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Cultural trauma and epigenetic inheritance

Published online by Cambridge University Press:  28 September 2018

Amy Lehrner
James J. Peters Veterans Affairs Medical Center Icahn School of Medicine at Mount Sinai
Rachel Yehuda
James J. Peters Veterans Affairs Medical Center Icahn School of Medicine at Mount Sinai
E-mail address:


The question of whether and how the effects of cultural trauma can be transmitted intergenerationally from parents to offspring, or even to later generations, has evoked interest and controversy in academic and popular forums. Recent methodological advances have spurred investigations of potential epigenetic mechanisms for this inheritance, representing an exciting area of emergent research. Epigenetics has been described as the means through which environmental influences “get under the skin,” directing transcriptional activity and influencing the expression or suppression of genes. Over the past decade, this complex environment–biology interface has shown increasing promise as a potential pathway for the intergenerational transmission of the effects of trauma. This article reviews challenges facing research on cultural trauma, biological findings in trauma and posttraumatic stress disorder, and putative epigenetic mechanisms for transmission of trauma effects, including through social, intrauterine, and gametic pathways. Implications for transmission of cultural trauma effects are discussed, focused on the relevance of cultural narratives and the possibilities of resilience and adaptivity.

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The authors would like to thank Alex Ropes, Migle Staniskyte, and Emmanuel Ruhamya for assistance with manuscript preparation.


Aarons, V. (Ed.) (2016). Third-generation holocaust narratives: Memory in memoir and fiction. Lanham, MD: Lexington Books.Google Scholar
Abrams, M. S. (1999). Intergenerational transmission of trauma: Recent contributions from the literature of family systems approaches to treatment. American Journal of Psychotherapy, 53, 225231. doi:10.1176/appi.psychotherapy.1999.53.2.225CrossRefGoogle Scholar
Alexander, J. C. (2004). Toward a theory of cultural trauma. Cultural Trauma and Collective Identity, 76, 620639. doi:10.1525/california/9780520235946.003.0001Google Scholar
American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.Google Scholar
Anway, M. D., Cupp, A. S., Uzumcu, M., & Skinner, M. K. (2005). Epigenetic transgenerational actions of endocrine disruptors and male fertility. Science, 308, 14661469. doi:10.1126/science.1108190CrossRefGoogle ScholarPubMed
Argenti, N., & Schramm, K. (2009). Remembering violence: Anthropological perspectives on intergenerational transmission. New York: Berghahn Books.Google Scholar
Azarian-Ceccato, N. (2010). Reverberations of the Armenian genocide: Narrative's intergenerational transmission and the task of not forgetting. Narrative Inquiry, 20, 106123. doi:10.1075/ni.20.1.06azaCrossRefGoogle Scholar
Bader, H. N., Bierer, L. M., Lehrner, A., Makotkine, I., Daskalakis, N. P., & Yehuda, R. (2014). Maternal age at Holocaust exposure and maternal PTSD independently influence urinary cortisol levels in adult offspring. Frontiers in Endocrinology, 5, 18. doi:10.3389/fendo.2014.00103CrossRefGoogle ScholarPubMed
Bale, T. L. (2014). Lifetime stress experience: Transgenerational epigenetics and germ cell programming. Dialogues in Clinical Neuroscience, 16, 297305.Google ScholarPubMed
Barocas, H. A., & Barocas, C. B. (1980). Separation-individuation conflicts in children of Holocaust survivors. Journal of Contemporary Psychotherapy, 11, 614. doi:10.1007/BF00946270CrossRefGoogle Scholar
Barron, I. G., & Abdallah, G. (2015). Intergenerational trauma in the occupied Palestinian territories: Effect on children and promotion of healing. Journal of Child & Adolescent Trauma, 8, 103110. doi:10.1007/s40653-015-0046-zCrossRefGoogle Scholar
Betancourt, T. S., McBain, R. K., Newnham, E. A., & Brennan, R. T. (2015). The intergenerational impact of war: Longitudinal relationships between caregiver and child mental health in postconflict Sierra Leone. Journal of Child Psychology and Psychiatry, 56, 11011107. doi:10.1111/jcpp.12389CrossRefGoogle ScholarPubMed
Bezo, B., & Maggi, S. (2015). Living in “survival mode”: Intergenerational transmission of trauma from the Holodomor genocide of 1932–1933 in Ukraine. Social Science & Medicine, 134, 8794. doi:10.1016/j.socscimed.2015.04.009CrossRefGoogle ScholarPubMed
Blades, L. A. (2016). Trauma from slavery can actually be passed down through your genes. Retrieved from Scholar
Brach, C., & Fraserirector, I. (2000). Can cultural competency reduce racial and ethnic health disparities? A review and conceptual model. Medical Care Research and Review, 57(Suppl. 2), 181217. doi:10.1177/1077558700057001S09CrossRefGoogle ScholarPubMed
Brave Heart, M. Y. H. (1998). The return to the sacred path: Healing the historical trauma and historical unresolved grief response among the Lakota through a psychoeducational group intervention. Smith College Studies in Social Work, 68, 287305. doi:10.1080/00377319809517532CrossRefGoogle Scholar
Breslau, N. (2009). The epidemiology of trauma, PTSD, and other posttrauma disorders. Trauma, Violence & Abuse, 10, 198210. doi:10.1177/1524838009334448CrossRefGoogle ScholarPubMed
Bronfenbrenner, U. (1977). Toward an experimental ecology of human development. American Psychologist, 32, 513531. doi:10.1037/0003-066X.32.7.513CrossRefGoogle Scholar
