{"doi":"10.1002/wps.20733","title":"Intergenerational psychiatry: a new look at a powerful perspective","abstract":"Intergenerational psychiatry focuses on disorder-related phenotypes in one generation following the manifestation of a psychiatric disorder, or the exposure to adversity, in the prior one. Intense interest in families has a long history in psychiatry. We argue that new concepts, tools and research findings coalescing around the area of intergenerational psychiatry have the potential to make the focus on familial risk even more relevant to understanding the roots of mental disorders and, most importantly, how, when and with whom to intervene. Intergenerational psychiatry integrates three lines of investi­gation. The first, familial high-risk studies, examines risk of mental disorder as it travels within families1, 2. Studying individuals at risk by virtue of their familial background, this approach helps isolate pathways by which mental disorder is transmitted in families, as well as endophenotypes predating disorder onset such as, for instance, cortical thinning and altered neural connectivity3. The second, intergenerational effects of trauma, considers the effects of parental exposure to trauma on psychiatric outcomes in the next generation. These studies have, for example, started to identify variation in stress regulation in children of Holocaust survivors as well as war veterans, independent of the children’s direct exposure to significant life stressors4. Finally, fetal programming studies have shown that “the womb may be as important as the home” in putting a child at risk for compromised neurobehavioral outcomes following prenatal exposures to stress or anxiety/depression. This work establishes an individual’s first environment as the in utero milieu. Whereas the first approach emphasizes parental psychopa­thology as the primary component of intergenerational process­es, the second highlights parental trauma, and principally, trauma occurring during parents’ adulthood prior to conceiving children. Finally, the third emphasizes gestation as the time period during which familial non-genetic influences on child outcomes can occur. We argue for integrating these paradigms to encompass the life course nature of risk and exposure emanating from the parent (and grandparents) to impact the child. Our current understanding of the mechanisms of intergener­ational transmission is still in its early stages. Familial high-risk studies have excelled in identifying parent-to-offspring transmission and correlates of psychiatric risk. They have shed light on certain mechanistic processes by which disorders are transferred from one generation to the next, suggesting, for example, neural endophenotypes of risk and resilience. Studies focused on intergenerational effects of trauma have produced additional mechanistic insights. These include germ­line epigenetic effects of pre-conception trauma, both maternal and paternal. Yet, most of these preclinical insights remain unproven in humans5. Finally, fetal programming studies have mostly focused on gestational experiences versus those from a mother’s lifetime (or her mother’s) that might influence her oocyte and/or her health during childbearing years. Building on these foundational paradigms, intergenerational psychiatry can apply a wider investigative lens in terms of the sources (maternal and paternal), types, and timing of exposures. It considers, as relevant exposures for the next generation, paren­tal psychopathology and trauma as well as experiences of psychosocial adversity (e.g., famine/starvation, social isolation, discrimination, poverty) and expands the time frame of these exposures, by considering parents’ adulthood experiences, as well as those of their childhood, or even before. Central hypotheses of intergenerational psychiatry are ripe for testing. First, advances in fetal and perinatal neurobehavioral assessments have converged with our capacity to detect disruptions in brain circuitry in the first days following birth, or even before, in utero (e.g., fetal brain imaging). S","journal":"World Psychiatry","year":2020,"id":65525,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":57,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9521,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2020-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":340349,"name":"Catherine Monk","orcid":"0000-0001-7827-2602","position":1,"is_corresponding":false},{"id":5360,"name":"Myrna M. Weissman","orcid":"0000-0003-3490-3075","position":2,"is_corresponding":false},{"id":218508,"name":"Jonathan Posner","orcid":"0000-0002-2704-1094","position":3,"is_corresponding":false},{"id":275847,"name":"Cristiane S. Duarte","orcid":"0000-0001-7214-4255","position":0,"is_corresponding":true}],"reference_count":9,"raw_metadata":null,"created_at":"2026-07-18T21:13:43.728351Z","pmid":"32394546","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}