Abraham Sagi-Schwartz

Surviving the Holocaust: A Meta-Analysis of the Long-Term Sequelae of a Genocide

The current set of meta-analyses elucidates the long-term psychiatric, psychosocial, and physical consequences of the Holocaust for survivors. In 71 samples with 12,746 participants Holocaust survivors were compared with their counterparts (with no Holocaust background) on physical health, psychological well-being, posttraumatic stress symptoms, psychopathological symptomatology, cognitive functioning, and stress-related physiology. Holocaust survivors were less well adjusted, as apparent from studies on nonselected samples (trimmed combined effect size d = 0.22, 95% CI [0.13, 0.31], N = 9,803) and from studies on selected samples (d = 0.45, 95% CI [0.32, 0.59], N = 2,943). In particular, they showed substantially more posttraumatic stress symptoms (nonselect studies: d = 0.72, 95% CI [0.46, 0.98], N = 1,763). They did not lag, however, much behind their comparisons in several other domains of functioning (i.e., physical health, stress-related physical measures, and cognitive functioning) and showed remarkable resilience. The coexistence of stress-related symptoms and good adaptation in some other areas of functioning may be explained by the unique characteristics of the symptoms of Holocaust survivors, who combine resilience with the use of defensive mechanisms. In most domains of functioning no differences were found between Israeli samples and samples from other countries. The exception was psychological well-being: For this domain it was found that living in Israel rather than elsewhere can serve as a protective factor. A biopsychological stress-diathesis model is used to interpret the findings, and future directions for research and social policy are discussed.

Does intergenerational transmission of trauma skip a generation? No meta-analytic evidence for tertiary traumatization with third generation of Holocaust survivors

In a series of meta-analyses with the second generation of Holocaust survivors, no evidence for secondary traumatization was found (Van IJzendoorn, Bakermans-Kranenburg, & Sagi-Schwartz, 2003). With regard to third generation traumatization, various reports suggest the presence of intergenerational transmission of trauma. Some scholars argue that intergenerational transmission of trauma might skip a generation. Therefore, we focus in this study on the transmission of trauma to the third generation offspring (the grandchildren) of the first generations traumatic Holocaust experiences (referred to as “tertiary traumatization”), and we present a narrative review of the pertinent studies. Meta-analytic results of 13 non-clinical samples involving 1012 participants showed no evidence for tertiary traumatization in Holocaust survivor families. Our previous meta-analytic study on secondary traumatization and the present one on third generations psychological consequences of the Holocaust indicate a remarkable resilience of profoundly traumatized survivors in their (grand-)parental roles.

Coping in old age with extreme childhood trauma: aging Holocaust survivors and their offspring facing new challenges.

Objective: The Holocaust has become an iconic example of immense human-made catastrophes, and survivors are now coping with normal aging processes. Childhood trauma may leave the survivors more vulnerable when they are facing stress related to old age, whereas their offspring might have a challenging role of protecting their own parents from further pain. Here we examine the psychological adaptation of Holocaust survivors and their offspring in light of these new challenges, examining satisfaction with life, mental health, cognitive abilities, dissociative symptoms, and physical health. Methods: Careful matching of female Holocaust survivors and comparison subjects living in Israel was employed to form a case-control study design with two generations, including four groups: 32 elderly female Holocaust survivors and 47 daughters, and 33 elderly women in the comparison group, and 32 daughters (total N = 174). Participants completed several measures of mental and physical health, and their cognitive functioning was examined. The current study is a follow-up of a previous study conducted 11 years ago with the same participants. Results: Holocaust survivors showed more dissociative symptomatology (odds = 2.39) and less satisfaction with their life (odds = 2.79) as compared to a matched group. Nonetheless, adult offspring of Holocaust survivors showed no differences in their physical, psychological, and cognitive functioning as compared to matched controls. Conclusions: Holocaust survivors still display posttraumatic stress symptoms almost 70 years after the trauma, whereas no intergenerational transmission of trauma was found among the second generation.

The well being of children living in chronic war zones: The Palestinian—Israeli case

The paper presents a comprehensive review and integration of available studies on the effects of severe traumatic experiences on children, especially in the context of short and enduring exposure to harsh events and adversities, as they relate to children who live in violent war zones, in particular in Israel and the Palestinian territories. The review focuses on the role of risk and protective factors in determining the debilitating and damaging effects as well as resiliencies of short term and chronic catastrophic experiences on the future well being of children and emerging adults.

Social information processing in middle childhood: Relations to infant-mother attachment

This longitudinal study was designed to examine the links between infant-mother attachment and social information processing in middle childhood. The Strange Situation was used to assess infant-mother attachment at 12 months and a revised and adapted Hebrew version of the Social Information Processing Interview (Dodge & Price, 1994) was used to measure social information processing in middle childhood (at 7.5 years). Findings revealed that with regard to both peer-group relationships and mother-child relationships, secure children demonstrated more competent social information processing than insecure-ambivalent children in one out of four social information processing stages. The major characteristic distinguishing secure from insecure-ambivalent childrens social information processing was their level of expectations from others: secure children expected others to be emotionally and instrumentally available to them (but in the case of peers — only if their own behavior was socially acceptable), whereas ambivalent children did not expect others to be available to them in both peer-group and mother-child circumstances.

