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mits maltreatment, or fails to notice and pre-gation. Relative to demographically similar vent it from occurring (Cicchetti ). At the very least, childhood trauma can prevalence of PTSD despite comparable rates be understood resulting from more global of adult trauma exposure (Y ehuda, Schmeid-environmental adversity or chaos, implicating ler, Giller, et al., 1998; Yehuda, Schmeidler, some form of neglect. The presence of these Wainberg, et al., 1998). Offspring of Holo-additional elements may help to explain the caust survivors are generally stable, well-edu-contrast between the low rates of PTSD ob-cated persons of medium to high sociodemo-served children who experience single trau-graphic status, with relatively low levels of matic events, or discrete chronic traumas such substance abuse. Thus, the risk factors associ- war (e.g., Pynoos, Frederick, Nader, Ar-ated with the development of PTSD off-royo, Steinberg, Eth, Nunez, & Fairbanks, spring are likely to be largely confined to 1987; Sack, Clarke, Him, Dickason, Goff, variables associated with parental trauma ex-Lanham, ski, 1991; Terr, 1981), and the high rates of sure. symptomatology associated with ongoing The Holocaust marked a watershed childhood maltreatment. The child who has an modern human history, because of the sys-otherwise stable and secure environment can tematic exposure of millions of individuals to identify discrete traumatic events being un-previously unimaginable acts of human cru-usual. A child who need only recover from elty. To the extent that parental traumatic ex-the effects of an event, and not also from the periences are contributors to child trauma, the more pervasive factors that gave rise to that early experiences of children of Holocaust event, may be less vulnerable to mental health survivors provide a strong test of that hypoth-consequences adulthood. esis. Between and 75% of Holocaust survi-This paper will consider the specific out-vors meet the diagnostic criteria for lifetime come of PTSD in relation to both childhood PTSD; therefore, it is also possible to examine trauma and other risk factors that have the contribution of parental PTSD symptoms been associated with PTSD-namely, paren-to childhood trauma offspring in this popu-tal trauma exposure and parental PTSD. There lation. By examining interrelationships among evidence linking trauma exposure in a par-childhood trauma, PTSD, parental PTSD, and ent both subsequent maltreatment of chil-cortisol this unique population, we may be-dren (e.g., Kaufman describe more complex constellations Leventhal, re-to an increased prevalence of PTSD in the off-sponsiveness to stress. spring following exposure to trauma in adult-hood (Yehuda, Schmeidler, Wainberg, Binder-Brynes, have recently hypothesized that parental PTSD, rather than just parental trauma expo- sure, may be a more specific risk factor for Fifty-one offspring (20 men, 31 women) and the development of PTSD offspring (Y e- comparison participants (23 men, 18 wom-huda, Schmeidler, Giller, Siever, & Binder-en) gave informed consent and participated in Brynes, I 998). this study, which was approved by the Institu-The current research examines the associa-tional Review Board at Mount Sinai School tions between childhood trauma and PTSD of Medicine. Offspring were defined hav-adult children of Holocaust survivors, in con-ing been born to at least one biological parent sideration of parental trauma exposure and pa-who experienced the Nazi Holocaust. For the rental PTSD. We also examine these variables purposes the current study, Holocaust sur- relation to 24-hr urinary cortisol levels in vivors were individuals who were in a ghetto, offspring. Offspring of Holocaust survivors a labor or concentration camp, or had to hide represent ideal population for such investi- or flee Nazi-occupied territory after 1939.
DOI link for mits maltreatment, or fails to notice and pre-gation. Relative to demographically similar vent it from occurring (Cicchetti ). At the very least, childhood trauma can prevalence of PTSD despite comparable rates be understood resulting from more global of adult trauma exposure (Y ehuda, Schmeid-environmental adversity or chaos, implicating ler, Giller, et al., 1998; Yehuda, Schmeidler, some form of neglect. The presence of these Wainberg, et al., 1998). Offspring of Holo-additional elements may help to explain the caust survivors are generally stable, well-edu-contrast between the low rates of PTSD ob-cated persons of medium to high sociodemo-served children who experience single trau-graphic status, with relatively low levels of matic events, or discrete chronic traumas such substance abuse. Thus, the risk factors associ- war (e.g., Pynoos, Frederick, Nader, Ar-ated with the development of PTSD off-royo, Steinberg, Eth, Nunez, & Fairbanks, spring are likely to be largely confined to 1987; Sack, Clarke, Him, Dickason, Goff, variables associated with parental trauma ex-Lanham, ski, 1991; Terr, 1981), and the high rates of sure. symptomatology associated with ongoing The Holocaust marked a watershed childhood maltreatment. The child who has an modern human history, because of the sys-otherwise stable and secure environment can tematic exposure of millions of individuals to identify discrete traumatic events being un-previously unimaginable acts of human cru-usual. A child who need only recover from elty. To the extent that parental traumatic ex-the effects of an event, and not also from the periences are contributors to child trauma, the more pervasive factors that gave rise to that early experiences of children of Holocaust event, may be less vulnerable to mental health survivors provide a strong test of that hypoth-consequences adulthood. esis. Between and 75% of Holocaust survi-This paper