Parental Posttraumatic Stress Disorder Research Articles

Efficacy of Psychological Intervention for Children with Concurrent Posttraumatic Stress Disorder and Mild Traumatic Brain Injury.

Posttraumatic stress disorder (PTSD) and mild traumatic brain injury (mTBI) are common conditions following motor vehicle accidents (MVAs). Mild TBI and PTSD not only share similar features but may also coexist and interact. Nonetheless, research on psychotherapeutic interventions for PTSD in patients with a history of mTBI, particularly regarding pediatric populations, is limited. The present study compared the efficacy of the prolonged exposure treatment protocol for children and adolescents (PE-A) with PTSD and mTBI (n = 16) versus PTSD alone (n = 21); treatment commenced at least 3 months following an MVA. Emotional status and cognitive functioning were assessed pre- and postintervention using questionnaires and standardized neuropsychological tests. Participants from both groups benefitted from the intervention, as reflected in their emotional status via increased ratings of well-being and decreased ratings of PTSD, anxiety, depression, and postconcussive symptoms, η2 = .21-.50. Ratings of cognitive function also improved for cognitive flexibility, η2 = .30; executive function in everyday life, η2 = .27; and attention and inhibition, η2 = .16. Parental PTSD was the strongest predictor of improvement after intervention, sr2 = .35. Thus, it appears that PE-A is an effective intervention for children with MVA-related PTSD regardless of its comorbidity with mTBI.

Parental attachment, coping, and psychological adjustment among adolescents following an earthquake: a longitudinal study

ABSTRACT Background and objective: The study aim was to examine the predictive effect of parental attachment on positive psychological outcomes (posttraumatic growth, PTG) and negative psychological outcomes (posttraumatic stress disorder (PTSD) and depression symptoms), and to test the mediating role of positive and negative coping in the relationship among adolescents following an earthquake in China. Design: The study used a longitudinal design with a 6-month time interval. Method: Data was collected from middle schools in the most severely affected areas at 18 and 24 months following an earthquake. Data were analyzed from 398 adolescents who completed self-report measures of parental attachment, coping, PTSD, depression, and PTG. Path analysis was conducted to examine the relationships among the main study variables. Results: Secure parental attachment predicted lower PTSD and depression symptoms at 24-months follow-up, and negative coping partly mediated the effects of parental attachment on PTSD and depression. No significant association was observed between parental attachment and PTG. Conclusions: The findings indicate that secure parental attachment had a protective effect for adolescents after the disaster. Such attachment may reduce the use of negative coping and in turn decrease psychological distress over time.

Prevalence of Symptoms of Anxiety, Depression, and Post-traumatic Stress Disorder in Parents and Children Following Pediatric Stroke.

Post-traumatic stress disorder (PTSD), anxiety, and depression are seen in parents and children following critical illness. Whether this exists in parents and children following pediatric stroke has not been thoroughly studied. We examined emotional outcomes in 54 mothers, 27 fathers, and 17 children with stroke. Parents of children 0-18 years and children 7-18 years who were within 2 years of stroke occurrence were asked to complete questionnaires to determine their emotional outcomes. Of participating mothers, 28% reported PTSD, 26% depression, and 4% anxiety; in fathers, 15% reported PTSD, 24% depression, and none reported anxiety. Further, children reported significant emotional difficulty, with 24% having depression, 14% anxiety, and 6% PTSD by self-report ratings. Maternal PTSD, anxiety and depression, and paternal anxiety were all negatively associated with the child's functional outcome. Clinically significant anxiety (based on clinical thresholds) was not found in fathers; however, continuous scores were still analyzed for association between subclinical anxiety and functional outcome, which revealed a statistically significant association between more reported symptoms and higher Recovery and Recurrence Questionnaire scores. Prevalence of PTSD and depression are greater in parents compared to the general population in this preliminary study.

