each parent who experienced the Holocaust, significant abuse, as indicated by the CTQ di-participants then completed a checklist based chotomies. on the symptoms of PTSD listed in the Second, we examined whether parental fourth edition of the PTSD specifically (rather than parental (DSM-IV; American Psychiatric trauma exposure) is related self-reported Association, 1994 rating severity on a 4-trauma offspring by carrying out analyses point Likert scale. Preliminary evidence sug-of CTQ scores (means and dichotomies) gests that this scale correlates well with inde-within the offspring group, comparing off-pendent diagnostic evaluations. the nine spring with versus without parental PTSD. cases where both the Parental Stress History We also carried out exploratory analyses Scale and face-to-face diagnostic assessments looking more specifically at parental PTSD. of the parents by experienced clinicians were ANOV A was used to compare CTQ scores in available, there was complete agreement re-comparison subjects, offspring without paren-garding the presence or absence of PTSD tal PTSD, offspring with a single parent with (Y ehuda et a!., 2000). PTSD, and offspring with both parents with PTSD. Pearson's correlations were used to as- sess dose-response effects, examining associ- ations between parental PTSD symptoms and Urine was collected for 24 hr after the first offspring CTQ scores. The correlational anal-voided urine following awakening, including yses were repeated separately for maternal the first voided urine on the following day. and paternal symptoms. Two-liter polyethylene collection bottles were Third, we examined the extent to which used and kept in freezers in the participants' childhood trauma represents a risk factor for residences order to ensure stability of corti-the development of PTSD. This was accom-sol. Collections were scheduled occur on plished by performing chi-square tests com-days that were anticipated not to be particu-paring the frequency of PTSD in individuals larly stressful, in order to obtain samples that with and without self-reported childhood reflect typical basal secretion. Most partici-trauma. In addition, we examined whether pants stayed at home for the 24-hr period in there are differences self-reported child-order facilitate collection. Urinary-free cor-hood trauma in participants reporting PTSD tisol levels were determined by using an ex- a focal trauma occurring in adulthood com-traction procedure and radioimmunoassay kit pared to those who experienced a trauma in from Clinical Assays, Inc. (Cambridge, MA; adulthood but did not develop PTSD. Correla-interassay coefficient of variation was 4.0% ). tions between mean CTQ scores and PTSD symptoms were also performed in the subset of participants reporting an adult trauma. This allowed us to assess whether childhood trauma is a risk factor for PTSD to focal trau- mas that occur independently of childhood Four sets of analyses were performed. First, events. Finally, logistic regression was used we examined whether parental trauma expo-to assess the extent to which self-reported sure related to higher levels of self-reported childhood trauma predicted the development childhood trauma by comparing the offspring of PTSD, over and above the contribution of group as a whole with the comparison partici-parental trauma exposure and parental PTSD. pants. This question was addressed by com-The fourth area of inquiry concerned the paring scores on each of the CTQ dimensions relationship of early trauma to 24-hr urinary for offspring versus comparison participants. cortisol secretion. In the first analysis, total Two-way analysis of variance (ANOV A; 24-hr urinary cortisol was compared using Group x Gender) was used to compare mean analysis of covariance (ANCOV A) in individ-scores, and chi-square tests were used to ex-uals with and without significant trauma, co-amine the relative frequencies of clinically varying for age and gender. In the second

DOI link for each parent who experienced the Holocaust, significant abuse, as indicated by the CTQ di-participants then completed a checklist based chotomies. on the symptoms of PTSD listed in the Second, we examined whether parental fourth edition of the PTSD specifically (rather than parental (DSM-IV; American Psychiatric trauma exposure) is related self-reported Association, 1994 rating severity on a 4-trauma offspring by carrying out analyses point Likert scale. Preliminary evidence sug-of CTQ scores (means and dichotomies) gests that this scale correlates well with inde-within the offspring group, comparing off-pendent diagnostic evaluations. the nine spring with versus without parental PTSD. cases where both the Parental Stress History We also carried out exploratory analyses Scale and face-to-face diagnostic assessments looking more specifically at parental PTSD. of the parents by experienced clinicians were ANOV A was used to compare CTQ scores in available, there was complete agreement re-comparison subjects, offspring without paren-garding the presence or absence of PTSD tal PTSD, offspring with a single parent with (Y ehuda et a!., 2000). PTSD, and offspring with both parents with PTSD. Pearson's correlations were used to as- sess dose-response effects, examining associ- ations between parental PTSD symptoms and Urine was collected for 24 hr after the first offspring CTQ scores. The correlational anal-voided urine following awakening, including yses were repeated separately for maternal the first voided urine on the following day. and paternal symptoms. Two-liter polyethylene collection bottles were Third, we examined the extent to which used and kept in freezers in the participants' childhood trauma represents a risk factor for residences order to ensure stability of corti-the development of PTSD. This was accom-sol. Collections were scheduled occur on plished by performing chi-square tests com-days that were anticipated not to be particu-paring the