Intergenerational Trauma and Resilience among Im/Migrant Families: Child Mental Health Outcomes and Psychosocial Mechanisms of Transmission — Oak Academic Publishing
Research ArticleOpen AccessGoogle Scholar indexed
Intergenerational Trauma and Resilience among Im/Migrant Families: Child Mental Health Outcomes and Psychosocial Mechanisms of Transmission
Massachusetts General Hospital Department of Obstetrics and Gynecology, Strength and Serenity: Global Initiative against Gender-Based Violence, Boston, Massachusetts, USA
,
Massachusetts General Hospital Department of Obstetrics and Gynecology, Strength and Serenity: Global Initiative against Gender-Based Violence, Boston, Massachusetts, USA
,
Massachusetts General Hospital Center for Immigrant Health, Boston, Massachusetts, USA
,
Massachusetts General Hospital Center for Immigrant Health, Boston, Massachusetts, USA
,
Massachusetts General Hospital Department of Obstetrics and Gynecology, Strength and Serenity: Global Initiative against Gender-Based Violence, Boston, Massachusetts, USA
,
Massachusetts General Hospital Center for Immigrant Health, Boston, Massachusetts, USA
1 Massachusetts General Hospital Department of Obstetrics and Gynecology, Strength and Serenity: Global Initiative against Gender-Based Violence, Boston, Massachusetts, USA
2 Massachusetts General Hospital Department of Obstetrics and Gynecology, Strength and Serenity: Global Initiative against Gender-Based Violence, Boston, Massachusetts, USA
3 Massachusetts General Hospital Center for Immigrant Health, Boston, Massachusetts, USA
4 Massachusetts General Hospital Center for Immigrant Health, Boston, Massachusetts, USA
5 Massachusetts General Hospital Department of Obstetrics and Gynecology, Strength and Serenity: Global Initiative against Gender-Based Violence, Boston, Massachusetts, USA
6 Massachusetts General Hospital Center for Immigrant Health, Boston, Massachusetts, USA
Research Background: Psychological stressors leading to poor mental health outcomes accumulate throughout the migration process. The impact of a parent or caregiver’s posttraumatic stress on non-traumatized children is significant and may lead to adverse development and mental health outcomes. Research Objectives: The objective of this review is to explore both the consequences of parental trauma transmission on descendants’ psychological adjustment and well-being, and the mechanisms through which trauma has been transmitted among im/migrant populations. Methods: Criteria outlined in the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement guided this systemic review. The questions guiding this review are: (a) What are the consequences of parental trauma transmission on the psychological adjustment and well-being of im/migrant offspring? And (b) What are the psychosocial mechanisms of trauma and resilience transmission among im/migrant populations? Each potential study was assessed based on relevance to the review question(s). Results: Parental trauma can lead to adverse mental health outcomes among descendants including increased internalizing and externalizing problems, the adoption of coping behaviors and worldviews, and worsening school performance. Mechanisms that influence trauma transmission include parental trauma symptom severity, the parent-child dyad, social learning, and family stressors. Pathways of resilience exist across socioecological levels to include individual resilience such as coping skills and meaning making, family resilience, structural protective factors, and social and cultural protective factors. Conclusions: Despite the prevalence of traumatic events throughout the migration process, im/migrant families display strong levels of resilience. Mental health services and providers should incorporate a strength-based approach in designing interventions that are culturally responsive and take into accounts the broader ecological contexts in which im/migrant families live.
