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

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]

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]

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]

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]

Student nurses often do not receive adequate preparation, support, and debriefing related to witnessing or experiencing critical events in the clinical setting. The purpose of this analysis was to describe the experiences of student nurses who have witnessed critical events in the clinical setting, the support and preparation they received, and staff and faculty actions they perceived as facilitating or hindering their processing of the event. This is a sub-analysis of a Straussian Grounded Theory qualitative study. Staff and faculty actions that helped and hindered the processing of the critical event were identified at four time points: pre-event, during the critical event, immediately post-event, and in the days and weeks following. Students exposed to critical events during their clinical rotations can experience psychological trauma. If unresolved, this can result in new nurses entering the profession already in distress. Preparation and support for witnessing critical patient events should start at the beginning of nursing school. During critical patient events, students need faculty or staff to be actively present to explain the event and support the student throughout the event. Immediate debrief and follow-up is recommended and should continue weeks or months after the event. • Nurses are exposed to critical events more frequently than any other health profession, and students often witness these same events. • Exposure to critical events in the clinical setting can be traumatizing for those who witness them. • Clinical instructors, nursing staff, and other faculty should consider providing psychological support to these students. • Schools of nursing have a responsibility to prepare students for critical events and following up with students after events. [ABSTRACT FROM AUTHOR]

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

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

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

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

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

• Patient sociodemographic and trauma profiles were similar between hospitals. • Public hospital patients reported higher odds of intimate partner violence. • Public hospital patients reported higher odds of death/sickness in the family. • Private hospital patients reported higher odds of coming from an abusive home. To date not much is known about the differences, if any, between patients with functional seizures (FS) from different socioeconomic backgrounds. We sought to compare the psychological stress and trauma profiles of patients with FS from a private and public hospital in Cape Town, South Africa. Only video-electroencephalography-confirmed patients with FS were eligible for the study. In this retrospective case-control study we collected data on self-reported demographic and psychological stressor/trauma variables using digital patient records starting with the earliest available digital patient record for each hospital. A total of 321 patients from a private hospital and 68 patients from a public hospital were included in the study. Most factors showed no significant differences. However, public hospital patients had higher odds of being older (p = 0.002), almost nine times the odds of reporting physical violence by an intimate partner (aOR = 8.65, 95% CI [1.70, 44.08]), more than eight times the odds of reporting psychological stress in the form of death and/or sickness in the family (aOR = 8.56, 95% CI [1.81, 40.41]) and almost three times the odds for other general psychosocial stressors (aOR = 2.82, 95% CI [1.08, 7.42]) compared to those attending the private hospital. They also had half the odds of being female compared to the private hospital patients (aOR = 0.47, 95% CI [0.23, 0.95]) and 93% fewer odds of reporting coming from an abusive home (aOR = 0.07, 95% CI [0.01, 0.52]). History and psychological trauma and stressor profiles showed many similarities between the public and private hospital groups; however, some differences were noted and could benefit further exploration and consideration in therapeutic and diagnostic contexts. [ABSTRACT FROM AUTHOR]

Cette étude a pour but d'investiguer l'impact de l'abus sexuel infantile sur le sentiment de compétence parentale et d'en proposer un modèle structural, en prenant en compte l'effet cumulatif des différents types de maltraitance. Notre échantillon était composé de 1904 mères d'enfants âgés entre 3 et 8 ans. Il leur était demandé de remplir un formulaire en ligne comprenant une fiche sociodémographique, le Childhood Trauma Questionnaire–Short Form (CTQ-SF) et le Questionnaire d'Auto-Évaluation de la Compétence Éducative Parentale (QAECEP). Nos résultats confirment le lien entre la maltraitance sexuelle et la maltraitance intrafamiliale. Ils suggèrent que le vécu d'abus sexuel infantile impacte le sentiment de compétence parentale des mères quand il se produit dans des situations d'abus multiples et sévères. En outre, nos analyses statistiques indiquent que le bien-être psychologique maternel et la présence de troubles chez l'enfant médient la relation entre le vécu infantile de la mère et son sentiment de compétence parentale. Il semble que le sentiment de compétence parentale est altéré par un vécu d'abus sexuel lorsque celui-ci s'inscrit dans un vécu de traumatismes multiples entraînant des symptômes d'un trouble du stress post-traumatique complexe. Le bien-être psychologique de la mère et l'absence de troubles chez l'enfant démontrent un rôle protecteur sur le sentiment de compétence parentale des mères victimes de maltraitance infantile. Ces constats ont des implications concernant les interventions à proposer aux mères en difficultés parentales. Nos résultats suggèrent que prendre en compte le sentiment de compétence parentale et le vécu infantile des mères est essentiel pour pouvoir proposer des interventions adaptées. Cette étude confirme l'importance d'intégrer le vécu infantile des mères dans les interventions de soutien à la parentalité, pour mieux comprendre leurs difficultés parentales et pour pouvoir intervenir sur leurs difficultés d'origine traumatique. The aim of this study was to investigate the impact of childhood sexual abuse on the parental sense of competence and to propose a structural model, taking into account the cumulative effect of the different types of abuse. The participants were 1904 mothers of children aged 3 to 8. They were asked to complete an online form that included a sociodemographic questionnaire, the Childhood Trauma Questionnaire - Short Form (CTQ-SF), and the Questionnaire d'Auto-Évaluation de la Compétence Éducative Parentale (QAECEP). Our results confirm the link between sexual abuse and intrafamilial abuse. They suggest that the experience of childhood sexual abuse impacts mothers' parental sense of competence when it occurs in situations of multiple and severe abuses. Furthermore, our statistical analyses indicate that maternal psychological well-being and the presence of child disorders mediate the association between the mother's childhood experience and her parental sense of competence. It seems that the parental sense of competence is impacted by sexual abuse when it is part of multiple traumas leading to symptoms of complex post-traumatic stress disorder. Psychological well-being of the mother and the absence of disorders in the child demonstrates a protective role in the parental sense of competence of mothers with histories of childhood abuse. These findings have implications for interventions for mothers experiencing parenting difficulties. Our results suggest that taking into account the parental sense of competence and the childhood experiences is essential for providing appropriate interventions. This study confirms the importance of integrating the mother's childhood experiences to better understand her parenting difficulties and to be able to intervene on her difficulties of traumatic origin. [ABSTRACT FROM AUTHOR]

Many women experience giving birth as a negative or even as a traumatic event. Birth space and its occupants are fundamentally interconnected with negative and traumatic experiences, highlighting the importance of the social space of birth. To explore experiences of women who have had a negative or traumatic birth to identify the value, sense and meaning they assign to the social space of birth. A feminist standpoint theory guided the research. Secondary discourse analysis of 51 qualitative data sets/transcripts from Dutch and Czech Republic postpartum women and 551 free-text responses of the Babies Born Better survey from women in the United Kingdom, Netherlands, Belgium, Germany, Austria, Spain, and the Czech Republic. Three themes and associated sub-themes emerged: 1. The institutional dimension of social space related to staff-imposed boundaries, rules and regulations surrounding childbirth, and a clinical atmosphere. 2. The relational dimension of social space related to negative women-healthcare provider interactions and relationships, including notions of dominance, power, authority, and control. 3. The personal dimension of social space related to how women internalised and were affected by the negative social dimensions including feelings of faith misplaced, feeling disconnected and disembodied, and scenes of horror. The findings suggest that improving the quality of the social space of birth may promote better birth experiences for women. The institutional, relational, and personal dimensions of the social space of birth are key in the planning, organisation, and provision of maternity care. [ABSTRACT FROM AUTHOR]

The war in Ukraine is a major poly-traumatic event, which leads to massive population displacements. The question of the evaluation and psychological care of psychotraumatised people is an urgent matter. As many countries hosting refugees are well endowed with a good number of psychologists, some of these interested professionals should mobilise themselves and make themselves known to carry out these clinical acts. Priority should be given to trained and experienced psychologists to support victims. The language barrier will have to be overcome. Initially, it would be desirable to make contact or get closer to local and national refugee centres to facilitate these operations. Face-to-face or remote consultations, as developed during the Covid-19 pandemic, are possible. Reinforcements of the number of available and dedicated psychologists, including remotely, from the countries hosting the most refugees, are also desirable. The issue of detection, assessment and care of psychologically traumatised people who remained on the Ukrainian territory is probably even more massive. Whether non-combatants or combatants, part of the international psychological community should mobilise, in addition to local colleagues, to provide them with this psychological help. These humanitarian actions would be feasible depending on the evolution of the conflict. Whether it is psychological support for refugees or people still on the Ukrainian soil, models for organising and coordinating these actions must be carefully considered and implemented in an evolving way to optimise their effectiveness. [ABSTRACT FROM AUTHOR]

