Transgenerational trauma

Transgenerational trauma is the psychological and physiological effects that the trauma experienced by people has on subsequent generations in that group. The primary mode of transmission is the shared family environment of the infant causing psychological, behavioral and social changes in the individual.

Collective trauma is when psychological trauma experienced by communities and identity groups is carried on as part of the group's collective memory and shared sense of identity. For example, collective trauma was experienced by Jewish Holocaust survivors and other members of the Jewish community at the time, by the Indigenous Peoples of Canada during the Canadian Indian residential school system and by African Americans who were enslaved. When this collective trauma affects subsequent generations, it is called transgenerational trauma. For example, if Jewish people experience extreme stress or practice survivalism out of fear of another Holocaust, despite being born after the Holocaust, then they are experiencing transgenerational trauma.

Transgenerational trauma can be a collective experience that affects groups of people who share a cultural identity (e.g., ethnicity, nationality, or religious identity). It can also be applied to single families or individual parent–child dyads. For example, survivors of individual child abuse and both direct survivors of the collective trauma and members of subsequent generations individually may develop complex post-traumatic stress disorder.

Examples of this include collective trauma experienced by descendants of the Atlantic slave trade; segregation and Jim Crow laws in the United States; apartheid in South Africa; the Scramble for Africa, Armenian genocide survivors, Jewish Holocaust survivors and other members of the Jewish community at the time; by the First Peoples of Canada during the Canadian Indian residential school system; and in Australia, the Stolen Generations and other hardships inflicted on Aboriginal and Torres Strait Islander peoples. Descendants of survivors may experience extreme stress, leading to a variety of other consequences.

While transgenerational trauma made headlines in the mid-2000s, it has been met with skepticism and criticism from some scientists, particularly regarding claims of an epigenetic mechanism.^{[why?][citation needed]}

History

This field of research is relatively young, but has been expanded since the mid-2000s.^[1] Intergenerational trauma was first recognized in the children of Holocaust survivors. In 1966, psychologists began to observe large numbers of children of Holocaust survivors seeking mental help in clinics in Canada. The grandchildren of Holocaust survivors were overrepresented by 300% among the referrals to a psychiatry clinic in comparison with their representation in the general population.^[2] Since then, transgenerational trauma has been noted amongst descendants of African-Americans forced into slavery,^[3] Native American genocide survivors,^[4] war survivors,^[5] refugees,^[6] survivors of domestic violence,^[7] and many other groups that have experienced collective distress.

Research on possible biological mechanisms for inheritance of trauma began in the late 1990s.^[8] It has been suggested that traumatic stress can be passed down to future generations via epigenetics.^[9] However, the effect is difficult to separate from environmental and cultural transmission and conclusive evidence that it occurs in humans has yet to be found.^{[8][10][11][12]}

Although methylation of stress-related genes in humans may affect development,^[13] there is no evidence that these changes in humans are passed on to subsequent generations.^[14][15][16] Methylation is normally erased when an egg cell is fertilized.^[17]

Definitions and description

Transgenerational trauma is a collective experience that affects groups of people because of their cultural identity (e.g., ethnicity, nationality, or religious identity).^[18] Because of its collective nature, the term is not usually applied to single families or individual parent–child dyads. However, like survivors of individual child abuse, individually, both direct survivors of the collective trauma and members of subsequent generations may develop complex post-traumatic stress disorder.^[19]

Trauma may be transmitted socially (e.g., through learned behaviors) or through the effects of stress on development before birth (inc. increased smoking/alcohol use).

Historical trauma

Historical trauma, a sub-type of transgenerational trauma, is the collective devastation of the past that continues to affect populations in the present through inter-generational transmission. Historical trauma results in vulnerability to mental and physical health problems due to ancestral suffering which has been collected throughout generations into "legacies of disability for contemporary descendants".^[20] Although the actual traumatic event and affect group(s) are heterogeneous, all historical traumas consist of three elements: a traumatic event, a resulting collective suffering, and a multigenerational impact of that trauma. Over time the trauma and relationship to the victims typically evolve in a similar but more complicated way to genetic anticipation, resulting in a greater loss of identity of the victims and further integration into society.

For individual victims, historical trauma often manifests in four ways: depression, hyper-vigilance, traumatic bond formation, and reenactment of the trauma. Building upon the clinical observations by Selma Fraiberg, child trauma researchers such as Byron Egeland, Inge Bretherton, and Daniel Schechter have empirically identified psychological mechanisms that favor intergenerational transmission, including dissociation in the context of attachment, and "communication"^{[clarification needed]} of prior traumatic experience as an effect of parental efforts to maintain self-regulation in the context of post-traumatic stress disorder and related alterations in social cognitive processes.^{[21][22][23][24][25]}

Symptoms

Symptoms of intergenerational trauma always begins with the survivor of a trauma, which tend to manifest as symptoms of PTSD. Oftentimes trauma in the second generation is deemed as a traumatic response to parental trauma.^[26] Transmission between the parent and child can be broken down into five measures: communication, conflict, family cohesion, parental warmth, and parental involvement.^[27] High levels of maternal stress were directly correlated with weak family functioning and indirectly correlated with deviant behavior among children. Common symptoms in children consisted of depression, antisocial behavior, delinquency, and disruptive behavior in school.^[28] Some children experienced direct transmission in which their trauma stemmed from the interactions and relationships with their parents, while others experienced indirect transmission in which their trauma was mainly rooted in guilt. Those who were affected through direct transmission were more likely to lash out through their actions, while those who were affected through indirect transmission were more likely to develop depression, anxiety, and guilt.^[29]

Symptoms also differed based on ethnicity and type of original trauma. Enslavement, genocide, domestic violence, sexual abuse, and extreme poverty are all common sources of trauma that lead to intergenerational trauma. A lack of therapy also worsens symptoms and can lead to transmission. For instance, survivors of child sexual abuse may negatively influence future generations due to their past unresolved trauma. This can lead to increased feelings of mistrust, isolation, and loneliness.^[30] Descendants of enslaved persons when faced with racism-motivated violence, microaggressions, or outward racism, react as if they were faced with the original trauma that was generationally transmitted to them. There are a variety of stressors in one's life that led to this PTSD-like reaction such as varying racist experiences, daily stressors, major race-related life events, or collective racism or traumas.^[31] This also presents itself in parenting styles. Goodman and West-Olatunji proposed potential transgenerational trauma in the aftermath of natural disasters.^[32] In a post-Hurricane Katrina New Orleans, residents have seen a dramatic increase in interpersonal violence with higher mortality rates.^[33] This phenomenon has been also been reported in the descendants of Indigenous students at residential schools, who were removed from their parents and extended family and lacked models for parenting as a result. Being punished for speaking their native language and forbidden from practicing traditional rituals had a traumatic effect on many students, and child abuse was rampant in the schools as well.^{[34][35][36][37]}

Symptoms of transgenerational trauma have in recent years been identified among black Americans, in relation to the effects of slavery and racial discrimination. This passing of trauma can be rooted from the family unit itself, or found in society via current discrimination and oppression.^[38] The traumatic event does not need to be individually experienced by all members of a family; the lasting effects can still remain and impact descendants from external factors. For example, black children's internalization of others' reactions to their skin color manifests as a form of lasting trauma originally experienced by their ancestors.^[39][40] This reaction to black skin stems from similar attitudes that led to the traumatizing conditions and enslavement of slaves. Black children and youth are more susceptible to racial trauma because they have not yet acquired the knowledge to have a full understanding of racism and its effects. However, these traumatizing behaviors experienced at such a young age are a reflection of a child's parenting. A White child may learn racist behaviors from their environment, but by the same token a black child can learn to assert their blackness and how to respond to racist remarks and actions from their parents.^[41] Traces of trauma have an impact on black and other minority children's success in an educational context. Transgenerational trauma has also been heavily recorded in refugees and their children, which can last through several generations. Such traumas can stem from violence, political persecution, familial instability, as well as the hardships of migration.^[6]

