WASHINGTON — Holocaust survivors show remarkable resilience in their day-to-day lives, but they still manifest the pain of their traumatic past in the form of various psychiatric symptoms, according to an analysis of 44 years of global psychological research.

Jewish Holocaust survivors living in Israel also have higher psychological well-being than those who live in other countries, which suggests living in that country could serve as a protective factor, according to researchers in Israel and the Netherlands. Their findings are reported in Psychological Bulletin, which is published by the American Psychological Association. The studies chosen for this analysis focused on Holocaust survivors of Jewish ancestry.

“Six decades after the end of World War II and we are still learning how a mass genocide like the Holocaust is affecting its victims,” said the study’s lead author, Efrat Barel, PhD, a psychology professor at the Max Stern Academic College of Emek Yezreel in Israel. “What we’ve found is that they have the ability to overcome their traumatic experiences and even to flourish and gain psychological growth, but it may not be as easy as it seems.”

The central question of this analysis was how the Holocaust affected survivors’ general adjustment, according to Barel. General adjustment levels were determined by examining the participants’ psychological well-being, post-traumatic stress symptoms, cognitive functioning, physical health, stress-related symptoms and psychopathological symptoms. The researchers analyzed findings from 71 different research samples, which included 12,746 people from around the world. The researchers searched for studies with samples of Holocaust survivors in addition to control groups of people who were not Holocaust survivors. The nature of these control groups varied across studies. For example, some studies matched on background characteristics, except for the Holocaust experience; other studies compared Holocaust survivors to other European-born Jews who did not undergo the Holocaust. All the studies were published between 1964 and 2008.

As the researchers examined the findings, they were able to see some interesting differences and similarities between Holocaust survivors and the control groups:

• Holocaust survivors had poorer psychological well-being, more post-traumatic stress symptoms and more psychopathological symptoms.
• There were no significant differences in cognitive functioning or physical health.
• Holocaust survivors who lived in Israel showed better psychological well-being and social adjustment than survivors who lived in other countries.

“The psychological scars of Holocaust survivors are evident in their continued experience of post-traumatic symptoms, but these experiences have not necessarily prevented their ability to adapt to day-to-day life,” said co-author Abraham Sagi-Schwartz, a dean of social sciences at Haifa University, Israel. “It’s possible these survivors repressed a lot of these traumatic memories in the immediate aftermath of the war and instead focused on rebuilding their lives and raising new families.”

This research is particularly relevant for survivors who were children during the Holocaust, the authors added. “Most survivors alive today were children during World War II and the current findings call for special attention to the care of these survivors,” said co-author Marinus Van IJzendoorn of Leiden University in the Netherlands. “As they approach old age, they face new challenges, including retirement, declining health and losing a spouse, and this may reactivate their extreme early stresses.”

Approximately half of the samples included participants selected randomly from different populations around the world, the researchers noted. In the other studies, participants were recruited through Holocaust survivor meetings or advertisements. There were some differences in the findings but in their conclusions of this meta-analysis, the psychologists focused on the randomly selected samples since these types of studies are more scientifically sound than studies that are more select in their recruiting methods. They outline their findings for each sample type within the published article.

Article: “Surviving the Holocaust: A Meta-Analysis of the Long-Term Sequelae of a Genocide," Efrat Barel, University of Haifa and the Max Stern Academic College of Emek Yezreel; Marinus H. Van IJzendoorn, Leiden University; Abraham Sagi-Schwartz, University of Haifa; Marian J. Bakermans-Kranenburg, Leiden University; Psychological Bulletin, Vol. 136, No. 5.

Reporters: Please note time difference when contacting authors.

Contact Dr. Efrat Barel by email or by phone at +011 972 502481549.

Contact Dr. Abraham Sagi-Schwartz by email or by phone at +011 972 542688310.

Contact Dr. Marinus van IJzendoorn by email.

The American Psychological Association, in Washington, D.C., is the largest scientific and professional organization representing psychology in the United States and is the world's largest association of psychologists. APA's membership includes more than 152,000 researchers, educators, clinicians, consultants and students. Through its divisions in 54 subfields of psychology and affiliations with 60 state, territorial and Canadian provincial associations, APA works to advance psychology as a science, as a profession and as a means of promoting health, education and human welfare.