Survival and Resilience Versus Psychopathology: A Seven-Decade Perspective Post-Holocaust

  • Haim Y. Knobler
  • Moshe Z. Abramowitz
  • Jutta Lindert


A seven-decade perspective post Holocaust reveals a significant change in attitudes, from an initial emphasis on the survivors’ (even their offspring’s) psychopathology, to the underscoring of their resilience including new findings of their surprising longevity and the low rate of their current post-traumatic symptomatology. At first, most psychotherapists who treated Holocaust survivors found them post-traumatic, seen as the common response to experiencing the horrors of the Holocaust. Later on, studies on the influence of Holocaust trauma on the survivors’ children described these offspring as the “Second Generation,” alluding to how they were deeply affected by their parents’ chronic post-traumatic state. In parallel, researchers found that the survivors served as a model for post traumatic growth, resilience, and an inspiration for Antonovsky’s salutogenic theory. Recent meta-analytic studies have found no proof of “transgenerational transmission” of post-traumatic psychopathogy to the second or the third generations. Surprisingly, the data now shows that Holocaust survivors live longer than non-survivors and have less post-traumatic symptoms.

Some of the more elegantly designed nonclinical studies were done in Israel, due to the presence of a large number of survivors and of their offspring, and due to the existence of appropriate control groups.


