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Echoes of trauma are traced in the relational narratives that the sons and daughters of Holocaust survivors tell about their experiences growing up in survivor families. An innovative combination of the Core Conflictual Relationship Theme (CCRT) method with narrative-qualitative analysis revealed common themes and emotional patterns that are played out in the survivors' children's meaningful relationships, especially in those with their parents. The relational world of the second generation is understood in the context of an intergenerational communication style called 'knowing-not knowing', in which there is a dialectical tension between knowing and not knowing the parental trauma. In the survivors' children's current parent-adolescent relationships with their own children, they aspire to correct the child-parent dynamics that they had experienced by trying to openly negotiate conflicts and to maintain close bonds. Clinicians treating descendents of other massive trauma would benefit from the insights offered into these complex intergenerational psychological processes.

No previous community-based epidemiological study has explored psychiatric disorders among those who survived the Holocaust. To examine anxiety and depressive disorders, sleep disturbances, other health problems and use of services among individuals exposed and unexposed to the Holocaust. The relevant population samples were part of the Israel World Mental Health Survey. The interview schedule included the Composite International Diagnostic Interview and other health-related items. The Holocaust survivor group had higher lifetime (16.1%; OR = 6.8, 95% CI 1.9-24.2) and 12-month (6.9%; OR = 22.5, 95% CI 2.5-204.8) prevalence rates of anxiety disorders, and more current sleep disturbances (62.4%; OR = 2.5, 95% CI 1.4-4.4) and emotional distress (P<0.001) than their counterparts, but did not have higher rates of depressive disorders or post-traumatic stress disorder. Early severe adversity was associated with psychopathological disorder long after the end of the Second World War, but not in all survivors. Age during the Holocaust did not modify the results.

Despite the abundant scholarship on posttraumatic stress disorder (PTSD) and the memoropolitics entailed by testimonial accounts of trauma and genocide, little is known of the everyday experience of trauma survivors and their descendants. Survivor silence is thought to signify only psychological or political repression and the “unspeakability” of traumatic pasts. It is widely accepted that the everyday lives of trauma victims and their descendants entail only the “absence of presence” of the past and the absence of descendant knowledge of that past, while the familial social milieu is thought to foster only the wounds of transmitted PTSD. Contrary to the literature, ethnographic accounts of Holocaust descendants depict the survivor home as embedding the nonpathological presence of the Holocaust past within silent, embodied practices, person‐object interaction, and person‐person interaction. These silent traces form an experiential matrix of Holocaust presence that sustains familial “lived memory” of the past and transmits tacit knowledge of the past within the everyday private social milieu. The ethnography of silent memory may also provide a tentative model of nontraumatic individual and familial memory work in everyday life.

Objective We explore the experience of intergenerational transmission of trauma in grandchildren of Holocaust survivors. Background Impacts of mass and collective trauma may exceed those initially affected to include the survivor's extended family and, thus, impact families for generations to come. Understanding these impacts is paramount to developing interventions and support programs for the survivors and their families. Method Fourteen semistructured interviews were conducted with randomly recruited 11 female and three male Australian grandchildren of Holocaust survivors (Mage = 36.5 years). Data were analyzed using interpretative phenomenological analysis. Results Six main themes were identified: knowledge about the past, communication modes about the Holocaust, kinship with other descendants, emotional reactions, the meaning of the Holocaust, and impacts on present life. Conclusions The findings demonstrated that intergenerational transmission of trauma occurred and included both features of vulnerability and resilience. Although traumatic content was mainly transmitted through open communication, echoes of the past trauma were also transmitted nonverbally. Implications There is scope for developing and formulating guidelines for clinicians working with families of collective trauma survivors to educate the clients and support familial communication pathways. Additional clinical and research implications are discussed.

The trauma of a genocide can be transmitted to subsequent generations though familial mental health, sociopolitical trauma, and cultural narratives, thereby impacting mental health and well-being. Understanding specific mechanisms that are unique to each ethnic group impacted by genocide illuminates cultural, sociopolitical, and individual factors related to the transmission. For the Armenian community, the unresolved historical loss of the Armenian Genocide of 1915, with the threat of acculturation for such a large diasporic population, a continued denial by the perpetrators, as well as subsequent generations’ refugee experiences, may further exasperate the impact of transgenerational trauma from the genocide. This literature review explores the mental health needs of Armenian youth in the current sociopolitical context and provides implications for how schools and communities may use this knowledge to inform supports that center Armenian community healing. Future directions for research are also discussed.

