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Les modèles d'intervention médico-psychologique précoce sont actuellement dominés par l'exercice du débriefing dans des conditions de stress exceptionnel tels que les conflits armés. L'intervention doit être rapide et coordonnée pour répondre aux besoins des victimes, en favorisant la verbalisation des émotions et la restauration des liens sociaux. L'origine historique et l'évolution du débriefing depuis les guerres passées jusqu'à son application contemporaine, soulignent son rôle dans une psychiatrie ainsi pensée sur un registre préventif. Les effets du traumatisme psychique sur l'individu et le groupe, impliquent des phénomènes de dissociation délétères nécessitant la restauration d'un cadre sécurisant. Le rôle du débriefing dans la réintégration de l'expérience vécue par l'élaboration d'un récit commun favorise un processus de reliaison, participant de cet effet de sécurisation. Le principe de libération immédiate de la parole des individus traumatisés remet toutefois en question sa conformité aux pratiques habituelles en psychothérapie. Son enseignement, qui n'est pas en soi un acte de soin, est pour autant une occasion d'en approcher les effets, par une même dynamique d'identification chez les stagiaires. Le développement de nouvelles méthodes pédagogiques telles que la simulation s'y applique particulièrement, privilégiant l'acquisition d'un savoir-faire à la transmission de connaissances théoriques. L'enseignement s'effectue selon un prisme comportemental, l'objectif étant d'inscrire le stagiaire dans une pratique qui vise à se parfaire par la répétition d'exercices de mise en situation, avec une transmission des habiletés relationnelles et communicationnelles qui s'en trouve ainsi facilitée. La formation des professionnels de santé militaires, notamment en psychiatrie, est capitale pour faire face aux contraintes spécifiques des opérations militaires. Ces formations, visent à préparer les soignants à intervenir en cas de situations isolées et à gérer des scénarios de crise. Une initiative pédagogique spécifique a été mise en place à l'hôpital militaire Sainte-Anne de Toulon, axée sur la simulation pour enseigner le débriefing médico-psychologique au profit des soignants amenés à partir en mission. L'équipe pédagogique utilise des jeux de rôle pour simuler des situations de crise opérationnelle avec exposition traumatique, offrant ainsi une approche réaliste et interactive aux stagiaires. Cette approche par la simulation permet aux stagiaires de se confronter à des situations imprévues et spécifiques du contexte militaire, tout en développant des compétences pratiques et émotionnelles essentielles dans la prise en charge des troubles psychiques. En outre, cette méthode d'enseignement encourage la pratique réflexive et favorise une approche empathique vis-à-vis des patients, différenciant la posture de l'enseignant dans ce contexte de celle habituellement adoptée en médecine. La simulation sert ainsi de catalyseur pour amorcer des échanges authentiques entre stagiaires et formateurs, au-delà des effets d'éprouvés subjectifs propres à chacun dans l'expérience des jeux de rôle. La simulation diffère ainsi du discours académique en cherchant à créer une expérience engageante et sensorielle pour les stagiaires. Cette approche immersive peut d'ailleurs être comparée à la nature même des événements traumatiques, en impliquant tous deux une expérience sensorielle intense avec une empreinte corporelle ou émotionnelle durable. La singularité de la simulation réside aussi dans sa capacité à se détacher des discours universels pour se rapprocher des questionnements personnels, des doutes et des limites de chaque individu. Cette approche résonne avec les concepts lacaniens de transmission du savoir et met en lumière les effets d'interprétation individuelle et d'interaction entre formateurs et stagiaires, comparables à ceux du transfert en psychothérapie. Tout ceci n'est toutefois possible que par le rôle actif du stagiaire dans ce processus, mais aussi par l'engagement des enseignants, en s'appuyant sur un cadre théorique rigoureux avec une attention particulière portée à la manière dont les émotions influencent l'apprentissage chez les stagiaires. La simulation revêt en définitive un caractère imprévisible par la genèse d'effets d'apprentissages inattendus, tant pour les stagiaires que pour les enseignants, rappelant ainsi la nécessité de rester ouvert aux connaissances nouvelles qui peuvent surgir de cette expérience d'apprentissage. L'apprentissage par la simulation du débriefing offre une approche séduisante aux étudiants par ses effets d'implication subjective, mais remet également en question les méthodes traditionnelles d'enseignement en santé. Bien que ces nouvelles approches pédagogiques enrichissent indéniablement les connaissances des étudiants, elles ne peuvent cependant reproduire l'authenticité de la relation thérapeutique entre le patient et son thérapeute. L'apprentissage clinique reste essentiel, mais il doit intégrer la confrontation à l'inconnu, à la singularité de chaque expérience clinique, tout en tenant compte du décalage indéfectible entre les connaissances acquises et la réalité de la pratique. Early medical and psychological intervention models are currently dominated by debriefing in conditions of exceptional stress such as armed conflict. Intervention must be rapid and coordinated in order to meet the needs of the victims, by encouraging the verbalization of emotions and the restoration of social links. The historical origins and evolution of debriefing, from past wars to its contemporary application, underline a different, preventive, role in a psychiatry. The effects of psychological trauma on the individual and the group involve deleterious dissociation phenomena requiring the restoration of a reassuring framework. The role of debriefing in reintegrating the experience through the development of a shared narrative encourages a process of reconnection, which contributes to this reassuring effect. However, the principle of immediately encouraging traumatized individuals to express themselves verbally calls into question debriefing's conformity with usual psychotherapy practices. Teaching it, which is not in itself an act of care, is nevertheless an opportunity to approach its effects, through the same dynamic of identification in the trainees. The development of new teaching methods, such as simulation, is particularly relevant here, as it emphasizes the acquisition of know-how rather than the transmission of theoretical knowledge. The teaching is based on a behavioral approach, the aim being to encourage trainees to perfect their skills by repeating role-playing exercises, thereby facilitating the transmission of interpersonal and communication skills. The training of military health professionals, particularly in psychiatry, is vital if they are to cope with the specific constraints of military operations. The aim of this training is to prepare healthcare professionals to intervene in isolated situations and to manage crisis scenarios. A specific educational initiative has been set up at the military hospital Sainte-Anne in Toulon, based on simulation to teach medical-psychological debriefing for the benefit of medical staff who are deployed on missions. The teaching team uses role-playing to simulate operational crisis situations involving traumatic exposure, offering trainees a realistic and interactive approach. This simulation-based approach enables trainees to confront unforeseen situations specific to the military context, while developing the practical and emotional skills that are essential in the management of psychological disorders. In addition, this teaching method encourages reflective practice and promotes an empathetic approach to patients, differentiating the teacher's posture in this context from that which is usually adopted in medicine. In this way, simulation serves as a catalyst for initiating authentic exchanges between trainees and trainers, over and above the effects of subjective experiences specific to each in the role-playing experience. Simulation thus differs from academic discourse by seeking to create an engaging and sensory experience for trainees. This immersive approach can also be compared to the very nature of traumatic events, both involving an intense sensory experience with a lasting physical or emotional imprint. The uniqueness of the simulation also lies in its ability to detach itself from universal discourse and draw closer to the personal questions, doubts, and limits of each individual. This approach resonates with Lacanian concepts of the transmission of knowledge and highlights the effects of individual interpretation and interaction between trainers and trainees, comparable to those of transference in psychotherapy. All of this is only possible, however, if the trainee plays an active role in the process, but also if the teachers are committed to it, based on a rigorous theoretical framework with particular attention paid to the way in which emotions influence learning in trainees. In the final analysis, simulation is unpredictable in that it generates unexpected learning effects for both trainees and teachers, reminding us of the need to remain open to the new knowledge that may emerge from this learning experience. Learning through debriefing simulation offers an approach that is attractive to students because of its subjective involvement effects, but it also challenges traditional health teaching methods. Although these new teaching approaches undeniably enrich students' knowledge, they cannot reproduce the authenticity of the therapeutic relationship between patient and therapist. Clinical learning is still essential, but it must include confrontation with the unknown, with the singularity of each clinical experience, while taking into account the indefectible gap between the knowledge acquired and the reality of practice. [ABSTRACT FROM AUTHOR]

To date, there has been little research on the history of work-related mental health issues among coal workers. Much of the coal extraction industry peaked during the early twentieth century and then began its precipitous decline. Mining has high casualty rates, and the medical field did not understand the long-term effects of psychological trauma on mine workers until recently. Newspaper articles and other historical records provide accounts of accidents and tragedies. Heroism is often emphasized in recalling tragic episodes at the expense of recording the emotional stress suffered by survivors. A diverse set of historical sources provides a context for work-related mental health issues in the coal extraction industry. Probing a set of historic oral histories of coal workers and creating analogies to current studies provide additional clues about the under-told story of these historic actors’ general health and well-being. While incorporating oral histories from other regions, focusing on the anthracite coal industry in northeastern Pennsylvania allows us to identify historical actors and helps us think differently about other working-class communities impacted by industrial capitalism. [ABSTRACT FROM AUTHOR]

The Russian-Ukrainian war (RUW) is responsible for extensive individual suffering and a socio-economic impact on the world and is reshaping global affairs. Many studies have focused on direct exposure to conflict and several public health policies have been devised. Nonetheless, indirect exposure through media has received minimal attention and there is limited evidence that mental health symptoms and disorders may arise as a result. We explored the role of voluntary or involuntary media-based exposure to the RUW on individuals' mental health including stress symptoms, coping strategies, daily functioning, and worries across demographic variables. In our sample, subjects with involuntary and higher amount of exposure seem to have higher stress symptoms. Also, those who had previous ruminations on war issues could be at risk of developing more post-traumatic stress symptoms. Therefore, media appears to be a conduit that spreads negative consequences of community trauma beyond directly affected communities. [ABSTRACT FROM AUTHOR]