Transgenerational effects of the genocide against the Tutsi in Rwanda: A post-traumatic stress disorder symptom domain analysis

Background: A number of studies have investigated transgenerational effects of parental post-traumatic stress disorder (PTSD) and its repercussions for offspring. Few studies however, have looked at this issue in the African context. Methods: The present study addresses this gap by utilizing a Pearson correlation matrix to investigate symptom severity within the three Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) PTSD symptom domains in mothers exposed to the genocide against the Tutsi in Rwanda (n=25) and offspring (n=25), and an ethnically matched set of controls (n=50) who were outside of Rwanda during the 1994 genocide. All mothers were pregnant with the offspring included in the study during the time of the genocide. Results: Total PTS score was significantly (p<0.01) correlated with each of the three symptom domains at various strengths in both cases and controls. No significant differences in association of total PTS score and PTSD symptom domains were observed between exposed mothers and offspring, suggesting that each symptom domain contributed equivalently to both exposed mothers and offspring distress. In contrast, the re-experiencing symptom domain showed a significant difference in correlation to overall PTS score in non-exposed mothers compared to their offspring (p<0.05), with mothers showing a significantly higher correlation. Furthermore, the correlation between avoidance/numbing symptoms to overall PTS was significantly different (p≤0.01) across exposed and non-exposed mothers. As a secondary analysis, we explored the relationship between DNA methylation in the glucocorticoid receptor (NR3C1) locus, an important stress modulating gene, and PTSD symptom domains, finding an association between DNA methylation and re-experiencing among genocide-exposed mothers that exceeded any other observed associations by approximately two-fold. Conclusions: This is the first report, to our knowledge, of a symptom-based analysis of transgenerational transmission of PTSD in sub-Saharan Africa. These findings can be leveraged to inform further mechanistic and treatment research for PTSD.

Parental trajectories of PTSD and child adjustment: Findings from the Building a New Life in Australia study.

Evidence suggests that the psychosocial adjustment of children of refugees may be compromised when a parent has symptoms of posttraumatic stress disorder (PTSD). We sought to determine whether trajectories of parental PTSD symptoms might relate to child adjustment and whether there is an additive effect when both parents, as opposed to just one, has prominent PTSD symptoms. We report data from the first three years of a prospective study of recent Australian humanitarian migrants: the Building a New Life in Australia study. Parental PTSD symptoms were assessed on three occasions, and latent class growth analysis was used to identify homogenous groups of parents based on their PTSD symptoms. The Strength and Difficulties Questionnaire was administered to assess child psychosocial adjustment. Regression analyses were then conducted to determine whether trajectories of parental PTSD symptoms predicted child adjustment. After controlling for child age and gender, the presence of either one or both parents with persistently high PTSD symptoms was associated with children's having greater emotional difficulties and poorer overall psychosocial adjustment. Children with both parents with persistently high PTSD had higher levels of emotional difficulties than did children with a single parent with high PTSD symptoms. For emotional difficulties, though not other domains of child psychosocial adjustment, there indeed appears to be an additive impact of having two parents, rather than just one, with persistently high PTSD symptoms, although the magnitude of these effects was small. The clinical and service provision implications of these findings are discussed. (PsycINFO Database Record (c) 2020 APA, all rights reserved).

Posttraumatic stress disorder and complicated grief in bereaved parents of the Sewol Ferry disaster exposed to injustice following the loss.

Perceived justice after man-made disaster bereavement may involve as a protective factor in the recovery process. However, perceived justice related to posttraumatic stress disorder (PTSD) or complicated grief (CG) after disaster bereavement has not been sufficiently discussed in previous studies. This study aims to assess PTSD and CG in bereaved parents of Sewol disaster and to explore whether perceived justice is related with the diagnostic groups. Bereaved parents of Sewol disaster (N = 122) were interviewed approximately 2 years after the incident. Structured interviews for PTSD and CG were assessed, and perceived institutional justice surrounding the incident was measured. Symptom groups were identified, and multinomial logistic regression was conducted to find whether perceived justice was related with PTSD or CG. Participants showed high rates of CG and PTSD, and were classified into the both PTSD and CG group, the CG-only group and the resilient group. The analysis revealed that less perceived justice and being a mother increased the likelihood of having both PTSD and CG. Less perceived justice also showed a tendency to be associated with having CG without PTSD. Parents bereaved by the Sewol disaster had high PTSD and CG related to lower levels of perceived justice surrounding the post-disaster period. Post-disaster environment seeking justice may facilitate the natural grieving process or encourage access to effective individual interventions.

