Understanding how Genocide-Associated Lived Experience Impacts Post-Traumatic Stress Disorder in Rwanda

The goal of the proposed work is to characterize biological mechanisms contributing to the intergenerational transmission of post-traumatic stress disorder (PTSD) in the context of the Rwandan Genocide against ethnic Tutsi. This work will use a quasi-experimental design to test the hypothesis that (i) exposure to the Genocide induced lasting epigenetic changes that elevate risk for PTSD and are transmitted between generations; and (ii) a subset of these changes are associated with HPA axis dysregulation. We will collect epigenome wide and genome wide association study data from biobanked blood samples from 432 study participants (144 mothers, 144 children born from a pregnancy that occurred during the genocide, and 144 younger siblings born after the genocide). We will also use ELISA testing to assess levels of HPA axis markers. In addition, we will work with individuals with lived experience of the genocide and recruit at least 195 additional participants (65 mother, 65 first child and 65 second child), enabling a total sample size of 200 per group for analyses after accounting for attrition. Our work builds upon a strong international collaboration among applicants located at the University of South Florida, the University of Rwanda, and the Medical Research Council of Uganda.