The relationship between suicidality and resilience is underexplored among the general population. This study aimed to explore the relationship between lifetime, one-year, and one-month prevalence of suicidality (ideation, plan, attempt) and resilience in the general population. Data on suicidality, resilience, prevalence of major mental disorders, and other key psychological factors were collected from the National Mental Health Survey of Korea 2021. Interviewees comprised 5511 South Koreans aged 18–79 years. The contribution of resilience to suicidality was evaluated using Rao–Scot logistic regression, adjusting for possible confounders such as mental disorder prevalence and demographic and psychological characteristics. Significantly lower resilience levels were noted among participants who reported lifetime, one-year, and one-month suicidal ideation, plan, or attempts. High resilience levels predicted no suicidal ideation, plans, and attempts in the lifetime, and no suicidal ideation and plans in the one-year and one-month time frames. First, this study's cross-sectional design has limitations for ascertaining a causal relationship between resilience and suicidality. Second, because the number of participants who had attempted suicide in the past year and reported suicidal thoughts/attempts in the past month was small, there were limitations in the analysis of suicidality in these time frames. Third, it was difficult to rule out the mediating effects of personality and temperament on the relationship between resilience and suicidality. High resilience levels predicted lower lifetime and current suicidal ideation and suicidal planning in the general population. This study shows that psychological resilience is an important factor in evaluating an individual's current suicidality. • This study examines the relationship between suicidality and resilience in Korea. • Interviewees comprised 5511 adults aged 18–79 years. • Lower resilience was noted among participants who reported suicidal ideation. • Resilience is an important factor in evaluating an individual's suicidality. [ABSTRACT FROM AUTHOR]

Emerging evidence suggests that social identities are an important determinant of adaptation following traumatic life experiences. In this paper, we analyse accounts of people who experienced child sexual abuse. Using publicly available talk of people who waived their right to anonymity following successful conviction of perpetrators, we conducted a thematic analysis focusing on trauma‐related changes in their social identities. Analysis of these accounts highlighted two themes. The first highlights the acquisition in these accounts of unwanted and damaging identity labels. The second presents child sexual abuse as a key destructive force in terms of important identity work during childhood. Discussion of this analysis centres on the pathological consequences of social identity change. Both the loss of valued identities and the acquisition of aberrant and isolating identities are experienced and constructed as devastating by those affected by child sexual abuse. This has important implications, not only for those impacted by child sexual abuse but for how abuse is discussed in society, and how it is approached by policy makers, educators and individuals working with survivors and their families. [ABSTRACT FROM AUTHOR]

Nurse scholar Karen J. Foli has had an unconventional trajectory. She has written everything from mysteries to thrillers to peer-reviewed journal manuscripts and Food and Drug Administration documents. She conceptualized and disseminated two middle-range theories, one surrounding parental postadoption depression and one surrounding nurses' psychological trauma. Foli's research has revealed a new type of nurse-specific trauma, insufficient resource trauma, which calls for efforts at the organizational level. Winner of several book of the year awards, she is now working on a third middle-range theory. Dr. Foli shares her journey and encourages nurses to give theory a shot. [ABSTRACT FROM AUTHOR]

Après trois décennies de développement, l'EMDR fait partie des traitements de référence du trouble de stress post-traumatique chez l'adulte. Malgré la diffusion d'une pratique en population pédiatrique dans le cadre de centres experts, sa place dans la prise en charge du psychotraumatisme de l'enfant et l'adolescent reste incertaine. Une recherche bibliographique a été réalisée dans les bases de données PubMed et Cochrane pour identifier les essais contrôlés évaluant l'efficacité de l'EMDR chez les moins de 18 ans. Quatorze essais ont été retrouvés (non randomisés k = 3, randomisés k = 11). L'EMDR s'est montrée systématiquement plus efficace dans le traitement des symptômes psychotraumatiques chez l'enfant et l'adolescent comparée à l'absence d'intervention ou à des interventions non spécifiques. Aucune des études qui comparent l'EMDR à une psychothérapie centrée sur le psychotrauma (TCC-focalisée sur le trauma ou basée sur l'écriture) n'a montré de différence significative sur les critères de jugements principaux. Deux méta-analyses retrouvent une taille d'effet global moyenne, d = 0,49–0,66, comparable aux autres psychothérapies centrées sur le psychotraumatisme. Si ces résultats sont encourageants, on peut regretter le manque d'étude évaluant l'efficacité de l'EMDR pour des patients avec des problématiques plus complexes (forme chronique, association avec des troubles développementaux). Très peu de travaux ont été conduits pour évaluer les bénéfices d'interventions de groupe, en particulier en cas de traumatismes collectifs. D'autres études cliniques seront utiles pour permettre d'évaluer le bénéfice de l'EMDR chez l'enfant et l'adolescent, mais aussi sa place dans une prise en charge du psychotraumatisme intégrant aussi le travail avec la famille et le volet social. Over three decades, EMDR therapy became a gold standard treatment for post-traumatic stress disorder in adults. While a pediatric adaptation of EMDR therapy has been developed and disseminated in specialized trauma centers, its place in the management of psychotrauma in children and adolescents remains unclear. A literature search was conducted using PubMed and Cochrane databases to identify controlled trials evaluating the benefit of EMDR therapy in subjects under 18 years of age. Fourteen studies were found (non-randomized k = 3, randomized k = 11) in which EMDR therapy was consistently more effective for trauma-related symptoms in children and adolescents compared to no intervention (waiting list) or non-specific interventions. None of the studies comparing EMDR to psychotrauma-focused psychotherapy (CBT-trauma-focused or writing-based) showed a significant difference on the primary outcomes. Two meta-analyses reported a medium effect size, d = 0.49–0.66, i.e., in the same range as other psycho-trauma focused psychotherapies. Although encouraging, one may regret the lack of studies evaluating the benefit EMDR therapy for youths with more complex trauma-related disorders (e.g., chronic form, association with suicidal behaviors, and/or developmental disabilities). Further research would help to assess the benefit of EMDR therapy in children and adolescents, not only in terms of efficacy but also in terms of acceptability and effectiveness compared to other interventions. [ABSTRACT FROM AUTHOR]

Background: Authors discuss the connections between novel psychoactive substance (NPS) use and psychological trauma. The transition from classical substances to NPS, a paradigm change, poses a challenge for the treatment systems. Objective: Research evidence suggests difficulties in emotion regulation and trauma-related NPS-use. Authors explore some demographic and psychopathological characteristics related to such findings and examine the connections between emotion regulation deficiency and the choice of substance. Method: This study uses a methodological triangulation of a biologically identified sample to confirm NPS use, a survey method to describe users' socioeconomic characteristics, and Minnesota Multiphasic Personality Inventory (MMPI-2) subscales to study dysfunctions in emotion regulation. Results: Participants (77 patients) were mainly polydrug users. The transgenerational transfer of substance use was a salient feature, but material deprivation was not characteristic of the entire sample. NPS use was not connected to certain psychopathological characteristics the way classical substance use was. More than half of the respondents had elevated scores on MMPI-2 Demoralization (RCd) and Dysfunctional Negative Emotions (RC7) scales. Nearly half of them also scored high on Neuroticism/Negative Emotionality (NEGE). Conclusions: Results suggest that NPS use in the context of polydrug use is connected to psychological trauma and emotion regulation deficiency, but the MMPI-2 scales to assess emotional dysfunctions are not connected to a particular type of NPS. [ABSTRACT FROM AUTHOR]

Introduction Aims of the Study Methods Results Conclusion Clinical Trial Registration Depression with a history of trauma often responds poorly to conventional antidepressants and has a poor prognosis. Prazosin, an α1‐adrenoceptor blocker, has shown promise in treating post‐traumatic stress disorder symptoms, particularly nightmares. Its potential in treating depression with trauma history warrants investigation.This randomised, double‐blind, placebo‐controlled study aimed to investigate the efficacy and tolerability of low‐dose prazosin (0.5–1 mg/day) as an augmentation strategy in patients with depression and a history of trauma. We sought to determine if prazosin could provide rapid symptom improvement and enhance overall treatment response compared to placebo in this difficult‐to‐treat patient population.This randomised, double‐blind, placebo‐controlled clinical study included 59 patients with first‐episode or recurrent unipolar or bipolar depression. After basic antidepressant treatment, they were randomly assigned to a prazosin (0.5–1 mg/day) or placebo group for a 6‐week double‐blind controlled study. The Montgomery–Åsberg Depression Rating Scale, 17‐item Hamilton Depression Scale (HAMD‐17), and Hamilton Anxiety Scale (HAMA) were used to evaluate efficacy.There were no significant differences in the results of the demographic and clinical symptom assessment between the two groups (p > 0.05). The difference between the HAMD‐17 and HAMA scores was statistically significant after 3 days of treatment (p < 0.05). The difference in response rate between the two groups was statistically significant after week 4 of treatment (end of week 4, 56.7% vs. 24.1%, p = 0.011; end of week 6, 80.0% vs. 48.3%, p = 0.011). The incidence of adverse reactions in the prazosin and placebo groups was 20.0% and 24.1%, respectively, with no statistically significant differences (p > 0.05); however, the prazosin group had a lower incidence of sleeplessness or nightmares (3.3% vs. 20.7%, p = 0.039) but a higher incidence of orthostatic hypotension (16.7% vs. 0%, p = 0.007). The severity of orthostatic hypotension was mild to moderate.Low‐dose prazosin can effectively improve the emotional symptoms of patients with depression and a history of trauma, and the common adverse reaction is mild‐to‐moderate orthostatic hypotension.ChiCTR2200063642. [ABSTRACT FROM AUTHOR]

Background: Intrusive memories of psychologically traumatic events bring distress both sub-clinically and clinically. This parallel-group, two-arm randomised controlled trial evaluated the effect of a brief behavioural intervention on reducing intrusive memories in frontline healthcare workers exposed to traumatic events during the COVID-19 pandemic. Methods: Participants with at least two intrusive memories of work-related trauma in the week before recruitment were randomised 1:1 to an imagery-competing task intervention (n = 73) or attention-based control task (n = 71). The number of intrusive memories was assessed at baseline and 5 weeks after the guided session (primary endpoint). Results: The intervention significantly reduced intrusive memory frequency compared with control [intervention Mdn = 1.0 (IQR = 0–3), control Mdn = 5.0 (IQR = 1–17); p < 0.0001, IRR = 0.30; 95% CI = 0.17–0.53] and led to fewer post-traumatic stress-related symptoms at 1, 3 and 6 month follow-ups (secondary endpoints). Participants and statisticians were blinded to allocation. Adverse events data were acquired throughout the trial, demonstrating safety. There was high adherence and low attrition. Conclusions: This brief, single-symptom, repeatable digital intervention for subclinical-to-clinical samples after trauma allows scalability, taking a preventing-to-treating approach after trauma. Trial registration: 2020–07-06, ClinicalTrials.gov identifier: NCT04460014. [ABSTRACT FROM AUTHOR]

