Search

Autistic women are at an increased risk of experiencing trauma and mental health issues compared with the general population. This is further compounded by significant barriers to diagnosis and to accessing appropriate support for this group. By employing a feminist approach, this study recognises the effects of socio-historical inequality on this group, including identity dysfunction and disempowerment, which further exacerbate the effects of trauma. This paper argues that restoring identity and supporting empowerment are paramount to Autistic women’s recovery from trauma. Previous research focusing specifically on Autistic women who have suffered trauma is scarce. This research seeks to contribute to filling the gap in the knowledge of how counsellors can best support this group. This research elevates the voices of Autistic women, by working with a board consisting of Autistic women, and through conducting semistructured interviews with six Autistic women ranging in age and in their prior experience of counselling. The researcher, with two Autistic board members, thematically coded responses, revealing that both social and psychological empowerment were key to Autistic women’s recovery from psychological trauma. Recommendations are provided as to how therapists can help facilitate empowerment for this population, including through the restoration of autonomy and decision-making capacity within the therapy process, taking a flexible and transparent approach, and by encouraging connection with the wider autism community within which individuals can thrive and grow.

Trauma and its related psychological and somatic consequences are associated with higher cardiovascular morbidity. The regulation of both the gasotransmitter hydrogen sulfide (H2S) and the neuropeptide oxytocin (OT) have been reported to be affected during physical and psychological trauma. Both mediators are likely molecular correlates of trauma-induced cardiovascular complications, because they share parallel roles and signaling pathways in the cardiovascular system, both locally as well as on the level of central regulation and the vagus nerve. Meditation can alter the structure of specific brain regions and can have beneficial effects on cardiovascular health. This perspective article summarizes the evidence pointing toward the significance of H2S and OT signaling in meditation-mediated cardio-protection.

BackgroundTo “model and simulate change” is an accepted strategy to support implementation at scale. Much like a power analysis can inform decisions about study design, simulation models offer ananalytic strategyto synthesize evidence that informs decisions regarding implementation of evidence-based interventions. However, simulation modeling is under-utilized in implementation science. To realize the potential of simulation modeling as animplementation strategy, additional methods are required to assist stakeholders to use models to examine underlying assumptions, consider alternative strategies, and anticipate downstream consequences of implementation. To this end, we propose Rapid-cycle Systems Modeling (RCSM)—a form of group modeling designed to promote engagement with evidence to support implementation. To demonstrate its utility, we provide an illustrative case study with mid-level administrators developing system-wide interventions that aim to identify and treat trauma among children entering foster care.MethodsRCSM is an iterative method that includes three steps per cycle: (1) identify and prioritize stakeholder questions, (2) develop or refine a simulation model, and (3) engage in dialogue regarding model relevance, insights, and utility for implementation. For the case study, 31 key informants were engaged in step 1, a prior simulation model was adapted for step 2, and six member-checking group interviews (n= 16) were conducted for step 3.ResultsStep 1 engaged qualitative methods to identify and prioritize stakeholder questions, specifically identifying a set of inter-related decisions to promote implementing trauma-informed screening. In step 2, the research team created a presentation to communicate key findings from the simulation model that addressed decisions about programmatic reach, optimal screening thresholds to balance demand for treatment with supply, capacity to start-up and sustain screening, and availability of downstream capacity to provide treatment for those with indicated need. In step 3, member-checking group interviews with stakeholders documented the relevance of the model results to implementation decisions, insight regarding opportunities to improve system performance, and potential to inform conversations regarding anticipated implications of implementation choices.ConclusionsBy embedding simulation modeling in a process of stakeholder engagement, RCSM offers guidance to realize the potential of modeling not only as an analytic strategy, but also as an implementation strategy.

BackgroundUnderstanding the interplay between trauma-related psychological mechanisms and psychotic symptoms may improve the effectiveness of interventions for post-traumatic stress reactions in psychosis. Network theory assumes that mental health problems persist not because of a common latent variable, but from dynamic feedback loops between symptoms, thereby addressing the heterogeneous and overlapping nature of traumagenic and psychotic diagnoses. This is a proof-of-concept study examining interactions between post-traumatic stress symptoms, which were hypothesized to reflect trauma-related psychological mechanisms, and auditory hallucinations and delusions.MethodBaseline data from two randomised controlled trials (N = 216) of trauma-focused therapy in people with post-traumatic stress symptoms (87.5% met diagnostic criteria for PTSD) and psychotic disorder were analysed. Reexperiencing, hyperarousal, avoidance, trauma-related beliefs, auditory hallucinations and delusional beliefs were used to estimate a Gaussian graphical model along with expected node influence and predictability (proportion of explained variance).ResultsTrauma-related beliefs had the largest direct influence on the network and, together with hypervigilance, were implicated in the shortest paths from flashbacks to delusions and auditory hallucinations.ConclusionsThese findings are in contrast to previous research suggesting a central role for re-experiencing, emotional numbing and interpersonal avoidance in psychosis. Trauma-related beliefs were the psychological mechanism most associated with psychotic symptoms, although not all relevant mechanisms were measured. This work demonstrates that investigating multiple putative mediators may clarify which processes are most relevant to trauma-related psychosis. Further research should use network modelling to investigate how the spectrum of traumatic stress reactions play a role in psychotic symptoms.

BackgroundPosttraumatic stress disorder (PTSD) and major depressive disorder (MDD) are commonly reported co-occurring mental health consequences of psychological trauma exposure. The disorders have high genetic overlap. Trauma is a complex phenotype but research suggests that trauma sensitivity has a heritable basis. We investigated whether sensitivity to trauma in those with MDD reflects a similar genetic component in those with PTSD.MethodsGenetic correlations between PTSD and MDD in individuals reporting trauma and MDD in individuals not reporting trauma were estimated, as well as with recurrent MDD and single-episode MDD, using genome-wide association study (GWAS) summary statistics. Genetic correlations were replicated using PTSD data from the Psychiatric Genomics Consortium and the Million Veteran Program. Polygenic risk scores were generated in UK Biobank participants who met the criteria for lifetime MDD (N = 29 471). We investigated whether genetic loading for PTSD was associated with reporting trauma in these individuals.ResultsGenetic loading for PTSD was significantly associated with reporting trauma in individuals with MDD [OR 1.04 (95% CI 1.01–1.07), Empirical-p = 0.02]. PTSD was significantly more genetically correlated with recurrent MDD than with MDD in individuals not reporting trauma (rg differences = ~0.2, p < 0.008). Participants who had experienced recurrent MDD reported significantly higher rates of trauma than participants who had experienced single-episode MDD (χ2 > 166, p < 0.001)ConclusionsOur findings point towards the existence of genetic variants associated with trauma sensitivity that might be shared between PTSD and MDD, although replication with better powered GWAS is needed. Our findings corroborate previous research highlighting trauma exposure as a key risk factor for recurrent MDD.

