Project Summary

Ruth Feldman, Ph.D., (Independent Investigator 2006) of Bar-Ilan University, plans to examine post-traumatic stress symptoms and psychosocial adaptation in 300 Israeli and Palestinian infants and young children aged 1.5 to 5 years exposed to repeated war- and terror-related trauma as compared to 100 culturally-matched controls. Early and chronic maternal depression and genetic vulnerability are expected to interact with trauma exposure in shaping the child's symptoms in four symptom clusters; re-experiencing of trauma, avoidant behavior, hyper-arousal and emotion dysregulation, and fear and aggression, as well as in predicting the degree of developmental arrest and/or regression. Resiliency factors, including family support networks, cultural ideologies, community cohesion, temperamental regulation, maternal psychological well-being, and the mother's interactive style are expected to attenuate the effects of trauma and developmental outcome at both initial assessment and one-year follow-up. Differences between exposed and non-exposed children are expected in the domains of physiological stress regulation, behavior problems, observed child social involvement with mother and unfamiliar adults, and the capacity for symbolic-imaginary play. Culture-specific risk and resilience predictors of child outcomes are likely to emerge and inform culture-specific modes of psychotherapy. Symptomatic improvement between initial assessment and one-year follow-up is expected to be determined in part by the child's genetic disposition and to be greater in cases where maternal depression has remitted. The study represents a first attempt at providing a multi-dimensional and cultural assessment of PTSD in infants and young children. Findings may contribute to understanding gene-environment interplay in psychiatric disorder development with a clear and measurable environmental precursor. The role of early maternal depression for the child's later functioning in the face of adversity may also emerge.

Program Area: ANXIETY DISORDERS\Post-Traumatic Stress Disorder (PTSD)

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