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Forensic services have shifted their focus to the importance of forensic practice becoming more trauma informed. Trauma exposure is pervasive in forensic mental health populations and has been found to negatively impact the course of severe mental illness (SMI) and increase risk of violence. This study aimed to explore the trauma histories of adult male inpatients in a medium-secure psychiatric hospital, and examine childhood and adulthood trauma as predictors of diagnoses, self-harm, suicidality, hospital re-admissions, substance use, and nature of offense. The case files of 85 male patients in a medium secure unit in the UK were reviewed. Eighty-seven percent of patients had a schizophrenia diagnosis and 86% had extensive trauma histories, the most common trauma type being physical violence in childhood (44.7%). One patient had a PTSD diagnosis. Logistic regressions demonstrated that cumulative childhood and adulthood trauma significantly increased the odds of self-harm. Cumulative childhood trauma exposure was found to decrease the likelihood of having a schizophrenia diagnosis. There is a serious under-recognition of the extent and consequences of trauma exposure; trauma histories are likely greater than the findings of this study and existing literature suggests. Implications for clinical practice, trauma-informed care (TiC), and future research are proposed. [ABSTRACT FROM AUTHOR]

Introduction: The Syrian refugee crisis has led to significant population displacement, with many seeking refuge and asylum in Nordic countries. While these countries offer safety and stability, the resettlement process combined with the refugees' own traumatic experiences can exacerbate existing or precipitate new mental health issues. Aim: This systematic review aims to comprehensively analyse the literature on mental health problems among Syrian refugees resettled in Nordic countries, exploring their prevalence and associated factors. Methods: A comprehensive literature search was conducted following PRISMA guidelines, utilizing databases including Web of Science, PubMed, MEDLINE, and Cochrane. The included studies focused on adult Syrian refugees or asylum seekers aged 18 and above, residing within Nordic countries, and investigated various mental health problems between March 2011 and January 2024, conducted in various Nordic countries. Results: Studies revealed high prevalence rates of PTSD (26%–45%), depression (40%–45%), and anxiety (30%–32%). Factors contributing to mental health problems included pre- and post-migration trauma, perceived discrimination, and socio-demographic variables. Pre-migration trauma exposure, such as witnessing violent events, was linked to trauma centrality and emotional suppression. Post-migration stressors like discrimination and financial strain, along with socio-demographic factors like gender and age, were associated with mental health issues. Specifically, female and older refugees reported higher levels of anxiety, depression, and low future expectations. Conclusion: The findings underscore the urgent need for comprehensive mental health assessment and services for Syrian refugees in Nordic countries. Addressing trauma, discrimination, and socio-economic challenges is crucial for improving their well-being and facilitating successful integration into host countries. [ABSTRACT FROM AUTHOR]

People with dissociative symptoms are generally poly-symptomatic and require high levels of healthcare resources. Post-traumatic stress disorder (PTSD) and depressive symptoms are two major disabling comorbid symptoms in people with dissociative symptoms. While the sense of control over symptoms may be associated with PTSD and dissociative symptoms, the interplay among these factors over time remains unexplored. This study examined the predictors of PTSD and depressive symptoms in people with dissociative symptoms. Longitudinal data from 61 participants with dissociative symptoms were analyzed. Participants completed self-report measures of dissociative, depressive, and PTSD symptoms and the sense of control over symptoms two times (T1 & T2) with an interval of over one month. PTSD and depressive symptoms were not transient or time-specific, but they persisted over time in our sample. Hierarchical multiple regression analyses revealed that, after controlling for age, treatment usage and baseline symptom severity, T1 symptom management scores (β = −.264, p =.006) negatively predicted T2 PTSD symptoms, while T1 PTSD symptoms (β =.268, p =.017) positively predicted T2 depressive symptoms. T1 depressive symptoms (β = −.087, p =.339) did not predict T2 PTSD symptoms. The findings highlight the importance of improving symptom management skills and treating comorbid PTSD symptoms when working with people with dissociative symptoms. [ABSTRACT FROM AUTHOR]

Secondary traumatic stress (STS) has been studied in therapists, spouses, and mainly in children of traumatised individuals. To date, the relationship between children's posttraumatic stress disorder (PTSD) symptoms and their parents' mental health outcomes have been understudied, and specifically, long term STS symptoms of parents of war veterans were not investigated. The current study examined PTSD symptoms among veterans of the 2014 Israel-Gaza war and STS among their parents, five years after the war. The control group consisted of veterans from combat military units who were on active duty at the time of the war but did not actively participate in the war (stand-by units) – providing a natural experiment condition. We found that PTSD symptoms were almost twice as high in the directly active war veterans (DAV, N = 32) group compared to the indirectly active war veterans (IAV, N = 26) group. Results showed that mothers had higher STS symptoms in general, and DAV PTSD symptoms correlated with their fathers STS symptoms. The current study provides novel evidence for: (a) subclinical PTSD symptoms in war veterans 5 years after the war, and (b) transmission of trauma from war veterans to their parents. The overall negative effect of sending a child to war on the parents are also discussed. The current study examined post-traumatic stress symptoms among undiagnosed war veterans of the 2014–2014 Israel-Gaza Military Conflict compared to matched control who were on active military duty at the same time but did not actively participate in the war. We found higher post-traumatic stress symptoms in the veterans who actively participated in the war, roughly five years after the war. Parents of veterans who actively participated in the war exhibited higher secondary traumatic stress compared to parents of veterans who did not actively participate in the war. This is especially interesting given that parents of all veterans were not aware of their whereabouts during the war. Overall, mothers exhibited higher secondary traumatic stress compared to fathers. However, fathers were more 'in-sync' with their sons' traumatic experience as evident by a significant correlation between the war veterans' post-traumatic stress and the fathers' secondary traumatic stress symptoms. [ABSTRACT FROM AUTHOR]

