WTC Impact, Familial Transmission and Child PTSD

描述（由申请人提供）：这项进行试点研究的申请源于我们对9/11事件后6个月纽约市公立学校儿童（N=8,200）进行的大型流行病学研究的发现，该研究发现儿童中可能出现精神疾病的比率高于预期，尤其是在世界贸易中心（WTC）撤离者的儿童中。迄今为止，文献提供了关于父母创伤的影响如何传递给孩子的诱人见解，但这些发现都不是结论性的。9/11的悲剧提供了一个前所未有的机会，通过成年人（撤离者）的样本，为解决这一重要问题做出重大贡献，他们都有类似的创伤暴露，因此可能比以前对越南退伍军人和大屠杀幸存者的研究更有信息。本试点研究旨在最终确定工具选择和确定最佳现场方法，以抽样、联系、招募和评估（2005年）世界贸易中心（WTC）撤离人员及其子女的代表性样本，并确定他们参与关于创伤家族传播的纵向研究的意愿。凯洛格基金会已经资助了必要的初步活动，以选择相关的暴露域，并根据与世贸中心撤离人员进行的焦点小组改进试点研究工具。当拟议的试点研究完成时，疾控中心-纽约-部门。9/11时世贸中心内及周围所有人员的健康和心理卫生登记将已完成（预计日期：2005年；见信件）。到2005年，我们将在此试点研究的基础上获得开展WTC撤离人员人口研究（EPBS）所需的所有信息。基于从登记处抽取的代表性样本，我们将使用纵向设计，全面检查父母创伤经历对儿童创伤后应激障碍（以及其他9/11后精神病理）的影响。这项研究将使我们能够研究高暴露人群中创伤的家族性传播，以及与非疏散者相比，父母从疏散者到其后代的创伤传播。更具体地说，EPBS将调查(1)父母创伤经历与儿童创伤后应激障碍（以及其他9/11后精神病理）之间是否存在关联；(2)如果这种可能的关联是由父母的情绪/行为表现介导的，包括育儿障碍；如果同样的关联可以部分解释：(3)遗传（DNA）因素和/或(4)生物因素（皮质醇水平）；(5)生物心理社会模型，通过测试创伤、情绪/行为、生物和遗传因素的综合影响，同时控制其他生活变化、家庭SES、儿童WTC暴露和其他焦虑障碍。

DESCRIPTION (provided by applicant): This application to conduct a Pilot Study grew out of our findings from a large epidemiological study of New York City public school children (N=8,200) six months post-9/11, which identified higher than expected rates of probable psychiatric disorders in children, most especially among children of World Trade Center (WTC) evacuees. The literature, to date, provides tantalizing insights about how the effects of parental trauma may be transmitted to children, but none of these findings are conclusive. The tragedy of 9/11 provides an unprecedented opportunity to make a significant contribution to resolving this important issue with a sample of adults (evacuees) who have all shared a similar traumatic exposure, therefore being potentially even more informative than previous studies of Vietnam Veterans and Holocaust Survivors. This Pilot Study is designed to finalize instrument selection and identify the best field methodologies to sample, contact, recruit and assess (in 2005) a representative sample of World Trade Center (WTC) evacuees and their children, and to determine their willingness to participate in a longitudinal study about familial transmission of trauma. The Kellogg Foundation has already funded the preliminary activities requisite to selecting relevant exposure domains and refining the Pilot Study instruments based on focus groups conducted with WTC evacuees. By the time the proposed Pilot Study is done, the CDC-NYC-Dept. of Health and Mental Hygiene Registry of all persons in and around the WTC on 9/11 will have been completed (projected date: 2005; see letter). By 2005, based on this Pilot Study, we will have all the information necessary to conduct a WTC Evacuee Population- Based Study (EPBS). Based on a representative sample drawn from the Registry we will then comprehensively examine the influence of parental traumatic experiences on child PTSD (and other post-9/11 psychopathology), using a longitudinal design. This study will allow us to study familial transmission of trauma within a highly exposed population, as well as parental transmission of trauma from evacuees to their offspring as compared to non-evacuees. More specifically, the EPBS will investigate (1) if there is an association between parental traumatic experiences with child PTSD (and other post-9/11 psychopathology); (2) if this possible association is mediated by emotional/behavioral parental manifestations, including impaired parenting; if the same association can be partially explained by (3) genetic (DNA) factors and/or (4) biological factors (cortisol level); and (5) a biopsychosocial model, by testing for the combined influence, over time, of exposure to trauma, emotional/behavioral, biological and genetic factors, while controlling for other life changes, family SES, child WTC exposure, and other anxiety disorders.