Bronfenbrenner, U. (2009). The ecology of human development: Experiments by nature and design. Cambridge, MA: Harvard University Press.Google Scholar
Calhoun, L. G., & Tedeschi, R. G. (Eds.) (2014). Handbook of posttraumatic growth: Research and practice. New York: Routledge.CrossRefGoogle Scholar
Carpenter, T., Grecian, S., & Reynolds, R. (2015). Sex differences in early life programming of the hypothalamic-pituitary-adrenal axis in humans suggest increased vulnerability in females. Psychoneuroendocrinology, 61, 32. doi:10.1016/j.psyneuen.2015.07.476CrossRefGoogle Scholar
Chaitin, J., & Steinberg, S. (2008). “You should know better”: Expressions of empathy and disregard among victims of massive social trauma. Journal of Aggression, Maltreatment & Trauma, 17, 197226. doi:10.1080/10926770802344851CrossRefGoogle Scholar
Champagne, D. L., Bagot, R. C., van Hasselt, F., Ramakers, G., Meaney, M. J., De Kloet, E. R., … Krugers, H. (2008). Maternal care and hippocampal plasticity: Evidence for experience-dependent structural plasticity, altered synaptic functioning, and differential responsiveness to glucocorticoids and stress. Journal of Neuroscience, 28, 60376045. doi:10.1523/JNEUROSCI.0526-08.2008CrossRefGoogle Scholar
Chodoff, P. (1963). Late effects of the concentration camp syndrome. Archives of General Psychiatry, 8, 323333. doi:10.1001/archpsyc.1963.01720100013002CrossRefGoogle ScholarPubMed
Chorbov, V. M., Todorov, A. A., Lynskey, M. T., & Cicero, T. J. (2011). Elevated levels of DNA methylation at the OPRM1 promoter in blood and sperm from male opioid addicts. Journal of Opioid Management, 7, 258. doi:10.5055/jom.2011.0067CrossRefGoogle ScholarPubMed
Chrousos, G. P. (2009). Stress and disorders of the stress system. Nature Reviews Endocrinology, 5, 374381. doi:10.1038/nrendo.2009.106CrossRefGoogle ScholarPubMed
Cortessis, V. K., Thomas, D. C., Levine, A. J., Breton, C. V., Mack, T. M., Siegmund, K. D., … Laird, P. W. (2012). Environmental epigenetics: Prospects for studying epigenetic mediation of exposure–response relationships. Human Genetics, 131, 15651589. doi:10.1007/s00439-012-1189-8CrossRefGoogle ScholarPubMed
Danieli, Y. (1985). The treatment and prevention of long-term effects and intergenerational transmission of victimization: A lesson from Holocaust survivors and their children. In Figley, C. R. (Ed.), Trauma and its wake (pp. 295313). New York: Brunner/Mazel.Google Scholar
Danieli, Y. (Ed.) (1998). International handbook of multigenerational legacies of trauma. New York: Plenun Press.CrossRefGoogle Scholar
Daskalakis, N. P., Cohen, H., Cai, G., Buxbaum, J. D., & Yehuda, R. (2014). Expression profiling associates blood and brain glucocorticoid receptor signaling with trauma-related individual differences in both sexes. Proceedings of the National Academy of Sciences, 111, 1352913534. doi:10.1073/pnas.1401660111CrossRefGoogle ScholarPubMed
Daskalakis, N. P., Oitzl, M. S., Schächinger, H., Champagne, D. L., & de Kloet, E. R. (2012). Testing the cumulative stress and mismatch hypotheses of psychopathology in a rat model of early-life adversity. Physiology & Behavior, 106, 707721. doi:10.1016/j.physbeh.2012.01.015CrossRefGoogle Scholar
Daxinger, L., & Whitelaw, E. (2012). Understanding transgenerational epigenetic inheritance via the gametes in mammals. Nature Reviews Genetics, 13, 153164. doi:10.1038/nrg3188CrossRefGoogle ScholarPubMed
DeGruy, J. (2017). Post traumatic slave syndrome: America's legacy of enduring injury and healing: Milwaukee, WI: Uptone Press.Google Scholar
de Jong, J. (Ed.) (2006). Trauma, war, and violence: Public mental health in socio-cultural context: New York: Kluwer Academic.Google Scholar
De Kloet, C., Vermetten, E., Geuze, E., Kavelaars, A., Heijnen, C., & Westenberg, H. (2006). Assessment of HPA-axis function in posttraumatic stress disorder: Pharmacological and non-pharmacological challenge tests, a review. Journal of Psychiatric Research, 40, 550567. doi:10.1016/j.jpsychires.2005.08.002CrossRefGoogle ScholarPubMed
De Kloet, E. R., Joëls, M., & Holsboer, F. (2005). Stress and the brain: From adaptation to disease. Nature Reviews Neuroscience, 6, 463475. doi:10.1038/nrn1683CrossRefGoogle ScholarPubMed
Desai, N., Ludgin, J., Sharma, R., Anirudh, R. K., & Agarwal, A. (2017). Female and male gametogenesis. In Falcone, T. & Hurd, W.W. (Eds.), Clinical reproductive medicine and surgery (pp. 4362). New York: Springer.Google Scholar
de Tubert, R. H. (2006). Social trauma: The pathogenic effects of untoward social conditions. International Forum of Psychoanalysis, 15, 151156. doi:10.1080/08037060500526037CrossRefGoogle Scholar
Dias, B. G., & Ressler, K. J. (2014). Experimental evidence needed to demonstrate inter- and trans-generational effects of ancestral experiences in mammals. Bioessays, 36, 919923. doi:10.1002/bies.201400105CrossRefGoogle ScholarPubMed
Dietz, D. M., LaPlant, Q., Watts, E. L., Hodes, G. E., Russo, S. J., Feng, J., … Nestler, E. J. (2011). Paternal transmission of stress-induced pathologies. Biological Psychiatry, 70, 408414. doi:10.1016/j.biopsych.2011.05.005CrossRefGoogle ScholarPubMed
Dimsdale, J. E. (1974). The coping behavior of Nazi concentration camp survivors. American Journal of Psychiatry, 131, 792797. doi:10.1176/ajp.131.7.792CrossRefGoogle ScholarPubMed
