Heidemarie Blumenthal

Offspring psychological and biological correlates of parental posttraumatic stress: review of the literature and research agenda.

Millions of individuals with posttraumatic stress disorder (PTSD) are parents. A burgeoning literature suggests that offspring of parents with this condition may be at increased risk for psychological problems. The current paper provides an integrative and comprehensive review of the diverse research literature examining the sequelae of parental posttraumatic stress among offspring. Over 100 studies that evaluated psychological and/or biological variables among children of parents with PTSD are reviewed. Findings suggest parental symptoms of posttraumatic stress are uniquely related to an array of offspring outcomes, including internalizing-type problems, general behavioral problems, and altered hypothalamic-pituitary-adrenal axis functioning. Although very little work has directly evaluated mechanisms of transmission, there is increasing support for genetic and epigenetic effects as well as parenting behaviors. These and other mechanisms are discussed; drawing upon findings from other literatures to consider how parental PTSD may impart psychobiological vulnerability upon offspring. We conclude with a detailed discussion of the methodological strengths and challenges of the extant research, along with a recommended agenda for future research in this important area of study.

A test of the effects of acute sleep deprivation on general and specific self-reported anxiety and depressive symptoms: an experimental extension.

Evidence indicates acute sleep deprivation affects negative mood states. The present study experimentally tested the effects of acute sleep deprivation on self-reported symptoms of state anxiety and depression as well as general distress among 88 physically and psychologically healthy adults. As hypothesized, the effects of acute sleep deprivation increased state anxiety and depression, as well as general distress, relative to a normal night of sleep control condition. Based on the tripartite model of anxiety and depression, these findings replicate and extend prior research by suggesting sleep deprivation among individuals without current Axis I disorders increases both state symptoms of anxiety and depression specifically, and general distress more broadly. Extending this work to clinical samples and prospectively testing mechanisms underlying these effects are important future directions in this area of research.

Social anxiety and motives for alcohol use among adolescents.

Social anxiety evidences significant comorbidity with alcohol use disorders and alcohol-related problems. In an effort to better understand this co-occurrence, researchers are beginning to evaluate specific drinking-related factors, including alcohol use motives, among socially anxious individuals. Drawing on Coopers (1994) 4-factor model of drinking motives (enhancement, social, conformity, coping), a growing body of work suggests that socially anxious individuals may consume alcohol in an effort to cope with their anxious symptoms; however, no study to date has examined these relations among youth. Accordingly, we examined alcohol use motives as a function of social anxiety in a community-based sample of 50 adolescents ages 12 to 17 years (Mage = 16.35, SD = 1.10). As predicted, heightened social anxiety was associated with elevated coping-related drinking motives. More important, other alcohol-use motives did not vary as a function of social anxiety. Collectively, these findings uniquely extend research conducted with adults, and suggest socially anxious youth may be motivated to use alcohol to manage their anxious arousal.

Associations between parental posttraumatic stress disorder and both offspring internalizing problems and parental aggression within the National Comorbidity Survey-Replication.

Data from the National Comorbidity Survey-Replication were used to evaluate links between parental posttraumatic stress disorder (PTSD) and elevated (1) offspring internalizing problems and (2) parental physical aggression toward children. We extended prior tests via the use of an independent nationally representative sample and by examining specific associations between these outcomes and PTSD above and beyond variance accounted for by several theoretically relevant demographic factors and PTSD-related comorbidity. As hypothesized, offspring anxiety and depression was elevated among parents with PTSD compared to those without the condition. Parents with PTSD also were more likely to endorse the use of both moderate (e.g., pushing) and severe (e.g., hitting with a fist) physical aggression with their children. These findings advance work in the area by suggesting that there is a unique relation between PTSD and these outcomes, which sets the stage for research to elucidate factors uniquely introduced by PTSD.

Interactive Roles of Pubertal Timing and Peer Relations in Predicting Social Anxiety Symptoms Among Youth

The interaction between early maturation and problematic peer relations in relation to social anxiety symptoms was examined among 167 adolescents aged 10-17 years. Results indicated that early-maturing youth with problematic peer relations evidenced elevated social anxiety symptoms. Findings are discussed in terms of theoretical implications for adolescent social anxiety development.