The evidence regarding the benefits of yoga for treating psychological trauma is well-established; however, there is a paucity of qualitative reviews exploring this topic. The purpose of this rapid review is to gain a deeper understanding of the impact that yoga can have on people with a history of psychological trauma and to reveal barriers and facilitators to the uptake of yoga in this cohort, from a qualitative perspective. The Ovid(EMBASE), Ovid(MEDLINE), PsycINFO, PubMed, and SPORTDiscus databases were searched using key terms. The systematic search generated 148 records, and 11 peer-reviewed articles met the inclusion criteria. The following main impacts of yoga on participants were identified: feeling an increased sense of self-compassion; feeling more centred; developing their coping skills; having a better mind–body relationship; and improving their relationships with others. The main barriers were also identified: concerns initiating yoga; time and motivational issues; and the costs and location of classes. The main facilitator was the feeling of safety generated in the trauma-informed yoga classes. This review suggests that yoga offers great potential in the field of trauma recovery. Despite this, more high-quality research with rigorous methodologies is called for to allow this field to advance.

Based on research from previous pandemics, studies of critical care survivors, and emerging COVID-19 data, we estimate that up to 30% of survivors of severe COVID will develop PTSD. PTSD is frequently undetected across primary and secondary care settings and the psychological needs of survivors may be overshadowed by a focus on physical recovery. Delayed PTSD diagnosis is associated with poor outcomes. There is a clear case for survivors of severe COVID to be systematically screened for PTSD, and those that develop PTSD should receive timely access to evidence-based treatment for PTSD and other mental health problems by multidisciplinary teams., HIGHLIGHTS We anticipate that up to 30% of survivors of severe COVID will develop PTSD, yet PTSD is frequently undetected in primary and secondary care settings.There is, therefore, a clear case for establishing systematic screening and ensuring timely access to treatment.

BACKGROUND: Retrograde amnesia has several causes and may be the core concern in several conditions. When acute, somatic, and neurologic causes are excluded, along with substance use, a consideration of psychiatric disease is imminent. Here, we present a case with amnesia, where diagnostics and treatment were challenging due to severe psychiatric symptoms and course of the disease. CASE REPORT: After a minor trauma while driving an electric scooter, a 41-year-old man lost all memories of the past 20 years. The patient was raised in a refugee camp, where he experienced traumatic events, and later came to Denmark and established family and work life. He had 1 prior contact with the psychiatric ward. After the incident, the patient was brought to the emergency room. The patient could not recognize his wife or children and believed he was 21 years old and living with his mother in the refugee camp. A full somatic and neurological workup was performed and no somatic or organic cause could explain the retrograde amnesia. He developed post-traumatic stress disorder (PTSD) and psychotic symptoms. Treatment consisted of a combination of psychoeducation, cognitive remediation, and medical treatment for psychotic symptoms and PTSD. CONCLUSIONS: The diagnosis “prolonged delirium”, “PTSD”, and “dissociative amnesia” were considered. Psychiatric comorbidity and previous traumatic experiences might have contributed to the development of long-term amnesia, which eventually was considered to be dissociative. During 8 months, the patient slowly regained his memory. It is impossible to conclude with certainty whether the successful outcome was the result of psychological treatment, pharmacological treatment, the passing of time, or a mixture of these.

Experiences of high adversity can lead to a very deep and long-lasting psychological impact. Some events, due to their intensity, severity, extraordinarily negative character and, above all, if they put physical and/or psychological integrity at risk, have a very significant traumatic potential. The evaluation of the psychological impact of a given event is a procedure often requested from forensic psychologists, and it is essential to conduct this evaluation in a very rigorous manner, considering that the traumatic character of a given situation is multidetermined and subjective. The experience of traumatic experiences may lead to the development of a set of symptoms that significantly affect several areas: emotional and affective, cognitive, relational, school/work, reducing functionality and exceeding the person's adaptive resources. In response to traumatic situations, in some cases, a more specific set of symptoms develops, described as Post Traumatic Stress Disorder (PTSD), which is characterized, among other elements, by intrusive thoughts, nightmares, or flashbacks of a past traumatic event, avoidance of stimuli, people, situations, or activities that trigger memories associated with the traumatic event, a constant state of alertness, and sleep disturbances. However, it is possible for an event to have a highly significant traumatic effect, without all the symptoms associated with PTSD being present, and it is therefore fundamental to assess psychological trauma from a broader and deeper perspective, in order to be able to correctly and fairly value the damage suffered. The aim of this presentation is to reflect theoretically on the psychological assessment of the traumatic impact of an event when the diagnostic criteria for PTSD (defined in DSM V) are not met, but there is clinically significant symptomatology due to its intensity, duration, severity and ability to affect various areas of psychological functioning in a relevant way. This discussion will be conducted from two forensic cases: a survivor of a serious assault in traffic and a survivor of an attempted murder (in both cases the father of each of the examinees were fatal victims of these same events, that is, in either case the examinees witnessed the assault on their parents). In both cases the presence of a very deep psychological trauma picture was diagnosed, with very significantly negative psychological impact, namely the presence of debilitating anxious and depressive symptomatology, but without the presence of all the symptoms attributed to PSPT. We discuss the implications of these data for forensic assessment and correct valuation of situations related to psychological trauma and their implications for victim reparation.

Background Geriatric hospital wards are highly medicalised environments with limited opportunities for choice and control, and can be distressing for older survivors of psychological trauma. While trauma-informed models of care (TIC) are effectively applied across mental health and other settings, the utility of these models in aged care settings has not been assessed. The objective of this study was to examine whether TIC can reduce responsive behaviour, chemical restraint, and improve staff skills and patient experiences in inpatient geriatric settings. Methods Four wards participated in this type I hybrid implementation-effectiveness study across southern Adelaide, Australia, including 79 beds. Using a co-design method, the principles of TIC were transformed into an implementation strategy including staff training, establishment of highly trained ‘champions’ on each ward, screening for trauma-related needs, and amending ward policies and procedures. Primary outcomes will be examined using an interrupted time-series design and are monthly incidence of responsive behaviour incidents and use of chemical restraint. Process evaluation will be used to examine secondary, implementation outcomes including the acceptability, feasibility, and fidelity to the implementation strategy. Discussion Trauma-informed care has potential to improve the safety and accessibility of hospital wards for older people who have survived psychologically traumatic events and has an extensive evidence base supporting its effectiveness in other settings. Identifying trauma-related needs and amending care to reduce the risk of re-traumatisation and distress may also reduce the incidence of responsive behaviour change, which has a significant impact on the quality of life of hospital patients and staff and is very costly. The inclusion of a process evaluation will allow us to identify and report changes made on each ward and make recommendations for future implementation efforts.

This pre- and posttreatment study of 22 severely traumatized adult refugees spanned a mean of 6.5 years. Changes in personality functioning, mental health, and well-being were examined using the Rorschach Performance Assessment System, Harvard Trauma Questionnaire, Hopkins Symptom Checklist–25, and the World Health Organization’s Quality of Life–BREF questionnaire. A paired samples t-test revealed significant improvement after psychotherapy in traumatic ideation and initial severe disruptions in thought processes, reality testing, perception, self and other representations, and relational capacity (Cohen’s d = 0.46–0.59). Symptoms of anxiety, depression, and posttraumatic stress were significantly reduced (d = 0.54–0.84), quality of life in the physical health and psychological health domains increased significantly (d = 0.87 and 0.97), and percentage of participants with exile language proficiency and work/study status increased significantly. The findings demonstrate the potential of psychotherapy to contribute to normalizing perceptual, cognitive, and relational capacities in severely traumatized refugees, paramount to well-being and functioning in exile.