KeywordsIntergenerational TraumaIm/MigrantsFamiliesResilienceMental Health
Crumlish, N. and Bracken, P. (2011) Mental Health and the Asylum Process. Irish Journal of Psychological Medicine , 28, 57-60. https://doi.org/10.1017/s0790966700011447
Clini, C., Thomson, L.J.M. and Chatterjee, H.J. (2019) Assessing the Impact of Artistic and Cultural Activities on the Health and Well-Being of Forcibly Displaced People Using Participatory Action Research. BMJ Open , 9, e025465. https://doi.org/10.1136/bmjopen-2018-025465
Porter, M. and Haslam, N. (2005) Predisplacement and Postdisplacement Factors Associated with Mental Health of Refugees and Internally Displaced Persons. JAMA , 294, 602-612. https://doi.org/10.1001/jama.294.5.602
Flanagan, N., Travers, A., Vallières, F., Hansen, M., Halpin, R., Sheaf, G., et al . (2020) Crossing Borders: A Systematic Review Identifying Potential Mechanisms of Intergenerational Trauma Transmission in Asylum-Seeking and Refugee Families. European Journal of Psychotraumatology , 11, Article ID: 1790283. https://doi.org/10.1080/20008198.2020.1790283
Miller, K.E. and Rasco, L.M. (2004) An Ecological Framework for Addressing the Mental Health Needs of Refugee Communities. In: Miller, K.E. and Rasco, L.M., Eds., The Mental Health of Refugees : Ecological Approaches to Healing and Adaptation , Lawrence Erlbaum Associates Publishers, 1-64.
Cerdeña, J.P., Rivera, L.M. and Spak, J.M. (2021) Intergenerational Trauma in Latinxs: A Scoping Review. Social Science & Medicine , 270, Article ID: 113662. https://doi.org/10.1016/j.socscimed.2020.113662
Kira, I.A., Ashby, J.S., Odenat, L. and Lewandowsky, L. (2013) The Mental Health Effects of Torture Trauma and Its Severity: A Replication and Extension. Psychology , 4, 472-482. https://doi.org/10.4236/psych.2013.45067
Toney-Butler, T.J., Ladd, M. and Mittel, O. (2023) Human Trafficking. StatPearls. https://pubmed.ncbi.nlm.nih.gov/28613660/
Watson, W.H. (2012) Family Systems. In: Ramachandran, V.S., Ed., Encyclopedia of Human Behavior , Elsevier, 184-193. https://doi.org/10.1016/b978-0-12-375000-6.00169-5
Fitzgerald, M., London-Johnson, A. and Gallus, K.L. (2020) Intergenerational Transmission of Trauma and Family Systems Theory: An Empirical Investigation. Journal of Family Therapy , 42, 406-424. https://doi.org/10.1111/1467-6427.12303
Sangalang, C.C. and Vang, C. (2016) Intergenerational Trauma in Refugee Families: A Systematic Review. Journal of Immigrant and Minority Health , 19, 745-754. https://doi.org/10.1007/s10903-016-0499-7
Braga, L.L., Mello, M.F. and Fiks, J.P. (2012) Transgenerational Transmission of Trauma and Resilience: A Qualitative Study with Brazilian Offspring of Holocaust Survivors. BMC Psychiatry , 12, Article No. 134. https://doi.org/10.1186/1471-244x-12-134
Fazel, M. (2019) Focusing a Lens on Refugee Families to Address Layers of Avoidance. The Lancet Public Health , 4, e318-e319. https://doi.org/10.1016/s2468-2667(19)30107-0
Vélez-Agosto, N.M., Soto-Crespo, J.G., Vizcarrondo-Oppenheimer, M., Vega-Molina, S. and García Coll, C. (2017) Bronfenbrenner’s Bioecological Theory Revision: Moving Culture from the Macro into the Micro. Perspectives on Psychological Science , 12, 900-910. https://doi.org/10.1177/1745691617704397
Antonovsky, A. (1993) The Structure and Properties of the Sense of Coherence Scale. Social Science & Medicine , 36, 725-733. https://doi.org/10.1016/0277-9536(93)90033-z
Han, M. (2006) Relationship among Perceived Parental Trauma, Parental Attachment, and Sense of Coherence in Southeast Asian American College Students. Journal of Family Social Work , 9, 25-45. https://doi.org/10.1300/j039v09n02_02
van Ee, E., Kleber, R.J. and Mooren, T.T.M. (2012) War Trauma Lingers On: Associations between Maternal Posttraumatic Stress Disorder, Parent-Child Interaction, and Child Development. Infant Mental Health Journal , 33, 459-468. https://doi.org/10.1002/imhj.21324
Dalgaard, N.T. and Hviid, P. (2016) Exploring the Transgenerational Transmission of Trauma in a Cultural Life Course Perspective. In: Sato, T., Mori, N. and Valsiner, J., Eds., Making of the Future : The Trajectory Equifinality Approach in Cultural Psychology , Information Age Publishing, 67-86.
