Transgenerational trauma: Perceived parental style, children's adaptational efforts, and mental health outcomes in second generation and third generation holocaust offspring in Hungary.

The intergenerational impact of genocide has been studied in various contexts, however, the mechanisms of trauma transmission remain unclear. The present study aimed to better understand the relationship between parental trauma and offspring mental health by exploring mechanisms of trauma transmission in the children (n = 599) and grandchildren (n = 311) of Holocaust survivors (HS) in Hungary. In a cross-sectional online survey study, we used the paradigm developed by Danieli, Norris, Lindert, Paisner, Engdahl, et al. (2015) and Danieli, Norris, Lindert, Paisner, Kronenberg, et al. (2015) to assess HS parental styles (i.e., parenting impacted by efforts to cope with past traumatic experiences), as reported by offspring participants, as well as participants' reported level of adaptational impact, that is, their efforts to cope and adapt, and current mental health symptoms posttraumatic stress disorder (PTSD, complex PTSD [C-PTSD], anxiety, depression). We found differences in parental styles reported by generation; however, the mechanism of how it impacted offspring mental health was similar. Mediation analyses showed that more intense parental styles were associated with higher adaptational impact, which, in turn, was related to more mental health symptoms, in both generations. This is the first study to apply the Danieli paradigm in a third-generation sample and the first to assess the psychological impact of the Holocaust in an Eastern European country (Hungary), using systematic quantitative assessment. Our findings highlight the Holocaust's continued impact on the third generation, and the importance of raising awareness of the impact of collective traumas through educational programs, enhancing culturally sensitive and transgenerational trauma-informed mental health services, and fostering tolerance and diversity in public policy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Assessing transgenerational trauma transmission: development and psychometric properties of the Historical Intergenerational Trauma Transmission Questionnaire (HITT-Q).

ABSTRACTObjective/Background: Despite increasing attention on transgenerational trauma, currently no comprehensive model and measure exists to be applied on various populations. This study represents the first step in the validation of such a model and a related scale. The Historical Intergenerational Trauma Questionnaire (HITT-Q) assesses family and offspring self-reported vulnerability and resilience, as well as offspring historical moral injury and current levels of insidious trauma.Method: We developed the HITT-Q based on the cross-population model (HITT model; [Starrs, C. & Békés, V. (2024). Historical and transgenerational trauma: A conceptual framework. Traumatology. In Press]) which incorporates key findings in existing population specific studies. For initial validation of the model and its measurement, Holocaust survivors' offspring (N = 1104) completed the HITT-Q, measures of current mental health symptoms (PTSD, C-PTSD, anxiety, and depression), and a resilience scale.Results: In line with the HITT model, confirmatory factor analyses supported a 12-factor solution with the following factors under theorized dimensions: I. Family Vulnerability: (1) Dysregulated and Trauma-related Communication; (2)Trauma-influenced Parenting, (3) Fear; (4) Distress; II. (5) Family Resilience, III. Offspring Vulnerability: (6) Escape; (7) Heightened Responsibility; (8) Trauma-related distress; IV. Offspring Resilience: (9) Coping; (10) Belonging; (11) Values; V. (12) Historical Moral injury. The 12-factor model showed acceptable to good internal validity, and comparison with an existing measure of transgenerational Holocaust trauma indicated good concurrent validity. Finally, the HITT-Q demonstrated predictive validity for mental health symptoms and current resilience.Conclusions: The current study represents the first step in validating the HITT-Q as a comprehensive measure of historical intergenerational vulnerability and resilience. Our findings provide strong support for the underlying model, and suggest that the HITT-Q represents a valuable scale for both research and historical trauma-informed care.

The papers provides support for the underlying model of historical and transgenerational trauma.Findings showed that the Historical Intergenerational Trauma Questionnaire (HITT-Q) has 12 factors, and that it has good psychometric qualities, including internal, concurrent, and predictive validity.The Historical Intergenerational Trauma Questionnaire (HITT-Q) represent a valuable scale for both research and historical trauma-informed care.

The COVID-19 pandemic as traumatic stressor: Distress in older adults is predicted by childhood trauma and mitigated by defensive functioning.