Disgust, mental contamination, and posttraumatic stress: Unique relations following sexual versus non-sexual assault

Disgust and mental contamination (or feelings of dirtiness and urges to wash in the absence of a physical contaminant) are increasingly being linked to traumatic event exposure and posttraumatic stress (PTS) symptomatology. Evidence suggests disgust and mental contamination are particularly relevant to sexual assault experiences; however, there has been relatively little direct examination of these relations. The primary aim of the current study was to assess disgust and mental contamination-based reactivity to an individualized interpersonal assault-related script-driven imagery procedure. Participants included 22 women with a history of traumatic sexual assault and 19 women with a history of traumatic non-sexual assault. Sexual assault and PTS symptom severity predicted greater increases in disgust, feelings of dirtiness, and urges to wash in response to the traumatic event script. Finally, assault type affected the association between PTS symptom severity and increases in feelings of dirtiness and urges to wash in response to the traumatic event script such that these associations were only significant among sexually assaulted individuals. These findings highlight the need for future research focused on elucidating the nature of the relation between disgust and mental contamination and PTS reactions following various traumatic events.

Elevated Social Anxiety among Early Maturing Girls.

Adolescence is a key period in terms of the development of anxiety psychopathology. An emerging literature suggests that early pubertal maturation is associated with enhanced vulnerability for anxiety symptomatology, although few studies have examined this association with regard to social anxiety. Accordingly, the current study was designed to further elucidate the relation between pubertal timing and social anxiety, with a focus on clarifying the role of gender. Participants were 138 adolescents (ages 12-17 years) recruited from the general community. Level of social anxiety was examined as a function of gender and within-sample pubertal timing. As expected, early maturing girls evidenced significantly higher social anxiety, compared with on-time girls and early maturing boys, and no other differences were found as a function of gender or developmental timing. Findings and future directions are discussed in terms of forwarding developmentally sensitive models of social anxiety etiology and prevention.

Traumatic Event Exposure, Posttraumatic Stress, and Substance Use Among Youth: A Critical Review of the Empirical Literature

Traumatic event exposure and subsequent posttraumatic stress have been linked to increased use of various substances among adults. Relatively less is known about this linkage among youth, despite high rates of traumatic event exposure and substance use within this population. To address this gap, the current review presents a detailed summary and critical analysis of the empirical literature focused on the co-occurrence of traumatic event exposure, posttraumatic stress, and substance use among youth. The evidence suggests that multiple types of substance use are highly related to exposure to a traumatic event and posttraumatic stress reactions among youth. Relatively little is known about the directionality or specificity of this relation, and additional research on factors that affect or account for this association is needed. Critical challenges of this literature, as well as specific recommendations for future research, are discussed.

Social Support and Grandparent Caregiver Health: One-Year Longitudinal Findings for Grandparents Raising Their Grandchildren

OBJECTIVES The role of social support in predicting health among grandparents raising grandchildren was explored among 86 grandparent caregivers assessed twice over a 1-year timeframe. METHOD Relationships between social support and health were ascertained via cross-lagged analyses. Regression analyses explored the mitigating role of social support in influencing both health and depression among grandparent caregivers. RESULTS Cross-lagged findings suggested that social support predicted health over time rather than vice versa. Regression analyses found that this relationship held when adjusting for multiple covariates as well as previous levels of health, depression, and parental stress. Additionally, the interaction of overall health and social support at Time 1 predicted Time 2 depression. For those who lacked social support, overall health was negatively related to self-reported depression symptoms 1 year later; this was not the case among those reporting greater social support. In addition, parental stress moderated the effects of social support on depression, and social support moderated the effects of parental stress on depression. DISCUSSION Greater social support may lay the groundwork for better health, and such support, in concert with better health as well as lessened parental stress may prevent the development of depression among grandparent caregivers.

Posttraumatic Stress and Sleep: Differential Relations across Types of Symptoms and Sleep Problems

Posttraumatic stress symptoms and self-reported sleep problems reliably covary. The current study investigated how posttraumatic stress symptom clusters (i.e., hyperarousal, avoidance, and reexperiencing) relate to trouble initiating and maintaining sleep and nightmares. Participants included traumatic event-exposed respondents from the NCS-R. Results suggested that posttraumatic stress symptom severity is related to trouble initiating and maintaining sleep and nightmares. Investigation of symptom clusters indicated that reexperiencing symptoms were related to trouble initiating and maintaining sleep and nightmares, while hyperarousal symptoms were related to trouble maintaining sleep and nightmares. Findings partially support both reexperiencing and hyperarousal-based models of the relation between sleep and posttraumatic stress.