Background: Guilt and Shame, two core self-related emotions, often emerge following trauma and play an important role in the development and maintenance of post-traumatic stress disorder (PTSD). Importantly, Guilt and Shame exhibit specific focal and non-specific global impacts of trauma on self-perception, respectively. Objective and Methods: Integrating psychological theories with neuroscientific knowledge, we suggest a scheme of two diverging clinical phenotypes of PTSD, associated with distinct self-related processes and differential functionality of relevant neural networks. Proposal: The Guilt-driven phenotype is characterized by preoccupation with negative self-attributes of one's actions in the traumatic event. It involves altered functionality of both the salience network (SN) and the default-mode network (DMN), associated with heightened interoceptive signalling and ruminative introspection which may lead to hyperarousal and intrusive symptoms, respectively. On the contrary, the Shame-driven phenotype is characterized by global, identity-related negative self-attributions. It involves altered functionality of both the SN and the DMN, associated with blunted interoceptive signalling and diminished introspection which may result in withdrawal and anhedonia symptoms together with dissociative experiences, respectively. Conclusion: The proposed PTSD phenotypes may inform neuropsychological therapeutic interventions (e.g. self-focused psychotherapy and neuromodulation) aiming to restore the function of large-scale self-related neural processing. Guilt and Shame are two self-related emotions that often emerge following traumatic events and may contribute to the clinical profile of post-traumatic stress disorder (PTSD). Our framework suggests Guilt and Sham driven phenotypes of post-traumatic psychopathology, associated with two self-processing deficiencies related to specific action or global identity, respectively. The proposed phenotypes may inform neuropsychological treatments aiming to restore dysfunctional neural networks, later to be evident in alleviating Guilt and Shame and improving clinical outcomes. [ABSTRACT FROM AUTHOR]

Little is known about the efficacy of eye movement desensitization and reprocessing (EMDR) therapy for post-traumatic stress disorder (PTSD) symptoms in people with mild intellectual disability or borderline intellectual functioning (MID-BIF). To explore the safety, feasibility, and efficacy of EMDR therapy in adults with MID-BIF, PTSD, and comorbid mental health and psycho-social problems. Data were collected from nine participants using a non-concurrent multiple baseline design. PTSD symptoms, level of daily life impairment, and possible adverse effect were measured weekly during baseline, treatment, post-treatment, and at three-month follow-up. Depressive symptoms, general psychopathology, and mental health problems were assessed once in every phase. Participants displayed a significant reduction of PTSD symptoms, and the majority of participants no longer met criteria for DSM-5 PTSD diagnosis after therapy. EMDR therapy appeared to be safe, as no adverse events were reported during the study time frame. Further, participants showed a decrease in depressive symptoms as well as less severe general psychopathology and mental health problems following therapy. EMDR therapy was found to be safe, feasible, and (potentially) efficacious in decreasing PTSD symptoms, loss of PTSD diagnoses, reduction of level of daily life impairment, and general psychopathology for adults with MID-BIF, suffering from both severe mental health and psycho-social problems. [ABSTRACT FROM AUTHOR]

Network meta-analysis is an extension of standard meta-analysis. It allows researchers to build a network of evidence to compare multiple interventions that may have not been compared directly in existing publications. With a Bayesian approach, network meta-analysis can be used to obtain a posterior probability distribution of all the relative treatment effects, which allows for the estimation of relative treatment effects to quantify the uncertainty of parameter estimates, and to rank all the treatments in the network. Ranking treatments using both direct and indirect evidence can provide guidance to policy makers and clinicians for making decisions. The purpose of this paper is to introduce fundamental concepts of Bayesian network meta-analysis (BNMA) to researchers in psychology and social sciences. We discuss several essential concepts of BNMA, including the assumptions of homogeneity and consistency, the fixed and random effects models, prior specification, and model fit evaluation strategies, while pointing out some issues and areas where researchers should use caution in the application of BNMA. Additionally, using an automated R package, we provide a step-by-step demonstration on how to conduct and report the findings of BNMA with a real dataset of psychological interventions extracted from PubMed. [ABSTRACT FROM AUTHOR]

Background: The ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD diagnoses have been examined in several studies using the International Trauma Questionnaire (ITQ). The cross-cultural validity of the ITQ has not previously been studied using item responses theory methods focused on the issue of equal item functioning and thus comparability of scores across language groups. Objective: To investigate the cross-cultural validity of the ITQ scales considering specifically local independence of items and differential item functioning (DIF) in a cross-cultural sample of refugees. Method: Data from 490 treatment-seeking refugees were included, covering Danish, Arabic, and Bosnian languages and different levels of interpreter-assisted administration. Rasch and graphical log-linear Rasch models were used. Results: There was strong local dependence among items from the same symptom clusters in the PTSD and disorders in self-organization (DSO) scales, except between affective dysregulation items. Weak local dependence was discovered between an item from the affective dysregulation cluster and an item from the disturbed relationship cluster. There was no evidence of DIF related to language or interpreter assistance. There was evidence of DIF for two PTSD items relative to gender and time since the traumatic event. The targeting of the scales to the study population was not optimal. Reliability varied from 0.55 to 0.78 for subgroups. Conclusions: The PTSD and the DSO scales have stable psychometric properties across the Danish, Arabic, and Bosnian language versions and different levels of assisted administration. Scores are comparable across these groups. However, DIF relative to gender and time since trauma introduces considerable measurement bias. DIF-adjusted summed scale scores or estimated person parameters should be used to avoid measurement bias. Future research should investigate whether scales including more and/or alternative items that require higher levels of PTSD and DSO to be endorsed will improve targeting and measurement precision for refugee populations. A first cross-cultural validity study of the ITQ using IRT. PTSD and DSO subscales functioned invariantly across Danish, Arabic, and Bosnian, and also across degrees of interpreter assistance. Two PTSD items did not function invariantly across gender and time since trauma. The Danish, Arabic, and Bosnian ITQ can be used for screening treatment-seeking refugees, taking into account the item bias in the PTSD subscale, and suboptimal targeting and reliability, which require extensions or modification of items. [ABSTRACT FROM AUTHOR]