Mathiesen, K.S., Sanson, A., Stoolmiller, M. and Karevold, E. (2008) The Nature and Predictors of Undercontrolled and Internalizing Problem Trajectories across Early Childhood. Journal of Abnormal Child Psychology , 37, 209-222. https://doi.org/10.1007/s10802-008-9268-y
Cai, J., Hayden, B. and Operario, D. (2017) Intergenerational Trauma and Mental Health in Asian American Immigrant Families. Bachelor’s Thesis, Brown University.
East, P.L., Gahagan, S. and Al-Delaimy, W.K. (2017) The Impact of Refugee Mothers’ Trauma, Posttraumatic Stress, and Depression on Their Children’s Adjustment. Journal of Immigrant and Minority Health , 20, 271-282. https://doi.org/10.1007/s10903-017-0624-2
Sangalang, C.C., Jager, J. and Harachi, T.W. (2017) Effects of Maternal Traumatic Distress on Family Functioning and Child Mental Health: An Examination of Southeast Asian Refugee Families in the U.S. Social Science & Medicine , 184, 178-186. https://doi.org/10.1016/j.socscimed.2017.04.032
Mak, C., Lewis, D.C. and Seponski, D.M. (2021) Intergenerational Transmission of Traumatic Stress and Resilience among Cambodian Immigrant Families along Coastal Alabama: Family Narratives. Health Equity , 5, 431-438. https://doi.org/10.1089/heq.2020.0142
Bryant, R.A., Edwards, B., Creamer, M., O’Donnell, M., Forbes, D., Felmingham, K.L., et al . (2018) The Effect of Post-Traumatic Stress Disorder on Refugees’ Parenting and Their Children’s Mental Health: A Cohort Study. The Lancet Public Health , 3, e249-e258. https://doi.org/10.1016/s2468-2667(18)30051-3
Dalgaard, N.T. and Montgomery, E. (2017) The Transgenerational Transmission of Refugee Trauma: Family Functioning and Children’s Psychosocial Adjustment. International Journal of Migration , Health and Social Care , 13, 289-301. https://doi.org/10.1108/ijmhsc-06-2016-0024
Rizkalla, N., Mallat, N.K., Arafa, R., Adi, S., Soudi, L. and Segal, S.P. (2020) “Children Are Not Children Anymore; They Are a Lost Generation”: Adverse Physical and Mental Health Consequences on Syrian Refugee Children. International Journal of Environmental Research and Public Health , 17, Article 8378. https://doi.org/10.3390/ijerph17228378
Bezo, B. and Maggi, S. (2015) Living in “Survival Mode:” Intergenerational Transmission of Trauma from the Holodomor Genocide of 1932-1933 in Ukraine. Social Science & Medicine , 134, 87-94. https://doi.org/10.1016/j.socscimed.2015.04.009
Qureshi, F., Misra, S. and Poshni, A. (2023) The Partition of India through the Lens of Historical Trauma: Intergenerational Effects on Immigrant Health in the South Asian Diaspora. SSM — Mental Health , 4, Article ID: 100246. https://doi.org/10.1016/j.ssmmh.2023.100246
Sack, W.H., Clarke, G.N. and Seeley, J. (1995) Posttraumatic Stress Disorder across Two Generations of Cambodian Refugees. Journal of the American Academy of Child & Adolescent Psychiatry , 34, 1160-1166. https://doi.org/10.1097/00004583-199509000-00013
Der Sarkissian, A. and Sharkey, J.D. (2021) Transgenerational Trauma and Mental Health Needs among Armenian Genocide Descendants. International Journal of Environmental Research and Public Health , 18, Article 10554. https://doi.org/10.3390/ijerph181910554
Karenian, H., Livaditis, M., Karenian, S., Zafiriadis, K., Bochtsou, V. and Xenitidis, K. (2010) Collective Trauma Transmission and Traumatic Reactions among Descendants of Armenian Refugees. International Journal of Social Psychiatry , 57, 327-337. https://doi.org/10.1177/0020764009354840
