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Background: Opioid use disorder is one of the most severe forms of substance use disorder and is associated with high morbidity and mortality. Opiate overdose deaths in the US are increasing every year, claiming over 100,000 lives in 2022. Psychological trauma exposure and post-traumatic stress disorder are major health problems in the United States and may contribute to the development of an opiate use disorder. The purpose of this study was to examine the association of psychological trauma exposure and post-traumatic stress disorder with opiate use disorder., Methods: This study used a retrospective design with a convenience sample size of n = 150 participants diagnosed with opiate use disorder or substance use disorder from a drug treatment center in urban Pennsylvania. Retrospective data was collected on demographic characteristics, trauma exposures, diagnoses of post-traumatic stress disorder, opiate use disorder, and substance use disorder. Demographic data was gathered using a demographic survey, psychological trauma exposure was documented using the self-reported Life Events Checklist, and a diagnosis of post-traumatic stress disorder, opiate use disorder, and substance use disorder was confirmed as documented in the medical record by mental health providers., Results: Persons with psychological trauma exposure >5 are more likely to develop opiate use disorder, Chi-Square (χ 2  = 5.17, df = 1, p = 0.023)., Conclusion: Our study showed that psychological trauma exposure may lead to opiate use disorder, emphasizing the importance of identification of psychological trauma exposure and post-traumatic stress disorder diagnosis as part of trauma-informed strategies during the treatment of persons with opiate use disorder to help prevent disability and death., Competing Interests: Declaration of competing interest The authors declare that they have no conflicts of interest related to this manuscript. Roxanne Jeffries-Baxter, DNP, PMHNP-BC, FNP-BC, GNP-BC, has received research grants from SAMHSA, Grant Number 5H79SM080386-04. Roxanne Jeffries-Baxter, DNP, PMHNP-BC, FNP-BC, GNP-BC, has received research grants from Alpha Mu Research Grant. The author confirms that the funding sources had no role in the design, execution, analysis, or interpretation of the study results., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Purpose of Review: This is a critical review of English language literature (January 2023-June 2024) on psychological trauma amongst forcibly displaced migrant women. The Mental Health and Psychosocial Support (MHPSS) Framework was used to organize multi-layered mental health interventions., Recent Findings: Findings indicate many promising community-based interventions, often delivered by trained lay facilitators. Interventions address: upstream drivers of mental health such as empowerment and economic security, group-based care focused on social connection and well-being, and trauma focused treatment such as Mindfulness Based Interventions, Cognitive Processing Therapy, and Culturally Adapted Cognitive Behavioral Therapy. The variety of (primarily short-term) interventions must be complemented by longitudinal evaluation. Clinicians and care systems should partner with those delivering psychosocial interventions outside of clinical settings. Continued research on the impacts of cumulative and intergenerational trauma amongst refugee women, and intervention research that centers the experiences of marginalized groups (e.g., sexual and gender minority refugees) is needed., Competing Interests: Declarations. Competing Interests: The authors declare no competing interests., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Objective: Recent studies have revealed a heterogeneous prevalence and presentation of PTSD across countries. It is crucial to assess the methodological and item-level measurement factors that contribute to variations in mental disorder rates across cultures. This study aimed to investigate the traumatic experiences of hospital workers by employing item analysis of the Impact of Event Scale-Revised (IES-R)., Methods: Data were collected from 1,000 employees of a large hospital during the COVID-19 pandemic and were further subjected to item response theory (IRT) analysis with respect to the discrimination (a) and difficulty (b) parameters of the item pool., Results: Our results demonstrated that the IES-R items had a good discriminative ability (a) and covered a range of distress severity (b) associated with traumatic experiences. The IES-R was found to be a reliable and informative instrument for assessing individuals with moderate to severe trauma-related distress across the spectrum of traumatic symptoms. In particular, items #10 ("jumpy or easily startled") and #6 (" thought about it when didn't mean to"), reflecting the PTSD domains of hyperarousal and intrusion, excelled in discriminating between different levels of traumatic distress. Conversely, items related to avoidance and sleep disturbance showed diminished discriminative ability., Conclusions: The item analysis of the IES-R may be used to assess trauma symptoms in the context of a traumatic exposure, thereby identifying the most discriminative and informative items of the PTSD measure in our context. Our findings may refine the IES-R and facilitate the development of a more effective scale with optimized item parameters., Competing Interests: The authors report no conflicts of interest.

Background: Frontline health care staff are frequently exposed to traumatic events as part of their work. Although this study commenced before the emergence of COVID-19, levels of exposure were heightened by the pandemic. Many health care staff members report intrusive memories of such events, which can elicit distress, affect functioning, and be associated with posttraumatic stress disorder symptoms in the long term. We need evidence-based interventions that are brief, preventative, nonstigmatizing, suitable for the working lives of frontline health care staff, and effective for repeated trauma exposure. A brief, guided imagery-competing task intervention involving a trauma reminder cue and Tetris gameplay may hold promise in this regard, given evidence that it can prevent and reduce the number of intrusive memories following trauma across various settings., Objective: This case series aims to investigate the impact of a brief imagery-competing task intervention on the number of intrusive memories, general functioning, and symptoms of posttraumatic stress, anxiety, and depression, and examine the feasibility and acceptability of the intervention for UK National Health Service frontline health care staff. The intervention was delivered with guidance from a clinical psychologist., Methods: We recruited 12 clinical staff from the UK National Health Service, specifically from emergency departments, the intensive care unit, and the ambulance service. We evaluated the intervention using an AB single-case experimental design, where the baseline (A) was the monitoring-only phase and the postintervention (B) period was the time after the intervention was first administered. Methods were adapted once the COVID-19 pandemic began., Results: There was a decrease (59%) in the mean number of intrusive memories per day from baseline (mean 1.29, SD 0.94) to postintervention (mean 0.54, SD 0.51). There was a statistically significant reduction in the number of intrusive memories from baseline to postintervention, as shown by an aggregated omnibus analysis with a small effect size (τ-U=-0.38; P<.001). Depression, anxiety, and posttraumatic stress symptoms all significantly reduced from preintervention to postintervention. Participants also reported improvements in functioning based on both quantitative and qualitative measures. The intervention was feasible to deliver and rated as acceptable by participants., Conclusions: These preliminary findings suggest that this brief therapist-guided imagery-competing task intervention offers a potential approach to mitigating the impact of work-related traumatic events in frontline health care staff, both during a pandemic and beyond. Randomized controlled trials will be an important next step., (©Veronika Kubickova, Craig Steel, Michelle L Moulds, Marie Kanstrup, Sally Beer, Melanie Darwent, Liza Keating, Emily A Holmes, Lalitha Iyadurai. Originally published in JMIR Human Factors (https://humanfactors.jmir.org), 18.11.2024.)

