Liviu Bunaciu

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.

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.

Specificity of fear and disgust experienced during traumatic interpersonal victimization in predicting posttraumatic stress and contamination-based obsessive–compulsive symptoms

Emerging evidence has documented comorbidity between posttraumatic stress disorder (PTSD) and obsessive-compulsive disorder (OCD) among individuals with a history of traumatic events. There is growing recognition of the importance of disgust in each of these conditions independently. No study, however, has examined the potential role of disgust in these conditions following traumatic event exposure. The current study examined the unique role of peritraumatic fear, self-focused disgust, and other-focused disgust in predicting posttraumatic stress symptoms and contamination-based OC symptoms among 49 adult women (M(age)=28.37, SD=13.86) with a history of traumatic interpersonal victimization. Results demonstrated that intensity of peritraumatic self-focused disgust was significantly related to contamination-based OC symptoms while peritraumatic fear and other-focused disgust were related to posttraumatic stress symptoms. These results highlight the need for future research aimed at elucidating the nature of the association between disgust experienced during traumatic events and subsequent psychopathology.

An Examination of Anxiety Sensitivity as a Moderator of the Relation between Sleep Anticipatory Anxiety and Sleep Onset Latency

Evidence suggests that advancing currently limited knowledge about self-reported sleep onset latency is important for better understanding insomnia. Relatively little research has been conducted to understand factors that affect sleep onset latency. The current study tested a hypothesized role of factors of the global anxiety sensitivity (AS) construct as moderators of the relation between sleep onset latency and physical and cognitive components of sleep anticipatory anxiety. As hypothesized, AS-Physical Concerns moderated the relation between the physical component of sleep anticipatory anxiety and sleep onset latency, even after controlling for age, gender, negative affect, and substance use variables. However, in contrast to prediction, AS-Mental Incapacitation Concerns did not appear to moderate the relation between sleep onset latency and the cognitive component of sleep anticipatory anxiety. These findings are discussed in terms of extant research on sleep onset latency, and future directions for research to advance this body of knowledge are considered.

A test of the relations between avoidance of panic-related situations and substance use, substance dependence, and depression among subclinical panickers.

The hypotheses that among subclinical panickers, avoidance of panic-related situations would be associated with elevated substance use levels and increased likelihood of lifetime diagnoses of substance dependence and major depressive disorder (MDD) were tested. Findings confirmed that panic-related avoidance was associated with an elevated likelihood of lifetime diagnoses of nicotine and alcohol dependence as well as MDD, but not drug dependence. Panic avoidance was also related to relatively greater daily levels of cigarette and alcohol use.

Parenting-related childhood learning history and panic vulnerability : A test using a laboratory-based biological challenge procedure

A small but growing literature highlights specific parenting behaviors in increasing panic vulnerability among offspring. The current study examined the association between parenting-related instrumental and observational learning of sick-role behavior during childhood and reactivity to a panic-relevant biological challenge procedure that has evidenced predictive validity in terms of panic onset. Participants were 93 physically and psychologically healthy young adults (39 females; M(age)=23.41 years). As expected, results indicated that instrumental learning experiences involving (panic-relevant) arousal-reactive symptoms predicted increased post-challenge anxiety, arousal, and negative affective valence, even after accounting for variability associated with other theoretically relevant variables (e.g., anxiety sensitivity). Consistent with prior work, this learning history effect was specific to arousal-reactive, as opposed to arousal non-reactive, symptoms. Unexpectedly, observational learning was not related to challenge responding. Findings are discussed in terms of the potential role of parenting in etiologic models of panic development.

Differential Emotional Responding to Ideographic Cues of Traumatic Interpersonal Violence Compared to Non-Interpersonal Traumatic Experiences

Models of traumatic event-related emotional reactivity have primarily focused on fear. Emerging research points to the importance of advancing our currently limited understanding of how anger and disgust relate to certain types of traumatic experiences, such as interpersonal violence (IPV). The current study compared anger, disgust, and anxiety in response to an ideographic neutral and traumatic event script between IPV victims and those exposed to a non-interpersonally-relevant traumatic event. Victims of IPV evidenced greater anger and disgust in response to the traumatic event script compared to the non-IPV group after accounting for variability in posttraumatic stress symptoms and negative affect. No differences emerged in terms of anxiety responding. These findings suggest reminders of IPV may be particularly likely to elicit anger and disgust, in addition to anxiety, which may have implications for the treatment of IPV-related posttraumatic stress.

The relationship of sleep quality and PTSD to anxious reactivity from idiographic traumatic event script-driven imagery.

Poor sleep quality has been linked to posttraumatic stress disorder (PTSD). This study provided a test of how poor sleep quality relates to real-time assessment of anxious reactivity to idiographic traumatic event cues. Script-driven imagery (SDI) was employed to examine reactivity to traumatic event cues among 46 women (mean age = 27.54 years, SD = 13.62; 87% Caucasian) who had experienced either physical or sexual assault. We tested 3 hypotheses: (a) individuals with PTSD would report greater anxiety reactions to SDI than trauma-exposed individuals without PTSD, (b) poorer sleep quality would be positively related to anxiety reactions to SDI, and (c) there would be an interaction between PTSD and sleep quality such that individuals with PTSD and relatively poor sleep quality would report greater anxious reactivity to SDI than would be expected from each main effect alone. Poor sleep quality and PTSD were related to elevated anxious reactivity to trauma cues (sr(2) = .06). In addition, sleep quality was negatively associated with anxious reactivity among people without PTSD (sr(2) =.05). The current findings, in combination with longitudinal evidence, suggest that poor sleep quality following exposure to a traumatic event may be a risk factor for anxious reactivity to traumatic event cues.

Biological sex and panic-relevant anxious reactivity to abrupt increases in bodily arousal as a function of biological challenge intensity.

An emerging pattern of results from panic-relevant biological challenge studies suggests women respond with greater subjective anxiety than men, but only to relatively abrupt and intense challenge procedures. The current investigation examined the relation between biological sex and self-reported anxious reactivity following biological challenges of varying durations and intensity. Participants were 285 (152 females; M(age) = 21.38; SD = 5.92) nonclinical adults who completed one of three protocols: a 3-min voluntary hyperventilation challenge (VH), a 5-min 10% carbon dioxide-enriched air (CO(2)) challenge, or a 25-s 20% CO(2) challenge. As predicted, results indicated that the 20% CO(2) challenge elicited greater self-reported anxiety than the VH and 10% CO(2) challenges. Moreover, women endorsed greater anxious reactivity than men, but only following the 20% CO(2) challenge. Results are discussed in terms of processes likely to account for sex differences in anxious reactivity following relatively abrupt and intense biological challenges.