Transgenerational transmission of trauma and resilience: a qualitative study with Brazilian offspring of Holocaust survivors

BMC Psychiatry

José Paulo Fiks¹  Marcelo Feijó Mello¹  Luciana Lorens Braga¹ 

[1]Department of Psychiatry, São Paulo School of Medicine, Federal University of São Paulo, Rua Botucatu 431, 04023-061, São Paulo, SP, Brazil

关键词: PTSD;    Holocaust;    Offspring;    Resilience;    Trauma;    Transmission;    Transgenerational;   

Others  :  1124297
DOI  :  10.1186/1471-244X-12-134

 received in 2011-02-21, accepted in 2012-08-14,  发布年份 2012

【 摘 要 】

Background

Over the past five decades, clinicians and researchers have debated the impact of the Holocaust on the children of its survivors. The transgenerational transmission of trauma has been explored in more than 500 articles, which have failed to reach reliable conclusions that could be generalized. The psychiatric literature shows mixed findings regarding this subject: many clinical studies reported psychopathological findings related to transgenerational transmission of trauma and some empirical research has found no evidence of this phenomenon in offspring of Holocaust survivors.

Method

This qualitative study aims to detect how the second generation perceives transgenerational transmission of their parents’ experiences in the Holocaust. In-depth individual interviews were conducted with fifteen offspring of Holocaust survivors and sought to analyze experiences, meanings and subjective processes of the participants. A Grounded Theory approach was employed, and constant comparative method was used for analysis of textual data.

Results

The development of conceptual categories led to the emergence of distinct patterns of communication from parents to their descendants. The qualitative methodology also allowed systematization of the different ways in which offspring can deal with parental trauma, which determine the development of specific mechanisms of traumatic experience or resilience in the second generation.

Conclusions

The conceptual categories constructed by the Grounded Theory approach were used to present a possible model of the transgenerational transmission of trauma, showing that not only traumatic experiences, but also resilience patterns can be transmitted to and developed by the second generation. As in all qualitative studies, these conclusions cannot be generalized, but the findings can be tested in other contexts.