Challenging child behaviours positively predict symptoms of posttraumatic stress disorder in parents of children with Autism Spectrum Disorder and Rare Diseases

BackgroundThis study investigated the validity of conceptualising elevated stress in parents of children who exhibit challenging behaviour within the framework of posttraumatic stress disorder (PTSD). It was hypothesised that parents of children with autism spectrum disorder (ASD), and parents of children with a rare disease would endorse greater PTSD symptomatology than parents of typically developing (TD) children, and that challenging child behaviours would positively predict PTSD symptomatology. MethodThe Life Events Checklist for DSM-5, Developmental Behaviour Checklist (Parent) and PTSD Checklist for DSM-5 were administered to 395 parents. ResultsSignificantly more PTSD symptomatology was reported by parents of children with ASD and parents of children with a rare disease than parents of TD children, and challenging child behaviours positively predicted PTSD symptomatology in both groups. ConclusionA PTSD framework may validly explain elevated stress among some parents of children with ASD and parents of children with a rare disease, and has important implications for support delivered to parents by healthcare providers.

Variables Connecting Parental PTSD to Offspring Successful Aging: Parent-Child Role Reversal, Secondary Traumatization, and Depressive Symptoms.

The effects of parental trauma on offspring of Holocaust survivors (OHS) are debated in the literature. Recently, scholars suggested that it may be more productive to ask when and via which mechanisms such effects are observed. Following, the current study examines if parental Holocaust-related posttraumatic stress disorder (PTSD) symptoms are linked with the aging processes of their middle-aged offspring. Beyond this association, we also suggested a putative mediation path, indicating three underlying mechanisms by which parental trauma lingers on: perceived parent–child role reversal, secondary traumatization, and depressive symptoms. Using a convenience sample of 682 community-dwelling participants, comprising 341 older adult parent–middle-aged offspring dyads (M age = 81.71 and 54.58 for parents and offspring, respectively) to address this issue. Parents reported PTSD with the valid measure of PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition. OHS reported perceived parent–child role reversal, secondary traumatization, depressive symptoms, and completed indices of successful aging. Based on parents’ reports, we divided the parent–offspring dyads into three groups: OHS whose parents had probable PTSD (n dyads = 43), OHS whose parents did not have PTSD (n dyads = 161), and comparison with parents who did not undergo the Holocaust (n dyads = 137). Findings reveal that OHS with parents suffering from probable PTSD aged less successfully than comparisons. Serial mediation analyses validated the aforementioned putative pathway (perceived parent–child role reversal, secondary traumatization, and depression) linking parental PTSD with offspring successful aging. Our findings are discussed through a vignette depicting a fictional OHS character. These underlying mechanisms suggest that different types of interventions, each geared towards a specific mechanism, may mitigate the lingering effect of parental PTSD on diminished OHS successful aging.

Family Chaos and Asthma Control.

Asthma is a highly prevalent childhood chronic disease, with particularly high rates among poor and minority youth. Psychosocial factors have been linked to asthma severity but remain poorly understood. This study examined (1) relationships between parent and child depression and posttraumatic stress disorder (PTSD) symptoms, family functioning, and child asthma control in a sample of urban minority youth with uncontrolled asthma and (2) family functioning as a pathway linking parent depression and asthma outcomes. Data were drawn from the baseline cohort of a randomized trial testing community interventions for children aged 5 to 16 with uncontrolled asthma (N = 223; mean age = 9.37, SD = 3.02; 85.2% Hispanic). Asthma control was defined by using the Asthma Control Test and Childhood Asthma Control Test, activity limitation, and previous-12-month asthma severity. Psychosocial measures included parent and child depression and PTSD symptoms, family chaos, and parent social support. Parent and child depression symptoms, but not PTSD, were associated with worse asthma control (β = -.20 [SE = 0.06] and β = -.12 [SE = -.03]; P < .001). Family chaos corresponded to worse asthma control, even when controlling for parent and child depression (β = -.33; [SE = 0.15]; P < .05), and was a mediator of the parent depression-asthma path. Emotional triggers of asthma also mediated the parent depression-asthma relationship. Findings highlight family chaos as a mechanism underlying the relationship between parent depression and child asthma control. Addressing parent and child depression, family routines, and predictability may optimize asthma outcomes.

Long-Term Impact of Parental Post-Traumatic Stress Disorder Symptoms on Mental Health of Their Offspring After the Great East Japan Earthquake.