This study was conducted during a period of lockdown and ban on social gatherings, including religious gatherings, in Ghana. The restrictions were instituted in response to the COVID-19 pandemic. The purpose of the study was to understand how the well-being of Christian church leaders was impacted during the prohibition in terms of aspects of their vocation and religious practices. Fourteen Christian church leaders located in urban and rural settings in Ghana, with 5 to 32 years of experience, discussed how they and their families were impacted by the ban on religious gatherings in Ghana. Findings revealed negative impacts of the COVID-19 restrictions, including spiritual slacking, loss of fellowship, disruption of normal routine, pandemic anxiety, and financial stress. Positive impacts included increased faith, relief/reduced stress, and increased family time. These findings are discussed from psychological trauma and disaster response perspectives.

Being a cross‐cultural systemic therapist, clinical supervisor, and educator means that culture and language are central to my work They provide a scaffold to develop deeper understanding, increased trust, and connection between myself and my supervisees, students, and clients and facilitate a process for the latter to connect to their own selves and values Given the fear and uncertainty generated by the COVID‐19 pandemic, there exists a pervasive activation of the sympathetic nervous system in the community In this article, I present two case studies as examples of a cross‐cultural/cross‐linguistic approach that facilitates two clients to find a place of comfort and calmness and consequently a balancing activation of the para‐sympathetic nervous system First is a client who, due to the overwhelming pandemic chaos, suddenly exhibited a host of signs and symptoms of a functional neurological nature, which she experienced as a lack of control and disconnection from her body, her primary language, and herself Within a trusted therapeutic relationship that draws on the culture and primary language of the therapist, the client regains connection with language and enhances her ability to communicate and connect with her body Second is an international student who is encouraged to use her culture of origin and primary language to induce calmness, reconnect with herself, and return to the familiar as a ‘known’ collectively inclusive, comforting, and nurturing environment [ABSTRACT FROM AUTHOR] Copyright of Australian & New Zealand Journal of Family Therapy is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission However, users may print, download, or email articles for individual use This abstract may be abridged No warranty is given about the accuracy of the copy Users should refer to the original published version of the material for the full abstract (Copyright applies to all Abstracts )

The Dutch protocol for Eye Movement Desensitization and Reprocessing (EMDR) uses two psychological myths as part of the therapeutic instruction: memory works as a video camera and individuals can have a photographic memory. This study explored how participants experience and evaluate such instructions and if these instructions affect their beliefs on memory. Participants received a video, photo, or a control instruction. Participants indicated on a visual analog scale how vivid and emotional they expected to recall the traumatic memory, how credible the therapeutic instruction was, and how reliable they would consider a therapist providing such an instruction. Next, participants completed a memory belief survey. Participants who received the video instruction were most likely to expect to vividly recall a memory. The credibility of the instructions and the reliability of the therapist providing the instruction were at chance level, which might pose problems for the therapeutic alliance and therapy outcome. ispartof: JOURNAL OF PSYCHOLOGY vol:155 issue:2 pages:129-139 ispartof: location:United States status: published

Aim: The aim of the study was to study the association of childhood psychological trauma with eating disorders (EDs) and to assess and compare the relationship with food, concerns about weight gain, and restrictive or compensatory practices in male and female undergraduate medical students. Materials and Methods: A cross-sectional, analytical study was performed in a Tertiary Care Medical College and Research Hospital in a suburban area of India. After obtaining ethical clearance, 100 final-year undergraduate students were included in the study with their informed consent. Self-made questionnaire, Childhood Trauma Questionnaire, Stirling ED Scale with Disordered Eating Attitude Scale were used. Spearman's correlation coefficient (Rho) was calculated. Results: There was a significant correlation of history of childhood psychological trauma in the form of emotional abuse, emotional neglect or physical abuse and physical neglect with higher prevalence of disordered eating behaviors and relationship with food, concern about weight gain, and compensatory practices. No significant relationship was found in a history of sexual abuse. Conclusion: The importance of a healthy psychosocial upbringing and nurturing by parents to prevent development of psychiatric comorbidities is an important finding in this study.

Narratives of autobiographical memories may be impaired by adverse childhood experiences, generating narrative fragmentation and increased levels of perceived distress. Eye movement desensitization and reprocessing (EMDR) proved to be an effective treatment to overcome traumatic experiences and to promote coherent autobiographical narratives. However, the specific mechanisms by which EMDR promotes narrative coherence remains largely unknown. We conducted a randomized controlled pilot trial (ClinicalTrials.gov Identifier NCT05319002) in a non-clinical sample of 27 children recruited in a primary school. Participants were randomly assigned to the experimental and control groups. The experimental group underwent a three-week group EMDR intervention. Subjective unit of distress (SUD), validity of cognition (VoC), classification of autobiographical memories, narrative complexity and specificity were assessed before and after the group EMDR intervention. The group EMDR intervention was able to improve SUD and VoC scales, narrative complexity and specificity, and promoted the classification of autobiographical memories as relational. The path analysis showed that SUD was able to predict VoC and narrative specificity, which, in turn, was able to predict both narrative complexity and the classification of autobiographical memories as relational. Machine-learning analysis showed that random tree classifier outperformed all other models by achieving a 93.33% accuracy. Clinical implications are discussed.

Addressing the mental health needs of healthcare staff exposed to psychologically traumatic events at work during the COVID-19 pandemic is a pressing global priority. We need to swiftly develop interventions to target the psychological consequences (e.g., persistent intrusive memories of trauma). Interventions for healthcare staff must be brief, flexible, fitted around the reality and demands of working life under the pandemic, and repeatable during ongoing/further trauma exposure. Intervention delivery during the pandemic should be remote to mitigate risk of infection; e.g., here using a blend of digitalized self-administered materials (e.g., video instructions) and guided (remote) support from a researcher. This parallel groups, two-arm, randomised controlled trial (RCT) with healthcare staff working during the COVID-19 pandemic is the first evaluation of whether a digitalized form of a brief cognitive task intervention, which is remotely-delivered (guided), reduces intrusive memories. Healthcare staff (target N = 130 completers) who experience intrusive memories of work-related traumatic event(s) during the COVID-19 pandemic (≥2 in the week before inclusion) will be randomly allocated (1:1) to receive either the cognitive task intervention or an active (attention placebo) control, and followed up at 1-week, 1-month, 3-months, and 6-months post-intervention. The primary outcome will be the number of intrusive memories reported during Week 5; secondary and other outcomes include the number of intrusive memories reported during Week 1, and other intrusive symptoms. Findings will inform further development and dissemination of a brief cognitive task intervention to target intrusive memories.

