Associations of Maternal PTSD and Depression with Problems of Preschoolers Exposed to the World Trade Center Attacks

Although events such as the World Trade Center (WTC) attacks are apt to be traumatic for people of all ages, research has shown that preschoolers who had experienced other traumatic events prior to the WTC attacks were more likely to develop behavioral/emotional problems than children exposed only to the WTC events (Chemtob et al., 2008, Archives of Pediatrics and Adolescent Medicine, 126, 126-132). In a further study of 116 preschoolers directly exposed to the WTC events, Chemtob et al. (2010) analyzed relations between maternal depression and PTSD, on the one hand, and children’s problem scores on the CBCL/1½-5 completed by their mothers and the C-TRF completed by their preschool teachers, on the other. Differences in maternal education and in time since the WTC attacks, as well as maternal and child exposure to WTC traumas and other traumas were controlled statistically.

It was found that children whose mothers had depression or both depression and PTSD were more likely than other children to obtain elevated scores (i.e., in the combined borderline and clinical range) on the Emotionally Reactive, Anxious/Depressed, and Aggressive Behavior scales of the CBCL and C-TRF. Children whose mothers had depression or depression and PTSD were also more likely to obtain elevated scores on CBCL Somatic Complaints and Sleep Problems (not scored on the C-TRF) and on C-TRF Withdrawn and Attention Problems. Furthermore, there was a “dose-response” relation between children’s ASEBA scores and classification of mothers as having neither depression nor PTSD, depression only, or both depression and PTSD: On all but the CBCL Sleep Problems scale, children whose mothers had depression and PTSD obtained the highest problem scores, followed by children whose mothers had only depression and then by children whose mothers had neither. The C-TRF results showed that the relations between mothers’ and children’s psychopathology were borne out in teachers’ ratings, even though the teachers did not know about the mothers’ depression or PTSD. Although the study’s cross-sectional design could not determine whether maternal depression or PTSD predated the WTC attacks, the findings demonstrated the importance of parental psychopathology for understanding problems among preschoolers who had all been exposed to the WTC events. The authors concluded that co-occurring maternal depression and PTSD may especially interfere with mothers’ ability to help their children cope and that research should focus on ameliorating outcomes for mothers as well as for children exposed to traumatic events.

Reference: Chemtob, C.M., Nomura, Y., Rajendran, K., Yehuda, R., Schwartz, D., & Abramovitz, R. (2010). Impact of maternal posttraumatic stress disorder and depression following exposure to the September 11 attacks on preschool children’s behavior. Child Development, 81, 1129-1141.