La guerre en Ukraine est un événement polytraumatique majeur qui donne lieu à des déplacements massifs de population. La question de l'évaluation et de la prise en charge psychologique des personnes psychotraumatisées se pose de façon urgente. De multiples pays d'accueil de réfugiés étant bien dotés en nombre de psychologues, une partie de ces professionnels intéressés devrait se mobiliser et se faire connaître pour réaliser ces actes cliniques. La priorité devrait être donnée aux psychologues formés et expérimentés pour prendre en charge les victimes. La barrière de la langue devra être surmontée. Dans un premier temps, une prise de contact ou un rapprochement auprès des dispositifs locaux et nationaux d'accueil des réfugiés serait souhaitable pour faciliter ces opérations. Des consultations en présentiel ou en distantiel, comme cela a été développé pendant la pandémie de Covid-19, sont envisageables. Des renforts en psychologues, y compris à distance, des pays accueillant le plus de réfugiés sont également souhaitables. La question de la détection, de l'évaluation et de la prise en charge des personnes psychologiquement traumatisées restées sur le territoire ukrainien est probablement encore plus massive. Que ce soit des non-combattants ou des combattants, une partie de la communauté psy internationale devrait se mobiliser, en complément des collègues locaux, pour leur apporter cette aide psychologique. Ces actions humanitaires seraient réalisables en fonction de l'évolution du conflit. Qu'il s'agisse de soutien psychologique aux réfugiés ou aux personnes sur le sol ukrainien, des modèles d'organisation et de coordination de ces actions doivent être pensés et mis en place de façon évolutive pour en optimiser l'efficacité. The war in Ukraine is a major poly-traumatic event, which leads to massive population displacements. The question of the evaluation and psychological care of psychotraumatised people is an urgent matter. As many countries hosting refugees are well endowed with a number of psychologists, some of these interested professionals should mobilise themselves and make themselves known to carry out these clinical acts. Priority should be given to trained and experienced psychologists to support victims. The language barrier will have to be overcome. Initially, it would be desirable to make contact or get closer to local and national refugee centres to facilitate these operations. Face-to-face or remote consultations, as developed during the Covid-19 pandemic, are possible. Reinforcements of available and dedicated psychologists, including remotely, from the countries hosting the most refugees are also desirable. The issue of detection, assessment and care of psychologically traumatised people who remained in the Ukrainian territory is probably even more massive. Whether non-combatants or combatants, part of the international psychological community should mobilise, in addition to local colleagues, to provide them with this psychological help. These humanitarian actions would be feasible depending on the evolution of the conflict. Whether it is psychological support for refugees or people still on the Ukrainian soil, models for organizing and coordinating these actions must be carefully thought out and implemented in an evolving way to optimise their effectiveness. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) is a pervasive issue within military populations, with approximately 29 % of post-9/11 service members experience PTSD at some point in their lifetime. One potentially important factor in PTSD development and treatment response is dysregulation of the stress response system stemming from exposure to multiple traumas and sustained operational stress associated with military training and deployment. In particular, the end-product of the hypothalamic-pituitary-adrenal (HPA) axis, cortisol, is of particular interest to researchers examining physiological stress response in the context of mental health. Research exploring cortisol has been ongoing for decades, both to further understand its pathways and mechanisms, and to develop potential novel PTSD treatments. This paper provides a narrative review of some of the published literature examining cortisol's role in PTSD as a potential factor in development, maintenance, and treatment augmentation, with emphasis on military populations. The results of this review highlight the importance of exploring alterations to the stress response system, and cortisol in particular, for the evaluation and treatment of PTSD in the military, the need for more comprehensive work towards understanding development of these alterations through military training and service, and its impact on long-term PTSD outcomes. • Trauma-focused PTSD treatments demonstrate less effectiveness among service members. • Cortisol reactivity has been found to behave differently in military and civilian populations. • One potentially important factor in PTSD development and treatment response is dysregulation of the nervous system. • Service members may have a desensitized stress response due to sustained operational stress. • More work is needed on cortisol and PTSD, specifically in the military population. [ABSTRACT FROM AUTHOR]

A "person under train" (PUT) incident is a suicidal action involving a person throwing themselves at a moving train. This may cause trauma, including post-traumatic stress disorder (PTSD), to railroad drivers. This study investigated the experiences of railroad drivers of a PUT incident. Data were obtained from two drivers through in-depth interviews and personal narratives regarding their PUT experience and personal lives after the incident. Expressing thoughts through writing was an effective intervention that provided insights into their experience. Thus, an educational program combining mental health management and PTSD treatment is recommended for workers who experience such trauma. • Narrative exploration helps to alleviate post-traumatic stress disorder symptoms. • Governmental trauma management programs are need for traumatized engineers. • Railroad engineers who experience trauma are likely to ruminate on its memory. • Reinterpreting traumatic experiences can positively impact one's quality of life. • Immediate immersion is needed following trauma, with long-term follow-up. [ABSTRACT FROM AUTHOR]

De multiples dispositifs de soins, dits alternatifs, sont organisés par des personnes qui déclarent posséder un don de guérison. Un nombre croissant de patients en quête de soins se dirige vers ces dispositifs de plus en plus présents dans le paysage thérapeutique. Nous proposons, dans cet article, d'explorer la dynamique psychique sous-jacente à ce don, afin de mieux en comprendre les enjeux intrapsychiques et intersubjectifs. Pour cela, le don de guérison est étudié à partir d'entretiens de recherches menés auprès de cinq guérisseurs. Le don émerge, souvent, dès l'enfance dans un environnement familial marqué par la présence de secrets. Des expériences exceptionnelles consécutives à des vécus traumatiques accompagnent le développement du don. Notre propos est illustré par deux vignettes cliniques dans lesquelles le don participe d'un travail de symbolisation des souffrances psychiques et peut se lire comme une tentative de subjectivation des éléments transgénérationnels. Le potentiel thérapeutique de ce don est discuté en conclusion. Multiple so-called alternative care arrangements are organized by people who claim to have a gift of healing. A growing number of patients seeking care are moving towards these settings, which are increasingly present in the therapeutic landscape. In this article, we propose to explore the psychic dynamics underlying this gift in order to better understand its intrapsychic and intersubjective implications. For this purpose, the gift of healing is studied on the basis of research interviews conducted with five healers. The gift often emerges during childhood, in a family environment marked by the presence of secrets. Exceptional experiences following traumatic experiences accompany the development of the gift. This is illustrated by two clinical vignettes in which the gift is part of a work of symbolization of psychic suffering and can be read as an attempt to subjectivize transgenerational elements. The therapeutic potential of this gift is discussed in conclusion. [ABSTRACT FROM AUTHOR]

En opposition à la « psychose », on parlait dans les classifications encore en vogue il y a moins d'une décennie de « névroses traumatiques ». Un texte juridique important affirme encore aujourd'hui, dans notre pays, que « les psychoses post-traumatiques n'existent pas », ce qui empêche leur indemnisation au titre de la réparation du dommage psychique. Et pourtant, battant ces dogmes en brèche, certains praticiens ont itérativement rendu compte de situations cliniques où traumatisme psychique et psychose se découvrent intimement liés. Les enjeux thérapeutiques et médico-légaux sont majeurs, de même que les implications en termes de recherche. D'après une revue de la littérature internationale confrontée à notre expérience pratique, nous définissons les différentes typologies anatomocliniques de psychoses post-traumatiques. Nous exposons successivement les psychoses induites par : (i) un traumatisme psychique isolé en subdivisant les troubles fonctionnels (aigus et chroniques) et structurels (schizophréniques et paranoïaques); (ii) un traumatisme crânien isolé avec présentation des symptômes en fonction de l'étendue des lésions cérébrales (troubles psychotiques organiques, schizophrenia-like psychosis , schizophrénique post-traumatique). La très récente densification de la description clinique des troubles psychiques post-traumatiques a mis en évidence la notion de psychoses post-traumatiques. Pourtant, si certains barèmes médico-légaux évoquent ces troubles, c'est parfois paradoxalement pour en récuser l'existence ou l'imputabilité, sans d'ailleurs forcément préciser si le fait en cause constitue un trauma psychique ou un trauma crânien, lesquels peuvent en pratique s'intriquer. En réalité, les liens séméiologiques et étiopathogéniques entre traumas et psychoses sont complexes, souvent bidirectionnels, sans que l'imputabilité des symptômes résultants soit à récuser pour autant, au contraire le plus souvent. In opposition to "psychosis", one spoke in the classifications still in vogue less than a decade ago of "traumatic neuroses". An important legal text still affirms today, in our country, that "post-traumatic psychosis does not exist", which prevents their compensation under the reparation of psychic damage. But defeating these dogmas in breach, clinicians have repeatedly reported on situations where psychological trauma and psychosis are found to be intimately linked. The therapeutic and medico-legal issues are major, as are the implications in terms of research. Based on a review of the international literature compared to our practical experience, we define the different anatomoclinical typologies of post-traumatic psychosis. We successively present the psychoses induced by: (i) an isolated psychic trauma by subdividing the functional (acute and chronic) and structural (schizophrenic and paranoid) disorders; (ii) an isolated traumatic brain injury with presentation of symptoms according to the extent of the brain lesions (organic psychotic disorders, schizophrenia-like psychosis, post-traumatic schizophrenia). The very recent densification of the clinical description of post-traumatic mental disorders has highlighted the notion of post-traumatic psychosis. However, if certain medico-legal scales mention these disorders, it is sometimes paradoxically to deny their existence or their imputability (without necessarily specifying whether the fact in question constitutes a psychic or cranial trauma). In reality, the semiological and etiopathogenic links between trauma and psychosis are complex, often bidirectional, without the medico-legal attribution of the resulting symptoms having to be challenged, on the contrary most often. [ABSTRACT FROM AUTHOR]