Trauma survivors may see images of monsters in nightmares and visions when experiencing posttraumatic stress. However, there has been little commentary on the significance and meaning of this imagery and the wider relationship between monster imagery and posttraumatic stress. Applying an integrated experiential-processing approach to working with trauma in Counselling and Psychotherapy, emphasis is placed on facilitating ‘processing’ or making sense of the trauma, psychologically, emotionally, existentially and culturally. Examining the interplay of these elements, this paper explores monsters as symbol and metaphor for unspoken or unprocessed personal and cultural trauma, vessels for symbolically representing underlying, unacknowledged fears and experience. This paper discusses how encounters with the monster onscreen, in mental imagery or metaphor, may be allegorical to the individual’s internal struggle with post-traumatic stress. The model presented is applied within an analysis of the symbolic representation of the trauma of cancer, cancer treatment and traumatic loss in survival horror movie The Shallows (Collet-Serra (dir) (2016). The Shallows. Columbia Pictures). Jungian ideas are integrated to consider monsters as emergent symbolisation of unspoken ‘shadow’ fears, such as those surrounding cancer. In an experiential-processing account of trauma, incongruence between self-concept (our beliefs about self and world) and our actual experience of traumatic events is viewed as a source of psychological distress, prompting a breakdown and reorganisation of the self-structure. It is proposed that trauma experience confronts us with our mortality and fragility, bringing us into contact with the sense of ‘abject’ horror represented by monster imagery. Creeds (2007. The monstrous feminine: film, feminism, psychoanalysis. Routledge, London and New York) description of the abject as the ‘place where meaning collapses’ is applied to an understanding of psychological trauma, given that encounters with existential threats may render the everyday meaningless, engendering a need for meaning-making. Monster imagery psychologically represents the collapsing border between our ideas about self and world, and the destabilising experience of the shattering of pre-trauma assumptions. In this account monsters are located within a wider, adaptive evolutionary drive towards the reduction of trauma-related psychological distress, through symbolising experience into awareness for processing and meaning making. In this way monsters may play a complex role in a human struggle to come to terms with overwhelming events.

The coexistence of humans and dogs, in addition to all positive effects, can result in negative effects on human health. A particular risk is posed by a population of stray dogs, that is, dogs without owners and veterinary supervision. A contact with dogs in addition to bites, carries the risk of viral, bacterial and parasitic zoonoses, and can also cause psychological trauma. Children, the elderly and pregnant women are the categories most susceptible to the negative effects of dogs. The aim of the paper was to make an interdisciplinary analysis of the negative effects of dogs on humans. Dog bites cause wounds and dysfunction of damaged tissue, and often lead to various infections. The risks of rabies and tetanus are particularly significant if proper and timely treatment is not performed. Ongoing training for dog owners can significantly reduce the number of bites inflicted by owned dogs, but stray dogs remain a serious social problem and pose potential health risks of some zoonosis. Timely and adequate management of bite wounds and the use of rabies-post-exposure prophylaxis as well as psycho-therapy, where indicated, significantly reduce possible adverse health effects for patients who have been bitten by dogs.

Background Black men who have sex with men (MSM) are disproportionately affected by HIV compared to almost every other demographic group in the country and have worse outcomes along the care continuum. Diagnosis is a critical juncture. This study aims to explore the impact and meaning of an HIV diagnosis for Black MSM, and how this has changed over time, both for the individual’s experience living with HIV as well as for Black MSM in general. Methods From 2017 to 2018, we conducted in-depth interviews with 16 black MSM living with HIV in New York City diagnosed between 1985 and 2016. Results Inductive analysis of the qualitative data allowed three major themes to emerge: diagnosis trauma, lack of patient -centeredness in the healthcare system, and acceptance of HIV diagnosis over time. Conclusions This small pilot study signals that an HIV diagnosis experience possibly remains traumatic for black MSM even in the era of highly effective ART, and they often perceive a lack of patient-centeredness in the delivery of a new diagnosis. This has persisted over time. In most cases, black MSM in our sample overcame this trauma due to self-motivation, social support and seeking out and fostering trusting relationships with their HIV provider and the healthcare system.

Introduction Childhood trauma has been suggested to be involved in susceptibility to bipolar disorder (BP). However, it remains unclear whether the occurrence of childhood trauma is differently distributed in subthreshold bipolar disorder (SBP). Objective To assess childhood trauma in young adults with SBP, as compared to young adults with BP and population controls (PC). Method This was a cross-sectional, population-based study. The Mini International Neuropsychiatric Interview (MINI) was used to define the groups with BP (subjects with a lifetime or current manic episode or lifetime or current hypomania with a history of a depressive episode), SBP (subjects with a history of hypomanic episode without lifetime or current depressive episode), and subjects without mood disorders (PC). Childhood trauma was assessed using de Childhood Trauma Questionnaire (CTQ). We investigated differences regarding childhood trauma across the three groups (BP, SBP and PC). Result Except for sexual abuse, all subtypes of childhood trauma remained associated with the BP group as compared to PC. Additionally, when we compared SBP and BP, significant differences were found only for emotional abuse. No significant differences were found in relation to childhood trauma between the SBP and PC groups after adjusting for confounding factors. Conclusion These findings suggest that investigating childhood trauma, with a particular focus on emotional abuse, could be considered a preventive measure and potentially improve the prognosis.

The consumption of Islamic products has been discussed quite extensively in many studies, yet the opposite case which is the dissociation from Islamic products is rarely discussed. This study aims to investigate the phenomena in which Muslim women who were raised with conservative values at home countries choose to dissociate from hijab when they live in the western countries. Moreover, they become activists who discourage other Muslim women from wearing hijab. This study adopts a phenomenological research design. The results suggest that hijab dissociation is a form of compensatory mechanism aimed at minimizing self-discrepancy, restoring self-esteem, gaining personal control, reducing perceived alienation and coping with psychological trauma. This study contributes to the theoretical gap in compensatory consumption literature by linking the theory with the non-consumption of religious products.

Empirical research spanning the past three decades has consistently upheld that traumatic experiences are prevalent (Gold, Psychological Trauma Theory Research Practice and Policy, S(1), 114-124, 2008; Kilpatrick et al. Journal of Traumatic Stress, 26(5), 537-547, 2013; Resnick, Kilpatrick, Dansky, Saunders, & Best Journal of Clinical and Consulting Psychology, 61(6), 984-991, 1993). Therefore, the likelihood of encountering an individual who has experienced significant trauma within forensic settings is high (Dalenberg, Straus, & Ardill, 2017). Further, forensic psychologists are frequently called upon to assess the impact of such traumatic events and to opine about their connection to a specific psycho-legal issue such as damages in a civil case or the presence of extreme emotional disturbance or mitigating factors in criminal matters. Childhood trauma that has occurred repeatedly and cumulatively, particularly within the context of family relationships, has been referred to as complex trauma. Complex trauma has been shown to result in significant difficulties in a broad range of capabilities such as affect regulation, dissociation, identity development, relational capacities, and somatic distress (Courtois and Ford 2009). The author delineates core ethical principles and challenges encountered in forensic assessment both generally and more specifically in the forensic assessment of complex trauma and dissociation. She also details practical strategies for responding to those challenges. In addition, the author identifies essential skills needed for competency in this arena and outlines professional considerations that arise when working with this population.