Posttraumatic growth Post-trauma adjustment Holocaust Salutogenesis 


  1. Antonovsky, A. (1979). Health, stress and coping. San Francisco: Jossey-Bass Publishers.Google Scholar
  2. Antonovsky, A. (1987). Unraveling the mystery of health – How people manage stress and stay well. San Francisco: Jossey-Bass Publishers.Google Scholar
  3. Antonovsky, A., Maoz, B., Dowty, N., & Wijsenbeek, H. (1971). Twenty-five years later: A limited study of the sequelae of the concentration camp experience. Social Psychiatry and Psychiatric Epidemiology, 6(4), 186–193.Google Scholar
  4. Baron, L., Eisman, H., Scuello, M., Veyzer, A., & Lieberman, M. (1996). Stress resilience, locus of control, and religion in children of Holocaust victims. The Journal of Psychology, 130(5), 513–525.CrossRefGoogle Scholar
  5. Basoglu, M., Livanou, M., Crnobaric, C., Franciskovic, T., Suljic, E., Duric, D., & Vranesic, M. (2005). Psychiatric and cognitive effects of war in former Yugoslavia: Association of Lack of redress for trauma and posttraumatic stress reactions. Journal of the American Medical Associaiion, 294(5), 580–590.CrossRefGoogle Scholar
  6. Bomba, J., & Orwid, M. (2010). A psychological study of World War II survivors – The case of Poland. In J. Withuis & A. Mooij (Eds.), The politics of war trauma (pp. 217–239). Chicago: The University of Chicago Press Books.Google Scholar
  7. Calhoun, L. G., & Tedeschi, R. G. (2014). Handbook of post-traumatic growth research and practice. New York/London: Psychology Press.Google Scholar
  8. Chodoff, P. (1963). Late effects of the concentration camp syndrome. Archives of General Psychiatry, 8, 323–333.CrossRefGoogle Scholar
  9. Collins, C., Burazeri, G., Gofin, J., & Kark, J. D. (2004). Health status and mortality in Holocaust survivors living in Jerusalem 40–50 years later. Journal of Traumatic Stress, 17(5), 403–411.CrossRefGoogle Scholar
  10. Davidson, S. H. (1973). Massive psychic traumatization and social support. Journal of Psychosomatic Research, 23(6), 395–402.Google Scholar
  11. Eitinger, L. (1961). Pathology of the concentration camp syndrome: Preliminary report. Archives of General Psychiatry, 5, 371–379.CrossRefGoogle Scholar
  12. Eitinger, L. (1972). Concentration camp survivors in Norway and Israel. Berlin: Springer Science & Business Media.CrossRefGoogle Scholar
  13. El-Sayed, A. M., Haloosim, M. R., Galea, S., & Koenan, K. C. (2012). Epigenetic modifications associated with suicide and common mood and anxiety disorders: A systematic review of the literature. Biology of Mood and Anxiety Disorders, 2, 2–10.CrossRefGoogle Scholar
  14. Epstein, E. (1979). Children of the Holocaust, conversations with sons and daughters of survivors. New York: Penguin.Google Scholar
  15. Eriksson, M., & Lindstrom, B. (2006). Antonovsky’s sense of coherence scale and the relation with health: A systematic review. Journal of Epidemiology and Community Health, 60(5), 376–381.CrossRefGoogle Scholar
  16. Gampel, Y. (1996). The interminable uncanny. In L. Rangell & R. Moses-Hrushovsky (Eds.), Psychoanalysis at the political border. Madison: International University Press.Google Scholar
  17. Hazan, Y. (1987). Second generation of the Holocaust – A topic in doubt. Sihot – Israeli Journal of Psychotherapy, 1, 104–107.Google Scholar
  18. Jablonski, R. K., Leszek, J., Rosinczuk, J., Uchmanowicz, I., & Panaszek, B. (2015a). Impact of incarceration in Nazi concentration camps on multimorbidity of former prisoners. Neuropsychiatric Disease and Treatment, 11, 669–674.Google Scholar
  19. Jablonski, R. K., Rosinczuk, J., Leszek, J., Uchmanowicz, I., & Panaszek, B. (2015b). The progressive nature of concentration camp syndrome in former prisoners of Nazi concentration camps – Not just history, but the important issue of contemporary medicine. Journal of Psychiatric Research, 75, 1–6.CrossRefGoogle Scholar
  20. Kellerman, N. P. (2001). Psychopathology in children of holocaust survivors: A review of the research literature. Israel Journal of Psychiatry, 38(1), 36–46.Google Scholar
  21. Klein, H. (1972). Holocaust survivors in kibbutzim: Readaptation and reintegration. Israel Annals of Psychiatry, 10(1), 78–91.Google Scholar
  22. Klein, H. (2012). Survival and trials of revival. Boston: Academic Studies Press.Google Scholar
  23. Knobler, H. Y., Haber, L., Brutin, B., & Zemishlany, Z. (2015). Myth and reality: On “future generations” of the Holocaust. In N. Davidovitch & D. Soen (Eds.), Shoa and experience – A journey in time (pp. 81–90). Boston: Academic Studies Press.Google Scholar
  24. Levav, I., Levinson, D., Radomislensky, I., Shemesh, A. A., & Kohn, R. (2007). Psychopathology and other health dimensions among the offspring of Holocaust survivors: Results from the Israel National Health Survey. Israel Journal of Psychiatry, 44(2), 144–151.Google Scholar
  25. Levine, S. Z., Levav, I., Goldberg, Y., Pugachova, I., Becher, Y., & Yoffe, R. (2016). Exposure to genocide and the risk of schizophrenia: A population-based study. Psychological Medicine, 46(4), 855–863.CrossRefGoogle Scholar
  26. Mahgoub, M., & Monteggia, L. M. (2013). Epigenetics and psychiatry. Neurotherapeutics, 10(4), 734–741.CrossRefGoogle Scholar
  27. Marshal, G. N., Schell, T. L., Elliot, M. N., Berthold, S. M., & Chun, C. A. (2005). Mental health of Cambodian refugees 2 decades after resettlement in the United States. JAMA, 294(5), 571–579.CrossRefGoogle Scholar
