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This paper aims to review the subtypes of childhood trauma and its effects on brain structures and function, especially the hippocampus and amygdala within the limbic system, in the context of clinical psychology. For this purpose, original articles published between 1996 and 2024 were systematically searched in major databases such as PubMed, PsycArticles, Web of Science, and Google Scholar using keywords such as early childhood trauma, psychological trauma, limbic system, hippocampus, amygdala, and neuroimaging. The articles were initially screened based on their titles, and those meeting the search criteria, including study population, investigated brain regions, and types of traumas, were further assessed for relevance. Ultimately, 136 articles were selected and discussed in this review. Trauma experiences in early life can have a significantly negative influence on a person's psychological health by causing neurodevelopmental impairments, especially in the limbic system. While it is understood that trauma influences how individuals think, behave, and feel, the results of neuroimaging studies reveal variations in the amygdala and hippocampus based on different trauma subtypes. These changes merit deeper investigation in future research to fully understand the reasons behind the diverse findings in existing literature.

Abstract Background This study explored the relationship between attention, negative emotions, empathy, mindfulness, and psychological trauma in catastrophic events to reduce psychological trauma in the public. Methods A total of 526 adults in Guangxi Province, China, were investigated using self-rating scales for post-traumatic stress disorder, emotion, and empathy, as well as a five-factor self-rating mindfulness scale and a catastrophic incident concern questionnaire. Results The results revealed the following: (1) Emotion significantly mediated attention and psychological trauma. (2) Empathy had a significant mediating effect on attention and psychological trauma. (3) Mindfulness moderated the relationship between negative emotions and psychological trauma, amplifying the impact of emotions on trauma rather than buffering it. Conclusions When people pay attention to catastrophic events, they should remain sensible and restrained, and avoid excessive emotional involvement to reduce the excessive psychological trauma caused by the event.

Abstract 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

This article looks into the ethical issues raised by AI-generated content, focusing on ‘sensitive’ topics like school shootings. As AI technologies progress, there is a greater risk that such information can accidentally reinforce negative narratives, glorify acts of violence, or cause psychological damage to victims and their communities. The study tackles these concerns by estimating the existing ethical frameworks and finding their limitations in dealing with these complicated situations. A main goal of the research is to create a refined set of ethical principles specifically geared to address the risks connected with AI-generated information about school shootings. The paper contains actual experiments using AI models such as ChatGPT, Claude, GigaChat, and YandexGPT to generate and analyze information about school shootings. These experiments highlight important issues in ensuring that AI-generated texts do not reinforce negative themes or cause suffering. For example, while some models, such as GigaChat, declined to generate content on sensitive themes, others, such as ChatGPT, created elaborate texts that risked retraumatizing readers or praising offenders. The findings show that, while current frameworks take into consideration basic concepts such as transparency, accountability, and fairness, they frequently lack precise direction for dealing with difficult issues. To close this gap, the suggested ethical framework incorporates particular content development criteria, stakeholder participation, responsible dissemination techniques, and ongoing research. This paradigm prioritizes the protection of vulnerable people and the prevention of psychological injury.

Abstract 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 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

Abstract 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 Introduction: The Posttraumatic Cognitions Inventory (PTCI) is a widely used measure for assessing negative posttraumatic cognitions that are common among individuals with trauma-related disorders. There was a need for a valid and reliable short form of the PTCI in Persian. Objectives: This study aimed to translate the 9-item version of the PTCI (PTCI-9) into Persian and evaluate its characteristics and psychometric properties. Methods: This was a cross-sectional psychometric study using the translation and back-translation technique. Experts assessed the scale's content validity. Participants were 207 Iranian individuals recruited from the general population, 151 of whom were trauma-exposed. Participants completed the Persian version of the PTCI-9, the Beck Depression Inventory (BDI-II), and the World Health Organization Quality of Life (WHO-QOL) scale. The psychometric properties of the Persian version of PTCI-9 were assessed using exploratory and confirmatory factor analysis (CFA) methods. Cronbach's α coefficient and Pearson's correlation coefficients were also calculated. Results: Factor analyses supported a three-factor model including the Self, World, and Self-Blame subscales. The Cronbach's alpha of the Persian version of PTCI-9 (α = 0.74) and its subscales (0.76, 0.82, 0.78) demonstrated acceptable reliability. The Persian PTCI-9 also had strong test-retest reliability (r = 0.79). The correlations between the Persian version of the PTCI-9 and the BDI-II (r = 0.60) and the WHO-QOL (r = −0.54) indicated that the scale also has convergent validity. Conclusion: The Persian version of the PTCI-9 showed acceptable psychometric properties. It is a brief and pragmatic measure that can be used in Iranian trauma-exposed patients for research and clinical purposes.

Background: Accessible, low-cost digital programmes are emerging as a means by which to address high rates of mental health problems. However, the development and assessment of scalable training programmes for effective use of digital interventions has lagged. This is particularly important, as coach-supported digital interventions provide benefits that substantially and consistently exceed those of programmes that are entirely self-guided.Objectives: This report describes the evaluation of a brief coach training programme consisting of a two-hour workshop and six 1-hour consultation sessions for delivery of webSTAIR, a 10-module transdiagnostic web-based programme for trauma-exposed populations.Method: The training was provided to 68 mental health counsellors at Veteran Health Administration Readjustment Counselling Services, who delivered the treatment to 99 veteran clients.Results: A total of 51% of the coaches completed the programme. Client outcomes were encouraging. Veterans enrolled in the programme demonstrated significant and clinically meaningful improvements in functioning (Cohen’s d = 0.88), emotion regulation (Cohen’s d = 0.97), posttraumatic stress disorder (PCL-5 Cohen’s d = 0.61; ITQ Cohen’s d = 0.60), and depression (Cohen’s d = 0.53).Conclusions: The study contributes much needed information regarding evidence for the effectiveness of ‘light-touch’ training strategies. The data support the integration and testing of brief training programmes in the implementation and dissemination of evidence-based digital interventions. Strategies for improving training completion rates among busy providers and resource-burdened clinical services need to be considered.

Abstract 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.