Background PTSD is a chronic condition with high rates of comorbidity, but current treatment options are limited and not always effective. One novel approach is MDMA-assisted psychotherapy for people diagnosed with treatment-resistant PTSD, where MDMA is used as a catalyst to facilitate trauma processing during psychotherapy. The aim was to review all current research into MDMA-assisted psychotherapy for PTSD. Methods Articles were identified through PubMed and Science Direct for items published up to 31st March 2019 using terms “treatments for PTSD”, “drug treatments for PTSD”, “MDMA”, “MDMA pathway”, “MDMA-assisted psychotherapy” and “MDMA-assisted psychotherapy for PTSD”. Articles were identified through Google Scholar and subject-specific websites. Articles and relevant references cited in those articles were reviewed. Results Small-scale studies have shown reduced psychological trauma, however there has been widespread misunderstanding of the aims and implications of this work, most commonly the notion that MDMA is a ‘treatment for PTSD’, which to date has not been researched. This has harmful consequences, namely dangerous media reporting and impeding research progression in an already controversial field. Conclusions MDMA-assisted psychotherapy may help people who have experienced psychological trauma and who have not been able to resolve their problems through existing treatments, however more research is needed. If this is to get appropriate research attention, we must report this accurately and objectively.

We present two datasets from a project about the relationship between traumatic life experiences and religiosity. These include data from 1,754 individuals in the United States (n = 322), Brazil (n = 205), China (n = 202), India (n = 205), Indonesia (n = 205), Russia (n = 205), Thailand (n = 205), and Turkey (n = 205). Surveys were consistent across samples: they include measures of traumatic life experiences, negative affective traits, existential security, life satisfaction, death anxiety, and various religious beliefs, attitudes, and behaviours. Psychometric evaluations of measures of supernatural belief and death anxiety were conducted., Measurement(s)response to trauma exposure • religiosityTechnology Type(s)survey methodFactor Type(s)sex • age • ethnicity • marital status • employment status • socioeconomic statusSample Characteristic - OrganismHomo sapiensSample Characteristic - LocationUnited States of America • Brazil • China • India • Indonesia • Russia • Thailand • Turkey Machine-accessible metadata file describing the reported data: 10.6084/m9.figshare.12173592

Psychological trauma is a silent epidemic which presents as a global public health issue, often in the form of post-traumatic stress disorder (PTSD). Eye Movement Desensitisation and Reprocessing (EMDR) Therapy is an empirically supported treatment intervention for PTSD and has been used as part of trauma-capacity building, particularly in low- and middle-income countries (LMIC). For some survivor’s, their trauma experiences cannot be spoken of: they may be alluded to, suggested and though not directly expressed. There are several factors as to why these implicit trauma experiences are ‘unspoken’, for example, when the trauma involves a deep-rooted sense of shame or guilt, a distorted sense of over-responsibility or when to speak of the trauma engenders fear of retribution, reprisal and consequence. This paper will explore the effectiveness of using two protocol variations of EMDR Therapy—standard versus a ‘Blind 2 Therapist’ protocol version as part of a quasi-experimental study which took place in Northern Iraq. The study contains two projects and subsequently tested several hypotheses regarding safety, effectiveness, efficiency and relevance of the ‘Blind 2 Therapist’ protocol within EMDR Therapy. Results indicated support for the B2T protocol intervention with various trauma populations including Yezidi survivors of Islamic State of Iraq and the Levant (ISIL)—also known as Daesh.

Background Paediatric burns are highly painful and traumatising injuries that are overrepresented among Aboriginal and Torres Strait Islander people. Paediatric burn patients’ pain remains poorly managed by pharmacological interventions, leading to increased anxiety, distress, and trauma in patients and their caregivers. Non-pharmacological psychosocial interventions have been suggested as effective in reducing pain and psychological morbidities among paediatric burn patients and their caregivers; however, their degree of effectiveness and appropriateness for Aboriginal and Torres Strait Islander people is unclear. Methods A non-date restricted systematic review was conducted through four databases. Studies published in English assessing psychosocial interventions on paediatric burn patients’ physical pain along with theirs and/or their caregiver’s anxiety, distress, or trauma symptoms were identified and included in this review. Included studies were assessed for their ability to reduce one of the outcomes of interests and for their reflection of Aboriginal and Torres Strait Islander peoples’ perspectives of health. Results Of the 3178 identified references, 17 were eligible. These include distraction based techniques (n = 8), hypnosis/familiar imagery (n = 2), therapeutic approaches (n = 4), and patient preparation/procedural control (n = 3). Distraction techniques incorporating procedural preparation reduced pain, while discharge preparation and increased ‘patient control’ reduced patient and caregiver anxiety; and internet based Cognitive Behaviour Therapy reduced short-term but not long-term post-traumatic stress symptoms. No interventions reflected Aboriginal and Torres Strait Islander peoples’ perspectives of health; and few targeted caregivers or focused on reducing their symptoms. Conclusions The development and assessment of psychosocial interventions to appropriately meet the needs of Aboriginal and Torres Strait Islander paediatric burn patients is required.

Vitiligo is a common form of localized depigmentation. It is an acquired hypomelanotic condition resulting from the progressive loss of melanocytes. It is characterized by milky white macules. It can be associated with tremendous psychological trauma. A number of medical treatment options exist in the armamentarium of a dermatologist treating vitiligo. However, a significant number of lesions of vitiligo either fail to respond to medical therapy or respond with incomplete repigmentation. Such lesions are considered appropriate for surgical management. Surgical management has provided a very good tool to the management of refractory cases of vitiligo. Hence, in this article, we emphasize on vitiligo and vitiligo surgery.

Childhood adversity increases the risk of developing psychiatric symptoms later in life. However, the neuro-biological mechanisms underlying this association are unknown. This paper reviews the current literature regarding structural and functional alterations in the hippocampus and amygdala following childhood adversity, ultimately converging into a model that proposes impaired 'pattern separation' as an important underlying mechanism associated with risk or resilience for psychopathology through increased fear generalization. In the present model, decreased DG/CA3 activity and amygdala hyper-reactivity are considered to be a consequence of childhood adversity, which in turn may result in impaired pattern separation of emotional information. Impaired pattern separation is hypothesized to result in increased fear generalization, threat anticipation, and social threat interpretation, thus increasing risk for later affective, anxiety and psychotic symptoms. The proposed model provides testable hypotheses for future studies and stresses the need to stratify according to childhood adversity as an etiological factor.

Background: Domestic violence was identified as a major contributor to the global burden of ill health in terms of female morbidity leading to psychological trauma and depression, injuries, sexually transmitted diseases, suicide, and murder. Aims: The study was conducted to find out the prevalence of different types of lifetime domestic violence against women, factors associated with it, and care-seeking behavior. Settings and Design: An observational cross-sectional study conducted at a slum of Burdwan district of West Bengal, India. Methods and Material: Study was done among 320 ever-married women of 15–49 years of age using a predesigned pretested proforma from March 2019 to December 2019 by face-to-face interview. Statistical Analysis Used: Data were compiled and analyzed by EpiInfo 6 and SPSS 20 version. Results and Conclusions: The overall prevalence of any form of violence during the lifetime among the study population was 35.63%. Verbal/psychological violence was the most common form of domestic violence (91.23%) followed by physical (82.46%) and sexual violence (64.91%). Slapping and/or beating, kicking, and object throwing were the major forms of physical violence; humiliation (88.46%) was the commonest form of psychological violence and most common form of sexual violence was forced sexual intercourse (51.35%). About 20% of the study population faced violence every day. Older age, lower age at marriage, longer duration of marriage, lower education of husband and wife, lower family income, unemployment of the husband, and alcohol consumption of husband were associated with the occurrence of domestic violence. We have found that the prevalence of domestic violence in this group of population is high. The alarming issue is that approximately one-third of women (32.46%) who faced violence in their lifetime had never sought any help. The findings indicate to develop appropriate and culturally relevant public health interventions to increase awareness.

