Long-term psychological and cognitive impacts and transgenerational trauma among survivors and offspring of the Anfal attempted genocide against Kurds

Abstract Background and objective The 1988 Anfal attempted genocide exposed thousands of Kurdish civilians to severe traumatic experiences. However, its long-term psychological, cognitive, and intergenerational consequences remain not adequately investigated. The present study examined long-term psychological and cognitive outcomes among survivors of the Anfal campaign and their first-generation offspring approximately 35 years after the genocide, with particular emphasis on the role of Anfal exposure severity in mental health and executive functioning. Methods A cross-sectional study was conducted among 464 participants, including 231 Anfal survivors and 233 offspring, in genocide-affected areas in the Kurdistan Region of Iraq. Standardized measures assessed probable PTSD and C-PTSD, depression, anxiety, suicidality, and executive functioning deficits. Group differences were examined using independent sample t-tests and MANOVA, while correlations and parameter estimates examined associations between exposure severity and psychological and cognitive outcomes. Results Survivors demonstrated significantly higher levels of depression (M = 9.63 vs. 7.19, p < .001), anxiety (M = 8.00 vs. 4.86, p < .001), suicidality (M = 2.21 vs. 1.35, p = .029), and working memory impairment (M = 26.19 vs. 22.93, p < .001) compared to offspring. Depression and suicidality showed small effect sizes, whereas anxiety and working memory impairment showed moderate effect sizes. No significant group differences were observed for PTSD, C-PTSD, or inhibition deficits. The severity of Anfal exposure had a significant overall effect on combined psychological and cognitive outcomes (Wilks Lambda = 0.82, F = 14.2, a p < .001) and was positively associated with depression ( r = .30), anxiety ( r = .38), suicidality ( r = .17), C-PTSD symptoms ( r = .10), working memory impairment ( r = .29) and inhibition deficits ( r = .14), but not PTSD symptoms. Conclusion The findings demonstrated enduring psychological and cognitive impacts of the Anfal attempted genocide among survivors and their offspring decades after the events. Evidence of transgenerational trauma and the role of Anfal exposure severity highlight the need for long-term trauma-informed and intergenerational mental health interventions for genocide-affected populations.