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 p0.05). 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. Key implications for practice • Mental health practitioners should focus on interventions highlighting personal strengths that increase active coping skills and self-efficacy and reduce self-blame • Policymakers should take actions to prevent the retraumatization of the refugees by considering the psychological impact of the lack of the host country’s language and the inconsistency of the refugees’ work with their education • Mental health researchers should focus on factors that explain posttraumatic growth and developing intervention tools that promote growth

In Durban, South Africa, heavy rainfall leading to flooding has become more frequent over the past decade, resulting in devastating consequences for households. However, studies in South Africa have predominantly focused on understanding the impacts of flooding on rural livelihoods. With intense rainfall events that could result in localized flash flooding to be expected to increase in Durban in the near future, failure to understand how households prepare for flooding and the interventions implemented by local authorities could jeopardize the achievement of Sustainable Development Goal (SDG) 11 – resilient and sustainable cities. To address this gap, primary data were collected from purposively selected residents of the Amanzimtoti community in Durban using questionnaires that comprised both closed and open-ended questions. Additionally, secondary data were analyzed to determine the measures implemented by the eThekwini Municipality to mitigate the adverse effects of flooding. The findings indicate that flooding has triggered psychological trauma among residents. Regarding interventions to mitigate flooding impacts, some homeowners and business owners purchased insurance. Despite the municipality providing early warnings, a severe flood event in 2019 had a significant negative impact on households partly due to the municipality's failure to utilize preferred communication channels – such as X (formally known as Twitter) – that resonate with residents. The study also found that adoption of early warnings may be partly hinged on the extent to which they remember the last flood episode that resulted in disaster. The findings are discussed in terms of their implications for achieving SDG 11 in Durban.

BackgroundAfter decades of research output, it is well established that transnational adoptees—i.e., individuals who are placed for adoption outside their country of birth—exhibit an increased risk of various negative mental health outcomes. Even so, there is a lack of suggestions for preventive measures or treatment interventions targeting the transnational adoptee population in the literature.ObjectiveTo explore experiences, opinions, and needs among adult transnational adoptees in Sweden concerning healthcare in general and mental healthcare in particular.MethodsSixty-six adult transnational adoptees residing in Sweden, born in 15 different non-European countries, were recruited for individual in-depth interviews about their experiences and opinions regarding psychosocial support and healthcare. The interview data were analyzed employing a codebook thematic analysis approach.ResultsThree overarching themes were identified: (a) barriers to adequate treatment, (b) helpful resources in dealing with health-related issues, and (c) health-related needs and suggestions for the development of adequate support. Identified barriers include a lack of insight into and interest in adoptee health, colorblindness and unwillingness to address racism, expectations of gratitude, steep financial costs, lack of support from adoptive parents, and mistrust of support structures that involve adoptive parents or adoption organizations. Participants also describe helpful resources, such as the community of fellow transnational adoptees. Health-related needs and suggestions include more well-defined and easily accessible structures of support, improved knowledge and competence, a broader psychotherapeutic repertoire that better addresses adoption-related themes, improved support in situations that can be particularly stressful for adoptees (such as during pregnancy and as new parents), routine follow-up during childhood and adolescence, and education targeting adoptive parents. The need for greater attention to the well-being of children of transnational adoptees is also highlighted.ImplicationsBased on these findings, a number of recommendations can be made. For example, knowledge about adoptee health should be strengthened, and psychotherapeutic competence in addressing issues related to racism should become a priority. After over 20 years of discussion, one or more national research and knowledge hubs on transnational adoption should be created. Moreover, economic resources should be made available to support transnational adoptees in accessing adequate treatment.

The article is devoted to substantiate the need to clarify the definition of emotional intelligence (hereinafter referred to as EI). With consideration to the accumulated data on the neurophysiological foundations of EI and psychological trauma, as well as to the methods of psychotherapeutic work of various directions with human emotions and feelings, the introduction of a new element in the definition and structure of EI – emotional sensitivity (hereinafter referred to as ES) – is proposed and argued. ES is considered as the ability to focus attention on your emotions and feelings, be in contact with them, fully experience, be aware of them, immerse yourself into them, live deeply in safe conditions, distance yourself from them if necessary, and return to your experiences again. If the ability to realise one’s emotions and feelings is integrative, affective-cognitive in nature, then ES is the emotional basis of awareness of them, which is proposed to be distinguished separately as an independent and most important element of EI. In general, EI appears as an emotional-cognitive-personal education when the integrative essence of the concept, consisting in the unity of affective and cognitive processes of a person, is emphasised and reflected. In long-term psychotherapy, special and particular attention is given to the development of such an ability as ES. However, due to its important practical significance in people’s daily life, it should be showed in the definitions of EI and remembered in all forms of psychological work with a person.

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.

IntroductionIt has been suggested that the COVID-19 pandemic was a potentially traumatic occurrence that may have induced generalized anxiety and discomfort, particularly in susceptible populations like individuals with mental illnesses. The therapeutic approach known as eye movement desensitization and reprocessing (EMDR) has been shown to be successful in helping patients process traumatic events and restore wellbeing. Nevertheless, little is known about the precise processes through which EMDR fosters symptom recovery. MethodsIn order to disentangle these issues, we conducted a randomized controlled trial (ClinicalTrials.gov Identifier NCT06110702) with 107 participants who were selected from university hospitals as a sample of investigation. Random assignments were applied to the participants in order to assign them to the experimental and control groups. The experimental group, but not the control group, underwent an 8-week EMDR intervention. Body perception, disgust, and emotions of guilt and shame, as well as mental contamination and posttraumatic and obsessive-compulsive symptoms, were investigated before and after the EMDR intervention.ResultsThe EMDR intervention was able to improve all of the variables investigated. Path analysis showed that body perception was able to predict both disgust and emotions of guilt and shame. Disgust was able to predict both mental contamination and obsessive-compulsive symptoms, while guilt and shame were able to predict post-traumatic symptoms. ConclusionsEMDR is an effective therapy for the treatment of post-traumatic and obsessive symptoms that acts through the promotion of improvement of the emotions of guilt/shame and disgust, respectively. Implications for clinical practice are examined.Clinical trial registrationhttps://www.clinicaltrials.gov, identifier NCT06110702.

Problem definition. The uncertainty of the consequences of situations related to stressful situations for the child's psyche actualizes the issue of introducing new approaches, methods and tools of psychological influence that would contribute to the preschooler's ability to overcome stress in a constructive way. Problem analysis. Childhood psychological trauma leaves its mark on the subconscious, can shape a person's worldview, beliefs, and identification of the self. And since trauma affects the levels of primary safety, it creates very powerful patterns in the mind. Signs of childhood trauma include mood swings, guilt, anxiety, feelings of abandonment, confusion and impaired concentration, and withdrawal. The conceptualization of traumatic experience is widely presented in scientific literature: theories of traumatic emotional experience (O.S. Kocharyan, R. Lanius, M. Massey, R. Hammer), conceptual foundations of the subverbal model of client-centered psychotherapy (O.S. Kocharyan), theories and typologies of infantile traumas (Johnson St. M., Burbo L., etc.), theoretical positions of procedural-experiential and emotionally-focused psychotherapy (Greenberg L. and Elliott R.), psychoanalytic theory according to Freud Z., ideas about the formation of early maladaptive schemes (Boterhoven de H., Christopher W., Fassbinder E., Hayes C., Katrina L., Yong J.) and others. However, solving many complex problems remains relevant, one of which includes psychological assistance to the most vulnerable population groups in extreme situations, one of which includes children and work with current traumatic experiences. The purpose of the study is to develop and test a multifunctional tool for working with childhood trauma in conditions of long-term traumatic circumstances. Conclusions. The stories about Hibuki, through which the child identified with the hero of the story, contribute to the restoration of internal mechanisms of the psyche, which help the process of restoring the child's psychological health. A psychologist can use these stories both to rehabilitate a child's psyche and to diagnose his or her emotional state.