In sub-Saharan Africa, the increase in pornographic video consumption over the past 15 years might be shaping the sexual practices of the new generation. Using a comprehensive approach, the present study aims to first, measure the prevalence of acts of violence during sex reportedly inspired by pornography (VDSIP) among Mozambican adolescents and young adults; second, examine the consequences of these practices on the individuals involved; and third, identify the cognitive and psychosocial mechanisms by which these practices are adopted and normalized. Overall, 105 Mozambicans were interviewed. Participants’ responses were subjected to discourse content and frequency analysis. The results show that, in the 12 months preceding the interview, between 77.6% and 89.2% of male participants performed VDSIP that included inflicting physical or psychological violence on their partners. In the same period, between 8.5% and 16.8% of female participants performed VDSIP that included inflicting physical or psychological violence on their partners. Females (63.1% of them) were shown to be much more affected by the negative consequences (e.g., depression, low self-esteem, physical and psychological trauma) associated with the practice of VDSIP compared to males (17.7% of them). The main mechanisms by which these practices are adopted and normalized were reported to be imitation, reinforcement, desire for recognition, addiction, development of sexual scripts, misunderstanding about women’s sexual desire, gender inequalities, cognitive and psychosocial biases, and manipulation of the partner’ consent. This study’s findings can be used to design tailored education interventions to mitigate the negative effects of violence during sex among African adolescents and young adults.

During the thirty-year period (1968-1998) known as the Troubles in Northern Ireland, 3500 people died and thousands more suffered physical disabilities and psychological trauma. Belfast, among other conflict cities, inspired the term ‘dark tourism’ in 1989. The country continues to be in conflict but is officially in a period of peace. Northern Ireland has been the theme for much peace and reconciliation research, but literature to date concentrates on polarised discourses rather than rural representation. Toward meeting and expanding the UN SDG16 peace goals, this research explores how what we term emotive peace tourism can be used as a methodology to affect emotional reconciliation registers in a unique rural Northern Ireland visitor experience. Bringing domestic tourists from Catholic and Protestant communities into face-to-face contact through a liminal participative ‘out-of-place’ visitor experience, we choreographed and performed a series of “Troubles” events: a guided night walk through a checkpoint, an IRA Wake, a UDA Funeral, and a Mixed-Marriage. Contributing to the debate as to whether tourism is more of a ‘peacekeeper’ than a ‘peacemaker’, our research demonstrates that an in situ liminal, emotive peace tourism experience, can generate sustainable tolerance, respect, trust, sympathy, and empathy towards others in post-conflict Northern Ireland.

Physical and sexual abuse during childhood can have long lasting consequences such as posttraumatic stress disorder (PTSD). Prolonged Exposure (PE) is an established and effective guideline treatment for PTSD. Nevertheless, a considerable number of patients drop out from treatment or do not (completely) recover from PTSD during PE. It has been suggested that patients with PTSD resulting from childhood abuse are specifically at risk for suboptimal treatment outcomes. We carried out a randomized controlled trial with 149 patients with childhood abuse-related PTSD comparing PE with two innovations: intensified PE (iPE) and skills training in affective and interpersonal regulation followed by PE (STAIR+PE). We found that all treatments were safe and resulted in large improvements in PTSD symptoms. iPE and STAIR+PE did not improve treatment outcomes of PE, although iPE led to faster symptom improvements. Not all patients benefitted from the allocated treatment, but we found no contra-indications for the treatments. We found that a combination of patient characteristics was predictive of a larger effect size of PTSD symptom improvement in PE and iPE or STAIR+PE. We conclude that the three forms of exposure therapy were effective treatments for patients with childhood abuse-related PTSD.

MA (Industrial and Organisational Psychology), North-West University, Potchefstroom Campus It is undeniable that certain occupational environments are more susceptible to traumatic incidents than others. The policing sector is one such agency, where exposure to traumatic incidents is an inherent part of the job. Exposure to such incidents lead to members in the policing sector experiencing psychological trauma. Psychological trauma is a prevalent mental-health challenge in the policing sector globally. This includes the South African Police Services (SAPS). This is why it becomes highly important for psychological trauma management programmes to be put in place to assist with managing the adverse aftermaths of traumatic incidents. More especially in a country as crime-ridden as South Africa. The SAPS has over the years adopted various psychological trauma interventions to support its members to better manage how they respond to traumatic events. The main objective of this study was to explore the experience of helping professions’ regarding the psychological trauma management programmes of the SAPS. This study employed a qualitative research design with a social constructivist/interpretivist paradigm. Data were collected from a population group that was sampled by means of purposive sampling (N=16). The participants were helping professionals from Employee Health and Wellness (EHW) that had more than a year’s experience working with psychological trauma management programmes. The data were collected by conducting semi-structured telephonic interviews. Thereafter it was analysed by applying thematic analysis. The findings of this study indicated that participants consider the psychological debriefing model outdated and that it needs redevelopment to enhance its effectiveness. Much focus also needs to be placed on putting programmes and policies in place to assist EHW professionals with the secondary trauma they incur whilst implementing psychological trauma management programmes such as debriefing. Participants also indicated that they do find the psychological trauma management programmes educational and helpful. Recommendations were also made for future research and practice. Masters

The clinical heterogeneity of dissociation constitutes a challenge to the culture-sensitive clinician. Variability in experiencing dissociation, the interplay between acute and chronic conditions, and the predominance of a nosologically interface-type of clinical surface conceal core dissociative symptoms. While the latter (amnesia, depersonalization, dere-alization, identity confusion, and identity alteration) usually remain underreported, the clinical surface may be dominated by acute (functional neurological symptoms, brief psy-chosis, an experience of possession, or acute dissociative reaction to a stressful event) or chronic (mood and personality disorders) secondary syndromes. However, these syn-dromes also constitute gateways in pursuing the clues of core dissociation. Given that culture influences communication between clinician and patient, accurate expression of mental content requires the idiomatic armamentarium describing the experience. The latter is problematic in dealing with phenomena of core dissociation while the second-ary representations have a relatively universal character for both clinicians and patients. Nevertheless, this approach requires a transdiagnostic understanding in conceiving this clinical interface. This interface reflects, in fact, complications of dissociative disorders which require to be addressed in the first line. This is either due to the medical and psychi-atric urgency (e.g., functional neurological symptoms, brief psychosis) or due to resistance to treatment (e.g., antidepressant pharmacotherapy) which seem to be indicated for the particular condition. This transdiagnostic schema is based on a combined utilization of etic and emic principles in the cultural understanding of psychiatric disorders. Namely, universal medical-psychiatric categories are conceived as tools of communication and mutual understanding rather than being mere appearances or primary disturbances., NA

