Children born decades after the Holocaust to mothers who were older than five years old when Nazi persecution began faced more than double the risk of schizophrenia, according to a new study that identifies a specific childhood period when parental trauma may have lasting effects across generationsç according to TPS-IL.
While previous research has documented psychological effects among Holocaust survivors and their descendants, the study provides new evidence that the age at which parents experience severe trauma may influence how its effects are transmitted to future generations.
“Awareness in Israel has come a long way, but it is still not uniform,” Mark Sherman, director of the Medical Psychology Service at Meuhedet’s Northern District and an expert in trauma and resilience who was not involved in the study, told The Press Service of Israel. Meuhedet is one of Israel’s four national health maintenance organizations, providing healthcare services to more than 1 million members nationwide.
“In the first decades after the Holocaust, there was a tendency to repress and silence within families, whereas today there is broader recognition among professionals of the phenomenon of intergenerational transmission of trauma,” Sherman said.
The research, published in the peer-reviewed American Journal of Psychiatry, was led by Prof. Hagit Hochner and Dr. Iaroslav Youssim from the Braun School of Public Health and Community Medicine at the Hebrew University of Jerusalem, together with Prof. Dolores Malaspina from Mount Sinai School of Medicine in New York, and other researchers.
The researchers analyzed data from the Jerusalem Perinatal Study, which tracked births in West Jerusalem between 1964 and 1976, and linked the records to Israel’s National Psychiatric Registry through 2004. The study included 14,759 children of tracked mothers and 18,085 children of tracked fathers.
Parents were classified as Holocaust-exposed if they were Jewish, born in European countries under Nazi rule, and immigrated to Israel after anti-Jewish persecution began. Researchers divided them according to whether they were five years old or younger, or older than five, when Nazi persecution started.
The strongest association was found among children of mothers who were older than five at the time. Their children had more than twice the risk of schizophrenia compared with children whose mothers were not exposed, even after adjustments for socioeconomic factors, birth weight, and maternal psychiatric history.
The researchers stressed that the findings show an association, not a direct cause-and-effect relationship. Schizophrenia is a complex disorder influenced by a combination of genetic, biological, environmental and social factors, and most children of Holocaust survivors did not develop the illness.
The study found no increased schizophrenia risk among children of parents who were five years old or younger when persecution began.
Sherman said the age identified in the study may be significant because around age five, children undergo major emotional and cognitive development.
“This is the stage in which a child begins to internalize his parents as those who represent the world for him,” he explained. “When a parent deals with unresolved trauma, the child may absorb the parent’s anxiety and internalize it as part of his own perception of reality.”
The study also found differences between maternal and paternal exposure. While children of fathers who were older than five at the start of Nazi persecution initially showed elevated risk, the association weakened after adjustments for demographic factors. Researchers suggested that maternal trauma may affect future generations through factors including the prenatal environment, early childhood caregiving, or biological mechanisms.
Sherman said the findings have relevance beyond Holocaust survivors, noting that similar patterns may appear among populations affected by war, genocide, and forced displacement.
“Trauma does not remain only with the parents, but often becomes an entire family climate,” he said. “Children born into a reality of violence, war, or displacement may develop a worldview that the world is an unpredictable, dangerous, and unsafe place.”
He said policymakers should focus on early identification, family-based treatment, and community resilience programs.
“When it comes to complex trauma, it is not enough to treat the child alone,” Sherman said. “In many cases, integrative treatment is needed that addresses both the parent and the child and the entire family system.”
Sherman added that Meuhedet provides mental health services through community clinics staffed by psychologists and clinical social workers trained in trauma treatment. In complex cases, patients may be referred to specialized centers treating intergenerational trauma among second- and third-generation Holocaust survivors.