Background: The International Trauma Questionnaire (ITQ) is a standardized and validated measure aligned with the 11th version of the International Classification of Diseases (ICD-11) diagnostic criteria to assess post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD). It has been translated into 25 different languages, but is yet to be translated into Dari and validated for use in the Afghan population. Objective: This study aimed (1) to translate and culturally adapt the ITQ for use in Dari; (2) to assess the construct validity and composite reliability of ICD-11 PTSD and CPTSD using the Dari ITQ; and (3) to examine the concurrent, convergent, and discriminant validity of the Dari ITQ. Method: The Dari ITQ was validated through the completion of a set of standardized measures by 305 Afghan asylum seekers and refugees in Austria. Factorial analyses and psychometric properties of the Dari ITQ were assessed using confirmatory factor analysis (CFA), bivariate correlations, and multivariate regression. Results: Asylum seekers showed significantly higher levels of ICD-11 CPTSD symptomatology and probable diagnoses of ICD-11 PTSD, Diagnostic and Statistical Manual of Mental Disorders, 4th Edition (DSM-IV) PTSD, anxiety, depression, and psychological distress in comparison to refugees. CFA results supported the two-factor second-order model comprised of the PTSD and disturbances in self-organization (DSO) as the best fit to the data. The psychometric adequacy of this model in the Dari ITQ was evidenced by high factor loadings and excellent internal reliability. The Dari ITQ showed satisfactory concurrent, convergent, and discriminant validity. Conclusion: The current study supports the statistical validity and cultural sensitivity of the Dari ITQ in identifying symptoms of ICD-11 PTSD and CPTSD among Afghan asylum seekers and refugees. This study provides the first translation and validation of the ITQ in Dari with an Afghan refugee population in Austria. The two-factor second-order model was supported as the best fit to the data. Additional support for the composite reliability, and concurrent, convergent, and discriminant validity was provided, suggesting the statistical validity and cultural sensitivity of the Dari ITQ in identifying symptoms of ICD-11 PTSD and CPTSD among Afghan asylum seekers and refugees. [ABSTRACT FROM AUTHOR]

This study investigated the prevalence of post-traumatic stress disorder (PTSD) and mental health comorbidities among career firefighters in the U.S. and examined occupational factors related to PTSD. A total of 624 male career firefighters completed questions regarding PTSD and mental health conditions. Nearly 7% met the criteria for being in the range of concern for PTSD, and among those, 87% screened positive for at least one other mental health condition. Those with PTSD also reported significantly higher occupational stress and duty-related incident stress, having a lower perception of self-efficacy to manage stress/trauma exposure and lower perceptions of support from their department and peers than those without PTSD. [ABSTRACT FROM AUTHOR]

Post-traumatic stress disorder (PTSD) is prevalent in traumatic events. It is a great hazard of physical and mental health due to their severity and frequency. Traumatic fractures are one of the major causes of PTSD. The incidence of traumatic fractures has been high in recent years, which will directly or indirectly result in PTSD. Our target is to estimate the pooled incidence of PTSD in fracture patients after traumatic events and to explore possible influencing factors by a meta-analysis. The systematic searches in the electronic bibliographic databases of Web of Science, ScienceDirect, Ovid MEDLINE, PubMed, CNKI (China National Knowledge Infrastructure), Wangfang , and Veipu Databases. Not only were heterogeneity and 95% confidence interval (CI) used for comprehensive assessing each pooled, but also was the P value. Subgroup analyses for some sample characteristics were calculated the pooled incidence of PTSD among patients suffered from fractures. In total, 2619 patients suffered from fracture, and were assessed PTSD in the 12 eligible studies. The heterogeneity was not low (I2 = 97.6%, P < 0.001) in the 12 eligible studies. The pooled incidence of PTSD in fracture patients was 29% (95% CI, 20% to 39%) using random-effects model. Subgroup analyses revealed that the pooled incidence of PTSD among patients after traumatic fracture was statistically significant differences according to the study design, the study location, tools to assess the symptoms of PTSD, the mean age and injury mechanism (all P < 0.001). Fracture sites, injury mechanism and pain were the main influencing factors of PTSD in fracture patients. Our results highlight the phenomenon that high incidence of PTSD in patients after fracture and they should be followed up regularly and be provided effective interventions. Future efforts to improve and control the main influencing factors of PTSD for this population still needed. [ABSTRACT FROM AUTHOR]

This paper is a systematic research review examining the best treatment intervention for children experiencing post-traumatic stress disorder (PTSD) or PTSD-like symptoms after a natural disaster event. Research articles (12) were reviewed using a checklist that assesses face, content, and criterion validity: 9 quantitative, 2 mixed-methods, and 1 qualitative, to determine best screening and intervention practices to reduce the negative symptoms resulting from trauma. Researchers in the cited studies collected data via phone interviews, face-to-face interviews, surveys, self-evaluations, observation methods, teacher and social worker assessments, and parent assessments. For the purpose of this paper, we focused on the question: What is the best way to screen for and treat PTSD in children in post-natural disaster areas? Based on these studies, we identified three major themes: 1) the treatment of PTSD is necessary in post-natural disaster children; 2) school-based screenings (with considerations) are the most viable way to screen children for PTSD; and 3) CBT is the most universal intervention for children post-disaster. We included additional findings on EMDR and parenting techniques. More research needs to be done on the impact of family dynamics in post-natural disaster treatment and the long-term effects of experiencing a natural disaster. [ABSTRACT FROM AUTHOR]

Background: Coronavirus disease 2019 (COVID-19) can place an immense psychological strain on the infected patient. The psychological distress can linger after the initial recovery from the infection. Objective: This study aimed to evaluate the prevalence and predictors of provisional post-traumatic stress disorder (PTSD) in patients with cured COVID-2019. Methods: The baseline survey was conducted from 10 to 25 February 2020 in patients with COVID-19 in a designated hospital. Demographic and clinical characteristics were acquired, and depression and anxiety levels were assessed, using the 9-item Patient Health Questionnaire and 7-item Generalized Anxiety Disorder scale, respectively. A follow-up survey was conducted 1 month post-discharge. PTSD symptoms were measured by the Impact of Event Scale-6 (IES-6) and patients' perception of supportive care during hospitalization was investigated using a self-developed questionnaire. Results: In total, 114 patients completed both the baseline and follow-up surveys. Of these, 41 (36.0%) met the cut-off score for provisional PTSD diagnosis according to the IES-6. Female gender [odds ratio (OR) = 4.69, 95% confidence interval (CI) 1.54–14.37], educational level of high school or below (OR = 15.49, 95% CI 1.13–212.71), higher anxiety levels (OR = 1.34, 95% CI 1.12–1.61) and lower perceptions of emotional support during hospitalization (OR = 0.41, 95% CI 0.17–0.96) predicted a higher risk for provisional PTSD. Conclusions: PTSD is commonly seen in patients with COVID-19 1 month post-discharge. Female patients, and patients with lower educational levels, higher anxiety levels and lower perceptions of emotional support during hospitalization may be more likely to develop PTSD in the near future. Enhancing emotional support during hospitalization could help to prevent PTSD in patients with COVID-19. More than one-third ofpatients met the diagnostic criteria of probable PTSD 1 month post-discharge. Providing timely emotional support during hospitaliza-tion may be one of the key measures for preventing PTSD in patients with COVID-19. [ABSTRACT FROM AUTHOR]