Dor-Shav, N. K. (1978). On the long-range effects of concentration camp internment on Nazi victims: 25 years later. Journal of Consulting and Clinical Psychology, 46, 111. doi:10.1037/0022-006X.46.1.1CrossRefGoogle ScholarPubMed
Doucet, M., & Rovers, M. (2010). Generational trauma, attachment, and spiritual/religious interventions. Journal of Loss and Trauma, 15, 93105. doi:10.1080/15325020903373078CrossRefGoogle Scholar
Eitinger, L. (1961). Pathology of the concentration camp syndrome: Preliminary report. Archives of General Psychiatry, 5, 371379. doi:10.1001/archpsyc.1961.01710160051006CrossRefGoogle ScholarPubMed
Esmaeili, S. (2011). Intergenerational transmission of trauma: Traumatic impact on second-generation Armenian genocide survivors and its effects on parenting. San Francisco: Alliant International University, California School of Professional Psychology.Google Scholar
Evans-Campbell, T. (2008). Historical trauma in American Indian/Native Alaska communities: A multilevel framework for exploring impacts on individuals, families, and communities. Journal of Interpersonal Violence, 23, 316338. doi:10.1177/0886260507312290CrossRefGoogle ScholarPubMed
Eyerman, R. (2001). Cultural trauma: Slavery and the formation of African American identity. Cambridge: Cambridge University Press.CrossRefGoogle Scholar
Faulk, C., & Dolinoy, D. C. (2011). Timing is everything: The when and how of environmentally induced changes in the epigenome of animals. Epigenetics, 6, 791797. doi:10.4161/epi.6.7.16209CrossRefGoogle ScholarPubMed
Field, N. P., Muong, S., & Sochanvimean, V. (2013). Parental styles in the intergenerational transmission of trauma stemming from the Khmer Rouge regime in Cambodia. American Journal of Orthopsychiatry, 83, 483494. doi:10.1111/ajop.12057CrossRefGoogle ScholarPubMed
Fowler, P. J., Tompsett, C. J., Braciszewski, J. M., Jacques-Tiura, A. J., & Baltes, B. B. (2009). Community violence: A meta-analysis on the effect of exposure and mental health outcomes of children and adolescents. Development and Psychopathology, 21, 227259. doi:10.1017/S0954579409000145CrossRefGoogle ScholarPubMed
Franklin, T. B., Russig, H., Weiss, I. C., Gräff, J., Linder, N., Michalon, A., … Mansuy, I. M. (2010). Epigenetic transmission of the impact of early stress across generations. Biological Psychiatry, 68, 408415. doi:10.1016/j.biopsych.2010.05.036CrossRefGoogle Scholar
Friedler, G. (1996). Paternal exposures: Impact on reproductive and developmental outcome. Pharmacology Biochemistry and Behavior, 55, 691700. doi:10.1016/S0091-3057(96)00286-9CrossRefGoogle ScholarPubMed
Galea, S., Nandi, A., & Vlahov, D. (2005). The epidemiology of post-traumatic stress disorder after disasters. Epidemiologic Reviews, 27, 7891. doi:10.1093/epirev/mxi003CrossRefGoogle ScholarPubMed
Galtung, J. (1990). Cultural violence. Journal of Peace Research, 27, 291305. doi:10.1177/0022343390027003005CrossRefGoogle Scholar
Gapp, K., Bohacek, J., Grossmann, J., Brunner, A. M., Manuella, F., Nanni, P., & Mansuy, I. M. (2016). Potential of environmental enrichment to prevent transgenerational effects of paternal trauma. Neuropsychopharmacology, 41, 27492758. doi:10.1038/npp.2016.87CrossRefGoogle ScholarPubMed
Gapp, K., von Ziegler, L., Tweedie-Cullen, R. Y., & Mansuy, I. M. (2014). Early life epigenetic programming and transmission of stress-induced traits in mammals. Bioessays, 36, 491502. doi:10.1002/bies.201300116CrossRefGoogle ScholarPubMed
Gillman, M. W. (2005). Developmental origins of health and disease. New England Journal of Medicine, 353, 18481850. doi:10.1056/NEJMe058187CrossRefGoogle ScholarPubMed
Glover, D. A., & Poland, R. E. (2002). Urinary cortisol and catecholamines in mothers of child cancer survivors with and without PTSD. Psychoneuroendocrinology, 27, 805819. doi:10.1016/S0306-4530(01)00081-6CrossRefGoogle ScholarPubMed
Goldberg, A. D., Allis, C. D., & Bernstein, E. (2007). Epigenetics: A landscape takes shape. Cell, 128, 635638. doi:10.1016/j.cell.2007.02.006CrossRefGoogle ScholarPubMed
Goldberg, R. (2015). Motherland: Growing up with the Holocaust: New York: New Press.Google Scholar
Gone, J. P. (2013). Redressing First Nations historical trauma: Theorizing mechanisms for indigenous culture as mental health treatment. Transcultural Psychiatry, 50, 683706. doi:10.1177/1363461513487669CrossRefGoogle ScholarPubMed
Gone, J. P., & Kirmayer, L. J. (2010). On the wisdom of considering culture and context in psychopathology. In Millon, T., Krueger, R. F., & Simonsen, E. (Eds.), Contemporary directions in psychopathology: Scientific foundations of the DSM-V and ICD-11 (pp. 7296). New York: Guilford Press.Google Scholar
Hamad, M., Shelko, N., Kartarius, S., Montenarh, M., & Hammadeh, M. (2014). Impact of cigarette smoking on histone (H2B) to protamine ratio in human spermatozoa and its relation to sperm parameters. Andrology, 2, 666677. doi:10.1111/j.2047-2927.2014.00245.xCrossRefGoogle ScholarPubMed
Harper, L. (2005). Epigenetic inheritance and the intergenerational transfer of experience. Psychological Bulletin, 131, 340360. doi:10.1037/0033-2909.131.3.340CrossRefGoogle Scholar
Heard, E., & Martienssen, R. A. (2014). Transgenerational epigenetic inheritance: Myths and mechanisms. Cell, 157, 95109. doi:10.1016/j.cell.2014.02.045CrossRefGoogle ScholarPubMed
Heijmans, B. T., Tobi, E. W., Stein, A. D., Putter, H., Blauw, G. J., Susser, E. S., … Lumey, L. (2008). Persistent epigenetic differences associated with prenatal exposure to famine in humans. Proceedings of the National Academy of Sciences, 105, 1704617049. doi:10.1073/pnas.0806560105CrossRefGoogle ScholarPubMed