L'expérience traumatique s'avère caractérisée par l'« indicibilité » : point de mot pour réellement exprimer, pour traduire, pour se représenter l'horreur traversée. Et pourtant, paradoxalement, l'accès principal à notre connaissance de la dissociation traumatique provient de ce que les patients arrivent à nous en dire ne serait-ce que partiellement, chaotiquement... Les empreintes lexicales, syntaxiques et pragmatiques du trauma dans le discours, que nous avons baptisées syndrome psycholinguistique traumatique (SPLIT), s'expriment selon une dissociation automatico-volontaire prenant forme graduelle : plus le trauma apparaît présent et plus les stigmates psycholinguistiques se manifestent ; plus le sujet s'éloigne psychiquement du trauma et de ses conséquences, plus le discours regagne l'état nominal. Comment le sujet peut-il redevenir maître de sa propre vie, de sa propre parole, sans que le trauma ne la contraigne ? Comment le sujet arrive-t-il parfois, seul ou avec l'aide d'autrui, à s'extraire de ses reviviscences par la narrativisation de la scène traumatique ? Ces espaces de retour au « je » n'ont jamais été étudiés en langue française dans le discours de patients souffrant de trouble de stress post-traumatique. Outre la forme linguistique « je », quelles sont les autres formes utilisées (personnelles, exclusives, inclusives, génériques) par les locuteurs de récits traumatiques dans leurs discours afin de faire référence à eux-mêmes ? À partir des témoignages de survivants du Bataclan recueillis immédiatement après l'attentat puis quelques années plus tard, ainsi qu'à partir des récits produits par des patients militaires souffrant de trouble de stress post-traumatique chronique, nous analysons, grâce à l'étude linguistique précise des marqueurs pronominaux, comment les locuteurs font référence à eux-mêmes. Une analyse détaillée des formes pronominales et des différentes valeurs qu'elles signifient, nous a conduit à quatre principales découvertes : (i) surreprésentation de la première personne dans les récits traumatiques, tant par l'emploi du pronom « je » que par les autres pronoms incluant le locuteur ; (ii) prédominance de l'emploi des valeurs pronominales génériques dans les récits traumatiques ; (iii) utilisation préférentielle de la valeur exclusive du pronom « on » dans le corpus « Guerre d'Afghanistan » ; et enfin (iv), le déroulé temporel de ces trois premiers résultats suit la chronologie de la clinique évolutive du trouble de stress post-traumatique. Les récits traumatiques contiennent significativement davantage d'occurrences du pronom « je », mais aussi d'autres formes de références à soi-même comparativement aux sujets témoins. L'évocation à la première personne témoigne principalement de la singularité du trauma : ce qui est traumatique pour quelqu'un, à un moment particulier de son histoire, ne le sera pas forcément pour quelqu'un d'autre qui traverserait la « même » épreuve aux sens des coordonnées objectives (lieu, date des faits, intensité des sons, étendue de lésions physiques, etc.). Dire « je » c'est aussi lutter contre les symptômes dissociatifs, au premier rang desquels la dépersonnalisation confinant à la réification et à la désubjectivation. Cependant, le trauma s'accroche aux premières tentatives de s'en extraire : la prééminence du pronom « je » apparaît parallèlement telle une marque de la répétition dans le discours, disjonction entre les dimensions lexicales et pragmatiques de l'énonciation. Pour cause de dissociation massive, le « je » discursif renvoie même parfois à un asubjectif dans la scène traumatique tel un « Out of Langage Experience » : le sujet dit quelquefois « je » mais sans parler de lui. En outre, l'emploi des pronoms génériques est retrouvé avec une plus grande fréquence dans les récits d'événements traumatiques, notamment dans le corpus du « Bataclan différé », alors que les témoins les utilisent significativement moins. En employant « tu » ou « vous » générique, c'est comme si le locuteur disait : si vous aviez été à ma place, voilà ce que vous auriez éprouvé, vu, entendu, pensé, car n'importe quel humain, dans ces circonstances, éprouverait ce que j'ai éprouvé. En un sens, je suis donc un être humain « normal » mais en même temps, j'évite ma propre subjectivité, ce qui reste une forme de dépersonnalisation. Par l'utilisation d'un « vous » générique, voire même davantage par un « tu » familier, un changement de perspective cognitive adoptée pour décrire le vécu, le sujet blessé psychique décrit l'expérience de l'extérieur. Ainsi, le processus de dissociation traumatique se protège toujours, voire s'étend, en incluant l'interlocuteur dans la scène traumatique, en suggérant une quête empathique, comme pour l'en rendre captif, témoin invité ou participant obligé de la scène verbale. Enfin, alors que les témoins emploient « je » et « on » de manière équivalente, chez les sujets blessés psychiques, plus l'on s'éloigne du trauma temporellement alors que ses conséquences cliniques persistent, plus l'utilisation du pronom « je » augmente et plus l'emploi du pronom « on » diminue tout en se polarisant sur un caractère exclusif ou générique. De telles évolutions croisées, témoignant en même temps d'une tentative de recours à l'affirmation de soi et de la dissolution dans un collectif extérieur, restent une marque de la dissociation traumatique dans le discours. Ces résultats concordent avec l'évolution chronologique de la clinique post-traumatique de la phase immédiate marquée de trouble de stress aigu, à la phase différée souvent lieu d'une période intermédiaire latente, puis aux symptômes chroniques évoluant vers des souffrances multiples. L'approche linguistique peut nous offrir à la fois de comprendre les marques générales de la blessure psychique dans le discours et le traumatisme au sens de la singularité du vécu. Alors que le syndrome psycholinguistique traumatique résulte de la blessure du langage constitutive du trauma, inversement, c'est une parole singulière qui permet de s'extraire des reviviscences. Sans doute que des processus salvateurs surviennent notamment grâce à la relation intersubjective entre le patient et autrui, par la co-construction d'un discours. L'analyse de la restauration de ce langage, et en particulier des marques pronominales, pourrait unifier une conception spécifique de l'apaisement des conséquences traumatiques tout en définissant des marqueurs linguistiques objectifs offrant d'évaluer l'efficacité des traitements recommandés. The traumatic experience is characterized by "unspeakability:" there are no words to truly express, to translate, to represent the horror. And yet, paradoxically, the main access to our knowledge of traumatic dissociation comes from what patients manage to tell us, if only partially, chaotically... The lexical, syntactic, and pragmatic imprints of the trauma on discourse, which we have baptized psycholinguistic traumatic syndrome (SPLIT), are expressed according to an automatico-voluntary dissociation taking gradual form: the more the trauma appears present, the more the psycholinguistic stigmata manifest themselves; the more the subject psychically moves away from the trauma and its consequences, the more the discourse returns to the nominal state. How can the subject become master of his own life, of his own speech, without being constrained by trauma? How do some subjects manage, alone or with the help of others, to extract themselves from their flashbacks by narrativizing the traumatic scene? These spaces of return to the "I" have never been studied in French in the discourse of patients suffering from posttraumatic stress disorder. In addition to the linguistic form "I," what other forms (personal, exclusive, inclusive, generic) do speakers of traumatic narratives use in their discourse in order to refer to themselves? Based on the testimonies of survivors of the Bataclan attack collected immediately after the event and a few years later, as well as on the narratives produced by military patients suffering from chronic posttraumatic stress disorder, we analyze, through the precise linguistic study of pronominal markers, how the speakers refer to themselves. A detailed analysis of the pronominal forms and the different values they signify led us to four main findings: (i) over-representation of the first person in traumatic narratives, both by the use of the pronoun "I" and by others pronouns including the speaker; (ii) predominance of the use of generic pronominal values in traumatic narratives; (iii) preferential use of the exclusive value of the pronoun " on " in the "War in Afghanistan" corpus; and finally (iv), the temporal unfolding of these first three results mirrors the habitual chronology that characterizes the clinical evolution of posttraumatic stress disorder. The narratives of trauma survivors contain significantly more occurrences of the pronoun "I," but also other forms of self-reference, compared to control subjects. The use of the first-person pronoun mainly reflects the singularity of the trauma: what is traumatic for one person at a particular moment in his or her history will not necessarily be traumatic for someone else who, objectively, went through the same ordeal (in terms of place, date of the event, intensity of the sounds, extent of physical injuries, etc.). To say "I" is also to fight against dissociative symptoms, first and foremost depersonalization bordering on reification and desubjectification. However, the trauma clings to subjects' first attempts to extract themselves from it: the preeminence of the pronoun "I" appears in parallel as a mark of repetition in the discourse, a disjunction between the lexical and pragmatic dimensions of enunciation. Because of massive dissociation, the discursive "I" sometimes even refers to a form of asubjectivity in the traumatic scene, an "Out-of-Language Experience:" the subject sometimes says "I" but without talking about her/himself. Moreover, the use of generic pronouns is found with greater frequency in accounts of traumatic events, particularly in the "later Bataclan" corpus, whereas controls use them significantly less. By using the generic " vous " (the formal or plural form of second-person address) or the informal " tu " ("you"), it is as if the speaker were saying: if you had been in my place in that circumstance, this is what you would have felt, seen, heard, thought, because any human, in those circumstances, would feel what I felt. In a sense, I am a "normal" human being, but at the same time, I avoid my own subjectivity, which is a form of depersonalization. Through the use of a generic "you," or even more so through a familiar "you," a change in cognitive perspective is adopted to describe the experience; the psychically injured subject looks at the experience described from the outside. Thus, the process of traumatic dissociation remains untouched, or even extends itself, by including the interlocutor in the traumatic scene, suggesting an empathic quest, as if to make him or her a captive, an invited witness, or a forced participant in the verbal scene. Finally, while the control subjects use "I" and " on " (a commonly used French pronoun that expresses, alternately or simultaneously, "one" and "we") in an equivalent way, with the psychologically injured subjects, the further one moves away temporally from the trauma while its clinical consequences persist, the more the use of the pronoun "I" increases and the more the use of the pronoun " on " decreases, while the latter takes on an exclusive or generic character. These intersecting evolutions, which suggest an attempt to resort to self-affirmation and to a dissolution into an external collective, signal the presence of traumatic dissociation in the discourse. These results are consistent with the chronological clinical evolution of posttraumatic stress disorder from the immediate phase marked by acute stress disorder, to the deferred phase, which is often followed by an intermediate latent period, and then to chronic symptoms evolving into a multiplicity of suffering. The linguistic approach can offer us both an understanding of the general marks of the psychic wound in the discourse and of the trauma, in the sense of the singularity of the experience. While traumatic psycholinguistic syndrome results from linguistic wound constitutive of the trauma, conversely, it is a singular word, which makes it possible to extract oneself from flashbacks. Undoubtedly, life-saving processes occur thanks to the intersubjective relationship between the patient and others, through the co-construction of a discourse. The analysis of the restoration of this language, particularly its pronominal forms, could unify a specific conception of the alleviation of traumatic consequences while defining objective linguistic markers that could help clinicians evaluate the effectiveness of recommended treatments. [ABSTRACT FROM AUTHOR]