OBJECTIVE: It has been broadly anticipated that COVID-19 pandemic-related experiences may constitute traumatic stressors, and that older adults' might be especially at risk of experiencing mental health symptoms during the pandemic. The present study aimed to examine older adults' psychological distress: posttraumatic stress, Covid-related fears, anxiety, and depression during the pandemic, and the relationship between present distress, defensive functioning, and childhood trauma. We also explored potential differences between older adults (between 65 and 74 years), and older-older adults (75 years and above). METHOD: A large-scale online survey was conducted during the early months of the pandemic, for the present study, we included participants above 65 years old (N = 1,225) mainly from the United States and Canada. RESULTS: Results showed that age, adverse childhood experiences, and overall defensive functioning were significantly related to posttraumatic stress, anxiety, and depression. Specifically, younger age and more reported childhood adversity were related to higher distress, whereas the use of more adaptive defenses was related to less distress. Covid-related fears were not associated with age. Our final model showed that defensive functioning mediated the relationship between childhood trauma and distress. CONCLUSIONS: Our results support the relative resilience of older-older adults compared to older adults, as well as the long-lasting impact of childhood adversity through defensive functioning later in life, specifically in times of heightened stress, such as the COVID-19 pandemic. Future studies are warranted to identify further factors affecting defensive functioning as adults age, as well as processes that are associated with resilience in response to stressors in older adulthood. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Defense mechanisms are associated with mental health symptoms across six countries.

Defense mechanisms are adaptative processes that are related to mental health and psychological functioning and may play an important role in adaptation to distress, as well as in mental health interventions. The present study aimed to compare the use of defense mechanisms and their relationship to mental health symptoms across six countries. In a large-scale descriptive study, we collected data from community- based individuals (N=19,860) in the United States, Australia, Canada, Germany, Italy, and the United Kingdom about the use of defense mechanisms and experienced mental health symptoms during the early phase of the pandemic. We found that the use of defense mechanism categories was similar across countries. Moreover, lower defensive functioning, specifically, neurotic and immature defenses were related to experiencing higher distress across countries, whereas mature defenses were generally inversely related to symptoms. Furthermore, these findings were relatively similar across the six countries. Cross-cultural research on defense mechanisms and mental health has important clinical implications. Our results are consistent with the goal of promoting more adaptive defensive functioning to increase psychological well-being and mitigate the detrimental impact of situational stress.

A systematic survey of adults' health-protective behavior use during early COVID-19 pandemic in Canada, Germany, United Kingdom, and the United States, and vaccination hesitancy and status eight months later.

Adoption of health-protective behaviors, including social distancing measures, are a mainstay of mitigating pandemics, so it is important to understand the characteristics associated with those who use them or not. We aimed to delineate local and personal factors associated with self-reported use of health-protective behaviors (HPB) in response to COVID-19, among adults across 4 economically developed countries. We conducted an exploratory, cross-sectional, representative, on-line survey of adults in Canada, Germany, U.K., or the U.S. during the COVID-19 pandemic (June-July 2020) with two and eight month follow-ups. All countries were experiencing the initial waves of the COVID-19 pandemic. We obtained N = 6,990 participants, who reported 20 specific health-protective behaviors (dependent measure), along with locally mandated health measures, individual characteristics and psychological scales. Using health-protective behaviors (HPB-Quartile score) was significantly associated with 28 of 35 variables studied. In stepwise logistic regression, 21 variables predicted 23.51 % of the variance in HPB-Q scores (p <.000). The strongest predictors were locally mandated protective measures, immature defense mechanisms, COVID-fears, age, moving due to COVID-19, domestic violence, and perceived emotional support from significant others. HPB-Q predicted vaccination hesitancy/willingness (OR = 4.61, CI-95 %: 2.66-8.00) and adoption 8 months later. During the early pandemic, HPB use was most strongly associated with locally mandated measures, followed by psychiatric, demographic, and other personal factors. Considering these empirically derived characteristics may improve public health approaches to optimize HPB and vaccination adoption, mitigating SAR-CoV-2 transmission. Findings may also inform public health responses to future epidemics/pandemics.

The Relationship Between Defense Mechanisms and Attachment as Measured by Observer-Rated Methods in a Sample of Depressed Patients: A Pilot Study.