Hooker, D. A., & Czajkowski, A.P. (n.d.). Transforming historical harms. Manual published by Coming to the Table, a project of Eastern Mennonite University's Center for Justice and Peacebuilding. Harrisonburg, VA: Eastern Mennonite University.Google Scholar
Jablonka, E., & Raz, G. (2009). Transgenerational epigenetic inheritance: Prevalence, mechanisms, and implications for the study of heredity and evolution. Quarterly Review of Biology, 84, 131176. doi:10.1086/598822CrossRefGoogle Scholar
Jaenisch, R., & Bird, A. (2003). Epigenetic regulation of gene expression: How the genome integrates intrinsic and environmental signals. Nature Genetics, 33, 245250. doi:10.1038/ng1089CrossRefGoogle ScholarPubMed
Juster, R.-P., McEwen, B. S., & Lupien, S. J. (2010). Allostatic load biomarkers of chronic stress and impact on health and cognition. Neuroscience & Biobehavioral Reviews, 35, 216. doi:10.1016/j.neubiorev.2009.10.002.CrossRefGoogle ScholarPubMed
Kaati, G., Bygren, L. O., Pembrey, M., & Sjöström, M. (2007). Transgenerational response to nutrition, early life circumstances and longevity. European Journal of Human Genetics, 15, 784790. doi:10.1038/sj.ejhg.5201832CrossRefGoogle ScholarPubMed
Karenian, H., Livaditis, M., Karenian, S., Zafiriadis, K., Bochtsou, V., & Xenitidis, K. (2011). Collective trauma transmission and traumatic reactions among descendants of Armenian refugees. International Journal of Social Psychiatry, 57, 327337. doi:10.1177/0020764009354840CrossRefGoogle ScholarPubMed
Kessler, R. C., Berglund, P., Demler, O., Jin, R., Merikangas, K. R., & Walters, E. E. (2005). Lifetime prevalence and age-of-onset distributions of DSM-IV disorders in the National Comorbidity Survey Replication. Archives of General Psychiatry, 62, 593602. doi:10.1001/archpsyc.62.6.593CrossRefGoogle ScholarPubMed
Kessler, R. C., Sonnega, A., Bromet, E., Hughes, M., & Nelson, C. B. (1995). Posttraumatic stress disorder in the National Comorbidity Survey. Archives of General Psychiatry, 52, 10481060. doi:10.1001/archpsyc.1995.03950240066012CrossRefGoogle ScholarPubMed
Kosten, T. R., Mason, J. W., Giller, E. L., Ostroff, R. B., & Harkness, L. (1987). Sustained urinary norepinephrine and epinephrine elevation in post-traumatic stress disorder. Psychoneuroendocrinology, 12, 1320. doi:10.1016/0306-4530(87)90017-5CrossRefGoogle ScholarPubMed
Leacock, E. B. (Ed.) (1971). The culture of poverty: A critique. New York: Simon and Schuster.Google Scholar
Lehrner, A., Bierer, L. M., Passarelli, V., Pratchett, L. C., Flory, J. D., Bader, H. N., … Makotkine, I. (2014). Maternal PTSD associates with greater glucocorticoid sensitivity in offspring of Holocaust survivors. Psychoneuroendocrinology, 40, 213220. doi:10.1016/j.psyneuen.2013.11.019CrossRefGoogle ScholarPubMed
Leon, G. R., Butcher, J. N., Kleinman, M., Goldberg, A., & Almagor, M. (1981). Survivors of the Holocaust and their children: Current status and adjustment. Journal of Personality and Social Psychology, 41, 503516. doi:10.1037//0022-3514.41.3.503CrossRefGoogle Scholar
Liberzon, I., Abelson, J. L., Flagel, S. B., Raz, J., & Young, E. A. (1999). Neuroendocrine and psychophysiologic responses in PTSD: A symptom provocation study. Neuropsychopharmacology, 21, 4050. doi:10.1016/S0893-133X(98)00128-6CrossRefGoogle ScholarPubMed
Lim, J. P., & Brunet, A. (2013). Bridging the transgenerational gap with epigenetic memory. Trends in Genetics, 29, 176186. doi:10.1016/j.tig.2012.12.008CrossRefGoogle ScholarPubMed
Linden, M., Baumann, K., Lieberei, B., Lorenz, C., & Rotter, M. (2011). Treatment of posttraumatic embitterment disorder with cognitive behaviour therapy based on wisdom psychology and hedonia strategies. Psychotherapy and Psychosomatics, 80, 199205. doi:10.1159/000321580CrossRefGoogle ScholarPubMed
Linden, M., & Rutkowski, K. (2013). Hurting memories and beneficial forgetting: Posttraumatic stress disorders, biographical developments, and social conflicts. London: Elsevier.Google Scholar
Martino, J. (1980). Collective memory of cultural trauma in Peru: Efforts to move from blame to reconciliation. In Yovanovich, G. & Huras, A. (Eds.), Latin American identities after 1980 (pp. 235255). Waterloo: Wilfrid Laurier University Press.Google Scholar
Mason, J. W., Giller, E. L., Kosten, T. R., & Harkness, L. (1988). Elevation of urinary norepinephrine/cortisol ratio in posttraumatic stress disorder. Journal of Nervous and Mental Disease, 176, 498502. doi:10.1097/00005053-198808000-00008CrossRefGoogle ScholarPubMed
Mason, J. W., Giller, E. L., Kosten, T. R., Ostroff, R. B., & Podd, L. (1986). Urinary free-cortisol levels in posttraumatic stress disorder patients. Journal of Nervous and Mental Disease, 174, 145149. doi:10.1097/00005053-198603000-00003CrossRefGoogle ScholarPubMed
McEwen, B. S. (1998). Stress, adaptation, and disease: Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840, 3344. doi:10.1111/j.1749-6632.1998.tb09546.xCrossRefGoogle ScholarPubMed
McEwen, B. S. (2012). Brain on stress: How the social environment gets under the skin. Proceedings of the National Academy of Sciences, 109(Suppl. 2), 1718017185. doi:10.1073/pnas.1121254109CrossRefGoogle ScholarPubMed
McEwen, B. S., & Wingfield, J. C. (2003). The concept of allostasis in biology and biomedicine. Hormones and Behavior, 43, 215. doi:10.1016/s0018-506x(02)00024-7CrossRefGoogle ScholarPubMed