Affected groups

Descendants of enslaved people

In general, black Americans who have any mental illness are resistant to receiving treatment due to stigma, negative conceptions, and fear of discrimination. This reduces the number of those affected to seek help.^[42] Lack of treatment causes the symptoms to compound leading to further internalization of distress and a worsening of mental health in the individual.^[43] Those affected by race-based trauma oftentimes do not seek treatment not only because of stigma but because of fear that the medical professional will not understand their perspective of a disenfranchised minority. Furthermore, the existing stigma of mental health has led to a lack of research and consequently treatment. However, lack of treatment can also be attributed to the misdiagnosis of symptoms. Signs of trauma exhibited in black children are often labeled as behavioral or educational disabilities, allowing the trauma to go untreated. While trauma symptoms often manifest as other mental illnesses such as depression and anxiety, the larger diagnosis often goes untreated.^[44]

Koreans

Main article: Han (cultural)

Han is a concept of an emotion, variously described as some form of grief or resentment, among others, that is said to be an essential element of Korean identity by some, and a modern post-colonial identity by others.^[45]

Michael D. Shin argues that the central aspect of han is loss of identity, and defines han as "the complex of emotions that result from the traumatic loss of collective identity". Han is most commonly associated with divided families: families who were separated during the Korean War. According to Shin, all Koreans may experience han, or a "constant feeling of being less than whole", because of not having a collective identity as a result of the continued division of Korea. Furthermore, new generations of Koreans seemingly inherit it because of growing up in a divided country.^[46]

Refugees

Refugees are often at risk of experiencing transgenerational trauma.^[47] While many refugees experience some sort of loss and trauma, war-related trauma has been documented to have longer-lasting effects on mental health and span through more generations.^[6] Children are especially prone to the trauma of resettling, as their childhood may have been disrupted by migration to a new country. Additionally, they often face the difficulty of learning a new language, adapting to a new environment, and navigating the school's social system in their host country. Normal caregiving is disrupted by the process of fleeing from their original home, and it may continue to be disrupted by their parents' PTSD symptoms and challenges faced in their new home.^[47] Furthermore, many host countries do not provide adequate mental healthcare systems to refugees, which can worsen symptoms and lead to transmission of trauma.^[48] In general, children of refugees exhibited higher overall levels of depression, PTSD, anxiety, attention deficiency, stress, and other psychological issues.^[6] Most refugees who flee from their homes do so to escape war, conflict, or natural disasters.^[49] More often times than not the wellness of refugees' homeland does not improve which causes continuous exposure to the originating trauma.^[50] This can be described as secondhand trauma and can be experienced by many.^[51] However, the offspring who have both transgenerational trauma and intergenerational trauma may experience secondhand trauma and a greater scale.^[51]

Vietnam war refugees

Since 1975, the US has accepted many refugees from Vietnam, Cambodia, Thailand, and Laos. As a result of the Vietnam War, many of these Southeast Asian refugees are at high risk of experiencing transgenerational trauma. Factors occurring both before and after immigration to America could contribute to traumatization in these groups. Being forced to witness and flee violence and war was a uniquely traumatic occurrence, resulting in high levels of psychological distress.^[52] Upon arriving in the United States, Vietnamese Americans struggled to adapt to their new environment, resulting in limited social mobility, high rates of poverty within the community, and exposure to community violence. Exposure to these stressors is correlated with higher trauma symptoms in first-generation Vietnamese-American refugees.^[53] In turn, these traumatic experiences impacted the ways that refugees raised their children since they internalized notions of being outsiders in a new country and emphasized success in the face of their many sacrifices. This cultural and familial transmission of trauma has led second-generation Vietnamese Americans to face their own forms of intergenerational trauma. These unique forms of mental health and stress are often not addressed due to socio-cultural standards of silence and refusal to seek treatment.^[54]

While a majority of these groups were fleeing war and poverty, Cambodian refugees were also fleeing a genocide from the Khmer Rouge. The atrocities of violence, starvation, and torture were common themes experienced by these refugees.^[55] Many Cambodian refugee families refused to talk about their trauma which created an isolating environment for the child. This led to a transmission of trauma through the continuing pattern of silence and refusal to acknowledge an issue or seek treatment.^[56] There has also been data showing that the children of survivors from regions with higher rates of violence and mortality displayed stronger overall symptoms.^[55] The parenting style of caregivers may also contribute to the rate of impact among children of Khmer Rouge survivors. A 2013 study found that among Khmer Rouge survivors with PTSD who engage in role-reversal parenting, a form of parenting where the parent looks to the child for emotional support, there may be higher rates of anxiety and depression in the children.^[57]

Indigenous Australians

Many Aboriginal Australian and Torres Strait Islander children were forcibly removed from their parents and placed in Aboriginal reserves and missions in the late 19th and first half of the 20th century. Some were subsequently placed with white families, and this practice continued after people were no longer forcibly removed to reserves. These people became known as the Stolen Generations, and successive generations suffer from intergenerational trauma as a result of this as well as other issues related to the colonisation of Australia, such as dispossession of land, loss of language, etc.^[58] Many Aboriginal Australians often face discrimination and resistance when trying to access many services including legal, health, housing, and education.^[59] It was found that in 2019, 28% of the total prison population consisted of Aboriginal Australians and Torres Strait Islanders.^[59] As of 2022, this percentage has increased to 32% of all prisoners.^[60] A study consisting of 43 Aboriginal women found that Aboriginal women often face more struggles when incarcerated compared to their peers.^[59] With these struggles Aboriginal Australians face, the trauma is often passed down to their offspring as they are on the receiving end of the discrimination, often are targeted themselves as children, or grow up to face similar of not the same struggles as their family members.^[59]

Native/Indigenous Peoples of the Americas

Settler-colonization encompasses a wide range of practices: war, displacement, forced labor, removal of children, relocation, destruction, massacre, genocide, slavery, unintentional and intentional spread of deadly diseases, banning of indigenous language, regulation of marriage, assimilation, eradication of culture, social and spiritual practices. European colonization has, in some instances, involved subjugation of the indigenous peoples of the Americas through violence, ethnic cleansing, forced assimilation, and acculturation.^[20] Indian reservations, and harmful policies excluding and oppressing Natives evoked similar responses to trauma as the descendants of Holocaust survivors. In a similar way we find transgenerational trauma in Holocaust survivors we find the same patterns and effects in Indigenous populations and their children and grandchildren.^[61]

Due to the effects of settler colonialism, oppression, racism, and other aversive events, Native Americans disproportionately experience adverse childhood experiences as well as health disparities, including high rates of posttraumatic stress, depression, substance abuse, diabetes, and other psychiatric disorders.

Military personnel and their families

Transgenerational trauma is also commonly known as secondary trauma due to the transmission of symptoms that can take place between individuals in close proximity (i.e., children, spouses/partners, and other family members).^[62] Transgenerational trauma affects everyone, including those in the military and their families.^[63] Patterns of transgenerational trauma can be recognized through the use of a genogram, a family tree that provides a visual representation of hereditary patterns. Specifically, a trauma-focused genogram can be used with those who suffer from acute stress disorder (ASD) and posttraumatic stress disorder (PTSD).^[64] Traumatic family patterns could include things such as sexual abuse, domestic violence, and even things such as natural disasters. This type of genogram is inclusive to military personnel in that it takes into consideration the servicemembers' experiences. Some of these considerations include taking into account how long the servicemember served, what their role was, if they were a prisoner of war and if they witnessed the death or injury of others.^[64] However, not all military personnel pass down intergenerational trauma.^[65]

Military personnel who have seen or participated in abusive acts of violence have been found to transmit the trauma they experienced to their children.^[66] Children of these veterans have been found to suffer from behavioral disturbances such as aggression, hyperactivity, and delinquency.^[66] Children whose parent was diagnosed with PTSD had a higher rate of anxiety as well as aggression when compared to children of civilians or non-veterans.^[67] These children can also have increased depressive symptoms and other PTSD symptoms.^[68] However, it has been found that spouses and partners of military veterans can help to buffer the effects of the transmission of trauma symptomology.^[69]

This type of intergenerational trauma can be experienced and transmitted not only to children of veterans but also to their spouses/partners, ultimately affecting the whole family unit. Veterans who experienced PTSD or wartime combat stress reaction (CSR) had spouses/partners who experienced increased psychiatric symptoms.^[70] These symptoms included feelings of loneliness and having impaired relationships within the family unit and marriage.^[70] Much like veterans who suffer from PTSD, their spouses or partners can suffer from many of the same symptoms as well. Spouses or partners of military veterans can experience the avoidance of thoughts, behaviors, and emotions. Spouses or partners may also experience intrusions such as unwanted cognitions and images that may remind them of the negative experiences of their spouse or partner. Common symptoms of emotional distress that spouses may experience are depression and anxiety.^[68] These symptoms are intergenerational trauma symptoms that are being passed down from the veteran to the spouse.