Background: Thus far, most researchers on genocide and transgenerational transmissions have focused on the National Socialist Holocaust as the most abhorrent example of this severe human rights violation. Few data have been published on other ethnic or religious groups affected by genocidal actions in this context. Methodology: Using a mixed-method approach integrating qualitative interviews with standardized instruments (SCID and PDS), this study examines how individual and collective trauma have been handed down across three generations in an Alevi Kurd community whose members (have) suffered genocidal perpetrations over a longer time period (a “genocidal environment”). Qualitative, open-ended interviews with members of three generations answering questions yielded information on (a) how their lives are shaped by the genocidal experiences from the previous generation and related victim experiences, (b) how the genocidal events were communicated in family narratives, and (c) coping strategies used. The first generation is the generation which directly suffered the genocidal actions. The second generation consists of children of those parents who survived the genocidal actions. Together with their family (children, partner, relatives), this generation suffered forced displacement. Members of the third generation were born in the diaspora where they also grew up. Results: Participants reported traumatic memories, presented in examples in this publication. The most severe traumatic memories included the Dersim massacre in 1937–1938 in Turkey, with 70,000–80,000 victims killed, and the enforced resettlement in western Turkey. A content analysis revealed that the transgenerational transmission of trauma continued across three generations. SCID and PDS data indicated high rates of distress in all generations. Conclusions: Genocidal environments such as that of the Kurdish Alevis lead to transgenerational transmission mediated by complex factors.

Background The Holocaust was one of the most traumatic catastrophes in recorded human history. Survivors seeking psychotherapeutic help today, now in their seventies and older, often show symptoms of a posttraumatic stress disorder (PTSD), depression, or prolonged grief disorder. Established psychological treatments for PTSD (e.g. cognitive behaviour therapy, psychodynamic therapies) have been tested and assessed mainly with young and middle-aged adults; only very few studies examined them in old age. There is no therapy outcome study known to us for any treatment mode for Holocaust survivors. Moreover, there is a need for an age group-specific treatment of PTSD and other stress-related mental disorders. A narrative approach including life-review and narrative exposure seems to meet very well the natural need of older people to review their lives and is highly effective. However, most studies on the efficacy of life review therapy (LRT) focus on late-life depression. There is a lack of efficacy studies evaluating the effect of LRT on PTSD symptoms in older individuals that have experienced traumatic events. Methods The main goal of this study is to evaluate the effect of LRT for Holocaust survivors (LRT-HS) on symptoms of PTSD and related mental health problems (depression, anxiety, prolonged grief), compared to a supportive control group. A secondary goal is to identify the characteristics of participants that seem to especially benefit from the treatment. The proposed study is a randomised, controlled follow-up trial including Holocaust survivors with one or more trauma-related disorders. The LRT treatment consists of 20–25 sessions. Before and after the treatment phase, participants in both conditions will be assessed. Follow-up will take place 6 months after the treatment. A sample size of 80 is required (drop-out rate included). Discussion Efficacious treatments for trauma-related disorders in older people are of high importance, also because the probability of traumatisation and loss increases with age. Because this study is conducted with this specific group of multiply traumatised people, we are convinced that the results can easily transfer to other samples. Trial registration ISRCTN, ISRCTN12823306 . Registered 31 March 2018 – Retrospectively registered (first participant 22 December 2017).

