Journal of Immigrant and Minority Health

, Volume 19, Issue 3, pp 745–754 | Cite as

Intergenerational Trauma in Refugee Families: A Systematic Review

  • Cindy C. SangalangEmail author
  • Cindy Vang
Review Paper


Although a robust literature describes the intergenerational effects of traumatic experiences in various populations, evidence specific to refugee families is scattered and contains wide variations in approaches for examining intergenerational trauma. Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) criteria, the purpose of this systematic review was to describe the methodologies and findings of peer-reviewed literature regarding intergenerational trauma in refugee families. In doing so we aimed to critically examine how existing literature characterizes refugee trauma, its long-term effects on descendants, and psychosocial processes of transmission in order to provide recommendations for future research. The results highlight populations upon which current evidence is based, conceptualizations of refugee trauma, effects of parental trauma transmission on descendants’ health and well-being, and mechanisms of transmission and underlying meanings attributed to parental trauma in refugee families. Greater methodological rigor and consistency in future evidence-based research is needed to inform supportive systems that promote the health and well-being of refugees and their descendants.


Intergenerational trauma Refugees Families 


Compliance with Ethical Standards

Conflict of Interest

All listed authors have reviewed and approved this manuscript, report no conflicts of interest, and will accept responsibility for its content.


  1. 1.
    United Nations High Commissioner on Refugees (UNHCR): population statistics. UNCHR, 2015. Available from
  2. 2.
    Fazel M, Reed RV, Panter-Brick C, Stein A. Mental health of displaced and refugee children resettled in high-income countries: risk and protective factors. Lancet. 2012;379(9812):266–82.CrossRefPubMedGoogle Scholar
  3. 3.
    Kirmayer LJ, Narasiah L, Munoz M, Rashid M, Ryder AG, Guzder J, Hassan G, Rousseau C, Pottie K. Common mental health problems in immigrants and refugees: general approach in primary care. Can Med Assoc J. 2011;183(12):E959–E967.CrossRefGoogle Scholar
  4. 4.
    Marshall GN, Schell TL, Elliott MN, Berthold SM, Chun CA. Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA. 2005;294(5):571–9.CrossRefPubMedGoogle Scholar
  5. 5.
    Weine S, Muzurovic N, Kulauzovic Y, Besic S, Lezic A, Mujagic A, Muzurovic J, Spahovic D, Feetham S, Ware N, Knafl K, Pavkovic I. Family consequences of refugee trauma. Fam Process. 2004;43(2):147–60.CrossRefPubMedGoogle Scholar
  6. 6.
    Dekel R, Goldblatt H. Is there intergenerational transmission of trauma? The case of combat veterans’ children. Am J Orthopsychiatry. 2008;78(3):281.CrossRefPubMedGoogle Scholar
  7. 7.
    Bezo B, Maggi S. Living in “survival mode:” Intergenerational transmission of trauma from the Holodomor genocide of 1932–1933 in Ukraine. Soc Sci Med. 2015;134:87–94.CrossRefPubMedGoogle Scholar
  8. 8.
    Han M. Relationship among perceived parental trauma, parental attachment, and sense of coherence in Southeast Asian American college students. J Fam Soc Work. 2005;9(2):25–45.CrossRefGoogle Scholar
  9. 9.
    George M. A theoretical understanding of refugee trauma. Clin Soc Work J. 2010;38(4):379–87.CrossRefGoogle Scholar
  10. 10.
    Hein J. Refugees, immigrants, and the state. Annu Rev Sociol. 1993;43–59.Google Scholar
  11. 11.
    Moher D, Liberati A, Tetzlaff J, Altman DG. Preferred reporting items for systematic reviews and meta-analyses: the PRISMA statement. Ann Intern Med. 2009;151(4):264–9.CrossRefPubMedGoogle Scholar
  12. 12.
    Braga LL, Mello MF, Fiks JP. Transgenerational transmission of trauma and resilience: a qualitative study with Brazilian offspring of Holocaust survivors. BMC Psychiatry. 2012;12(1):134–44.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Lev-Wiesel R. Intergenerational transmission of trauma across three generations: a preliminary study. Qual Soc Work. 2007;6(1):75–94.CrossRefGoogle Scholar
  14. 14.
    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 (London). 2011;15(2):232–42.Google Scholar
  15. 15.
    Kellermann NPF. Perceived parental rearing behavior in children of Holocaust survivors. Isr J Psychiatry Relat Sci. 2015;38(1):58–68.Google Scholar
  16. 16.
    Letzter-Pouw S, Shrira A, Ben-Ezra M, Palgi Y. Trauma transmission through perceived parental burden among Holocaust survivors’ offspring and grandchildren. Psychol Trauma. 2013;6(4):420–9.CrossRefGoogle Scholar
  17. 17.
    Sagi-Schwartz A, Van Ijzendoorn MH, Grossmann KE, 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(6):1086–92.CrossRefPubMedGoogle Scholar
  18. 18.
    Shrira A, Palgi Y, Ben-Ezra M, Shmotkin D. Transgenerational effects of trauma in midlife: evidence for resilience and vulnerability in offspring of Holocaust survivors. Psychol Trauma. 2012;3(4):394–402.CrossRefGoogle Scholar