Unprocessed collective trauma may create fertile soil for political manipulation. This article introduces a new concept, that of "substitutive trauma," which refers to the utilization of unprocessed collective traumatic experiences by political leadership to create shared feelings of victimhood and vengeful attitudes within a population. The analysis explores how a substitutive trauma-based psycho-political dynamic culminated in February 2022 in Russia’s war against Ukraine. The article argues that the community of traumatic stress professionals, studying and understanding macro-societal processes can contribute to reducing and ameliorating such destructive psycho-political developments.

Objectives: The objective of the research was to create the "Small ‘t’ Traumatic Experiences Identification Scale" for the purpose of identifying small ‘t’ traumatics experiences and to investigate the influence of psychological needs on small ‘t’ traumatic occurrences. Method: The study participants consisted of 549 individuals for the exploratory factor analysis, 307 for the confirmatory factor analysis, and 89 for the test-retest analysis, all over the age of 18. Exploratory and confirmatory factor analyses were employed to assess the construct validity of the newly developed scale. Reliability analyses of the scale were performed using test-retest and internal consistency coefficients. Following the creation of the scale, multiple linear regression analyses (MLRA) were conducted using data from 806 university students to ascertain the extent to which psychological needs, along with their sub-dimensions, predict small ‘t’ traumatic experiences. Findings: The goodness of fit indices were χ2/sd (3102.59/942) =3.29, p=.001, SRMR: .064; NNFI:96; IFI=.96; CFI=.96; RMSEA=.087. The internal consistency coefficients were .96 for ‘Small ‘t’ Trauma Related to Family Relationships’, .92 for ‘Small ‘t’ Trauma Related to Social Relationships’, and .76 for ‘Small ‘t’ Trauma Related to Physiological Needs’, and .96 for the total scale. Result: The findings of the study indicated that the developed scale exhibited a three-factor structure and demonstrated satisfactory levels of validity and reliability, supporting its suitability for application. Additionally, the study revealed that psychological needs emerged as a significant predictor of small ‘t’ traumatic experiences based on the obtained results.

This research aimed to develop a scale for adolescent psychological health problems (APHP). The population consisted of parents of high school pupils in six provinces in 2016: Alborz, Kermanshah, East Azarbaijan, Sistan and Baluchistan, Fars, and Razavi Khorasan. For each province, two cities (the provincial center and a low-income city) were selected on purpose. The selection of six institutions in each city was based on a random sampling method, and the selection of parents was based on available sampling. There were 308 parents in the sample, including 195 mothers and 111 fathers. After the data were collected, they were input into the 18th version of the statistical software for social sciences (SPSS). 133 items were examined for their adequacy using seven indicators (mean, standard deviation, standard skew, standard kurtosis, deletion alpha coefficient, multiple correlation, and correlation coefficient with total score) during item analysis. The item analysis revealed that the majority of objects possessed appropriate properties. Exploratory factor analysis of the coefficient revealed six factors that explain 42% of the variance. Internal homogeneity coefficients for the subscales ranged from 0.78 (attention deficit hyperactivity disorder) to 0.95 (deficit in assignments and self-control) and 0.95 for the full scale. The results indicated that the preliminary version of the instrument has adequate psychometric properties.

Abstract Background Trauma is an emotional response to distressing events where coping and subsequent recovery are absent. Adverse Childhood Experiences (ACEs) are traumas, occurring before the age of 18 years, such as child abuse or neglect, caregiver instability, and household dysfunction. Sixty-four percent of the U.S. population report experiencing at least one ACE, with over 1 billion children experiencing abuse and neglect annually worldwide. Chronic exposure to stressful circumstances or multiple traumatic events has negative physiologic impacts. Persons who experience 3 or more ACEs in childhood are at greater risk of poor mental health outcomes and may be more likely to engage in high-risk behaviors, predisposing them to long-term health impacts, such as metabolic diseases, anxiety, depression, substance use, and chronic pain. Trauma informed care (TIC) is a recommended approach to healthcare delivery across professions, especially when a trauma history is suspected. This commentary aims to increase awareness of the impact of ACEs on health outcomes and introduce TIC concepts as they may apply to chiropractic care for adults with a history of ACEs. Discussion This commentary reviews an introductory model (4R's: realize, recognize, respond, resist re-traumatization) as one TIC framework used by healthcare practitioners. Prior trauma can lessen trust, alter perceptions of physical touch, and hands-on examinations and chiropractic treatments may trigger stress responses. Using TIC after appropriate training, includes referrals to multidisciplinary providers to address trauma-related concerns outside the scope of chiropractic, and screening for ACEs if deemed appropriate. Creating safe spaces, communicating clearly, avoiding victimizing language, explaining procedures, asking for consent before physical contact, and giving patients choice and control in their own care may avoid triggering prior traumas. Conclusion Given the high worldwide prevalence of persons experiencing 3 or more ACEs, TIC principles are practical adaptations to chiropractic care for use with many patient populations. As TIC and ACEs are emerging concepts within chiropractic, students and practitioners are encouraged to undertake additional training to better understand these complex and sensitive topics. Exploratory research on the incidence, presentation, and impacts of various trauma types, including ACEs, to support adoption of TIC in chiropractic settings is essential.

Background: Ongoing evidence of trauma in nurses, beginning in nursing school, requires educators to take a trauma-informed approach to teaching and learning to minimize re-traumatization and to ultimately achieve socially-just student outcomes. Methods: The purpose of this study was to evaluate the outcomes of trauma-informed educational practices (TIEP) on nursing students and the trauma-informed climate in the classroom using an intervention comparison group pre-posttest design. Results: Secondary traumatic stress (STS) scores declined for both groups pre- to post-test. There was a statistically significant difference in STS change scores between intervention and comparison groups (p < 0.05), but not in the direction hypothesized. Conclusion: Findings from this study indicate that other factors in the nursing classroom might have contributed significantly to a reduction in STS. In addition to outcomes, future TIEP evaluations should explore student awareness and experiences of trauma, resilience, professional preparation, and learning outcomes in the classroom setting.