【 授权许可】

   
2012 Braga et al.; licensee BioMed Central Ltd.

【 参考文献 】

• [1]Starman H: Generations of Trauma: Victimhood and the Perpetuation of Abuse in Holocaust Survivors. Hist Anthropol 2006, 17(4):327-338.
• [2]Danieli Y: Intergenerational handbook of multigenerational legacies of trauma. Plenum Press, New York; 1998.
• [3]Daud A, Skoglund DA, Rydelius P-A: Children in families of torture victims: Transgenerational transmission of parents’ traumatic experiences to their children. Int J Soc Welf 2005, 14:23-32.
• [4]Epstein H: Children of the Holocaust: conversations with sons and daughters of survivors. Penguin, New York; 1979.
• [5]Rakoff V, Sigal JJ, Epstein NB: Children and families of concentration camp survivors. Can Ment Health 1967, 14:24-26.
• [6]Trossman B: Adolescent children of concentration camp survivors. J Can Psychiatr Assoc 1968, 13:121-131.
• [7]Sigal JJ: Second Generation Effects of Massive Psychic Trauma. Int Psychiatr Clin 1971, 8:55-65.
• [8]Niederland WG: Clinical observations on the “Survivor Syndrome”. Int J Psychoanal 1968, 49:313-315.
• [9]Barocas HA, Barocas CB: Manifestations of concentration camp effects on the second generation. Am J Psychiatry 1973, 130:820-821.
• [10]Barocas HA, Barocas CB: Wounds of the fathers: The next generation of holocaust victims. Int Rev Psycho Anal 1979, 6:331-340.
• [11]Freyberg JT: Difficulties in separation – individuation as experienced by offspring of Nazi Holocaust survivors. Am J Orthopsychiatry 1980, 50:87-95.
• [12]Fogelman E, Savran B: Brief group therapy with offspring of Holocaust survivors. Am J Orthopsychiatry 1980, 50:96-108.
• [13]Danieli Y: Differing adaptational styles in families of survivors of the Nazi Holocaust: some implications for treatment. Child Today 1981, 10(6-10):34-35.
• [14]Solkoff N: Children of survivors of Nazi holocaust: A critical review. Am J Orthopsychiatry 1992, 62:342-358.
• [15]Sorscher N, Cohen LJ: Trauma in children of Holocaust survivors: transgenerational effects. Am J Orthopsychiatry 1997, 67:493-500.
• [16]Yehuda R, Schmeidler J, Wainberg M, Binder-Brynes K, Duvdevani T: Vulnerability to posttraumatic stress disorder in adult offspring of Holocaust survivors. Am J Psychiatry 1998, 155:1163-1171.
• [17]Yehuda R, Halligan SL, Grossman R: Childhood trauma and risk for PTSD: Relationship to intergenerational effects of trauma, parental PTSD, and cortisol excretion. Dev Psychopathol 2001, 13:733-753.
• [18]Leon GR, Butcher JN, Kleinman M, Goldberg A, Almagor M: Survivors of the Holocaust and their children: current status and adjustment. J Pers Soc Psychol 1981, 41:502-516.
• [19]Rieck M: The psychological state of Holocaust survivors’ offspring: An epidemiological and psycho-diagnostic study. Int J Behav Dev 1994, 17:649-667.
• [20]Magids DM: Personality comparison between children of hidden Holocaust survivors and American Jewish parents. J Psychol 1998, 132:245-254.
• [21]Nadler A, Kav-Venaki S, Gleitman B: Transgenerational effects of the Holocaust: externalization of aggression in second-generation of Holocaust survivors. J Consult Clin Psychol 1985, 53:365-369.
• [22]Felsen I: Erlich: Identification patterns of offspring of Holocaust survivors with their parents. Am J Orthopsychiatry 1990, 60:506-520.
• [23]Lichtman H: Parental communication of Holocaust experiences and personality characteristics among second-generation survivors. J Clin Psychol 1984, 40:914-924.
• [24]Wiseman H, Barber JP, Raz A, Yam I, Foltz C, Livne-Snir S: Parental communication of Holocaust experiences and interpersonal patterns in offspring of Holocaust survivors. Int J Behav Dev 2002, 26:371-381.
• [25]Baron L, Reznikoff M, Glenwick DS: Narcisism, interpersonal adjustment and coping in children of Holocaust survivors. J Psychol 1993, 127:257-269.
• [26]Sagi-Schwartz A, van IJzendoorn MH, Grossmann K, Joels T, Grossmann K, Scharf M, Koren-Karie N, Alkalay S: Attachment and traumatic stress in female Holocaust child survivors and their daughters. Am J Psychiatry 2003, 160:1086-1092.
• [27]Van IJzendoorn MH, Bakermans-Kranenburg MJ, Sagi-Schwartz A: Are children of Holocaust survivors less well-adapted? No meta-analytic evidence for secondary traumatization. J Trauma Stress 2003, 16:459-469.
