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Child abuse has intergenerational consequences for psychopathology, however, there remains a paucity of research regarding how these experiences affect Latinx families, particularly those at risk for additional negative life events, such as racial discrimination. This study aims to contribute to this gap in the literature by examining the impact maternal child abuse exposure has on youth and maternal psychopathology, as well as whether these associations are moderated by racial discrimination, in a sample of 224 Latinx mother-youth dyads. Hierarchical regressions revealed small but significant maternal child abuse exposure x racial discrimination interactions for youth depression and anxiety, but not maternal depression or anxiety, which were solely positively associated with maternal child abuse exposure. Findings highlight the multifarious, and at times convergent, nature of trauma and oppression among Latinx families, as well as the impact across generations. Future work is needed to further elucidate developmental pathways of intergenerational trauma in understudied populations.

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

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. 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. Persons with psychological trauma exposure >5 are more likely to develop opiate use disorder, Chi-Square (χ2 = 5.17, df = 1, p = 0.023). 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. Key Findings: • Individuals with psychological trauma exposure score greater than five are more likely to develop opioid use disorder. • The prevalence of PTSD diagnosis within the OUD group results is lower than expected. • Minorities are underrepresented in opioid use disorder treatment in the study sample. Implications: • Our study found higher PTE scores in persons with OUD, emphasizing the important identification of PTE and PTSD along with implementing trauma-based and trauma-informed strategies during OUD treatment planning. • This study also indicated that a small number of PTSD diagnoses observed in the OUD sample is inconsistent with the statistics from the public domain as well as prior research on PTSD and SUD. This phenomenon indicates the need for structured evaluations for the assessment and diagnosis of PTSD as a best practice initiative. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

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

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

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

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 alter 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). [ABSTRACT FROM AUTHOR]

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

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

BACKGROUND: Stroke is a sudden-onset, uncontrollable event; stroke-related stress may impede rehabilitation and recovery. Lifetime stress may sensitize patients to experiencing greater stroke-related stress and indirectly affect outcomes. We examine lifetime stress as predictor of poststroke acute stress and examine lifetime and acute stress as predictors of 3- and 12-month functional status. We also compare acute stress and baseline National Institutes of Health Stroke Scale as predictors of poststroke functional status. METHODS: Between 2016 and 2020 the STRONG Study (Stroke, Stress, Rehabilitation, and Genetics) enrolled adults with new radiologically confirmed stroke 2 to 10 days poststroke onset at 28 acute care US hospitals. Participants were interviewed 3 times: acute admission (acute stress; Acute Stress Disorder Interview), 3 months (Fugl-Meyer Upper Extremity motor impairment [Fugl-Meyer Upper Arm Assessment; N=431], modified Rankin Scale [3 months; N=542], Stroke Impact Scale-Activities of Daily Living [3 months; N=511], Lifetime Stress Exposure Inventory), and 12 months (modified Rankin Scale, N=533; Stroke Impact Scale 3.0 Activities of Daily Living; N=485; Telephone Montreal Cognitive Assessment; N=484) poststroke. Structural equation models examined whether acute stress predicted 3- and 12-month functional outcomes, and mediated an association between lifetime stress and outcomes controlling for demographics and initial National Institutes of Health Stroke Scale. Standardized betas are reported. RESULTS: Sample (N=763) was 19 to 95 years old (mean=63; SD=14.9); 448 (58.7%) were male. Acute stress scores ranged from 0 to 14 (mean, 3.52 [95% CI, 3.31-3.73]). Controlling for age, gender, baseline National Institutes of Health Stroke Scale, and race and ethnicity, higher lifetime stress predicted higher acute stress (β=0.18, P0.18), but Fugl-Meyer scores (χ2[1]=7.01, P=0.008) less strongly than baseline National Institutes of Health Stroke Scale. CONCLUSIONS: Lifetime stress/trauma is associated with more poststroke acute stress, which is associated with greater motor and cognitive impairment and disability 3 and 12 months poststroke. Poststroke interventions for acute stress may help mitigate stroke-related disability.

