSD reported higher level of PTSD and anxiety symptoms 10 years after the earthquake. Limitations: Only two waves of maternal PTSD were collected, self-reported tools other than clinical reviews were used to collect data, and a significant proportion of participants did not respond at the 10-year follow-up. Conclusions: This study identified maternal PTSD trajectories following the Wenchuan earthquake. Chronic PTSD symptoms in mothers were associated with increased risk of children's PTSD and anxiety 10 years after the earthquake.

Maternal Adverse Childhood Experiences, Family Strengths, and Chronic Stress in Children.

Researchers have demonstrated that maternal adverse childhood experiences (ACEs), such as abuse and neglect, are associated with prenatal risk factors and poor infant development. However, associations with child physiologic and health outcomes, including biomarkers of chronic or "toxic" stress, have not yet been explored. The purpose of this study was to examine the associations among past maternal experiences, current maternal posttraumatic stress disorder (PTSD) symptoms, and children's indicators of exposure to chronic stress in a multiethnic sample of mothers and children at early school age (4 to 9 years). This cross-sectional study included maternal-child dyads (N = 54) recruited from urban community health centers in New Haven, Connecticut. Mothers reported history of ACEs, family strengths, and current PTSD symptoms. Child measures included biomarkers and health and developmental outcomes associated with chronic stress. Correlational and regression analyses were conducted. Childhood trauma in mothers was associated with higher systolic blood pressure percentile (ρ = .29, p = .03) and behavioral problems (ρ = .47, p = .001) in children, while maternal history of family strengths was associated with lower salivary interleukin (IL)-1β (ρ = -.27, p = .055), salivary IL-6 (ρ = -.27, p = .054), and body mass index z-scores (ρ = -.29, p = .03) in children. Maternal PTSD symptoms were associated with more child behavioral problems (ρ = .57, p < .001) and higher odds of asthma history (ρ = .30, p = .03). Results indicate that past maternal experiences may have important influences on a child's health and affect his or her risk for experiencing toxic stress.

Toxic Environment of war: Maternal prenatal heavy metal load predicts infant emotional development

BackgroundPeople in war zones are exposed to heavy metal contamination deriving from new-generation weapons, in addition to exposure to psychologically traumatizing war events. Pregnant women and their children-to-be are particularly vulnerable to both biological and psychological war effects. ObjectiveThe aim of the current study was to analyse the impact of maternal prenatal heavy metal contamination on infant emotional development and to examine the potential moderating role of maternal symptoms of post-traumatic stress disorder (PTSD) in the association between heavy metal load and infant emotional development. MethodsThe participants were 502 Palestinian mothers, pregnant in their first trimester during the 2014 War on Gaza. The mothers were recruited at their delivery (T1) and followed at the infants’ age of 6–7 months (T2; N = 392). The load of five weapon-related heavy metals (chromium, mercury, vanadium, strontium, and uranium) was analysed by Inductively Coupled Plasma Mass Spectrometry (ICP/MS) from mothers’ hair samples at childbirth (T1). Assessment of maternal PTSD symptoms was based on the Harvard Trauma Questionnaire (HTQ) and infant emotional development on the Infant Behavior Questionnaire (IBQ), both reported by mothers (T2). ResultsTwo of the analysed metals, chromium and uranium, adversely predicted children’s early emotional development, indicated by decreased positive affectivity, increased negative emotionality, and problems in early orientation and regulation. Mother’s PTSD did not moderate the impact of heavy metal contamination on children’s emotional development. ConclusionsAdverse impact of war is not limited to those who experience it directly, but is passed on to future generations through multiple mechanisms. International organizations are obliged to protect parents and infants from the modern weaponry in wars.

The interplay between prematurity, maternal stress and children\u2019s intelligence quotient at age 11: A longitudinal study

Very premature children (<33 weeks of gestational age (GA)) experience greater academic difficulties and have lower, though normal-range, intelligence quotients (IQs) versus their full-term peers. These differences are often attributed to GA or familial socio-economic status (SES). However, additional factors are increasingly recognized as likely contributors. Parental stress after a child’s premature birth can present as post-traumatic stress disorder (PTSD) symptoms and can in turn reinforce difficulties in parent-child interaction pattern. Following a longitudinal design, we studied the interplay between a premature child’s perinatal history and maternal PTSD symptoms on intelligence abilities assessed at 11 years of age. Thirty-three very preterm and 21 full-term mother-children dyads partook in the study. Children’s perinatal risk was evaluated at hospital discharge, maternal PTSD symptoms were assessed when the children were 18 months old, and children’s IQ was measured at 11 years old. IQ was significantly lower for preterm than full-term children, without reliable influences from perinatal risk scores. However, lower maternal PTSD symptoms predicted higher IQ in preterm children. This preliminary study highlights the importance detecting maternal PTSD symptoms after a preterm birth and suggests interventions should target reducing maternal PTSD symptoms during early childhood to enhance very preterm children’s intelligence development.

Maternal PTSD and Behavioral Parent Training Treatment for a Girl With Conduct Disorder and Callous–Unemotional Traits

Very little is known about the impact of parental psychopathology on treatment outcome for youth with conduct problems (CPs) and callous–unemotional (CU) traits. This case study describes behavioral parent training (BPT) for “Amy,” an 11-year-old girl presenting with CP/CU traits who had a mother diagnosed with posttraumatic stress disorder (PTSD). Maternal and paternal reports of child behavior problems and impairments were collected to assess treatment outcome. Weekly ratings of maternal PTSD were also collected to examine changes in maternal psychopathology over the course of BPT. Parent ratings showed that treatment was associated with reductions in oppositional defiant disorder (ODD) symptoms, conduct disorder (CD) symptoms, and impairment, and with improvements in treatment goal progress. However, the frequency of negative behaviors remained high throughout treatment. Maternal PTSD symptoms remained in the clinical range throughout BPT, but there was some evidence of synchrony between maternal PTSD symptoms and child negative behaviors. These findings highlight the importance of examining parental psychopathology in understanding BPT outcomes for children with CP/CU traits and call for greater attention to addressing child and parent difficulties that may impede improvement in treatment for youth with CP/CU traits.

