Transgenerational transfer of genocidal trauma: a systematic review and meta-analysis

This meta-analysis aims to estimate the prevalence of posttraumatic stress disorder (PTSD) among the offspring of genocide survivors and examine study-level moderators influencing PTSD rates across cultural settings. Following PRISMA guidelines, seven peer-reviewed studies were identified through systematic searches of major databases, covering genocides in Rwanda, Cambodia, Armenia and Israel (Holocaust). A total of 1,569 participants were included. Data were extracted on sample size, mean age, gender composition, generation, diagnostic assessment tools, and World Bank country classification. A random-effects model was used to estimate pooled prevalence, and meta-regressions assessed the moderating effects of gender composition and mean age. Heterogeneity was evaluated using I² and Q statistics. The pooled probable PTSD prevalence across the seven studies was 17.9% (95% CI: 9.9%-25.8%), which is significantly higher than global population norms during peacetime and not substantially lower than prevalence estimates reported in civilian populations living in war zones. Heterogeneity was substantial (I² = 95.03%, p