Background: The use of remotely delivered early intervention after trauma may prevent and/or reduce symptoms of post-traumatic stress. Our research group evaluated a novel three-week therapist-guided internet-delivered intervention based on prolonged exposure (Condensed Internet-Delivered Prolonged Exposure; CIPE) in a pilot trial. The results indicated that the intervention was feasible, acceptable and reduced symptoms of post-traumatic stress at post-intervention compared to a waiting-list condition. Exposure to traumatic memories can be emotionally demanding and there is a need for detailed investigation of participants' experiences in receiving this type of intervention remotely. Objective: Investigate participants' experiences of receiving CIPE early after trauma. Method: In this study, qualitative thematic analysis was used and semi-structured interviews with 11 participants six months after intervention completion were conducted. All interviews were audio-recorded and transcribed verbatim. Results: One overarching theme labelled as 'demanding and effective' was identified. Participants expressed that treatment effects could only be achieved by putting in a lot of effort and by being emotionally close to the trauma memory during exposure exercises. Participants reported CIPE to be a highly credible- and educative intervention that motivated them to fully engage in exposure exercises. The most distressing parts of the intervention was perceived as tolerable and important to do to heal psychologically after trauma. For many participants, the possibility to engage in the intervention whenever and where it suited them was helpful, although some participants described it as challenging to find a balance between their own responsibility and when to expect therapist support. The internet-based format was perceived as a safe forum for self-disclosure that helped some participants overcome avoidance due to shame during imaginal exposure. Conclusion: CIPE was considered demanding, yet effective by the interviewed participants. The most distressing parts of the intervention was perceived to be the most important and were tolerable and feasible to provide online. Condensed online prolonged exposure (CIPE) was perceived by participants as a demanding yet effective early intervention after trauma. The most distressing part, revisit the memory of the traumatic event, was perceived as the most helpful component. [ABSTRACT FROM AUTHOR]

Background: Post Traumatic Stress Disorder (PTSD) has been described as an independent risk factor for cognitive decline and dementia. At the same time, cognitive deterioration and increased loss experiences in dementia may increase liability for the reactivation of traumatic memories and thereby PTSD symptoms. Objective: In order to investigate co-occurrence of PTSD in dementia this systematic literature review summarizes all the available evidence on reported comorbidity rates of PTSD in patients with dementia. Method: PubMed, Embase, PsycINFO and CINAHL were searched for potential publications investigating the co-occurrence of PTSD in dementia until 25 November 2019. Cohort and cross-sectional studies were included. To assure current comorbidity of PTSD in dementia, only publications with a recent PTSD diagnosis (<2 years before onset of dementia) were selected. Results: Of the 860 identified abstracts, three studies (0.35%) met the eligibility criteria and were included. These three studies concerned only military veteran populations, and they comprised two cross-sectional cohort studies and one prospective cohort study. The estimated comorbidity rate of PTSD in veterans with dementia varied between 4.7% and 7.8%. Conclusions: The limited research available shows comorbidity rates only in military veterans, which were possibly dependent on investigated population with respect to dementia severity and possibly associated behavioural and psychiatric symptoms of dementia (BPSD). In dementia patients the comorbidity with PTSD may be high and we suggest that worldwide the impact of PTSD in dementia is high and probably underestimated. Research and care on this topic should improve urgently with the current expanding prevalence of dementia. A first step to improve quality of dementia research and care would be to develop a structured tool to diagnose PTSD in these patients. Dementia patients may have a high comorbidity rate of post-traumatic stress disorder. [ABSTRACT FROM AUTHOR]

In this essay, I examine the representation of female sexuality in the aftermath of childhood and adolescent sexual abuse and in the course of post-traumatic stress disorder (PTSD) in Una's Becoming Unbecoming. Drawing from work on mental illness, social justice, and graphic medicine, I investigate the narrativisation of the autobiographical subject's suffering through the comics medium. My aim is to show how Becoming Unbecoming counters the silences and stereotypes existing around the sexuality of abused and mentally ill women and girls. In her attempt to represent the symptoms of PTSD – itself the outcome of sexual violence – and to remove stigma from female rape survivors, Una makes use of braiding and metaphors in her narrative. These allow for a complex demonstration of PTSD symptoms and of the autobiographical subject's desire for (sexual) intimacy as she grows up. In this way, Becoming Unbecoming breaks into the silence and challenges the stereotypes that render the sexuality of (mentally ill) women and girls invisible at best and perverse at worst. [ABSTRACT FROM AUTHOR]

