Transgenerational trauma in a post-conflict setting: Effects on offspring PTSS/PTSD and offspring vulnerability in Cambodian families.

We assessed transgenerational effects of maternal traumatic exposure, posttraumatic stress symptoms and posttraumatic stress disorder on trauma-related symptoms in Cambodian offspring born after the genocidal Khmer Rouge Regime. We conducted a randomized cross-sectional study. N=378 mothers from 4 provinces of the country and one of each of their grown-up children were interviewed. Lifetime traumatic exposure was determined using a context-adapted event list. Present posttraumatic stress symptoms and a potential posttraumatic stress disorder were assessed using the civilian version of the Posttraumatic Stress Disorder Checklist. We found no indication of transgenerational effects that were directly related to maternal traumatic exposure, posttraumatic stress symptoms or posttraumatic stress disorder. Instead, a gender-specific moderating effect was found. Individual traumatic exposure had a stronger effect on posttraumatic stress symptoms in daughters, the higher the mother's lifetime traumatic exposure. There is evidence of an interaction between lifetime traumatic exposure of mothers and their offspring that can be interpreted as an increased vulnerability to symptoms of posttraumatic stress in daughters. The mechanisms of transgenerational trauma in the Cambodian context require further research, as learning from previous conflicts will be instructive when addressing the pressing humanitarian needs of today's world.

Recalling war trauma of the Pacific War and the Japanese occupation in the oral history of Malaysia and Singapore.

The Pacific War and the Japanese Occupation were traumatic periods in the lives of people now over seventy years old in Malaysia and Singapore. This study traces why individuals interviewed for oral history of the Pacific War and the Japanese Occupation have often been able to tell stories of trauma without being overwhelmed by their reminiscences. It emphasizes that memories of traumatic experiences of the Pacific War and the Japanese Occupation in Malaysia and Singapore are mediated and eased by supportive social networks that are part of the interview subject's community. The individual's personal memories of traumatic war experiences are positioned in the context of the collective memory of the group and, thus, are made easier to recall. However, for individuals whose personal memories are at variance with the collective memory of the group they belong to, recalling traumatic experiences is more difficult and alienating as they do not have the support in their community. The act of recalling traumatic memories in the context of the collective memory of a group is particularly relevant in Malaysia and Singapore. These countries have a long history of being plural societies, where although the major ethnic groups -- the Malays, Chinese, and Indians -- have lived side by side peacefully, they have lived in culturally and socially separate worlds, not interacting much with the other groups. The self -- identity of many older people who lived through the Pacific War and the Japanese Occupation is inextricably bound up with their ethnicity. Oral history on war trauma strongly reflects these identities.

Far from Oblivion: the Nanking Massacre in Japanese historical writing for children and young adults.

The Nanking Massacre of 1937 frequently has been described as a forgotten genocidal act or "Holocaust." Concentrating on atrocity as reflected in Japanese popular historical writing for children and adolescents since the 1960s, this essay argues that such war crimes are far from ignored. Representations of the Nanking Massacre in particular, and of Japanese World War II atrocities in general, have been widely mobilized in Japan to inculcate an anti-war philosophy.

Late-life mortality in older Jews exposed to the Nazi regime.

OBJECTIVES: To evaluate the mortality risk associated with exposure to the Nazi regime 6 decades after the war. DESIGN: A national representative survey with 7-year follow-up data. SETTING: A national representative survey of Israeli Jews aged 60 and older conducted in 1997 and 1998. PARTICIPANTS: Four thousand one hundred seventy-nine Israeli Jews participated in the study. To evaluate the mortality risk associated with exposure to the Nazi regime, Cox proportional-hazards models were used, controlling for age, sex, education, religiousness, mental health, sleep disturbance, and baseline health. MEASUREMENTS: A 7-year follow-up of all-cause mortality. RESULTS: Of the 4,179 Israeli Jews who participated in the study, 1,472 (35%) self-identified as being exposed to the Nazi regime, defined as having lived in a country that was under the Nazi occupation or directly ruled by the Nazi regime. There was no statistically significant difference in mortality rate between those exposed to the Nazi regime (29.8%) and those who were not (27.5%) (adjusted hazard ratio=1.01, 95% confidence interval=0.88-1.15). CONCLUSION: Israeli Jews who survived exposure to the Nazi regime are not at greater risk for death than the general population of Israeli Jews in later life. It is unclear whether these individuals represent a particularly resilient group or whether the risks of psychological trauma on mortality are mitigated over time.

