WTC Impact, Familial Transmission and Child PTSD

描述（由申请人提供）：本申请进行试点研究的结果源于我们对纽约市公立学校儿童（N= 8，200）在9/11事件后6个月进行的一项大型流行病学研究，该研究确定儿童可能的精神疾病发生率高于预期，尤其是在世界贸易中心（WTC）疏散人员的儿童中。到目前为止，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悲剧提供了一个前所未有的机会，可以通过一组经历过类似创伤的成年人（撤离者）样本为解决这一重要问题做出重大贡献，因此可能比之前对越南退伍军人和大屠杀幸存者的研究提供更多信息。该试点研究旨在最终确定工具选择和确定最佳的现场方法，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，并确定他们是否愿意参加有关创伤家庭传播的纵向研究。凯洛格基金会已经资助了选择相关暴露领域所需的初步活动，并根据对世贸中心疏散人员进行的焦点小组改进了试点研究工具。到拟议的试点研究完成时，CDC-NYC部门。在9/11世界贸易中心内和周围的所有人的健康和心理卫生登记册将已完成（预计日期：2005年;见信）。到2005年，我们将根据这项试验性研究，获得进行以世贸中心疏散人口为基础的研究所需的所有资料。基于从登记处抽取的代表性样本，我们将采用纵向设计，全面研究父母创伤经历对儿童PTSD（和其他9/11后精神病理学）的影响。这项研究将使我们能够研究在一个高度暴露的人群中的创伤的家庭传播，以及与非疏散人员相比，从疏散人员到他们的后代的创伤的父母传播。更具体地说，EPBS将调查（1）父母的创伤经历与儿童PTSD之间是否存在关联（和其他后9/11精神病理学）;（2）如果这种可能的关联是由情感/行为父母表现介导的，包括受损的养育;如果相同的关联可以部分地由（3）遗传（DNA）因素和/或（4）生物因素解释，（皮质醇水平）;（5）生物心理社会模型，通过测试随着时间的推移，暴露于创伤，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暴露和其他焦虑症。

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.