frequency of PTSD in individuals larly stressful, in order to obtain samples that with and without self-reported childhood reflect typical basal secretion. Most partici-trauma. In addition, we examined whether pants stayed at home for the 24-hr period in there are differences self-reported child-order facilitate collection. Urinary-free cor-hood trauma in participants reporting PTSD tisol levels were determined by using an ex- a focal trauma occurring in adulthood com-traction procedure and radioimmunoassay kit pared to those who experienced a trauma in from Clinical Assays, Inc. (Cambridge, MA; adulthood but did not develop PTSD. Correla-interassay coefficient of variation was 4.0% ). tions between mean CTQ scores and PTSD symptoms were also performed in the subset of participants reporting an adult trauma. This allowed us to assess whether childhood trauma is a risk factor for PTSD to focal trau- mas that occur independently of childhood Four sets of analyses were performed. First, events. Finally, logistic regression was used we examined whether parental trauma expo-to assess the extent to which self-reported sure related to higher levels of self-reported childhood trauma predicted the development childhood trauma by comparing the offspring of PTSD, over and above the contribution of group as a whole with the comparison partici-parental trauma exposure and parental PTSD. pants. This question was addressed by com-The fourth area of inquiry concerned the paring scores on each of the CTQ dimensions relationship of early trauma to 24-hr urinary for offspring versus comparison participants. cortisol secretion. In the first analysis, total Two-way analysis of variance (ANOV A; 24-hr urinary cortisol was compared using Group x Gender) was used to compare mean analysis of covariance (ANCOV A) in individ-scores, and chi-square tests were used to ex-uals with and without significant trauma, co-amine the relative frequencies of clinically varying for age and gender. In the second

each parent who experienced the Holocaust, significant abuse, as indicated by the CTQ di-participants then completed a checklist based chotomies. on the symptoms of PTSD listed in the Second, we examined whether parental fourth edition of the PTSD specifically (rather than parental (DSM-IV; American Psychiatric trauma exposure) is related self-reported Association, 1994 rating severity on a 4-trauma offspring by carrying out analyses point Likert scale. Preliminary evidence sug-of CTQ scores (means and dichotomies) gests that this scale correlates well with inde-within the offspring group, comparing off-pendent diagnostic evaluations. the nine spring with versus without parental PTSD. cases where both the Parental Stress History We also carried out exploratory analyses Scale and face-to-face diagnostic assessments looking more specifically at parental PTSD. of the parents by experienced clinicians were ANOV A was used to compare CTQ scores in available, there was complete agreement re-comparison subjects, offspring without paren-garding the presence or absence of PTSD tal PTSD, offspring with a single parent with (Y ehuda et a!., 2000). PTSD, and offspring with both parents with PTSD. Pearson's correlations were used to as- sess dose-response effects, examining associ- ations between parental PTSD symptoms and Urine was collected for 24 hr after the first offspring CTQ scores. The correlational anal-voided urine following awakening, including yses were repeated separately for maternal the first voided urine on the following day. and paternal symptoms. Two-liter polyethylene collection bottles were Third, we examined the extent to which used and kept in freezers in the participants' childhood trauma represents a risk factor for residences order to ensure stability of corti-the development of PTSD. This was accom-sol. Collections were scheduled occur on plished by performing chi-square tests com-days that were anticipated not to be particu-paring the frequency of PTSD in individuals larly stressful, in order to obtain samples that with and without self-reported childhood reflect typical basal secretion. Most partici-trauma. In addition, we examined whether pants stayed at home for the 24-hr period in there are differences self-reported child-order facilitate collection. Urinary-free cor-hood trauma in participants reporting PTSD tisol levels were determined by using an ex- a focal trauma occurring in adulthood com-traction procedure and radioimmunoassay kit pared to those who experienced a trauma in from Clinical Assays, Inc. (Cambridge, MA; adulthood but did not develop PTSD. Correla-interassay coefficient of variation was 4.0% ). tions between mean CTQ scores and PTSD symptoms were also performed in the subset of participants reporting an adult trauma. This allowed us to assess whether childhood trauma is a risk factor for PTSD to focal trau- mas that occur independently of childhood Four sets of analyses were performed. First, events. Finally, logistic regression was used we examined whether parental trauma expo-to assess the extent to which self-reported sure related to higher levels of self-reported childhood trauma predicted the development childhood trauma by comparing the offspring of PTSD, over and above the contribution of group as a whole with the comparison partici-parental trauma exposure and parental PTSD. pants. This question was addressed by com-The fourth area of inquiry concerned the paring scores on each of the CTQ dimensions relationship of early trauma to 24-hr urinary for offspring versus comparison participants. cortisol secretion. In the first analysis, total Two-way analysis of variance (ANOV A; 24-hr urinary cortisol was compared using Group x Gender) was used to compare mean analysis of covariance (ANCOV A) in individ-scores, and chi-square tests were used to ex-uals with and without significant trauma, co-amine the relative frequencies of clinically varying for age and gender. In the second