Suite à la tragique explosion du 4 août 2020 au Liban, l'auteur présentera son intervention en deux parties. Une première partie lors de l'intervention immédiate auprès des secouristes, une partie qui décrit l'importance du cadre mis en place par téléphone dans la langue des sauveteurs. La deuxième partie est une approche thérapeutique sur le long terme (toujours en cours au moment de la rédaction de l'article), utilisant l'écriture comme outil thérapeutique pour les traumatismes et le deuil. La mise en place d'un dispositif de soutien et/ou de supervision par téléphone des secouristes et des soignants montre son efficacité lorsque le cadre du pays lui-même est défaillant, voire inexistant. Le cadre apporté permettant un cadre à penser. Pour le suivi de patients à dix-huit mois après l'explosion avec, pour outil, l'écriture à visée thérapeutique semble favoriser la mise en place d'une mise en abîme de cadre nécessaire suite à un effondrement extérieur et intérieur, là où le corps et le psychisme sont blessés. Une ligne conductrice sera celle de l'impact d'un évènement tragique dans la sphère individuelle et dans la sphère collective. Du drame individuel au drame collectif et inversement, ainsi que de l'importance du multilinguisme pour le thérapeute face à la sidération traumatique possible chez les patients. Une tragédie comme celle du 4 août 2020 est un traumatisme pouvant fragiliser l'espace intime. Le traumatisme, cet indicible, est difficile à raconter. La psychothérapie en plusieurs langues, étayée par l'écriture thérapeutique, semble avoir un rôle réparateur et structurant là où l'effondrement est extérieur et intérieur. Following the tragic explosion of August 4, 2020 in Lebanon, the author will present his intervention in two parts. A first part during the immediate intervention with the rescuers, a part which describes the importance of the framework set up by telephone in the language of the rescuers. The second part is a long-term therapeutical approach (still in progress at the time of writing the article), using writing as a therapeutical tool for trauma and bereavement. The setting of a telephone support and/or supervision for rescuers and caregivers shows its effectiveness when the framework of the country itself is weak or non-existent. Thus, the framework provided allowing a framework to think. Regarding the follow up of patients eighteen months after the explosion, writing as a therapeutical tool seems to favor the setting up in the abyss of the framework that is needed following an external and internal collapse, where the body and psyche are injured. A guiding line will be that of the impact of a tragic event in the individual sphere and in the collective sphere. From individual drama to collective drama and vice versa. As well as the importance of multilingualism for the therapist regarding the traumatic sideration that could occur with patients. A tragedy like that of August 4, 2020 is a trauma that can weaken the intimate space of a person. The trauma is unspeakable, difficult to tell. Psychotherapy in different languages, supported by writing as a therapeutical tool, seems to have restorative and structuring role where the collapse is external and internal. [ABSTRACT FROM AUTHOR]

Background: Each year, nearly 790.000 new cases of myocardial infarction (MI) are recorded in the United States. Better knowledge of the modifiable risk factors for this cardiovascular disease remains a major public health issue. In this perspective, the aim of this systematic review and meta-analysis was to estimate the relationship between post-traumatic stress disorder (PTSD) and risk of subsequent myocardial infarction (MI).Methods: A systematic review using PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analysis) guidelines was performed by searching four bibliographic databases (PubMed/Medline, PsycINFO, Science Direct and Proquest Dissertations and Theses).Results: A total of 14 articles were included. Nine of these included depression as a covariate. Among 13 studies (N = 848.903), the pooled HR for the magnitude of the relationship between PTSD and MI was 1.49 (95% CI 1.31-1.69) before adjustment for depression. The pooled HR estimate for the 9 depression-adjusted estimates (N = 814.441) was 1.32 (95% CI 1.12-1.56).Limitations: These results should be considered with caution because there is high heterogeneity between studies and possible publication bias; thus, further research is required to support these results.Conclusions: Further research is still needed to identify in more precise terms the mediating factors involved in the direct association between PTSD and the subsequent occurrence of ischemic heart disease. [ABSTRACT FROM AUTHOR]

We investigated changes in the severity of obsessive-compulsive and related disorders (OCRDs) symptoms as a result of the COVID-19 pandemic. An Amazon Mechanical Turk sample of 829 individuals was evaluated with a series of instruments assessing the severity of the OCRDs before and during the pandemic. Additional questionnaires about sociodemographic factors, personal and family histories of OCRD, COVID-19 related events, compulsivity and impulsivity traits, schizotypal symptoms, and the severity of depression, anxiety and stress levels, were also used. Participants reported that OCD, hoarding disorder (HD) and skin picking disorder (SPD) symptoms significantly worsened during the pandemic along with increased disability, more affective symptoms and reduced quality of life. Female gender, a higher number of COVID-19 related stressful events, and higher pre-COVID-19 fear of harm and symmetry symptoms predicted more severe OCD symptoms during the pandemic, whereas lack of a HD diagnosis by a mental health professional and more severe schizotypal symptoms predicted worsened hoarding symptoms. Greater compulsivity traits were associated with more severe COVID-19 pandemic obsessive-compulsive and hoarding symptoms. These data indicate that the immense distress resulting from the COVID-19 included significant deterioration of OCRDs' symptoms, particularly of OCD, HD and SPD. It was also possible to identify a pre-pandemic profile of people most at risk of pandemic-related deterioration in OCRDs' symptoms, which may prove valuable for preventative initiatives in relation to the likely future waves of COVID-19 or of other communicable diseases. Future studies should follow up these findings longitudinally. • OCD, hoarding disorder and skin picking disorder significantly worsened during the pandemic. • Female gender, COVID-19 stressful events, fear of harm and symmetry predicted more severe pandemic OCD. • Lack of a diagnosis and schizotypal traits predicted more severe pandemic hoarding. • Greater compulsivity traits were associated with more severe pandemic OCD and hoarding. [ABSTRACT FROM AUTHOR]