Glucocorticoid signaling is fundamental in healthy stress coping and in the pathophysiology of stress-related diseases, such as post-traumatic stress disorder (PTSD). Glucocorticoids are metabolized by cytochrome P450 (CYP) as well as 11-β-hydroxysteroid dehydrogenase type 1 (11βHSD1) and 2 (11βHSD2). Acute stress-induced increase in glucocorticoid concentrations stimulates the expression of several CYP sub-types. CYP is primarily responsible for glucocorticoid metabolism and its increased activity can result in decreased circulating glucocorticoids in response to repeated stress stimuli. In addition, repeated stress-induced glucocorticoid release can promote 11βHSD1 activation and 11βHSD2 inhibition, and the 11βHSD2 suppression can lead to apparent mineralocorticoid excess. The activation of CYP and 11βHSD1 and the suppression of 11βHSD2 may at least partly contribute to development of the blunted glucocorticoid response to stressors characteristic in high trait anxiety, PTSD, and other stress-related disorders. Glucocorticoids and glucocorticoid-metabolizing enzymes interact closely with other biomolecules such as inflammatory cytokines, monoamines, and some monoamine-metabolizing enzymes, namely the monoamine oxidase type A (MAO-A) and B (MAO-B). Glucocorticoids boost MAO activity and this decreases monoamine levels and induces oxidative tissue damage which then activates inflammatory cytokines. The inflammatory cytokines suppress CYP expression and activity. This dynamic cross-talk between glucocorticoids, monoamines, and their metabolizing enzymes could be a critical factor in the pathophysiology of stress-related disorders. Lay summary Glucocorticoids, which are produced and released under the control by brain regulatory centers, are fundamental in the stress response. This review emphasizes the importance of glucocorticoid metabolism and particularly the interaction between the brain and the liver as the major metabolic organ in the body. The activity of enzymes involved in glucocorticoid metabolism is proposed to play not only an important role in positive, healthy glucocorticoid effects, but also to contribute to the development and course of stress-related diseases. [ABSTRACT FROM AUTHOR]

The International Trauma Questionnaire (ITQ) is a self-report measure for post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD), corresponding to the diagnostic criteria in the International Classification of Diseases, 11th Revision (ICD-11). A 12-item version of the ITQ based on samples from English-speaking countries has been presented, and the wider generalizability to other languages needs to be examined. The current study examines the psychometric properties of scores from a longer, preliminary 22-item version of the ITQ and the current reduced 12-item version by means of generalizability theory (G-theory) and confirmatory factor analysis (CFA). The 22-item version of the ITQ was translated into Norwegian and administered to patients in two trauma treatment trials (total N = 202). A generalizability study was used to investigate the psychometric properties of scores reflecting CPTSD. G-theory was also used to investigate alternative measurement designs to optimize the sufficient number of items that provide acceptable generalizability and dependability of scores. Model fit to the theoretical factor structure was then examined by CFA, both for the 22-item version and for the 12-item version of the ITQ. The two subscales negative self-concept and relational disturbances had acceptable generalizability coefficients. We found substantial measurement error related to affective dysregulation, mainly attributable to affective hyperactivation. A latent factor structure model with two separate affective dysregulation factors: hyperactivation and deactivation, represented the data well in the 22-item version. The proposed confirmatory structure model for the 12-item short form did not converge in the CFA. This study supports the applicability of the ITQ in a non-English-speaking country and provides support for the validity of the Norwegian translation. Further research is needed to improve the psychometric properties of the affective dysregulation subscale. [ABSTRACT FROM AUTHOR]

Background: Mobile health applications (apps) are considered to complement traditional psychological treatments for Post-Traumatic Stress Disorder (PTSD). However, the use for clinical practice and quality of available apps is unknown. Objective: To assess the general characteristics, therapeutic background, content, and quality of apps for PTSD and to examine their concordance with established PTSD treatment and self-help methods. Method: A web crawler systematically searched for apps targeting PTSD in the British Google Play and Apple iTunes stores. Two independent researchers rated the apps using the Mobile App Rating Scale (MARS). The content of high-quality apps was checked for concordance with psychological treatment and self-help methods extracted from current literature on PTSD treatment. Results: Out of 555 identified apps, 69 met the inclusion criteria. The overall app quality based on the MARS was medium (M = 3.36, SD = 0.65). Most apps (50.7%) were based on cognitive behavioural therapy and offered a wide range of content, including established psychological PTSD treatment methods such as processing of trauma-related emotions and beliefs, relaxation exercises, and psychoeducation. Notably, data protection and privacy standards were poor in most apps and only one app (1.4%) was scientifically evaluated in a randomized controlled trial. Conclusions: High-quality apps based on established psychological treatment techniques for PTSD are available in commercial app stores. However, users are confronted with great difficulties in identifying useful high-quality apps and most apps lack an evidence-base. Commercial distribution channels do not exploit the potential of apps to complement the psychological treatment of PTSD. [ABSTRACT FROM AUTHOR]

Purpose: To explore the effectiveness of scuba diving in providing therapeutic and rehabilitative benefit to ex-service personnel who have experienced traumatic physical and/or psychological injuries resulting from combat. Methods: This study took the form of a service evaluation of Deptherapy, a UK-based niche charity offering support to military veterans who have experienced life-changing injuries. Deptherapy provides scuba diving qualifications, consisting of theory and practical diving experience, to participants alongside a Peer Support Buddy scheme that provides continuing support to servicemen involved with the charity. A total of 15 male veterans were invited to take part in the study. The methodology comprised retrospective and current quantitative measures of mental well-being and functional ability, utilising the General Health Questionnaire-28, and subsequent semi-structured interviews with participants, their families and health professionals. Results: Participants reported an improvement in levels of anxiety, depression and social functioning, and a reduction in insomnia, following their involvement in organised scuba diving activities. There was a mean average difference of 14.3 points improvement on the General Health Questionnaire-28 scale variants between prior interaction with Deptherapy and current perceptions following engagement with the programme. The positive perceptions, as indicated from the semi-structured interviews, were more pronounced in those whose injuries were predominantly psychological, rather than physical. Conclusion: Scuba diving can offer significant therapeutic benefits, particularly for ex-military amputees experiencing co-morbid anxiety and/or chronic psychological adjustment disorders, notably in terms of improvements in social dysfunction and symptomology of depression. Military combat can result in devastating, chronic physical and/or psychological injury. Current research suggests that a combination of medical and psychological therapy may prove to be the most beneficial for military veterans. Scuba diving has the potential to benefit injured veterans due the requirement of complete focus and the feeling of weightlessness when underwater. This article evaluates whether scuba diving is an effective physical and psychological therapy through GHQ-28 analysis and veteran interviews. Scuba diving benefited injured veterans in terms of chronic pain relief and depression symptoms alleviation. [ABSTRACT FROM AUTHOR]

