Low levels of posttraumatic stress symptoms and psychiatric symptomatology among third-generation Holocaust survivors whose fathers were war veterans Gadi Zerach a, * , Zahava Solomon b a Department of Behavioral Sciences, Ariel University, Ariel, Israel b Bob Shapell School of Social Work, Tel Aviv University, Tel Aviv, Israel article info Article history: Received 10 September 2015 Received in revised form 11 November 2015 Accepted 20 November 2015 Keywords: Holocaust Captivity PTSS Secondary traumatization Anxiety sensitivity Third generation abstract There is an ongoing debate regarding the intergenerational transmission of Holocaust trauma to the third generation (TGH). However, due to the rareness of this population, there are no studies that have examined TGH individuals whose fathers were also victims of war-related trauma and captivity. This prospective study aimed to assess the role of parents' Holocaust background, fathers' posttraumatic stress symptoms (PTSS), and adult offspring's anxiety sensitivity (AS) in adult offspring's PTSS and psychiatric symptomatology. A sample of 123 Israeli father-child dyads (42 TGH and 71 non-TGH), that included 80 former prisoners of war (ex-POWs) dyads and a comparison group of 44 veteran dyads, completed AS, PTSS and psychiatric symptomatology self-report measures. Fathers were assessed 17 years following the Yom Kippur War (T1: 2008) while offspring took part in T2 (2013e2014). Surpris- ingly, results show that TGH participants reported lower levels of PTSS and psychiatric symptomatology than non-TGH participants, regardless of their fathers' captivity status. Interestingly, a moderated mediation analysis indicated that offspring's AS mediated the association between Holocaust background and participants' PTSS and psychiatric symptomatology, only among ex-POWs' offspring. This study provides evidence for relatively lower levels of PTSS and psychiatric symptomatology among TGH in- dividuals whose fathers were war veterans. Ex-POWs' adult offspring who are grandchildren of Holo- caust survivors reported lower levels of AS that was related to lower levels of PTSS and psychiatric symptomatology. © 2015 Elsevier Ltd. All rights reserved. 1. Introduction Research on the intergenerational transmission of trauma from Holocaust survivors (HS) to their second-generation offspring (SGH) has gained increased attention over the two last decades (e.g., Van IJzendoorn et al., 2003). However, only a limited number of empirical studies have examined whether the intergenerational transmission of trauma spills over to the third generation of Ho- locaust survivors (TGH; e.g., Letzter-Pouw et al., 2014). Beyond the catastrophic implication of the Holocaust to its survivors, this is a world-wide relevant question as a number of populations around the globe continue to suffer from massive genocides that may potentially affect their children and grandchildren through a continuous cycle of fear and pain. The literature regarding TGH has shown various, and somewhat contradictory, findings. On the one hand, some studies indicated that TGH adults endorsed disordered eating (Zohar et al., 2007), depression and psychosomatic symptoms (Ullmann et al., 2013) and secondary traumatization symptoms (Giladi and Bell, 2013), more so than comparison groups. On the other hand, some studies have found no significant differences in various psychopathology outcomes between TGH and comparison groups (e.g., Perlstein and Motta, 2013). Moreover, a comprehensive meta-analysis revealed no evidence of intergenerational transmission of Holocaust trauma to TGH in terms of psychological functioning and attachment pat- terns (Sagi-Schwartz et al., 2008). This may be considered, among other explanations, as a sign of resilience. Resilience may be nominally defined as a dynamic process encompassing positive adaptation within the context of significant * Corresponding author. Department of Behavioral Sciences, Ariel University, Ariel 40700, Israel. E-mail address: gadize@ariel.ac.il (G. Zerach). Contents lists available at ScienceDirect Journal of Psychiatric Research journal homepage: www.elsevier.com/locate/psychires http://dx.doi.org/10.1016/j.jpsychires.2015.11.014 0022-3956/© 2015 Elsevier Ltd. All rights reserved. Journal of Psychiatric Research 73 (2016) 25e33