Phenomenology and Psychobiology of the Intergenerational Response to Trauma

  • Rachel Yehuda
  • Jim Schmeidler
  • Abbie Elkin
  • Skye Wilson
  • Larry Siever
  • Karen Binder-Brynes
  • Milton Wainberg
  • Dan Aferiot
Part of the The Plenum Series on Stress and Coping book series (SSSO)


The literature describing the effects of the Holocaust on offspring of survivors has developed in a parallel fashion to the literature describing the effects of the Holocaust on its survivors. Early descriptions of the “Survivor Syndrome” arose as clinicians began to realize that classical psychoanalytic views of depression, mourning, and responses to trauma did not provide an adequate framework for understanding and treating Holocaust survivors. The classic observations describing severe symptomatology, maladjustment, and impairment of functioning were made on treatment-seeking individuals, many of whom were being evaluated for compensation or reparations, who did not benefit from psychoanalytic therapy (e.g., Chodoff, 1963; Eitinger, 1961; Krystal, 1968; Neiderland, 1969).


Cortisol Level Ptsd Symptom Posttraumatic Stress Disorder Comparison Subject Trauma Survivor 
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  1. Aleksandrowicz, D. R. (1973). Children of concentration camp survivors. In E. J. Anthony & C. Koupernik (Eds.), The child in his family: Vol. 2: The impact of disease and death (pp. 385–392 ). New York: Wiley.Google Scholar
  2. Antonovsky, A. (1979). Health, stress and coping. San Francisco: Jossey-Bass.Google Scholar
  3. Antonovsky, A., Maoz, B., Dowty, N., & Wijsenbeek, B. (1971). Twenty-five years later: A limited study of the sequelae of the concentration camp experience. Social Psychiatry, 6, 186–193.CrossRefGoogle Scholar
  4. Barocas, H., & Barocas, C. (1983). Wounds of the fathers: The next generation of Holocaust victims. International Review of Psychoanalysis, 5, 331–341.Google Scholar
  5. Bernstein, E. M., & Putnam, F. W. (1986). Development, reliability, and validity of a dissociation scale. Journal of Nervous Mental Disease, 174, 727–735.CrossRefGoogle Scholar
  6. Blake, D., Weathers, F., Nagy, D., Kaloupek, G., Klauminzer, D., Charney, D., & Keane, T. (1990). A clinician rating scale for current and lifetime PTSD. Behavior Therapist, 13, 187–188.Google Scholar
  7. Carroll, B. J. (1982). The dexamethasone suppression test for melancholia. British Journal of Psychiatry, 140, 292–304.PubMedCrossRefGoogle Scholar
  8. Chodoff, P. (1963). Late effects of the concentration camp syndrome. Archives of General Psychiatry, 8, 323–333.PubMedCrossRefGoogle Scholar
  9. Danieli, Y. (1981). Differing adaptational styles in families of survivors of the Nazi Holocaust: Some implications for treatment. Children Today, 10, 6–10.PubMedGoogle Scholar
  10. Danieli, Y. (1982). Families of survivors of the Nazi Holocaust: Some short and long-term effects. In C. D. Spiel-berger, I. G. Sarason, & N. A. Milgram (Eds.), Stress and anxiety (Vol. 8, pp. 405–421 ). New York: McGrawHill/Hemisphere.Google Scholar
  11. Dimsdale, J. G. (1974). The coping behavior of Nazi concentration camp survivors. American Journal of Psychiatry, 131, 792–797.PubMedGoogle Scholar
  12. Eaton, W. W, Sigal, J. J., & Weinfeld, M. (1982). Impairment in Holocaust survivors after 33 years: Data from an unbiased community sample. American Journal of Psychiatry, 139, 773–777.Google Scholar
  13. Eitinger, L. (1961). Pathology of the concentration camp syndrome. Archives of General Psychiatry, 5, 371–380. Green, B. Trauma history questionnaire. Available from the author.Google Scholar