Introduction: Recent advances in research on stress and, respectively, on disorders of perception, learning, and behaviour speak to a promising synthesis of current insights from (i) neurobiology, cognitive neuroscience and psychology of stress and post-traumatic stress disorder (PTSD), and (ii) computational psychiatry approaches to pathophysiology (e.g. of schizophrenia and autism). Methods: Specifically, we apply this synthesis to PTSD. The framework of active inference offers an embodied and embedded lens through which to understand neuronal mechanisms, structures, and processes of cognitive function and dysfunction. In turn, this offers an explanatory model of how healthy mental functioning can go awry due to psychopathological conditions that impair inference about our environment and our bodies. In this context, auditory phenomena—known to be especially relevant to studies of PTSD and schizophrenia—and traditional models of auditory function can be viewed from an evolutionary perspective based on active inference. Results: We assess and contextualise a range of evidence on audition, stress, psychosis, and PTSD, and bring some existing partial models of PTSD into multilevel alignment. Conclusions: The novel perspective on PTSD we present aims to serve as a basis for new experimental designs and therapeutic interventions that integrate fundamentally biological, cognitive, behavioural, and environmental factors. [ABSTRACT FROM AUTHOR]

Design: A randomized waitlist-controlled design (n = 74) examined the efficacy of Reconsolidation of Traumatic Memories (RTM) among male veterans with current-month flashbacks and nightmares. Volunteers were randomly assigned to immediate treatment (three 120-minute sessions of RTM), or to a 3-week waiting condition before receiving the RTM treatment. Blinded psychometricians evaluated the symptoms at intake, 2 weeks, and 6 weeks post. Wait-listed participants were re-evaluated and then treated. Sixty-five volunteers completed the treatment. Results: Of those treated, 46 (71%) lost DSM diagnosis for post-traumatic stress disorder (PTSD) by one of the following definitions: 42 persons (65%) were in complete remission (PTSD Symptom Scale Interview (PSS-I) ≤ 20 and DSM criteria not met). Four others (6%) lost the DSM diagnosis or were otherwise sub-clinical by dichotomous criteria (PSS-I < 20 and absence of flashbacks and nightmares) but non-ambiguous on the PTSD Checklist Military Version measures. Within-group RTM effect sizes (Hedges' g) for PSS-I score changes ranged from 1.45 to 2.3. The between-group comparison between the treatment group and the untreated controls was significant (p <.001) with an effect size equivalent to two standard deviations (g = 2.13; 95% CI [1.56, 2.70]). Patient satisfaction with the intervention was high. Conclusions: RTM shows promise as a brief, cost-effective intervention for PTSD characterized primarily by intrusive symptoms. Clinical or methodological significance of this article: The article provides evidence to support a fast (5 hours or fewer) robust intervention for PTSD characterized by intrusive symptoms including current-month flashbacks, nightmares, and accompanied by sympathetic arousal in response to trauma narratives. The intervention is well tolerated and has demonstrated efficacy up to one year. [ABSTRACT FROM AUTHOR]

Introduction: Risk factors for young adults with mTBI are not well understood. Improved understanding of age and sex as risk factors for impaired six-month outcomes in young adults is needed. Methods: Young adult mTBI subjects aged 18–39 years (18-29y; 30-39y) with six-month outcomes were extracted from the Transforming Research and Clinical Knowledge in Traumatic Brain Injury Pilot (TRACK-TBI Pilot) study. Multivariable regressions were performed for outcomes with age, sex, and the interaction factor age-group*sex as variables of interest, controlling for demographic and injury variables. Mean-differences (B) and 95% CIs are reported. Results: One hundred mTBI subjects (18-29y, 70%; 30-39y, 30%; male, 71%; female, 29%) met inclusion criteria. On multivariable analysis, age-group*sex was associated with six-month post-traumatic stress disorder (PTSD; PTSD Checklist-Civilian version); compared with female 30-39y, female 18-29y (B= −19.55 [−26.54, −4.45]), male 18-29y (B= −19.70 [−30.07, −9.33]), and male 30-39y (B= −15.49 [−26.54, −4.45]) were associated with decreased PTSD symptomatology. Female sex was associated with decreased six-month functional outcome (Glasgow Outcome Scale-Extended (GOSE): B= −0.6 [1.0, −0.1]). Comparatively, 30-39y scored higher on six-month nonverbal processing speed (Wechsler Adult Intelligence Scale-Processing Speed Index (WAIS-PSI); B= 11.88, 95% CI [1.66, 22.09]). Conclusions: Following mTBI, young adults aged 18-29y and 30-39y may have different risks for impairment. Sex may interact with age for PTSD symptomatology, with females 30-39y at highest risk. These results may be attributable to cortical maturation, biological response, social modifiers, and/or differential self-report. Confirmation in larger samples is needed; however, prevention and rehabilitation/counseling strategies after mTBI should likely be tailored for age and sex. [ABSTRACT FROM AUTHOR]

More than 1 in 3 women in the United States experience intimate partner violence (IPV) and many of them develop post-traumatic stress disorder (PTSD). Trauma-sensitive yoga (TSY), a structured, body-oriented yoga practice, has been reported for its potential to ameliorate PTSD symptoms. The purpose of the study was to examine adult female IPV survivors' experiences of recovery from IPV and trauma as facilitated by an 8-week TSY intervention using a collective case study research design. Participants ages 26 to 52 from diverse ethnic backgrounds participated in the study's 4 phases. Measures used include the Clinician-Administered PTSD Scale-5, Subjective Units of Distress Scale, pre- and post-interviews, and observations. Analyses reflected a moderate change in participants' PTSD scores attributed to the TSY intervention. Collective themes that emerged include physiological, emotional, and spiritual benefits. Although exploratory, the study illuminates the potential efficacy of TSY for facilitating multifaceted trauma recovery. [ABSTRACT FROM AUTHOR]