Intergenerational trauma can sometimes go unrecognized by the spouse or partner suffering from the transmission of trauma. It sometimes can be difficult for those suffering from intergenerational trauma to recognize that they are emotionally affected, and thus difficult for these individuals to find treatment.^[71] Resources such as a genogram can be an excellent way in which an individual can recognize the trauma that has been passed down to them.^[64]

When it comes to transgenerational trauma, it can be transmitted quite quickly and can affect many people in which the servicemember has encountered.^[72] This also includes mental health workers and primary care physicians with whom the servicemember may be working. Mental health workers and primary care physicians asked to take a survey entitled “Secondary Traumatic Stress Scale” reported that they had trouble sleeping, feeling emotionally numb, and having intrusive thoughts about clients.^[72]

Treatment

Mental health workers who are considering working with veterans who suffer from PTSD and other traumatic experiences should have experience working with veterans and servicemembers.^[63] Cultural sensitivity is another aspect to consider when working with this population. Understanding the military culture and lifestyle is informative when developing the therapeutic relationship and treatment plans. Another cultural consideration is the family component. This can include the servicemember's actual family or their chosen family.^[63] The military can bring on a lot of stress when it comes to the servicemember and his family. These include, moving to different places on short notice, deployment plans constantly changing, difficulty transitioning when coming back from deployment, and many other stressors. Therefore, it is crucial that a mental health worker truly understands military life.

In the case of PTSD, in order to prevent or minimize intergenerational trauma, it is important that the family also seek mental health services.^[73] A spouse/partner who is receiving mental health services and is at a better place in their life because of these interventions can help the family unit overall.^[73] In a military family, the roles are constantly changing due to the servicemember being on deployment and other factors. The family, as a unit, needs to adjust to the servicemember coming into and out of their lives. With a healthy family unit, the spouse/partner becomes a predicting factor of soldier retention and a functioning family unit.^[73] Resiliency can also play a role in this dynamic. A few things can contribute to resiliency in a family unit. These include flexibility/organizational style, the family's belief system, and the communication process.^[74] These are important things to look for and identify as they can help in the treatment of intergenerational trauma. Making the family unit strong can help to empower each individual member of the family, and together they can overcome intergenerational trauma within the family. Understanding military culture can help aid families through the process of overcoming intergenerational trauma.

In addition to the genograms, solution-focused brief therapy (SFBT) has been found to be successful with military families.^[63] It uses an emphasis on the client's successes and creating small steps that are attainable for the client. This type of therapy uses the client's language and experience to address things systematically within the family.^[63] SFBT, together with the genograms, can be informative to both the client and clinician and can help to inform the future of practice. As the genograms can help to give a clear picture as to what the trauma patterns are in the family, SFBT can help to change these patterns and provide the family with a healthier way of living and functioning. This specific type of therapy can help to educate the client and their family as to what exactly has been passed down from previous generations. It can also inform the family as to what is now beginning to be transmitted and can help to change the trajectory in the future and change the family dynamic principles.

Transmission

There are many current transgenerational studies that have been done on adults that have experienced natural disasters or adversities. One study found that the children of torture victims showed more symptoms of anxiety, depression, post-traumatic stress, attention deficits, and behavioral disorders than the comparison group of those who had not experienced the specific trauma.^[75] A qualitative study was done on the Brazilian children of Holocaust survivors and proposed a supported model of the transgenerational transmission of traumatic experiences but also one of resilience patterns, which can be transmitted in between generations and developed within generations.^[76] According to Froma Walsh, resilience theory suggests that individuals' and families' responses to traumatic experiences is an ever-changing process that involves both exposure to challenges and the development of coping mechanisms that aide in one's ability to overcome such challenges.^[77] Regardless of risk, there are also opportunities for the development of resilience via exposure to meaningful resources that support one's ability to overcome adversity.^[78] The researchers Cowan, Callaghan, and Richardson studied the impact of early-life adversities on individuals and their descendants. Their research was also consistent with the transmission theory in which their findings revealed that the stress phenotype that was expressed in individuals who experienced the adversity was also observed in children and even grandchildren.^[79]

The oppression that black people experienced through slavery and racism has a psychological impact on how they view achievement.^[80] In terms of the social aspects, that seems to make it difficult for black people to surpass a certain socioeconomic status threshold, escape a certain neighborhood, or move beyond a certain lifestyle or status.^[81]

For Native Americans, past government policy and internal displacements are theorized to have an effect even generations later.^[82] The social enforcement of their ostracization causes them to be generally removed from society, to be powerless and uninvited in government, and to be left to fend for themselves.^[36] The transgenerational transmission of colonial trauma is also considered a contributing factor in the high rates of mental health difficulties that Native Canadian communities experience. Displacement and maltreatment during colonization had led to negative effects in the children of those who survived such experiences. This is passed down generationally via ongoing social marginalization and lateral violence. The loss of cultures and resulting lack of community cohesion poses a further challenge for groups in resolving transgenerational trauma.^[83]

The fetal environment is influenced by the maternal diet. This environmental history can cause the fetal developmental response to change to produce a metabolic phenotype that suits the anticipated environment.^[84]

It has been suggested that a mother's mood may influence the fetus, though studies on this have mixed results.^[85] It is unclear whether any of the effects persist after birth.

Treatment

Because transgenerational trauma is a form of indirect traumatic exposure, it often goes unrecognized or is misdiagnosed by clinicians.^[86] A lack of treatment accessibility can have several consequences such as health, behavioral, and social issues that may persist across an individual's lifespan.^[87]

The experience of traumatic stress can modify cognitive, behavioral, and physiological functions, which can increase susceptibility to both mental and physical health issues.^[88] Because transgenerational trauma is a form of traumatic stress, it can increase risk for developing psychological disorders such as post-traumatic stress disorder, major depressive disorder, generalized anxiety disorder, schizophrenia, autism, and substance use disorders.^[89]

Several therapy modalities have been found to be effective in treating various trauma and stress disorders, such as cognitive behavioral therapy, cognitive processing therapy, prolonged exposure, compassion focused therapy, dialectical behavior therapy, and narrative therapy.^{[90][91][92][93][94][95][96][97][98]} Each of these therapies share similar components that are useful in addressing trauma, such as psychoeducation, emotion regulation and processing, cognitive processing and reconstruction, and trauma processing. Given that transgenerational trauma is a unique form of traumatic exposure, such therapy modalities can be effective in reducing its negative long-term effects. However, there are specific components of transgenerational trauma that must be addressed directly despite the modality of therapy chosen. Because the attachment relationship between parent or caregiver and child is a dominant mechanism through which transgenerational trauma is transmitted, treatment should focus on the importance familial and interpersonal patterns relative to the client, and utilize attachment-focused interventions.^[99][86]