Despite the growing incidence of burn injuries globally and the advancements in physical recovery, the psychological aspect of burn trauma recovery remains inadequately addressed. This review aims to consolidate existing literature on posttraumatic stress disorder (PTSD) and depression in adult burn survivors, recognizing the need for a holistic approach to burn recovery that encompasses both physical and mental health. The comprehensive analysis of 156 studies revealed significant variations in methodological approaches, leading to challenges in creating standardized protocols for mental health assessment in burn care. Key findings include the identification of a wide range of psychological assessment tools and a substantial research gap in low- and middle-income countries, where the majority of burn injuries occur. Only 7.0% of the studies assessed interventions for PTSD or depression, indicating a lack of focus on treatment modalities. The studies identified demographic factors, patient history, psychosocial factors, burn injury characteristics, and treatment course as risk factors for PTSD and depression postburn injury. The review highlights the need for early screening, intervention, and attention to subjective experiences related to burn injury, as these are strong predictors of long-term psychological distress. It also emphasizes the complexity of addressing psychological distress in burn survivors and the need for more standardized practices in assessing PTSD and depression specific to this population., (© The Author(s) 2024. Published by Oxford University Press on behalf of the American Burn Association. All rights reserved. For commercial re-use, please contact reprints@oup.com for reprints and translation rights for reprints. All other permissions can be obtained through our RightsLink service via the Permissions link on the article page on our site—for further information please contact journals.permissions@oup.com.)

Background: Experiencing a traumatic event can significantly impact mental and emotional well-being. Social media platforms offer spaces for sharing stories, seeking support, and accessing psychoeducation. TikTok (ByteDance), a rapidly growing social media platform, is increasingly used for advice, validation, and information, although the content of this requires further study. Research is particularly needed to better understand TikTok content relating to trauma and the potential implications for young viewers, considering the distressing nature of the subject and the possibility of users experiencing vicarious trauma through exposure to these videos., Objective: This study aims to explore the content of trauma-related videos on TikTok, focusing on hashtags related to trauma. Specifically, this study analyzes how TikTok videos present information, advice, stories, and support relating to trauma., Methods: A quantitative cross-sectional descriptive content analysis was performed on TikTok in December 2022. A total of 5 hashtags related to trauma were selected: #trauma, #traumatized, #traumatok, #traumatic, and #traumabond, with the top 50 videos from each hashtag analyzed (total N=250 videos). A standardized codebook was developed inductively to analyze the content of the videos, while an existing generic codebook was used to collect the video features (eg, age of people in the video) and metadata (likes, comments, and shares) for each video., Results: A total of 2 major content themes were identified, which were instructional videos (54/250, 21.6%) and videos disclosing personal stories (168/250, 67.3%). The videos garnered significant engagement, with a total of 296.6 million likes, 2.3 million comments, and 4.6 million shares, indicating that users find this content engaging and useful. Alarmingly, only 3.7% (9/250) of videos included a trigger warning, despite many featuring highly distressing stories that young people and those with trauma may be exposed to., Conclusions: The study highlights the potential risks of vicarious trauma due to trauma dumping without trigger warnings on TikTok, and the need for further research to assess the accuracy of advice and information in these videos. However, it also underscores the platform's potential to foster social connections, provide validation, and reduce stigma around mental health issues. Public health professionals should leverage social media to disseminate accurate mental health information, while promoting user education and content moderation to mitigate potential harms. People often use social media, such as TikTok to share advice, stories, and support around mental health, including their experiences with trauma. Out of 250 videos, most were either giving advice (54/250, 21.6%) or sharing personal experiences (168/250, 67.3%). The study found many videos lacked warnings about upsetting content, which could potentially harm young viewers or people suffering from trauma. While TikTok can help people feel connected and reduce the stigma around mental health, it is important to seek support from professionals when needed., (©Alix Woolard, Rigel Paciente, Emily Munro, Nicole Wickens, Gabriella Wells, Daniel Ta, Joelie Mandzufas, Karen Lombardi. Originally published in JMIR Formative Research (https://formative.jmir.org), 07.11.2024.)

Our experience of working with veterans traumatized by their encounter with death has enabled us to evolve our nursing practice so as to better welcome the singular voice of the psychically wounded in a military environment. This approach aims to highlight the resonance between an unspeakable experience of annihilation and the singularity of the subject. The interest of this notion lies in its clinical value, which is tending to disappear in modern therapies, as the personal history of our soldiers becomes the necessary framework for attempting to heal a major existential rupture. In this way, it confers an ethical value on treatment, by respecting the symptoms of these soldiers through their specific experiences. Every war has its share of suffering, but every soldier has his own war and his own unique story., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

The psychiatric department at the Laveran Army Training Hospital in Marseille is a referral center for legionnaires, a population at high risk of psychological trauma. As part of a multi-disciplinary team, nurses and orderlies play a major role in their care. The dual status of caregiver and soldier is an asset in providing comprehensive care for psychologically injured legionnaires. The service's civilian staff also have extensive knowledge of the military environment., (Copyright © 2024 Elsevier Masson SAS. All rights reserved.)

