Posttraumatic Stress Disorder Symptoms Among Offspring of Holocaust Survivors: A Systematic Review and Meta-Analysis

There is ongoing discussion across the literature as to whether parental exposure to potentially traumatic events, such as the Holocaust, have a carry-on effect across generations. This systematic review examines the presence of intergenerational trauma effects in children and grandchildren of Holocaust survivors. A systematic search of PsycINFO, PTSDPubs, PubMed, Web of Science Core Collection and Embase identified observational studies that examined posttraumatic stress disorder (PTSD) symptoms in children and grandchildren of Holocaust survivors. A quantitative estimate of the overall standardized mean difference was then calculated and between-study heterogeneity explored. A total of 13 separate samples across 10 studies met inclusion criteria. For children of Holocaust survivors, there was a moderate size association (Standardized Mean Difference [SMD] = .43), suggesting increased levels of PTSD symptoms for children of survivors compared to control. For grandchildren of Holocaust survivors, the association was near trivial (SMD = .06), indicating that grandchildren of survivors had a slightly increased level of PTSD symptoms. Our review suggests that PTSD symptoms may be elevated among offspring of Holocaust survivors, but that this effect is not evident in grandchildren and that other factors no doubt explain the magnitude of PTSD symptoms. There was insufficient evidence to indicate that grandchildren of Holocaust survivors have elevated levels of PTSD symptoms when compared to the general population.