Background: While cognitive-behavioural therapy (CBT) is a well-established treatment for odontophobia, research is sparse regarding its effect on patients with dental anxiety related to psychological trauma experiences. This study aimed to evaluate changes in symptoms and acceptability of interdisciplinary Torture, Abuse, and Dental Anxiety (TADA) team treatment for patients with odontophobia or dental anxiety. We also wanted to describe the sample's oral health status. The TADA teams offer targeted anxiety treatment and adapted dental treatment using a CBT approach. Methods: The study used a naturalistic, case series design and included 20 consecutively referred outpatients at a public TADA dental clinic. Pre- and post-treatment assessments included questionnaires related to the degree of dental anxiety, post-traumatic stress, generalized anxiety, and depression. Patients underwent a panoramic X-ray before treatment. Before dental restoration, patients underwent an oral health examination to determine the mucosal and plaque score (MPS) and the total number of decayed, missing, and filled teeth (DMFT). Patients were referred to dentist teams for further dental treatment and rehabilitation (phase 2) after completing CBT in the TADA team (Phase 1). Results from the dental treatment in phase 2 is not included in this study. Results: All patients completed the CBT treatment. There were significant improvements in symptoms of dental anxiety, post-traumatic stress, and depression and moderate changes in symptoms of generalized anxiety. Dental statuses were heterogeneous in terms of the severity and accumulated dental treatment needs. The TADA population represented the lower socioeconomic range; 15% of patients had higher education levels, and half received social security benefits. All patients were referred to and started adapted dental treatment (phase 2). Conclusions: TADA treatment approach appears acceptable and potentially beneficial for patients with odontophobia and dental anxiety related to psychological trauma experiences. The findings suggest that further research, including larger controlled studies, is warranted to validate these preliminary outcomes. Trial registration: The study was approved by the regional ethical committee in Norway (REK-Midt: 488462) and by the Data Protection Board at Møre and Romsdal County Authority. [ABSTRACT FROM AUTHOR]

The October 29, 2022, Seoul Halloween Crowd Crush (SHCC) caused the loss of 159 lives, making it the deadliest global mass-gathering disaster between 2018 and 2022. Despite the fact that years have passed since the incident, there remains a significant gap in research addressing the mental health of citizens to evaluate their recovery progress. Therefore, in this study, a survey was conducted to assess citizens' anxiety, depression, post-traumatic stress disorder (PTSD), and well-being after the SHCC. The data were analyzed using t-tests, analysis of variance (ANOVA), correlations, a Kruskal–Wallis test, and post hoc tests. The citizens' well-being differed significantly by victimization status, with direct victims showing languishing well-being (p =.036). PTSD severity level was higher in victims and direct witnesses (p <.001). Victims and direct witnesses exhibited worse outcomes in subjective, social, and psychological well-being as well as in PTSD (p <.001). Well-being exhibited a significant negative correlation with PTSD (r = −.247, p <.001). The results of the analysis suggest the SHCC's psychological impact has endured not only for victims and direct witnesses but also for media-exposed citizens. Offering continuous psychological support and fostering positive self-perceptions and social interactions are crucial for their recovery and well-being enhancement. [ABSTRACT FROM AUTHOR]

This study is a qualitative analysis of fathers' experiences of preterm birth. Preterm birth affects about ten per cent of the families globally. It is a traumatic event, especially when the infant is very preterm. Often, parents are struggling with the experience without any psychological support. Though fathers' role in the child's healthy psychological development has been confirmed by recent studies, the impact of preterm birth on their paternal identity and their needs for support in this emotionally burdening situation has not been studied extensively. We analysed ten interviews using Interpretative Phenomenological Analysis, a method to study sensitive themes to determine the key themes as potential areas of intervention. We could find that these fathers live their lives in extended liminality, characterized by chaos and unpredictability, and are struggling with new, often unusual roles and responsibilities that may completely upset their private life – work balance. The first contact with the child is usually ambivalent and is burdened with grave concerns about the potential harms. Communication at Perinatal Intensive Care Units (PICUs), though seen as supportive, is not tailored to fathers' competencies. Targeted intervention by trained counsellors at PICU could help the fathers overcome these traumatizing experiences. [ABSTRACT FROM AUTHOR]

Guidelines are lacking for patients with calciphylaxis on renal replacement therapy, often leading to difficulty optimally treating these patients. A 60-year-old male veteran receiving hemodialysis presented with calciphylaxis of the left lower extremity and intractable pain. His condition was complicated by chronic back pain, long-term opioid therapy, and psychological trauma history. He was ultimately transferred to a calciphylaxis treatment center but was unable to tolerate further treatments due to sepsis and hemodynamic instability. He was transitioned to comfort measures and died in the hospital. Addressing complicated pain physiologies and complex trauma is challenging even in well-resourced tertiary medical centers. Despite the availability of calciphylaxis therapies and trauma-informed care, there remains a high rate of suffering and mortality in this patient population. There is much work to be done in this cohort, particularly when considering the implications of past traumatic experiences on health care engagement and pain management. [ABSTRACT FROM AUTHOR]

Background Methods Results Discussion Prenatal ultrasounds form an important part of routine maternity care in Australia and indeed internationally. The COVID‐19 pandemic necessitated rapid changes in society and healthcare to curb transmission, with evidence demonstrating detrimental impacts on childbearing women associated with these restrictions. However, experiences with pandemic restrictions for prenatal ultrasounds in relation to distress, patient expectations, and satisfaction are largely unknown. This study aimed to explore the experiences of pregnant women attending prenatal ultrasound during the pandemic in Australia.A cross‐sectional online survey of people in Australia who had undergone at least one prenatal ultrasound during the period of maternity care restrictions was performed. The survey included validated tools for assessing post‐traumatic stress, satisfaction, and expectations with maternity care.A total of 1280 responses were obtained. Almost 37% of respondents returned a PCL‐C score consistent with probable post‐traumatic stress disorder. Unexpected ultrasound findings or a high PCL‐C score were more likely to have higher expectations and lower levels of satisfaction with their maternity care experience. Having an ultrasound for pregnancy loss, fetal abnormality, and/or a prior post‐traumatic stress disorder diagnosis were the strongest factors correlating with a high PCL‐C score.The prevalence of post‐traumatic stress symptoms in the study population is concerning and elucidates the distress experienced in association with prenatal ultrasounds during pandemic restrictions in Australia. Maternity services should acknowledge the high levels of service consumers with post‐trauma symptoms and consider trauma‐responsive maternity care adaptations in response to adverse perinatal outcomes for those afflicted with post‐trauma and distress‐related symptoms. [ABSTRACT FROM AUTHOR]

The goal of this study was to assess students' responses to a potentially triggering passage from literature using differing trigger warnings. 123 undergraduates read a passage which contained depictions of physical and sexual assault. Students were randomly assigned to differing trigger warning conditions prior to reading the passage that anticipated either neutral, positive, or negative emotional reactions. Measures of PTSD symptoms and distress were taken on Day 1, Day 2, and Day 14. Distress to the triggering passage did not vary as a function of either trauma history or trigger warning type. Those with higher PTSD scores to start did not experience more distress over time. The data suggest that instructors can assign challenging passages with the expectation that those with related traumas will not be disproportionately affected. In addition, the type of warning is not likely to impact on student emotional responses. [ABSTRACT FROM AUTHOR]

The article focuses on the re-traumatization experienced by individuals seeking justice after a traumatic event. Topics include the mental well-being threats faced by Moira and family, the flaws in the judicial system, and the importance of raising awareness about these issues. It reports that the process of seeking justice can exacerbate trauma, and it mentions the need for judicial reform to better support victims.

Background: Past research has suggested a cross-sectional association between COVID-19-related discrimination and PTSD symptom severity. However, no cohort study has examined the longitudinal association that better supports causal interpretation. Also, even if such an association genuinely exists, the specific pathway remains unclear. Methods: We conducted a two-year follow-up study, obtaining data from healthcare workers in a hospital setting. We first evaluated how COVID-19-related discrimination in 2021 was associated with subsequent PTSD symptom severity in 2023. Thereafter, we conducted causal mediation analysis to examine how this association was mediated by psychological distress in 2022, accounting for exposure-mediator interaction. Missing data were handled using random forest imputation. Results: A total of 660 hospital staff were included. The fully adjusted model showed greater PTSD symptom severity in individuals who experienced any COVID-19-related discrimination compared with those without such experiences (β, 0.44; 95% CI, 0.04–0.90). Regarding each type of discrimination, perceived discrimination was associated with greater PTSD symptom severity (β, 0.52; 95% CI, 0.08–0.96), whereas verbal discrimination did not reach statistical significance. Psychological distress mediated 28.1%–38.8% of the observed associations. Conclusions: COVID-19-related discrimination is associated with subsequent PTSD symptom severity in healthcare workers. Psychological distress may serve as an important mediator, underscoring the potential need for interventions targeting this factor. [ABSTRACT FROM AUTHOR]

This school program evaluation aims to highlight the mental health needs of students in special education with behavioral and emotional challenges and describe the implementation of a resilience curriculum with this population. We evaluated district mental health data from a convenience sample of 814 students in grades 5–12 special education to identify risk for mental health symptoms, violence exposure, and substance use. School social workers provided feedback on the implementation of the resilience curriculum to inform program evaluation. Students reported significant risk for traumatic stress, anxiety, and depressive symptoms, and high rates of violence exposure and substance use. School social workers described adaptations to the resilience curriculum and gave recommendations for future implementation. Students receiving special education services for behavioral and emotional challenges had high mental health need, including high rates of violence exposure, and may benefit from a trauma-informed school-based resilience curriculum adapted for their needs. [ABSTRACT FROM AUTHOR]

People in secure psychiatric services experience high levels of exposure to early psychological trauma, are often diagnosed with severe mental illness (SMI) and have increased risk for obesity. Developmental trauma, SMI and obesity are associated with poor physical health outcomes and early death. This study aimed to assess the predictive power of Adverse Childhood Experiences (ACEs), self-harm and psychiatric diagnosis for secure inpatient weight gain and obesity. Data for 248 Welsh patients accommodated in low, medium, and high secure hospitals throughout England and Wales was analyzed. Patient admission bodyweight (in kilograms), bodyweight at the time of audit, and patient BMI at the time of audit was collected. Sex, psychiatric diagnosis, length of current admission, number of ACEs, and frequency of self-harm were also examined. Patients gained significant amounts of weight between admission until the time of the audit (median period = 1 – 2 years) and showed high levels of obesity. Self-harm frequency significantly predicted weight difference. Number of ACEs and diagnosis of schizophrenia significantly predicted patient BMI at the time of audit. The study findings indicate that psychological trauma and the nature of mental illness are important factors driving weight gain and excess morbidity in this vulnerable group. [ABSTRACT FROM AUTHOR]