Objective: Dissociative symptoms are both a pathological consequence of exposure to psychological trauma as well as a side effect of N-methyl-d-aspartate (NMDA) receptor antagonist medications; therefore, accurate and valid assessment of these symptoms is important. The psychometric properties of the 23-item Clinician Administered Dissociative States Scale (CADSS) have been characterized in the ketamine and esketamine literatures. Here, we examine its performance in a sample with and without posttraumatic stress disorder (PTSD) and a history of exposure to psychological trauma., Methods: Participants with a history of psychological trauma with (N = 148) and without (N = 100) the diagnosis of PTSD and healthy participants without a psychiatric disorder or history of trauma (N = 28) were assessed with the 23-item CADSS and other psychometric and neuropsychological assessments. Analyses were performed to examine internal consistency, convergent and discriminant validity, factor structure, differential performance in populations reported to be more or less likely to report dissociative symptoms (e.g., patients with and without PTSD), and sensitivity to change resulting from exposure to trauma-related sights and sounds., Results: The 23-item CADSS was found to have high internal consistency (Cronbach's alpha 0.91) and a single-factor structure. CADSS total scores in trauma-exposed participants with PTSD were higher than those in trauma-exposed participants without PTSD and non-traumatized non-PTSD participants. Finally, veterans with Iraq combat-related PTSD showed a significant increase in CADSS total score after exposure to combat-related slides and sounds., Conclusion: The 23-item CADSS, already validated as a tool to measure dissociation related to administration of NMDA receptor antagonist medication, performs in a reliable and valid manner in the assessment of dissociation in psychologically traumatized participants., Competing Interests: Declaration of competing interest J.D.B. holds a copyright on the CADSS and receives royalties for its use. None of the other authors reported financial interests related to the subject of this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

Posttraumatic stress disorder (PTSD) is a pervasive issue within military populations, with approximately 29 % of post-9/11 service members experience PTSD at some point in their lifetime. One potentially important factor in PTSD development and treatment response is dysregulation of the stress response system stemming from exposure to multiple traumas and sustained operational stress associated with military training and deployment. In particular, the end-product of the hypothalamic-pituitary-adrenal (HPA) axis, cortisol, is of particular interest to researchers examining physiological stress response in the context of mental health. Research exploring cortisol has been ongoing for decades, both to further understand its pathways and mechanisms, and to develop potential novel PTSD treatments. This paper provides a narrative review of some of the published literature examining cortisol's role in PTSD as a potential factor in development, maintenance, and treatment augmentation, with emphasis on military populations. The results of this review highlight the importance of exploring alterations to the stress response system, and cortisol in particular, for the evaluation and treatment of PTSD in the military, the need for more comprehensive work towards understanding development of these alterations through military training and service, and its impact on long-term PTSD outcomes., Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier Ltd. All rights reserved.)

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., Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

This hypotheses article presents understandings and practices of tohu (signs) in the personal, eco-environmental, and spiritual wellbeing of Māori. Tohu can be observed in the natural, social, physical, or spiritual environment, and within a Māori worldview provide important ways of understanding and responding to phenomena. Wānanga (shared dialogue and debate) were held with seven Māori clinical psychologists from He Paiaka Tōtara (Māori Psychologist Network) and two mātauranga Māori specialists to explore their experiences, knowledge, and perspectives about tohu, with their insights collected through online information sharing. Our wānanga goals were to inform the creation of a therapeutic framework to address patu ngākau, psychological and spiritual trauma experienced by Māori. The results identified that tohu are located within the person and their environment, and the importance of exploring how tohu are interpreted. We propose a TOHU acronym as a framework for understanding and addressing the multifaceted impacts of patu ngākau., (Copyright © 2024 Elsevier Inc. All rights reserved.)

Objectives: The Russian-Ukrainian War of 2022 (RUW-2022) was accompanied by the subsequent risk of accidents at a nuclear power plant in Ukraine. This study investigated posttraumatic stress (PTS) symptoms related to media reports of an attack on a Ukrainian nuclear power plant during the RUW-2022 among victims of the Fukushima nuclear disaster and revealed their association with radiation risk perception (RRP) of the accident., Methods: This cross-sectional study targeted 1193 residents of Naraha Town in Fukushima Prefecture. PTS symptoms were measured using the Japanese version of the Impact of Events Scale-Revised (IES-R). Univariate and multivariate analyses explored the association between IES-R scores and background factors, particularly RRP., Results: Participants with higher RRP showed significantly higher IES-R scores; furthermore, the proportion of disruption because of radiation anxiety was significantly larger among higher RRP residents. Radiation anxiety mediated the association between RRP and PTS symptoms (total IES-R score and sub-item of intrusion)., Conclusions: People with higher RRP in Fukushima may continue to be at risk of persistent, unwanted PTS symptoms due to future nuclear crises. Therefore, mental health practitioners need to continue providing support in affected areas for a longer period than anticipated. Moreover, a population-based approach to cope with these stressors from media reports is essential.

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., (© 2024. The Author(s).)

Background: 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., Methods: 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., Results: 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., Limitations: 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., Conclusions: 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., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 Elsevier B.V. All rights reserved.)

