Post-traumatic stress disorder and resilience in children of traumatised parents

The main aim of this thesis was to explore the possible association between parents severe emotional trauma and their children's psychopathology (Transgenerational transmission of parents' traumatic experiences to their children), as well as resiliency factors and the relationship between prolonged traumatisation and personality development.

The association between parental trauma and children s psychopathology was explored by investigating a group of parents with torture experiences, a group without torture experiences, and the children in both groups. The traumatised parents' group consisted of 15 families where either one or both of the parents had a history of torture (30 parents, fathers' mean age 43.5 years, mothers' 38.7 years) and their children in the age group 7-18 years (29 boys, mean age 12, and 16 girls, mean age 11.3 years). The comparison group consisted of 15 families with 26 parents (fathers' mean age 45.8 years, mothers' 38.7 years) and their children in corresponding age groups (15 boys, mean age 11.0 years, and 16 girls, mean age 12.6 years).

The Diagnostic Interview for Children and Adolescents (DICA), the Post-Traumatic Symptoms Check List, the Harvard/Uppsala Trauma Questionnaire (H/UTQ) and the Karolinska Scales of Personality (KSP) were used together with the Machover Draw-A-Person test (DAP) to investigate the emotional state of the children. The results showed associations between parental PTSD and the children s maladaptive stress reactions, including symptoms of ADHD and somatisation. The projective method revealed differences between the two groups of children with respect to emotional impairments, such as secure/insecure attachment, depressiveness and aggressiveness, in favour of the comparison group.

The findings regarding possible comorbidity/overlapping between Post-Traumatic Stress Disorder (PTSD-related symptoms) and Attention-Deficit/Hyperactivity Disorder (ADHD-like symptoms) was studied at a later point in time in the children of the same families; 40 children of traumatised parents and 40 children of non-traumatised parents fulfilled the inclusion criteria. The DICA interview, the Post-Traumatic Symptoms Check List, The WISC-III, the Yale Children s Inventory (YCI) and the Strengths and Difficulties Questionnaire (SDQ) were used in that study. The results indicated an overload symptomatology with lowered IQ in the children of traumatised parents where the same child could have both PTSD-related symptoms and an ADHD-like syndrome. The two groups of children were also investigated concerning resilience and vulnerability factors using the 'I Think I AM' (ITIA) questionnaire in addition to the above mentioned methods. The results indicated that adequate self-esteem, high scores on IQ measures and adequate relation to family facilitated the development of resilience. The impact of prolonged traumatisation or early childhood trauma exposure on personality impairments was examined in four groups of adult men (N=161) with and without trauma exposure, using KSP and H/UTQ with hypothetical regrouping of PTSD symptoms. The results revealed aspects of impairments described in terms of Trauma-Related Disorder with PTSD, or hypothetically posttraumatic personality disorder, as a main outcome.

List of scientific papers

I. Daud A, Skoglund E, Rydelius PA. (2005). Children in families of torture victims: transgenerational transmission of parents traumatic experiences to their children. International Journal of Social Welfare. 14:23-32.

II. Daud A, Skoglund E, Rydelius PA. (2005). The emotional state of children of torture victims compared with the emotional state of children of non-traumatized parents. Egyptian Journal of Psychiatry. 24(2):171-182.

III. Daud A, Rydelius PA. (2008). Comorbidity/overlapping between: symptoms of Attention-Deficit/ Hyperactivity Disorder (ADHD) and Post-Traumatic Stress Disorder (PTSD) in relation to IQ among children of traumatized/non-traumatized parents. [Submitted]

IV. Daud A, Af Klinteberg B, Rydelius PA. (2008). Resilience and vulnerability among refugee children of traumatized and non-traumatized parents. Child Adolesc Psychiatry Ment Health. 2(1):7.
https://pubmed.ncbi.nlm.nih.gov/18373846

V. Daud A, Klinteberg BA, Rydelius PA. (2008). Trauma, PTSD and personality: the relationship between prolonged traumatization and personality impairments. Scand J Caring Sci. Feb 21.
https://pubmed.ncbi.nlm.nih.gov/18298618