Effective treatment for those experiencing transgenerational trauma also focuses on exploring, developing, and maintaining protective factors that can reduce the negative impact of transgenerational trauma.^[99] Some protective factors include fostering secure attachment between parent and child, as well as having access to several sources of support (i.e., family, peers, community).^[99] One treatment model that places focus on the parent-child relationship is the Intergenerational Trauma Treatment Model (ITTM).^[100] The model incorporates several features from existing empirically supported methods of treatment, such as trauma exposure, cognitive processing and reframing, stress management, and parent education.^[100] ITTM gives specific attention to the intergenerational nature of traumatic experiences and targets the parent's or caregiver's ability to respond to a child's traumatic experiences.^[100] Fostering secure attachment and a supportive home environment can mitigate the potential negative impact of transgenerational trauma.^[99][86]

Other less conventional modalities of therapy have also been found useful in addressing the negative impact of transgenerational trauma. Music therapy has been found to be an effective form of treatment for those who have witnessed or experienced a traumatic event.^[101][102] For example, music therapy has been successfully implemented with military personnel, traumatized refugees, and Holocaust survivors.^{[101][102][103]} Specifically, analytic music therapy (AMT) was found to be effective in facilitating a degree of healing through self-exploration that mitigates the negative impact of transgenerational trauma.^[103] Trauma healing stories have been suggested as a form of therapy.^[104]

Outside the treatment modalities described, several tools and techniques were also found to be helpful in bringing awareness to the effects of transgenerational trauma, as well as decreasing its psychological impact. For example, the Transgenerational Script Questionnaire (TSQ) has been used to compliment psychotherapy sessions as a means of helping to develop consciousness of both the internal and external family system.^[105][106] The TSQ targets transgenerational scripts, which are unconscious systemic patterns that persist in families and groups, and are perpetuated through emotions, beliefs, and behaviors.^[106] These scripts are then used to explore a client's implicit and explicit perceptions about their family dynamic and system.^[105] In using the TSQ, the clinician can guide the client to separate their ancestors' experiences from their own. In more complex cases of intergenerational trauma, the Transgenerational Trauma and Resilience Genogram (TTRG) can help guide clinicians to better understand and assess the impact of such trauma.^[107] The TTRG targets the various components that contribute to the maintenance of transgenerational trauma by implementing an ecosystemic view of trauma, as well as attention to specific sociopolitical concerns. The TTRG maps out the family unit, marking those who have experienced trauma and their experience, as well as relationships between individuals, and patterns of functioning.^[107] This process allows for clinicians to better assess the origins and maintaining factors of an individual's experience of transgenerational trauma, which ultimately contributes to a more comprehensive conceptualization of treatment.

In conceptualizing treatment for individuals experiencing transgenerational trauma, it is critical to take into account the ways in which various cultural factors impact how different treatments may be received or perceived. Although the mechanisms through which transgenerational trauma are consistent across cultures, there are variations in the degree of salience regarding sociocultural factors that may exacerbate the effects of transgenerational trauma in different marginalized communities.^[108][109] Additionally, therapists must incorporate a culturally responsive perspective to whichever modality of therapy they chose to implement. It is imperative for therapists to focus on establishing a concrete basis of trust and safety within the therapeutic relationship, as several minoritized groups who have transgenerational trauma may have developed significant mistrust within interpersonal interactions, as well as mistrust of larger organizations or institutions.^[86]

Criticism of inherited trauma via epigenetics

One proposed model suggests that an parents trauma could be inherited through an epigenetic biological mechanism. Although the idea has been widely touted in the media, it is not supported by robust evidence.^[110]

Research in rodents suggests that epigenetic changes can be observed in genes associated with the hypothalamic-pituitary-adrenal (HPA) axis, which coordinates the body's stress response system.^{[111][112][17]} Non-heritable stress-related epigenetic changes have also been studied in monkeys.^[113] However, most epigenetic effects are not transmitted to the next generation, and most transfer of information across generations does not involve epigenetic inheritance.^[114]

According to geneticist Kevin Mitchell, "these are, in fact, extraordinary claims, and they are being advanced on less than ordinary evidence." He says "This is a malady in modern science: the more extraordinary and sensational and apparently revolutionary the claim, the lower the bar for the evidence on which it is based, when the opposite should be true."^[110] Mitchell adds that many have looked at it as a "get out of genetics free card" and adds, "I think people don't like the idea, some people anyway, that we are born with certain predispositions that are hard to change." He says that experiences are expressed through changes in human neuroanatomy, not patterns of gene expression and says that scientists in this area have contributed to the misleading research in this area: "There is a hype industry around science, which I think is corrosive. And I think scientists are willing participants in it in a way that I find more and more distasteful the older I get, because it does a massive disservice cumulatively to how science is understood by the general public because we have this constant hype."^[16]

The biologist Ewan Birney specifically criticized a paper which used a sample size of 32 people to back its claim that children of Holocaust survivors showed evidence of inherited stress.^[115] He argues that the mechanism for epigenetic inheritance in humans remains elusive due to the many other influencing factors including "complex societal forces that persist over time", and the fact that human developing females already have all their eggs as a foetus in the womb, and lastly that throughout one individual's life epigenetic influences remain so influential that "epigenetic cell memory" is what cause our genetically identical cells to differentiate into their specific forms. Further, even in mice, where these confounding influences can be controlled, "true trans-generational epigenetic inheritance is extremely rare."^[14]

See also

• American Indian boarding schools
• Intergenerationality
• National memory
• Post Traumatic Slave Syndrome
• Seasoning (slavery)
• Slave health on plantations in the United States
• Slavery hypertension hypothesis
• Transgenerational epigenetic inheritance
• Weathering hypothesis