Longitudinal studies of the long-term psychological impact of the Great East Japan Earthquake (GEJE) on parents and their children have been limited. The current study aimed to monitor parents’ post-traumatic stress disorder (PTSD) symptoms and behavioral problems among their children over time and to analyze their long-term associations among the survivors of the GEJE. We used data from the GEJE Follow-up for Children study, which recruited 4- to 6-year-old children and those children’s parents immediately after the GEJE in March 2011, with ongoing follow-up. Children’s total, internalizing, and externalizing behavioral problems were assessed using the Child Behavior Checklist (CBCL), and parental probable PTSD was assessed using the Impact of Event Scale-R (IES-R), in 2012 (baseline) and 2014 (follow-up). Parental PTSD symptoms and children’s behavioral problems declined slightly over time, and both showed a significant correlation between the surveys (r = 0.55–0.77, P < 0.001). The association between parental PTSD symptoms and children’s behavioral problems was investigated using multivariate logistic regression analysis adjusting for baseline children’s behavioral problems and other potential confounders. Cross-sectionally, while no significant association was detected in 2012, all types of children’s behavioral problems exhibited significant positive associations with parental PTSD symptoms in multiple logistic regression analysis adjusted odds ratio (AOR) = 3.03, 3.30, and 5.34 for total, internalizing, and externalizing behavior problems, respectively. Maternal educational attainment level (higher than high school education) showed a significant negative association with children’s total and externalizing behavioral problems (AOR = 0.30 and 0.13, respectively) in 2014. Longitudinally, parental PTSD symptoms in 2012 showed a significant association with children’s internalizing behavioral problems in 2014 after adjusting for children’s behavioral problems in 2012 and parental PTSD symptoms in 2014 (AOR = 4.62). These results suggest that the effect of the GEJE on parental PTSD symptoms and children’s behavioral problems was long-term, lasting for at least 3 years. These possibilities should be carefully considered in mental health support for parents and their offspring in areas affected by the GEJE.

Risk of childhood psychiatric disorders in children of refugee parents with post-traumatic stress disorder: a nationwide, register-based, cohort study

Children of refugees are often exposed to the consequences of parental post-traumatic stress disorder (PTSD), potentially leaving them vulnerable to intergenerational transmission of psychopathology. The present study aimed to determine whether parental PTSD is associated with childhood psychiatric morbidity among children of refugees. This study is a two-generation nationwide cohort study using the Danish Immigration Services database. We followed up children younger than 18 years with at least one refugee parent until psychiatric contact, end of the study, their 18th birthday, emigration, or death. We excluded children if their parents were diagnosed only with psychiatric diagnoses other than PTSD or if they had received a psychiatric contact before parental PTSD diagnosis. Information on parental PTSD and offspring psychiatric morbidity was obtained from the Danish Psychiatric Central Research Register. We used Cox proportional hazards regression models to assess the risk of psychiatric contacts among children of refugees with PTSD compared with children of refugees with no psychiatric diagnosis. Between Jan 1, 1995, and Dec 31, 2015, 102 010 refugees obtained residency permission in Denmark and 62 239 biological children of refugees were born in Denmark before Dec 31, 2015. 51 793 were eligible and included in the study (median follow-up 7·15 years [IQR 3·37-11·78]); of these, 1307 (2·5%) children had a psychiatric contact. 7486 (14·5%) children of refugees were exposed to parental PTSD. Parental PTSD significantly increased the risk of psychiatric contact in offspring (hazard ratio 1·49 [95% CI 1·17-1·89] for paternal PTSD, p=0·0011; 1·55 [1·20-2·01] for maternal PTSD, p=0·00084) after adjustment for sociodemographic variables. Children of refugees exposed to parental PTSD are at increased risk of psychiatric morbidity. Targeted screening and interventions are necessary to prevent psychiatric morbidity and ensure access to adequate care. Section for Immigrant Medicine, Department of Infectious Diseases, Copenhagen University Hospital Hvidovre.