Consensus Statement on Group Care for Children and Adolescents: A Statement of Policy of the American Orthopsychiatric Association

Group care for children and adolescents is widely used as a rearing environment and sometimes used as a setting in which intensive services can be provided. This consensus statement on group care affirms that children and adolescents have the need and right to grow up in a family with at least 1 committed, stable, and loving adult caregiver. In principle, group care should never be favored over family care. Group care should be used only when it is the least detrimental alternative, when necessary therapeutic mental health services cannot be delivered in a less restrictive setting.

Ecological constraints on the formation of infant–mother attachment relations: When maternal sensitivity becomes ineffective

Abstract This study investigated in a sample of infants and mothers that represented the full SES spectrum in Israel ( n =704) the hypothesis that low quality non-maternal care imposes ecological constraints on infant–mother attachment formation by moderating the relations between maternal sensitivity and infant attachment security. Infant attachment to mother was assessed with the Strange Situation Procedure (SSP) [Patterns of Attachment: A Psychological Study of the Strange Situation, Erlbaum, Hillsdale, NJ, 1978] and maternal sensitivity was assessed with the Emotional Availability Scales [The Emotional Availability Scales, Unpublished manuscript, University of Colorado, Health Science Center, Denver, 1993]. Results show that the expected links between maternal sensitivity and infant attachment security were found only for infants in individual care but not for infants in daycare centers, which were of low quality. The findings suggest that extensive exposure to difficult environments of non-maternal care constrains infants’ relations with their mothers by moderating the associations between maternal sensitive caregiving and infants’ attachment security.

Against All Odds: Genocidal Trauma Is Associated with Longer Life-Expectancy of the Survivors

Does surviving genocidal experiences, like the Holocaust, lead to shorter life-expectancy? Such an effect is conceivable given that most survivors not only suffered psychosocial trauma but also malnutrition, restriction in hygienic and sanitary facilities, and lack of preventive medical and health services, with potentially damaging effects for later health and life-expectancy. We explored whether genocidal survivors have a higher risk to die younger than comparisons without such background. This is the first population-based retrospective cohort study of the Holocaust, based on the entire population of immigrants from Poland to Israel (N = 55,220), 4–20 years old when the World War II started (1939), immigrating to Israel either between 1945 and 1950 (Holocaust group) or before 1939 (comparison group; not exposed to the Holocaust). Hazard of death – a long-term outcome of surviving genocidal trauma – was derived from the population-wide official data base of the National Insurance Institute of Israel. Cox regression yielded a significant hazard ratio (HR = 0.935, CI (95%) = 0.910–0.960), suggesting that the risk of death was reduced by 6.5 months for Holocaust survivors compared to non-Holocaust comparisons. The lower hazard was most substantial in males who were aged 10–15 (HR = 0.900, CI (95%) = 0.842–0.962, i.e., reduced by 10 months) or 16–20 years at the onset of the Holocaust (HR = 0.820, CI (95%) = 0.782–0.859, i.e., reduced by18 months). We found that against all odds genocidal survivors were likely to live longer. We suggest two explanations: Differential mortality during the Holocaust and “Posttraumatic Growth” associated with protective factors in Holocaust survivors or in their environment after World War II.

Is the ideal mother a sensitive mother? Beliefs about early childhood parenting in mothers across the globe

In this article, we test the hypothesis that beliefs about the ideal mother are convergent across cultures and that these beliefs overlap considerably with attachment theory’s notion of the sensitive mother. In a sample including 26 cultural groups from 15 countries around the globe, 751 mothers sorted the Maternal Behavior Q-Set to reflect their ideas about the ideal mother. The results show strong convergence between maternal beliefs about the ideal mother and attachment theory’s description of the sensitive mother across groups. Cultural group membership significantly predicted variations in maternal sensitivity belief scores, but this effect was substantially accounted for by group variations in socio-demographic factors. Mothers living in rural versus urban areas, with a low family income, and with more children, were less likely to describe the ideal mother as highly sensitive. Cultural group membership did remain a significant predictor of variations in maternal sensitivity belief scores above and beyond socio-demographic predictors. The findings are discussed in terms of the universal and culture-specific aspects of the sensitivity construct.

Negotiation Styles in Mother--Child Narrative Co-Construction in Middle Childhood: Associations with Early Attachment.

This study examined associations between infant—mother attachment, assessed using Ainsworths Strange Situation at 12-months, and mother—child narrative co-construction in 110 Israeli mothers and their 71/2 year-old children to examine aspects of Bowlbys (1973) notion of Goal-Corrected Partnerships. Narrative co-constructions were classified into a mutual-balanced style or one of two non-mutual/unbalanced styles of affective negotiation. Dyads with children classified as secure were more likely to be classified as mutual-balanced than dyads with children classified as insecure (ambivalent or disorganized). The latter were likely to be classified into one of the two Non-mutual/Unbalanced classifications (i.e., Disengaged or Overwhelming). Contributions of this study to broadening our understanding of secure-base in the post-infancy years, and for increasing our knowledge about goal-corrected partnerships, are discussed.