United States Military Veterans are an increasingly elderly population, and more and more veterans are choosing hospice care at the end of life. These veterans, particularly if they served in combat, can bring unique management challenges and opportunities to a hospice team. This review highlights the physical and psychosocial traumas experienced by many veterans, and discusses how these issues can affect their hospice care. Traumatic injury-related issues such as chronic pain, neuropathic pain, insomnia, and chronic headaches can worsen for veterans at the end of life, and the psychological sequelae of these traumatic events such as Post-Traumatic Stress Disorder (PTSD), Chronic Anxiety, Substance Abuse, and increased risk of suicide can also be magnified during this time. This review details these and other commonly seen service-related comorbidities, and offers evidence-based recommendations regarding their diagnosis and treatment. In addition, it discusses what is important to veterans at the end of life, and provides suggestions on how hospice programs can individualize and optimize their care of this special population. Honoring their service and respecting their sacrifices are also important aspects of "Best Care" for veterans at the end of life, and this review provides suggestions on how to do so and includes a list of resources that can greatly assist hospice programs, veterans, and families in delivering the most respectful, comprehensive, and thoughtful care possible., Competing Interests: Declaration of Conflicting InterestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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 ., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the authorship and/or publication of this review.

Purpose: Early intervention after trauma is needed for reduction in clinical distress and prevention of chronic posttraumatic stress disorder (PTSD). This study describes findings from an open pilot trial of a brief stabilization psychotherapy based on imagery techniques for adults with acute PTSD (i.e., within 3 months of onset)., Materials and Methods: Four sessions of 60-minute individual psychotherapy were conducted on 18 participants with PTSD within 3 months after accidents, 15 of whom completed the treatment. The clinician-administered PTSD scale for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), the Hamilton Depression and Anxiety Rating Scales, and self-questionnaires were administered at pre-treatment, post-treatment, and 6-month follow-up., Results: Eight (53.3%) of the 15 patients at post-treatment and 8 of the 9 patients at 6-month follow-up did not meet the DSM-5 criteria for PTSD. Reliable change of PTSD symptoms after treatment was observed in 6 of 15 (45.0%) patients at post-treatment and in 4 of 9 (45.0%) patients after 6 months. There was a significant decrease in PTSD, depression, anxiety, and impaired quality of life scores after treatment, and these gains were maintained after 6 months. No cases of exacerbated PTSD symptoms were observed among completers and non-completers., Conclusion: Our findings suggest that brief stabilization sessions are safe treatment options for acute PTSD (KCT0001918)., Competing Interests: The authors have no potential conflicts of interest to disclose., (© Copyright: Yonsei University College of Medicine 2024.)

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., (© 2024 The Authors. British Journal of Social Psychology published by John Wiley & Sons Ltd on behalf of British Psychological Society.)

Experiencing trauma leads to intrusive memories (IMs), a hallmark symptom of post-traumatic stress disorder (PTSD), which also occurs transdiagnostically. Understanding why IMs increase or decrease is pivotal in developing interventions to support mental health. In this preregistered meta-analysis (PROSPERO: CRD42021224835), we included 134 articles (131 techniques, 606 effect sizes and 12,074 non-clinical participants) to investigate how experimental techniques alter IM frequency, intrusion-related distress and symptoms arising from lab-analogue trauma exposure. Eligible articles were identified by searching eight databases until 12 December 2023. To test potential publication biases, we employed methods including Egger's test and three-parameter selection models. We employed three-level multilevel modelling and meta-regressions to examine whether and how experimental techniques would modulate IM frequency and associated outcomes. Results showed that techniques (behavioural, pharmacological, neuromodulation) significantly reduced intrusion frequency (g = 0.16, 95% confidence interval [0.09, 0.23]). Notably, techniques aimed to reduce IMs also ameliorated intrusion-related distress and symptoms, while techniques that increased IMs exacerbated these related outcomes, thus highlighting IM's centrality in PTSD-like symptoms. Techniques tapping into mental imagery processing (for example, trauma reminder followed by playing Tetris) reduced intrusions when administered immediately after, or at a delayed time after trauma. Although our meta-analysis is limited to symptoms induced by lab-analogue trauma exposure, some lab-based results have now generalized to real-world trauma and IMs, highlighting the promising utility of lab-analogue trauma paradigms for intervention development., (© 2024. The Author(s).)

Introduction: Patients with bipolar disorder (BD) are frequently exposed to traumatic events which worsen disease course, but this study is the first multicentre randomised controlled trial to test the efficacy of a trauma-focused adjunctive psychotherapy in reducing BD affective relapse rates., Materials and Methods: This multicentre randomised controlled trial included 77 patients with BD and current trauma-related symptoms. Participants were randomised to either 20 sessions of trauma-focused Eye Movement Desensitization and Reprocessing (EMDR) therapy for BD, or 20 sessions of supportive therapy (ST). The primary outcome was relapse rates over 24-months, and secondary outcomes were improvements in affective and trauma symptoms, general functioning, and cognitive impairment, assessed at baseline, post-treatment, and at 12- and 24-month follow-up. The trial was registered prior to starting enrolment in clinical trials (NCT02634372) and carried out in accordance with CONSORT guidelines., Results: There was no significant difference between treatment conditions in terms of relapse rates either with or without hospitalisation. EMDR was significantly superior to ST at the 12-month follow up in terms of reducing depressive symptoms (p=0.0006, d=0.969), manic symptoms (p=0.027, d=0.513), and improving functioning (p=0.038, d=0.486). There was no significant difference in dropout between treatment arms., Conclusions: Although the primary efficacy criterion was not met in the current study, trauma-focused EMDR was superior to ST in reducing of affective symptoms and improvement of functioning, with benefits maintained at six months following the end of treatment. Both EMDR and ST reduced trauma symptoms as compared to baseline, possibly due to a shared benefit of psychotherapy. Importantly, focusing on traumatic events did not increase relapses or dropouts, suggesting psychological trauma can safely be addressed in a BD population using this protocol., (Copyright © 2023 Sociedad Española de Psiquiatría y Salud Mental (SEPSM). Published by Elsevier España S.L.U. All rights reserved.)

