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Filial anxiety, sense of obligation higher in children of Holocaust survivors

Amit Shrira

Children of Holocaust survivors who care for their elderly parents experienced a higher sense of filial obligation and anxiety, especially when parents had PTSD, according to research published in Aging & Mental Health.

“Abundant research has been devoted to delineate the dynamics between adults and their aging parents, mainly focusing on relationship quality, caregiving experience and well-being concomitants,” Amit Shrira, PhD, of the interdisciplinary department of social sciences, Bar-Ilan University, Israel, and colleagues wrote. “However, much less is known about adult offspring caring for traumatized parents. Massive trauma and its long-term effects may shape familial relationships across the lifespan and create unique interpersonal qualities.”

The investigators conducted three studies to examine the filial anxiety and sense of obligation among adult children of Holocaust survivors who care for their aging parents.

Researchers interviewed 10 offspring of Holocaust survivors, asking them to share their experiences as caretakers, to determine themes of filial anxiety in the first study. In the second, they interviewed 28 children of Holocaust survivors and 31 children of parents not directly exposed to the Holocaust using a newly constructed scale of filial anxiety based on data from the first study. In the third, researchers interviewed 86 Holocaust survivor parent-child dyads and 57 control dyads, and parents completed the DSM-5 20-item PTSD Checklist.

In the first study, the children of Holocaust survivors shared concerns regarding their parents’ condition and decline, their desire to ensure their parents suffered as little as possible and the emotional toll of caring for parents who survived traumatic events alongside normal caregiving difficulties.

The results of study two showed that offspring who cared for Holocaust survivors reported higher filial anxiety related to higher obligation (P < .0001) and more symptoms of generalized anxiety (P = .002) and sense of obligation compared to comparisons.

In study three, there were 21 Holocaust parent-child dyads with a parent with PTSD. Shrira and colleagues observed that higher familial anxiety was linked to a stronger sense of obligation (P < .0001), more anxiety symptoms (P < .0001) and higher PTSD in children (P = .006). Furthermore, these results remained significant after adjusting for child symptoms in the second and third studies.

“These findings have some important practical implications for practitioners assisting adult offspring of Holocaust survivors in caring for their parents,” Shrira said in a press release. “Practitioners should help both sides process negative emotions, resolve conflictual and problematic relationships and improve their relationships. They should also facilitate offspring comprehension of, and empathy towards, complicated behaviors exhibited by the care recipient. Lastly, they should encourage offspring of Holocaust survivors to express their own needs and suggest other methods of care for their parents so that the burden doesn't fall entirely upon them.” – by Savannah Demko

Disclosures: The authors report no relevant financial disclosures.