Research on the neuroscience of fear in both humans and non-humans has suggested that a lack of acquisition of safety cues might be a biological hallmark of posttraumatic stress disorder (PTSD). Danger perception, and in particular, feeling as one's own life is in danger, is thought to represent a major predictor of PTSD. Persistent danger perception is concurrently associated with a persistence of lack of safety. However, despite several research efforts, no validated psychometric tools exist regarding psychological safety as a unique core construct in the domain of a soothing-contentment system. By including social, compassionate, and bodily components, the Neuroception of Psychological Safety Scale (NPSS), neurophysiologically rooted in the polyvagal theory, aims to specifically assess psychological safety. Originally developed in English, we employed a rather large non clinical sample to validate our Italian translation of the NPSS (n = 338) and the scale was found to retain a three-factor structure. In light of its positive moderate correlations with the Unconditional Self-Kindness Scale (ρ = 0.376) and the Self-Compassion Scale-Short-Form (ρ = 0.481), good convergent validity and robust psychometric properties were shown by the NPSS. The Subjective Traumatic Outlook Questionnaire (ρ = −0.283) and the three subscales of the Body Perception Questionnaire-22—Body Awareness (ρ = −0.103), Supradiaphragmatic Reactivity (ρ = −0.234), and Body Awareness/Subdiaphragmatic Reactivity (ρ = −0.146)—were found to have weak negative correlations with the NPSS, which further demonstrated its good discriminant validity. Eventually, the NPSS was found to show good test-retest reliability (intraclass correlation coefficient = 0.922; three-week time interval), and its usage is fostered in clinical and research contexts where the evaluation of psychological safety is of relevance.

ObjectiveTraumatic experiences are a significant risk factor for psychological disturbances, including disorders such as complex posttraumatic stress disorder, emotion-processing problems, and trauma-related dissociative experiences. The present investigation examined the coexistence of these symptoms using a network analysis model.MethodThis study included a sample of 406 people referred to comprehensive health centers in Tehran from September to December 2023 with psychopathological syndromes. Variables were assessed using The International Trauma Questionnaire, International Measurement of Exposure to Traumatic Event checklist, Baker Emotional Processing Questionnaire, and Dissociative Experiences. A regularized partial correlation network and Glasso algorithm, in combination with Extended Bayesian information criteria, were applied to estimate the network structure.ResultsSigns of unprocessed emotions and disturbance in self-organization symptoms were the most important symptoms in the symptom network, forming strong connections with other nodes. Thereby, these two symptoms can be regarded as the most important clinical manifestations in the symptom network following traumatic experiences. Three distinct symptom communities were identified: the community of traumatic experiences (childhood, adolescence, adulthood), the community of dissociative experiences (amnesia, depersonalization/derealization, and absorption), and the community of emotional processing (suppression, unpleasant emotional experience, Signs of unprocessed emotions, avoidance, and emotional control, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms). The strongest edges observed were between childhood trauma-adolescence trauma (0.473) in the community of traumatic experiences, between amnesia and depersonalization/derealization (0.644) in the community of dissociative experiences, and between disturbance in self-organization symptoms and unprocessed emotions (0.324) in the community of emotional processing, indicating the recurrent occurrence of these symptoms.ConclusionIn this study, disturbance in self-organization symptoms was identified as the central psychopathologic symptom in individuals experiencing traumas at different developmental stages. It seems that adolescent trauma and not childhood trauma plays a more decisive role in the symptoms that a person manifests after traumatic experiences. Also, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms were recognized in the cluster of emotional processing symptoms and can have substantial roles in prioritizing therapeutic measures.

Functional neurological disorder is a condition in which a person experiences physical symptom that cannot be fully explained by a medical condition. In Pakistan, domestic violence as well as emotional, physical and sexual abuse in children are prevalent. Despite legal and social support for victims, stigmatisation regarding seeking psychological help complicates the challenge. Some of the research culminated that patients with fneurological disorder reported high level of sexual abuse and trauma. The symptomatology of functional neurological disorder is being ignored in Asian countries due to indigenous factors like poverty, lack of information on reporting abuse, poor law-enforcement and victim blaming. Functional neurological disorder can be manifested in various ways in the human body, such as blindness, paralysis, dystonia, swallowing difficulties, difficulty walking, motor symptoms affecting limbs, ---continue

Medical trauma is a profound concern for those with chronic conditions like inflammatory bowel disease (IBD), especially young adults. This trauma, arising from both the disease itself and necessary medical interventions, manifests as an accumulation of traumatic experiences impacting a patient’s physical and psychological well-being. The Crohn’s and Colitis Young Adults Network (CCYAN) conducted a roundtable discussion involving young adult IBD patients and healthcare professionals focused on medical trauma and its implications in the treatment of young adults with IBD. This article summarizes the key insights from this discussion, including medical trauma in IBD as an accumulation of ‘micro-traumas,’ the impacts of such trauma and disruptions in care regardless of post-traumatic stress diagnosis, the role of adverse childhood experiences and trauma-informed care, practical strategies to cultivate trust during individual patient encounters, and recommendations for providing trauma-informed care within the clinical setting.

Abstract Background Healthcare services can be re-traumatising for trauma survivors where they trigger memories of past distressing events and exert limits to a survivor’s sense of autonomy, choice, and control. The benefits of receiving trauma-informed healthcare are well established; however, factors that promote or impede the implementation of trauma-informed care are not yet well characterised and understood. The aim of this review was to systematically identify and synthesise evidence regarding factors that promote or reduce the implementation of TIC in healthcare settings. Methods This systematic review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) 2.0 guidelines. Scopus, MEDLINE, Proquest, PsycINFO and grey literature were searched for original research or evaluations published between January 2000 and April 2021 reporting barriers and/or facilitating factors for the implementation of trauma-informed care in a healthcare setting. Two reviewers independently assessed the quality of each included study using the Mixed Methods Appraisal Tool (MMAT) Checklist. Results Twenty-seven studies were included, 22 of which were published in the USA. Implementation occurred in a range of health settings, predominantly mental health services. The barriers and facilitators of implementing trauma-informed care were categorised as follows: intervention characteristics (perceived relevance of trauma-informed care to the health setting and target population), influences external to the organisation (e.g. interagency collaboration or the actions of other agencies) and influences within the organisation in which implementation occurred (e.g. leadership engagement, financial and staffing resources and policy and procedure changes that promote flexibility in protocols). Other factors related to the implementation processes (e.g. flexible and accessible training, service user feedback and the collection and review of initiative outcomes) and finally the characteristics of individuals within the service or system such as a resistance to change. Conclusions This review identifies key factors that should be targeted to promote trauma-informed care implementation. Continued research will be helpful for characterising what trauma-informed care looks like when it is delivered well, and providing validated frameworks to promote organisational uptake for the benefit of trauma survivors. Registration The protocol for this review was registered on the PROSPERO database (CRD42021242891).