This practitioner essay will discuss the evidence base for an Australian trauma-informed kickboxing program, The Fight Back Project. We share key differences and adjustments while delivering this program in the Salvadoran context. We consider practitioner assumptions and limitations when transferring trauma-informed practice principles from the Global North to the Central American setting, and the criticality of gender-responsive adaptations. Drawing from existing research on the benefits of trauma-informed martial arts as a form of physical exercise, we describe the collaborative development and implementation of a trauma-informed kickboxing program alongside a local, community-led organization., Competing Interests: Declaration of Conflicting InterestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Introduction: 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., Aims of the Study: 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., Methods: 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., Results: 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., Conclusion: 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., Clinical Trial Registration: ChiCTR2200063642., (© 2024 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.)

Background: Little is known about the functional consequences of violence when directly assessed as a primary outcome, and even less about how consistently these consequences are evaluated in a judicial context. The World Health Organization (WHO) highlighted the importance of a functional approach to health in 2001 with the release of the International Classification of Functioning, Disability, and Health (ICF). In most European countries, forensic physicians assess individuals exposed to violence to evaluate the outcomes of violence, providing certified medical evidence for magistrates' sentencing decisions. This evaluation involves a mix of objective, subjective, and contextual elements, such as reported symptoms of fear, pain, and details of the assault. Quantifying these subjective elements with scales could enhance their interpretation and application in a judicial context., Objective: This study aims to (1) characterize and (2) assess 6 scales measuring subjective elements of functional impairment among individuals exposed to violence., Methods: We conducted a retrospective study that included individuals exposed to violence examined in a French department of forensic medicine over 12 months. A typology of violence encountered in medical settings was built based on the mining of electronic health records and the use of pattern recognition algorithms. The optimal number of violence types was determined using a robust and stable clustering approach, involving sample resampling and a multimetric scheme. Patients were then paired according to their homogeneous profiles, and the intra- and interrater reproducibility of the scales was evaluated., Results: All pain, fear, and life threat scales were significantly associated with higher functional impairment, suggesting that these measures contribute to the overall assessment of functional impairment. The intra- and interrater reproducibility of scales among similar situations of violence was measured, ranging from mild to good, with coefficients of concordance between 0.46-0.66 and 0.43-0.66, respectively. Individuals reporting intimate partner violence showed higher scores in both fear and perception of a life threat during the assault and medical interview, while individuals reporting battery by multiple unknown assailants presented higher scores only in perception of a life threat during the assault. We identified 5 remarkably stable profiles of situations of violence, consistent with clinical practice., Conclusions: Pain, fear, and life threat scales were related to functional impairment according to expert knowledge and demonstrated fair reproducibility under real-life conditions for similar situations of violence. Subjective elements related to functional impairment in individuals exposed to violence can be quantified using Likert scales during medical interviews., (©Ivan Lerner, Patrick Chariot, Thomas Lefèvre. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 27.09.2024.)

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., (© 2024. The Author(s).)

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., (© 2024. The Author(s).)

Background: Preterm birth trauma has become a growing concern in achieving the sustainable development goal targets for mental, maternal, and child health. Although obstetric and developmental complications associated with preterm birth have received a great deal of research attention over the years, subjective trauma experiences of mothers are often understudied. This qualitative study aims to fill this gap by adopting a phenomenological design to explore the traumatic experiences of mothers from pregnancy to care after childbirth of preterm babies in a low-resource economy., Results: The results of our Interpretative Phenomenological Analysis (IPA) revealed three superordinate and six subordinate themes: pregnancy-related (Primary pregnancy-related complications and secondary pregnancy-related factors), healthcare-related (Trauma from invasive procedures performed on babies and trauma from the poor physical health status of the babies at NICU), and parenting-related trauma (Initial shock and denial and feelings of inadequateness and helplessness in caring for their babies)., Conclusions: The study shows the complex nature of the birth trauma experienced by mothers of preterm babies. The study recommends client-centered, culturally sensitive, and trauma-focused mental health support within the maternal health system., Competing Interests: The authors declared no potential conflicts of interest with respect to the research, authorship and/or publication of this article., (© 2024 The Author(s).)

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., (© 2024. The Author(s).)

The special issue, "School Personnel Well-Being: Advancing Measurement, Best Practices, and Policy," showcases empirical quantitative and qualitative research that presents a range of social-ecological factors that directly and indirectly associate with school personnel well-being, trauma, and safety in prekindergarten through 12th grade schools. This introduction article represents Section 2 of the special issue reviewing eight articles that focus on the Role of Traumatic Experiences in Educator Well-Being. Collectively, these studies increase awareness of school personnel trauma experiences and make important contributions to the field. We offer lessons learned from the studies and directions for research. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Educators are often on the frontline of supporting the well-being of their students. Thus, it is critical to ask teachers what they need in regard to implementing trauma-informed practices in schools (TIPS). This mixed-methods, community-initiated needs assessment explored educators' well-being and use of trauma-informed resources. A random selection of 450 certificated school staff from two school districts was invited to participate. Educators ( n = 178; 39.5% response rate) completed a survey, and four focus groups were conducted ( n = 14) to obtain feedback on factors affecting the use of TIPS. Descriptive statistics and logistic regression analyses were used to determine the factors most related to resource use. Teachers reported strong well-being and low levels of secondary traumatic stress, but high levels of burnout. Themes from the focus groups highlight administrator actions that can improve teacher well-being. Teachers rated their most used resources as a list of mental health resources, virtual-guided wellness activities, and opportunities to connect with others, whereas the most helpful were opportunities to connect with others, in-person-guided wellness activities, and training to identify students who may need support. Teacher well-being and school climate achieved traditional significance values for predicting teacher use of resources; however, they did not reach the Bonferroni-adjusted significance value. Results from this needs assessment indicate that teachers wanted resources to adequately respond to their own and their students' mental well-being. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This systematic review aimed to explore sex differences in exposure to traumatic events and posttraumatic stress disorder (PTSD) symptomatology among refugees, internally displaced persons (IDPs), and asylum seekers. A comprehensive search was conducted across three databases (PubMed, PsychInfo, and Embase), which yielded 2,255 studies. A total of 15 studies were included for trauma exposure assessment, and 8 studies for PTSD symptomatology assessment. The review revealed significant sex differences in trauma exposure, with women experiencing higher rates of sexual violence, while men faced greater risks of imprisonment and torture. In terms of PTSD symptomatology, our findings showed that women tend to exhibit greater symptoms of arousal and specific symptoms of avoidance such as loss of interest and avoidance of activities reminding of trauma, while men were more likely to experience estrangement and detachment. Findings regarding symptoms of reexperiencing were not entirely consistent. This review emphasizes the importance of considering sex-specific symptoms in trauma assessment among displaced populations and advocates for further research into targeted interventions, especially regarding sexual violence., Competing Interests: Declaration of competing interest All authors declare that there are no conflicts of interest. This research did not receive any specific grant from funding agencies in the public, commercial, or not-for profit sectors., (Copyright © 2024. Published by Elsevier B.V.)