Nursing students often experience critical events in the clinical setting and clinical instructors may not be prepared to adequately support them. These students often feel alone and abandoned, increasing their risk of psychological distress. A grounded theory study was conducted to explore pre-licensure nursing students' experiences of critical events in the clinical setting. Specific attention was paid to understanding how they are prepared for and supported before, during, and after critical events, and their experiences of psychological distress and psychological recovery. Strauss and Corbin's Grounded Theory methodology was used for this study. Fourteen undergraduate student nurses from universities in the western United States were interviewed. Ten concepts were identified, and a theory of Student Nurses' Experiences of Critical Events in the Clinical Setting emerged. Findings indicate that student nurses need active instructor and/or staff support during critical events, and pre-briefing whenever possible. Debriefing positively affected students' post-event stress response and lack of debrief was associated with post-event psychological distress. Support for students exposed to critical events during clinical experiences should continue in the days, weeks, and months following the event; clinical instructors need to be prepared to provide this support. All faculty members should monitor students for signs of psychological distress and better support students' mental health and emotional wellbeing. • Nursing students are frequently exposed to critical events in the clinical setting. • Exposure to critical events in the clinical setting can be traumatizing for students. • Faculty and nursing staff must provide adequate psychological support to these students. • Nursing programs have a responsibility for preparing students before critical events and following up after these events. [ABSTRACT FROM AUTHOR]

Birth is often viewed as a pathological event, consequently, there has been an increase in literature focusing on predictors, experience and implications of traumatic childbirth and childbirth-related posttraumatic stress. However, to fully understand childbirth experiences a salutogenic perspective is required. This enables an understanding of what facilitates a positive childbirth experience besides what places women at risk of experiencing traumatic childbirth. To identify the psychosocial factors that could contribute to or be influenced by women's subjective accounts of childbirth. An in-depth literature search across four databases was undertaken. Quality appraisal based on internal and external validity was conducted and a combined numerical summary and categorical description were undertaken. Nineteen papers were included in the review and the variables grouped into three categories. The variables relate to 'Measures of labour and birth experience' (discussing the impact of events and perceptions during labour and birth). The second category discusses how 'support and relationships' can potentially shape the birth experience or be altered by it and finally, 'Psychological variables: influence and impact' is examined extensively. The results of the review highlight significant contradictory evidence of what influences birth experiences. The findings confirm the dearth of available literature concerning positive birth experiences and most variables identified were pathogenic. This review suggests that such factors for PTSD may differ from those that influence birth experiences and should be examined separately. An enhanced understanding of the range of experiences is required to support women's rights in achieving a positive birth. [ABSTRACT FROM AUTHOR]

[Display omitted] • The mental health burden during the COVID-19 crisis is heavy among healthcare workers. • This meta-analysis estimated high pooled prevalences of psychiatric conditions. • Anxiety, depression and sleep problems were respectively 300 %, 311 %, and 440 %. • Estimates of acute and post-traumatic stress were high (56.5 %, 20.2 %). • Support interventions are urgent for workers' wellbeing and quality of care. Healthcare workers have been facing the COVID-19 pandemic, with numerous critical patients and deaths, and high workloads. Quality of care is related to the mental status of healthcare workers. This PRISMA systematic review and meta-analysis, on Pubmed/Psycinfo up to October 8, 2020, estimates the prevalence of mental health problems among healthcare workers during this pandemic. The systematic review included 70 studies (101 017 participants) and only high-quality studies were included in the meta-analysis. The following pooled prevalences were estimated: 300 % of anxiety (95 %CI, 24.2–37.05); 311 % of depression (95 %CI, 25.7–36.8); 565 % of acute stress (95 %CI - 30.6–80.5); 20,2% of post-traumatic stress (95 %CI, 9.9–33.0); 44.0 % of sleep disorders (95 %CI, 24.6–64.5). The following factors were found to be sources of heterogeneity in subgroups and metaregressions analysis: proportion of female, nurses, and location. Targeted prevention and support strategies are needed now, and early in case of future health crises. [ABSTRACT FROM AUTHOR]

Le trouble dissociatif de l'identité (TDI) fait l'objet de controverses dans la littérature scientifique et dans la pratique clinique. Cet article relève les principales croyances des cliniciens et les confronte aux études scientifiques sur ce sujet par une présentation des principales recherches des spécialistes du TDI et des opposants à ce trouble. Il résulte de cette revue de la littérature que (1) le TDI est un trouble différent de la schizophrénie ; (2) qu'il existe en dehors de toute influence iatrogène du thérapeute ou des médias ; (3) ces patients ne sont pas particulièrement sujets à la suggestibilité ni à la tendance à l'affabulation ; (4) le TDI apparaît en dehors de tout traitement hypnothérapeutique ; (5) il est le plus sévère des troubles d'origine traumatique ; (6) l'amnésie de traumas de l'enfance est un phénomène démontré ; (7) l'étendue des violences physiques et sexuelles extrêmes réalisées par des individus ou des groupes organisés sur des enfants, parfois des bébés, est connue des instances policières et judiciaires. Dissociative Identity Disorder (DID) has long been the subject of controversy in scientific literature and in clinical practice. This article identifies the main beliefs of clinicians and compares them to the scientific studies on this subject by presenting the main research of DID specialists and the opponents of this disorder. It results the following from this review of the literature: (1) DID is a different disorder from schizophrenia; (2) it exists independently of any iatrogenic influence of the therapist or of the media; (3) these patients are not particularly prone to suggestibility or fantasy; (4) DID appears outside of any hypnotherapeutic treatment; (5) it is the most severe of the traumatic disorders; (6) amnesia of childhood trauma is a proven phenomenon; (7) the extent of extreme physical and sexual abuse of children, sometimes infants, by individuals or organized groups, is known to police and judicial authorities. [ABSTRACT FROM AUTHOR]

Opioid Use Disorders (OUD) cause great disfunction and pain to individuals, families, and societies. There are few good treatments. This paper presents a novel, easily applied, painless, therapy that can be applied as an adjunct to psychotherapies and medications. The author presents a retrospective overview and 4 brief case reports. Two are typical of very positively responsive patients, one is of a positively but not remarkably responsive patient, and one of a non-responsive patient. The author used unilateral transcranial photobiomodulation (UtPBM), near infrared mode, applied to the hemisphere with the more positive hemispheric emotional valence (HEV) as a treatment to augment the patients' usual treatment. The case reports are from 42 consecutive patients in his practice with OUD where he has given 382 treatments over 18 months, as needed. The author's subjective clinical observations were that of the 42 patients, 26 (62%) consistently had responses to the UtPBM (as described in the case reports) that were easily observable to the patient and the author as strikingly beneficial, 8 (19%) had helpful, but not remarkable responses, and 8 (19%) had no noticeable response. These 3 characterizations will be illustrated with clinical examples. There were no side-effects reported or observed aside from 2 women who experienced anxiety which resolved with psychotherapy. Using UtPBM as an adjunctive treatment to the author's usual in-depth psychotherapy and medication management, he found subjectively that for the majority of his patients, this treatment was a valuable, safe benefit to their treatment for OUD. Image 1 • Unilateral transcranial photobiomodulation induced remarkable clinical responses. • Treatment was applied to the forehead over a brain hemisphere with a more positive valence. • Unilateral treatment appears far superior to bilateral treatment. • No side-effects were observed or reported. [ABSTRACT FROM AUTHOR]

La sévérité des symptômes du Trouble Stress Post-Traumatique (TSPT) altère considérablement le quotidien des militaires hospitalisés au sein de l'Hôpital d'Instruction des Armées Robert Picqué et se répercute sur la dynamique de couple en impactant les conjoints ainsi que la famille dans son ensemble. S'inscrivant dans un dispositif de soins intégratif et global, la journée des aidants et les réunions des aidants jouent un rôle soutenant pour la famille et étayant pour les patients. Espace de rencontres, de parole et d'écoute, ces réunions permettent aux familles des militaires blessés psychiques, autour de différents thèmes, d'y échanger leurs expériences, d'y trouver empathie, réconfort et cohésion, avec l'espoir d'améliorer les relations de couple et familiales. Severity of post-traumatic stress disorder (PTSD) symptoms significantly alters the daily lives of soldiers hospitalized at the Robert Picqué Instruction des Armées hospital and affects the couple's dynamics by impacting spouses and the family as a whole. As part of a comprehensive integrative car system, caregiver day and caregivers meetings play a supportive role for the family and support for patients. Meeting places, for speaking and listening, these meetings allow the families of members with mental injuries and around different themes to share their experiences, to find empathy, comfort and cohesion, with the hope of improving couple and family relationships. [ABSTRACT FROM AUTHOR]