ABSTRACTThe 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 [1–3]. 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) [4].

Background: Police officers are at considerable risk of developing posttraumatic symptoms because they frequently encounter violent or emotionally disturbing incidents. We investigate experiences with potentially traumatic events (PTE), traumatic exposure, and the prevalence of probable posttraumatic stress disorder (PTSD), complex PTSD and subclinical PTSD in a sample of Belgian police officers. Methods: In total, 1,465 police officers from 15 Belgian Local Police zones participated in a web-based survey, consisting of three segments: evaluating experiences with a list of 29 PTE, assessing if any of these PTE accounted for traumatic exposure, and evaluating 1-month probable PTSD, complex PTSD and subclinical PTSD prevalence using the International Trauma Questionnaire (ITQ). Results: Police officers frequently experience a wide range of PTE. A large majority of 93.0% reports traumatic exposure. Assessment with ITQ shows a 1-month prevalence of 5.87% for probable PTSD and 1.50% for probable complex PTSD, while an additional 7.58% report subclinical PTSD. No demographic variables influenced PTSD prevalence. Cumulative PTE experiences in itself did not predict PTSD, while the characteristics of certain PTE did entail a higher prevalence of probable PTSD and subclinical PTSD. Discussion: This study is the first to evaluate experiences with PTE, traumatic exposure and 1-month prevalence of probable PTSD, complex PTSD, and subclinical PTSD in Belgian police officers. Police officers are frequently confronted with a broad variety of PTE, and a large majority reports traumatic exposure. The 1-month prevalence of probable PTSD is significantly higher compared to previous international research in the general population, but lower than in similar international research involving police officers. In this study, cumulative PTE experiences in itself did not reliably predict PTSD, while the characteristics of certain PTE did. Posttraumatic symptoms are an important mental health challenge in Belgian police.

Background: 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. Objectives: To identify the effects of dance therapy in adults with psychological trauma as well as the barriers and facilitators associated with its therapeutic use. Method: 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. Results: 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. Conclusion: 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.

Psychological interventions may improve patients’ motivation and adherence to various therapies, including those alleviating pain, depression, and fatigue. Evaluating patients’ psychological status and choosing the most appropriate intervention may improve combined treatment outcomes, particularly in the elderly and other vulnerable groups. Exposure to psychotraumatic events such as violence, torture, and limb amputation should be appropriately assessed to choose a psychotherapy method. Narrative exposure therapy and cognitive behavioural therapy are commonly used psychological interventions with variable level of evidence. Training first-contact health professionals and psychologists to use the most efficient evidence-based psychological interventions is thus becoming critical at the current stage.

This article deals with a selection of contemporary texts by Swiss authors that address the theme of the family in various ways. The question put forward is whether such literary representations still represent today’s families or whether they miss the mark. The variety of literary forms and the spectrum of perspectives in this selection proved far more diverse than expected. Nevertheless, auto-fictional narration is still fundamental, whereby retrospectives of a life lived are conveyed from within the narrator’s own family circle. The discourse of memory continues to dominate substantial parts of the narrative, and a preoccupation with father-son and mother-daughter relations within family constellations still remains relevant. However, humour and irony are also important as a means of creating distance at moments where reality verges on the absurd and the narrator’s own family is shown in a comic light, or where the terrain is delicate, as for example when the action takes place in a nursing home.

Abstract Background Knowledge on healthcare utilization after mass trauma is needed to strengthen the public health preparedness to such incidents. Using register-based data, this study had a unique opportunity to investigate how young survivors’ use of primary care physicians (PCP) and mental health services (MHS) changed after a terrorist attack. Methods We examined register-based data on PCP and MHS consultations among 255 survivors (52% male) of the 2011 Utøya youth camp attack in Norway 3 years before and after the attack, and their reason for encounter with the PCP according to the International Classification for Primary Care (ICPC− 2). Results The PCP and MHS consultation rates (CR) were higher in female than male survivors both acutely and at long-term. The mean yearly CRs increased from 2.25 to 4.41 for PCP and 1.77 to 13.59 for MHS the year before and after the attack in female survivors, and from 1.45 to 3.65 for PCP and 1.02 to 11.77 for MHS in male survivors. The third year post-attack CRs for PCP were 3.55 and 2.00; and CRs for MHS were 5.24 and 2.30 in female and male survivors, respectively. Among female survivors, 76% consulted PCP and 12% MHS the year preceding the attack; post-attack 93% consulted PCP and 73% MHS the first year; decreasing to 87 and 40% the third year. Among male survivors, 61% consulted PCP and 7% MHS the year preceding the attack; post-attack 86% consulted PCP and 61% MHS the first year, and 67 and 31% the third year. As for PCP consultations, there was a particular increase in psychological reasons for encounter following the attack. Conclusions This study indicates that it is important to anticipate an increased healthcare utilization several years following mass trauma, particularly of MHS. Both PCP and MHS practitioners played important roles in providing healthcare for psychological problems in young survivors of terrorism in a country with universal and largely publicly financed healthcare and a gatekeeping system. The healthcare utilization could be different in countries with other health systems or psychosocial care responses to mass trauma.

IntroductionThis study aims to address the positive changes due to traumatic experiences, such as being diagnosed with cancer and experiencing this disease for a certain period. Within this purpose, socio-demographic and disease-related variables, coping ways and illness perceptions that affect posttraumatic growth in cancer patients were examined. Secondly, the findings of this study, which is one of the first studies on posttraumatic growth in cancer patients in Turkey, were compared with the findings of current studies on the subject.MethodDatums were collected by an interview form and three scales (Posttraumatic Growth Scale, Ways of Coping Inventory and Illness Perception Scale-R) to 78 cancer outpatients in Istanbul University Oncology Institute in 2007.ResultsResults showed that cancer patients have higher posttraumatic growth levels than the mean. According to analysis, posttraumatic growth total score between confrontive coping (t = −2.344, p

Dissociative disorders (DDs) are characterized by a discontinuity in the normal integration of consciousness, memory, identity, emotion, perception, bodily representation, motor control, and action. The life-threatening coronavirus disease 2019 (COVID-19) pandemic has been identified as a potentially traumatic event and may produce a wide range of mental health problems, such as depression, anxiety disorders, sleep disorders, and DD, stemming from pandemic-related events, such as sickness, isolation, losing loved ones, and fear for one's life. In our conceptual analysis, we introduce the contribution of the structural dissociation of personality (SDP) theory and polyvagal theory to the conceptualization of the COVID-19 pandemic-triggered DD and the importance of assessing perceived safety in DD through neurophysiologically informed psychometric tools. In addition, we analyzed the contribution of eye movement desensitization and reprocessing (EMDR) to the treatment of the COVID-19 pandemic-triggered DD and suggest possible neurobiological mechanisms of action of the EMDR. In particular, we propose that, through slow eye movements, the EMDR may promote an initial non-rapid-eye-movement sleep stage 1-like activity, a subsequent access to a slow-wave sleep activity, and an oxytocinergic neurotransmission that, in turn, may foster the functional coupling between paraventricular nucleus and both sympathetic and parasympathetic cardioinhibitory nuclei. Neurophysiologically informed psychometric tools for safety evaluation in DDs are discussed. Furthermore, clinical and public health implications are considered, combining the EMDR, SDP theory, and polyvagal conceptualizations in light of the potential dissociative symptomatology triggered by the COVID-19 pandemic.

