Decades After the Anfal Campaign, Trauma Persists Across Kurdish Generations

More than three and a half decades after the Anfal campaign targeted Kurdish civilians in Iraq, the psychological scars of the attempted genocide remain measurable not only in those who lived through it but also in their children. A new cross-sectional study published in BMC Psychiatry examined 464 people from genocide-affected areas of the Kurdistan Region of Iraq, including 231 survivors of the Anfal operations and 233 of their first-generation offspring. The researchers found that survivors showed significantly elevated depression, anxiety, suicidality, and working memory impairment compared with their children, while the severity of exposure to Anfal-related atrocities predicted worse mental health and cognitive outcomes across both groups. The findings, the authors argue, provide some of the most systematic evidence to date that the consequences of genocide can echo across generations.

The Anfal campaign of 1988 was a series of military operations against Kurdish civilians that exposed thousands of people to extreme traumatic experiences, including mass displacement, the disappearance of family members, and violence on a genocidal scale. Although the historical record of the campaign is well documented, the researchers note that its long-term psychological, cognitive, and intergenerational consequences had not been adequately investigated. Their study set out to fill that gap by assessing survivors and their offspring roughly 35 years after the events, with a particular focus on how the intensity of Anfal exposure shaped mental health and executive functioning over the decades that followed.

To capture the full breadth of possible harm, the team used standardized clinical instruments to assess a range of outcomes. These included probable post-traumatic stress disorder (PTSD) and complex PTSD, a broader trauma-related condition associated with prolonged and repeated exposure to interpersonal violence. The researchers also measured symptoms of depression using the Patient Health Questionnaire-9, alongside anxiety, suicidality, and deficits in executive functioning, the suite of higher-order cognitive processes that govern working memory, impulse control, and behavioral regulation. Executive functioning was assessed with the Adult Executive Functioning Inventory, a self-report measure designed to detect everyday difficulties in cognitive control.

The comparison between generations produced a strikingly consistent pattern. Survivors reported significantly higher levels of depression than their offspring, with mean scores of 9.63 compared with 7.19, a difference that was highly statistically significant. Anxiety showed an even larger gap, with survivors averaging 8.00 versus 4.86 among offspring. Suicidality was also elevated in the survivor group, with mean scores of 2.21 compared with 1.35. When the researchers calculated effect sizes, depression and suicidality differences fell into the small range, whereas the differences in anxiety and working memory impairment were moderate, indicating that these two domains carried the clearest signature of generational divergence.

Working memory, the mental workspace that allows people to hold and manipulate information over short periods, emerged as a particularly important finding. Survivors showed significantly greater working memory impairment than their offspring, with mean scores of 26.19 versus 22.93 on the executive functioning measure. By contrast, the study found no significant group differences for PTSD, complex PTSD, or inhibition deficits, the component of executive functioning that governs the suppression of impulsive responses. This selective pattern suggests that the long-term cognitive toll of the Anfal campaign is concentrated in specific domains rather than spread uniformly across all aspects of trauma psychopathology and cognition.

Beyond the comparison of generations, the researchers examined how the severity of Anfal exposure related to psychological and cognitive outcomes across the entire sample. Using multivariate analysis of variance, they found that exposure severity had a significant overall effect on the combined set of psychological and cognitive measures, with a Wilks Lambda of 0.82 and a multivariate test statistic of 14.2, which was highly significant. In other words, the more severe a participant’s exposure to Anfal-related trauma, the worse their combined mental health and cognitive profile tended to be, regardless of whether they were a direct survivor or a member of the second generation.

The correlation analyses added further texture to this picture. Severity of exposure was positively associated with depression, with a correlation coefficient of 0.30, and showed an even stronger association with anxiety at 0.38. Suicidality correlated at 0.17, working memory impairment at 0.29, inhibition deficits at 0.14, and complex PTSD symptoms at 0.10. Interestingly, exposure severity was not significantly associated with PTSD symptoms themselves, a finding that complicates the traditional assumption that classic PTSD is the primary vehicle through which mass trauma expresses itself over time. Instead, the data point toward depression, anxiety, and cognitive impairment as the more persistent and dose-dependent consequences of the genocide.

The presence of measurable psychological burden in the offspring generation, even at lower levels than in survivors, is what elevates this study into the domain of transgenerational trauma research. The children of Anfal survivors did not experience the campaign directly, yet they carry elevated depression, anxiety, and suicidality relative to what would be expected, and their outcomes worsen in proportion to their parents’ exposure severity. This pattern is consistent with theoretical models in which parental trauma affects offspring through family communication patterns, altered parenting under chronic distress, socioeconomic disruption, and the cumulative stress of living in communities still processing collective loss. The study cannot disentangle these pathways definitively, but it establishes that the intergenerational signal is real and quantifiable.

From a methodological standpoint, the study has both strengths and constraints typical of research conducted in post-conflict settings. The sample of 464 participants drawn from genocide-affected areas is substantial for this field, and the use of validated instruments for PTSD, complex PTSD, depression, and executive functioning lends credibility to the measurements. The research received ethics approval from Soran University and adhered to the Declaration of Helsinki, with written informed consent obtained from literate participants and carefully documented verbal consent for illiterate participants. At the same time, the cross-sectional design means the researchers captured a single moment in time roughly 35 years after the events, so they can establish associations between exposure severity and current outcomes but cannot trace how these symptoms developed or changed over the intervening decades.

The practical implications of the findings are considerable, particularly for low- and middle-income countries where genocide-affected populations often have limited access to specialized mental health care. The authors conclude that the enduring psychological and cognitive impacts observed among both survivors and offspring highlight the need for long-term, trauma-informed, and intergenerational mental health interventions rather than short-term crisis responses. Because exposure severity predicted outcomes across both generations, screening for trauma history may help identify families at elevated risk even decades after mass violence. And because anxiety and working memory impairment showed the strongest and most persistent effects, intervention programs may need to address cognitive rehabilitation and anxiety management alongside conventional trauma-focused therapy. For the Kurdish communities studied here, the message of the research is sobering but clear: the harm inflicted in 1988 did not end with the survivors’ generation, and effective responses must be designed to reach across generational lines.

Subject of Research: Long-term psychological and cognitive effects and transgenerational trauma among survivors and offspring of the Anfal attempted genocide against Kurds

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

Article References: Ahmed, D. R., Kira, I., Sarchl, L., Mahmood, N. H., Kakamad, K. K., Al-Taie, R. H., Sabir, G. F., Jasim, K. F., Hassan, S., Shuwiekh, H., & Heun, R. (2026). Long-term psychological and cognitive impacts and transgenerational trauma among survivors and offspring of the Anfal attempted genocide against Kurds. BMC Psychiatry. https://doi.org/10.1186/s12888-026-08726-2

Image Credits: AI Generated

DOI: 10.1186/s12888-026-08726-2

Keywords: Anfal genocide, Kurds, PTSD, complex PTSD, transgenerational trauma, depression, anxiety, suicidality, working memory, executive functioning, BMC Psychiatry, Kurdistan Region of Iraq