Center for the Study of Child Development, University of Haifa, Haifa, Israel.
Psychol Bull. 2010 Sep;136(5):677-98. doi: 10.1037/a0020339.
The current set of meta-analyses elucidates the long-term psychiatric, psychosocial, and physical consequences of the Holocaust for survivors. In 71 samples with 12,746 participants Holocaust survivors were compared with their counterparts (with no Holocaust background) on physical health, psychological well-being, posttraumatic stress symptoms, psychopathological symptomatology, cognitive functioning, and stress-related physiology. Holocaust survivors were less well adjusted, as apparent from studies on nonselected samples (trimmed combined effect size d = 0.22, 95% CI [0.13, 0.31], N = 9,803) and from studies on selected samples (d = 0.45, 95% CI [0.32, 0.59], N = 2,943). In particular, they showed substantially more posttraumatic stress symptoms (nonselect studies: d = 0.72, 95% CI [0.46, 0.98], N = 1,763). They did not lag, however, much behind their comparisons in several other domains of functioning (i.e., physical health, stress-related physical measures, and cognitive functioning) and showed remarkable resilience. The coexistence of stress-related symptoms and good adaptation in some other areas of functioning may be explained by the unique characteristics of the symptoms of Holocaust survivors, who combine resilience with the use of defensive mechanisms. In most domains of functioning no differences were found between Israeli samples and samples from other countries. The exception was psychological well-being: For this domain it was found that living in Israel rather than elsewhere can serve as a protective factor. A biopsychological stress-diathesis model is used to interpret the findings, and future directions for research and social policy are discussed.
目前的一系列荟萃分析阐明了大屠杀对幸存者的长期精神、心理和身体健康后果。在 71 个样本中，共有 12746 名参与者，将大屠杀幸存者与对照组（无大屠杀背景）进行了比较，比较的方面包括身体健康、心理健康、创伤后应激症状、精神病理学症状、认知功能和应激相关的生理指标。非选择性样本研究表明（修剪后的综合效应大小 d = 0.22，95%置信区间 [0.13，0.31]，N = 9803），从选择性样本研究中也可以看出（d = 0.45，95%置信区间 [0.32，0.59]，N = 2943），大屠杀幸存者的适应能力较差。特别是，他们表现出更多的创伤后应激症状（非选择性研究：d = 0.72，95%置信区间 [0.46，0.98]，N = 1763）。然而，在其他几个功能领域（即身体健康、与应激相关的生理指标和认知功能），他们并没有明显落后于对照组。在一些其他功能领域中，存在应激相关症状和良好适应的共存现象，这可能可以用大屠杀幸存者的症状的独特特征来解释，他们将韧性与防御机制的使用结合起来。在大多数功能领域中，以色列样本和其他国家的样本之间没有差异。例外的是心理健康：对于这一领域，发现生活在以色列而不是其他地方可以作为一个保护因素。一个生物心理应激素质模型被用来解释这些发现，并讨论了未来研究和社会政策的方向。