Abstract Background Trauma-informed (TI) approach is a framework for a system change intervention that transforms the organizational culture and practices to address the high prevalence and impact of trauma on patients and healthcare professionals, and prevents re-traumatization in healthcare services. Review of TI approaches in primary and community mental healthcare identified limited evidence for its effectiveness in the UK, however it is endorsed in various policies. This study aimed to investigate the UK-specific context through exploring how TI approaches are represented in health policies, and how they are understood and implemented by policy makers and healthcare professionals. Methods A qualitative study comprising of a document analysis of UK health policies followed by semi-structured interviews with key informants with direct experience of developing and implementing TI approaches. We used the Ready Extract Analyse Distil (READ) approach to guide policy document review, and the framework method to analyse data. Results We analysed 24 documents and interviewed 11 professionals from healthcare organizations and local authorities. TI approach was included in national, regional and local policies, however, there was no UK- or NHS-wide strategy or legislation, nor funding commitment. Although documents and interviews provided differing interpretations of TI care, they were aligned in describing the integration of TI principles at the system level, contextual tailoring to each organization, and addressing varied challenges within health systems. TI care in the UK has had piecemeal implementation, with a nation-wide strategy and leadership visible in Scotland and Wales and more disjointed implementation in England. Professionals wanted enhanced coordination between organizations and regions. We identified factors affecting implementation of TI approaches at the level of organization (leadership, service user involvement, organizational culture, resource allocation, competing priorities) and wider context (government support, funding). Professionals had conflicting views on the future of TI approaches, however all agreed that government backing is essential for implementing policies into practice. Conclusions A coordinated, more centralized strategy and provision for TI healthcare, increased funding for evaluation, and education through professional networks about evidence-based TI health systems can contribute towards evidence-informed policies and implementation of TI approaches in the UK.

Abstract: This research elaborates the effects of parental divorce on the children psychological condition and are looking for a satisfactory solution to protect them from its negative-psychological effects through Islamic laws approach. This research applied descriptive qualitative method, with data collection conducted through observation, interviews, and documentation. The object of this research is the students of Al-Muhibbin Modern Islamic Boarding School Jatirogo Tuban with divorced parent. The results of this study indicate that the impact of parental divorce on the psychological conditions is shown on the student’s behavior, i.e. feeling inferior to others, become stubborn, rude, and naughty. Therefore, to minimize these negative impacts, one of the efforts that can be used is through Islamic counseling using the forgiveness method which is considered quite effective so the children with this condition can live and participate properly in their community as mandated by the child protection law in Indonesia. Abstrak: Penelitian ini mengkaji tentang perlindungan bagi anak dari pengaruh perceraian orang tua terhadap kondisi psikologis anak. Tujuan dari penelitian ini adalah untuk mengetahui solusi atas permasalahan akibat perceraian orang tua. Penelitian ini bersifat deskriptif kualitatif, dengan metode pengumpulan data yang dilakukan dengan cara observasi, wawancara, dan dokumentasi. Obyek dalam penelitian ini adalah santri PPM Al-Muhibbin Jatirogo Tuban yang menjadi korban perceraian orang tua mereka. Hasil penelitian menunjukkan bahwa dampak perceraian orang tua terhadap kondisi psikologis yang terjadi pada diri santri di antaranya muncul sifat rendah diri terhadap teman-temannya yang lain, menjadi lebih bandel dan nakal, serta bersikap kasar dengan teman-temannya. Untuk mengatasi perubahan terhadap kondisi psikologis anak yang berdampak negatif tersebut, salah satu upaya yang dapat digunakan adalah melalui bimbingan penyuluhan Islam dengan menggunakan metode pemaafan yang dinilai cukup efektif dan sesuai dengan tuntunan ajaran Islam. Hal tersebut dilakukan agar ia dapat hidup, tumbuh, berkembang dan berpartisipasi secara wajar, selaras dengan yang diamanatkan oleh ketentuan tentang perlindungan anak di Indonesia.

BackgroundContracting COVID-19 can cause negative and distressing psychological sequelae, but traumatic stressors may also facilitate the development of positive psychological change beyond an individual’s previous level of adaptation, known as posttraumatic growth (PTG). As a result, studies have investigated the negative effects of COVID-19 on mental health, but data on PTG among patients who have recovered from COVID-19 remains limited. This study aims to evaluate the level of PTG and its associations with stigma, psychological complications, and sociodemographic factors among COVID-19 patients 6 months post-hospitalization.MethodA cross-sectional online survey of 152 COVID-19 patients was conducted after 6 months of being discharged from Hospital Canselor Tuanku Muhriz, MAEPS Quarantine Center, or Hospital Sungai Buloh, Malaysia. Patients completed a set of questionnaires on sociodemographic and clinical data. The Posttraumatic Growth Inventory (PTGI-SF) was used to assess the level of PTG, the Kessler Psychological Distress (K6) was used to measure the degree of psychological distress, the General Anxiety Disorder-7 (GAD-7) was used to evaluate the severity of anxiety symptoms, the Patient Health Questionnaire (PHQ-9) was used to assess the severity of depression symptoms, and the Explanatory Model Interview Catalog Stigma Scale (EMIC-SS) was used to record the degree of perceived stigma toward COVID-19.ResultsThe median PTGI SF score of the respondents was 40.0 (Interquartile range 16.0). Multivariable general linear model with bootstrapping (2,000 replications) revealed factors that significantly predicted PTG, which were at the higher level of the perceived stigma score, at 37 (B = 0.367, 95% CI = 0.041 to 0.691, p = 0.026), among the Malay ethnicity (B = 12.767, 95% CI 38 = 7.541 to 17.993, p