  14. Harel, Z., Kahana, B., & Kahana, E. (1988). Psychological well-being among Holocaust survivors and immigrants in Israel. Journal of Traumatic Stress, I, 413–429.Google Scholar
  15. Horowitz, M., Wilner, N., & Alvarez, W. (1979). Impact of event scale: A measure of subjective distress. Psychosomatic Medicine, 41, 209–218.PubMedGoogle Scholar
  16. Kahana, B., Harel, Z., & Kahana, E. (1988). Predictors of psychological well-being among survivors of the Holocaust. In J. Wilson, Z. Harel, & B. Kahana (Eds.), Human adaptation to extreme stress (pp. 171–192 ). New York: Plenum Press.Google Scholar
  17. Kahana, E., & Kahana B. (1982). The elderly care research center life events scale: Adaptation. In D. J. Mangen & W. A. Peterson (Eds.), Clinical and social psychology (vol. 1, pp. 145–193 ). Minneapolis: University of Minnesota Press.Google Scholar
  18. Kaminer, H., & Lavie, P. (1991). Sleep and dreaming in Holocaust survivors: Dramatic decrease in dream recall in well-adjusted survivors. Journal of Nervous and Mental Disease, 179, 664–670.PubMedCrossRefGoogle Scholar
  19. Keane, T. M., Caddell, J. M., & Taylor, K. L. (1991). The Civilian Mississippi PTSD Scale. Boston: National Center for Posttraumatic Stress Disorder.Google Scholar
  20. Kestenberg, J. L. (1972). Psychoanalytic contributions to the problems of children of survivors from Nazi persecution. Israel Annals of Psychiatry and Related Disciplines, 10,311–325.Google Scholar
  21. Kestenberg, J. S. (1980). Psychoanalyses of children of survivors from the Holocaust: Case presentation and assessment. Journal of the American Psychoanalytic Association, 28, 775–804.PubMedCrossRefGoogle Scholar
  22. Kinsler, F. (1981). Second generation effects of the Holocaust: The effectiveness of group therapy in the resolution of the transmission of parental trauma. Journal of Psychology and Judaism, 6, 53–66.Google Scholar
  23. Klein, H., Zellermayer, J., & Shana, J. (1963). Former concentration camp inmates on a psychiatric ward. Archives of General Psychiatry, 8, 334–342.PubMedCrossRefGoogle Scholar
  24. Krystal, H. (Ed.). (1968). Massive psychic trauma. New York: International Universities Press.Google Scholar
  25. Kuch, K., & Cox, B. J. (1992). Symptoms of PTSD in 124 survivors of the Holocaust. American Journal of Psychiatry, 149, 337–340.PubMedGoogle Scholar
  26. Last, U. (1989). The transgeneration impact of Holocaust trauma: Current state of the evidence. Institutional Journal of Mental Health, 17, 72–89.Google Scholar
  27. Last, U., & Klein, H. (1981). Impact de l’holocauste: Transmission aux enfants de vecu des parents [Impact of the Holocaust: Transmission of the parents’ experiences to their children]. L’Evolution Psychiatrique, 41, 375–388.Google Scholar
  28. Leon, G., Butcher, J. N., Kleinman, M., Goldberg, A., & Almagor, M. (1981). Survivors of the Holocaust and their children. Journal of Personality and Social Psychology, 41, 503–516.PubMedCrossRefGoogle Scholar
  29. Mason, J. W., Giller, E. L., Kosten, T. R., Ostroff, R. B., & Podd, L. (1986). Urinary free-cortisol levels in post-traumatic stress disorder patients. Journal of Nervous Mental Disease, 174, 145–159.CrossRefGoogle Scholar
  30. Munck, A., Guyre, P. M., & Holbrook, N. J. (1984). Physiological functions of glucocorticoids in stress and their relation to pharmacological actions. Endocrinological Review, 93, 9779–9783.Google Scholar