The correlation of post-traumatic stress disorder and emotional regulation of parents with children having acute lymphoblastic leukemia

Objective To explore the correlation between post-traumatic stress disorder (PTSD) and emotional regulation in the parents whose children have acute lymphoblastic leukemia (ALL) . Methods By convenient sampling method, a total of 233 parents whose children had ALL were selected in the First Affiliated Hospital of Zhengzhou University from June 2013 to June 2017, and the levels of PTSD and emotional regulation were evaluated by The PTSD Checklist-Civilian Version (PCL-C) and Emotion Regulation Questionnaire (ERQ) . A total of 233 questionnaires were distributed and 233 valid ones were retrieved, yielding an effective recovery rate of 100%. Results In this study, the participants got (35.82±4.93) points for PCL-C, among which the highest average item score was (2.29±0.36) points for Avoid/Numb; the score of and were (4.27±0.64) and (4.35±0.60) points in ERQ. Pearson correlation analysis showed that the total score and each dimension score in PCL-C were negatively correlated with cognitive reappraisal (P<0.05) , and were positively correlated with expressive suppression (P<0.05) . Multivariate linear regression analysis showed that cognitive reappraisal and expressive suppression were the influencing factors for PTSD of the parents with ALL children (P<0.05) . Conclusions ALL children's parents have serious PTSD and tend to choose the emotional regulation way of expressive suppression. There is correlation between the degree of PTSD in ALL children's parents and their emotional regulating ability, therefore, nursing staff should assist them in the improvement of their emotional regulation ability to reduce the level of PTSD. Key words: Leukemia; Acute lymphoblastic leukemia; Post-traumatic stress disorder; Emotional regulation

Vulnerable Child Syndrome.

1. Kristine Schmitz, MD* 1. *St Christopher’s Hospital for Children/Drexel University College of Medicine, Philadelphia, PA Vulnerable child syndrome (VCS) describes a phenomenon in which a child is perceived as being at higher risk for medical, behavioral, or developmental problems than is warranted by the child’s current health. It is most often thought to occur in children who have experienced a serious or life-threatening event or who have a chronic medical condition. However, VCS should be considered a maladaptive family dynamic and can also occur in families that have not experienced a significant event, particularly where parental mental health needs are unmet. Parental perception of exaggerated risk may lead to overuse of medical services, possible unnecessary interventions, and poor parenting practices, parent-child attachment, and child development. Several factors may predispose families to develop these maladaptive relationships and perceptions of their child. Infertility, pregnancy loss or emergent pregnancy complications, and premature birth may result in VCS. While the child is in the NICU, parents of premature infants face uncertainty about their child’s health, and many premature children develop chronic medical problems, many of which require subspecialty involvement. In addition, parents of children who have experienced a life-threatening event (eg, intubation due to respiratory syncytial virus) or diagnosis (eg, cancer) may continue to fear serious illness even after the illness has resolved. Similarly, children diagnosed as having chronic medical conditions, such as asthma or type 1 diabetes, require ongoing management and can have exacerbations, increasing the risk of parental misperception of vulnerability. Last, early childhood feeding difficulty or excessive crying may predispose families to develop VCS. Parental mental health is an important consideration in identifying risk factors for the development of VCS. Acute stress disorder or posttraumatic stress disorder in parents …

Parental PTSD and school performance in 16-year-olds – a Swedish national cohort study

Aim: Posttraumatic stress disorder (PTSD) in parents can have severe consequences also for their children. Prevalence of PTSD is high among refugees. Refugee children have been reported to perform poorly in school. The aim of this study was to investigate the impact of PTSD in refugee and native Swedish parents on children’s school performance and to compare the impact of PTSD with that of other major psychiatric disorders.Methods: Register study where multiple regression models were used to analyse school performance in 15–16-year-olds in a national cohort (n = 703,813). PTSD and other major psychiatric disorders (bipolar, depression and/or psychotic disorders) were identified from out- and in-patient hospital care.Results: Maternal and paternal PTSD were associated with lower grades, with adjusted effects of 0.30–0.37 SD in refugee and 0.46–0.50 SD in native Swedish families. Impact of PTSD was greater than that of other psychiatric disorders and comorbidity to PTSD did not increase this impact. Although the impact of PTSD on grades was greater in children in native Swedish families, consequences with regard to eligibility to secondary education were greater for children in refugee families, where 35% of these children were ineligible.Conclusions: Parental PTSD has major consequences for children’s school performance and contributes to the lower school performance in children in refugee families in Sweden. Identification and treatment of PTSD in refugee parents is important for offspring educational achievement. Psychiatric clinics and treatment centres need to have a strategy for support, including educational support, to the offspring of their patients with PTSD.