Relations between ethnic Croats and ethnic Serbs at Vukovar General Hospital in wartime and peacetime.

This article examines war and peacetime ethnic relations at Vukovar General Hospital in Croatia's Eastern Slavonia region. A negotiated peace agreement paved the way for a multi-sectored approach to the reintegration of Eastern Slavonia back into the state and rapprochement between ethnic groups under the supervision of a United Nations transitional administration. This case study provides a glimpse into the realities of those peace-building processes on an institutional level in Eastern Slavonia's healthcare system. The reintegration of Vukovar hospital, the transition of Eastern Slavonia's health sector and peace-building in the region in general received much deserved accolades despite some flaws and minor setbacks. These experiences can still serve as a model for the rest of Croatia and for other countries emerging from civil conflicts.

Social contexts of trauma and healing.

The social contexts in which the mass trauma of thousands of people occur and in which their recovery should progress have qualities that distinguish it in important ways from individualised trauma in which a person is a victim of a violent attack, rape or a traffic accident. Organised violence, such as wars, oppression by dictatorships and massive terrorist attacks are extreme cases in which hundreds or thousands of people are exposed to trauma in a short period of time. As such, it has multiple consequences that extend beyond the affected individuals and the symptoms they suffer. Although the symptoms may be similar, the social contexts in which individual victimisation and exposure to organised violence happen are very different. The social milieu in which the survivors of individual trauma and survivors of mass trauma are embedded is likewise different, with important consequences for recovery. Understanding the social context of the trauma helps create the right social intervention for healing at social and personal levels.

Psychosocial healing and post-conflict social reconstruction in the former Yugoslavia.

Post-conflict reconstruction encompasses social, physical and political reconstruction. Social reconstruction entails rebuilding the human interactions that allow a society to function. This involves the healing of psychological and social wounds of individuals and society. Psychosocial healing is a process to promote psychological and social health of individuals, families and community groups. The Medical Network for Social Reconstruction in the Former Yugoslavia has pioneered a broad range of psychosocial healing programmes including community-integration programmes, development of volunteer action, and training of professional and lay people to take part in psychosocial healing. These programmes have demonstrated that psychosocial healing can be an effective way to heal post-conflict societal trauma and contribute to rebuilding society with an improved quality of life.

War, gender and culture: Mozambican women refugees.

Analyses of the psychological sequelae of war-related violence for women tend to rely on the concepts developed in research on male combatants. Post-traumatic stress disorder or varying combinations of its symptoms are identified as the principal outcomes of war-related events for women. By and large, the dominant literature does not examine possible outcomes which could be specified by gender. This paper refers to the war in Mozambique during the 1970s and 1980s as a typical illustration of how women are an integral part of the battlefield. It draws on research on African women and uses testimony of Mozambican women refugees who settled in South Africa to explore how gender is linked to psycho-social outcomes of massive social conflict. The paper argues that a richer understanding of the psycho-social outcomes of war and the needs of survivors is promoted by investigating gender in specific historical situations and how this frames the responses people have to experiences of violence and social destruction.

The sound of barking dogs: violence and terror among Salvadoran families in the postwar.

This article examines the transgenerational transmission of trauma among campensino living in a rural, repopulated community in El Salvador. Research with Holocaust survivors and their children has shown that traumatic symptoms can be transmitted to children who did not directly experience the Holocaust. The mechanisms by which this transgenerational transmission occurs have not been fully explored and require an expansion of medical and anthropological conceptualizations of posttraumatic illness. Through their reactions to and interpretations of everyday events, campesino parents who lived in the guerrilla camps explicitly transmit trauma to children who did not experience the recent civil war. Illness narratives by sufferers of nervios transmit trauma and point to the basic immorality of the war, an immorality that continues today. In addition, the symptoms of nervios constitute a mechanism by which trauma is implicitly transmitted. Symptoms of nervios point to what generally is not and, indeed, cannot be voiced: the destruction of primary relationships in the family and unresolved grief and helplessness, which, through the responses of family members to the sufferer, are reproduced and reenacted in the present family context.