Understanding Intergenerational Effects of Trauma from a Psychological and Biological Perspective

Our studies have demonstrated that children of trauma survivors constitute a high risk group for posttraumatic stress disorder (PTSD) because they have a greater prevalence of lifetime PTSD compared to demographically similar persons who have experienced equivalent numbers and types of DSM-IV traumatic events. Adult children of trauma survivors also show a greater prevalence of mood and other anxiety disorders. In a sample for which PTSD could be evaluated directly in parents and children, PTSD was present in children of Holocaust survivors with chronic PTSD, but not in children of parents who either never developed PTSD or had recovered from it within several years after World War II. More recently we have examined neuroendocrine parameters in the putative high risk group of adult children of Holocaust survivors. This presentation will describe results of all these studies, but will particularly focus on assessment of urinary and plasma cortisol over the diurnal cycle in adult children with and without parental PTSD, and with and without their own PTSD, and comparison subjects. The results will show that low cortisol levels are associated with both parental PTSD and lifetime PTSD, whereas having a current psychiatric diagnoses other than PTSD is associated with higher cortisol levels in offspring. The risk of PTSD and low cortisol also appears to be different between offspring with one vs. two Holocaust parents. Furthermore, there are significant interactions among variables associated with risk for PTSD and cortisol levels. Findings will be interpreted as suggesting that some neuroendocrine alterations may reflect risk factors for PTSD that determines responsiveness to subsequent trauma, whereas other parameters may be more true measure of the consequent traumatic stress. These data may have consequences for understanding individual differences in, and particularly genetic contributions to, the human response to extreme stress.