References

1. Dekel R, Goldblatt H (July 2008). "Is there intergenerational transmission of trauma? The case of combat veterans' children". The American Journal of Orthopsychiatry. 78 (3): 281–289. doi:10.1037/a0013955. PMID 19123747. S2CID 12737543.
2. Fossion P, Rejas MC, Servais L, Pelc I, Hirsch S (2003). "Family approach with grandchildren of Holocaust survivors". American Journal of Psychotherapy. 57 (4): 519–527. doi:10.1176/appi.psychotherapy.2003.57.4.519. PMID 14735877.
3. Leary JG (2005). Post traumatic slave syndrome: America's legacy of enduring injury and healing. Portland, OR. ISBN 0-9852172-0-0. OCLC 810135371.{{cite book}}: CS1 maint: location missing publisher (link)^{[page needed]}
4. Substance Abuse and Mental Health Services Administration. "Understanding Historical Trauma When Responding to an Event in Indian Country" (PDF). Samhsa.gov.
5. Castro-Vale I, Severo M, Carvalho D, Mota-Cardoso R (2019-08-09). "Intergenerational transmission of war-related trauma assessed 40 years after exposure". Annals of General Psychiatry. 18 (1): 14. doi:10.1186/s12991-019-0238-2. PMC 6688296. PMID 31413722.
6. Sangalang CC, Vang C (June 2017). "Intergenerational Trauma in Refugee Families: A Systematic Review". Journal of Immigrant and Minority Health. 19 (3): 745–754. doi:10.1007/s10903-016-0499-7. PMC 5362358. PMID 27659490.
7. Pears KC, Capaldi DM (November 2001). "Intergenerational transmission of abuse: a two-generational prospective study of an at-risk sample". Child Abuse & Neglect. 25 (11): 1439–1461. doi:10.1016/S0145-2134(01)00286-1. PMID 11766010.
8. Yehuda R, Lehrner A (October 2018). "Intergenerational transmission of trauma effects: putative role of epigenetic mechanisms". World Psychiatry. 17 (3): 243–257. doi:10.1002/wps.20568. PMC 6127768. PMID 30192087.
9. Jawaid A, Roszkowski M, Mansuy IM (2018). "Transgenerational Epigenetics of Traumatic Stress". Progress in Molecular Biology and Translational Science. 158: 273–298. doi:10.1016/bs.pmbts.2018.03.003. ISBN 9780128125922. PMID 30072057.
10. "Can Trauma Be Passed Down From One Generation to the Next?". Psycom.net - Mental Health Treatment Resource Since 1996. Retrieved 2021-03-22.
11. Horsthemke B (July 2018). "A critical view on transgenerational epigenetic inheritance in humans". Nature Communications. 9 (1): 2973. Bibcode:2018NatCo...9.2973H. doi:10.1038/s41467-018-05445-5. PMC 6065375. PMID 30061690.
12. Heard E, Martienssen RA (March 2014). "Transgenerational epigenetic inheritance: myths and mechanisms". Cell. 157 (1): 95–109. doi:10.1016/j.cell.2014.02.045. PMC 4020004. PMID 24679529.
13. Peng H, Zhu Y, Strachan E, Fowler E, Bacus T, Roy-Byrne P, et al. (September 2018). "Childhood Trauma, DNA Methylation of Stress-Related Genes, and Depression: Findings From Two Monozygotic Twin Studies". Psychosomatic Medicine. 80 (7): 599–608. doi:10.1097/PSY.0000000000000604. PMC 6113110. PMID 29781947.
14. Birney E (2015-09-11). "Why I'm sceptical about the idea of genetically inherited trauma". The Guardian. Retrieved 2020-09-06.
15. Carey B (2020-08-30). "Can We Really Inherit Trauma?". The New York Times.
16. McKenna C (April 2020). "Kevin Mitchell". BJPsych Bulletin. 44 (2): 81–83. doi:10.1192/bjb.2020.18. PMC 7283122. PMID 33858525.
17. Stenz L, Schechter DS, Serpa SR, Paoloni-Giacobino A (December 2018). "Intergenerational Transmission of DNA Methylation Signatures Associated with Early Life Stress". Current Genomics. 19 (8): 665–675. doi:10.2174/1389202919666171229145656. PMC 6225454. PMID 30532646.
18. Kolahdooz F, Nader F, Yi KJ, Sharma S (2015-07-16). "Understanding the social determinants of health among Indigenous Canadians: priorities for health promotion policies and actions". Global Health Action. 8: 27968. doi:10.3402/gha.v8.27968. PMC 4506643. PMID 26187697.
19. DeAngelis, Tori (February 2019). "The Legacy of Trauma". www.apa.org. Retrieved 2023-03-16.
20. Gone, Joseph (2014). Colonial Genocide in Indigenous North America. Duke University Press. pp. 273–291. ISBN 9780822376149.
21. Fraiberg S, Adelson E, Shapiro V (1975). "Ghosts in the nursery. A psychoanalytic approach to the problems of impaired infant-mother relationships". Journal of the American Academy of Child Psychiatry. 14 (3): 387–421. doi:10.1016/s0002-7138(09)61442-4. PMID 1141566.
22. Egeland B, Susman-Stillman A (November 1996). "Dissociation as a mediator of child abuse across generations". Child Abuse & Neglect. 20 (11): 1123–1132. doi:10.1016/0145-2134(96)00102-0. PMID 8958463.
23. Bretherton I (1990). "Communication patterns, internal working models, and the intergenerational transmission of attachment relationships". Infant Mental Health Journal. 11 (3): 237–251. doi:10.1002/1097-0355(199023)11:3<237::AID-IMHJ2280110306>3.0.CO;2-X.
24. Schechter DS (September 2003). "Intergenerational communication of maternal violent trauma: Understanding the interplay of reflective functioning and posttraumatic psychopathology.". In Coates SW, Rosenthal JL, Schechter DS (eds.). Trauma and Human Bonds. Hillside, NJ: Analytic Press, Inc. pp. 115–142.
25. Schechter DS, Zygmunt A, Coates SW, Davies M, Trabka K, McCaw J, et al. (September 2007). "Caregiver traumatization adversely impacts young children's mental representations on the MacArthur Story Stem Battery". Attachment & Human Development. 9 (3): 187–205. doi:10.1080/14616730701453762. PMC 2078523. PMID 18007959.
26. Weinberg MK, Cummins RA (2013-04-01). "Intergenerational Effects of the Holocaust: Subjective Well-Being in the Offspring of Survivors". Journal of Intergenerational Relationships. 11 (2): 148–161. doi:10.1080/15350770.2013.782745. S2CID 144450498.
27. Harachi TW, Choi Y, Abbott RD, Catalano RF, Bliesner SL (December 2006). "Examining equivalence of concepts and measures in diverse samples". Prevention Science. 7 (4): 359–368. doi:10.1007/s11121-006-0039-0. PMC 3293252. PMID 16845592.
28. Sangalang CC, Jager J, Harachi TW (July 2017). "Effects of maternal traumatic distress on family functioning and child mental health: An examination of Southeast Asian refugee families in the U.S". Social Science & Medicine. 184: 178–186. doi:10.1016/j.socscimed.2017.04.032. PMID 28515007. S2CID 13943373.
29. O'Neill L, Fraser T, Kitchenham A, McDonald V (June 2018). "Hidden Burdens: a Review of Intergenerational, Historical and Complex Trauma, Implications for Indigenous Families". Journal of Child & Adolescent Trauma. 11 (2): 173–186. doi:10.1007/s40653-016-0117-9. PMC 7163829. PMID 32318148.
30. Frazier K, West-Olatunji C, St Juste S, Goodman R (2009). "Transgenerational Trauma and Child Sexual Abuse: Reconceptualizing Cases Involving Young Survivors of CSA". Journal of Mental Health Counseling. 31 (1): 22–33. doi:10.17744/mehc.31.1.u72580m253524811.
31. Harrell SP (January 2000). "A multidimensional conceptualization of racism-related stress: implications for the well-being of people of color". The American Journal of Orthopsychiatry. 70 (1): 42–57. doi:10.1037/h0087722. PMID 10702849.
32. Goodman R, West-Olatunji C (2008). "Transgenerational Trauma and Resilience: Improving Mental Health Counseling for Survivors of Hurricane Katrina". Journal of Mental Health Counseling. 30 (2): 121–136. doi:10.17744/mehc.30.2.q52260n242204r84.
33. Franks J (2007-08-29). "Slow recovery goes on in crime-wear New Orleans". Reuters. Retrieved 22 September 2018.
34. Haag AM (2007). "The Indian Boarding School Era and Its Continuing Impact on Tribal Families and the Provision of Government Services". Tulsa L. Rev. 43: 149.
35. Brave Heart MY, DeBruyn LM (1998). "The American Indian Holocaust: healing historical unresolved grief" (PDF). American Indian and Alaska Native Mental Health Research. 8 (2): 56–78. PMID 9842066.
36. Brown-Rice K (2013). Examining the Theory of Historical Trauma Among Native Americans (PDF). The Professional Counselor. pp. 117–130.
37. Rotondaro V (1 September 2015). "Boarding schools: A black hole of Native American history". National Catholic Reporter. Retrieved 6 April 2017.
38. Gump JP (January 2010). "Reality Matters: The Shadow of Trauma on African American Subjectivity". Psychoanalytic Psychology. 27 (1): 48. doi:10.1037/a0018639.
39. Akhtar S (2012). The African American Experience Psychoanalytic Perspectives. Jason Aronson. p. 291.
40. Bonnovitz J (2012). White Analysts Seeing black Patients, The African American Experience Psychoanalytic Perspectives. Jason Aronson. p. 285.
41. Jernigan MM, Daniel JH (April 2011). "Racial trauma in the lives of black children and adolescents: Challenges and clinical implications". Journal of Child & Adolescent Trauma. 4 (2): 123–41. doi:10.1080/19361521.2011.574678. S2CID 145288431.
42. Williams MT, Malcoun E, Sawyer BA, Davis DM, Nouri LB, Bruce SL (June 2014). "Cultural adaptations of prolonged exposure therapy for treatment and prevention of posttraumatic stress disorder in african americans". Behavioral Sciences. 4 (2): 102–124. doi:10.3390/bs4020102. PMC 4219246. PMID 25379272.