will consider the specific out-vors meet the diagnostic criteria for lifetime come of PTSD in relation to both childhood PTSD; therefore, it is also possible to examine trauma and other risk factors that have the contribution of parental PTSD symptoms been associated with PTSD-namely, paren-to childhood trauma offspring in this popu-tal trauma exposure and parental PTSD. There lation. By examining interrelationships among evidence linking trauma exposure in a par-childhood trauma, PTSD, parental PTSD, and ent both subsequent maltreatment of chil-cortisol this unique population, we may be-dren (e.g., Kaufman describe more complex constellations Leventhal, re-to an increased prevalence of PTSD in the off-sponsiveness to stress. spring following exposure to trauma in adult-hood (Yehuda, Schmeidler, Wainberg, Binder-Brynes, have recently hypothesized that parental PTSD, rather than just parental trauma expo- sure, may be a more specific risk factor for Fifty-one offspring (20 men, 31 women) and the development of PTSD offspring (Y e- comparison participants (23 men, 18 wom-huda, Schmeidler, Giller, Siever, & Binder-en) gave informed consent and participated in Brynes, I 998). this study, which was approved by the Institu-The current research examines the associa-tional Review Board at Mount Sinai School tions between childhood trauma and PTSD of Medicine. Offspring were defined hav-adult children of Holocaust survivors, in con-ing been born to at least one biological parent sideration of parental trauma exposure and pa-who experienced the Nazi Holocaust. For the rental PTSD. We also examine these variables purposes the current study, Holocaust sur- relation to 24-hr urinary cortisol levels in vivors were individuals who were in a ghetto, offspring. Offspring of Holocaust survivors a labor or concentration camp, or had to hide represent ideal population for such investi- or flee Nazi-occupied territory after 1939.
mits maltreatment, or fails to notice and pre-gation. Relative to demographically similar vent it from occurring (Cicchetti ). At the very least, childhood trauma can prevalence of PTSD despite comparable rates be understood resulting from more global of adult trauma exposure (Y ehuda, Schmeid-environmental adversity or chaos, implicating ler, Giller, et al., 1998; Yehuda, Schmeidler, some form of neglect. The presence of these Wainberg, et al., 1998). Offspring of Holo-additional elements may help to explain the caust survivors are generally stable, well-edu-contrast between the low rates of PTSD ob-cated persons of medium to high sociodemo-served children who experience single trau-graphic status, with relatively low levels of matic events, or discrete chronic traumas such substance abuse. Thus, the risk factors associ- war (e.g., Pynoos, Frederick, Nader, Ar-ated with the development of PTSD off-royo, Steinberg, Eth, Nunez, & Fairbanks, spring are likely to be largely confined to 1987; Sack, Clarke, Him, Dickason, Goff, variables associated with parental trauma ex-Lanham, ski, 1991; Terr, 1981), and the high rates of sure. symptomatology associated with ongoing The Holocaust marked a watershed childhood maltreatment. The child who has an modern human history, because of the sys-otherwise stable and secure environment can tematic exposure of millions of individuals to identify discrete traumatic events being un-previously unimaginable acts of human cru-usual. A child who need only recover from elty. To the extent that parental traumatic ex-the effects of an event, and not also from the periences are contributors to child trauma, the more pervasive factors that gave rise to that early experiences of children of Holocaust event, may be less vulnerable to mental health survivors provide a strong test of that hypoth-consequences adulthood. esis. Between and 75% of Holocaust survi-This paper will consider the specific out-vors meet the diagnostic criteria for lifetime come of PTSD in relation to both childhood PTSD; therefore, it is also possible to examine trauma and other risk factors that have the contribution of parental PTSD symptoms been associated with PTSD-namely, paren-to childhood trauma offspring in this popu-tal trauma exposure and parental PTSD. There lation. By examining interrelationships among evidence linking trauma exposure in a par-childhood trauma, PTSD, parental PTSD, and ent both subsequent maltreatment of chil-cortisol this unique population, we may be-dren (e.g., Kaufman describe more complex constellations Leventhal, re-to an increased prevalence of PTSD in the off-sponsiveness to stress. spring following exposure to trauma in adult-hood (Yehuda, Schmeidler, Wainberg, Binder-Brynes, have recently hypothesized that parental PTSD, rather than just parental trauma expo- sure, may be a more specific risk factor for Fifty-one offspring (20 men, 31 women) and the development of PTSD offspring (Y e- comparison participants (23 men, 18 wom-huda, Schmeidler, Giller, Siever, & Binder-en) gave informed consent and participated in Brynes, I 998). this study, which was approved by the Institu-The current research examines the associa-tional Review Board at Mount Sinai School tions between childhood trauma and PTSD of Medicine. Offspring were defined hav-adult children of Holocaust survivors, in con-ing been born to at least one biological parent sideration of parental trauma exposure and pa-who experienced the Nazi Holocaust. For the rental PTSD. We also examine these variables purposes the current study, Holocaust sur- relation to 24-hr urinary cortisol levels in vivors were individuals who were in a ghetto, offspring. Offspring of Holocaust survivors a labor or concentration camp, or had to hide represent ideal population for such investi- or flee Nazi-occupied territory after 1939.
ABSTRACT
Childhood trauma and risk for PTSD