McGlothlin, E. H. (2006). Second-generation Holocaust literature: Legacies of survival and perpetration. Boston: Camden House.Google Scholar
McGowan, P. O., Sasaki, A., D'alessio, A. C., Dymov, S., Labonté, B., Szyf, M., … Meaney, M. J. (2009). Epigenetic regulation of the glucocorticoid receptor in human brain associates with childhood abuse. Nature Neuroscience, 12, 342348. doi:10.1038/nn.2270CrossRefGoogle ScholarPubMed
Meaney, M. J., Aitken, D. H., Bodnoff, S. R., Iny, L. J., & Sapolsky, R. M. (1985). The effects of postnatal handling on the development of the glucocorticoid receptor systems and stress recovery in the rat. Progress in Neuro-Psychopharmacology & Biological Psychiatry, 9, 731734. doi:10.1016/0278-5846(85)90050-8CrossRefGoogle ScholarPubMed
Meaney, M. J., Aitken, D. H., Bodnoff, S. R., Iny, L. J., Tatarewicz, J. E., & Sapolsky, R. M. (1985). Early postnatal handling alters glucocorticoid receptor concentrations in selected brain regions. Behavioral Neuroscience, 99, 765770. doi:10.1037/0735-7044.99.4.765CrossRefGoogle ScholarPubMed
Meaney, M. J., Aitken, D. H., van Berkel, C., Bhatnagar, S., & Sapolsky, R. M. (1988). Effect of neonatal handling on age-related impairments associated with the hippocampus. Science, 239(4841, Pt. 1), 766768. doi:10.1126/science.3340858CrossRefGoogle ScholarPubMed
Mendeloff, D. (2009). Trauma and vengeance: Assessing the psychological and emotional effects of post-conflict justice. Human Rights Quarterly, 31, 592623. doi:10.1353/hrq.0.0100CrossRefGoogle Scholar
Miller, G. (2010). The seductive allure of behavioral epigenetics. Science, 329, 2427. doi:10.1126/science.329.5987.24CrossRefGoogle ScholarPubMed
Mohatt, N. V., Thompson, A. B., Thai, N. D., & Tebes, J. K. (2014). Historical trauma as public narrative: A conceptual review of how history impacts present-day health. Social Science & Medicine, 106, 128136. doi:10.1016/j.socscimed.2014.01.043CrossRefGoogle ScholarPubMed
Moon, C. (2009). Healing past violence: Traumatic assumptions and therapeutic interventions in war and reconciliation. Journal of Human Rights, 8, 7191. doi:10.1080/14754830902717726CrossRefGoogle Scholar
Morris, M. C., Compas, B. E., & Garber, J. (2012). Relations among posttraumatic stress disorder, comorbid major depression, and HPA function: A systematic review and meta-analysis. Clinical Psychology Review, 32, 301315. doi:10.1016/j.cpr.2012.02.002CrossRefGoogle ScholarPubMed
Mulligan, C., D'Errico, N., Stees, J., & Hughes, D. (2012). Methylation changes at NR3C1 in newborns associate with maternal prenatal stress exposure and newborn birth weight. Epigenetics, 7, 853857. doi:10.4161/epi.21180CrossRefGoogle ScholarPubMed
Münyas, B. (2008). Genocide in the minds of Cambodian youth: Transmitting (hi) stories of genocide to second and third generations in Cambodia. Journal of Genocide Research, 10, 413439. doi:10.1080/14623520802305768CrossRefGoogle Scholar
Niederland, W. G. (1981). The survivor syndrome: Further observations and dimensions. Journal of the American Psychoanalytic Association, 29, 413425. doi:10.1177/000306518102900207CrossRefGoogle ScholarPubMed
Nugent, B. M., & Bale, T. L. (2015). The omniscient placenta: Metabolic and epigenetic regulation of fetal programming. Frontiers in Neuroendocrinology, 39, 2837. doi:10.1016/j.yfrne.2015.09.001CrossRefGoogle ScholarPubMed
Oberlander, T. F., Weinberg, J., Papsdorf, M., Grunau, R., Misri, S., & Devlin, A. M. (2008). Prenatal exposure to maternal depression, neonatal methylation of human glucocorticoid receptor gene (NR3C1) and infant cortisol stress responses. Epigenetics, 3, 97106. doi:10.4161/epi.3.2.6034CrossRefGoogle ScholarPubMed
O'Nell, T. D. (1996). Disciplined hearts: History, identity, and depression in an American Indian community. Berkeley, CA: University of California Press.Google Scholar
Ouko, L. A., Shantikumar, K., Knezovich, J., Haycock, P., Schnugh, D. J., & Ramsay, M. (2009). Effect of alcohol consumption on CpG methylation in the differentially methylated regions of H19 and IG-DMR in male gametes—Implications for fetal alcohol spectrum disorders. Alcoholism: Clinical and Experimental Research, 33, 16151627. doi:10.1111/j.1530-0277.2009.00993.xCrossRefGoogle ScholarPubMed
Painter, R. C., Osmond, C., Gluckman, P., Hanson, M., Phillips, D. I., & Roseboom, T. J. (2008). Transgenerational effects of prenatal exposure to the Dutch famine on neonatal adiposity and health in later life. British Journal of Obstetrics and Gynaecology, 115, 12431249. doi:10.1111/j.1471-0528.2008.01822.xCrossRefGoogle ScholarPubMed
Pembrey, M. E., Bygren, L. O., Kaati, G., Edvinsson, S., Northstone, K., Sjöström, M., & Golding, J. (2006). Sex-specific, male-line transgenerational responses in humans. European Journal of Human Genetics, 14, 159166. doi:10.3109/14647273.2010.524721CrossRefGoogle ScholarPubMed
Perroud, N., Rutembesa, E., Paoloni-Giacobino, A., Mutabaruka, J., Mutesa, L., Stenz, L., … Karege, F. (2014). The Tutsi genocide and transgenerational transmission of maternal stress: Epigenetics and biology of the HPA axis. World Journal of Biological Psychiatry, 15, 334345. doi:10.3109/15622975.2013.866693CrossRefGoogle ScholarPubMed
Pihama, L., Reynolds, P., Smith, C., Reid, J., Smith, L. T., & Nana, R. T. (2014). Positioning historical trauma theory within Aotearoa New Zealand. AlterNative, 10, 248262. doi:10.1177/117718011401000304CrossRefGoogle Scholar
Prager, J. (2003). Lost childhood, lost generations: The intergenerational transmission of trauma. Journal of Human Rights, 2, 173181. doi:10.1080/1475483032000078161CrossRefGoogle Scholar