This paper explores the social adaptation of 157 former Khmer Rouge (KR) cadres. The cadres lived in relative isolation in the former KR stronghold, the semi-autonomous Anlong Veng, under the leadership of their commander, Chhit Chhoeun (alias Ta Mok). With the help of survey analysis, the paper presents findings regarding the cadres' traumatisation, their views on assigning responsibility for actions during the genocide (1975–1979), as well as the cadres' feelings of shame and lack of trust. The cadres demonstrated avoidance and a lack of self-confrontation and, similarly, manifested limited reflection about their individual and collective participation in the genocidal regime of the KR. The paper concludes with the long-lasting impact of thought reform and obedience to authority. Community re-building in post-genocide societies requires efforts at collective rehabilitation of collaborators of genocidal regimes and survivors alike. [ABSTRACT FROM AUTHOR]

• Subjects with BD and MDD showed higher rates of childhood trauma. • Individuals with trauma and resilient are less vulnerable to have mood disorders. • Resilience is a mediator between trauma and depressive symptoms for both MDD and BD. Studies on the field of mood disorders has mainly focusing on the risk factors associated to develop the illness or the clinical factors associated with the clinical progression. Less attention was given to factors such as resilience that may be associated with better outcomes in the course of mood disorders. In this study, we assessed the mediation effect of resilience on the relationship between childhood trauma and mood disorders, as well as the severity of depressive symptoms in a population-based sample. This is a cross-sectional study with a community sample of young adults with bipolar disorder (BD), major depressive disorder (MDD), and community controls without any mood disorder. The trauma experiences during childhood were assessed by Childhood Trauma Questionnaire (CTQ). The severity of depressive symptoms was assessed using the Montgomery-Asberg Depression Rating Scale (MADRS) and to assess the resilience was used the Resilience Scale (RS-25). All subtypes of trauma were associated with both MDD and BD, however, only physical and emotional abuse differentiated BD from MDD subjects. Bootstrapping-enhanced mediation analyses indicated that resilience partly mediated the association of childhood trauma to both mood disorder and severity of depression. The employed mediation analyses are cross-sectional in nature, which limits any firm conclusions regarding causality. The findings support the clinical assumption that resilient subjects may be partly protected against the detrimental long-term effects of childhood trauma. This study provides important information regarding the relationships among childhood trauma, resilience, and mood disorder. [ABSTRACT FROM AUTHOR]

The sobering reality of the COVID-19 pandemic is that it has brought people together at home at a time when we want them apart in the community. This will bring both benefits and challenges. It will affect people differently based upon their age, health status, resilience, family support structures, and socio-economic background. This article will assess the impact in high income countries like Australia, where the initial wave of infection placed the elderly at the greatest risk of death whilst the protective measures of physical distancing, self-isolation, increased awareness of hygiene practices, and school closures with distance learning has had considerable impact on children and families acutely and may have ramifications for years to come. [ABSTRACT FROM AUTHOR]

Despite the known prevalence and detrimental health outcomes associated with adverse childhood experiences (ACEs), extant literature has rarely focused on the impact of ACEs on mothers' parenting practices. The purpose of this metasynthesis was to synthesize qualitative studies to understand how mothers with a history of ACEs parent their children. A systematic search was conducted across five databases with 11 studies meeting eligibilty criteria. Relevant data were extracted and analyzed with qualitative description. Six subthemes and three themes emerged from the data. Themes included breaking the cycle, parent and child well-being, and supporting mothers. All mothers described strategies to protect their children, with some describing hypervigilant parenting practices. Mothers discussed worries about appropriate discipline and a pervasive fear of community-based services for fear of removal of the child. Across studies, mothers described their current support system and offered several suggestions for formal support services. This metasynthesis provides the synthesized perspectives of traumatized mothers' parenting practices, which may inform future interventions. [ABSTRACT FROM AUTHOR]

L'objectif de cet article est d'étudier le sentiment de compétence parentale chez des mères qui ont été victimes d'agressions sexuelles pendant leur enfance (entre 0 et 16 ans) et de mettre en évidence les facteurs qui affectent cette perception chez ces mères. Nous avons examiné diverses caractéristiques relatives à l'abus sexuel (durée, âge lors des premiers faits, force et menace, intensité du traumatisme subi, avoir suivi une thérapie ou non, divers troubles encore présents actuellement). En outre, nous avons pris en considération la présence d'autres maltraitances infantiles survenues durant l'enfance et/ou l'adolescence. Les outils utilisés pour la récolte des données sont le questionnaire d'autoévaluation de la compétence parentale (QAECP), le TraumaQ et un entretien semi-structuré réalisé suite à une revue de la littérature. Onze mères victimes d'agression ont été rencontrées ainsi que 11 mères non victimes (groupe contrôle). Nos résultats montrent que le sentiment de compétence parentale est inférieur chez les mères qui ont été agressées sexuellement. En outre, plus le traumatisme psychologique est intense, plus le sentiment de compétence parentale est faible. Ainsi, le sentiment de compétence parentale est particulièrement bas en cas de : traumatisme psychologique intense, de précocité du trauma, de survenue intrafamiliale, d'association avec d'autres types d'abus et d'existence de symptômes dépressifs et de troubles du sommeil. On remarque également que ces mères victimes d'agression sexuelle perçoivent leurs parents comme étant moins compétents que les mères contrôles. Cependant, c'est particulièrement le cas lorsqu'il y a eu d'autres maltraitances infantiles que l'agression sexuelle ou encore lorsque celle-ci était intrafamiliale que les mères se sentent particulièrement moins compétentes. Ce ne serait donc pas seulement l'agression sexuelle qui affecterait le sentiment de compétence parentale mais les caractéristiques de cette agression, à savoir la présence d'autres formes de maltraitances et le fait qu'elle soit intrafamiliale. Nos résultats montrent en effet l'influence d'autres caractéristiques sur le sentiment de compétence parentale, telles que l'âge au début des faits, le statut de l'agresseur, les troubles dépressifs et les troubles du sommeil. L'ensemble de ces facteurs et de leurs conséquences illustre la complexité individuelle mais aussi intergénérationnelle de cette problématique. The aim of this paper was to study the self-perception of parenting skills in mothers who were sexually abused during their childhood (between 0 and 16 years old) and to highlight the factors that affect this perception among these mothers. In order to take into account the complexity of the phenomenon, we examined various characteristics of sexual assault (duration, age at first occurrence, strength and threat, intensity of trauma, whether or not one has received therapy, various disorders still present today). In addition, we considered the presence of other child abuse that occurred during childhood and/or adolescence. The tools used for data collection were the Parental Competency Self-Assessment Questionnaire (QAECP), the Trauma Q and a semi-structured interview constructed following a literature review. Eleven assaulted mothers were interviewed and 11 non-victim mothers (control group) were matched. Qualitative and quantitative analyses showed that mothers who have been sexually assaulted have a lower feeling of parental competency and that the more severe the psychological trauma, the lower the scores of self-perception of parenting. It is also noted that these sexually assaulted mothers perceived their own parents as less competent than control mothers. The association with other types of child abuse and sexual abuse occurring within a family were associated with a particularly poor prognosis. It would therefore not be sexual assault as such that would affect the self-perception of parenting skills, but the characteristics of this assault, namely the presence of other forms of abuse and the fact that it is within the family. Our results show the influence of other characteristics on the self-perception of parenting skills, such as age at the beginning of the event, aggressor status, depressive disorders and sleep disorders. All these factors and their consequences illustrate the individual and intergenerational complexity of this issue. [ABSTRACT FROM AUTHOR]

To describe nurses' personal and professional psychological trauma. A content analysis of 372 responses surrounding personal and professional trauma was performed. Five themes emerged. A new type of trauma was uncovered, heretofore undescribed in the literature: insufficient resource trauma caused by a lack of resources and staff needed to render quality, safe care. Nurses' reports were vivid, frequently indicating they were still recovering from traumatic experiences. Professional sources of trauma were categorized as inherent in the role of the nurse and those that could be mitigated through organizational policy, adequate resources, and oversight. • Insufficient resource trauma, a new form of nurse-specific trauma, is present when needed resources are lacking. • Psychological trauma affecting nurses may be avoidable or unavoidable. • Outcomes of psychological trauma indicate nurses' mental health and career issues that need to be addressed. [ABSTRACT FROM AUTHOR]

