Intergenerational Transmission of Traumatic Stress and Resilience Among Cambodian Immigrant Families Along Coastal Alabama: Family Narratives

Health Equity. 2021 Jun 18;5(1):431-438. doi: 10.1089/heq.2020.0142. eCollection 2021.

Abstract

Purpose: Intergenerational transmission of psychological trauma is an ongoing global public health concern. Cambodia experienced ∼4 years of genocide, causing about 2 million deaths. Many survivors fled and resettled in the United States where they continued to face the psychological and relational consequences of forced displacement, with limited access to mental health treatment. This study employed an ecological social determinants of health framework to explore how resettled families discussed traumatic experiences and resilience transmitted across three generations. Methods: Narrative inquiry-guided, in-depth semistructured interviews were conducted with intergenerational families: five grandparents, six parents, and nine adult children. The interview protocol included developing detailed family genograms that facilitated the sharing of experiences of living through the Cambodian genocide (1975-1979) and resettlement to the United States in the 1980s. A thematic data analysis was conducted across individual and family experiences before, during, and after the genocide and resettlement. Results: The findings highlight parent-child relationships as the primary mechanism of intergenerational transmission of traumatic stress and resilience among Cambodian immigrant families. Specifically, high parental expectations, authoritarian parenting, corporal punishment, and submissive communication styles were reported. On the other hand, strong bonds and less hierarchy between parents and children were found to be resilience factors among this population. Conclusions: The results of this qualitative study underscore the need for a systemic mental health conceptualization for practitioners working with resettled Cambodian families to overcome the cycle of intergenerational transmission of traumatic stress and promote resilience postresettlement.

Keywords: Cambodian immigrant families; ecological social determinants of health; intergeneration; resilience; traumatic stress.