Radomislensky, I., & Shemesh, A. A. (2007). Psychopathology and other health dimensions among the offspring of Holocaust survivors: Results from the Israel National Health Survey. Israel Journal of Psychiatry and Related Sciences, 44, 144151.Google Scholar
Radtke, K. M., Ruf, M., Gunter, H. M., Dohrmann, K., Schauer, M., Meyer, A., & Elbert, T. (2011). Transgenerational impact of intimate partner violence on methylation in the promoter of the glucocorticoid receptor. Translational Psychiatry, 1, e21. doi:10.1038/tp.2011.21CrossRefGoogle ScholarPubMed
Raphael, B., Swan, P., & Martinek, N. (1998). Intergenerational aspects of trauma for Australian Aboriginal people. In Danieli, Y. (Ed.), International handbook of multigenerational legacies of trauma (pp. 327339). New York: Plenun Press.CrossRefGoogle Scholar
Ravelli, G.-P., Stein, Z. A., & Susser, M. W. (1976). Obesity in young men after famine exposure in utero and early infancy. New England Journal of Medicine, 295, 349353. doi:10.1056/NEJM197608122950701CrossRefGoogle ScholarPubMed
Rodgers, A. B., Morgan, C. P., Bronson, S. L., Revello, S., & Bale, T. L. (2013). Paternal stress exposure alters sperm microRNA content and reprograms offspring HPA stress axis regulation. Journal of Neuroscience, 33, 90039012. doi:10.1523/JNEUROSCI.0914-13.2013CrossRefGoogle ScholarPubMed
Rosenheck, R. (1986). Impact of posttraumatic stress disorder of World War II on the next generation. Journal of Nervous and Mental Disease, 174, 319327. doi:10.1097/00005053-198606000-00001CrossRefGoogle ScholarPubMed
Roth, M., Neuner, F., & Elbert, T. (2014). Transgenerational consequences of PTSD: Risk factors for the mental health of children whose mothers have been exposed to the Rwandan genocide. International Journal of Mental Health Systems, 8, 12. doi:10.1186/1752-4458-8-12CrossRefGoogle ScholarPubMed
Ryan, W. (1976). Blaming the victim. New York: Random House.Google Scholar
Santarelli, S., Lesuis, S. L., Wang, X.-D., Wagner, K. V., Hartmann, J., Labermaier, C., … Schmidt, M. V. (2014). Evidence supporting the match/mismatch hypothesis of psychiatric disorders. European Neuropsychopharmacology, 24, 907918. doi:10.1016/j.euroneuro.2014.02.002CrossRefGoogle ScholarPubMed
Schagdarsurengin, U., & Steger, K. (2016). Epigenetics in male reproduction: Effect of paternal diet on sperm quality and offspring health. Nature Reviews Urology, 13, 584595. doi:10.1038/nrurol.2016.157CrossRefGoogle ScholarPubMed
Schmidt, M. V. (2011). Animal models for depression and the mismatch hypothesis of disease. Psychoneuroendocrinology, 36, 330338. doi:10.1016/j.psyneuen.2010.07.001CrossRefGoogle Scholar
Schwab, G. (2010). Haunting legacies: Violent histories and transgenerational trauma. New York: Columbia University Press.Google Scholar
Shrira, A., Palgi, Y., Ben-Ezra, M., & Shmotkin, D. (2011). Transgenerational effects of trauma in midlife: Evidence for resilience and vulnerability in offspring of Holocaust survivors. Psychological Trauma: Theory, Research, Practice, and Policy, 3, 394402. doi:10.1037/a0020608CrossRefGoogle ScholarPubMed
Smith, S. M., & Vale, W. W. (2006). The role of the hypothalamic-pituitary-adrenal axis in neuroendocrine responses to stress. Dialogues in Clinical Neuroscience, 8, 383395.Google ScholarPubMed
Solkoff, N. (1981). Children of survivors of the Nazi Holocaust: A critical review of the literature. American Journal of Orthopsychiatry, 51, 2942. doi:10.1111/j.1939-0025.1981.tb01345.xCrossRefGoogle ScholarPubMed
Solomon, Z., Kotler, M., & Mikulincer, M. (1988). Combat-related posttraumatic stress disorder among second-generation Holocaust survivors: Preliminary findings. American Journal of Psychiatry, 145, 865868. doi:10.1176/ajp.145.7.865Google ScholarPubMed
Sorel, E. (2010). The WHO World Mental Health Surveys: Global perspectives on the epidemiology of mental disorders: American Psychiatric Association, 167, 354355. doi:10.1176/appi.ajp.2009.09081218CrossRefGoogle Scholar
Spiegelman, A. (2003). The complete maus. London: Penguin Books Limited.Google Scholar
Steel, Z., Silove, D., Phan, T., & Bauman, A. (2002). Long-term effect of psychological trauma on the mental health of Vietnamese refugees resettled in Australia: A population-based study. Lancet, 360, 10561062. doi:10.1016/s0140-6736(02)11142-1CrossRefGoogle ScholarPubMed
Steinitz, L. Y. (1982). Psycho-social effects of the Holocaust on aging survivors and their families. Journal of Gerontological Social Work, 4, 145152. doi:10.1300/j083v04n03_13CrossRefGoogle Scholar
Sullivan, P. (1986). The generation of cultural trauma: What are anthropologists for? Australian Aboriginal Studies, 1, 1323.Google Scholar
Svob, C., Brown, N. R., Takšić, V., Katulić, K., & Žauhar, V. (2016). Intergenerational transmission of historical memories and social-distance attitudes in post-war second-generation Croatians. Memory & Cognition, 44, 846855. doi:10.3758/s13421-016-0607-xCrossRefGoogle ScholarPubMed
Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15, 118. doi:10.1207/s15327965pli1501_01CrossRefGoogle Scholar
Tobi, E. W., Slieker, R. C., Luijk, R., Dekkers, K. F., Stein, A. D., Xu, K. M., … Heijmans, B. T. (2018). DNA methylation as a mediator of the association between prenatal adversity and risk factors for metabolic disease in adulthood. Science Advances, 4, 110. doi:10.1126/sciadv.aao4364CrossRefGoogle ScholarPubMed