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.

Objective: Identity-based stress and trauma are key drivers of alcohol use-related health inequities among minoritized people. Research on intersectional experiences of identity-based stress and alcohol use among trauma-exposed minoritized people is scant. This pilot study used a 30-day diary design to examine the effect of identity-based discrimination exposure on alcohol use in a racially diverse sample of trauma-exposed sexual minoritized (SM) adults ( N = 47; 63.8% cisgender female; 65.2% Black, Indigenous, and People of Color [BIPOC])., Method: Multilevel logistic regression models were used to evaluate whether days marked by any (vs. no) identity-based discrimination were concurrently or prospectively associated with increased likelihood of reporting a higher (vs. lower) level of drinking-and whether these associations differed by race/ethnicity., Results: Discrimination was associated with increased likelihood of reporting a higher level of same-day drinking ( B = 0.91, p = .03), but did not predict next-day drinking. BIPOC (vs. White) individuals were less likely to report a higher drinking level on or following nondiscrimination days ( B s = -2.18 to -1.52, p s ≤ .005), but more likely to do so on or following discrimination days ( B s = 1.13-1.60, p s ≤ .03)., Conclusions: Results suggest that everyday discrimination may create insidious risk for coping-motivated alcohol use among SM BIPOC, a subgroup that otherwise exhibits resilience with respect to drinking. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: 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., Methods: 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., Results: 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., Discussion: 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., (© 2024 The Author(s). Birth published by Wiley Periodicals LLC.)

Background: After 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., Objective: To explore experiences, opinions, and needs among adult transnational adoptees in Sweden concerning healthcare in general and mental healthcare in particular., Methods: Sixty-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., Results: Three 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., Implications: Based 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., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Strand and Hillerberg.)

Background: To prevent the infection from spreading, patients who were dying from COVID-19 were treated in isolation with restricted family access, which differed from existing end-of-life care procedures. This was a significant change that affected the care provided by nurses., Objectives: This study explored nurses' end-of-life care experiences in a limited family visitation setting during the COVID-19 pandemic., Methods: A descriptive qualitative study was conducted. Data were collected through individual, in-depth, semistructured interviews with ten critical care nurses who provided end-of-life care to patients with COVID-19 in South Korea. The data were analysed using thematic analysis. The Consolidated Criteria for Reporting Qualitative Research checklist was used to assess the study's rigour., Findings: Three themes were identified: 'Witnessing patients' and families' heartbreak over separation', 'The gaps between the ideals and realities of end-of-life care', and 'Efforts to provide patients with a comfortable final journey'. Nurses realise the importance of their central role in supporting interactions between patients and families during end-of-life care., Conclusions: Family participation, facilitated by nurses' interest and efforts as mediators connecting patients and families, is essential for achieving high-quality care for inpatients facing end of life. This study is significant as it emphasises that the direction of end-of-life care should be family centric, even in a pandemic situation with limited family participation. To improve interaction between patients and families, creating an environment based on family participation that builds trust and strengthens communication is essential. Additionally, hospital support, such as professional education and counselling, should be provided to strengthen nurses' end-of-life care competency., Competing Interests: Conflict of interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this manuscript., (Copyright © 2024 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.)

Objective: Previous studies investigated the varying prevalence of post-epileptic seizure posttraumatic stress disorder (PS-PTSD). The current study aimed first to compare the profiles of patients with and without PS-PTSD and, second, to study the interaction between other past traumatic experiences, subjective ictal anxiety, psychiatric comorbidities, and PS-PTSD in people with epilepsy (PWE)., Methods: We conducted an observational study, investigating past traumatic experiences and PS-PTSD through standardized scales (CTQ-28, LEC-5 and PCL-5). We used semi-structured interviews and validated psychometric scales (NDDIE for depression and GAD-7 for anxiety) to collect data on general psychiatric comorbidities. We also assessed epilepsy specific psychiatric symptoms (interictal and peri-ictal). We performed a mediation analysis through PROCESS for SPSS to evaluate the effect of history of past trauma and subjective ictal anxiety on PS-PTSD through interictal depression and anxiety symptoms., Results: We enrolled 135 PWE, including 35 patients with PS-PTSD (29.5 %). Patients with PS-PTSD had significantly higher depression (12.87 vs 10; p = 0.005) and anxiety (7.74 vs 5.01; p = 0.027) scores and higher prevalence of peri-ictal psychiatric symptoms, compared to patients without PS-PTSD. The relationship between other past traumatic experiences and PS-PTSD was totally mediated by interictal depression and anxiety. We found a significant indirect effect of interictal anxiety symptoms on the path between subjective ictal anxiety and PS-PTSD., Significance: Our results showed that patients with PS-PTSD have a more severe psychopathological profile (more peri ictal and inter ictal depressive and anxiety symptoms). Both inter ictal and subjective ictal anxiety appear to have a significant role in PS-PTSD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier Inc. All rights reserved.)

