Transgenerational transmission of trauma and resilience in Shoah survivors offspring

Nas ultimas cinco decadas, clinicos e pesquisadores debateram a respeito do impacto da Shoah nos descendentes de sobreviventes. A transmissao transgeracional do trauma foi explorada em mais de 500 artigos, que nao obtiveram exito em encontrar conclusoes que pudessem ser generalizadas. A literatura psiquiatrica divide-se em relacao a esse assunto: apesar dos estudos clinicos reportarem achados psicopatologicos relacionados a transmissao transgeracional do trauma, pesquisas empiricas nao encontraram evidencias de traumatizacao secundaria. Metodo: Esse estudo qualitativo objetiva analisar experiencias, significados e processos subjetivos que podem contribuir para o desenvolvimento de traumatizacao secundaria ou de resiliencia em descendentes de sobreviventes da Shoah. Entrevistas em profundidade foram conduzidas com quinze descendentes. A abordagem da Grounded Theory (GT) foi empregada e o metodo de comparacoes constantes foi utilizacao na analise textual dos dados. Resultados:O desenvolvimento e categorias conceituais levou a emergencia de distintos padroes de comunicacao dos pais em relacao aos seus filhos. A abordagem da GT tambem permitiu que fosse feita uma sistematizacao dos diferentes modos pelos quais os descendentes podem lidar com o trauma parental, o que determina o desenvolvimento de mecanismos especificos de traumatizacao secundaria ou de resiliencia na segunda geracao. Conclusoes: As categorias conceituais construidas mediante a GT foram usadas para o desenvolvimento de um modelo compreensivo de transmissao transgeracional do trauma, evidenciando que nao apenas a traumatizacao secundaria, mas tambem padroes de resiliencia podem ser transmitidos e desenvolvidos pela segunda geracao. Como em todos os estudos qualitativos, essas conclusoes nao podem ser generalizadas, mas os modelos teoricos desenvolvidos podem ser testados em outros contextosBV UNIFESP: Teses e dissertaçõe

Transgenerational transmission of trauma and resilience: a qualitative study with Brazilian offspring of Holocaust survivors

Background: Over the past five decades, clinicians and researchers have debated the impact of the Holocaust on the children of its survivors. the transgenerational transmission of trauma has been explored in more than 500 articles, which have failed to reach reliable conclusions that could be generalized. the psychiatric literature shows mixed findings regarding this subject: many clinical studies reported psychopathological findings related to transgenerational transmission of trauma and some empirical research has found no evidence of this phenomenon in offspring of Holocaust survivors.Method: This qualitative study aims to detect how the second generation perceives transgenerational transmission of their parents' experiences in the Holocaust. In-depth individual interviews were conducted with fifteen offspring of Holocaust survivors and sought to analyze experiences, meanings and subjective processes of the participants. A Grounded Theory approach was employed, and constant comparative method was used for analysis of textual data.Results: the development of conceptual categories led to the emergence of distinct patterns of communication from parents to their descendants. the qualitative methodology also allowed systematization of the different ways in which offspring can deal with parental trauma, which determine the development of specific mechanisms of traumatic experience or resilience in the second generation.Conclusions: the conceptual categories constructed by the Grounded Theory approach were used to present a possible model of the transgenerational transmission of trauma, showing that not only traumatic experiences, but also resilience patterns can be transmitted to and developed by the second generation. As in all qualitative studies, these conclusions cannot be generalized, but the findings can be tested in other contexts.Universidade Federal de São Paulo, São Paulo Sch Med, Dept Psychiat, BR-04023061 São Paulo, BrazilUniversidade Federal de São Paulo, São Paulo Sch Med, Dept Psychiat, BR-04023061 São Paulo, BrazilWeb of Scienc

A randomized, double-blind, placebo-controlled trial to assess the efficacy of topiramate in the treatment of post-traumatic stress disorder

<p>Abstract</p> <p>Background</p> <p>Topiramate might be effective in the treatment of posttraumatic stress disorder (PTSD) because of its antikindling effect and its action in both inhibitory and excitatory neurotransmitters. Open-label studies and few controlled trials have suggested that this anticonvulsant may have therapeutic potential in PTSD. This 12-week randomized, double-blind, placebo-controlled clinical trial will compare the efficacy of topiramate with placebo and study the tolerability of topiramate in the treatment of PTSD.</p> <p>Methods and design</p> <p>Seventy-two adult outpatients with DSM-IV-diagnosed PTSD will be recruited from the violence program of Federal University of São Paulo Hospital (UNIFESP). After informed consent, screening, and a one week period of wash out, subjects will be randomized to either placebo or topiramate for 12 weeks. The primary efficacy endpoint will be the change in the Clinician-administered PTSD scale (CAPS) total score from baseline to the final visit at 12 weeks.</p> <p>Discussion</p> <p>The development of treatments for PTSD is challenging due to the complexity of the symptoms and psychiatric comorbidities. The selective serotonin reuptake inhibitors (SSRIs) are the mainstream treatment for PTSD, but many patients do not have a satisfactory response to antidepressants. Although there are limited clinical studies available to assess the efficacy of topiramate for PTSD, the findings of prior trials suggest this anticonvulsant may be promising in the management of these patients.</p> <p>Trial Registration</p> <p>NCT 00725920</p