• [28]Sagi-Schwartz A, van IJzendoorn MH, Bakermans-Kranenburg MJ: Does intergenerational transmission of trauma skip a generation? No meta-analytic evidence for tertiary traumatization with the third generation of Holocaust survivors. Attach Hum Dev 2008, 10:105-121.
• [29]American Psychological Association: The road to resilience. http://www.apa.org/helpcenter/road-resilience.aspx webcite
• [30]Lee TY, Cheung CK, Kwong WM: Resilience as a positive youth development construct: a conceptual review. Sci World J 2012, 390450:9.
• [31]Bar-On D, Eland J, Kleber RJ, Krell R, Moore Y, Sagi A, Soriano E, Suedfeld P, Van der Velden PG, van IJzendoorn MH: Multigenerational perspectives on coping with the holocaust experience: An attachment perspective for understanding the developmental sequelae of trauma across generations. Int J Behav Dev 1998, 22:315-338.
• [32]Levav I, Kohn R, Schwartz S: The psychiatric after-effects of the Holocaust on the second generation [Editorial]. Psychol Med 1998, 28:755-760.
• [33]Phillips RE: Impact of Nazi Holocaust on children of survivors. Am J Psychother 1978, 32:370-378.
• [34]Baider L, Peretz T, Hadani PE, Perry S, Avramov R, De Nour AK: Transmission of response to trauma? Second-generation Holocaust survivors’ reaction to cancer. Am J Psychiatry 2000, 157:904-910.
• [35]Solomon Z, Kotler M, Mikulincer M: Combat-related posttraumatic stress disorder among 2ndgeneration Holocaust survivors. Preliminary findings. Am J Psychiatry 1988, 145:865-868.
• [36]Chaitin J: Facing the Holocaust in generations of families of survivors: the case of partial relevance and interpersonal values. Contemp Fam Ther 2000, 22:289-313.
• [37]Chaitin J: Issues and interpersonal values among three generations in families of Holocaust survivors. J Soc Pers Relat 2002, 19:379-402.
• [38]Lev-Wiesel R: Intergenerational transmission of trauma across three generations: a preliminary study. Qual Soc Work 2007, 6:75-94.
• [39]Braga LL, Fiks JP, Mari JJ, Mello MF: The importance of the concepts of disaster, catastrophe, violence, trauma and barbarism in defining posttraumatic stress disorder in clinical practice. BMC Psychiatry 2008, 12:68-75.
• [40]Landau R, Litwin H: The effects of extreme early stress in very old age. J Trauma Stress 2000, 13:473-487.
• [41]Glaser BG, Strauss A: A discovery of Grounded Theory. Strategies for Qualitative Research, Sociology Press; 1967.
• [42]Miles MB, Huberman AM: Qualitative Data Analysis: An expanded sourcebook. 2nd edition. Sage, London & Thousand Oaks, California; 1994.
• [43]Walker D, Myrick F: Grounded Theory: an exploration process and procedure. Qual Health Res 2006, 16:547-559.
• [44]Strauss A, Corbin J: Basics of qualitative research: techniques and procedures for developing Grounded Theory. 2nd edition. Sage Publications, Thousand Oaks; 1998.
• [45]Shrira A, Palgi Y, Ben-Ezra M: Transgerational effects of trauma in midlife: evidence for for resilience and vulnerability in offspring of Holocaust survivors. Psychol Trauma Theory Res Pract Police 2011, 3(4):394-402.
• [46]Dekel R, Goldblatt H: Is there transgenerational transmission of trauma? The case of combat veteran’s children. Am J Orthopsychiatry 2008, 78(3):281-289.
• [47]Fridman A, Bakermans-Kranenburg MJ, Sagi-Schwartz A, Van IJzendoorn MH: Coping in old age with extreme childhood trauma: aging Holocaust survivors and their offspring facing new challenges. Aging Ment Health 2011, 15(2):232-242.
• [48]Oppenheim-Gluckman H, Oppenheim D: Transmission de l’histoire familiale et des references identitaires dans les familles qui ont connu l’exil et la Shoah. L’Evolution Psychiatrique 2008, 73:145-57.
• [49]Wiseman H: On failed intersubjetivity: recollections of loneliness experiences in offspring of Holocaust survivors. Am J Orthopsychiatry 2008, 78(3):350-358.
• [50]Weiss E, O’Connell AG, Siiter R: Comparisons of second-generation Holocaust survivors, immigrants and nonimmigrants on measures of mental health. J Pers Soc Psychol 1986, 50:828-831.
• [51]Ben-Ezra M, Palgi Y, Soffer Y, Shrira A: Mental health consequences of the 2011 Fukushima nuclear disaster: are the grandchildren of people living in Hiroshima and Nagasaki during the drop of the atomic bomb more vulnerable? World Psychiatry 2012, 11(2):133.