The concept of psychological trauma implies a causal relation between the traumatic event and subsequent psychopathology. Difficulties in defining the characteristics of causal agent and establishing its firm correlation with signs and symptoms of disorder stem from the paradoxes embedded in the concept of posttraumatic stress disorder (PTSD), which ignores unconscious dynamics of posttraumatic states. In this article, we argue that the impact of extreme traumatization on personality can be made observable through analysis of unconscious mechanisms, processes and structures, such as capacity for symbolization/mentalization, representation and meaning making as well as thinking and intersubjective transformation. The article focuses on the theoretical background for creating a multifactorial, complex and biopsychosocial model of psychopathology of posttraumatic states and does not focus on treatment and psychosocial interventions directly. [ABSTRACT FROM AUTHOR]

Trauma‐informed care has emerged as a prominent strategy to eliminate coercive practices and improve experiences of care in mental health settings, with advocacy from international bodies for mental health reform. Despite this, there remains a significant gap in research understanding the integration of trauma‐informed care in mental health nursing practice, particularly when applied to the acute mental health or hospital‐based setting. The study aimed to explore the experiences of mental health nurses employed in acute hospital‐based settings from a trauma‐informed care perspective. The study design was qualitative, using a phenomenological approach to research. A total of 29 nurses employed in acute mental health or hospital‐based environments participated. Three over‐arching themes were uncovered: 'Embodied Awareness': highlighting mental health nursing emotional capabilities are deeply rooted in bodily awareness. 'Navigating Safety': signifying spatial elements of fear and how some mental health nurses' resort to coercive or restrictive practices for self‐preservation. 'Caring Amidst Uncertainty': revealing the relational influences of security guards in mental health nursing. The study reveals a significant gap in trauma‐informed care implementation when applied to the context of mental health nursing practice in this setting. Limited evidence on trauma‐informed care for mental health nurses, coupled with inadequate workforce preparation and challenging work environments, hinder the effective integration of it. To genuinely embed TIC in acute mental health settings, the study emphasises the need for a thorough exploration of what this entails for mental health nurses. [ABSTRACT FROM AUTHOR]

Historical, cultural, and social trauma, along with social determinants of health (SDOH), shape health outcomes, attitudes toward medicine, government, and health behaviors among communities of color in the United States (U.S.). This study explores how trauma and fear influence COVID-19 testing and vaccination among Black/African American, Latinx/Indigenous Latin American, and Native American/Indigenous communities. Leveraging community-based participatory research methods, we conducted 11 virtual focus groups from January to March of 2021 with Black/African American (n = 4), Latinx/Indigenous Latin American (n = 4), and Native American/Indigenous (n = 3) identifying community members in Inland Southern California. Our team employed rapid analytic approaches (e.g., template and matrix analysis) to summarize data and identify themes across focus groups and used theories of intersectionality and trauma to meaningfully interpret study findings. Historical, cultural, and social trauma induce fear and mistrust in public health and medical institutions influencing COVID-19 testing and vaccination decisions in communities of color in Inland Southern California. This work showcases the need for culturally and structurally sensitive community-based health interventions that attend to the historical, cultural, and social traumas unique to racial/ethnic minority populations in the U.S. that underlie fear and mistrust of medical, scientific, and governmental institutions. [ABSTRACT FROM AUTHOR]

Notre travail a visé à évaluer l'anxiété, la dépression et le trouble de stress post-traumatique post-maladie à coronavirus 2019 (COVID-19) et à identifier les facteurs associés. Nous avons mené une étude transversale durant la période allant du 1er mars 2021 au 15 mai 2021 à l'unité COVID-19 du service de pneumologie à l'hôpital Hédi Chaker Sfax (Tunisie). L'évaluation psychométrique a été réalisée à l'aide des échelles « Hospital Anxiety and Depression Scale », « Impact of Event Scale-Revised » et « Self-Reported Instrument Measuring COVID-19 Related Stigma ». Notre étude a inclus 154 patients. La prévalence de l'anxiété, la dépression et le trouble de stress post-traumatique étaient de 24,7 %, 11 % et 13,6 % respectivement. Nous avons constaté une association entre la dépression et le sexe féminin (p = 0,025), l'atteinte gastro-intestinale (p = 0,002) et la stigmatisation (p = 0,002). Nous avons trouvé une association entre l'anxiété et le niveau scolaire (p = 0,034), ainsi qu'entre l'anxiété et l'asthénie (p = 0,032). L'anxiété, la dépression et le trouble stress post-traumatique étaient indépendants de la majorité des caractéristiques de la maladie, notamment la sévérité de la COVID-19. Our study aimed to assess anxiety, depression, and post-traumatic stress disorder in post coronavirus disease 2019 (COVID-19) and identify associated factors. Our study is a descriptive and analytical cross-sectional study carried out during the period from March 1 to May 15th 2021 on patients who were hospitalized and discharged from the COVID-19 unit in the pneumology department at the Hédi Chaker hospital in Sfax (Tunisia). Patients who met all of the following criteria were included: aged 18 and over; having a diagnosis of COVID-19 by polymerase chain reaction (PCR) and/or by CT scan; monitored at the COVID-19 unit and who their clinical conditions did not require intensive care; survivors after 3 months of discharge; and having given their informed and informal consent to participate in the study. Our study included 154 patients. The prevalence of anxiety, depression and post-traumatic stress disorder was 24.7%, 11% and 13.6% respectively. We found an association between depression and female gender (P = 0.025), gastrointestinal involvement (P = 0.002) and stigma (P = 0.002). We found an association between anxiety and grade level (P = 0.034), and between anxiety and asthenia (P = 0.032). Anxiety, depression, and post-traumatic stress disorder were independent of the majority of disease characteristics including the severity of COVID-19. [ABSTRACT FROM AUTHOR]

Aim Design Methods Data sources Results Conclusion Implications for the profession and/or patient care What problem did the study address? What were the main findings? Where and on whom will the research have an impact? Patient or public contribution To facilitate an understanding of the risk for psychological trauma in labour and delivery nurses.Concept analysis.The Walker and Avant method of concept analysis was applied to 56 articles. The characteristics, antecedents, and consequences of psychological trauma in labour and delivery nurses were identified.Peer‐reviewed articles in English from CINAHL, PubMed and Google Scholar were reviewed on July 2023.The characteristics of psychological trauma in labour and delivery nurses are overwhelming distress, intrusive symptoms, avoidance and numbing behaviours, hypervigilance or hyperarousal, emotional dysregulation, cognitive distortions, and interpersonal challenges. The antecedents are exposure to one or more of the following nurse‐specific traumas: natural or person‐made disasters, historical role limitations, second victim situations, secondary trauma, system‐mediated or over‐medicalized care, insufficient resources, or workplace incivility. The consequences are disruptions in mental health, diminished physical health, alterations in relationships, and variable work performance.Labour and delivery nurses experience unique causes of psychological trauma due to their practice environment and patient population. The consequences of labour and delivery nurses' psychological trauma extend beyond individual health and impact the quality of patient care and organizational capacity.Furthermore, research is needed to inform education, support and policy measures to mitigate harm effectively.Nurse‐specific trauma theory has not been applied to the unique labour and delivery environment with a high incidence of patient trauma.Multiple causes of trauma in the perinatal context have created a pervasive yet largely preventable issue.This research will impact labour and delivery nurses, their leadership, and their patients.No patient or public contribution. [ABSTRACT FROM AUTHOR]

Background: The International Trauma Questionnaire (ITQ) is used to measure posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) symptoms, and the Posttraumatic Cognitions Inventory-9 (PTCI-9) is used to measure posttraumatic cognitions. Both tools have been translated for use in Brazil. However, the psychometric properties of the Brazilian versions were not investigated, and no study has verified the invariance of these tools for many traumatic event types. Objective: This study examined the validity, reliability, and measurement invariance of the Brazilian versions of the ITQ and the PTCI-9 for trauma type, gender, race, age group, education level, and geographical region. Methods: A total of 2,111 people (67.74% women) participated in an online survey. The scale models were tested via confirmatory factor analyses and measurement invariance through multigroup analyses. Pearson's correlation analyses were used to examine the relationships between PTSD, CPTSD, posttraumatic cognitions, and depressive symptoms. Results: Except for the affective dysregulation factor, the reliabilities of the ITQ and PTCI-9 dimensions were adequate. Models with six correlated dimensions for the ITQ and three correlated dimensions for the PTCI-9 showed adequate fit to the data. The ITQ and PTCI-9 exhibited scalar invariance for gender, race, age group, education level, and geographical region. The ITQ also demonstrated full invariance for trauma type. The factors of both instruments were related to each other and to depressive symptoms, with higher effect sizes for posttraumatic cognitions and complex posttraumatic stress disorder symptoms. Conclusion: We recommend using the Brazilian versions of the ITQ and PTCI-9, which are crucial tools for assessing and treating trauma-related disorders. [ABSTRACT FROM AUTHOR]

Objective: It is widely acknowledged that emotional states can influence skin conditions, yet limited research has delved into the impact of stress on skin cancer development. This retrospective study sought to expand the perspective on skin cancer risk factors by investigating the complex relationship between stressful life events and the incidence of skin cancer. Methods: The sample included 268 individuals followed‐up in a dermatological clinic, in three groups: Patients who had previously been diagnosed with cutaneous melanoma and are currently in remission (32%), those who had been diagnosed with non‐melanoma skin cancer (30%), and a control group who are at risk for skin cancer (38%). Participants filled in questionnaires regarding childhood and adulthood life events, and loss and gain of resources following their subjectively most stressful event in adulthood. Multinomial logistic regression was used to examine the associations of life events with skin cancer occurrence, and mediating and moderating effects of resource loss/gain. Results: Adverse childhood experiences were associated with melanoma occurrence, with the melanoma group reporting significantly more such experiences compared to the control group (p < 0.001). Resource loss from subjectively significant stressful life events in adulthood partially mediated the association between adverse childhood experiences and melanoma incidence. Conclusions: The findings suggest that there may be intricate connections between stress, life events, adaptation to change, and skin cancer, which future research may further unravel. This study underscores the need for a more comprehensive approach to stress management, coping strategies development, and skin cancer prevention in healthcare settings. [ABSTRACT FROM AUTHOR]