Posttraumatic stress disorder symptoms in parents and adolescents after the Wenchuan earthquake: A longitudinal actor-partner interdependence model

BackgroundPrevious research has examined the association between parents’ and children’s posttraumatic stress disorder symptoms (PTSS) after a variety of traumatic events. However, longitudinal parent-child dyadic studies are scarce. MethodsIndependent self-reports were collected from parent-adolescent dyads (n = 688) after the 2008 Wenchuan earthquake. Adolescents (Mean = 15.22 years; 61.63% female) and one of their parents (Mean = 41.04 years; 58.14% female) each reported on their PTSS at 12 (T12m) and 18 months (T18m) following the earthquake. Longitudinal actor-partner interdependence models (APIMs) were used to examine PTSS within dyads. ResultsThe prevalence rates of probable PTSD at T12m and T18m were 18.90% and 11.92% in adolescents; as well as 22.09% and 15.12% in parents, showing a significant decline over time. After adjusted for earthquake exposure, both maternal and paternal PTSS at T12m prospectively predicted adolescent girls’ and boys’ PTSS at T18m (mother to daughter: β = 0.13; mother to son: β = 0.17; father to daughter: β = 0.17; father to son: β = 0.33), while adolescent girls’ and boys’ PTSS at T12m only predicted maternal PTSS at T18m (daughter to mother: β = 0.20; son to mother: β = 0.20), but not paternal PTSS at T18m. LimitationsSelf-reported measures other than clinical reviews were used to collect data. ConclusionsThis study highlights the mutual impacts of adolescent and parental (especially maternal) PTSS after a disaster. Psychological prevention and intervention for adolescent disaster survivors should adopt a whole family approach.

Post-traumatic stress reactions in young victims of road traffic accidents

ABSTRACTMany children and adolescents are exposed to traumatic experiences every year. Over 30% of these children develop a clinical syndrome with emotional, behavioural, cognitive, social, and physical symptoms called post-traumatic stress disorder (PTSD). Road traffic accidents (RTAs) are the main cause of morbidity and mortality in ages 0–19 in industrialized countries. In Greece, 30,000 individuals are injured and 2000 die in RTAs every year, 40% of them between 15 and 34 years old. Findings from previous research exhibit that each fatal motor vehicle accident is related to 50 severe injuries. Although distress after the accident can persist for several months and the need of early assessment and treatment has been highlighted, the emotional needs of children involved in RTAs are rarely recognized and children have received hardly any planned intervention (Kramer & Landolt, 2014). In addition, studies on the extent to which the degree of physical injury predicts PTSD development show mixed results (Delahanty, Raimonde, Spoonster, and Cullado, 2003). In these relatively limited studies, contradicting results concerning the relationship between demographic, accident and trauma factors and the psychological symptoms are shown.In a previous study (Pervanidou et al., 2007), which was conducted over a two-year period, the main aim was to identify and evaluate the severity of PTSD symptoms after a RTA. Furthermore, epidemiological, psychosocial and clinical characteristics related to the disorder were reviewed. The sample consisted of 57 children (39 male, 18 female), aged 7–18, who were admitted to ‘Aghia Sophia’ Children’s General Hospital and other hospitals. Self-reported questionnaires and a semi-structured psychiatric diagnostic interview (K-SADS-PL) were administered. Stress-related hormones were also measured. Assessment took place during the admission to the general hospital, in one month, and six months later. There was a community control group of 30 children/adolescents.Concerning the type of the accident, 36 (59%) of the young victims were traumatized as pedestrians, while 25 (41%) were passengers. The severity of body injury was mild in 21 (34.4%), moderate in 24 (39.3%) and severe in 16 (26.2%) victims. Results showed that 38.3% of children/adolescents who were involved in a RTA suffered from PTSD one month afterwards, while the percentage is significantly lower (15%) six months after the RTA. PTSD symptoms were experienced by children of all ages, although boys were most likely to be affected, especially those who were severely injured during the accident. The only predictor variable that had a significant positive effect on the development of PTSD (one month after the accident) was current maternal PTSD symptoms. Important findings regarding the consequent short- and/or long-term alterations on the circulating concentrations of stress hormones and adipo-cytokines were established as well (Pervanidou et al., 2007).Despite increasing attention over the past 20 years, PTSD is a significant public health issue that has not been properly addressed. It is well documented that highly stressful events affect the normal activity of the neurotransmitter norepinephrine and elevate levels of the hormone cortisol. Furthermore, continuous arousal during the course of time may produce difficulty in the hippocampus’s ability to manage in the future highly stressful events. Children and adolescents may respond to a traumatic event differently, depending on the degree of exposure, the age or developmental stage, the effect of the personal impact and the proximity to the actual traumatizing event. In our study, almost one out of three young victims of RTAs was found to suffer from PTSD a month later, confirming previous findings. The child’s perception of the accident was important, with badly injured children being more likely to develop PTSD. Further research could contribute to improved treatment approaches to reduce the devastating personal and societal impact of PTSD.