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      Intergenerational transmission of war-related trauma assessed 40 years after exposure

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          Abstract

          Background

          The intergenerational transmission of posttraumatic stress disorder (PTSD) from parent to offspring has been suggested in the literature, but this is highly controversial. We aimed to study the association between veterans’ war exposure and lifetime PTSD and the psychological characteristics of their respective offspring, 40 years after war-related trauma.

          Methods

          Forty-four adult offspring of veterans with PTSD and 29 offspring of veterans without PTSD were included in the study, from a total of 46 veterans. War exposure intensity, lifetime PTSD, and the general psychopathology (with Brief Symptom Inventory—BSI) of the veterans were studied, as were childhood trauma, attachment, and the general psychopathology (with BSI) of their offspring.

          Results

          Veterans’ war exposure was associated with BSI in the offspring with regard to somatisation ( β = 0.025; CI 0.001, 0.050), phobic anxiety ( β = 0.014; CI: 0.000, 0.027), Global Severity Index (GSI) ( β = 0.022; CI 0.005, 0.038), and Positive Symptom Distress Index ( β = 0.020; CI 0.006, 0.033). The fathers’ GSI mediated only 18% of the effect of the veterans’ total war exposure on offspring’s GSI. Fathers’ war exposure was associated with offspring’s physical neglect as a childhood adversity, although non-significantly ( p = 0.063). None of the other variables was associated with veterans’ war exposure, and veterans’ lifetime PTSD was not associated with any of the variables studied.

          Conclusions

          The offspring of war veterans showed increased psychological suffering as a function of their fathers’ war exposure intensity, but not of their fathers’ lifetime PTSD. These results could be used to suggest that mental health support for veterans’ offspring should consider the war exposure intensity of their fathers, and not just psychopathology. This could spare offspring’s suffering if this mental health support could be delivered early on, after veterans return from war.

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          Most cited references49

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          Adult attachment, working models, and relationship quality in dating couples.

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            Development and validation of a brief screening version of the Childhood Trauma Questionnaire.

            The goal of this study was to develop and validate a short form of the Childhood Trauma Questionnaire (the CTQ-SF) as a screening measure for maltreatment histories in both clinical and nonreferred groups. Exploratory and confirmatory factor analyses of the 70 original CTQ items were used to create a 28-item version of the scale (25 clinical items and three validity items) and test the measurement invariance of the 25 clinical items across four samples: 378 adult substance abusing patients from New York City, 396 adolescent psychiatric inpatients, 625 substance abusing individuals from southwest Texas, and 579 individuals from a normative community sample (combined N=1978). Results showed that the CTQ-SF's items held essentially the same meaning across all four samples (i.e., measurement invariance). Moreover, the scale demonstrated good criterion-related validity in a subsample of adolescents on whom corroborative data were available. These findings support the viability of the CTQ-SF across diverse clinical and nonreferred populations.
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              The development of a Clinician-Administered PTSD Scale.

              Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician-Administered PTSD Scale (CAPS-1) appears to satisfy these standards most uniformly. The CAPS-1 is a structured interview for assessing core and associated symptoms of PTSD. It assesses the frequency and intensity of each symptom using standard prompt questions and explicit, behaviorally-anchored rating scales. The CAPS-1 yields both continuous and dichotomous scores for current and lifetime PTSD symptoms. Intended for use by experienced clinicians, it also can be administered by appropriately trained paraprofessionals. Data from a large scale psychometric study of the CAPS-1 have provided impressive evidence of its reliability and validity as a PTSD interview.
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                Author and article information

                Contributors
                ivonecastrovale@med.up.pt
                milton@med.up.pt
                davideccarvalho@gmail.com
                rmc@med.up.pt
                Journal
                Ann Gen Psychiatry
                Ann Gen Psychiatry
                Annals of General Psychiatry
                BioMed Central (London )
                1744-859X
                9 August 2019
                9 August 2019
                2019
                : 18
                : 14
                Affiliations
                [1 ]ISNI 0000 0001 1503 7226, GRID grid.5808.5, Medical Psychology Unit, Department of Clinical Neurosciences and Mental Health, Faculty of Medicine, , Universidade do Porto, ; Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
                [2 ]ISNI 0000 0001 1503 7226, GRID grid.5808.5, Instituto de Investigação e Inovação em Saúde, Universidade do Porto, ; Rua Alfredo Allen 208, 4200-135 Porto, Portugal
                [3 ]ISNI 0000 0001 1503 7226, GRID grid.5808.5, Department of Clinical Epidemiology, Predictive Medicine and Public Health, Faculty of Medicine, , Universidade do Porto, ; Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
                [4 ]ISNI 0000 0001 1503 7226, GRID grid.5808.5, Department of Medical Education and Simulation, Faculty of Medicine, , Universidade do Porto, ; Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
                [5 ]ISNI 0000 0001 1503 7226, GRID grid.5808.5, Department of Endocrinology, Diabetes and Metabolism, Centro Hospitalar Universitário Sāo Joāo, Faculty of Medicine, , Universidade do Porto, ; Al. Prof. Hernâni Monteiro, 4200-319 Porto, Portugal
                Author information
                http://orcid.org/0000-0002-5343-0229
                Article
                238
                10.1186/s12991-019-0238-2
                6688296
                31413722
                5f3976ea-9d10-4631-afae-10a89c134ab5
                © The Author(s) 2019

                Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.

                History
                : 9 November 2018
                : 27 July 2019
                Categories
                Primary Research
                Custom metadata
                © The Author(s) 2019

                Clinical Psychology & Psychiatry
                traumatic event,parental ptsd,intergenerational transmission,offspring,war

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