AbstractPhenomenonApproachFindingsInsightsLearners in medical education are often exposed to content and situations that might be experienced as traumatic, which in turn has both professional and personal implications. The purpose of this study was to synthesize the literature on how trauma has been conceptualized and approached within medical education, and the implications thereof.A metanarrative approach was adopted following the RAMESES guidelines. Searches of 7 databases conducted in January 2022 with no date limitations yielded 7,280 articles, of which 50 were identified for inclusion through purposive and theoretical sampling. An additional 5 articles were added from manual searches of reference lists. Iterative readings, interpretive and reflexive analysis, and research team discussions were performed to identify and refine metanarratives.Five metanarratives were identified, including the concept of trauma, the trauma event, the person with trauma, the impact of trauma, and addressing trauma, with each metanarrative encompassing multiple dimensions. A biomedical concept of trauma predominated, with lack of conceptual clarity. Theory was not integrated or developed in the majority of articles reviewed, and context was often ambiguous. Trauma was described in myriad ways among studies. Why certain events were experienced as trauma and the context in which they took place were not well characterized. The impact of trauma was largely concentrated on harmful effects, and manifestations beyond symptoms of post-traumatic stress were often not considered. Furthermore, the dominant focus was on the individual, yet often in a circumscribed way that did not seek to understand the individual experience. In addressing trauma, recommendations were often generic, and earlier research emphasized individually-focused interventions while more recent studies have considered systemic issues.Multiple dimensions of trauma have been discussed in the medical education literature and from many conceptual standpoints, with biomedical, epidemiologic, and individualized perspectives predominating. Greater precision and clarity in defining and understanding trauma is needed to advance research and theory around trauma in medical education and the associated implications for practice. Exploring trauma from intersectional and collective experiences and impacts of trauma and adapting responses to individual needs offers ways to deepen our understanding of how to better support learners impacted by trauma. [ABSTRACT FROM AUTHOR]

Les dispositifs d'accueil et d'accompagnement des victimes d'événements violents sont constitués aujourd'hui, dès l'urgence, de soignants médico-psychologiques et de juristes. Or, même s'ils sont étroitement intriqués, les soins psychiques et la réparation s'inscrivent dans deux champs différents : celui de la clinique et celui du droit. Certains termes ont des acceptions clairement différenciées alors que d'autres, sous des vocables similaires, recouvrent des réalités pourtant bien différentes. Par ailleurs, l'usage des termes de « victime », de « traumatisme » et de « réparation » après un événement violent a été tellement étendu, qu'ils en ont perdu toute spécificité. Aussi nous apparaît-il fondamental de définir ces termes dans chacun de leurs champs respectifs. Dans un second temps, nous nous attacherons à différencier soins et réparation de façon à ne pas entretenir les confusions entre ce qui relève de la réalité judiciaire ou de la réalité psychique. Juristes et psychothérapeutes ne peuvent qu'enrichir leurs pratiques si chacun garde sa place tout en faisant le lien, en instaurant une nécessaire continuité entre ce qui rassemble et ce qui fait différence, différences qui par moments s'estompent, ou se rapprochent... dangereusement ? Today, care and support systems for victims of violent events are composed, from the very beginning of the emergency, of medico-psychological caregivers and legal experts. Although closely intertwined, psychological care and reparation fall into two different fields: the clinical and the legal. Some terms have clearly differentiated meanings while others, using similar terms, cover very different realities. Furthermore, the use of the expressions "victim", "trauma" and "reparation" following a violent event has become so wide spread that they have lost all specificity. We therefore feel it is fundamental to define these terms in each of their respective fields. Secondly, we will attempt to differentiate between care and reparation, so as not to maintain the confusion between what lies in the legal realm or in the psychological reality. Legal experts and psychotherapists can only improve their practices if each maintains their respective place while liaising, establishing the necessary continuity between what unites people and what makes them different, distinctions that at times become blurred, or that come dangerously close? [ABSTRACT FROM AUTHOR]

As the Syrian crisis has reached its 10th year, this paper explores posttraumatic growth and the related factors among Syrian refugees in Turkey, with the aim of having a better understanding of the predictors of PTG and the risk factors that may play a role in the inhibition of the growth. In this cross-sectional study, 217 displaced Syrian refugees completed the Post Traumatic Growth Inventory (PTGI), Harvard Trauma Questionnaire (HTQ), Brief COPE, General Self-Efficacy Scale (GSES), PTSD Checklist for DSM-5 (PCL-5), and sociodemographic information form by a self-reported online survey. Risk and protective factors were associated in bivariate analysis with growth p<0.05 and were retained in multiple regression models to control the confounders. Participants' 60.7% were females, and the mean age was 32.6± 9.4 years. Growth was found to be highest in the Personal Strengths, New Possibilities and Appreciation of Life, Relating to Others, and Spiritual Change. While the consistency of job education, economic status, education level, number of children, level of self-efficacy, level of Turkish, active coping style, religious coping, and self-distraction (p<0.05) were protective factors, the number of traumatic events, and the PTSD symptoms and self-blame were risk factors (p<0.05) in multiple analysis. However, no significant relationship was found for the variables of marital status, taking support, self-distraction, emotional and instrumental support, positive reframing, planning, cultural perception, working type, and age (p>0.05). In conclusion, the findings have provided valuable insight into the domains of the growth among Syrian refugees and discussed both clinical and research-based future recommendations that could be made to improve the mental health of the refugees based on the obtained results. [ABSTRACT FROM AUTHOR]

Background: Treating the consequences of psychological trauma and PTSD is of major concern to psychiatry although outcomes are often rather poor, often giving to the fact that the diagnose of PTSD is misused and no consideration of the trauma settings and its consequences on the brain. Aims: This paper looks at the impact of false or induced memories in the trauma narrative and their potential impact on therapy with examples from the everyday world. The consequences of this in civilian therapy sessions is discussed compared to the classical debriefing for PTSD in the armed forces. Methods: We take a theoretical overview of the interaction between therapist and patient with PTSD and consider the shortfalls of any therapy that requires the patient to recount their experiences. Results: We argue the uncritical acceptance of trauma history fails to take account of, and even lends itself, to induced or false memories which undermine treatment. Conclusions: We conclude that, this is also often leading to a wrong conception of the outcome of treatment for PTSD, which is often much more sombre than the treatment outcome of lesser conditions. [ABSTRACT FROM AUTHOR]

Objective: Adverse childhood experiences (ACEs) may be a risk factor for later-life cognitive disorders such as dementia; however, few studies have investigated underlying mechanisms, such as cardiovascular health and depressive symptoms, in a health disparities framework. Method: 418 community-dwelling adults (50% nonHispanic Black, 50% nonHispanic White) aged 55+ from the Michigan Cognitive Aging Project retrospectively reported on nine ACEs. Baseline global cognition was a z-score composite of five factor scores from a comprehensive neuropsychological battery. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale. Cardiovascular health was operationalized through systolic blood pressure. A mediation model controlling for sociodemographics, childhood health, and childhood socioeconomic status estimated indirect effects of ACEs on global cognition via depressive symptoms and blood pressure. Racial differences were probed via t-tests and stratified models. Results: A negative indirect effect of ACEs on cognition was observed through depressive symptoms [ β = −.040, 95% CI (−.067, −.017)], but not blood pressure, for the whole sample. Black participants reported more ACEs (Cohen's d =.21), reported more depressive symptoms (Cohen's d =.35), higher blood pressure (Cohen's d =.41), and lower cognitive scores (Cohen's d = 1.35) compared to White participants. In stratified models, there was a negative indirect effect through depressive symptoms for Black participants [ β = −.074, 95% CI (−.128, −.029)] but not for White participants. Conclusions: These results highlight the need to consider racially patterned contextual factors across the life course. Such factors could exacerbate the negative impact of ACEs and related mental health consequences and contribute to racial disparities in cognitive aging. [ABSTRACT FROM AUTHOR]

Background: There is frequent overlap between and the connective tissue diseases Joint Hypermobility Syndrome/Ehlers–Danlos Syndrome (JHS/EDS) and disorders of the gut–brain interaction (DGBIs). Aims: Because not all JHS/EDS patients develop DGBIs, we sought to determine whether secondary environmental triggers may lead to development of irritable bowel syndrome (IBS) and functional dyspepsia (FD) in patients with JHS/EDS. Methods: We sent electronic surveys to 253 patients from a JHS/EDS support group, with responses collected over one year. IBS and FD were diagnosed by the Rome IV criteria, with additional validated assessments of adverse childhood experiences (ACEs) and traumatic stressors according to DSM-V criteria. We compared clinical and psychological characteristics of JHS/EDS patients with and without DGBIs using univariable and multivariable analyses. Results: We enrolled 193 JHS/EDS patients, of whom 67.9% met Rome IV criteria for IBS. The IBS and JHS/EDS overlap group reported significantly more traumatic exposures (P < 0.001) and were more likely to have experienced greater than 3 ACEs (P < 0.001) than JHS/EDS patients without IBS. FD was found in 35.2% of patients and was associated with significantly more traumatic exposures (P < 0.001) and were more likely to have experienced greater than 3 ACEs (P < 0.001) than JHS/EDS patients without FD. Conclusions: We found that JHS/EDS patients with IBS and FD overlap reported significantly more traumatic exposures and ACEs compared to JHS/EDS patients without overlapping IBS or FD. JHS/EDS patients may have increased susceptibility to DGBIs, with traumatic life experiences and/or ACEs acting a secondary environmental trigger driving the subsequent development of DGBIs. [ABSTRACT FROM AUTHOR]

Objective: The study investigated the association between childhood trauma (CT), which is an environmental factor, and obesity. Methods: The study was planned as a cross-sectional descriptive survey. Our study was conducted between 01.07.2022 and 01.08.2022. After obtaining informed consent from all participants over 18 years of age who presented to our outpatient clinic, they were examined using a face-to-face questionnaire. All subjects were interviewed using a 28-item CT scale form and a researcher-prepared questionnaire with 25 questions. The data obtained from the study were analyzed using the SPSS statistics 21 program and p<0.05 was considered significant. Results: In our study, 63.67% of the 256 participants were female and 36.33% were male. The mean age of the participants was 38.53±14.61 years, and the mean body mass index was 30.01±7.14 kg/m2. No statistically significant association was found between the variables of current and childhood obesity status of the study participants and their CT questionnaire (CTQ) score (p>0.05). In the study, the mean CTQ total score was 36.92±11.88. There was no statistically significant association between children's overweight/obesity problem and their childhood CTQ subgroup scores compared with their childhood peers (p<0.05). Conclusion: In our study, no association was found between adult obesity and CTQ score. However, a significant association was found between emotional abuse, physical abuse, physical neglect, and obesity in adults, which are CTQ subsets. [ABSTRACT FROM AUTHOR]