Background: Nurses have frequent interactions with traumatized individuals and may develop secondary traumatic stress (STS). Similarly, nursing students are at risk for STS development while completing clinical training. Purpose: To critique and synthesize available research on the prevalence, severity, and experience of STS and its associated factors in prelicensure nursing students. Methods: The Whittemore and Knafl integrative review methodology was used to perform structured searches of 6 electronic databases. Results: Twenty-five studies met the inclusion criteria. Findings revealed a range of STS symptom severity levels and associated factors; however, measurement is hampered by researchers' use of other concepts, like compassion fatigue. Conclusions: Conceptual clarity is needed to improve STS measurement in nursing students; however, students experience STS and are at risk of developing its negative consequences. Educators should implement trauma-informed educational practices targeted at reducing factors associated with STS. [ABSTRACT FROM AUTHOR]

Abstract Background Intrusive memories of psychologically traumatic events bring distress both sub-clinically and clinically. This parallel-group, two-arm randomised controlled trial evaluated the effect of a brief behavioural intervention on reducing intrusive memories in frontline healthcare workers exposed to traumatic events during the COVID-19 pandemic. Methods Participants with at least two intrusive memories of work-related trauma in the week before recruitment were randomised 1:1 to an imagery-competing task intervention (n = 73) or attention-based control task (n = 71). The number of intrusive memories was assessed at baseline and 5 weeks after the guided session (primary endpoint). Results The intervention significantly reduced intrusive memory frequency compared with control [intervention Mdn = 1.0 (IQR = 0–3), control Mdn = 5.0 (IQR = 1–17); p

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

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

Abstract The October 29, 2022, Seoul Halloween Crowd Crush (SHCC) caused the loss of 159 lives, making it the deadliest global mass-gathering disaster between 2018 and 2022. Despite the fact that years have passed since the incident, there remains a significant gap in research addressing the mental health of citizens to evaluate their recovery progress. Therefore, in this study, a survey was conducted to assess citizens’ anxiety, depression, post-traumatic stress disorder (PTSD), and well-being after the SHCC. The data were analyzed using t-tests, analysis of variance (ANOVA), correlations, a Kruskal–Wallis test, and post hoc tests. The citizens' well-being differed significantly by victimization status, with direct victims showing languishing well-being (p = .036). PTSD severity level was higher in victims and direct witnesses (p

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

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

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

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

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

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

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

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

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

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

This research paper aims to provide a comparative and critical view of the psychological and childhood traumas presented in both The Almond Tree by Michelle Cohen Corasanti and The Kite Runner by Khaled Hosseini in order to better understand how trauma defines personal and communal identity. Following the theoretical perspectives from Suzanne Keen, Jeffrey C. Alexander, Neil J. Smelser, Ron Eyerman, and Piotr Sztompka, the analysis explores the symbols and meanings of trauma in these novels. This is due to the fact that Keen's narrative empathy theory is helpful to explain how the characters' emotional worlds are built and thus, the reader gets a better insight of the characters' possible psychological traumas. Cultural trauma theory by Alexander deals with the loss of a collective identity due to conflict and displacement in The Almond Tree. Similarly Smelser theory of Collective behaviour focuses on the social reaction to the trauma in both novels. Eyerman's social memory theory focuses on the process of remembering and cultural distribution of traumatic experiences and Sztompka's social trauma theory educates about collective conditioning, shock and loss in culture. In doing so, this paper shows how literature reveals the role of the written and spoken word in mitigating or magnifying trauma, along with the ways in which literature elicits concern, identification, and additional layers of oligophyleptic acculturation in depicting human survival or perseverance across the life span. [ABSTRACT FROM AUTHOR]

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

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. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

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

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

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

AbstractUrologic chronic pelvic pain syndrome (UCPPS) is a complex, debilitating condition in which patients often report nonpelvic pain in addition to localized pelvic pain. Understanding differential predictors of pelvic pain only vs widespread pain may provide novel pathways for intervention. This study leveraged baseline data from the Multidisciplinary Approach to the Study of Chronic Pelvic Pain (MAPP) Research Network's Symptom Pattern Study to investigate the impact of childhood sexual and nonsexual violent trauma on pelvic and nonpelvic pain sensitivity among adult patients with UCPPS, as well as potential mediators of this association. Study participants who met inclusion criteria for UCPPS completed questionnaires assessing childhood and recent trauma, affective distress, cognitive dysfunction, and generalized sensory sensitivity. Experimental pain sensitivity was also evaluated using standardized pressure pain applied to the pubic region and the arm. Bivariate analyses showed that childhood violent trauma was associated with more nonviolent childhood trauma, more recent trauma, poorer adult functioning, and greater pain sensitivity at the pubic region, but not pain sensitivity at the arm. Path analysis suggested that childhood violent trauma was indirectly associated with pain sensitivity at both sites and that this indirect association was primarily mediated by generalized sensory sensitivity. More experiences of recent trauma also contributed to these indirect effects. The findings suggest that, among participants with UCPPS, childhood violent trauma may be associated with heightened pain sensitivity to the extent that trauma history is associated with a subsequent increase in generalized sensory sensitivity.