43. Coleman JA (July 2016). "Racial Differences in Posttraumatic Stress Disorder in Military Personnel: Intergenerational Transmission of Trauma as a Theoretical Lens". Journal of Aggression, Maltreatment & Trauma. 25 (6): 564–565. doi:10.1080/10926771.2016.1157842. S2CID 148220622.
44. Goodman RD, West-Olatunji C (2010). "Educational hegemony, traumatic stress, and african american and latino american students". Journal of Multicultural Counseling and Development. 38 (3): 176–178. doi:10.1002/j.2161-1912.2010.tb00125.x.
45. Pilzer 2016, p. 171. sfn error: no target: CITEREFPilzer2016 (help)
46. Shin MD. "A Brief History of Han". The Korea Society. Retrieved 20 May 2020.
47. Dalgaard, Nina Thorup; Thøgersen, Marie Høgh; Riber, Karin (2020-08-06), De Haene, Lucia; Rousseau, Cécile (eds.), "Transgenerational Trauma Transmission in Refugee Families: The Role of Traumatic Suffering, Attachment Representations, and Parental Caregiving", Working with Refugee Families (1 ed.), Cambridge University Press, pp. 36–49, doi:10.1017/9781108602105.004, ISBN 978-1-108-60210-5, S2CID 225509638, retrieved 2021-07-27
48. Fazel M, Wheeler J, Danesh J (2005). "Prevalence of serious mental disorder in 7000 refugees resettled in western countries: a systematic review". Lancet. 365 (9467): 1309–1314. doi:10.1016/S0140-6736(05)61027-6. PMID 15823380. S2CID 23060431.
49. "Refugee".
50. "About Refugees". 4 September 2018.
51. https://www.nctsn.org/sites/default/files/resources/fact-sheet/secondary_traumatic_stress_child_serving_professionals.pdf ^{[bare URL PDF]}
52. Kim I, Keovisai M, Kim W, Richards-Desai S, Yalim AC (April 2019). "Trauma, Discrimination, and Psychological Distress Across Vietnamese Refugees and Immigrants: A Life Course Perspective". Community Mental Health Journal. 55 (3): 385–393. doi:10.1007/s10597-018-0268-2. PMID 29574531. S2CID 4315129.
53. Maffini, Cara S.; Pham, Alfonse N. (2016-07-02). "Overcoming a Legacy of Conflict: The Repercussive Effects of Stress and Intergenerational Transmission of Trauma Among Vietnamese Americans". Journal of Aggression, Maltreatment & Trauma. 25 (6): 580–597. doi:10.1080/10926771.2016.1182955. ISSN 1092-6771. S2CID 147958261.
54. Jeyasundaram J, Cao LY, Trentham B (December 2020). "Experiences of Intergenerational Trauma in Second-Generation Refugees: Healing Through Occupation". Canadian Journal of Occupational Therapy. 87 (5): 412–422. doi:10.1177/0008417420968684. PMID 33256470. S2CID 227246197.
55. Islam A, Ouch C, Smyth R, Wang LC (2017). "The Intergenerational Effect of Cambodia's Genocide on Children's Education and Health". Population and Development Review. 43 (2): 331–353. doi:10.1111/padr.12047. hdl:10.1111/padr.2017.43.issue-2.
56. Lin NJ, Suyemoto KL, Kiang PN (August 2009). "Education as Catalyst for Intergenerational Refugee Family Communication About War and Trauma". Communication Disorders Quarterly. 30 (4): 195–207. doi:10.1177/1525740108329234. S2CID 145621745.
57. Field NP, Muong S, Sochanvimean V (October 2013). "Parental styles in the intergenerational transmission of trauma stemming from the Khmer Rouge regime in Cambodia". The American Journal of Orthopsychiatry. 83 (4): 483–494. doi:10.1111/ajop.12057. PMID 24164520.
58. Korff, Jens (16 May 2022). "Domestic and family violence". Creative Spirits. Retrieved 18 May 2022.
59. Kendall, S., Lighton, S., Sherwood, J. et al. Incarcerated Aboriginal women’s experiences of accessing healthcare and the limitations of the ‘equal treatment’ principle. Int J Equity Health 19, 48 (2020). doi:10.1186/s12939-020-1155-3
60. "Prisoners in Australia, 2022 | Australian Bureau of Statistics". www.abs.gov.au. 2023-10-05. Retrieved 2023-10-27.
61. Bombay A, Matheson K, Anisman H (June 2014). "The intergenerational effects of Indian Residential Schools: implications for the concept of historical trauma". Transcultural Psychiatry. 51 (3): 320–338. doi:10.1177/1363461513503380. PMC 4232330. PMID 24065606.
62. Galovski, Tara; Lyons, Judith A (August 2004). "Psychological sequelae of combat violence: A review of the impact of PTSD on the veteran's family and possible interventions". Aggression and Violent Behavior. 9 (5): 477–501. doi:10.1016/S1359-1789(03)00045-4.
63. Weiss, Eugenia L.; Coll, Jose E.; Gerbauer, Jennifer; Smiley, Kate; Carillo, Ed (October 2010). "The Military Genogram: A Solution-Focused Approach for Resiliency Building in Service Members and Their Families". The Family Journal. 18 (4): 395–406. doi:10.1177/1066480710378479. ISSN 1066-4807. S2CID 145341852.
64. Jordan, Karin (2006). "The Scripto-Trauma Genogram: An Innovative Technique for Working with Trauma Survivors' Intrusive Memories". Brief Treatment and Crisis Intervention. 6 (1): 36–51. doi:10.1093/brief-treatment/mhj002.
65. Dekel R, Goldblatt H (July 2008). "Is there intergenerational transmission of trauma? The case of combat veterans' children". The American Journal of Orthopsychiatry. 78 (3): 281–289. doi:10.1037/a0013955. PMID 19123747.
66. Rosenheck R, Fontana A (October 1998). "Transgenerational effects of abusive violence on the children of Vietnam combat veterans". Journal of Traumatic Stress. 11 (4): 731–742. doi:10.1023/A:1024445416821. PMID 9870224. S2CID 38931132.
67. Ahmadzadeh, Gh; Malekian, A (2004). "Aggression, Anxiety, and Social Development in Adolescent Children of War Veterans with PTSD Versus those of Non-Veterans". Journal of Research in Medical Sciences. 5: 231–234.
68. Herzog, Joseph R.; Everson, R. Blaine; Whitworth, James D. (December 2011). "Do Secondary Trauma Symptoms in Spouses of Combat-Exposed National Guard Soldiers Mediate Impacts of Soldiers' Trauma Exposure on Their Children?". Child and Adolescent Social Work Journal. 28 (6): 459–473. doi:10.1007/s10560-011-0243-z. ISSN 0738-0151. S2CID 72929473.
69. Davidson AC, Mellor DJ (June 2001). "The adjustment of children of Australian Vietnam veterans: is there evidence for the transgenerational transmission of the effects of war-related trauma?". The Australian and New Zealand Journal of Psychiatry. 35 (3): 345–351. doi:10.1046/j.1440-1614.2001.00897.x. PMID 11437808. S2CID 25301429.
70. Solomon Z, Waysman M, Levy G, Fried B, Mikulincer M, Benbenishty R, et al. (September 1992). "From front line to home front: a study of secondary traumatization". Family Process. 31 (3): 289–302. doi:10.1111/j.1545-5300.1992.00289.x. PMID 1451774.
71. Motta RW, Joseph JM, Rose RD, Suozzi JM, Leiderman LJ (December 1997). "Secondary trauma: assessing inter-generational transmission of war experiences with a modified Stroop procedure". Journal of Clinical Psychology. 53 (8): 895–903. doi:10.1002/(sici)1097-4679(199712)53:8<895::aid-jclp14>3.0.co;2-f. PMID 9403392.
72. Kintzle S, Yarvis JS, Bride BE (December 2013). "Secondary traumatic stress in military primary and mental health care providers". Military Medicine. 178 (12): 1310–1315. doi:10.7205/milmed-d-13-00087. PMID 24306012.
73. Gambardella LC (July 2008). "Role-exit theory and marital discord following extended military deployment". Perspectives in Psychiatric Care. 44 (3): 169–174. doi:10.1111/j.1744-6163.2008.00171.x. PMID 18577122.
74. Van Hook, Mary (2008). Social work practice with families : a resiliency-based approach. Chicago: Lyceum Books. ISBN 978-1-933478-16-6. OCLC 176648840.
75. Daud A, Skoglund E, Rydelius PA (2005-01-01). "Children in families of torture victims: transgenerational transmission of parents' traumatic experiences to their children". International Journal of Social Welfare. 14 (1): 23–32. doi:10.1111/j.1468-2397.2005.00336.x.
76. Braga LL, Mello MF, Fiks JP (September 2012). "Transgenerational transmission of trauma and resilience: a qualitative study with Brazilian offspring of Holocaust survivors". BMC Psychiatry. 12: 134. doi:10.1186/1471-244X-12-134. PMC 3500267. PMID 22943578.
77. Walsh F (2002). "A Family Resilience Framework: Innovative Practice Applications". Family Relations. 51 (2): 130–137. doi:10.1111/j.1741-3729.2002.00130.x.
78. Echterling, L. G., Presbury, J. H., & McKee, J. E. (2005). Crisis intervention: Promoting resilience and resolution in troubled times. Prentice Hall.^{[page needed]}
79. Cowan CS, Callaghan BL, Kan JM, Richardson R (January 2016). "The lasting impact of early-life adversity on individuals and their descendants: potential mechanisms and hope for intervention". Genes, Brain and Behavior. 15 (1): 155–168. doi:10.1111/gbb.12263. hdl:10468/7455. PMID 26482536.
80. Collins P. black Feminist Thought (PDF). pp. 32, 33.
81. Sampson RJ, Raudenbush SW (2016-06-22). "Seeing Disorder: Neighborhood Stigma and the Social Construction of 'Broken Windows'". Social Psychology Quarterly. 67 (4): 319–342. doi:10.1177/019027250406700401. S2CID 8626641.
82. Torpy SJ (January 2000). "Native American Women and Coerced Sterilization: On the Trail of Tears in the 1970s". American Indian Culture and Research Journal. 24 (2): 1–22. doi:10.17953/aicr.24.2.7646013460646042. S2CID 143126892.