Berg, L., de Montgomery, E., Brendler-Lindquist, M., Mittendorfer-Rutz, E. and Hjern, A. (2021) Parental Post-Traumatic Stress and Psychiatric Care Utilisation among Refugee Adolescents. European Child & Adolescent Psychiatry , 31, 1953-1962. https://doi.org/10.1007/s00787-021-01827-1
Cai, J. and Lee, R.M. (2022) Intergenerational Communication about Historical Trauma in Asian American Families. Adversity and Resilience Science , 3, 233-245. https://doi.org/10.1007/s42844-022-00064-y
Field, N.P., Muong, S. and Sochanvimean, V. (2013) Parental Styles in the Intergenerational Transmission of Trauma Stemming from the Khmer Rouge Regime in Cambodia.. American Journal of Orthopsychiatry , 83, 483-494. https://doi.org/10.1111/ajop.12057
Dalgaard, N.T., Todd, B.K., Daniel, S.I.F. and Montgomery, E. (2015) The Transmission of Trauma in Refugee Families: Associations between Intra-Family Trauma Communication Style, Children’s Attachment Security and Psychosocial Adjustment. Attachment & Human Development , 18, 69-89. https://doi.org/10.1080/14616734.2015.1113305
Peltonen, K., Gredebäck, G., Pollak, S.D., Lindskog, M. and Hall, J. (2022) The Role of Maternal Trauma and Discipline Types in Emotional Processing among Syrian Refugee Children. European Child & Adolescent Psychiatry , 32, 1487-1495. https://doi.org/10.1007/s00787-022-01962-3
Campbell, S.B., Shaw, D.S. and Gilliom, M. (2000) Early Externalizing Behavior Problems: Toddlers and Preschoolers at Risk for Later Maladjustment. Development and Psychopathology , 12, 467-488. https://doi.org/10.1017/s0954579400003114
Anakwenze, O. and Rasmussen, A. (2021) The Impact of Parental Trauma, Parenting Difficulty, and Planned Family Separation on the Behavioral Health of West African Immigrant Children in New York City. Psychological Trauma : Theory , Research , Practice , and Policy , 13, 457-466. https://doi.org/10.1037/tra0001011
Commijs, A.I. (2014) The Intergenerational Transmission of Trauma in Refugee and Asylum Seeker Families: Sex Differences and the Underlying Mechanism. Master’s Thesis, University of Utrecht. https://studenttheses.uu.nl/handle/20.500.12932/15670
Hinshaw, S.P. (1987) On the Distinction between Attentional Deficits/Hyperactivity and Conduct Problems/aggression in Child Psychopathology. Psychological Bulletin , 101, 443-463. https://doi.org/10.1037//0033-2909.101.3.443
Eruyar, S., Maltby, J. and Vostanis, P. (2018) Mental Health Problems of Syrian Refugee Children: The Role of Parental Factors. European Child & Adolescent Psychiatry , 27, 401-409. https://doi.org/10.1007/s00787-017-1101-0
Spencer, J.H. and Le, T.N. (2006) Parent Refugee Status, Immigration Stressors, and Southeast Asian Youth Violence. Journal of Immigrant and Minority Health , 8, 359-368. https://doi.org/10.1007/s10903-006-9006-x
Benazzo, Z., Benazzo, M. and Harrison, C. (2021) The Wisdom of Trauma. Science and Nonduality. https://thewisdomoftrauma.com/
Maleku, A., Soukenik, E., Haran, H., Kirsch, J. and Pyakurel, S. (2021) Conceptualizing Mental Health through Bhutanese Refugee Lens: Findings from a Mixed Methods Study. Community Mental Health Journal , 58, 376-393. https://doi.org/10.1007/s10597-021-00835-4
Berg, L., Brendler-Lindquist, M., de Montgomery, E., Mittendorfer-Rutz, E. and Hjern, A. (2021) Parental Posttraumatic Stress and School Performance in Refugee Children. Journal of Traumatic Stress , 35, 138-147. https://doi.org/10.1002/jts.22708