The principle of proportionality demands that a war (or action in war) achieve more goods than bads. In the philosophical literature there has been a wealth of work examining precisely which goods and bads may count toward this evaluation. However, in all of these discussions there is no mention of one of the most certain bads of war, namely the psychological harm(s) likely to be suffered by the combatants who ultimately must fight and kill for the purposes of winning in conflict. This paper argues that harms to one's own soldiers must be included in proportionality judgments, and goes on to argue that one of the most significant harms one's soldiers face are the psychological stresses and traumas associated with combat. The arguments draw on a growing wealth of psychological literature exploring the connections between combatancy and psychological trauma, and highlight, in particular, the uniquely negative impact which killing has on a combatant's mental well-being. The paper concludes that these factors place an almost certain and rather weighty negative weight in any proportionality calculations concerning wars with ground combatants who must fight "up close and personal", and that for more remote warfighters, there is also evidence to show that they may suffer deep psychological harm as a result of their combat roles as well. The argument, however, does not attempt to demonstrate that these factors render war impermissible. Rather, it merely shows that these harms, or bads, which can be quite significant, must be factored into our considerations of proportionality. The arguments themselves are rather uncontroversial, but they bring to light an element in the moral calculus which is sadly overlooked in most discussions of the ethics of war. [ABSTRACT FROM AUTHOR]

The article describes cases of patients at a Singapore hospital with trauma-related nightmares treated with prazosin. A 25-year old Chinese woman with post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) had reduced nightmares. A 25-year old Malay woman with PTSD, borderline personality disorder (PD) and MDD resolved her nocturnal enuresis. A 20-year old Malay woman with borderline PD, MDD, persistent depressive disorder and social anxiety disorder had reduced nightmares.

Suicide and PTSD are pressing public health issues in the US, with discrimination and potentially traumatic experiences (PTEs) influencing mental health. However, the unique effects of these factors on Multiracial/ethnic adults' PTSD and suicidal thoughts/behaviors (STB) are not thoroughly researched. Using a cross-sectional design, an online survey was conducted (N = 1012) from October to December 2022. Multivariable logistic regression models analyzed relationships between PTEs, discriminatory events, and mental health outcomes, accounting for sociodemographics. After adjusting for demographics, exposure to PTEs and discrimination correlated with heightened odds of PTSD and STB. Individual lifetime discrimination experiences and specific PTEs demonstrated varying associations with STB and PTSD. The study underscores discrimination's relevance as a risk factor. The study's cross-sectional nature restricts causality or temporality interpretations. Moreover, the convenience sample of English-speaking online participants might not be reflective of all Multiracial/ethnic US adults. Findings underscore PTEs and discrimination's interconnectedness in Multiracial/ethnic mental health outcomes. Discrimination might pose similar risks to PTEs. Acknowledging discrimination as potential precursors for PTSD and STB aids accurate diagnosis and effective treatment planning. Incorporating racial/ethnic discrimination and traumatic experiences into PTSD conceptualization and assessment is pivotal. This knowledge informs tailored interventions and mental health education for this population. • Potentially Traumatic Experiences (PTE) are events that meet qualifying criteria for PTSD. • Discrimination is not currently included as a qualifying PTE. • PTEs & discrimination linked to 5–34 % higher odds of STB and PTSD in Multiracial/ethnic adults. • Discrimination may pose similar STB/PTSD risks as traditionally noted PTEs. • Consider including assessment of exposure to discrimination as risk factor for STB and PTSD. [ABSTRACT FROM AUTHOR]

Sadly, much of the world is no stranger to Psychological Trauma, particularly in poorer areas with poor health infrastructure. Western Aid Organisations frequently deploy to such areas bringing with them a western psychiatric tradition of nosology and therapy which may not be appropriate in other cultures. We argue that imposing a western system of diagnosis and treatment may not only undermine local culture but may also be bad for the patient. We discuss this with reference to the WHO's Mental Health Gap initiative (MHGap). [ABSTRACT FROM AUTHOR]

Objective: To compare the number and severity of neuropsychiatric symptoms (NPS) and associated caregiver distress between those with and without a noted history of psychological trauma among those referred to a specialised national dementia NPS support service. Methods: This was a 5‐year retrospective observational study of records from the Dementia Support Australia NPS support service. NPS were reported by formal or informal caregivers at service entry using the Neuropsychiatric Inventory Nursing Home version or Questionnaire version. A history of psychological trauma was recorded in the person's social or medical history and/or endorsed as a contributor to NPS by a trained dementia consultant after a comprehensive clinical review. Regression was used to examine the impact of a recorded history of psychological trauma on NPS severity and associated caregiver distress, controlling for age and sex. Results: Among 41,876 eligible referrals with dementia, 6% (n = 2529) had some reference in their records to a history of psychological trauma. Referrals with a recorded history of psychological trauma were rated with a higher rate of both NPS severity (mean = 12.0) and associated caregiver distress (mean = 16.5) at service entry than those without a recorded history of psychological trauma (means = 10.7 and 14.5, respectively). A recorded history of psychological trauma was associated with higher odds of psychotic symptoms, agitation/aggression, irritability, disinhibition, affective symptoms and night‐time behaviours. Conclusions: Traumatic stress symptoms may represent a neglected target for intervention to reduce the impact of NPS in people with dementia. Key points: Psychological trauma is a putative risk factor for dementia, and dementia onset can also trigger the re‐emergence or exacerbation of traumatic stress. However, little is known about how trauma contributes to neuropsychiatric symptoms (NPS) in dementia.People with dementia and a recorded history of psychological trauma were rated as having more frequent, more severe, and more distressing NPS than people without a recorded history of psychological trauma.Traumatic stress symptoms are modifiable and therefore may represent a neglected target for intervention to reduce the impact of NPS in people with dementia. [ABSTRACT FROM AUTHOR]

Objective: Pathological responses can occur in the aftermath of traumatic experiences, alongside positive changes in levels of functioning, such as Post-Traumatic Growth (PTG). Neurocognitive flexibility involves the adaptive restructuring of information in response to changing conditions. The aim of this study is to investigate the potential impact of neurocognitive flexibility on PTG. Post-Traumatic Stress Disorder (PTSD) and PTG are examined together. Method: A total of 96 participants of had a traffic accident, consisting of 43 individuals with a diagnosis of PTSD and 53 without a diagnosis of PTSD, participated in the study. Structured Clinical Interview for DSM-5, Clinician-Administered PTSD Scale, Sociodemographic and Trauma-Related Characteristics Data Form, Life Events Checklist for DSM-5, PTSD Checklist for DSM-5, Depression Anxiety Stress Scale 42, Post-Traumatic Growth Inventory, Stroop Test, Trail Making Test, and Category Fluency Test were used as assessment tools. Results: According to correlation analyses, weak significant relationships were found between the PTG inventory subdimension of changes in life philosophy and neurocognitive flexibility scores. Statistically significant relationships were found between PTSD and neurocognitive flexibility scores. However, no significant relationship was found between PTSD and PTG. Linear regression analyses revealed a trend between PTG inventory and Category Fluency scores. Discussion: This study is the first in Turkey to examine the relationship between PTG and neurocognitive flexibility using neuropsychological tests. Including tests that measure neurocognitive flexibility in future studies with a larger sample size could yield more specific and robust findings. Investigating the impact of neurocognitive flexibility is theoretically important for understanding the cognitive variables that affect PTG and can help plan psychological interventions that encompass neurocognitive flexibility. This study was presented as a Poster Presentation at the 21st National Neuroscience Congress. [ABSTRACT FROM AUTHOR]

The aim of the present study was to assess the impact of past traumatic war experiences on preadolescents in the Gaza Strip, which could be useful for psychological intervention with current and future child victims. Participants were 521 preadolescents from United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) schools, aged 11 and 13 years old. Sections I to IV from Iraqi Version-Arabic of Harvard Trauma Questionnaire was used to assess trauma experiences and Post-Traumatic Stress Disorder (PTSD). The results show that the preadolescents in the Gaza Strip witnessed the destruction of their homes and the murder of family members and friends. A quarter of the individuals assessed either suffered torture or witnessed others undergoing it, including sexual assaults. Almost half of them experienced a lack of food and clean water. The traumatic and torture experiences seriously affected preadolescents' mental health as 26.29% met criteria for the diagnosis of PTSD. The data analysis revealed two PTSD modalities, with the severity of impact depending on whether social implications were involved. Further research is required to check whether these two modalities fit to PTSD and complex PTSD. Understanding the effects of past wars on preadolescents in Gaza and distinguishing between different PTSD types could enhance comprehension of the impacts of current attacks on child victims. It can also aid in determining the type of intervention needed to minimize the impact on the mental health of Palestinian youth, enhancing their resilience through psychological and social support. [ABSTRACT FROM AUTHOR]