83. Kirmayer LJ, Brass GM, Tait CL (September 2000). "The mental health of Aboriginal peoples: transformations of identity and community". Canadian Journal of Psychiatry. Revue Canadienne de Psychiatrie. 45 (7): 607–616. doi:10.1177/070674370004500702. PMID 11056823.
84. Gluckman PD, Lillycrop KA, Vickers MH, Pleasants AB, Phillips ES, Beedle AS, et al. (July 2007). "Metabolic plasticity during mammalian development is directionally dependent on early nutritional status". Proceedings of the National Academy of Sciences of the United States of America. 104 (31): 12796–12800. Bibcode:2007PNAS..10412796G. doi:10.1073/pnas.0705667104. PMC 1937546. PMID 17646663.
85. Kinsella MT, Monk C (September 2009). "Impact of maternal stress, depression and anxiety on fetal neurobehavioral development". Clinical Obstetrics and Gynecology. 52 (3): 425–440. doi:10.1097/GRF.0b013e3181b52df1. PMC 3710585. PMID 19661759.
86. Isobel S, Goodyear M, Furness T, Foster K (April 2019). "Preventing intergenerational trauma transmission: A critical interpretive synthesis". Journal of Clinical Nursing. 28 (7–8): 1100–1113. doi:10.1111/jocn.14735. PMID 30556334. S2CID 58768942.
87. Felitti VJ, Anda RF, Nordenberg D, Williamson DF, Spitz AM, Edwards V, et al. (May 1998). "Relationship of childhood abuse and household dysfunction to many of the leading causes of death in adults. The Adverse Childhood Experiences (ACE) Study". American Journal of Preventive Medicine. 14 (4): 245–258. doi:10.1016/s0749-3797(98)00017-8. PMID 9635069. S2CID 26055600.
88. Jawaid, Ali; Roszkowski, Martin; Mansuy, Isabelle M. (2018-01-01), Rutten, Bart P. F. (ed.), "Chapter Twelve - Transgenerational Epigenetics of Traumatic Stress", Progress in Molecular Biology and Translational Science, Neuroepigenetics and Mental Illness, 158, Academic Press: 273–298, doi:10.1016/bs.pmbts.2018.03.003, PMID 30072057, retrieved 2021-11-15
89. Alhassen S, Chen S, Alhassen L, Phan A, Khoudari M, De Silva A, et al. (June 2021). "Intergenerational trauma transmission is associated with brain metabotranscriptome remodeling and mitochondrial dysfunction". Communications Biology. 4 (1): 783. doi:10.1038/s42003-021-02255-2. PMC 8225861. PMID 34168265.
90. Asmundson GJ, Thorisdottir AS, Roden-Foreman JW, Baird SO, Witcraft SM, Stein AT, et al. (January 2019). "A meta-analytic review of cognitive processing therapy for adults with posttraumatic stress disorder". Cognitive Behaviour Therapy. 48 (1): 1–14. doi:10.1080/16506073.2018.1522371. hdl:1974/26093. PMID 30332919. S2CID 52986455.
91. Bohus M, Kleindienst N, Hahn C, Müller-Engelmann M, Ludäscher P, Steil R, et al. (December 2020). "Dialectical Behavior Therapy for Posttraumatic Stress Disorder (DBT-PTSD) Compared With Cognitive Processing Therapy (CPT) in Complex Presentations of PTSD in Women Survivors of Childhood Abuse: A Randomized Clinical Trial". JAMA Psychiatry. 77 (12): 1235–1245. doi:10.1001/jamapsychiatry.2020.2148. PMC 7376475. PMID 32697288.
92. Choi-Kain, Lois; Wilks, Chelsey R.; Ilagan, Gabrielle S.; Iliakis, Evan A. (2021-09-01). "Dialectical Behavior Therapy for Early Life Trauma". Current Treatment Options in Psychiatry. 8 (3): 111–124. doi:10.1007/s40501-021-00242-2. ISSN 2196-3061. S2CID 233303826.
93. Craig C, Hiskey S, Spector A (April 2020). "Compassion focused therapy: a systematic review of its effectiveness and acceptability in clinical populations". Expert Review of Neurotherapeutics. 20 (4): 385–400. doi:10.1080/14737175.2020.1746184. PMID 32196399. S2CID 214600120.
94. Cramer, Saviona. "Intergenerational narrative practice in response to intergenerational trauma". International Journal of Narrative Therapy and Community Work (1): 1–11.
95. Foa EB (December 2011). "Prolonged exposure therapy: past, present, and future". Depression and Anxiety. 28 (12): 1043–1047. doi:10.1002/da.20907. PMID 22134957. S2CID 28115857.
96. Hoosain, Shanaaz (2018-06-01). "Decolonising social work research with families experiencing intergenerational trauma". Southern African Journal of Social Work and Social Development. 30 (1): 1–18. doi:10.25159/2415-5829/2471. S2CID 149938541.
97. Metzger IW, Anderson RE, Are F, Ritchwood T (February 2021). "Healing Interpersonal and Racial Trauma: Integrating Racial Socialization Into Trauma-Focused Cognitive Behavioral Therapy for African American Youth". Child Maltreatment. 26 (1): 17–27. doi:10.1177/1077559520921457. PMC 8807349. PMID 32367729.
98. Porche, Michelle V.; Koslouski, Jessica B.; Oblath, Rachel (2020), "Trauma Disorders in Adolescence", The Encyclopedia of Child and Adolescent Development, John Wiley & Sons, Ltd, pp. 1–12, doi:10.1002/9781119171492.wecad451, ISBN 978-1-119-17149-2, S2CID 214506698, retrieved 2021-11-15
99. Giladi, Lotem; Bell, Terece S. (2013). "Protective factors for intergenerational transmission of trauma among second and third generation Holocaust survivors". Psychological Trauma: Theory, Research, Practice, and Policy. 5 (4): 384–391. doi:10.1037/a0028455. ISSN 1942-969X.
100. Scott, Katreena L.; Copping, Valerie E. (2008). "Promising directions for the treatment of complex childhood trauma: The Intergenerational Trauma Treatment Model". The Journal of Behavior Analysis of Offender and Victim Treatment and Prevention. 1 (3): 273–283. doi:10.1037/h0100449. ISSN 2155-8655.
101. Beck BD, Lund ST, Søgaard U, Simonsen E, Tellier TC, Cordtz TO, et al. (May 2018). "Music therapy versus treatment as usual for refugees diagnosed with posttraumatic stress disorder (PTSD): study protocol for a randomized controlled trial". Trials. 19 (1): 301. doi:10.1186/s13063-018-2662-z. PMC 5977477. PMID 29848343.
102. Bronson, Hannah; Vaudreuil, Rebecca; Bradt, Joke (2018-10-31). "Music Therapy Treatment of Active Duty Military: An Overview of Intensive Outpatient and Longitudinal Care Programs". Music Therapy Perspectives. 36 (2): 195–206. doi:10.1093/mtp/miy006. ISSN 0734-6875.
103. Abrams, Brian (2021-05-27). "Encountering transgenerational trauma through analytical music therapy". Nordic Journal of Music Therapy. 30 (3): 197–218. doi:10.1080/08098131.2020.1853801. ISSN 0809-8131. S2CID 233745526.
104. Struik A (2017). "The Trauma Healing Story. Healing Chronically Traumatised Children Through Their Families/Whanau". Australian and New Zealand Journal of Family Therapy. 38 (4): 613–626. doi:10.1002/anzf.1271.
105. Fornaro, Antonella (2019-10-02). "In Search of Transgenerational Footprints: The Transgenerational Script Questionnaire". Transactional Analysis Journal. 49 (4): 308–323. doi:10.1080/03621537.2019.1650231. ISSN 0362-1537. S2CID 203063217.
106. Gayol, Gloria Noriega (2019-10-02). "Untangling the Family Tree: Using the Transgenerational Script Questionnaire in the Psychotherapy of Transgenerational Trauma". Transactional Analysis Journal. 49 (4): 279–291. doi:10.1080/03621537.2019.1650235. ISSN 0362-1537. S2CID 203049629.
107. Goodman RD (2013-12-01). "The transgenerational trauma and resilience genogram". Counselling Psychology Quarterly. 26 (3–4): 386–405. doi:10.1080/09515070.2013.820172. S2CID 144188999.
108. Danieli, Yael (2007), Wilson, John P.; Tang, Catherine So-kum (eds.), "Assessing Trauma Across Cultures from a Multigenerational Perspective", Cross-Cultural Assessment of Psychological Trauma and PTSD, International and Cultural Psychology Series, Boston, MA: Springer US, pp. 65–89, doi:10.1007/978-0-387-70990-1_4, ISBN 978-0-387-70990-1, retrieved 2021-11-15
109. Sirikantraporn, Skultip; Green, Julii (2016-07-02). "Introduction: Multicultural Perspectives of Intergenerational Transmission of Trauma". Journal of Aggression, Maltreatment & Trauma. 25 (6): 559–560. doi:10.1080/10926771.2016.1194941. ISSN 1092-6771. S2CID 151622401.
110. Carey, Benedict (10 December 2018). "Can We Really Inherit Trauma?". The New York Times. Retrieved 18 February 2023.
111. Weaver IC, Cervoni N, Champagne FA, D'Alessio AC, Sharma S, Seckl JR, et al. (August 2004). "Epigenetic programming by maternal behavior". Nature Neuroscience. 7 (8): 847–854. doi:10.1038/nn1276. PMID 15220929. S2CID 1649281.
112. Roth TL, Sweatt JD (March 2011). "Epigenetic marking of the BDNF gene by early-life adverse experiences". Hormones and Behavior. Special Issue: Behavioral Epigenetics. 59 (3): 315–320. doi:10.1016/j.yhbeh.2010.05.005. PMC 2948595. PMID 20483357.
113. Sanchez MM (November 2006). "The impact of early adverse care on HPA axis development: nonhuman primate models". Hormones and Behavior. Translational Topics in Behavioral Neuroendocrinology. 50 (4): 623–631. doi:10.1016/j.yhbeh.2006.06.012. PMID 16914153. S2CID 28263262.
114. Youngson NA, Whitelaw E (2008). "Transgenerational epigenetic effects". Annual Review of Genomics and Human Genetics. 9: 233–257. doi:10.1146/annurev.genom.9.081307.164445. PMID 18767965. S2CID 2611836.
115. Yehuda R, Daskalakis NP, Bierer LM, Bader HN, Klengel T, Holsboer F, Binder EB (September 2016). "Holocaust Exposure Induced Intergenerational Effects on FKBP5 Methylation". Biological Psychiatry. 80 (5): 372–380. doi:10.1016/j.biopsych.2015.08.005. PMID 26410355. S2CID 3522658.

