Setting the Stage for Chronic Health Problems: Cumulative Childhood Adversity among Homeless Adults with Mental Illness in Vancouver, British Columbia

Abstract

Background: Understanding how parental Posttraumatic Stress Disorder (PTSD) may or may not affect the development and mental health in the offspring is particularly important in conflict regions, where trauma-related illness is endemic. In Rwanda, organised atrocities and the genocide against the Tutsi of 1994 have left a significant fraction of the population with chronic PTSD. The aim of the present investigation was to establish whether PTSD in mothers is associated with symptoms of depression, anxiety, and aggressive and antisocial behaviour in their children.Methods: A community sample of 125 Rwandan mothers who experienced the genocide of 1994 and their 12-year-old children were interviewed. Using a structured interview, symptoms of maternal PTSD and children's depression, anxiety, and aggressive and antisocial behaviour were assessed by trained and on-site supervised local B.A. psychologists. The interview also included a detailed checklist of event types related to family violence. Results: In showing that a maternal PTSD was not associated with child's psychopathology, the results contradict the assumption of straight "trans-generational trauma transmission". Instead, a child's exposure to maternal family violence posed a significant risk factor for a negative mental health outcome. Furthermore, it was not maternal PTSD-symptoms but mother's exposure to family violence during her own childhood that was associated with the magnitude of adversities that a child experiences at home. Conclusions:Contrary to a simple model of a trans-generational transmission of trauma, neither maternal PTSD nor maternal traumatic experiences were directly associated with symptoms of anxiety, depression, or antisocial and aggressive behaviour in the children. Instead, the present results suggest a relationship between parental child rearing practices and children's mental health. Furthermore, the study details the "cycle of violence", showing a significant link between maternal violence against a child and its mother's experience of childhood maltreatment.

The effects of childhood maltreatment on epigenetic regulation of stress-response associated genes: an intergenerational approach

“…Not only individuals who experienced CM, but also their offspring show an increased lifetime risk for stress-related behavioral [20][21][22] as well as physiological disorders (e.g. asthma or allergies) 23 .…”

Addressing the mental health needs of children affected by HIV in Rwanda: validation of a rapid depression screening tool for children 7–14 years old

“…The Structured Clinical Interview for DSM- IV (SCID) is widely considered the gold standard in both clinical practice and research [ 20 ]. The procedure has been validated in East African settings [ 21 ] and the Kinyarwanda Structured Clinical Interview for Depression have been widely used in different studies in the Rwandan context [ 11 , 22 ]. Children and their guardians were asked to participate in the study on a voluntary basis and understood that they could end their participation at any moment with no consequences to their right to access health services.…”