Abstract Background This international online survey investigated the experience and impact of emotional blunting in the acute and remission phases of depression from the perspective of patients and healthcare providers (HCPs). This paper presents data on the history and severity of psychological trauma and its potential impact on emotional blunting in major depressive disorder (MDD); differences between patient and HCP perceptions are explored. Methods Patient respondents (n = 752) were adults with a diagnosis of depression who were currently taking antidepressant therapy and reported emotional blunting during the past 6 weeks. HCPs provided details on two eligible patients: one in the acute phase of depression and one in remission from depression (n = 766). Trauma was assessed using questions based on the Childhood Trauma Questionnaire; emotional blunting was assessed using the Oxford Depression Questionnaire (ODQ). Multivariate regression analyses were applied to examine the relationship between trauma and ODQ score. Results A history of any childhood or recent traumatic event was reported by 97% of patients in the self-assessed cohort and for 83% of those in the HCP-assessed cohort (difference, p

Abstract Background Patients with complex dissociative disorders (CDD) report high levels of childhood- abuse experiences, clinical comorbidity, functional impairment, and treatment utilization. Although a few naturalistic studies indicate that these patients can benefit from psychotherapy, no randomized controlled trials have been reported with this patient-group. The current study evaluates a structured protocolled group treatment delivered in a naturalistic clinical setting to patients with CDD, as an add-on to individual treatment. Methods Fifty nine patients with CDD were randomized to 20 sessions of stabilizing group–treatment, conjoint with individual therapy, or individual therapy alone, in a delayed-treatment design. The treatment was based on the manual Coping with Trauma-Related Dissociation. The primary outcome was Global Assessment of Functioning (GAF), while secondary outcomes were PTSD and dissociative symptoms, general psychopathology, and interpersonal difficulties. Results Mixed effect models showed no condition x time interaction during the delayed treatment period, indicating no immediate differences between conditions in the primary outcome. Similar results were observed for secondary outcomes. Within-group effects were non-significant in both conditions from baseline to end of treatment, but significant improvements in psychosocial function, PTSD symptoms, and general psychopathology were observed over a 6-months follow-up period. Conclusion In the first randomized controlled trial for the treatment of complex dissociative disorders, stabilizing group treatment did not produce immediate superior outcomes. Treatment was shown to be associated with improvements in psychological functioning. Trial registration Clinical Trials ( NCT02450617 ).

Abstract The traumatic event produces intolerable excitations to the psychic apparatus that searches to relief them through the production of symptoms. When established, patients with post-traumatic stress disorders (PTSD) and complex post-traumatic stress disorder (CPTSD) may experience flashbacks, somatizations, negative emotions about themselves, and difficulty in social contact. This work seeks to understand how the psychodynamic functioning of women victims of interpersonal and urban violence, diagnosed with these disorders, is organized, identifying traumatic experiences, ways of interpersonal relationships, conflicts and psychic structures and use of defense mechanisms, and for peculiarities that may differentiate these disorders. The qualitative transversal method was used through the content analysis of clinical interviews based on the Operationalized Psychodynamic Diagnosis (OPD-2). The sample of this study consisted of five women with PTSD and five with CPTSD. The following categories were created: reasons for seeking care, symptoms and desire for treatment, traumatic developmental events, and characteristics of the psychic functioning. Early trauma generates psychic organizations with greater disintegration. A new traumatic event destabilizes the psychic organization and intensifies symptoms. Relationships were marked by dependence and isolation. Participants with CPTSD presented tendency to disintegration related to the object relation regulation and the psychic conflict was of Individuation versus Dependence, with more primitive flaws in object representations, existential need for the other and direct discharge of impulses. Participants with PTSD had moderate to low level of object relation integration and the conflict was need to be care of versus self-sufficiency, with self-representations being fragile and with reduced capacity to manage impulses. Thus, it could be observed that OPD-2 is capable of assessing in a broad and deep way patients with traumatic disorders, in addition to identifying essential peculiarities to guide health professionals towards treatment in the search for better quality of life for patients.

Abstract Background The international terrorism threat urges societies to invest in the planning and organization of psychosocial care. With the aim to contribute to cross-national learning, this study describes the content, target populations and providers of psychosocial care to civilians after terrorist attacks in Norway, France and Belgium. Methods We identified and reviewed pre- and post-attack policy documents, guidelines, reports and other relevant grey literature addressing the psychosocial care response to terrorist attacks in Oslo/Utøya, Norway on 22 July 2011; in Paris, France on 13 November 2015; and in Brussels, Belgium on 22 March 2016. Results In Norway, there was a primary care based approach with multidisciplinary crisis teams in the local municipalities. In response to the terrorist attacks, there were proactive follow-up programs within primary care and occupational health services with screenings of target groups throughout a year. In France, there was a national network of specialized emergency psychosocial units primarily consisting of psychiatrists, psychologists and psychiatric nurses organized by the regional health agencies. They provided psychological support the first month including guidance for long-term healthcare, but there were no systematic screening programs after the acute phase. In Belgium, there were psychosocial intervention networks in the local municipalities, yet the acute psychosocial care was coordinated at a federal level. A reception centre was organized to provide acute psychosocial care, but there were no reported public long-term psychosocial care initiatives in response to the attacks. Conclusions Psychosocial care responses, especially long-term follow-up activities, differed substantially between countries. Models for registration of affected individuals, monitoring of their health and continuous evaluation of countries’ psychosocial care provision incorporated in international guidelines may strengthen public health responses to mass-casualty incidents.

Context: There is a long history of interpersonal trauma in women, and the risk factors and mental health consequences have been well studied. Betrayal trauma (BT) theory by Freyd talks about the specific kind of trauma perpetrated by someone close to the victim, which may lead to increased dissociative responses. Recent research extends the theory to explain the role of posttrauma appraisals playing a mediating role in the development of psychopathological responses. Aim: The aim of this study was to explore trauma history, BT, and dissociative experiences among women in a Government Reception Centre. Setting: The sample included 30 women from the Reception Centre, Bangalore. Subjects and Methods: Data were obtained using a Sociodemographic Data Sheet, Brief BT Survey (revised), the Dissociative Experiences Scale, Posttrauma Cognitions Inventory and a visual analog scale for assessing psychological distress. Statistical Analysis Used: Descriptive statistics and nonparametric inferential statistics were used for quantitative analysis. Results: All the women in the sample had experienced BT directly or as witnesses. There was no significant difference in dissociation between high- and low-BT groups. The presence of negative cognitions toward oneself was associated with increased dissociative experiences. Negative cognitions toward self and depersonalization experiences were higher in the group with severe physical trauma than the group without. Conclusion: The article highlights the high prevalence of betrayal trauma, and risk for trauma-related psychopathology and revictimization that go unassessed in government shelter homes, while reiterating the need for a trauma-informed care approach to intervention.

