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Dear colleagues,
Written by: Helen Christie, Clinical Psychologist.
Three studies have examined possible biological traces of trauma, including altered cortisol levels in newborn babies and epigenetic changes. Epigenetics does not change the DNA sequence itself. Rather, processes such as DNA methylation can influence how cells read DNA and whether particular genes are more or less active.
Such changes may affect the body’s stress-response system and create greater vulnerability to later stress and adversity. However, they do not determine a child’s future. Supportive relationships, safe living conditions and appropriate assistance can protect children and help interrupt the transmission of trauma between generations.
Biological traces of trauma |
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These three studies illustrate how trauma may leave biological traces. Rachel Yehuda and colleagues studied women who had been pregnant during the 9/11 terrorist attacks and their children. The study found significantly lower cortisol levels in mothers who developed post-traumatic stress disorder and in their infants. |
Cortisol normally rises when the body responds to danger. However, after prolonged or “toxic” stress, the stress-response system may become dysregulated and no longer react in the usual way. Unusually low cortisol levels may therefore be associated with difficulties regulating emotions and coping with stress.
One hypothesis is that this reduced stress response contributes to detachment, numbness and flattened emotional expression. It may help explain so-called “shutdown” reactions, in which a child stops seeking comfort, reaching out to caregivers or clearly signalling their needs (Gerhardt, 2004; Yehuda et al., 2005).
A study of mothers exposed to the 1994 genocide against the Tutsi in Rwanda examined whether prenatal exposure to genocide-related trauma was associated with biological ageing in their children. The researchers found signs of accelerated epigenetic ageing, suggesting that fetal development may be particularly sensitive to extreme maternal stress (Uwizeye et al., 2025).
A more recent study involved 48 Syrian refugee families across three generations. The researchers identified patterns of DNA methylation associated with direct exposure to war-related violence and with exposure in earlier generations. They also found signs of accelerated epigenetic ageing among children exposed to violence before birth. These findings are important, but the study was relatively small and cannot by itself prove that trauma is biologically inherited (Mulligan et al., 2025).
Trauma can also be communicated through relationships
Intergenerational trauma is not only biological. Parents who have experienced severe trauma may become highly anxious and overprotective. Others may withdraw emotionally or alternate between being unavailable and becoming overwhelmed.
Research involving Palestinian families in Gaza has shown that war-related trauma and parents’ mental health can affect parent–child interaction and children’s emotional development. At the same time, sensitive caregiving and supportive relationships can protect children and strengthen their capacity to cope (Qouta et al.; Punamäki et al).
Children depend on caregivers to help them manage fear, anger and distress. Through sensitive and emotionally attuned responses, caregivers support the child’s developing capacity for emotional regulation. A child’s distress may sometimes activate a traumatised parent’s own memories and emotions. When the parent becomes overwhelmed, their ability to understand and respond to the child’s feelings may temporarily be reduced. Support can help parents recognise these reactions, regulate their own emotions and remain emotionally available to their children (Fonagy et al., 2002; Asen & Fonagy, 2017).
Trauma may also be communicated through what families say, or do not say about painful experiences. Research among Palestinian families indicates that children may benefit when parents communicate facts and meanings in ways they can understand. However, the effects of silence are complex, and silence alone was not associated with poorer child mental health in this study (Dalgaard et al., 2019).
Prevention is possible
Trauma in families is often surrounded by silence. Even when children are not told what has happened, they may sense that a family secret carries strong and difficult emotions.
Preventing the intergenerational transmission of trauma involves helping the traumatised person regulate and process their experiences. Parents also need psychoeducation to understand how their trauma and emotional reactions may affect their children.
Children should be given age-appropriate explanations of what the family has experienced. This should happen in a safe and controlled way, with emotions that are genuine but regulated, so that the child is not left alone with uncertainty or overwhelmed by the parent’s distress.
About the writer: Helen Christie is a clinical psychologist and former director of the RBUP. She is an expert in trauma, sexual abuse of children, and late effects in adults. Her extensive work includes helping traumatised refugee and war-zone children, and she has co-authored several key mental health manuals on gen der-based violence and trauma stabilisation.
Further Reading About Intergenerational Transmission of Trauma
How trauma can affect the next generation. Understanding how the effects of trauma may influence the second and third generations can help us prevent or reduce these effects.
Transgenerational effects of posttraumatic stress disor...
Rachel Yehuda, Stephanie Mulherin Engel, Sarah R Brand, Jonathan Seckl, Sue M Marcus, Gertrud S Berkowitz
Reduced cortisol levels have been linked with vulnerability to posttraumatic stress disorder (PTSD) and the risk factor of parental PTSD in adult offspring of Holocaust survivors.
Intergenerational transmission of trauma effects: putat...
Rachel Yehuda, Amy Lehrner
This paper reviews the research evidence concerning the intergenerational transmission of trauma effects and the possible role of epigenetic mechanisms in this transmission. Two broad categories of epigenetically mediated effects are highlighted. The...
Is silence about trauma harmful for children? Transgene...
