WTC Impact, Familial Transmission and Child PTSD

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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.