Resilient, recovering, distressed: A longitudinal qualitative study of parent psychosocial trajectories following child critical injury

IntroductionThe psychological distress and risk of mental health problems for parents of children with critical injury is well-established. There has been little exploration, however, of parent experiences and psychosocial trajectories over time following child critical injury. To address this knowledge gap, a longitudinal qualitative study was conducted to explore parent experiences and support needs and identify parent psychosocial trajectories in the 12 months following child critical injury. MethodsSemi- structured in-depth interviews were conducted with 27 parents at three time points over a 12 month period: the immediate hospital period post-child injury, and 6 and 12 months following injury, resulting in a total of 81 interviews. Data were analysed using a longitudinal within and across-case thematic analysis of patterns emerging over time. FindingsThree parent trajectory patterns were identified: resilient trajectory where parents were temporarily disrupted by the child’s injury and hospitalisation, but recovered their mental and emotional wellbeing quickly, which was maintained over time; recovering trajectory where parents were initially disrupted at the time of injury but their mental and emotional wellbeing fluctuated over time and had not been fully restored by 12 months; and distressed trajectory where parents experienced significant psychosocial disruption due to their child’s injury and struggled to adapt and regain their wellbeing over time, remaining emotionally distressed about the circumstances and impacts of the injury on their child and family. Illustrative narratives that represent each trajectory are presented. ConclusionsThis is the first qualitative study to report the psychosocial trajectories of parents of critically injured children. Clinical application of insights provided by these trajectories can assist clinicians to use targeted strategies to help strengthen parental adaptation and prevent adverse mental health outcomes, and address families’ psychosocial support needs following child injury. Screening for parent psychological distress and post-traumatic stress disorder is needed from the time of the child’s admission, and a dedicated trauma support role can facilitate an integrated care approach for children and families with complex needs across the care continuum.

The relationship between hope and post-traumatic stress disorder in Chinese shidu parents: The mediating role of perceived stress

BackgroundParents who lost their only child and can not conceive another child, are known as shidu parents in China. This study aimed to estimate the prevalence of post-traumatic stress disorder (PTSD) and examine the mediating role of perceived stress between hope and PTSD symptoms in Chinese shidu parents. Methods295 shidu mothers and 197 shidu fathers were recruited in Shenyang city. Shidu parents were asked to complete a questionnaire including the PTSD Checklist for DSM-5 (PCL-5), the Herth hope index (HHI) and the Perceived Stress Scale-10 (PSS-10). Hierarchical linear regression was performed to assess the associations among hope, perceived stress and PTSD symptoms. Asymptotic and resampling strategies were used to explore the mediating role of perceived stress. ResultsThe prevalence of PTSD in Chinese shidu parents was 23.78%. Mothers were more likely to develop PTSD than fathers. For shidu fathers, the proportion of mediation of perceived stress was 39.48%. For shidu mothers, the proportion of mediation of perceived stress was 40.00%. LimitationsDue to the cross-sectional design, the findings of the present study can not be used to establish formal causal relationships or to determine the direction of causality. Longitudinal studies are need to validate our findings. ConclusionsPerceived stress partly mediated the relationship between hope and PTSD symptoms in Chinese shidu parents. The interventions of hope and perceived stress should be included in PTSD prevention. More assistance should be directed to improve the mental health of shidu mothers.

Prevalence of anxiety, depression, and posttraumatic stress disorder in parents of children with cancer: A meta-analysis.

For parents, a diagnosis of cancer in their child is a traumatic experience. However, there is conflicting evidence about the risk of developing mental illness among parents following diagnosis. Our objective was to conduct a meta-analysis to determine the prevalence of mental illness in parents of children with cancer. Four databases were searched to identify articles describing the prevalence of anxiety, depression, or posttraumatic stress disorder (PTSD) in parents of pediatric cancer patients. Two reviewers independently screened and extracted data. Subgroup analyses by gender and phase of cancer experience were selected a priori. Studies were reviewed in accordance with PRISMA guidelines. Of 11394 articles identified, 58 met inclusion criteria. Reported prevalence was highly heterogeneous, ranging from 5% to 65% for anxiety (pooled prevalence 21% [95% CI, 13%-35%]), 7% to 91% for depression (pooled prevalence 28% [95% CI, 23%-35%]), and 4% to 75% for PTSD (pooled prevalence 26% [95% CI, 22%-32%]). Prevalence was consistently higher than noncancer parental controls. Heterogeneity was not explained by parental gender or child's cancer phase and was instead likely due to significant methodological differences in measurement tools and defined thresholds. Parents of children with cancer have a higher prevalence of anxiety, depression, and PTSD compared with population controls. Yet, the reported prevalence of mental illness was highly variable, hampering any conclusive findings on absolute prevalence. To better understand the risk of long-term mental illness in this population and target interventions, future studies must adhere to standardized reporting and methods.