Cette étude illustre l'association entre traumatisme infantile, généralement un harcèlement scolaire et/ou abus sexuel, et la conduite de retrait social. Une revue bibliographique avec les mots clés : hikikomori, claustration, abus sexuel, traumatisme, enfance, social withdrawal, social isolation, child abuse, sexual abuse, psychological trauma et les moteurs SantéPsy, Lissa, Google Scholar, PubMed, PBSC en français et en anglais a été effectuée à la bibliothèque du centre hospitalier Sainte-Anne ; les principales références retrouvées sont étudiées ici, le commentaire de la documentaliste étant, « très peu de résultats trouvés ». Deux observations de jeunes adultes en retrait social ayant rapporté leur situation répétée de victime dans le milieu scolaire sont utilisées. La définition classique du harcèlement apparaît ici trop étroite par rapport à la souffrance rapportée de ces victimes, anciennement nommées « souffre-douleur ». Le retrait social est mis directement en relation avec ces situations traumatiques. De plus, nous relevons une constante qui est celle de la mise en cause par ces jeunes de la société comme origine de toutes leurs difficultés. This study illustrates the association between childhood trauma, usually school bullying and/or sexual abuse, and social withdrawal conduct. A bibliographic review with the keywords: hikikomori, claustration, sexual abuse, trauma, childhood, social withdrawal, social isolation, child abuse, psychological trauma and motors HealthPsy, Lissa, Google Scholar, PubMed, PBSC in French and English was made at the library of the hospital Sainte-Anne, the main references found here are studied, the commentary of the documentalist being "very little results". Two observations of young adults in social withdrawal who reported their repeated victim status in the school environment are used. The classic definition of harassment/bullying here appears too narrow in relation to the reported suffering of these victims formerly known as "pain-sufferers". Social withdrawal is directly related to these traumatic situations. In addition, we note a constant, which is that of the questioning by these young people of society as the origin of all their difficulties. [ABSTRACT FROM AUTHOR]

Establishing the diagnosis of trauma-related disorders such as Acute Stress Disorder (ASD) and Posttraumatic Stress Disorder (PTSD) have always been a challenge in clinical practice and in academic research, due to clinical and biological heterogeneity. Machine learning (ML) techniques can be applied to improve classification of disorders, to predict outcomes or to determine person-specific treatment selection. We aim to review the existing literature on the use of machine learning techniques in the assessment of subjects with ASD or PTSD. We systematically searched PubMed, Embase and Web of Science for articles published in any language up to May 2019. We found 806 abstracts and included 49 studies in our review. Most of the included studies used multiple levels of biological data to predict risk factors or to identify early symptoms related to PTSD. Other studies used ML classification techniques to distinguish individuals with ASD or PTSD from other psychiatric disorder or from trauma-exposed and healthy controls. We also found studies that attempted to define outcome profiles using clustering techniques and studies that assessed the relationship among symptoms using network analysis. Finally, we proposed a quality assessment in this review, evaluating methodological and technical features on machine learning studies. We concluded that etiologic and clinical heterogeneity of ASD/PTSD patients is suitable to machine learning techniques and a major challenge for the future is to use it in clinical practice for the benefit of patients in an individual level. [ABSTRACT FROM AUTHOR]

Background: Emotional memory is a critical amygdala-dependent cognitive function characterized by enhanced memory for emotional events coupled with retrograde amnesia. Our study aims to assess the influence of bipolar disorder (BD), trauma, and the number of mood episodes on emotional memory.Methods: 53 subjects (33 euthymic patients with BD and 20 healthy controls) answered a clinical assessment, childhood trauma questionnaire (CTQ), and an emotional memory test composed of lists of nouns, including neutral words, one emotional (E), one preceding (E-1) and one following word (E + 1). We assessed for the influence of type, position, diagnosis, trauma, and number of mood episodes in word recall using generalized estimating equations.Results: Controlling for neutral words, BD had a higher recall for E-1 (p = 0.038) and a trend for a higher recall of E (p = 0.055). There was no difference between patients with and without trauma. Patients with BD who suffered multiple mood episodes had a higher recall of E compared to patients with fewer episodes (p = 0.016).Limitations: Cross-sectional design and small sample size.Conclusion: Our results indicate dysfunction in emotional memory in patients with BD, particularly after multiple mood episodes. While we expected an impaired emotional memory, patients with BD showed an increased recall for emotional stimuli and events preceding them. Childhood trauma does not seem to interfere with emotional memory changes in patients with BD. Emotional memory enhancement seems to be a promising marker of progression in BD. [ABSTRACT FROM AUTHOR]

Trauma-informed care (TIC) aims to create a safe and supportive healthcare environment that empowers patients and cultivates understanding of the role trauma plays in short-term and long-term health. TIC also has the potential to improve health outcomes and foster clinician wellness. Nurse educators must design evidence-based instruction to develop advanced practice registered nurses (APRNs) who deliver high-quality TIC while also protecting their own wellbeing. To identify patterns in subjective viewpoints about TIC among APRN students and describe how those patterns influence their learning experience in an advanced health assessment course. Q methodology was used to explore student perceptions of TIC. A virtual advanced health assessment course at a large, midwestern university in the United States. Ninety-five APRN students from six specialty APRN programs. Students completed an online Q-sort activity by ranking 32 TIC statements according to how well the statements aligned with their own perspectives. Q-sorts were analyzed using factor analysis and narrative responses to open-ended questions. Four factors were extracted that revealed different student viewpoints on TIC and their learning experiences: Comfortable/Confident Learners, Uncomfortable/Apprehensive Learners, Empathetic/Hesitant Learners, and Inexperienced/Uncertain Learners. All students acknowledged the need to learn about TIC to implement it effectively in practice. It is important for faculty to understand the potential range of divergent student viewpoints about TIC and acknowledge, accept, and support students who have anxiety related to learning about TIC. • Trauma-informed care creates a safe and supportive environment for patients. • Advanced practice nurses require education and training to adopt trauma-informed care principles. • Q methodology is a valid research method to increase student awareness of diverse viewpoints. • Students vary widely in level of confidence and anxiety regarding trauma-informed care implementation. • Students anxious about trauma-informed care need acceptance and support during learning activities. [ABSTRACT FROM AUTHOR]

L'explosion de l'usine AZF de Toulouse est une catastrophe dont les conséquences humaines et matérielles sont considérables. De nombreuses personnes ont été impactées physiquement et beaucoup plus l'ont été psychologiquement. Cet article rend compte de manifestations psychologiques immédiates et post-immédiates exprimées par des victimes lors de consultations à la cellule de crise mise en place après l'explosion. The explosion that took place at the AZF factory in Toulouse was a catastrophic event that had considerable human and material consequences. Many people were physically impacted and even more were affected psychologically. This article is a report on the immediate and post-immediate psychological manifestations as expressed by victims during consultation at the crisis centre that was set up in the wake of the explosion. [ABSTRACT FROM AUTHOR]

• Child maltreatment is a major contributor to a large proportion of poor mental health in our society, and by extension a significant amount of criminal activity. • Research to date suggests that childhood trauma causes permanent damage to key brain structures involved in emotion memory and regulation, thereby affecting interpersonal behaviour and awareness (e.g. the ability to empathise). • Hence, the question arises whether the psychological and physiological sequel of childhood maltreatment should be considered a mitigating factor in criminal court. It has long been recognized that sustained or repeated child maltreatment has lasting psychological and emotional effects on the victims. This has helped to inform the criminal and civil justice systems how best to deal with perpetrators of abuse, as well social and health services when treating the victims. However, what is generally less well recognized is that physical and emotional abuse has a lasting and potentially non-reversible effect on brain function. We conducted a literature review on the forensic, mental, psychological, and pathophysiological impact of child maltreatment and discuss the implications of child maltreatment as a potential mitigating factor in criminal court in cases where victims of abuse become perpetrators themselves. Repeated exposure to traumatic experiences changes the responsiveness in the hypothalamus-pituitary-adrenal axis with lasting consequences in the developing brain for structures, such as the hippocampus and amygdala. These physiological changes are thought to cause a range of mental disorders, which are associated with poor affect regulation, anxiety, depression, and substance abuse. The importance of developing our understanding of the long-term effects of child abuse and neglect cannot be overestimated as the result of child maltreatment will perpetrate criminal acts since offenders have higher rates of mental illness than the general community. [ABSTRACT FROM AUTHOR]

Si la littérature concernant la difficulté de devenir parent dans un pays qui n'est pas le sien est désormais riche, les données concernant l'impact de la migration ou du traumatisme psychologique sur un processus de parentalité déjà engagé sont moins nombreuses. Cet article propose d'explorer la façon dont la parentalité peut être mise à mal par des événements traumatiques tels que la guerre et l'exil. À travers l'histoire d'une mère ayant fui depuis l'Afrique subsaharienne avec deux de ses enfants, nous interrogeons les possibilités de mise au travail de la fonction maternelle qui, bien qu'entravée, peut faire l'objet de transformations et de reconsolidations, à la faveur du travail psychique engagé dans le cadre de consultations transculturelles. Le corps se fait ici voie d'expression privilégiée de la culpabilité et des souffrances portées par les différents membres de la famille. En acceptant d'entendre ce que le corps a à nous dire, en accueillant la singularité de chacun, le groupe transculturel permet à la famille de retrouver une capacité de narrativité et de co-construire un récit commun. La méthode transculturelle, qui préconise le recours à la psychanalyse et à l'anthropologie de façon non fusionnante et non simultanée, permet aux thérapeutes de s'appuyer sur des représentations à la fois singulières et collectives de la fonction parentale. L'analyse de certains fragments de cette thérapie, réunissant dans un même espace une mère et ses enfants, permet ainsi d'éclairer les différents leviers thérapeutiques auxquels les thérapeutes ont pu avoir recours pour venir soutenir le processus de parentalité. Even if the literature about the difficulty of becoming a parent in a foreign country is now rich, there are fewer data about the impact of migration or psychological trauma on a parenting process already underway. This article aims to show the way parenthood can be harmed by traumatic events such as war and exile. Through the story of a mother who fled from sub-Saharan Africa with two of her children, we question the possibilities of putting the maternal function to work which, although impeded, can be subject to changes and reconsolidations, thanks to psychic work undertaken in the context of a transcultural setting. In this situation, the body is a privileged expression of the guilt and suffering of the family members. Considering the meaning of somatic symptoms and welcoming the singularity of each person, the transcultural group allows the family to find a narrative capacity and a way to co-construct a common narrative. The transcultural method, which recommends the use of psychoanalysis and anthropology in a non-merging and non-simultaneous way, allows therapists to rely on both singular and collective representations of the parental function. The presence of an interpreter, fulfilling the true role of cultural mediator, allows the use of the mother tongue and a privileged access to the inner intimate and emotional world of the family members in a familiar and reassuring environment. The analysis of certain parts of this therapy, bringing together in the same space a mother and her children, thus helps to clarify the various therapeutic levers that therapists resorted to in order to support the process of parenthood. [ABSTRACT FROM AUTHOR]