Peu d'études ont recherché de manière systématique des antécédents de violences sexuelles chez des adolescents présentant des troubles psychiatriques sévères et hospitalisés en pédopsychiatrie. Nous présentons ici les résultats d'une étude rétrospective menée sur les dossiers de l'ensemble des adolescents hospitalisés dans un service de pédopsychiatrie du département de la Seine Saint-Denis entre 2017 et 2021. L'objectif de l'étude était de rechercher la fréquence des Antécédents d'Agression Sexuelle (AAS) chez les adolescents hospitalisés en service de pédopsychiatrie et de tenter de décrire des liens chronologiques et symptomatologiques entre ces antécédents et l'hospitalisation en pédopsychiatrie, dans le but de proposer d'éventuelles recommandations de dépistage et de prise en charge. Nous avons réalisé une étude rétrospective basée sur l'analyse des dossiers médicaux des 141 adolescents hospitalisés dans un service de pédopsychiatrie entre 2017 et 2021. En rappelant l'épidémiologie des agressions sexuelles dans l'enfance et l'adolescence (fréquente, concernant garçons et filles, dans un tiers des cas intrafamiliale, et dans environ la moitié des situations non crue et non-accompagnée) notre étude souligne l'importance de leur dépistage par les médecins et les soignants. La prévalence significativement plus importante des tentatives de suicide et des automutilations doit particulièrement attirer l'attention sur le risque d'antécédents d'agression sexuelle, car ces symptômes sont fortement associés dans notre étude. La prévalence significativement plus importante des dépressions et des troubles de personnalité limite peut permettre d'aller vers une meilleure compréhension des répercussions des agressions sexuelles à l'adolescence. Le délai court entre l'agression sexuelle et sa révélation dans notre observation et les révélations d'agressions sexuelles intra familiales majoritairement faites durant l'hospitalisation soulignent l'intérêt d'une hospitalisation systématique des adolescents, notamment après une tentative de suicide. Le cadre rassurant d'une hospitalisation peut favoriser une révélation d'agression sexuelle plus rapide et ainsi en diminuer les effets psychiques dévastateurs à l'adolescence. Une faiblesse potentielle de notre étude est que, même dans un service spécialisé, de tels antécédents sont encore probablement sous-évalués et insuffisamment notés dans les dossiers médicaux. Une attention accrue est certainement nécessaire lors des entretiens pédopsychiatriques sur d'éventuels antécédent d'agressions sexuelles. Néanmoins, la rareté des études systématiques sur le sujet fait que cette étude ouvre la voie à la réalisation d'études prospectives. Des recommandations peuvent être proposées, également pour des situations moins graves, sans troubles psychiatriques avérés, mais suite à une tentative de suicide. L'hospitalisation peut alors se dérouler en service de pédiatrie avec un accompagnement psychologique adapté et non en service de pédopsychiatrie. Quel que soit le lieu de prise en charge psychologique des adolescents ayant fait une tentative de suicide, l'attention sur les antécédents d'agression sexuelle doit être améliorée afin de les repérer au plus tôt, d'effectuer une prévention secondaire et d'éviter une dégradation psychique du processus adolescent qui s'en trouve fragilisé. Few studies have systematically searched for a history of sexual violence in adolescents with severe psychiatric disorders hospitalized in departments of child psychiatry. Here, we present the results of a retrospective study conducted on the records of all adolescents hospitalized in a child psychiatry department in the Seine Saint-Denis department between 2017 and 2021. The aim of the study was to investigate the frequency of Antecedents of Sexual Aggression (AAS) in adolescents hospitalized in child psychiatry departments and to attempt to describe chronological and symptomatological links between these antecedents and hospitalization in child psychiatry, with the aim of proposing possible screening and management recommendations. We conducted a retrospective study based on analysis of the medical records of 141 adolescents hospitalized in a child psychiatry department between 2017 and 2021. By recalling the epidemiology of sexual aggression in childhood and adolescence (frequent, involving both boys and girls, in a third of cases intrafamilial, and in about half of the situations uncrushed and unaccompanied) our study underlines the importance of their detection by physicians and caregivers. The significantly higher prevalence of suicide attempts and self-harm should draw particular attention to the risk of a history of sexual assault, as these symptoms are strongly associated in our study. The significantly higher prevalence of depression and borderline personality disorder may provide a better understanding of the repercussions of sexual assault in adolescence. The short delay between the sexual assault and its disclosure in our observation, and the fact that most disclosures of intra-family sexual assaults were made during hospitalization, underline the value of systematic hospitalization of adolescents, particularly after a suicide attempt. The reassuring environment of hospitalization may encourage a more rapid disclosure of sexual assault, and thus lessen its devastating psychic effects during adolescence. A potential weakness of our study is that, even in a specialized service, such antecedents are probably still undervalued and insufficiently noted in medical records. More attention should certainly be paid during child psychiatric interviews to any history of sexual assault. Nevertheless, given the scarcity of systematic studies on the subject, this study paves the way for prospective studies. Recommendations can also be made for less serious situations, with no proven psychiatric disorders, but following a suicide attempt. In such cases, the patient could be hospitalized in a pediatric ward, with appropriate psychological support, rather than in a child psychiatry ward. Regardless of where adolescents who have attempted suicide are psychologically cared for, greater attention needs to be paid to any history of sexual aggression, so as to identify it as early as possible, provide secondary prevention and avoid the psychic deterioration of the adolescent process which would be weakened as a result. [ABSTRACT FROM AUTHOR]

Les violences sexuelles sur les mineurs ont des répercussions psychologiques importantes tout au long de la vie. Chez les adolescents, elles peuvent notamment se traduire par des mises en danger comme des tentatives de suicide. Leur repérage par les professionnels de santé est donc un enjeu important afin de proposer à ces jeunes une prise en charge médicale et sociale adaptée. Des recommandations professionnelles émergent quant au repérage des violences sexuelles chez les mineurs, mais malgré cela elles restent souvent sous-diagnostiquées. Au sein du centre hospitalier Robert-Ballanger (Aulnay-sous-Bois, Seine-St-Denis), un protocole spécifique permet l'hospitalisation en pédiatrie de tous les adolescents suicidants. Nous avons réalisé une étude afin de mettre à profit ce temps d'hospitalisation pour un meilleur repérage des antécédents d'agressions sexuelles chez les adolescents. Nous avons réalisé une étude rétrospective basée sur l'analyse des dossiers médicaux de 138 adolescents hospitalisés dans le service de pédiatrie et suivis par l'équipe de liaison de pédopsychiatrie au centre hospitalier Robert-Ballanger en 2021. Nous retrouvions significativement plus d'adolescents agressés sexuellement parmi les adolescents hospitalisés pour des gestes ou des idées suicidaires (12 sur 54; 22 %) que parmi les adolescents hospitalisés pour d'autres motifs pédopsychiatriques (5 sur 84; 6 %). Les situations d'agressions sexuelles décrites par les adolescents concernés étaient concordantes avec les données des études épidémiologiques françaises : elles concernaient majoritairement les filles (14 sur 17), étaient des agressions répétées dans les trois quarts des cas, et il s'agissait d'agressions intrafamiliales dans un tiers des cas. La révélation des faits était souvent faite à un soignant (pour 5 adolescents sur 17). Les adolescents avec un antécédent d'agression sexuelle étaient davantage concernés par des faits de violences intrafamiliales, mais aussi de harcèlement scolaire. Nous retrouvions un nombre significativement plus élevé de tentatives de suicide chez les adolescents agressés sexuellement, ainsi qu'un nombre plus élevé de tentatives de suicide ayant nécessité une hospitalisation en réanimation. L'hospitalisation en pédiatrie des adolescents suite à une tentative de suicide apparaît comme un outil intéressant pour le repérage des antécédents d'agression sexuelle chez ces jeunes. Notre étude met en évidence une sur-représentation des adolescents agressés sexuellement parmi ceux pris en charge pour des idées suicidaires ou des tentatives de suicide, ainsi que des points de vigilance spécifiques. Un cadre rassurant, la sensibilisation des professionnels et une attention particulière pourraient permettre un meilleur repérage et, de fait, une meilleure protection et un suivi thérapeutique adapté. Sexual violence against minors has important psychological repercussions throughout life. In adolescents, it can result in endangerment or self-aggressive behaviour such as suicide attempts. Its detection by health professionals is therefore an important issue in order to provide these young people with appropriate medical and social care. Professional recommendations call for systematic hospitalization of adolescents who have attempted suicide, but these recommendations have not yet been widely applied. At the Robert-Ballanger hospital (Aulnay-sous-Bois, Seine-St-Denis, France), a specific protocol has been established between paediatrics and child psychiatry departments, allowing all suicidal adolescents to be hospitalized in paediatrics. We conducted a study to take advantage of this hospitalization time to better identify sexual violence in adolescents. We conducted a retrospective study based on the analysis of the medical records of 138 adolescents hospitalized in the paediatric ward and followed by the child psychiatry liaison team at the centre hospitalier Robert-Ballanger (Aulnay-sous-Bois) in 2021. We found significantly more sexually assaulted adolescents among those hospitalized for suicidal gestures or ideas (12 out of 54; 22%) than among those hospitalized for other reasons (5 out of 84; 6%). The sexual assaults described by the adolescents concerned were consistent with data from epidemiological studies and French victimization surveys : they mainly concerned girls (14 out of 17), were repeated assaults in three quarters of cases, and were intrafamilial assaults in one third of cases. The disclosure was often made to a caregiver (for 5 of 17 adolescents). Adolescents with a history of sexual assault were more concerned with intrafamilial violence but also with school harassment. We found a significantly higher number of suicide attempts among sexually assaulted adolescents, as well as a higher number of suicide attempts requiring hospitalization in intensive care. Paediatric hospitalization of adolescents attempting suicide appears to be an interesting tool for identifying a history of sexual assault in these young people. Our study highlights an over-representation of sexually assaulted adolescents among those treated for suicidal thoughts or suicide attempts, as well as specific factors that should be vigilantly monitored. A reassuring environment, awareness-raising among professionals, and special attention to detail could all help to improve detection and hence protection and appropriate therapeutic follow-up. [ABSTRACT FROM AUTHOR]