Berg, L., Charboti, S., Montgomery, E. and Hjern, A. (2019) Parental PTSD and School Performance in 16-Year-Olds—A Swedish National Cohort Study. Nordic Journal of Psychiatry , 73, 264-272. https://doi.org/10.1080/08039488.2019.1620852
Sim, A., Bowes, L. and Gardner, F. (2018) Modeling the Effects of War Exposure and Daily Stressors on Maternal Mental Health, Parenting, and Child Psychosocial Adjustment: A Cross-Sectional Study with Syrian Refugees in Lebanon. Global Mental Health , 5, e40. https://doi.org/10.1017/gmh.2018.33
Benson, M.A., Abdi, S.M., Miller, A.B. and Heidi Ellis, B. (2018) Trauma Systems Therapy for Refugee Children and Families. In: Morina, N. and Nickerson, A., Eds., Mental Health of Refugee and Conflict - Affected Populations , Springer, 243-259. https://doi.org/10.1007/978-3-319-97046-2_12
Hinton, D.E., Rasmussen, A., Nou, L., Pollack, M.H. and Good, M. (2009) Anger, PTSD, and the Nuclear Family: A Study of Cambodian Refugees. Social Science & Medicine , 69, 1387-1394. https://doi.org/10.1016/j.socscimed.2009.08.018
Anderson, K. and van Ee, E. (2020) Reflective Functioning of Refugee Mothers with Children Born of Conflict-Related Sexual Violence. International Journal of Environmental Research and Public Health , 17, Article 2873. https://doi.org/10.3390/ijerph17082873
van Ee, E., Jongmans, M.J., van der Aa, N. and Kleber, R.J. (2016) Attachment Representation and Sensitivity: The Moderating Role of Posttraumatic Stress Disorder in a Refugee Sample. Family Process , 56, 781-792. https://doi.org/10.1111/famp.12228
Parmar, D.D., Minnis, A.M., Caballero, E., Zerofsky, M., Comfort, M. and Raymond-Flesch, M. (2023) Latina Mothers’ Perspectives on Adverse Experiences and Protection of Latinx Youth in an Agricultural Community. BMC Public Health , 23, Article No. 223. https://doi.org/10.1186/s12889-023-14993-5
van Ee, E., Kleber, R.J., Jongmans, M.J., Mooren, T.T.M. and Out, D. (2016) Parental PTSD, Adverse Parenting and Child Attachment in a Refugee Sample. Attachment & Human Development , 18, 273-291. https://doi.org/10.1080/14616734.2016.1148748
Field, N.P., Om, C., Kim, T. and Vorn, S. (2011) Parental Styles in Second Generation Effects of Genocide Stemming from the Khmer Rouge Regime in Cambodia. Attachment & Human Development , 13, 611-628. https://doi.org/10.1080/14616734.2011.609015
De Haene, L., Grietens, H. and Verschueren, K. (2007) From Symptom to Context: A Review of the Literature on Refugee Children’s Mental Health. Hellenic Journal of Psychology , 4, 233-256.
Rousseau, C., Measham, T. and Nadeau, L. (2012) Addressing Trauma in Collaborative Mental Health Care for Refugee Children. Clinical Child Psychology and Psychiatry , 18, 121-136. https://doi.org/10.1177/1359104512444117
Weine, S., Muzurovic, N., Kulauzovic, Y., Besic, S., Lezic, A., Mujagic, A., et al . (2004) Family Consequences of Refugee Trauma. Family Process , 43, 147-160. https://doi.org/10.1111/j.1545-5300.2004.04302002.x
Hafford, C. (2010) Sibling Caretaking in Immigrant Families: Understanding Cultural Practices to Inform Child Welfare Practice and Evaluation. Evaluation and Program Planning , 33, 294-302. https://doi.org/10.1016/j.evalprogplan.2009.05.003
Weine, S.M., Ware, N. and Klebic, A. (2004) Converting Cultural Capital among Teen Refugees and Their Families from Bosnia-Herzegovina. Psychiatric Services , 55, 923-927. https://doi.org/10.1176/appi.ps.55.8.923
Chase, N.D. (1999) Parentification: An Overview of Theory, Research, and Societal Issues. In: Chase, N.D., Ed., Burdened Children : Theory , Research , and Treatment of Parentification , SAGE Publications, Inc., 3-33. https://doi.org/10.4135/9781452220604.n1
