Complex posttraumatic stress disorder in intergenerational trauma transmission among Eritrean asylum-seeking mother-child dyads

Background: Traumatic stress among forcibly displaced people has a variety of adverse consequences beyond individual mental health, including implications for poor socioemotional developmental outcomes for their children post-displacement.Objective: This study explored the intergenerational transmission of maternal ICD-11 Complex Posttraumatic Stress Disorder (CPTSD) and depression among asylum-seeking mothers for their children's internalizing and externalizing difficulties.Method: Participants were 127 trauma-affected Eritrean mothers of preschool-aged children in Israel. The severity of child difficulties was compared between mothers with probable ICD-11 CPTSD (94.5% comorbid depression), ICD-11 PTSD (48.5% comorbid depression), unimorbid depression, and healthy mothers, using multivariate analyses of variance, while controlling for children's direct exposure to adverse life experiences.Results: Probable ICD-11 CPTSD and PTSD were present in 23.6% and 26.0% of mothers, respectively. Relative to maternal PTSD, CPTSD was significantly and strongly associated with elevated child internalizing symptoms (d = 2.44) and marginally significantly, although strongly, associated with child externalizing symptoms (d = 1.30). Post-hoc exploratory analyses documented that, relative to maternal PTSD and depression, CPTSD and depression comorbidity was marginally significantly but strongly associated with child internalizing (SMD = .67), but not externalizing symptoms (SMD = .35).Conclusions: Findings implicate maternal CPTSD and comorbid depression in child socio-emotional development and inform clinical assessment, prevention, and intervention to attenuate poor development among children in unstable post-displacement settings. Trauma among forcibly displaced people has a variety of aversive multisystemic consequences, compromising the socioemotional development of non-exposed children.ICD-11 complex posttraumatic stress disorder (CPTSD) and comorbid depression may be functionally important to elevated risk for maternal intergenerational trauma transmission, even relative to ICD-11 posttraumatic stress disorder (PTSD).To effectively attenuate intergenerational transmission of trauma post-displacement, efforts and resources should be invested in maternal mental health care as well as socio-culturally adapted, trauma-sensitive parenting training. Antecedentes: El estres traumatico entre las personas desplazadas a la fuerza tiene una variedad de consecuencias adversas mas alla de la salud mental individual, incluyendo pobres resultados en el desarrollo socioemocional de sus hijos despues del desplazamiento.Objetivo: Este estudio exploro la transmision intergeneracional del trastorno de estres postraumatico complejo (TEPT-C) materno, segun la CIE-11, y la depresion materna de las madres solicitantes de asilo por las dificultades internalizantes y externalizantes de sus hijos.Metodo: Las participantes fueron 127 madres eritreas de ninos en edad preescolar viviendo en Israel afectadas por un trauma. Se comparo la gravedad de las dificultades de los ninos de madres con probable TEPT-C segun la CIE-11 (con un 94,5% de depresion comorbida) con aquellas con diagnosticos de TEPT segun la CIE-11 (con un 48,5% de depresion comorbida), de depresion sin comorbilidad y con madres sanas, utilizando analisis de varianza multivariados mientras se controlaba la exposicion directa de los ninos a experiencias vitales adversas.Resultados: Se encontraron casos probables de TEPT-C y de TEPT en el 23.,6% y el 26% de las madres, respectivamente. En relacion con el TEPT materno, el TEPT-C se asocio de forma significativa y fuerte con sintomas internalizantes infantiles elevados (d = 2.44). Asimismo, se asocio de manera marginalmente significativa, aunque fuerte, con sintomas externalizantes infantiles (d = 1.30). En relacion con el TEPT y la depresion materna, los analisis exploratorios post hoc documentaron que la comorbilidad del TEPT-C con la depresion fue marginalmente significativa, pero fuertemente asociada con sintomas infantiles internalizantes (SMD = .67), mas no con sintomas externalizantes (SMD = .35).Conclusiones: Los hallazgos relacionan el TEPT-C y la depresion comorbida en las madres con el desarrollo socioemocional de los hijos y brindan informacion para que la evaluacion clinica, prevencion e intervencion atenuen el pobre desarrollo de los ninos en entornos inestables luego de desplazamientos forzados.