  31. Nadler, A., & Ben-Shushan, D. (1989). Forty years later: Long-term consequences of massive-traumatization as manifested by Holocaust survivors from the city and the kibbutz. Journal of Consulting and Clinical Psychology, 57, 287–293.PubMedCrossRefGoogle Scholar
  32. Niederland, W. G. (1969). The problem of the survivor. In H. Krystal (Ed.), Massive Trauma. New York: International Universities Press.Google Scholar
  33. Novas, A. (1993, May). Clinical heterogeneity in children of Holocaust survivors. Psychiatry Newsletter of the World Psychiatric Association, pp. 24–26.Google Scholar
  34. Rakoff, V (1966). A long-term effect on the concentration camp experience. Viewpoints, 1, 17–20.Google Scholar
  35. Rakoff, V., Sigal, J. J., & Epstein, N. (1976). Children and families of concentration camp survivors. Canada’s Mental Health, 14, 24–26.Google Scholar
  36. Rose, S., & Garske, J. (1987). Family environment, adjustment, and coping among children of Holocaust survivors: A comparative investigation. American Journal of Orthopsychiatry, 57, 332–344.PubMedCrossRefGoogle Scholar
  37. Rosenheck, R., & Nathan, P. (1985). Secondary traumatization in the children of Vietnam veterans with posttraumatic stress disorder. Hospital and Community Psychiatry, 36, 538–539.PubMedGoogle Scholar
  38. Rubinstein, I., Cutter, F., & Templer, D. I. (1989–1990). Multigenerational occurrence of survivor syndrome symptoms in families of Holocaust survivors. Omega, 20, 239–244.Google Scholar
  39. Sachar, E. J., Hellman, L., & Roffwarg, H. P. (1973). Disrupted 24-hour patterns of cortisol secretion in psychotic depression. Archives of General Psychiatry, 28, 19–24.PubMedCrossRefGoogle Scholar
  40. Sigal, J. J. (1976). The effects of parental exposure to prolonged stress on the mental health of the spouse and children. Canadian Psychiatric Association Journal, 21, 169–172.PubMedGoogle Scholar
  41. Sigal, J. J., & Weinfeld, G. (1985). Control of aggression in adult children of survivors of the Nazi persecution. Journal of Abnormal Psychology, 94, 556–564.PubMedCrossRefGoogle Scholar
  42. Silverman, W K. (1987). Methodological issues in the study of transgenerational effect of the Holocaust: Comment on Nadler, Kav-Venaki, and Gleitman. Journal of Consulting and Clinical Psychology, 55, 125–126.PubMedCrossRefGoogle Scholar
  43. Solkoff, N. (1992). Children of survivors of the Nazi Holocaust: A critical review of the literature. American Journal of Orthopsychiatry, 62, 342–358.PubMedCrossRefGoogle Scholar
  44. Solomon, Z., Kotler, M., & Mikulincer, M. (1988). Combat-related posttraumatic stress disorder among second-generation Holocaust survivors: Preliminary findings. American Journal of Psychiatry, 145, 865–868.PubMedGoogle Scholar
  45. Spitzer, R. L., Williams, J. B. W., & Gibbon, M. (1987). Structural Clinical Interview for DSM-III-R (SCID). New York: New York State Psychiatric Institute, Biometrics Research.Google Scholar
  46. Stokes, P. E., Stoll, P. M., Koslow, S. H., Maas, J. W, Davis, J. M., Swann, A. C., & Robins, E. (1984). Pretreatment DST and hypothalamic-pituitary-adrenocortical function in depressed patients and comparison groups. Archives of General Psychiatry, 41, 257–267.Google Scholar
  47. Trossman, B. (1968). Adolescent children of concentration camp survivors. Canadian Psychiatric Association Journal, 13, 121–123.PubMedGoogle Scholar
  48. Waldfogel, S. (1991). Physical illness in children of Holocaust survivors. General Hospital Psychiatry, 14, 267–269. Wilson, A., & Fromm, E. (1982). Aftermath of the concentration camp: The second generation. Journal of the American Academy of Psychoanalysis, 10, 289–313.Google Scholar
