SUNDAY, Sept. 26 (HealthDay News) -- The suffering experienced by Holocaust survivors still leaves psychological scars but appears to have little effect on their cognitive functioning and physical health, according to a new international study.

Researchers from Israel and the Netherlands also found that Holocaust survivors living in Israel have better psychological health than those living in other countries, which suggests that living in Israel may serve as a protective factor.

"Six decades after the end of World War II and we are still learning how a mass genocide like the Holocaust is affecting its victims," lead author Efrat Barel, a psychology professor at the Max Stern Academic College of Emek Yezreel, said in an American Psychological Association news release.

"What we've found is that they have the ability to overcome their traumatic experiences and even to flourish and gain psychological growth, but it many not be as easy as it seems," Barel added.

Barel and colleagues analyzed the findings from 71 studies that were conducted over 44 years (1964 to 2008) and compared Holocaust survivors and control groups from the general population.

The analysis showed that Holocaust survivors had poorer psychological well-being, more symptoms of post-traumatic stress and more symptoms of mental illness. Holocaust survivors living in Israel had better psychological well-being and social adjustment than those living in other countries.

There were no significant differences in cognitive functioning or physical health between Holocaust survivors and those in the control groups.

"The psychological scars of Holocaust survivors are evident in their continued experience of post-traumatic symptoms, but these experiences have not necessarily prevented their ability to adapt to day-to-day life," co-author Abraham Sagi-Schwartz, a dean of social sciences at Haifa University, said in the news release. "It's possible these survivors repressed a lot of these traumatic memories in the immediate aftermath of the war and instead focused on rebuilding their lives and raising new families."

The study appears in the journal Psychological Bulletin.

The authors added that these findings are particularly relevant for most of the survivors who were children during the Holocaust. "The current findings call for special attention to the care of these survivors," said co-author Marinus Van IJzendoorn of Leiden University in the Netherlands. "As they approach old age, they face new challenges, including retirement, declining health and losing a spouse, and this may reactivate their extreme early stresses."

More information

The International Society for Traumatic Stress Studies explains traumatic stress.