  19. 19.
    Shrira A. Transmitting the sum of all fears: Iranian nuclear threat salience among offspring of Holocaust survivors. Psychol Trauma. 2015;7(4):364–71.CrossRefPubMedGoogle Scholar
  20. 20.
    Wiseman H, Metzl E, Barber JP. Anger, guilt, and intergenerational communication of trauma in the interpersonal narratives of second generation Holocaust survivors. Am J Orthopsychiatry. 2006;76(2):176–84.CrossRefPubMedGoogle Scholar
  21. 21.
    Wiseman H. On failed intersubjectivity: recollections of loneliness experiences in offspring of Holocaust survivors. Am J Orthopsychiatr. 2008;78(3):350–8.CrossRefGoogle Scholar
  22. 22.
    Giladi L, Bell TS. Protective factors for intergenerational transmission of trauma among second and third generation Holocaust survivors. Psychol Trauma. 2012;5(4):384–91.CrossRefGoogle Scholar
  23. 23.
    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(3):733–53.CrossRefPubMedGoogle Scholar
  24. 24.
    Yehuda R, Bell A, Bierer LM, Schmeidler J. Maternal, not paternal, PTSD is related to increased risk for PTSD in offspring of Holocaust survivors. J Psychiatr Res. 2008;42(13):1104–11.CrossRefPubMedPubMedCentralGoogle Scholar
  25. 25.
    Weinberg MK, Cummins RA. Intergenerational effects of the Holocaust: subjective well-being in the offspring of survivors. J Intergener Relatsh. 2013;11(2):148–61.Google Scholar
  26. 26.
    Vaage AB, Thomsen PH, Rousseau C, Wentzel-Larsen T, Ta TV, Hauff E. Paternal predictors of the mental health of children of Vietnamese refugees. Child Adolesc Psychiatr Ment Health. 2011;5(2):1–11.Google Scholar
  27. 27.
    Spencer JH, Le TN. Parent refugee status, immigration stressors, and Southeast Asian youth violence. J Immigr Minor Health. 2006;8(4):359–68.CrossRefPubMedGoogle Scholar
  28. 28.
    Lin NJ, Suyemoto KL, Kiang PNC. Education as catalyst for intergenerational refugee family communication about war and trauma. Commun Disord Q. 2009;30(4):195–207.CrossRefGoogle Scholar
  29. 29.
    Daud A, Skoglund E, Rydelius PA. Children in families of torture victims: transgenerational transmission of parents’ traumatic experiences to their children. Int J Soc Welf. 2005;14(1):23–32.CrossRefGoogle Scholar
  30. 30.
    Daud A, Klinetberg B, Rydelius PA. Resilience and vulnerability among refugee children of traumatized and non-traumatized parents. Child Adolesc Psychiatr Mental Health. 2008;2(7).Google Scholar
  31. 31.
    Ellis BH, MacDonald HZ, Lincoln AK, Cabral HJ. Mental health of Somali adolescent refugees: the role of trauma, stress, and perceived discrimination. J Consult Clin Psychol. 2008;76(2):184–93.CrossRefPubMedGoogle Scholar
  32. 32.
    Miller KE, Rasmussen A. War exposure, daily stressors, and mental health in conflict and post-conflict settings: bridging the divide between trauma-focused and psychosocial frameworks. Soc Sci Med. 2010;70(1):7–16.CrossRefPubMedGoogle Scholar
  33. 33.
    Fazel M, Wheeler J, Danesh J. Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review. Lancet. 2005;365(9467):1309–14.CrossRefPubMedGoogle Scholar
  34. 34.
    Van Ijzendoorn MH, Bakermans-Kranenburg MJ, Sagi-Schwartz A. Are children of Holocaust survivors less well-adapted? A meta-analytic investigation of secondary traumatization. J Trauma Stress. 2003;16(5):459–69.CrossRefPubMedGoogle Scholar
  35. 35.
    Hollifield M, Eckert V, Warner TD, Jenkins J, Krakow B, Ruiz J, Westermeyer J. Development of an inventory for measuring war-related events in refugees. Compr Psychiatry. 2005;46(1):67–80.CrossRefPubMedGoogle Scholar
  36. 36.
    Eisenbruch M. From post-traumatic stress disorder to cultural bereavement: diagnosis of Southeast Asian refugees. Soc Sci Med. 1991;33(6):673–80.CrossRefPubMedGoogle Scholar
  37. 37.
    Pedersen D. Political violence, ethnic conflict, and contemporary wars: broad implications for health and social well-being. Soc Sci Med. 2002;55(2):175–90.CrossRefPubMedGoogle Scholar
  38. 38.
    Hollifield M, Warner TD, Lian N, Krakow B, Jenkins JH, Kesler J, Stevenson J, Westermeyer J. Measuring trauma and health status in refugees: a critical review. JAMA. 2002;288(5):611–21.CrossRefPubMedGoogle Scholar
  39. 39.
    Taku K, Cann A, Calhoun LG, Tedeschi RG. The factor structure of the posttraumatic growth inventory: a comparison of five models using confirmatory factory analysis. J Trauma Stress. 2008;21(2):158–64.CrossRefPubMedGoogle Scholar
  40. 40.
    Weingarten K. Witnessing the effects of political violence in families: mechanisms of intergenerational transmission and clinical interventions. J Marital Fam Ther. 2004;30(1):45–59.CrossRefPubMedGoogle Scholar

Copyright information

© Springer Science+Business Media New York 2016

Authors and Affiliations

  1. 1.School of Social WorkArizona State UniversityTucsonUSA
  2. 2.School of Social WorkArizona State UniversityPhoenixUSA

Personalised recommendations