Further reading

• Coffey R (1998). Unspeakable truths and happy endings. Sidran Press. ISBN 1-886968-05-5.
• Danieli Y, ed. (1998). International handbook of multigenerational legacies of trauma. New York: Plenum.
• Daud A, Skoglund E, Rydelius P (2005). "Children in families of torture victims: transgenerational transmission of parents' traumatic experiences to their children". International Journal of Social Welfare. 14: 23–32. doi:10.1111/j.1468-2397.2005.00336.x.
• Degruy J (2005). Post Traumatic Slave Syndrome: America's Legacy of Enduring Injury and Healing. Uptone Press. ISBN 978-0963401120.
• Flanagan, Tom (2022). "Reparations for Historical Injustice and Intergenerational Trauma". Kulturní studia / Cultural Studies. 10 ((19) 2/2022): 3–14. doi:10.7160/KS.2022.190201. S2CID 253829510.
• Graff G (Spring 2017). "The Intergenerational Trauma of Slavery and Its Aftereffects: The Question of Reparations". Journal of Psychohistory. 44 (4): 256–268.
• Fossion P, Rejas MC, Servais L, Pelc I, Hirsch S (2003). "Family approach with grandchildren of Holocaust survivors". American Journal of Psychotherapy. 57 (4): 519–527. doi:10.1176/appi.psychotherapy.2003.57.4.519. PMID 14735877.
• Herman JL (1997). Trauma and recovery: The aftermath of violence from domestic abuse to political terror. New York: Basic Books.
• Schwab G (2010). Haunting Legacies: Violent Histories and Transgenerational Trauma. Columbia University Press.
• Sibrava NJ, Bjornsson AS, Pérez Benítez AC, Moitra E, Weisberg RB, Keller MB (January 2019). "Posttraumatic stress disorder in African American and Latinx adults: Clinical course and the role of racial and ethnic discrimination". The American Psychologist. 74 (1): 101–116. doi:10.1037/amp0000339. PMC 6338337. PMID 30652903.
• van der Kolk BA, Roth S, Pelcovitz D, Sunday S, Spinazzola J (October 2005). "Disorders of extreme stress: The empirical foundation of a complex adaptation to trauma". Journal of Traumatic Stress. 18 (5): 389–399. doi:10.1002/jts.20047. PMID 16281237.

External links

• Video by Leila Levinson, child of an American witness of concentration camp and author of Gated Grief.
• An article by a supervisor of Master's and Doctoral students specialising in trauma counselling, Wentzel Coetzer.
• Healing Collective Trauma, a website with resources on collective, historical, and transgenerational trauma.
• Maria Yellow Horse Brave Heart on intergenerational trauma in Native Americans