Intergenerational Trauma in Refugee Families: A Systematic Review

Background: Research across various disciplines has documented evidence of intergenerational trauma for diverse populations (e.g. combat soldiers, Holocaust survivors, American Indians) and potential mechanisms by which trauma is indirectly transmitted to offspring within families. A number of studies have examined the mental health consequences of direct trauma on refugee populations – individuals forcibly displaced from their countries of origin due to war, violence, and persecution. With a focus on refugee and forced-migrant families, this systematic reviews aims to examine what is known about the indirect effects of parents’ trauma on their offspring’s development and well-being. 

 

Methods: Using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA), we synthesized the results of all English-language peer-reviewed articles published up to 2015. We identified articles through PsycINFO, PsycARTICLES, PubMED, Academic Search Premier (EBSCO), Social Services Abstracts, Sociological Abstracts, Web of Science, and ERIC using the Boolean search strategy to combine the following keywords: intergenerational or transgenerational trauma, refugee, and child. After excluding duplicates, we conducted an article title and abstract review, followed by full paper review, to determine eligibility for inclusion. Studies included in the review were based on the underlying experience of trauma resulting from war or political violence that affected people bound by a common cultural identity. Further, children or offspring did not experience political trauma directly themselves or fled from conflict areas with their families at a very young age. We excluded articles that were non-empirical, based on non-refugee populations, focused on biological or epigenetic transmission of trauma, and based on treatment or clinical case studies. Of the 354 articles initially identified, 22 studies met inclusion criteria for the systematic review.

Results:Thirteen studies (59%) focused on offspring of Holocaust survivors, five studies (23%) were based on children of Southeast Asian refugees, and the remaining studies included descendants of forced migrants of the Middle East and Eastern Europe. All studies were based on community- or population-based samples, with the exception of one study that sampled participants from both clinical and community settings. Half of all studies examined the existence of intergenerational trauma by comparing psychiatric symptoms of refugee offspring with control groups, seven studies (32%) investigated psychosocial risks and characteristics among offspring of refugee parents alone, three studies (14%) used qualitative methods to explore themes related to the influence of parent’s trauma on children and family relationships among refugee offspring, and two studies (9%) quantitatively explored mechanisms by which trauma is transmitted intergenerationally within refugee families. Nine studies (41%) provided evidence that refugee parental trauma had negative psychological consequences for offspring, while two studies (9%) found no differences between offspring of refugee parents and controls. Eight studies overall (36%) described potential mechanisms of intergenerational trauma transmission, including family communication and relationships, parenting, and parent-child attachment.

Implications: This systematic review informs evidence-based social work practice with refugee families and highlights the importance of recognizing the potential effects of refugee parents’ trauma and mechanisms by intergenerational trauma is transmitted.