Purpose: To compare youth with psychogenic non-epileptic seizures (PNES) to youth with epilepsy on demographic and clinical features and the Trauma Symptom Checklist for Children (TSCC).Method: A retrospective study of 31 patients; 15 patients with PNES (11 females) and 16 patients with epilepsy (8 females) collected consecutively between 2014-2018. Demographic and clinical information (age of seizure onset, life adversities, individual/family psychiatric history, etc.) were gathered. Scales from the TSCC (Dissociation, Depression, Anxiety) were analyzed.Results: Eleven of the youth with PNES (YPNES) (73%) were female, mean age was 14.3 ± 1.6 years and years of education were 9 ± 1.9. Eight of the youth with epilepsy (YWE) (50%) were females, mean age was 11.9 ± 2.8 years and years of education were 5.6 ± 2.9. All 15 YPNES and over half of their families had comorbid psychological problems whilst rates of personal and family psychiatric histories were much lower in YWE. Well over half of YPNES reported experiencing life adversities while one fourth of YWE reported these types of experiences. Significant differences were observed between YPNES and YWE on TSCC Overt Dissociation (p < 0.003), Dissociation (p < 0.009), and Depression (p < 0.001) scales, with YWE producing lower scores. When the six target variables were condensed into one principal component, the global TSCC score was lower in the epilepsy group, even after adjusting for potential effects age, seizure frequency and intellectual quotient.Conclusions: The current study's results indicate that YPNES present with comparably higher self-reported symptoms of depression and dissociation than YWE. [ABSTRACT FROM AUTHOR]

Abstract Intrusive memories of a traumatic event can be distressing and disruptive, and comprise a core clinical feature of post-traumatic stress disorder (PTSD). Intrusive memories involve mental imagery-based impressions that intrude into mind involuntarily, and are emotional. Here we consider how recent advances in cognitive science have fueled our understanding of the development and possible treatment of intrusive memories of trauma. We conducted a systematic literature search in PubMed, selecting articles published from 2008 to 2018 that used the terms "trauma" AND ("intrusive memories" OR "involuntary memories") in their abstract or title. First, we discuss studies that investigated internal (neural, hormonal, psychophysiological, and cognitive) processes that contribute to intrusive memory development. Second, we discuss studies that targeted these processes using behavioural/pharmacological interventions to reduce intrusive memories. Third, we consider possible clinical implications of this work and highlight some emerging research avenues for treatment and prevention, supplemented by new data to examine some unanswered questions. In conclusion, we raise the possibility that intrusive memories comprise an alternative, possibly more focused, target in translational research endeavours, rather than only targeting overall symptoms of disorders such as PTSD. If so, relatively simple approaches could help to address the need for easy-to-deliver, widely-scalable trauma interventions. Highlights • Intrusive memories of trauma can be distressing and disruptive in their own right. • Intrusive memories are a core clinical feature of posttraumatic stress disorder. • Cognitive science offers insights on the aetiology of intrusive memories. • Targeting intrusive memories has implications for prevention and scalable treatment. • Focusing on one symptom, instead of a whole disorder, has translational benefits. [ABSTRACT FROM AUTHOR]

Highlights • Current symptom severity influenced memory for perceived past symptom severity. • Participants below the PTSD cut-off at Time 2 underestimated past symptom severity. • Participants above the PTSD cut-off at Time 2 overestimated past symptom severity. • Participants who showed adjustment over time underestimated past symptom severity. • Participants who did not adjust over time recalled their symptoms consistently. Abstract Clinicians often rely on clients' retrospective reports of past symptoms to diagnose and treat Posttraumatic Stress Disorder (PTSD). However, there is limited research investigating memory for past PTSD symptoms. We asked sexual assault survivors to report their PTSD symptoms and then recall them 6 months later. Overall , symptom recall was consistent with initial reports. However, after dividing participants into PTSD-positive and negative groups, we found that people who were PTSD-negative at follow-up underestimated past PTSD symptom severity while people who were PTSD-positive overestimated past symptoms. For example, 2.8% of PTSD-negative participants versus 15.9% of PTSD-positive participants recalled experiencing 20+ more points on the PCL-5 at follow-up than at initial assessment. Further, people who adjusted over time greatly underestimated past symptoms unlike those who remained PTSD-positive. Our findings have important theoretical and clinical implications because they show that current symptom severity may influence the memory reconstruction of prior levels of adjustment. [ABSTRACT FROM AUTHOR]

Introduction: Trauma-exposed individuals with and without posttraumatic stress disorder (PTSD) are more likely to smoke and less successful in quit attempts than individuals without psychopathology. Contingency management (CM) techniques (i.e., incentives for abstinence) have demonstrable efficacy for smoking cessation in some populations with psychopathology, but have not been well tested in PTSD. This pilot study examined the feasibility of CM plus brief cognitive behavioral therapy (CBT) in promoting smoking cessation among trauma-exposed individuals with and without PTSD.Methods: Fifty trauma-exposed smokers (18 with PTSD) were asked to abstain from tobacco and nicotine replacement therapy for one month. During week one of cessation, CBT was provided daily and increasing CM stipends were paid for each continuous day of biochemically-verified abstinence; CM stipends were withheld in response to smoking lapses and reset to the initial payment level upon abstinence resumption. CBT and fixed payments for study visits were provided during the subsequent three weeks.Results: Of the 50 eligible participants who attended at least one pre-quit visit (49% female, 35% current PTSD), 43 (86%) attended the first post-quit study visit, 32 (64%) completed the first week of CM/CBT treatment, and 26 (52%) completed the study. Post-quit seven-day point prevalence abstinence rates for participants with and without PTSD, respectively, were similar: 39% vs. 38% (1 week), 33% vs. 28% (2 weeks), 22% vs. 19% (3 weeks), and 22% vs. 13% (4 weeks).Conclusions: Use of CM + CBT to support tobacco abstinence is a promising intervention for trauma-exposed smokers with and without PTSD. [ABSTRACT FROM AUTHOR]

Objective: The objective of the study was to explore hospitalized youths' experiences with psychosocial care in the hospital after the shooting on Utøya Island, Norway, in 2011.Methods: 17 hospitalized youths were interviewed face-to-face 30-31 months after the attack. The interviews were analysed using interpretative phenomenological analysis (IPA). The initial reading and coding of the interviews was carried out inductively. To explore the emphasis placed on everyday conversation and ordinary interaction detected during the initial reading, the text was re-read while bearing in mind concepts from the research field of sociology concerning the therapeutic potential in commonplace conversations and situations.Results: The youths highlighted the need for health care workers to embrace essential aspects of their past, present and future. Therefore, three overarching categories emerged related to 1) Remembering the past, 2) Dealing with the present and 3) Preparing for the future. For each temporal category, two related subcategories were identified: Past:Engaging in the trauma narrative; Understanding the trauma reminders; Present: Bringing back normalcy; Being there; Future: Supporting confidence; Instilling trust.Conclusions: For the youths in the current study, talking with the hospital staff about their traumatic experiences was mostly perceived as positive and linked to various helpful outcomes. In addition to engaging in the trauma narrative, the staff needed to comprehend and address how the traumatic experiences and the hospitalization resulted in the survivors' extended fear and changed appraisals about the world and themselves. Having the time to stay physically and mentally close to the youths and engage in everyday interaction was crucial in rebuilding their sense of safety and bringing back normalcy. The hospital staff played a significant role in strengthening the survivors' confidence in own capabilities and trust in others. The different professionals in the hospital contributed to various aspects of psychosocial care, and both trauma-focused interventions and commonplace conversations and actions were emphasized as important and meaningful approaches. [ABSTRACT FROM AUTHOR]