Background: Post-traumatic stress disorder (PTSD) is triggered by distinct events and is therefore amenable to studies of its early pathogenesis. Longitudinal studies during the year that follows trauma exposure revealed typical symptom trajectories leading to either recovery or protracted PTSD. Thezneurobehavioral correlates of early PTSD symptoms’ trajectories have not been longitudinally explored. Objective: To present the rationale and design of a longitudinal study exploring the relationship between evolving PTSD symptoms and co-occurring cognitive functioning and structural and functional brain imaging parameters. Method: Adult civilians consecutively admitted to a general hospital emergency room (ER) for traumatic injury will be screened for early PTSD symptoms suggestive of chronic PTSD risk, and consecutively evaluated 1, 6 and 14 months following the traumatic event. Consecutive assessments will include structured clinical interviews for PTSD and comorbid disorders, self-reported depression and anxiety symptoms, a web-based assessment of cognitive domains previously linked with PTSD (e.g., memory, executive functions, cognitive flexibility), high-resolution structural MRI of both grey and white matter, functional resting-state connectivity, and fMRI tasks examining emotional reactivity and regulation, as well as motivation processing and sensitivity to risk and reward. Data analyses will explore putative cognitive predictors of non-remitting PTSD, and brain structural and functional correlates of PTSD persistence or recovery. Conclusion: This work will longitudinally document patterns of brain structures, connectivity, and functioning, predictive of (or associated with) emerging PTSD during the critical first year of after the traumatic event. It will thereby inform our understanding of the disorder’s pathogenesis and underlying neuropathology. Challenges to longitudinal MRI studies of recent survivors, and methodological choices used to optimize the study’s design are discussed. [ABSTRACT FROM AUTHOR]

Using oral testimony with 60 present and former Australian newspaper photographers, this article examines their frequent exposure to high-risk situations and the physical and psychological costs. Photographers engage with both vulnerability and aberration, and at the same time negotiate with editors who demand and prize a proximity and emotional closeness to danger. With a particular focus on war, disaster, and everyday assignments, the article reveals a litany of hazardous experiences. It considers the photographers' reflections, the physical effects, the significant prevalence of Post-Traumatic Stress Disorder (PTSD) and trauma-related symptoms, and the support and failings of their news organisations. The article argues that the seismic changes in the photographers' workplace and their profession have further compounded the psychological and physical stress. This work illuminates new understanding about the historical and contemporary experiences of news photographers and the impact of the fracturing newspaper industry in Australia. [ABSTRACT FROM AUTHOR]

Background: Trauma affects the family unit as a whole; however, most existing research uses individual or, at most, dyadic approaches to analyse families with histories of trauma. Objective: This study aims to identify potentially distinct family types according to attachment, parenting, and sibling relations, to analyse how these family types differ with respect to war trauma, and to explore how children's mental health and cognitive processing differ across these family types. Method: Participants included Palestinian mothers and fathers (N = 325) and their children (one per family; 49.4% girls; 10–13 years old; mean ± SD age = 11.35 ± 0.57 years) after the Gaza War of 2008–2009. Both parents reported their exposure to war trauma, secure attachment availability, and parenting practices, as well as the target child's internalizing and externalizing symptoms [Strengths and Difficulties Questionnaire (SDQ)]. Children reported their symptoms of post-traumatic stress disorder (on the Children's Revised Impact Event Scale), depression (Birleson), and SDQ, as well as their post-traumatic cognitions (Children's Post Traumatic Cognitions Inventory). Results: A cluster analysis identified four family types. The largest type reflected secure attachment and optimal relationships (security and positive family relationships, 36.2%, n = 102), and the smallest exhibited insecurity and problematic relationships (insecurity and negative family relationships, 15.6%; n = 44). Further, families with discrepant experiences (23.0%; n = 65) and moderate security and neutral relationships (25.2%; n = 71) emerged. The insecurity and negative relationships family type showed higher levels of war trauma; internalizing, externalizing, and depressive symptoms among children; and dysfunctional post-traumatic cognitions than other family types. Conclusion: The family systems approach to mental health is warranted in war conditions, and therapeutic interventions for children should, thus, also involve parents and siblings. Knowledge of unique family attachment patterns is fruitful for tailoring therapeutic treatments and preventive interventions for war-affected children and families. [ABSTRACT FROM AUTHOR]

Background: Although post-traumatic stress disorder (PTSD) onset-persistence is thought to vary significantly by trauma type, most epidemiological surveys are incapable of assessing this because they evaluate lifetime PTSD only for traumas nominated by respondents as their 'worst.' Objective: To review research on associations of trauma type with PTSD in the WHO World Mental Health (WMH) surveys, a series of epidemiological surveys that obtained representative data on trauma-specific PTSD. Method: WMH Surveys in 24 countries (n = 68,894) assessed 29 lifetime traumas and evaluated PTSD twice for each respondent: once for the 'worst' lifetime trauma and separately for a randomly-selected trauma with weighting to adjust for individual differences in trauma exposures. PTSD onset-persistence was evaluated with the WHO Composite International Diagnostic Interview. Results: In total, 70.4% of respondents experienced lifetime traumas, with exposure averaging 3.2 traumas per capita. Substantial between-trauma differences were found in PTSD onset but less in persistence. Traumas involving interpersonal violence had highest risk. Burden of PTSD, determined by multiplying trauma prevalence by trauma-specific PTSD risk and persistence, was 77.7 person-years/100 respondents. The trauma types with highest proportions of this burden were rape (13.1%), other sexual assault (15.1%), being stalked (9.8%), and unexpected death of a loved one (11.6%). The first three of these four represent relatively uncommon traumas with high PTSD risk and the last a very common trauma with low PTSD risk. The broad category of intimate partner sexual violence accounted for nearly 42.7% of all person-years with PTSD. Prior trauma history predicted both future trauma exposure and future PTSD risk. Conclusions: Trauma exposure is common throughout the world, unequally distributed, and differential across trauma types with respect to PTSD risk. Although a substantial minority of PTSD cases remits within months after onset, mean symptom duration is considerably longer than previously recognized. [ABSTRACT FROM AUTHOR]

The aftermath of complex trauma deeply impacts one's self-organization and interpersonal relationships, often resulting in clients who present to therapy with borderline characteristics and are typically labeled as difficult to treat. Further clinical complications with paranoid features may quickly place the therapist at a loss with respect to managing perceived and/or actual threats to client safety. Using psychodynamic theories, especially Kleinian understandings of psychosis and Winnicottian approaches to early disturbance and its impact on the emergence of self, this article provides a detailed case illustration that explores how a critical reflection of countertransference as “enactment,” “communication,” and “imagination” can help the therapist to understand the client's unconscious symbolic psychic struggles and to guide treatment selections in the therapy process. [ABSTRACT FROM PUBLISHER]