Tyrka, A. R., Parade, S. H., Eslinger, N. M., Marsit, C. J., Lesseur, C., Armstrong, D. A., … Seifer, R. (2015). Methylation of exons 1D, 1F, and 1H of the glucocorticoid receptor gene promoter and exposure to adversity in preschool-aged children. Development and Psychopathology, 27, 577585. doi:10.1017/S095457941500017CrossRefGoogle ScholarPubMed
Tyrka, A. R., Parade, S. H., Welch, E. S., Ridout, K. K., Price, L. H., Marsit, C., … Carpenter, L. L. (2016). Methylation of the leukocyte glucocorticoid receptor gene promoter in adults: Associations with early adversity and depressive, anxiety and substance-use disorders. Translational Psychiatry, 6, e848. doi:10.1038/tp.2016.112CrossRefGoogle ScholarPubMed
Tyrka, A. R., Price, L. H., Marsit, C., Walters, O. C., & Carpenter, L. L. (2012). Childhood adversity and epigenetic modulation of the leukocyte glucocorticoid receptor: Preliminary findings in healthy adults. PLOS ONE, 7, e30148. doi:10.1371/journal.pone.0030148CrossRefGoogle ScholarPubMed
van IJzendoorn, M. H., Bakermans-Kranenburg, M. J., & Sagi-Schwartz, A. (2003). Are children of Holocaust survivors less well-adapted? A meta-analytic investigation of secondary traumatization. Journal of Traumatic Stress, 16, 459469. doi:10.1023/A:1025706427300CrossRefGoogle ScholarPubMed
Veenendaal, M. V., Painter, R. C., Rooij, S., Bossuyt, P. M., Post, J., Gluckman, P. D., … Roseboom, T. J. (2013). Transgenerational effects of prenatal exposure to the 1944–45 Dutch famine. BJOG: International Journal of Obstetrics & Gynaecology, 120, 548554. doi:10.1111/j.1471-0528.2009.02108.xCrossRefGoogle ScholarPubMed
Volkan, V. D. (2001). Transgenerational transmissions and chosen traumas: An aspect of large-group identity. Group Analysis, 34, 7997. doi:10.1177/05333160122077730CrossRefGoogle Scholar
Weaver, I. C. (2007). Epigenetic programming by maternal behavior and pharmacological intervention. Nature versus nurture: Let's call the whole thing off. Epigenetics, 2, 2228. doi:10.4161/epi.2.1.3881CrossRefGoogle ScholarPubMed
Weaver, I. C., Cervoni, N., Champagne, F. A., D'Alessio, A. C., Sharma, S., Seckl, J. R., … Meaney, M. J. (2004). Epigenetic programming by maternal behavior. Nature Neuroscience, 7, 847854. doi:10.1038/nn1276CrossRefGoogle ScholarPubMed
Widom, C. S. (1989). Does violence beget violence? A critical examination of the literature. Psychological Bulletin, 106, 328. doi:10.1037//0033-2909.106.1.3CrossRefGoogle Scholar
Wright, S. E. (1993). Blaming the victim, blaming society or blaming the discipline: Fixing responsibility for poverty and homelessness. Sociological Quarterly, 34, 116. doi:10.1111/j.1533-8525.1993.tb00127.xCrossRefGoogle Scholar
Yahyavi, S. T., Zarghami, M., Naghshvar, F., & Danesh, A. (2015). Relationship of cortisol, norepinephrine, and epinephrine levels with war-induced posttraumatic stress disorder in fathers and their offspring. Revista Brasileira de Psiquiatria, 37, 9398. doi:10.1590/1516-4446-2014-1414CrossRefGoogle ScholarPubMed
Yehuda, R. (2009). Status of glucocorticoid alterations in post-traumatic stress disorder. Annals of the New York Academy of Sciences, 1179, 5669. doi:10.1111/j.1749-6632.2009.04979.xCrossRefGoogle ScholarPubMed
Yehuda, R., Bierer, L. M., Andrew, R., Schmeidler, J., & Seckl, J. R. (2009). Enduring effects of severe developmental adversity, including nutritional deprivation, on cortisol metabolism in aging Holocaust survivors. Journal of Psychiatric Research, 43, 877883. doi:10.1016/j.jpsychires.2008.12.003CrossRefGoogle ScholarPubMed
Yehuda, R., Bierer, L. M., Schmeidler, J., Aferiat, D. H., Breslau, I., & Dolan, S. (2000). Low cortisol and risk for PTSD in adult offspring of holocaust survivors. American Journal of Psychiatry, 157, 12521259. doi:10.1176/appi.ajp.157.8.1252CrossRefGoogle ScholarPubMed
Yehuda, R., Blair, W., Labinsky, E., & Bierer, L. M. (2007). Effects of parental PTSD on the cortisol response to dexamethasone administration in their adult offspring. American Journal of Psychiatry, 164, 163166. doi:10.1176/ajp.2007.164.1.163CrossRefGoogle ScholarPubMed
Yehuda, R., Boisoneau, D., Mason, J. W., & Giller, E. L. (1993). Glucocorticoid receptor number and cortisol excretion in mood, anxiety, and psychotic disorders. Biological Psychiatry, 34, 1825. doi:10.1016/0006-3223(93)90252-9CrossRefGoogle ScholarPubMed
Yehuda, R., Daskalakis, N. P., Lehrner, A., Desarnaud, F., Bader, H. N., Makotkine, I., … Meaney, M. J. (2014). Influences of maternal and paternal PTSD on epigenetic regulation of the glucocorticoid receptor gene in Holocaust survivor offspring. American Journal of Psychiatry, 171, 872880. doi:10.1176/appi.ajp.2014.13121571CrossRefGoogle ScholarPubMed
Yehuda, R., Engel, S. M., Brand, S. R., Seckl, J., Marcus, S. M., & Berkowitz, G. S. (2005). Transgenerational effects of posttraumatic stress disorder in babies of mothers exposed to the World Trade Center attacks during pregnancy. Journal of Clinical Endocrinology & Metabolism, 90, 41154118. doi:10.1210/jc.2005-0550CrossRefGoogle ScholarPubMed
Yehuda, R., Flory, J. D., Bierer, L. M., Henn-Haase, C., Lehrner, A., Desarnaud, F., … Meaney, M. J. (2015). Lower methylation of glucocorticoid receptor gene promoter 1F in peripheral blood of veterans with posttraumatic stress disorder. Biological Psychiatry, 77, 356364. doi:10.1016/j.biopsych.2014.02.006CrossRefGoogle ScholarPubMed
