Jutta Lindert1, Haim Y Knobler2, Ichiro Kawachi3, Paul A Bain4, Moshe Z Abramowitz5, Charlotte McKee6, Shula Reinharz7, Martin McKee8. 1. Department of Health and Social Work, University of Emden, Emden, Germany and Women`s Research Center, Brandeis University, Waltham, MA, USA. 2. Jerusalem Mental Health Center, Hadassah Hebrew University Medical School, Jerusalem, Israel and Peres Academic Center, Rehovot, Israel. 3. Department of Social and Behavioral Sciences. 4. Countway Library, Harvard School of Public Health, Boston, MA, USA. 5. Jerusalem Mental Health Center, Hadassah Hebrew University Medical School, Jerusalem, Israel. 6. Department pf Political Sciences, Exeter University, Exeter, UK. 7. Women's Research Center, Brandeis University, Waltham, MA, USA. 8. Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine, London, UK.
Abstract
Background: : The health consequences of genocides on children of survivors are increasingly discussed but conclusions have been conflicting. Methods: We systematically reviewed studies from five electronic databases (EMBASE, PILOTS, PUBMED, PsycINFO, Web of Science), which used a quantitative study design and included: (i) exposure to the genocides of Armenians in Nazi Germany, Cambodia, Rwanda and Bosnia; (ii) mental health outcomes; (iii) validated instruments; (iv) statistical tests of associations. Study quality was appraised using a quality assessment tool for genocide studies. PRISMA reporting guidelines were followed. Results: From 3352 retrieved records, 20 studies with a total of 4793 participants involving 2431 children of survivors and 2362 controls met the eligibility criteria. Studies were conducted in seven countries: Australia, Canada, Italy, Israel, Norway, Rwanda and the USAs over the past seven decades, using the Genocide Studies Quality Assessment Tool. Data from the high quality studies provide no consistent evidence that children of genocide survivors are more likely to have mental health problems than comparators who were not children of genocide survivors. Conclusions: Methodological characteristics were associated with findings: studies investigating random samples of genocide survivors did not find an impact of genocides on health of children of survivors. Potential confounders (e.g. recent life events, poverty) need further investigation. Future studies of the impact of genocides on mental health should report using a standardized structure, such as the quality tool used here.
Background: : The health consequences of genocides on children of survivors are increasingly discussed but conclusions have been conflicting. Methods: We systematically reviewed studies from five electronic databases (EMBASE, PILOTS, PUBMED, PsycINFO, Web of Science), which used a quantitative study design and included: (i) exposure to the genocides of Armenians in Nazi Germany, Cambodia, Rwanda and Bosnia; (ii) mental health outcomes; (iii) validated instruments; (iv) statistical tests of associations. Study quality was appraised using a quality assessment tool for genocide studies. PRISMA reporting guidelines were followed. Results: From 3352 retrieved records, 20 studies with a total of 4793 participants involving 2431 children of survivors and 2362 controls met the eligibility criteria. Studies were conducted in seven countries: Australia, Canada, Italy, Israel, Norway, Rwanda and the USAs over the past seven decades, using the Genocide Studies Quality Assessment Tool. Data from the high quality studies provide no consistent evidence that children of genocide survivors are more likely to have mental health problems than comparators who were not children of genocide survivors. Conclusions: Methodological characteristics were associated with findings: studies investigating random samples of genocide survivors did not find an impact of genocides on health of children of survivors. Potential confounders (e.g. recent life events, poverty) need further investigation. Future studies of the impact of genocides on mental health should report using a standardized structure, such as the quality tool used here.