Dalgaard, N.T. and Montgomery, E. (2015) Disclosure and Silencing: A Systematic Review of the Literature on Patterns of Trauma Communication in Refugee Families. Transcultural Psychiatry , 52, 579-593. https://doi.org/10.1177/1363461514568442
Karamehic-Muratovic, A., Sichling, F. and Doherty, C. (2022) Perceptions of Parents’ Mental Health and Perceived Stigma by Refugee Youth in the U.S. Context. Community Mental Health Journal , 58, 1457-1467. https://doi.org/10.1007/s10597-022-00958-2
Dalgaard, N.T., Diab, S.Y., Montgomery, E., Qouta, S.R. and Punamäki, R. (2019) Is Silence about Trauma Harmful for Children? Transgenerational Communication in Palestinian Families. Transcultural Psychiatry , 56, 398-427. https://doi.org/10.1177/1363461518824430
Bornstein, M.H. (2012) Cultural Approaches to Parenting. Parenting , 12, 212-221. https://doi.org/10.1080/15295192.2012.683359
Bulford, E., Fogarty, A., Giallo, R., Brown, S., Szwarc, J. and Riggs, E. (2022) Risk and Protective Factors Experienced by Fathers of Refugee Background during the Early Years of Parenting: A Qualitative Study. International Journal of Environmental Research and Public Health , 19, Article 6940. https://doi.org/10.3390/ijerph19116940
Ungar, M. (2006) Resilience across Cultures. British Journal of Social Work , 38, 218-235. https://doi.org/10.1093/bjsw/bcl343
Lin, M. (2022) Khmer Girls in Action and Healing Justice: Expanding Understandings of Anti-Asian Racism and Public Health Solutions. Frontiers in Public Health , 10, Article 956308. https://doi.org/10.3389/fpubh.2022.956308
Ngameni, E.G., El Husseini, M., Dozio, E., Kokou-Kpolou, C.K., Apter, G. and Moro, M.R. (2022) Whether and When Disclosing the Trauma to One’s Children in a Migratory Context? A Pilot Mixed Methods Investigation. BMC Psychology , 10, Article No. 144. https://doi.org/10.1186/s40359-022-00858-w
Kelstrup, L. and Carlsson, J. (2022) Trauma-Affected Refugees and Their Non-Exposed Children: A Review of Risk and Protective Factors for Trauma Transmission. Psychiatry Research , 313, Article ID: 114604. https://doi.org/10.1016/j.psychres.2022.114604
Hyman, I., Beiser, M. and Vu, N. (1996) The Mental Health of Refugee Children in Canada. Refuge : Canada ’ s Journal on Refugees , 15, 4-8. https://doi.org/10.25071/1920-7336.21885
Vaage, A.B., Thomsen, P.H., Rousseau, C., Wentzel-Larsen, T., Ta, T.V. and Hauff, E. (2011) Paternal Predictors of the Mental Health of Children of Vietnamese Refugees. Child and Adolescent Psychiatry and Mental Health , 5, Article No. 2. https://doi.org/10.1186/1753-2000-5-2
Parker, J., Shook, B., Washington, D., English, B. and Tatum, C. (2024) The Effect of Tension and Trauma Releasing Exercises (TRE) on Trauma Symptoms in East African Refugees. Psychology , 15, 77-91. https://doi.org/10.4236/psych.2024.151006
Phillips, M., McDonald, T. and Kishbaugh, D. (2017) Using Evidence Based Home Visiting for Preventing Intergenerational Adverse Childhood Experiences. Psychology , 8, 2516-2533.
Desai, G. and Chaturvedi, S.K. (2017) Idioms of Distress. Journal of Neurosciences in Rural Practice , 8, S094-S097. https://doi.org/10.4103/jnrp.jnrp_235_17
Briggs, R.D., Silver, E.J., Krug, L.M., Mason, Z.S., Schrag, R.D.A., Chinitz, S., et al . (2014) Healthy Steps as a Moderator: The Impact of Maternal Trauma on Child Social-Emotional Development. Clinical Practice in Pediatric Psychology , 2, 166-175. https://doi.org/10.1037/cpp0000060