IntroductionPeople often consume alcohol following trauma, particularly in response to distressing memories. To date, little is known about how post-encoding alcohol consumption influences episodic memory recall for negative events. Understanding these effects may help to improve support for trauma victims – for example, witnesses and victims of crimes.MethodsWe tested 60 participants who self-described as heavy drinkers. After watching an analog trauma film, half were allocated to consuming a moderate dose of alcohol (Alcohol-Exposed group), while half received a placebo drink (Placebo-Control group). Immediately and after a one-week delay, participants recalled the event via free and cued recall tasks. Participants also gave remember-know responses and confidence ratings, elucidating alcohol’s effect on experiential memory.ResultsFree recall performance was similar for the Alcohol-Exposed group and the Placebo-Control group during Sessions 1 and 2. The Alcohol-Exposed group benefitted more from the delayed repeated retrieval attempt. For the cued recall task, the Alcohol-Exposed group provided more “Do not Know” responses compared to the Placebo-Control group in both sessions. For the Alcohol-Exposed group only “Correct Know” responses increased from Session 1 to 2. Although memory performance improved across sessions, confidence levels decreased from Session 1 to 2 in the Alcohol-Exposed group.DiscussionPost-encoding alcohol consumption appears to impact immediate episodic memory retrieval; however, this effect is only temporary in nature. No evidence was found that alcohol primarily reduces remembering responses. Much like previous findings focusing on pre-encoding alcohol consumption (Hagsand et al., 2017), current findings suggest that providing individuals who drank alcohol after witnessing an incident with a delayed repeated retrieval attempt can lead to more complete and accurate testimonies.

Abstract Objective Intrusive memories are a core feature of posttraumatic stress disorder and have transdiagnostic relevance across mental disorders. Establishing flexible methods to monitor intrusions, including patterns and characteristics, is a key challenge. A daily diary has been developed in experimental settings to provide symptom count data, without the need for retrospective self‐report over extended time periods (e.g., 1 week, 1 month). We conducted an exploratory, pre‐registered data synthesis investigating convergence between the diary and questionnaire measures of intrusive symptoms long used in clinical practice (Impact of Event Scale, IES, and revised version, IES‐R, Intrusion subscale). Results Utilising datasets using the daily diary from 11 studies (4 real‐world trauma studies, seven analogue trauma studies; total N = 578), we found significant positive associations between the diary and IES/IES‐R Intrusion subscale. Exploratory analyses indicated that the magnitude of this association was stronger for the IES (vs. the IES‐R), and in individuals with real‐world (vs. analogue) trauma. Conclusion This study provides first evidence of convergent validity of a daily diary for monitoring intrusions with a widely used questionnaire. A diary may be a more flexible methodology to obtain information about intrusions (frequency, characteristics, triggers, content), relative to questionnaires which rely on retrospective reporting of symptoms over extended timeframes. We discuss potential benefits of daily monitoring of intrusions in clinical and research contexts.

This scoping review focused on the use of trauma focused therapy (TFT) with participants who have suicidal ideation. Methods: Following the PRISMA extension for Scoping Reviews guidelines, MEDLINE, EMBASE, APA PsycINFO, and CINAHL databases were searched on March 18, 2021. Peer-reviewed studies in English reporting on the use of TFT with patients with suicidal ideation or Borderline Personality Disorder (BPD) were included. Results: From 3,272 publications, 43 studies were included. Most studies utilized Prolonged Exposure, Eye Movement Desensitization and Reprocessing, Cognitive Processing Therapy, and other exposure-based interventions, alone or in combination with another intervention. Approximately 50% of studies used intensive (two sessions or more per week) delivery of the intervention. Studies mainly focused on clinical improvement of symptoms, rather than suicidality. Overall, studies reported symptom improvements in Posttraumatic Stress Disorder, depression, and BPD symptoms, suicidal ideation and non-suicidal self-injury, with few critical adverse events on record. Conclusion: Despite increased research interest in this area, knowledge gaps remain. Greater attention to mixed methods studies may increase our understanding of the lived experience of those with suicidal ideation undergoing TFT. There is a need for studies to explore the effect of TFT on symptoms associated with psychiatric diagnoses other than PTSD, and for studies reporting on the significance of both sex and gender of patients. Prospective interventional studies that focus on participants with suicidal ideation, and consensus on standardized suicidal ideation outcome measures, are also needed. There is a need to compare intensive vs. non-intensive TFT, and to examine whether inclusion of emotion regulation skills is a significant determinant of suicidal risk outcomes in this context. In contrast to common apparent clinical practice decisions restricting TFT to patients without suicidal symptoms, limited evidence indicates that TFT, including intensive delivery, may not increase suicide risk. Due to methodological issues, further studies are needed to confirm this observation and to determine any increased risk for specific patient subgroups and TFT interventions.

This paper provides an overview of my practice-based doctoral research: Bearing Witness: Autoethnographic Animation and the Metabolism of Trauma, which uses a multimethod approach (cognitive focus, thematic analysis of qualitative data and artistic practice), to investigate autoethnographic animation’s capacity to moderate psychological trauma. Traumatic events such as child abuse, domestic violence and military conflict often present a major health challenge for survi­vors, with many experiencing significantly impaired function due to symptoms such as nightmares, emotional dysregulation, negative cognitions and dissociative states. The symptoms most commonly reported are intrusive memories-sensory-perceptu­al impressions that involuntarily intrude into consciousness, causing distress and a sense of reexperiencing the trauma. A number of cognitive studies have measured how these intrusions may be moderated through models that either interfere with imagery, simulate trauma, or change its narrative. My research uses interviews, thematic analysis and artistic practice to inves­tigate whether animation may similarly moderate intrusions through processes that utilise the medium’s visuospatial capacities and its potential for rescripting, or changing, the trauma narrative. The desire to use personal experience as data motivated my interest in autoethnography as a methodology for qualitative inquiry. Autoethnography is a reflexive approach that explores autobiographical stories and connects these to wider socio-cultural-polit­ical issues through writing, performance and other media. In this research I am using autoethnography to both address my lived experience of trauma and to moderate its symptoms through my animation practice.

The article considers a new diagnostic category — complex post-traumatic stress disorder (CPTSD), introduced into the International Classification of Diseases (ICD-11). Differences in the mechanism of influence of situational and prolonged trauma are analyzed. CPTSD diagnostic criteria are compared to PTSD and BPD (borderline personality disorder) symptoms. The term “disturbances in self-organization” is analyzed, which explains the main mechanism of the impact of complex trauma and includes emotional dysregulation, disturbances in self-perception and relationships. Psychotherapeutic approaches developed for PTSD were shown to be insufficient for the treatment of CPTSD. The article reviews an approach to CPSTD therapy based on the consensus of experts in the field of post-traumatic stress and its possible limitations are discussed. “Component based psychotherapy” — another approach to CPTSD therapy — is described. Specific features of psychotherapy for complex trauma are discussed.