Transgenerational transfer of genocidal trauma: a systematic review and meta-analysis.

Abstract

This meta-analysis aims to estimate the prevalence of posttraumatic stress disorder (PTSD) among the offspring of genocide survivors and examine study-level moderators influencing PTSD rates across cultural settings. Following PRISMA guidelines, seven peer-reviewed studies were identified through systematic searches of major databases, covering genocides in Rwanda, Cambodia, Armenia and Israel (Holocaust). A total of 1,569 participants were included. Data were extracted on sample size, mean age, gender composition, generation, diagnostic assessment tools, and World Bank country classification. A random-effects model was used to estimate pooled prevalence, and meta-regressions assessed the moderating effects of gender composition and mean age. Heterogeneity was evaluated using I² and Q statistics. The pooled probable PTSD prevalence across the seven studies was 17.9% (95% CI: 9.9%-25.8%), which is significantly higher than global population norms during peacetime and not substantially lower than prevalence estimates reported in civilian populations living in war zones. Heterogeneity was substantial (I² = 95.03%, p <.001). Meta-regressions found no significant moderating effect of gender composition or age, possibly due to the limited number of studies with complete data and variations in study methodology. Overall, these findings underscore the persistent impact of genocidal trauma, highlighting how its effects extend beyond directly exposed individuals to shape the mental health of subsequent generations.<h4>Systematic review registration</h4>https://www.crd.york.ac.uk/PROSPERO/view/CRD420251046525.