Transgenerational effects of the genocide against the Tutsi in Rwanda: A post-traumatic stress disorder symptom domain analysis
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Background: A number of studies have investigated transgenerational effects of parental post-traumatic stress disorder (PTSD) and its repercussions for offspring. Few studies however, have looked at this issue in the African context. Methods: The present study addresses this gap by utilizing a Pearson correlation matrix to investigate symptom severity within the three Diagnostic and Statistical Manual of Mental Disorders IV (DSM-IV) PTSD symptom domains in mothers exposed to the genocide against the Tutsi in Rwanda (n=25) and offspring (n=25), and an ethnically matched set of controls (n=50) who were outside of Rwanda during the 1994 genocide. All mothers were pregnant with the offspring included in the study during the time of the genocide. Results: Total PTS score was significantly (p<0.01) correlated with each of the three symptom domains at various strengths in both cases and controls. No significant differences in association of total PTS score and PTSD symptom domains were observed between exposed mothers and offspring, suggesting that each symptom domain contributed equivalently to both exposed mothers and offspring distress. In contrast, the re-experiencing symptom domain showed a significant difference in correlation to overall PTS score in non-exposed mothers compared to their offspring (p<0.05), with mothers showing a significantly higher correlation. Furthermore, the correlation between avoidance/numbing symptoms to overall PTS was significantly different (p≤0.01) across exposed and non-exposed mothers. As a secondary analysis, we explored the relationship between DNA methylation in the glucocorticoid receptor ( NR3C1) locus, an important stress modulating gene, and PTSD symptom domains, finding an association between DNA methylation and re-experiencing among genocide-exposed mothers that exceeded any other observed associations by approximately two-fold. Conclusions : This is the first report, to our knowledge, of a symptom-based analysis of transgenerational transmission of PTSD in sub-Saharan Africa. These findings can be leveraged to inform further mechanistic and treatment research for PTSD.
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Methylation differences in survivors of the Tutsi genocide and related conflicts have been reported in genes regulating synaptic plasticity, neurotrophic signaling, and early developmental programming.
“Methylation differences in survivors of the Tutsi genocide and related conflicts have been reported in genes regulating synaptic plasticity, neurotrophic signaling, and early developmental programming (88–92).”
From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [89]
The Methods (DNA methylation measures; page not supplied) and Discussion (page not supplied) report NR3C1 methylation in genocide-exposed mothers and their offspring, including higher levels in the offspring. The paper identifies NR3C1 as a stress-response gene but does not report methylation findings in genes regulating synaptic plasticity or neurotrophic signaling, or establish the broader claim about early developmental programming. (LLM, conf=0.86)
Experimental — accuracy not yet measuredAcross survivor populations and their descendants, research suggests coordinated involvement of stress-response regulation, neurodevelopmental signaling, and behavioral adaptation.
“Across survivor populations and their descendants, research suggests coordinated involvement of stress-response regulation, neurodevelopmental signaling, and behavioral adaptation (7, 82–100).”
From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [89]
The Introduction and Discussion (page numbers unavailable) link stress-regulating NR3C1 methylation with PTSD symptom domains in genocide-exposed mothers and their offspring. Those passages support involvement of stress-response regulation and trauma-related symptoms, but they do not establish neurodevelopmental signaling or coordinated involvement of all three processes; PTSD symptoms are also narrower than behavioral adaptation generally. (LLM, conf=0.83)
Experimental — accuracy not yet measuredGenocide exposure has been associated with epigenetic variation in pathways involved in neurodevelopment and memory processing.
“Genocide exposure has also been associated with epigenetic variation in pathways involved in neurodevelopment and memory processing.”
From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [89]
The Results (Secondary analyses of NR3C1 DNA methylation; page unavailable) associate methylation of NR3C1 with PTSD symptom domains in genocide-exposed mothers and their offspring. The Methods (DNA methylation measures; page unavailable) identify NR3C1 as the locus studied. The paper describes it as a stress-response gene, but does not establish epigenetic variation in pathways involved in neurodevelopment or memory processing. (LLM, conf=0.87)
Experimental — accuracy not yet measuredSimilar involvement of stress-response pathways has been observed in survivors of the Tutsi genocide and related conflicts, where methylation differences in NR3C1 and NR3C2 have been reported.
“Similar involvement of stress-response pathways has been observed in survivors of the Tutsi genocide and related conflicts, where methylation differences in NR3C1 and NR3C2 have been reported (88, 89).”
From Epigenetic changes associated with multi-generational trauma: characterization, mechanisms, and therapeutics (2026) · cites this paper as [89]
The Results section reports an association between NR3C1 methylation and PTSD symptom domains in genocide-exposed mothers and their offspring. The Discussion states that the study explored only NR3C1; it does not support the claim about NR3C2 methylation or survivors of related conflicts. Page numbers are not provided in our copy. (LLM, conf=0.90)
Experimental — accuracy not yet measured
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- Authors
- Rudahindwa, S., Mutesa, L., Rutembesa, E., Mutabaruka, J., Qu, A., Wildman, D. E., Jansen, S., & Uddin, M.
- Affiliations
- University of Illinois Urbana-Champaign (US)
- University of Rwanda (RW)
- Corresponding author
- Uddin, Monica
- Venue
- Open Research Africa
- Publisher
- F1000 Research Ltd
- Published
- 2020-01-14
- Volume
- 1
- Pages
- 10
- ISSN
- 2752-6925 (ISSN-L)
- PMC
- PMC11231627
- OpenAlex
- W2802020276
- Cited by
- 14
- References
- 32
- Citations by year
- 2026: 2 · 2025: 2 · 2024: 1 · 2023: 1 · 2022: 1 · 2021: 5 · 2019: 1 · 2018: 1
- FWCI
- 0.70
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Licence
- public-domain
- creativecommons.org/licenses/by/4.0/ (tdm)
- Locations
- Open Research Africa (publishedVersion, public-domain)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
- Funders
- National Institutes of Health (U01MH115485)
- NEPAD Agency’s Alliance of Accelerating Science in Africa
- African Academy of Sciences
- Topics
- Social Sciences › Psychology › Clinical Psychology › Posttraumatic Stress Disorder Research
- Social Sciences › Psychology › Clinical Psychology › Child Abuse and Trauma
- Health Sciences › Medicine › Public Health, Environmental and Occupational Health › Maternal Mental Health During Pregnancy and Postpartum
- Keywords
- transgenerational transmission, post-traumatic stress disorder, Rwandan genocide, genocide survivors, re-experiencing symptoms, DNA methylation, glucocorticoid receptor, NR3C1, sub-Saharan Africa
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