OBJECTIVE: Researchers are often interested in assessing the causal effect of an exposure on an outcome when randomization is not ethical or feasible. Estimating causal effects by controlling for confounders can be unconvincing because important potential confounders remain unmeasured. Study designs leveraging instrumental variables (IVs) offer alternatives to confounder-control methods but are rarely used in stress and trauma research. METHOD: We review the conceptual foundations and implementation of IV methods. We discuss strengths and limitations of IV approaches, contrasting with confounder-control methods, and illustrate the relevance of IVs for stress and trauma research. RESULTS: IV approaches leverage an external or exogenous source of variation in the exposure. Instruments are variables that meet three conditions: relevance (variation in the IV is associated with variation in the chance of exposure), exclusion (the IV only affects the outcome through the exposure), and exchangeability (no unmeasured confounding of the IV-outcome relationship). Interpreting estimates from IV analyses requires an additional assumption, such as monotonicity (the instrument does not change the chance of exposure in different directions for any two individuals). Valid IVs circumvent the need to correctly identify, measure, and control for all confounders of the exposure-outcome relationship. The primary challenge is identifying a valid instrument. CONCLUSIONS: IV approaches have strengths and weaknesses compared with confounder-control approaches. IVs offers a promising complementary study design to improve evidence about the causal effects of exposures on outcomes relevant to stress and trauma. Collaboration with scientists who are experienced with identifying and analyzing IVs will support this work. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

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

Adverse childhood and adult experiences can affect health outcomes throughout life and across generations. The perinatal period offers a critical opportunity for obstetric clinicians to partner with patients to provide support and improve outcomes. This article draws on stakeholder input, expert opinion, and available evidence to provide recommendations for obstetric clinicians' inquiry about and response to pregnant patients' past and present adversity and trauma during prenatal care encounters. Trauma-informed care is a universal intervention that can proactively address adversity and trauma and support healing, even if a patient does not explicitly disclose past or present adversity. Inquiry about past and present adversity and trauma provides an avenue to offer support and to create individualized care plans. Preparatory steps to adopting a trauma-informed approach to prenatal care include initiating education and training for practice staff, prioritizing addressing racism and health disparities, and establishing patient safety and trust. Inquiry about adversity and trauma, as well as resilience factors, can be implemented gradually over time through open-ended questions, structured survey measures, or a combination of both techniques. A range of evidence-based educational resources, prevention and intervention programs, and community-based initiatives can be included within individualized care plans to improve perinatal health outcomes. These practices will be further developed and improved by increased clinical training and research, as well as through broad adoption of a trauma-informed approach and collaboration across specialty areas.

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

As the Syrian crisis has reached its 10th year, this paper explores posttraumatic growth and the related factors among Syrian refugees in Turkey, with the aim of having a better understanding of the predictors of PTG and the risk factors that may play a role in the inhibition of the growth. In this cross-sectional study, 217 displaced Syrian refugees completed the Post Traumatic Growth Inventory (PTGI), Harvard Trauma Questionnaire (HTQ), Brief COPE, General Self-Efficacy Scale (GSES), PTSD Checklist for DSM-5 (PCL-5), and sociodemographic information form by a self-reported online survey. Risk and protective factors were associated in bivariate analysis with growth p0.05). In conclusion, the findings have provided valuable insight into the domains of the growth among Syrian refugees and discussed both clinical and research-based future recommendations that could be made to improve the mental health of the refugees based on the obtained results. Key implications for practice • Mental health practitioners should focus on interventions highlighting personal strengths that increase active coping skills and self-efficacy and reduce self-blame • Policymakers should take actions to prevent the retraumatization of the refugees by considering the psychological impact of the lack of the host country’s language and the inconsistency of the refugees’ work with their education • Mental health researchers should focus on factors that explain posttraumatic growth and developing intervention tools that promote growth

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

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

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

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