  49. Yehuda, R., Boisoneau, D., Lowy, M. T., & Giller, E. L., Jr. (1995a). Dose-response changes in plasma cortisol and lymphocyte glucocorticoid receptors following dexamethasone administration in combat veterans with and without posttraumatic stress disorder. Archives of General Psychiatry, 52, 583–593.PubMedCrossRefGoogle Scholar
  50. Yehuda, R., Elkin, A., Binder-Brynes, K., Kahana, B., Southwick, S. M., Schmeidler, J., Giller, E. L., Jr. (1996a). Dissociation in aging Holocaust survivors. American Journal of Psychiatry, 153, 935–940.PubMedGoogle Scholar
  51. Yehuda, R., & Giller, E. L. (1994). Comments on the lack of integration between the Holocaust and PTSD literatures. PTSD Research Quarterly, 5, 5–7.Google Scholar
  52. Yehuda, R., Giller, E. L., Southwick, S. M., Lowy, M. T., & Mason, J. W. (1991). Hypothalamic-pituitary-adrenal dysfunction in post-traumatic stress disorder. Biological Psychiatry, 30, 1031–1048.PubMedCrossRefGoogle Scholar
  53. Yehuda, R., Kahana, B., Binder-Brynes, K., Southwick, S., Zemelman, S., Mason, J. W, & Giller, E. L., Jr. (1995b). Low urinary cortisol excretion in Holocaust survivors with posttraumatic stress disorder. American Journal of Psychiatry, 152, 982–986.PubMedGoogle Scholar
  54. Yehuda, R., Kahana, B., Schmeidler, J., Southwick, S. M., Wilson, S., & Giller, E. L., Jr. (1995c). Impact of cumulative lifetime trauma and recent stress on current posttraumatic stress disorder symptoms in Holocaust survivors. American Journal of Psychiatry, 152, 1815–1818.Google Scholar
  55. Yehuda, R., Kahana, B., Southwick, S. M., Giller, E. L., Jr. (1994). Depressive features in Holocaust survivors with post-traumatic stress disorder. Journal of Traumatic Stress, 7, 699–704.PubMedCrossRefGoogle Scholar
  56. Yehuda, R., Resnick, H., Kahana, B., & Giller, E. L., Jr. (1993a). Persistent hormonal alterations following extreme stress in humans: Adaptive,r maladaptive? Psychosomatic Medicine, 55, 287–297.PubMedGoogle Scholar
  57. Yehuda, R., Southwick, S. M., Krystal, J. M., Charney, D. S., & Mason, J. W. (1993b). Enhanced suppression of cortisol following dexamethasone administration in combat veterans with posttraumatic stress disorder and major depressive disorder. American Journal of Psychiatry, 150, 83–86.PubMedGoogle Scholar
  58. Yehuda, R., Southwick, S. M., Nussbaum, G., Wahby, V, Giller, E. L., Jr., & Mason, J. W. (1990). Low urinary cortisol excretion in patients with posttraumatic stress disorder. Journal of Nervous and Mental Disease, 178, 366–369.PubMedCrossRefGoogle Scholar
  59. Yehuda, R., Teicher, M. H., Levengood, R., Trestman, R., & Siever, L. J. (1996). Circadian rhythm of cortisol regulation in PTSD. Biological Psychiatry, 40, 79–88.PubMedCrossRefGoogle Scholar
  60. Zlotogorski, Z. (1983). Offspring of concentration camp survivors: The relationship of perceptions of family cohesion and adaptability of levels of ego functioning. Comprehensive Psychiatry, 24, 345–354.PubMedCrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media New York 1998

Authors and Affiliations

  • Rachel Yehuda
    • 1
  • Jim Schmeidler
    • 1
  • Abbie Elkin
    • 1
  • Skye Wilson
    • 1
  • Larry Siever
    • 1
  • Karen Binder-Brynes
    • 1
  • Milton Wainberg
    • 1
  • Dan Aferiot
    • 1
  1. 1.Mount Sinai Traumatic Stress Studies ProgramMount Sinai School of Medicine and Bronx Veterans Affairs HospitalBronxUSA

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