Despite many theoretical and clinical writings, the theorized connection between defense mechanisms and adult attachment in depressed patients has received little empirical attention. This is the first study to examine patients' defense mechanisms in relation to their attachment in a clinical sample of depressed patients and also the first to use observer-rated measures for assessing both defense mechanisms and attachment. In this pilot study, we aimed to investigate the relationship between patients' attachment and their use of defense mechanisms in psychotherapy sessions, as well as patterns of change over treatment. We conducted a secondary analysis of data from a randomized controlled trial of 30 patients receiving psychotherapy for major depression. Session transcripts were previously coded for defense mechanisms using the Defense Mechanisms Rating Scales, and depression severity data were collected by the clinician-rated HRSD-17 and the self-report BDI-II. Patients' attachment was assessed in two transcripts, one in an early session and a second in a late session, using the novel observer-rated Patient Attachment Coding System. In contrast with expectations, in the early phase of therapy, preoccupied attachment-related characteristics were significantly positively related to overall defensive functioning and negatively related to Depressive immature defenses. In the late phase of treatment, preoccupied attachment-related characteristics were negatively correlated with Non-depressive immature defenses. Moreover, as expected, early-phase defense use was related to late phase attachment; specifically, early neurotic and immature Depressive and Non-depressive defenses predicted an increase in avoidant, whereas immature Non-depressive defenses predicted a decrease in preoccupied attachment-related characteristics over the course of treatment, after controlling for early attachment effects. The results imply a longitudinal relationship between defenses and change in attachment-related characteristics over the course of treatment in a depressed sample and warrant further research about the relationship between defenses and attachment during psychotherapy.

Self-critical perfectionism and lower daily perceived control predict depressive and anxious symptoms over four years.

This study of 152 community adults examined whether perfectionism interacts with daily perceived control to predict depressive and anxious symptoms over 4 years. Participants completed measures of higher-order perfectionism dimensions [self-critical (SC), personal standards (PS)] and neuroticism at time 1, daily diaries for 14 consecutive days to assess perceived control over most bothersome events at time 2 three years later, and measures of depressive and anxious symptoms at time 1, time 2, and time 3 four years after baseline. Hierarchical regression analyses of moderator effects demonstrated that individuals with higher SC perfectionism at time 1 and lower perceived control across daily stressors at time 2 had higher levels of depressive symptoms at time 3 than others, adjusting for the effects of time 1 and time 2 depressive and anxious symptoms. Higher SC perfectionism also interacted with lower perceived control to predict time 3 anxious symptoms. PS perfectionism and neuroticism did not interact with perceived control to predict time 3 depressive or anxious symptoms. These findings highlight the importance of addressing cognitive appraisals of one's control over handling daily stressors for the prevention and treatment of depressive and anxious symptoms in individuals with higher SC perfectionism. (PsycInfo Database Record (c) 2020 APA, all rights reserved).

Coping Action Patterns as Mechanisms of Change Across Psychotherapies: Three Case Examples of Personality Disorders With Recurrent Major Depression.

Maladaptive coping has been shown to be related to increased symptoms of distress and lower levels of well-being, whereas the use of adaptive coping has been shown to diminish distress and improve functioning. This suggests that change in coping may constitute a significant mechanism of change in psychotherapy. Utilizing a novel observer-rating method for assessing coping, the current report examined changes in overall coping functioning (OCF) in three participants with diverse personality disorders who were undergoing two different types of psychotherapy (cognitive-behavioral therapy and dynamic therapy) for recurrent major depression. Results showed that overall coping functioning improved in two cases and remained stable in a third. Preliminary findings, based on a detailed examination of changes in specific coping patterns, suggest that improvement may differ according to severity of personality pathology. As hypothesized, coping improved in both types of psychotherapy. Thus, overall results suggest that coping may constitute an important general mechanism of change.

Predictors of Stress Generation in Adolescents in Mainland China.

The current longitudinal study examined whether the personality vulnerabilities of self-criticism and dependency prospectively predicted stress generation in Chinese adolescents. Participants included 1,116 adolescents (588 girls and 528 boys), aged 15 to 18 years from rural, urban and ultra-urban mainland China. Participants completed self-report measures of personality, depressive and anxious symptoms and participated in a clinical interview assessing lifetime history of depression. The occurrence of negative life events was measured using a contextual-threat interview every 6-months for a total period of 18-months. Logistic regression analyses showed that after controlling for past depressive episodes and current depressive and anxious symptoms, self-criticism was prospectively associated with the occurrence of interpersonal stress generation, but not noninterpersonal stress generation. Dependency also predicted interpersonal stress generation, although only in girls and not boys. In line with previous Western findings, girls reported more interpersonal stress generation. Analyses across 3 levels of urbanization revealed several significant differences including higher reported interpersonal stress generation in urban girls than urban boys and overall higher levels of negative life events in ultra-urban youth. In sum, findings from the current study suggest that the stress generation process may be generalizable to Chinese youth.