Objective: The goal of this study was to assess students' responses to a potentially triggering passage from literature using differing trigger warnings., Participants and Method: 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., Results: 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., Discussion: 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.

Introduction: Avoidance is a well-documented risk factor for poor mental and physical health outcomes. However, limited research has explored this relationship specifically among trauma-exposed veterans, a population known to be particularly prone to avoidance behavior. Conceptually, avoidance is often divided into two distinct but overlapping constructs - experiential avoidance (resisting distressing internal states) and behavioral avoidance (avoiding or changing experiences that elicit distress). In this exploratory survey study, we examined associations between behavioral and experiential avoidance and mental, physical, and cognitive functioning, as well as quality of life., Methods: Veterans with a trauma history (N = 89) completed a 121-item survey containing validated assessments to examine several mental and physical health and wellness-related variables. Correlations between experiential avoidance and outcome measures, and behavioral avoidance and outcome measures, were explored. Multivariable linear regression analyses were conducted to explore the association between experiential and behavioral avoidance on mental health outcomes. In addition, we conducted exploratory analyses in which we investigated these correlations in those who screened positive for PTSD versus those who did not, and between different types of behavioral avoidance and major outcomes., Results: Experiential avoidance was moderately correlated with distress from depressive symptoms, distress related to past trauma, and health-related and cognitive dysfunction. Experiential Avoidance was weakly correlated with distress from anxiety symptoms and poorer quality of life. Behavioral avoidance was moderately correlated with distress from depressive and anxiety symptoms, distress related to past trauma, and cognitive dysfunction, and was weakly correlated with health-related dysfunction and poorer quality of life. Results from multivariable analyses revealed that experiential avoidance was associated with greater distress related to depressive symptoms and past trauma, and behavioral avoidance was associated with greater distress related to anxiety symptoms, depressive symptoms, and past trauma., Conclusions: Results suggest that avoidance negatively influences major domains of mental and physical health as well as functioning and health-related quality of life in trauma-exposed veterans. They further indicate that behavioral and experiential avoidance may be differentially linked to mental health outcomes. The results support the idea that avoidance may be an important marker for psychosocial functioning and may serve as a treatment target in trauma-exposed veterans., Competing Interests: Declaration of competing interest None., (Published by Elsevier Ltd.)

Introduction: Nurses, who care for patients with various traumas, may also experience post-traumatic stress disorder due to indirect or direct exposure to traumatic situations. This study examined the effectiveness of an Internet-based trauma recovery intervention for Korean nurses., Methods: This randomized controlled trial was conducted with 112 nurses aged 23-40 years who were randomly assigned to the intervention ( n = 56) or control group ( n = 56) from May 7 to December 20, 2020. Nurses in the intervention group attended eight sessions, and the same intervention was administered to the control group. Repeated measures were collected at pre-test, post-test 1 (immediately after the intervention), and post-test 2 (4 weeks after the intervention). A total of 102 nurses (intervention group: n = 49; control group: n = 53) were completed because 10 nurses dropped out before the first session. Data were analyzed using the χ 2 test, Fisher's exact test, t -test, Mann-Whitney U test, and repeated measures ANOVA (intention-to-treat and per protocol)., Results: There were significant changes in functional health, resilience, post-traumatic stress, depressive symptoms, state anxiety, and trait anxiety over time and in the group-by-time interactions (intention-to-treat and per protocol). There was a significant difference in social support in the group-by-time interactions, but there were no significant changes between the two groups or over time (intention-to-treat and per protocol)., Conclusion: The Internet-based trauma recovery nursing intervention is effective in clinical and community settings for nurses who cannot participate in fixed-schedule programs due to shift work. This study's findings are relevant for implementing Internet-based trauma recovery programs for nurses and the general population, including survivors and relatives of patients who suffered from COVID-19. This program will also be very useful for people in other high-stress situations. Nurse leaders should consider different populations and situations when offering effective coping strategies suitable for changing environments., Competing Interests: The authors have no conflicts of interest to declare., (© 2024 The Author(s). Published by S. Karger AG, Basel.)

In pediatric primary care, incorporation of existing practice tools into screening for adverse childhood experiences (ACEs) may reduce screening barriers, promoting timely intervention on negative health impacts from childhood trauma. One such screening tool is the Bright Futures Previsit Questionnaire (PVQ). To evaluate the extent to which the PVQ may be used to screen for ACEs, this research aimed to map items related to ACEs from adolescent PVQs against adverse events historically identified as conventional and expanded ACEs. The adolescent PVQs mapped effectively to nine ACEs: adverse neighborhood experiences, bullying, emotional neglect, friend or family substance misuse, household safety, intimate partner violence, interpersonal violence, physical neglect, and sexual abuse. Universal ACE screening can be conducted using adolescent PVQs; however, issues remain regarding the reliability and validity of using the PVQs to identify ACEs, and some ACEs are not effectively assessed using adolescent PVQs., Competing Interests: CONFLICTS OF INTEREST The authors have no conflicts of interest with regard to this manuscript. Julie Carbray serves as a consultant to Karuna Therapeutics and has served on advisory boards for Supernus Pharmaceuticals and Karuna Therapeutics., (Copyright © 2024 National Association of Pediatric Nurse Practitioners. Published by Elsevier Inc. All rights reserved.)

