PTSD transmission: a review of secondary traumatization in Holocaust survivor families

Canadian Psychology, Nov 1998 by Williams-Keeler, Lyn, McCarrey, Michael, Baranowsky, Anna B, Young, Marta, Johnson-Douglas, Sue

Most of the research on survivors and their children is based predominantly on clinical analyses of self-referred mental health clients. The lack of controls in these studies certainly poses a dilemma when drawing conclusions and limits the ability to generalize to a larger survivor and survivor offspring population. Although the case studies presented in the clinical literature do not fall within the realm of strong scientific evidence, they do provide an exceedingly rich source of suggestive material.

At times, empirical studies have shone a more positive light on the subsequent functioning of survivors and their families. However, these studies (cited throughout this document) do not completely account for the complex trauma transmission issues, and in some cases are compromised through non-random samples, measures lacking appropriate sensitivity, unreliable and inadequately validated measures, poorly configured or non-existent control groups, and small sample sizes. Furthermore, these empirical studies often fail to tap the abundant resource gained in extensive clinical interviews or case studies. Subsequently, the absence of pathology in these studies does not adequately reassure the reader that, in fact, no psychological problems exist.

In an attempt to address earlier flaws, some studies have increased sample size significantly and incorporated random sampling techniques (Gross, 1988; Sigal & Weinfeld, 1087, 1080; Weiss, 1088). More recent studies attempt to address earlier flaws such as the acculturation issue by including non-Jewish immigrant and Jewish immigrant control groups (Rose & Garske, 1087; Weiss, 1088). However, there are a number of problems that are common to all Holocaust survivor studies, including the impossibility of random assignment dictated by the historical events and the difficulty of connecting an antecedent event such as the Holocaust with current behavior (i.e., separation difficulties) when so many other factors may have led to this end.

Immigrant status further complicates the Holocaust survivor and survivor offspring literature. Children of Holocaust survivors often report "feeling different" and alienated from their peers (Winik, 1088). This feeling of being alien to one's environment is not unique to survivor families. Obermeyer and Lukoff (1988) suggest that "feeling different" is also reported as being common to children born to immigrant non-survivor families. In fact, a number of researchers suggest that parents' immigrant status rather than Holocaust experience is a stronger factor in predicting significant differences between survivor offspring, non-survivor immigrant offspring and controls in studies measuring psychological, educational, occupational, and familial coping and interpersonal adjustment (Baron, Reznikoff, & Glenwick, 1992; Leon, Butcher, Kleinman, Goldberg, & Almagor, 1981; Rose & Garske, 1987; Rubenstein, Cutter, & Templer, 1989; Weiss, O'Connell, & Siiter, 1986). This raises the issue of the impact of immigration on the second generation and the problem of unravelling the effects of immigration from the effects of the Holocaust.