Yehuda, R., Golier, J. A., Yang, R.-K., & Tischler, L. (2004). Enhanced sensitivity to glucocorticoids in peripheral mononuclear leukocytes in posttraumatic stress disorder. Biological Psychiatry, 55, 11101116. doi:10.1016/s0006-3223(04)00188-xCrossRefGoogle ScholarPubMed
Yehuda, R., Halligan, S. L., & Bierer, L. M. (2002). Cortisol levels in adult offspring of Holocaust survivors: Relation to PTSD symptom severity in the parent and child. Psychoneuroendocrinology, 27, 171180. doi:10.1016/s0306-4530(01)00043-9CrossRefGoogle ScholarPubMed
Yehuda, R., Halligan, S. L., Grossman, R., Golier, J. A., & Wong, C. (2002). The cortisol and glucocorticoid receptor response to low dose dexamethasone administration in aging combat veterans and holocaust survivors with and without posttraumatic stress disorder. Biological Psychiatry, 52, 393403. doi:10.1016/s0006-3223(02)01357-4CrossRefGoogle ScholarPubMed
Yehuda, R., Kahana, B., Binder-Brynes, K., & Southwick, S. M. (1995). Low urinary cortisol excretion in Holocaust survivors with posttraumatic stress disorder. American Journal of Psychiatry, 152, 982. doi:10.1176/ajp.152.7.982Google ScholarPubMed
Yehuda, R., Kahana, B., Schmeidler, J., & Southwick, S. M. (1995). Impact of cumulative lifetime trauma and recent stress on current posttraumatic stress disorder symptoms in Holocaust survivors. American Journal of Psychiatry, 152, 18151818. doi:10.1176/ajp.152.12.1815Google ScholarPubMed
Yehuda, R., & Lehrner, A. (2018). Intergenerational transmission of trauma effects: Putative role of epigenetic mechanisms. World Psychiatry, 17, 243257. doi:10.1002/wps.20568.CrossRefGoogle ScholarPubMed
Yehuda, R., Lehrner, A., & Bierer, L. M. (2018). The public reception of putative epigenetic mechanisms in the transgenerational effects of trauma. Environmental Epigenetics, 4, 17. doi:10.1093/eep/dvy018.CrossRefGoogle ScholarPubMed
Yehuda, R., Lowy, M. T., Southwick, S. M., Shaffer, D., & Giller, E. L. Jr. (1991). Lymphocyte glucocorticoid receptor number in posttraumatic stress disorder. American Journal of Psychiatry, 148, 499504. doi:10.1176/ajp.148.4.499Google ScholarPubMed
Yehuda, R., & McFarlane, A. (1995). Conflict between current knowledge about posttraumatic stress disorder and its original conceptual basis. American Journal of Psychiatry, 152, 17051713. doi:10.1176/ajp.152.12.1705Google ScholarPubMed
Yehuda, R., McFarlane, A., & Shalev, A. (1998). Predicting the development of posttraumatic stress disorder from the acute response to a traumatic event. Biological Psychiatry, 44, 13051313. doi:10.1016/s0006-3223(98)00276-5CrossRefGoogle ScholarPubMed
Yehuda, R., Morris, A., Labinsky, E., Zemelman, S., & Schmeidler, J. (2007). Ten-year follow-up study of cortisol levels in aging holocaust survivors with and without PTSD. Journal of Traumatic Stress, 20, 757761. doi:10.1002/jts.20228CrossRefGoogle ScholarPubMed
Yehuda, R., Schmeidler, J., Siever, L. J., Binder-Brynes, K., & Elkin, A. (1997). Individual differences in posttraumatic stress disorder symptom profiles in Holocaust survivors in concentration camps or in hiding. Journal of Traumatic Stress, 10, 453463. doi:10.1002/jts.2490100310CrossRefGoogle ScholarPubMed
Yehuda, R., Schmeidler, J., Wainberg, M., Binder-Brynes, K., & Duvdevani, T. (1998). Vulnerability to posttraumatic stress disorder in adult offspring of Holocaust survivors. American Journal of Psychiatry, 155, 11631171. doi:10.1176/ajp.155.9.1163CrossRefGoogle ScholarPubMed
Yehuda, R., Siever, L. J., Teicher, M. H., Levengood, R. A., Gerber, D. K., Schmeidler, J., & Yang, R.-K. (1998). Plasma norepinephrine and 3-methoxy-4-hydroxyphenylglycol concentrations and severity of depression in combat posttraumatic stress disorder and major depressive disorder. Biological Psychiatry, 44, 5663. doi:10.1016/s0006-3223(98)80007-3CrossRefGoogle ScholarPubMed
Yehuda, R., Southwick, S. M., Giller, E. L., Ma, X., & Mason, J. W. (1992). Urinary catecholamine excretion and severity of PTSD symptoms in Vietnam combat veterans. Journal of Nervous and Mental Disease, 180, 321325. doi:10.1097/00005053-199205000-00006CrossRefGoogle ScholarPubMed
Yehuda, R., Southwick, S. M., Krystal, J. H., Bremner, D., Charney, D. S., & Mason, J. W. (1993). Enhanced suppression of cortisol following dexamethasone administration in posttraumatic stress disorder. American Journal of Psychiatry, 150, 83. doi:10.1176/ajp.150.1.83Google ScholarPubMed
Yehuda, R., Southwick, S. M., Nussbaum, G., Wahby, V. S., Giller, E. L., & Mason, J. W. (1990). Low urinary cortisol excretion in patients with posttraumatic stress disorder. Journal of Nervous and Mental Disease, 35, 710711. doi:10.1016/0006-3223(94)91000-6Google Scholar
Yehuda, R., Teicher, M. H., Seckl, J. R., Grossman, R. A., Morris, A., & Bierer, L. M. (2007). Parental posttraumatic stress disorder as a vulnerability factor for low cortisol trait in offspring of holocaust survivors. Archives of General Psychiatry, 64, 10401048. doi:10.1001/archpsyc.64.9.1040CrossRefGoogle ScholarPubMed
Yehuda, R., Teicher, M. H., Trestman, R. L., Levengood, R. A., & Siever, L. J. (1996). Cortisol regulation in posttraumatic stress disorder and major depression: A chronobiological analysis. Biological Psychiatry, 40, 7988. doi:10.1016/0006-3223(95)00451-3CrossRefGoogle ScholarPubMed
Young, E. A., & Breslau, N. (2004). Cortisol and catecholamines in posttraumatic stress disorder: An epidemiologic community study. Archives of General Psychiatry, 61, 394401. doi:10.1001/archpsyc.61.4.394CrossRefGoogle ScholarPubMed

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