This article analyses how people who identify with psychiatric diagnoses in England and Wales make sense of and talk about their experiences of sexual violence. I examine how interview participants engaged with the hegemonic trauma discourse, as well as the consequences of this for meaning-making, affective pain, and the feminist imperative to 'speak out'. The hegemonic trauma discourse is characterised by leaving a psychological 'scar'; is premised on a sudden interruption to a 'good life'; and is considered pathologically unspeakable without intervention. This discourse was both validating and affectively painful for participants, and interventions targeting dissociation were helpful for assuaging distress. However, it was additionally normative and exclusionary, and did not fulfil the political promise of 'speaking out', as all participants faced myriad socio-political denial., Competing Interests: Conflict of interest I declare no competing interests (intellectual or financial) in the research detailed.

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., (© 2024. The Author(s).)

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.

Background: It has been proposed that children and young people living in low- and middle-income countries (LMICs) are not only exposed more frequently to trauma but also have a higher likelihood of encountering traumas of greater severity than those living in high-income countries (HICs). This may lead to higher rates of post-traumatic stress symptoms (PTSS). However, developmental pathways to risk or resilience after trauma exposure in LMICs are underresearched., Methods: We examined early parenting and attachment as potentially important formative factors for later stress reactivity in a longitudinal cohort of South African children (N = 449). Parenting and attachment were assessed at child age 18 months, and interpersonal trauma exposure, PTSS and parenting stress were measured at 13 years (N = 333; core sample with data on all measures: N = 213). Following a vulnerability-stress approach, separate regression models were run to investigate whether parent-child attachment at 18 months, parental sensitivity and intrusiveness during play at 12 months, and current parenting stress at 13 years, interacted with adolescents' extent of interpersonal trauma exposure to predict their PTSS levels at 13 years., Results: We found no predictive effects of either early attachment or current parenting stress in relation to child PTSS. There was some evidence for predictive influences of parental early intrusiveness and sensitivity on adolescent outcomes, though associations were unexpectedly positive for the latter. No interaction effects supporting a vulnerability-stress model were found., Conclusions: Overall, we found limited evidence that elements of the early parent-child environment predict child risk/resilience to trauma in LMIC children. Future studies should include more frequent assessments of relevant constructs to capture changes over time and consider further what comprises adaptive parenting in high-risk contexts., (© 2023 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health.)

We conducted a qualitative study investigating traumatic daydreaming themes among individuals with maladaptive daydreaming (MD). Forty-one participants were interviewed regarding connections between their traumatic daydreams and real-life adversity. Specifically, we asked participants about 1) childhood trauma experiences, 2) trauma-related daydreaming, 3) perceived relationships between such daydreams and authentic experiences, and 4) difficulty distinguishing traumatic memories originating from daydreams versus actual events. Many participants reported past trauma and frequent traumatic daydream themes. However, participants also noted their daydreams often depicted corrected, more positive versions of experienced events. Finally, most participants stated they did not confuse daydreaming with actual experiences. This study provides new data on the complex interplay between trauma, memory, and daydreaming in MD., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024 The Authors. Published by Elsevier B.V. All rights reserved.)

Background: Research indicates that the nature of the relationship between a victim-survivor and perpetrator of child maltreatment can influence well-being experienced during young adulthood. However, further research is required to substantiate the possible mediating role of betrayal trauma following child maltreatment., Objective: To explore the relationship between child maltreatment and psychological well-being experienced during young adulthood by examining the extent of maltreatment, the importance of the type of perpetrator, and the potential mediating role of betrayal trauma following child maltreatment., Participants and Setting: The self-selected sample comprised 468 young adults (aged 18-25 years; M = 21.74 years, SD = 2.47) from Australia and internationally., Method: Information regarding participants' current well-being, the extent of enduring five types of maltreatment (witnessing family violence, neglect, physical abuse, psychological abuse, and sexual abuse) by their mother, father and other adults during childhood, multi-type maltreatment, and severity of betrayal trauma were obtained via an online survey., Results: Using multiple regression analysis, it was found that higher levels of multi-type maltreatment were associated with poorer current well-being. Maltreatment by one's mother or father predicted poorer well-being, maltreatment by another adult did not. Hierarchical regressions revealed young adults' sense of betrayal trauma in close relationships partially mediated the relationship between current well-being and child maltreatment by one's mother, father, and another adult., Conclusion: Findings show that the extent of child maltreatment experienced, one's sense of betrayal, and the relationship of the child/adolescent to the perpetrator can influence well-being experienced during young adulthood. These findings highlight the therapeutic benefit of clinicians supporting young adults who have endured child maltreatment to process betrayal trauma, to improve their well-being., Competing Interests: Declaration of competing interest None., (Copyright © 2024 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Humans must identify others as enemies or allies to develop, protect, maintain, and refine their sense of self. This is a part of their normal psychological development. These phenomena operate on individual and large group levels and are pronounced under threat. In peril, they help create psychological boundaries between conflicting parties and bonds between allies. These boundaries and bonds are invested with strong emotions. The narcissism of minor differences concept is involved in identifying and delineating enemies at times of perceived danger. This article introduces the concept of the narcissism of minor resemblances. This concept is discussed from the psychodynamic perspective and illustrated with examples of socio-political developments from modern history. The narcissism of minor resemblances concept may help us understand the underlying dynamics of bonding with allies and identifying with others when undergoing threat and hardship. This concept connects the public arena of political action with individual psychological development. Awareness of this phenomenon can help mitigate the negative aspects of rigid enemy-ally distinctions and promote cooperation and peace. It may also help individuals impacted by psychological trauma to make meaning of psychological and societal processes experienced and contribute to their healing., Competing Interests: The author declares that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Drožđek.)

Introduction: It 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., Methods: In 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., Results: The 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., Conclusions: EMDR 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 Registration: https://www.clinicaltrials.gov, identifier NCT06110702., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest., (Copyright © 2024 Miccoli and Poli.)