Parental Preconception Adversity and Offspring Health in African Americans: A Systematic Review of Intergenerational Studies.

Background: This systematic review explores the empirical literature addressing the association between parental preconception adversity and offspring physical health in African-American families. Method: We conducted a literature search in PubMed, Web of Science, PsycINFO, CINAHL, and Scopus through June 2021. Articles were included if they: reported data about at least two generations of African-American participants from the same family; measured parental preconception adversity at the individual level; measured at least one offspring physical health outcome; and examined associations between parental adversity and child health. Results: We identified 701 unique articles; thirty-eight articles representing 30 independent studies met inclusion criteria. Twenty-five studies (83%) reported that parental preconception adversity was associated with child health; six studies (20%) reported that parental preconception adversity was not associated with at least one offspring outcome; several studies reported both. Only six studies (20%) reported an association specific to African Americans. Conclusion: Empirical evidence linking parental preconception adversity with offspring physical health in African Americans is limited and mixed. In the current literature, very few studies report evidence addressing intergenerational associations between parental preconception adversity and offspring physical health in the African-American population, specifically, and even fewer investigate forms of parental preconception adversity that have been shown to disproportionately affect African Americans (e.g., racism). To better understand root causes of racial health disparities, more rigorous systematic research is needed to address how intergenerational transmission of historical and ongoing race-based trauma may impact offspring health among African Americans.

Intergenerational trauma transmission is associated with brain metabotranscriptome remodeling and mitochondrial dysfunction.

Intergenerational trauma increases lifetime susceptibility to depression and other psychiatric disorders. Whether intergenerational trauma transmission is a consequence of in-utero neurodevelopmental disruptions versus early-life mother-infant interaction is unknown. Here, we demonstrate that trauma exposure during pregnancy induces in mouse offspring social deficits and depressive-like behavior. Normal pups raised by traumatized mothers exhibited similar behavioral deficits to those induced in pups raised by their biological traumatized mothers. Good caregiving by normal mothers did not reverse prenatal trauma-induced behaviors, indicating a two-hit stress mechanism comprising both in-utero abnormalities and early-life poor parenting. The behavioral deficits were associated with profound changes in the brain metabotranscriptome. Striking increases in the mitochondrial hypoxia marker and epigenetic modifier 2-hydroxyglutaric acid in the brains of neonates and adults exposed prenatally to trauma indicated mitochondrial dysfunction and epigenetic mechanisms. Bioinformatic analyses revealed stress- and hypoxia-response metabolic pathways in the neonates, which produced long-lasting alterations in mitochondrial energy metabolism and epigenetic processes (DNA and chromatin modifications). Most strikingly, early pharmacological interventions with acetyl-L-carnitine (ALCAR) supplementation produced long-lasting protection against intergenerational trauma-induced depression.

Indigenous Apocalypse and Transgenerational Trauma.

The disproportionate negative impact of the COVID-19 pandemic on Native communities is a result of transgenerational traumas-mental and physical-which have been ongoing and developing for centuries. This article considers 19th-century American visual and narrative representations of Native experiences of and responses to transgenerational trauma. This article also suggests ethical implications for Native American health of interpreting those representations and suggests an obligation to look on 19th-century White American artists' romanticizations of Native experiences with humility.

Elder Abuse in American Indian Communities: An Integrative Review.

BACKGROUND: American Indian elders have one of the lowest life expectancies in the United States. Disproportionate disease burden, socioeconomic disparities, and higher rates of violence across the lifespan are thought to contribute to higher rates of elder abuse. Elder abuse and higher rates of trauma exposure are linked with adverse outcomes. METHODS: The Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines informed the methodology and assessment of the literature on elder abuse among American Indians. RESULTS: Of the nine studies published in the last 30 years, rates of elder abuse varied by study, location, and tribal affiliation from 4.3% to 45.9%. Large studies with comparison populations found higher rates for American Indians. There was a consensus for three risk factors: substance abuse, mental health problems, and caregiving issues. Importance of tribal norms, the notion of respect conferred to elders, and the concept of acculturation were major culturally relevant themes. Perceived tribal norms and strengths, for example, respect for elders, were at odds with abuse experiences, particularly financial exploitation and neglect. Historical trauma, shame, and fear impacted reporting. There was little consistency in study designs, most were qualitative or mixed methods, samples were small, there was no common measurement tool or time frame for abuse, and there was only one intervention study. IMPLICATIONS: High rates of abuse suggest healthcare providers should be encouraged to screen and intervene despite the lack of empirical evidence. Providers should not assume that traditional culturally ascribed strengths, such as honor and respect for elders, provide any degree of protection against elder abuse.

Intergenerational Trauma: The Relationship Between Residential Schools and the Child Welfare System Among Young People Who Use Drugs in Vancouver, Canada.

PURPOSE: This study investigated the relationship between familial residential school system (RSS) exposure and personal child welfare system (CWS) involvement among young people who use drugs (PWUD). METHODS: Data were obtained from two linked cohorts of PWUD in Vancouver, Canada, and restricted to Indigenous participants. Multivariable logistic regression analysis was used to investigate the relationship between three categories of familial RSS exposure (none, grandparent, and parent) and CWS involvement. A secondary analysis assessed the likelihood of CWS involvement between non-Indigenous and Indigenous PWUD with no familial RSS exposure. RESULTS: Between December 2011 and May 2016, 675 PWUD (aged <35 years) were included in this study, 40% identified as Indigenous. In multivariable analyses, compared with Indigenous participants with no RSS exposure (reference), those with a grandparent in the RSS had a higher likelihood of having been in CWS (adjusted odds ratio [AOR] = 1.34, 95% confidence interval [CI]: .67-2.71), as did those with a parent exposed to RSS (AOR = 2.03, 95% CI: 1.03-3.99). In secondary analysis, the odds of CWS involvement was not significantly different between non-Indigenous and Indigenous PWUD with no familial RSS exposure (AOR = .63, 95% CI: .38-1.06). CONCLUSIONS: We observed a dose-response-type trend between familial RSS exposure and personal CWS involvement and a nonsignificant difference in the likelihood of CWS involvement between Indigenous and non-Indigenous PWUD when controlling for RSS exposure. These data demonstrate the intergenerational impact of the RSS on the overrepresentation of Indigenous youth in the CWS. Findings have critical implications for public policy and practice including reconciliation efforts with Indigenous Peoples.