Both environmental (e.g. interpersonal traumatization during childhood and adolescence) and genetic factors may contribute to the development of Borderline Personality Disorder (BPD). Twin studies assessing borderline personality symptoms/features in the general population indicate that genetic factors underlying these symptoms/features are shared in part with the personality traits of the Five Factor Model (FFM) of personality—the “Big Five”. In the present study, the genetic overlap of BPD with the Big Five -Openness to Experience, Conscientiousness, Extraversion, Agreeableness, and Neuroticism- was assessed. Linkage disequilibrium score regression was used to calculate genetic correlations between a genome-wide association study (GWAS) in central European populations on BPD (N = 2543) and GWAS on the Big Five (N = 76,551–122,886, Neuroticism N = 390,278). Polygenic scores (PGS) were calculated to test the association of the genetic disposition for the personality traits with BPD case-control status. Significant positive genetic correlations of BPD were found with Neuroticism (rg = 0.34, p = 6.3*10−5) and Openness (rg = 0.24, p = 0.036), but not with the other personality traits (all | rg | p > 0.30). A cluster and item-level analysis showed positive genetic correlations of BPD with the Neuroticism clusters “Depressed Affect” and “Worry”, and with a broad range of Neuroticism items (N = 348,219–376,352). PGS analyses confirmed the genetic correlations, and found an independent contribution of the personality traits to BPD risk. The observed associations indicate a partially shared genetic background of BPD and the personality traits Neuroticism and Openness. Larger GWAS of BPD and the “Big Five” are needed to further explore the role of personality traits in the etiology of BPD.

BackgroundPost-traumatic stress disorder (PTSD) is an established comorbidity in Bipolar Disorder (BD), but little is known about the characteristics of psychological trauma beyond a PTSD diagnosis and differences in trauma symptoms between BD-I and BD-II.Objective(1) To present characteristics of a trauma-exposed BD sample; (2) to investigate prevalence and trauma symptom profile across BD-I and BD-II; (3) to assess the impact of a lifetime PTSD diagnosis vs. a history of trauma on BD course; and (4) to research the impacts of sexual and physical abuse.MethodsThis multi-center study comprised 79 adult participants with BD with a history of psychological trauma and reports baseline data from a trial registered in Clinical Trials (https://clinicaltrials.gov; ref: NCT02634372). Clinical variables were gathered through clinical interview, validated scales and a review of case notes.ResultsThe majority (80.8%) of our sample had experienced a relevant stressful life event prior to onset of BD, over half of our sample 51.9% had a lifetime diagnosis of PTSD according to the Clinician Administered PTSD scale. The mean Impact of Event Scale-Revised scores indicated high levels of trauma-related distress across the sample, including clinical symptoms in the PTSD group and subsyndromal symptoms in the non-PTSD group. Levels of dissociation were not higher than normative values for BD. A PTSD diagnosis (vs. a history of trauma) was associated with psychotic symptoms [2(1) = 5.404, p = 0.02] but not with other indicators of BD clinical severity. There was no significant difference between BD-I and BD-II in terms of lifetime PTSD diagnosis or trauma symptom profile. Sexual abuse significantly predicted rapid cycling [2(1) = 4.15, p = 0.042], while physical abuse was not significantly associated with any clinical indicator of severity.ConclusionTrauma load in BD is marked with a lack of difference in trauma profile between BD-I and BD-II. Although PTSD and sexual abuse may have a negative impact on BD course, in many indicators of BD severity there is no significant difference between PTSD and subsyndromal trauma symptoms. Our results support further research to clarify the role of subsyndromic PTSD symptoms, and highlight the importance of screening for trauma in BD patients.

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 p p p p = 0.001). Conclusions A high proportion of patients with depression and emotional blunting self-reported exposure to childhood and/or recent traumatic events, and emotional blunting was more severe in patients who reported having experienced severe trauma. However, history of psychological trauma in patients with MDD appeared to be under-recognized by HCPs. Improved recognition of patients who have experienced psychological trauma and are experiencing emotional blunting may permit more targeted therapeutic interventions, potentially resulting in improved treatment outcomes.

Refugee children in the Nordic countries have been reported to perform poorly in school and carry a high burden of familial posttraumatic stress. The present study aimed to investigate the impact of maternal and paternal posttraumatic stress on the school performance of refugee children. We used national register data on school grades at age 15-16 along with demographic and migration indicators during 2011-2017 in a population of 18,831 children in refugee families in Stockholm County, Sweden. Parental posttraumatic stress was identified in regional data from three levels of care, including a tertiary treatment center for victims of torture and war. Multivariable linear and logistic regression models were fitted to analyze (a) mean grade point averages as Z scores and (b) eligibility for upper secondary school. In fully adjusted models, children exposed to paternal posttraumatic stress had a lower mean grade point average, SD = -0.14, 95% CI [-0.22, -0.07], and higher odds of not being eligible for upper secondary education, OR = 1.37, 95% CI [1.14, 1.65]. Maternal posttraumatic stress had a similar crude effect on school performance, SD = -0.15, 95% CI [-0.22, -0.07], OR = 1.25, 95% CI [1.00, 1.55], which was attenuated after adjusting for single-parent households and the use of child psychiatric services. The effects were similar for boys and girls as well as for different levels of care. Parental posttraumatic stress had a small negative effect on school performance in refugee children, adding to the intergenerational consequences of psychological trauma.

The COVID-19 pandemic, which has affected a significant number of individuals worldwide, is generating serious mental health issues. Recovered COVID-19 patients have experienced traumatic events related to their symptoms, isolation, possible hospitalization, bereavement, fear of infecting loved ones and the physical consequences of COVID-19. One effective psychological treatment for these patients is Eye Movement Desensitization and Reprocessing (EMDR). The aim of this paper is to describe the therapeutic intervention and effects of EMDR in a pool of COVID-19 survivors referred to an integrated psychological/psychiatric outpatient service. Twelve patients, comprising of nine males and three females, underwent EMDR psychotherapy from October 2020 to February 2022. Each patient received 8-16 weekly treatment sessions. The standard EMDR protocol of eight stages was administered to enable desensitization and reprocessing of four main targets: first positive swab, hospitalization, isolation and fear for relatives' health. Efficacy of EMDR was demonstrated by the significant improvement at clinical scale for subjective distress caused by traumatic events. For the therapists, carrying out these treatments was an intense and challenging experience. In fact, the perceived distance between therapist and patient was less defined than in other hospital settings because the pandemic affects everyone equally. However, with the widespread availability of vaccines and although the pandemic is still ongoing with the emergence of new variants, a window of improvement in the mental health landscape is starting to open up.

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.

Objective: This study aimed to identify vulnerability and protective factors for suicidal histories among adults experiencing psychological trauma.\ud \ud Method: Adults seeking treatment for psychological trauma (N = 113) completed self-report questionnaires measuring childhood trauma history, self-concept, relational functioning, emotion regulation, living arrangements, employment status, marital status, and suicidal history. Independent samples t-tests were used to determine variables on which those with and without suicidal histories differed significantly. These variables were then entered into a binary logistic regression model to identify factors which independently distinguished between those with and without a suicidal history.\ud \ud Results: Univariate differences were found for childhood emotional abuse (CEA), childhood emotional neglect (CEN), emotion deactivation, and employment status, with those in the suicidal history group scoring higher on all of these. CEA (OR = 1.13, 95% CI = 1.01–1.27) and employment status (OR = 4.12, 95% CI = 1.23–13.73) remained significant predictors of suicidal status in the multivariable logistic regression.\ud \ud Conclusions: CEA was an independent vulnerability factor for suicidal risk, highlighting the need for clinicians to assess exposure to such trauma in those presenting with proximal traumatic experiences. Being in employment was an independent protective factor against suicidal risk, highlighting the importance of social buffers or networks when faced with traumatic situations.