Background The concept of Prolonged Grief Disorder (PGD) has been defined in recent years by Prigerson and co-workers, who have developed and empirically tested consensus and diagnostic criteria for PGD. Using these most recent criteria defining PGD, the aim of this study was to determine rates of and risks for PGD in survivors of the 1994 Rwandan genocide who had lost a parent and/or the husband before, during or after the 1994 events. Methods The PG-13 was administered to 206 orphans or half orphans and to 194 widows. A regression analysis was carried out to examine risk factors of PGD. Results 8.0% ( n = 32) of the sample met criteria for PGD with an average of 12 years post-loss. All but one person had faced multiple losses and the majority indicated that their grief-related loss was due to violent death (70%). Grief was predicted mainly by time since the loss, by the violent nature of the loss, the severity of symptoms of posttraumatic stress disorder (PTSD) and the importance given to religious/spiritual beliefs. By contrast, gender, age at the time of bereavement, bereavement status (widow versus orphan), the number of different types of losses reported and participation in the funeral ceremony did not impact the severity of prolonged grief reactions. Conclusions A significant portion of the interviewed sample continues to experience grief over interpersonal losses and unresolved grief may endure over time if not addressed by clinical intervention. Severity of grief reactions may be associated with a set of distinct risk factors. Subjects who lose someone through violent death seem to be at special risk as they have to deal with the loss experience as such and the traumatic aspects of the loss. Symptoms of PTSD may hinder the completion of the mourning process. Religious beliefs may facilitate the mourning process and help to find meaning in the loss. These aspects need to be considered in the treatment of PGD.

Based on twenty years of intense qualitative research, Transcending Trauma presents an integrated model of coping and adaptation after trauma that incorporates the best of recent work in the field with the expanded insights offered by Holocaust survivors. In the book's vignettes and interview transcripts, survivors of a broad range of traumas will recognize their own challenges, and mental-health professionals will gain invaluable insight into the dominant themes both of Holocaust survivors and of trauma survivors more generally. Together, the authors and contributors Sheryl Perlmutter Bowen, Hannah Kliger, Lucy Raizman, Juliet Spitzer and Emilie Scherz Passow have transformed qualitative narrative analysis and framed for us a new and profound understanding of survivorship. Their study has illuminated universal aspects of the recovery from trauma, and Transcending Trauma makes a vital contribution to our understanding of how survivors find meaning after traumatic events. Accompanying Transcending Trauma is a CD of full-text life histories that documents the survivor experience. In seven comprehensive interviews, survivors paint a picture of life before and after war and trauma: their own feelings, beliefs, and personalities as well as those of their family; their struggles to deal with loss and suffering; and the ways in which their family relationships were able, in some cases, to mediate the transmission of trauma across generations and help the survivors transcend the trauma of their experiences.

Collective traumas, such as war, genocide, natural disasters, and systemic oppression, have profound and lasting effects, not only on survivors but also on their descendants. Understanding how these traumas are transmitted across generations is essential to inform effective interventions and policy responses. This systematic review aimed to synthesize quantitative evidence on the physiological and psychological outcomes observed in second-generation descendants of individuals exposed to collective trauma. We included English-language, peer-reviewed quantitative studies published between 1997 and 2022 that investigated intergenerational trauma among second-generation descendants of survivors of collective trauma. Exclusion criteria included qualitative studies, and those that involved third-generation descendants. We conducted a comprehensive search across six databases: PsycINFO, PsycARTICLES, MEDLINE, Web of Science Core Collection, Embase, and PubMed. The final search was completed in December 2022. Search terms included keywords such as “intergenerational trauma,” “transgenerational trauma,” “collective trauma,” and “historical trauma.” Two independent reviewers screened titles and abstracts, followed by full-text assessments for eligibility. Discrepancies were resolved through discussion. Study quality was evaluated using the Critical Appraisal Skills Programme (CASP) checklist. Each study was assessed independently by two reviewers, with disagreements resolved by consensus. A narrative synthesis was conducted. Out of 3,904 records identified, 18 studies met the inclusion criteria. The findings revealed that physiological changes in stress regulation and brain structure suggest biological embedding of trauma across generations. Socially, intergenerational trauma shaped relationships and identity, often fostering mistrust and emotional restraint. Psychologically, descendants showed elevated distress and trauma symptoms, with parental PTSD as a key predictor. The overall quality of evidence was limited by small sample sizes, cross-sectional designs, reliance on self-reported measures, and inadequate control for confounding factors. More longitudinal and methodologically rigorous studies are needed to better understand the pathways of trauma transmission and inform prevention and intervention strategies. This review was registered with PROSPERO (CRD42023433181).