A five-year, $3.3 million grant from the National Institute of Mental Health will support a longitudinal study by the Boston College School of Social Work that aims to improve the lives of families affected by intergenerational trauma and violence.

The grant enables the school’s Research Program on Children and Adversity to build on its study of war-affected youth in Sierra Leone, which involves tracking the progress of 529 young people whose lives were disrupted by that country in a variety of ways—including many girls and boys associated with armed forces and armed groups. The RPCA observed how the trauma of their war-time experiences, as well as the post-conflict environment, shaped the lives of these children as they grew into adulthood; some went on to pursue successful careers and start families, others fell into isolation, depression, and despair.

Theresa Betancourt

Theresa Betancourt (Lee Pellegrini)

In the two decades since the study began, its focus has broadened to include the original participants’ intimate partners and biological children, noted Salem Professor in Global Practice Theresa Betancourt, the RPCA director. The intent is to understand not only how trauma resulting from violence can influence an individual’s psychosocial development, but how the emotional and behavioral effects of trauma may travel across generations, she explained: The NIMH grant will enable the researchers to gather quantitative data based on biological indicators of stress reactivity and self-regulation, such as inflammatory markers and telomere length.

“We will be adding a new biological perspective to understand the embedding of the trauma-related stress response in more simple terms: how war-time stressors get ‘under the skin,’ including heritable biophysiological disruptions, and what the implications are for the next generation,” said Betancourt. “Understanding leverage points in how to improve parent-child interactions, despite a family history of trauma, is very important for helping to inform development of evidence-based interventions that are scalable and high-quality even in the most low-resource of settings.”

Betancourt’s research in Sierra Leone has been cited as the most extensive examination of post-war intergenerational relationships since studies of Holocaust survivors. She has also undertaken projects in Rwanda, Uganda, India, Mexico, Ethiopia, and the Russian Federation. Betancourt is currently involved in intervention studies to help promote early childhood development and prevent violence among families in extreme poverty in Rwanda, and works with refugees resettling in New England and in communities around the world.

She noted that the interventions developed by RPCA—and being evaluated for effectiveness as well as feasibility and acceptability—do not require highly-credentialed professionals for implementation; instead, these are delivered by non-specialist workers, including well-trained and well-supervised community health workers.

“We have found that these sorts of interventions can be deployed via new and innovative delivery platforms such as social protection programs, or educational and livelihoods programs. When delivered with high quality and fidelity, we have found that non-specialist-provided interventions can have an important impact on promoting both child development and mental health while also reducing intergenerational violence.

“We have seen this in some of the family-based preventative work that we have been doing in post-genocide Rwanda that we are working to bring to west Africa as well as to migrant and refugee populations globally. In fact, our team is presently beginning collaborative work to help respond to the Afghan refugee resettlement across the United States, adapting similar models of family-based prevention.”

Betancourt hailed the long-term collaboration RPCA has had with its many partners in Sierra Leone, including CARITAS and the University of Makeni, and the new opportunities for collaborations with Kenema General Hospital and Tulane University under this NIMH grant.

“An interdisciplinary response is sorely needed to deal with the intergenerational challenges that result from war and other situations of violence globally,” she said.

Sean Smith | University Communications | March 2022