Background:COVID-19 causes immense psychological pressure on communities in addition to physical misery. There is currently a scarcity of data on the psychological impact of the COVID-19 epidemic on Ethiopian healthcare workers (HCWs). Therefore, this study was aimed to assess the post-traumatic stress disorder (PTSD) symptoms and its predictors following COVID-19 pandemic among healthcare workers (HCWs) in southern Ethiopia.Methods:A hospital based cross-sectional study design was used among 387 randomly selected HCWs between September 25 and October 25, 2020 at four selected public hospitals in Sidama National Regional State, southern Ethiopia. Impact of Event Scale-Revised (IES-R) was used to collect data post-traumatic stress disorder (PTSD) symptoms. Logistic regression analyses with 95% CI were used to examine the relationship between independent and outcome variables.Result:The prevalence of PTSD symptoms was found in 56.8% of participants. Significant factors that increase risk of PTSD symptoms were being female (AOR = 1.91, 95% CI = 1.19, 3.05), married (AOR = 1.87, 95% CI = 1.12, 3.14) and nurses (AOR = 3.31, 95% CI = 1.66, 6.63). On the other hand, HCWs working other than emergency unit such as inpatients/wards (AOR = 0.43, 95% CI = 0.24, 0.75), OPD (AOR = 0.48, 95% CI = 0.24, 0.97) and other units (AOR = 0.49, 95% CI = 0.25, 0.96) less likely to be affected by PTSD symptoms.Conclusion:The current study showed high levels of PTSD symptoms as psychological challenges for HCWs. Sex, age, marital status, type of profession and working environment were significant factors for PTSD symptoms in HCWs during the pandemic. HCWs require mental health support during and after the pandemic.

COVID-19 has created a general state of worry and distress, especially among vulnerable groups such as those with psychiatric diagnoses. Worldwide, psychiatric care provision has drastically suffered during the pandemic, with many patients unable to access proper care, which may have implications for increased mental health consequences in patients with psychiatric disorders (e.g., relapse and suicide). This cross-sectional study used structural equation modeling to investigate COVID-19-related trauma and distress among Arab psychiatric population during COVID-19 quarantine. Patients with pre-existing psychiatric disorders (N = 168) completed an online survey that comprised the Depression Anxiety Stress Scale 21 (DASS-21), the Impact of Event Scale-Revised (IES-R), and a questionnaire on COVID-19-related attitudes/perceptions, sources of information, used protective measures, and socio-demographic information. Respondents commonly reported feeling down-hearted/blue, trouble concentrating, along with symptoms of avoidance and rumination related to the pandemic. Patients with depression and sleep disorders expressed higher COVID-19-related trauma than patients with other disorders. Perceived physical health mediated the effect of co-morbid chronic physical disorders on COVID-19 trauma, psychological distress, perceived vulnerability to COVID-19, and perceived likelihood of recovery in case of contracting COVID-19. Perceived physical health and perceived vulnerability to COVID-19 were strong direct predictors of COVID-19-related trauma and psychological distress. Staying at home negatively predicted COVID-19 trauma and exerted an indirect negative effect on psychological distress via COVID-19 trauma. COVID-19 trauma, age, and marital status directly predicted psychological distress, with COVID-19 trauma being the strongest predictor. Educational level, income, having family members working in the medical field, keeping up to date with the news on deaths/infected cases or the development of COVID-19 drugs or vaccines, satisfaction with available information on COVID-19, and using different protective measures were not associated with significant differences in COVID-19 trauma and psychological distress scores. Immuno-psychiatric interventions should be designed to target COVID-19-trauma and distress among younger single patients with perceived poor physical health, especially those diagnosed with depression and sleep disorders.

Objective Psychological trauma (e.g., abuse, neglect) and posttraumatic stress symptoms (PTSS) commonly occur in pediatric pain populations and may be related to various maladaptive coping strategies, which may in turn affect short- and long-term pain-related outcomes in youth. Accordingly, the current scoping review and conceptual framework seeks to identify important gaps in the field’s current understanding of how coping impacts outcomes in youth who have experienced trauma/PTSS and pediatric chronic pain and explores avenues for future investigation. Methods A scoping review of the literature was performed in Medline, Embase, Cochrane Library, PsycInfo, and Sociological Abstracts. Eligibility criteria included pediatric populations experiencing chronic pain, trauma, adverse childhood events, and/or PTSS and associated coping mechanisms. Nine research papers were selected and used to support the conceptual framework. The framework builds upon the work of Compas et al.’s’ model of control-based coping (Compas et al., 2006; Compas & Harding Thomsen, 1999) and outlines the potential effects of trauma and/or PTSS and pain on coping and pain-related outcomes (e.g., pain chronicity, functional outcomes) in pediatric chronic pain populations. Results A history of chronic pain and psychological trauma and/or PTSS in youth may contribute to increased risk for maladaptive coping and in turn, poorer pain-related and psychosocial outcomes long-term. Conclusions Findings from the current scoping review and proposed conceptual framework will guide future research and treatment efforts for youths experiencing pain and trauma and/or PTSS and thereby enhance long-term outcomes.

Background Numerous traumatic experiences and post-migration living difficulties (PMLDs) increase the risk of developing symptoms of complex post-traumatic stress disorder (CPTSD) among Afghan refugees and asylum seekers, living in Austria. Research has repeatedly associated higher levels of CPTSD with higher levels of PMLDs. Summarizing PMLDs into empirically derived factors might facilitate a further understanding of their interaction with symptom presentation within distinct clusters of CPTSD. Objective The current study aimed to investigate homogeneous subgroups of ICD-11 CPTSD and their association with demographic variables, traumatic experiences, and empirically derived factors of PMLDs. Method Within a randomized controlled trail (RCT) CPTSD, PMLDs, and traumatic experiences were assessed in a sample of 93 treatment-seeking Afghan refugees and asylum seekers through a fully structured face-to-face and interpreter-assisted interview using the ITQ, the PMLDC, and a trauma checklist. Underlying clusters of CPTSD, superior factors of PMLDs, and their associations were investigated. Results In total, 19.4% of the sample met the diagnostic criteria for PTSD and 49.5% for CPTSD. We identified a 2-cluster solution consisting of two distinct subgroups as best fitting: (1) a CPTSD cluster and (2) a PTSD cluster. The multitude of PMLDs was summarized into four superior factors. CPTSD cluster membership was associated with childhood potentially traumatic experience types, and one of four PMLD factors, namely ‘language acquisition & barriers’. Conclusions The results suggest that not PMLDs in general, but rather specific types of PMLDs, are associated with CPTSD. An assumed bidirectional relationship between these PMLD factors and CPTSD symptoms might lead to a downward spiral of increasing distress, and could be considered in treatment strategies., HIGHLIGHTS Two homogeneous subgroups of CPTSD symptoms were identified (CPTSD, PTSD).Only the PMLD factor ‘language acquisition & barriers’, and childhood potentially traumatic experience types were associated with the CPTSD cluster.