Depuis quelques années, les crimes et délits sexuels, en particulier chez les mineurs, ont fait l'objet d'une médiatisation importante en France ainsi que d'une modification de la loi en avril 2021, porteuse de plusieurs transformations législatives allant dans le sens d'une meilleure reconnaissance et protection judiciaire des enfants et adolescents victimes de telles violences. Cette préoccupation sociétale et politique s'est également manifestée par la création en 2020 par le gouvernement de la Commission indépendante sur l'inceste et les violences sexuelles faites aux enfants. Cette commission a rendu en 2022 un certain nombre de préconisations s'adressant aux professionnels en contact avec des mineurs, notamment dans le champ de la pédiatrie et de la pédopsychiatrie. Nous proposons dans cet article, à la lumière du contexte actuel, de revoir comment depuis le XIXe siècle le milieu scientifique et médical s'est intéressé à cette question, traversant plusieurs périodes de polémiques et de controverses, avant d'en arriver à l'intérêt qui existe aujourd'hui pour ce sujet. En étudiant la littérature scientifique disponible depuis les années 1990, il apparaît que les violences sexuelles chez les mineurs et leurs répercussions psychologiques constituent un sujet de recherche désormais bien d'actualité, mais pourtant toujours complexe à appréhender, pris dans des enjeux éthiques et méthodologiques très spécifiques. Les données concernant les répercussions psychiques à long terme des violences sexuelles subies dans l'enfance et l'adolescence sont assez nombreuses, témoignant d'un impact considérable sur la santé mentale, avec des risques majorés de troubles anxiodépressifs, de stress post-traumatique, et un risque suicidaire accru. En revanche, la littérature s'intéressant aux conséquences plus rapprochées est moins fournie et se révèle comme un domaine dans lequel la recherche médicale peut encore se développer. Nous proposons un état des lieux s'intéressant plus spécifiquement aux conséquences psychologiques et psychiatriques chez les adolescents, dont la clinique du traumatisme, entrelacée avec celle de l'adolescence, peut être déroutante et questionnante. Si la recherche médicale a fourni de nombreuses données sur l'impact psychopathologique des violences sexuelles depuis 30 ans, de nombreux travaux de recherche restent à penser, en particulier dans le champ de la pédopsychiatrie et dans le cadre des services de soins directement, pour continuer à appréhender ce sujet délicat. In recent years, sexual crimes and offenses, in particular among minors, have been the subject of significant media coverage in France as well as a modification of the French law in April 2021. This new law carried several legislative transformations towards a better recognition and protection of children and adolescents who are victims of such violence. This societal and political concern was also exposed by the creation in 2020 by the French government of the Independent Commission on Incest and Sexual Violence against Children. In 2022, this commission issued a certain number of recommendations aimed at professionals in contact with minors, particularly in the field of paediatrics and child psychiatry. We propose in this article, in the light of the current context, to review and comment on how the scientific and medical community has been interested in this question since the 19th century, going through several periods of polemics, before arriving at the interest that exists today for this subject. By studying the scientific literature available since the 1990s, it appears that sexual violence among minors and their psychological reactions has constituted a subject of research that is now very topical, yet still complex to study, concerned by very specific ethical and methodological issues. Data concerning the long-term psychological consequences of sexual violence suffered in childhood and adolescence are quite numerous, demonstrating a considerable impact on mental health, with increased risks of anxiety-depressive disorders, post-traumatic stress disorders, and an increased suicidal risk. On the other hand, the literature focusing on more immediate consequences is less extensive and appears to be an area in which medical research can still develop. We present an inventory focusing on the psychological and psychiatric consequences in adolescents whose clinical traits of trauma, intertwined with that of adolescence, can be confusing. If medical research has provided much data on the psychopathological impact of sexual violence for over 30 years, many areas of research remain to be considered, in particular in the field of child psychiatry and within the framework of care services, to continue to understand this delicate topic. [ABSTRACT FROM AUTHOR]

Current views of psychological therapies for trauma typically assume the traumatic event to be in the past. Yet, individuals who live in contexts of ongoing organized violence or experience intimate partner violence (IPV) may continue to be (re)exposed to related traumatic events or have realistic fears of their recurrence. This systematic review considers the effectiveness, feasibility, and adaptations of psychological interventions for individuals living with ongoing threat. PsychINFO, MEDLINE, and EMBASE were searched for articles that examined psychological interventions in contexts of ongoing threat of either IPV or organized violence and used trauma-related outcome measures. The search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data on study population, ongoing threat setting and design, intervention components, evaluation methods, and outcomes were extracted, and study quality was assessed using the Mixed-Method Appraisal Tool. Eighteen papers featuring 15 trials were included (12 on organized violence and 3 on IPV). For organized violence, most studies showed moderate to large effects in reducing trauma-related symptoms when compared to waitlists. For IPV, findings were varied. Most studies made adaptations related to culture and ongoing threat and found that providing psychological interventions was feasible. The findings, albeit preliminary with mixed methodological quality, showed psychological treatments can be beneficial and should not be withheld in the context of ongoing organized violence and IPV. Clinical and research recommendations are discussed. [ABSTRACT FROM AUTHOR]

The experience of psychological trauma is common and has become even more prevalent during the COVID-19 pandemic for both health care workers and the general population. Traumatic experiences can have varied and lasting physical and mental health effects on patients, beyond what we are privy to in the acute environment of the emergency department. The effects of these prior traumatic experiences can be exacerbated by interaction with the healthcare system, and yet emergency medicine physicians have no standardized methods for working with patients in a trauma-informed way. The systematic implementation of trauma-informed care (TIC) practice requires the cooperation of multiple domains within the health care system, including focus on the physical environment, direct care, and administrative practices. Here we provide recommendations specific to emergency medicine for the development and implementation of TIC in the regular patient-clinician interaction, situated within the context of the TIC framework as outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA). [ABSTRACT FROM AUTHOR]

Background: Psychosocial stress has been associated with the development and progression of atherosclerotic cardiovascular disease (CVD). Previously, we reported subtle differences in global longitudinal strain in somatically healthy women with a psychiatric diagnosis of borderline personality disorder (BPD). This study aimed to investigate the impact of BPD on segmental myocardial wall motion using speckle tracking echocardiography (STE) analysis. Methods: A total of 100 women aged between 18 and 38 years were included in this study. Fifty patients meeting the diagnostic criteria for BPD were recruited from the Department of Psychiatry (LWL-University Hospital Bochum) and compared with fifty age-matched healthy control subjects without previous cardiac disease. Laboratory tests and STE were performed with segmental wall motion analysis. Results: The BPD group had a higher prevalence of risk factors for CVD, with smoking and obesity being predominant, when compared with the control group. Other cardiovascular parameters such as blood pressure, glucose, and cholesterol levels were also elevated, even though not to pathological values. Moreover, in the STE analysis, the BPD group consistently exhibited decreased deformation in nine myocardial wall regions compared with the control group, along with a shift toward higher values in the distribution of peak pathological segments. Additionally, significantly higher values of free thyroxine concentration and thyroid's secretory capacity were observed in the BPD group, despite falling within the (high-) normal range. Conclusions: BPD is associated with chronic stress, classical risk factors, and myocardial wall motion abnormalities. Further exploration is warranted to investigate the relationship between high-normal thyroid metabolism, these risk factors, and myocardial function in BPD patients. Long-term follow-up studies would be valuable in confirming the potential for predicting adverse events. [ABSTRACT FROM AUTHOR]

Dance therapy is thought to improve mental and physical health by activating psychological and physiological processes such as motor coordination, and expression of emotions. Some currently used mind–body interventions for posttraumatic symptoms address both mental and physical health. Although some studies have evaluated the efficacy of dance therapy for posttraumatic symptoms, a systematic review of extant research has not been conducted. To identify the effects of dance therapy in adults with psychological trauma as well as the barriers and facilitators associated with its therapeutic use. Articles published between 2000 and March 2023 have been selected with the help of six relevant keyword combinations applied on seven databases. Two reviewers independently screened 119 titles and abstracts against inclusion and exclusion criteria. Bias evaluation has been conducted with the help of the NIH study quality assessment tools and JBI's critical appraisal tools. A report of the results has been organized with the help of a thematic analysis. Of the 15 articles included, only one case study directly reports a diminution of pathognomonic symptoms of trauma. Other studies present improvements in the key aspects of trauma therapy: bodily sensations and perceptions, psychological processes, and interpersonal skills. These improvements depend on the stability of the intervention, the applied method (dance as therapy or dance/movement therapy), and likely, the skill set of the therapists. However, the reviewed studies lacked uniformity in assessments of adherence and its effect on therapeutic outcomes. Dance therapy may be a useful technique for improving both psychological and physiological symptoms associated with trauma exposure, such as avoidance and dissociative phenomena. To complement the results of this qualitative systematic review, further quantitative and qualitative research on the impact of dance therapy interventions as a trauma treatment should be conducted. Dance therapy may be a promising approach for the therapeutic management of psychological trauma as it can address both psychological and physical symptoms. Therapist skills and training may be important factors to consider in evaluating the impact of dance therapy on posttraumatic symptoms. Dance/movement therapy, a specific type of dance therapy, appears to be associated with improvements in sensory-motor perceptions and motor skills. To date, examination of dance therapy as a trauma treatment in an adult population has been limited primarily to women and people facing migration. [ABSTRACT FROM AUTHOR]

Linguistic racism explores the varied ideologies that may generate and endorse monolingual, native, and normative language practices, while reinforcing the discrimination and injustice directed towards language users whose language and communicative repertoires are not necessarily perceived as standard and normal. This article, thus, investigates linguistic racism, as a form of existing, but newly defined, racism against unconventional ethnic language practices experienced by Eastern-European immigrant women in the Australian workplace. Our ethnographic study shows that, once these women directly or subtly exhibit their non-nativism, through a limited encounter with local expressions, non-native language skills, and ethnic accents, they become victims of covert and overt linguistic racism in the form of social exclusion, mockery, mimicking, and malicious sarcasm in the hierarchical power environment of the workplace. As a result, these migrants can suffer from long-lasting psychological trauma and distress, emotional hurdles, loss of credibility, and language-based inferiority complexes. We, as researchers, need to highlight the importance of combatting workplace linguistic racism and revealing language realities of underprivileged communities. In that way, we can assist them in adapting to host societies and help them regain some degree of power equality in their institutional environments. [ABSTRACT FROM AUTHOR]

The study aimed to provide a preliminary evaluation of the acceptability and effectiveness of online eye movement desensitization and reprocessing (EMDR) compared with a waitlist control (WLC). A pilot nonrandomized controlled trial was conducted. Eighteen adults experiencing chronic pain completed the study (n EMDR = 10; n control = 8). The intervention group received up to 10 weekly sessions of online EMDR. The control group received treatment as usual. Participants completed baseline and post-intervention measures assessing posttraumatic stress, pain severity, interference, and catastrophizing, and depression levels. Additionally, the online EMDR group participants provided feedback on intervention acceptability and satisfaction. The online EMDR group demonstrated significant reductions in both trauma and pain-related outcomes; depression levels did not significantly change. No significant change was observed in any outcome within the control group. After the WLC also received the intervention, additional analysis results demonstrated similar effects but did not reach statistical significance, except for depression. Overall, online EMDR appeared acceptable and positively received by participants. The study provides preliminary support that online delivery of EMDR may reduce trauma- and pain-related outcomes in individuals experiencing chronic pain. Further large-scale research is warranted to substantiate these findings. Limitations and implications are discussed. REC ref: 2020/HCSREC/04 [ABSTRACT FROM AUTHOR]