Nina Thorup Dalgaard, Safwat Y. Diab, Raija-Leena Punamäki
Style of family communication is considered important in the transgenerational transmission of trauma. This study had three aims: first, to identify the contents of family communication about past national trauma; second, to examine how parents’ curr...
Mentalizing Family Violence Part 1: Conceptual Framewor...
Eia Asen, Peter Fonagy
This is the first of two companion papers describing concepts and techniques of a mentalization-based approach to understanding and managing family violence. We review evidence that attachment difficulties, sudden high levels of arousal, and poor aff...
War trauma and infant motor, cognitive, and socioemotio...
Samir R. Qouta, Mervi Vänskä, Safwat Y. Diab, Raija-Leena Punamäki
Development is intensive and miraculous during the first years of life: an infant creates a unique dyadic interaction with the caregiver; learns apt ways of attention and coordination; improves in grasping objects, crawling, and walking; and develops...
Family systems approach to attachment relations, war tr...
Raija-Leena Punamäki, Samir R Qouta, Kirsi Peltonen
When discussing families living in conflict zones, parents commonly express worry about their children’s safety, and children frequently refer to their family members as a source of security. A Palestinian father said, ‘My 3-year-old promised to guar...
Intergenerational trauma in forcibly-displaced populati...
Correa-Salazar, D S Torres-Benítez, E Agudelo-Avellaneda
Overlapping humanitarian crises make the Americas home to one in every five forcibly displaced or stateless persons worldwide. Although a robust body of literature describes the intergenerational effects of traumatic experiences related to forced dis...
Epigenetic signatures of intergenerational exposure to ...
Connie J. Mulligan, Edward B. Quinn, Dima Hamadmad, Christopher L. Dutton, Lisa Nevell, Alexandra M. Binder, Catherine Panter-Brick, Rana Dajani
Maternal trauma influences infant and adult health outcomes and may impact future generations through epigenetic modifications such as DNA methylation (DNAm). Research in humans on the intergenerational epigenetic transmission of trauma effects is li...
When Trauma Crosses Generations: Mechanisms, Clinical P...
Oliwia Froń, Kamila Chwesiuk, Dominika Jabłonka, Agnieszka Kułak-Bejda
Transgenerational trauma (TT)/Intergenerational trauma (IT) is the transmission of the effects of traumatic experiences of parents to their children, who have not themselves experienced traumatic events. This transmission occurs through neurobiologic...
The impact of historical trauma on health outcomes for ...
Joseph P. Gone, William E. Hartmann, Andrew Pomerville, Dennis C. Wendt, Sarah H. Klem, Rachel L. Burrage
Beginning in the mid-1990s, the construct of historical trauma was introduced into the clinical and health science literatures to contextualize, describe, and explain disproportionately high rates of psychological distress and health disparities amon...
Intergenerational Trauma in Phenomenological Research—A...
Alessia Cacace, S. J. Summers
This systematic review aimed to synthesize phenomenological qualitative research regarding the lived experience of intergenerational trauma. Twenty-two studies were included in the review and were analyzed using thematic synthesis. Five analytical th...
Assessing transgenerational trauma transmission: develo...
Vera Békés
Despite increasing attention on transgenerational trauma, currently no comprehensive model and measure exists to be applied on various populations. This study represents the first step in the validation of such a model and a related scale. The Histor...
Attachment, Mentalizing and Trauma: Then (1992) and Now...
Peter Fonagy, Chloe Campbell, Patrick Luyten
This article reviews the current status of research on the relationship between attachment and trauma in developmental psychopathology. Beginning with a review of the major issues and the state-of-the-art in relation to current thinking in the field ...
Child development and family mental health in war and m...
Samir Qouta, Raija-Leena Punamäki, Eyad El Sarraj
The article reviews developmental research among Palestinians living in Gaza. The aims are, first, to analyze how exposure to traumatic events associates with children’s mental health and their cognitive, emotional and social development. Secon...
Prenatal exposure to genocide accelerates epigenetic ag...
Glorieuse Uwizeye, Luisa M Rivera, Hannah G Stolrow, Brock C Christensen, Julienne N Rutherford, Zaneta M Thayer
Prenatal exposure genocide-related to trauma has been previously associated with increased morbidity. Whether the prenatal exposure to genocide and rape also impacts various aspects of biological regulation, including patterns of DNA methylation, rem...
Minireview: Stress-related psychiatric disorders with l...
Rachel Yehuda, Jonathan Seckl
Several stress-associated neuropsychiatric disorders, notably posttraumatic stress disorder and chronic pain and fatigue syndromes, paradoxically exhibit somewhat low plasma levels of the stress hormone cortisol. The effects appear greatest in those ...
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The International Society for Health and Human Rights (ISHHR) invites abstract submissions, focusing on ceremonial and culture-based approaches to healing in the context of human rights abuses. We welcome contributions from Indigenous leaders and community members, practitioners, researchers, students, educators, advocates, and others working with survivors of trauma and human rights violations. While all relevant topics are encouraged, we particularly welcome submissions addressing intergenerational trauma and Indigenous perspectives and experiences.
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