  28. Masten, A. S., & Narayan, A. J. (2012). Child development in the context of disaster, war, and terrorism: Pathways of risk and resilience. Annual Review of Psychology, 63, 227–257.CrossRefGoogle Scholar
  29. Nathan, T. S., Eitinger, L., & Winnik, Z. H. (1964). The psychiatric pathology of the Nazi-holocaust survivors. Israel Annals of Psychiatry, 2, 47–80.Google Scholar
  30. Page, W. F., Engdahl, B. E., & Eberly, R. E. (1991). Prevalence and correlates of depressive symptoms among former prisoners of war. Journal of Nervous and Mental Disease, 179(11), 670–677.CrossRefGoogle Scholar
  31. Pham, P. N., Weinstein, H. M., & Longman, T. (2004). Trauma and PTSD symptoms in Rwanda: Implications for attitudes toward justice and reconciliation. Journal of the American Medical Association, 292(5), 602–612.CrossRefGoogle Scholar
  32. Rakoff, V. (1961). Long term effects of the concentration camp experience. Viewpoints, 1, 7–21.Google Scholar
  33. Reed, R. V., Fazel, M., Jones, L., Panter-Brick, C., & Stein, A. (2012). Mental health of displaced and refugee children resettled in low-income and middle-income countries: Risk and protective factors. Lancet (London, England), 379(9812), 250–265.CrossRefGoogle Scholar
  34. Rutter, M. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57(3), 316–331.CrossRefGoogle Scholar
  35. Ryn, Z. J. (Ed.). (2005). Auschwitz survivors. Clinical-psychiatric studies. Cracow: Medical Review – Auschwitz.Google Scholar
  36. Sagi-Schwartz, A., van Ijzendoorn, M. H., & Bakermans-Kranenburg, M. J. (2008). Does intergenerational transmission of trauma skip a generation? No meta-analytic evidence for tertiary traumatization with third generation of Holocaust survivors. Attachment and Human Development, 10(2), 105–121.CrossRefGoogle Scholar
  37. Sagi-Schwartz, A., Bakermans-Kranenburg, M. J., Linn, S., & van Ijzendoorn, M. H. (2013). Against all odds: Genocidal trauma is associated with longer life-expectancy of the survivors. PloS One, 24, 8(7), e69179.CrossRefGoogle Scholar
  38. Schwartz, S., Dorenwend, B. P., & Levav, I. (1994). Non-genetic transmission of psychiatric disorders: Evidence from children of Holocaust survivors. Journal of Health and Social Behavior, 35(4), 385–402.CrossRefGoogle Scholar
  39. Sharon, A., Levav, I., Brodsky, J., Shemesh, A. A., & Kohn, R. (2009). Psychiatric disorders and other health dimensions among Holocaust survivors 6 decades later. British Journal of Psychiatry, 195(4), 331–335.CrossRefGoogle Scholar
  40. Sigal, J. J. (1995). Resilience in survivors, their children and their grandchildren. Echoes of the Holocaust, 4, 9–13.Google Scholar
  41. Solkoff, N. (1992). Children of survivors of the Nazi Holocaust: A critical review of the literature. American Journal of Orthopsychiatry, 62(3), 342–358.CrossRefGoogle Scholar
  42. Solomon, Z., Dekel, R., & Mikulincer, M. (2008). Complex trauma of war captivity: A prospective study of attachement and post-traumatic stress disorder. Psychological Medicine, 38(10), 1427–1434.CrossRefGoogle Scholar
  43. Solomon, Z., Greene, T., Ein-Dor, T., Zerach, G., Benyamini, Y., & Ohry, A. (2014). The long-term implications of war captivity for mortality and health. Journal of Behavioral Medicine, 37(5), 849–859.CrossRefGoogle Scholar
  44. Sonis, J., Gibson, J. L., de Jong, J. T., Field, N. P., Hean, S., & Komproe, I. (2009). Probable posttraumatic stress disorder and disability in Cambodia: Associations with perceived justice, desire for revenge, and attitudes toward the Khmer rouge trials. Journal of the American Medical Association, 302(5), 527–536.CrossRefGoogle Scholar
  45. Steel, Z., Chey, T., Silove, D., Marnane, C., Bryant, R. A., & van Ommeren, M. (2009). Association of torture and other potentially traumatic events with mental health outcomes among populations exposed to mass conflict and displacement: A systematic review and meta-analysis. Journal of the American Medical Assocaition, 302(5), 537–549.CrossRefGoogle Scholar
  46. Stessman, J., Cohen, A., Hammerman-Rozenberg, R., Bursztyn, M., Azoulay, D., Maaravi, Y., & Jacobs, J. M. (2008). Holocaust survivors in old age: The Jerusalem longitudinal study. Journal of the American Geriatric Society, 56(3), 470–477.CrossRefGoogle Scholar
  47. Ursano, R. J., & Rundell, J. R. (1990). The prisoner of war. Military Medicine, 155(4), 176–180.Google Scholar
  48. Van Ijzendoorn, M. H., Bakermans-Kranenburg, M. J., & Sagi-Schwartz, A. (2003). Are children of Holocaust survivors less well-adapted? A meta-analytic investigation of secondary traumatization. Journal of Traumatic Stress, 16(5), 459–469.CrossRefGoogle Scholar

Copyright information

© Springer International Publishing AG 2018

Authors and Affiliations

  • Haim Y. Knobler
    • 1
    • 2
  • Moshe Z. Abramowitz
    • 3
  • Jutta Lindert
    • 4
    • 5
  1. 1.The Jerusalem Mental Health CenterHebrew University, Hadassah Medical SchoolJerusalemIsrael
  2. 2.Peres Academic CenterRehovotIsrael
  3. 3.Jerusalem Mental Health CenterHebrew University, Hadassah Medical SchoolJerusalemIsrael
  4. 4.Department of Social Work and Public HealthUniversity of Applied Sciences EmdenEmdenGermany
  5. 5.Women’s Studies Research CenterBrandeis UniversityBrandeisUSA

Personalised recommendations