Parental immigration and offspring post-traumatic stress disorder: A nationwide population-based register study

ObjectivesThe aim of this study was to investigate the association between parental immigration status and a diagnosis of post-traumatic stress disorder (PTSD) in their offspring. MethodsThis nested matched case-control study was based on a Finnish national birth cohort for 1987–2010 and cases were diagnosed with PTSD by 2012 from the Care Register for Health Care. We identified 3639 cases and 14,434 controls individually matched for gender, place and date of birth (±30 days). Conditional logistic regression analyses were conducted to examine the association between parental immigration status, parents’ region of birth and time since paternal immigration, and PTSD after controlling for confounding factors. ResultsThe likelihood of being diagnosed with PTSD was significantly increased among children with an immigrant father (OR 1.8, 95% CI 1.3 - 2.4) than those with two Finnish parents and one immigrant mother. There was no significant association between having an immigrant mother or two immigrant parents and receiving a diagnosis of PTSD. The likelihood of being diagnosed with PTSD was increased if the children's fathers had migrated less than five years before their birth (OR 1.4, 95% CI 1.03 - 1.9) and if their immigrant fathers had been born in North Africa or the Middle East (OR 2.1, 95% CI 1.4 - 3.3). LimitationsThe sample included a heterogeneous migrant group without information on the reason for migration. The cases were identified from hospital diagnosis that may have only included severe cases. ConclusionThe increased likelihood of a diagnosis of PTSD underlines the need for psychosocial services among second-generation immigrants.

Parental Holocaust Exposure, Related PTSD Symptoms and Subjective Aging Across the Generations.

Traumatic exposure and posttraumatic stress disorder (PTSD) are related to less favorable perceptions of aging. The current study examined parental PTSD and perceptions of aging among old Holocaust survivor (HS) parents and their middle-aged offspring. Parents (mean age = 81.79) and their offspring (mean age = 55.41) reported PTSD symptoms, attitudes toward aging and subjective age. Offspring also rated how they perceive both their parents' aging and subjective age. Dyads were divided into three groups: HS with probable PTSD (n = 21 dyads), HS without probable PTSD (n = 65 dyads), and comparison parents without probable PTSD (n = 57 dyads). Relative to parents and offspring from other groups, HS parents with probable PTSD and their offspring had both less favorable attitudes toward their own aging as well as reporting feeling older. Offspring of posttraumatic HS also held less favorable attitudes toward parents' aging and perceived their own parents as being older. Serial mediation models showed that the effect of parental PTSD on offspring's subjective aging was serially mediated by parental subjective aging and offspring's perception of parents' aging. The study provides the first evidence that posttraumatic distress is related to less favorable perceptions of aging across generations in HS families. Possible mechanisms for such intergenerational effect and the implication for interventions are discussed.

Parental PTSD, health behaviors and successful aging among offspring of Holocaust survivors

Unhealthy behaviors and physical morbidity are more common among trauma survivors, especially those who suffer from posttraumatic stress disorder (PTSD). This study looked at the underexplored relationships between parental PTSD, unhealthy behaviors and aging of trauma survivors' offspring. Dyads of parents (mean age = 82.42) and offspring (mean age = 55.48) reported PTSD symptoms, health behaviors and completed indices of successful aging. Dyads were divided into three groups: Holocaust survivors (HS) with probable PTSD (n = 28 dyads), HS without PTSD (n = 86 dyads) and comparison parents without PTSD (n = 73 dyads). Relative to the other groups, HS parents with probable PTSD and their offspring reported more unhealthy behaviors. Serial mediation models showed that the effect of parental PTSD on offspring successful aging was mediated by both parental and offspring unhealthy behaviors. Findings remained significant after controlling for background characteristics and offspring PTSD. This study provides preliminary evidence that PTSD is related to unhealthy behaviors across generations in HS families. Possible mechanisms for such intergenerational effect and its clinical implication are discussed.