Background: Research has demonstrated that Post-Traumatic Stress Disorder (PTSD) is one of the most widely recognized mental disorders, but recognition is affected by trauma type. Aims: The current study investigated the effect of direct versus indirect exposure to traumatic event and trauma types on Mental Health Literacy (MHL) of PTSD. Methods: Two hundred and thirty-three participants were asked to identify the mental health problem after presentation of an unlabeled vignette describing a character experiencing PTSD symptoms. The six vignettes described the same symptoms but differed in directness (direct/indirect exposure) and trauma type (rape, military combat or man-made disaster). It was hypothesized that (1) recognition rate would be higher in direct than indirect conditions, and (2) higher in military combat, followed by man-made disaster, and lowest in rape condition. Results: Overall, correct recognition of PTSD was 42.5%. Recognition in direct exposure vignettes was significantly higher than indirect, supporting the first hypothesis. The second hypothesis was only partly supported. While PTSD recognition in rape vignettes was significantly lower than the other two scenarios, no difference was found between combat and man-made disaster trauma types. Conclusions: Our findings implied under-recognition of PTSD, with lack of awareness of different causes of PTSD and of PTSD from indirect trauma exposure. The latter finding is important in the light of DSM-V revisions to diagnostic criteria for PTSD. [ABSTRACT FROM PUBLISHER]

Creative bibliotherapy – or the guided reading of fiction or poetry – is used widely in mental healthcare settings. In the UK, partnerships between private organizations, libraries, and the NHS support reading groups for better mental health and social cohesion. In the USA, veterans’ reading support groups are common and private lifestyle consultancies offer services that match clients to books for general well-being. Considering the widespread employment of creative bibliotherapy, this systematic review was conducted to explore its effectiveness in reducing symptoms in adults with post-traumatic stress disorder (PTSD). Both randomized and non-randomized trials were included in the extensive search but no high-quality controlled trials were found. Importantly, there is no evidence to suggest harms from the trial designs related to creative bibliotherapy and some low-quality and qualitative studies indicated this intervention may help PTSD symptoms. High quality randomized controlled trials should be conducted urgently. [ABSTRACT FROM PUBLISHER]

This article addresses the tension in psychoanalytic thinking regarding adult-onset trauma and its potential effects on children who were not directly exposed to the same parental trauma. Psychoanalytic theory emphasizes early attachment trauma as predictive of the response to trauma later in life. This emphasis on early trauma delayed recognition of adult-onset trauma-related disorders and the development of adequate trauma-focused treatments. Presently, the confluence of findings from multiple disciplines, including trauma studies, biological research, and epidemiological data from across the globe, demonstrates the potentially devastating impact of adult-onset post-traumatic stress disorder (PTSD) following exposure to trauma, such as war, terror, and assaultive violence. Empirical evidence highlights the critical role of post-trauma family and social support in recovery from PTSD or, alternatively, in delayed PTSD. Given the numbers of servicemen returning from combat zones with post-traumatic disorders and other populations around the globe exposed to extreme political violence, new effective trauma-focused treatments are needed. Integration of perspectives within psychoanalytic theories and "cross pollination" among the fields of psychoanalysis, attachment studies, cognitive-behavioral psychology, neuroscience, and trauma research will enhance innovative and effective interventions that harvest beneficial therapeutic elements from multiple approaches. [ABSTRACT FROM AUTHOR]

Background: Alterations in brain-derived neurotrophic factor (BDNF) expression and release may play a role in the pathogenesis of post-traumatic stress disorder (PTSD).Design: This study evaluated road traffic accident (RTA) survivors to determine whether PTSD and trauma-related factors were associated with plasma BDNF levels and BDNF Val66Met carrier status following RTA exposure.Methods: One hundred and twenty-three RTA survivors (mean age 33.2 years, SD = 10.6 years; 56.9% male) were assessed 10 (SD = 4.9) days after RTA exposure. Acute stress disorder (ASD), as assessed with the Acute Stress Disorder Scale, was present in 50 (42.0%) of the participants. Plasma BDNF levels were measured with enzyme-linked immunosorbent assay and BDNF Val66Met genotyping was performed. PTSD, as assessed with the Clinician-Administered PTSD Scale, was present in 10 (10.8%) participants at 6 months follow-up.Results: Neither BDNF Val66Met genotype nor plasma BDNF was significantly associated with the presence or severity of ASD or PTSD. Plasma BDNF levels were, however, significantly correlated with the lifetime number of trauma exposures.Conclusions: In RTA survivors, plasma BDNF levels increased with increasing number of prior trauma exposures. Plasma BDNF may, therefore, be a marker of trauma load. [ABSTRACT FROM AUTHOR]

The article presents a study that found that post-traumatic stress disorder is highly prevalent among individuals who suffer from opioid use disorder. Post-traumatic stress disorder have a worse course of illness, occupational functioning and physical health. Diagnostic implications, treatment implications and directions for future research were also discussed in the study.

Traumatic events are highly prevalent in South African society and psychologists who work with survivors of trauma have been identified as particularly at risk of being adversely affected by their work, and experiencing vicarious trauma. This study aimed to explore the experiences of a group of South African psychologists who work predominantly with trauma survivors. Individual semi-structured interviews were conducted with six psychologists (females = 67%). The predominant type of trauma encountered by participants in clinical practice was interpersonal trauma in the form of physical and sexual abuse (83%). Data were analysed using thematic analysis. All participants reported symptoms of vicarious trauma including disruption in cognitive schemas, symptoms characteristic of post-traumatic stress disorder, and somatic symptoms. Participants also reported vicarious post-traumatic growth including an enhanced sense of interpersonal connectedness and positive changes in their philosophy of life and self-perceptions. The findings serve to sensitise psychologists to the impact of working with trauma survivors so as to enhance the efficiency of psychological service delivery to traumatised populations. [ABSTRACT FROM PUBLISHER]

The recently releasedDSM-5(2013) includes a new sexual dysfunction: female sexual interest/arousal disorder (FSIAD). For the first time, the low sexual desire disorders are split along gender lines, and lack of sexual ‘receptivity’ is offered as a criterion for diagnosis in women only. Although ‘severe relationship distress’ or other ‘significant stressors’ are to be considered during evaluation for FSIAD, the patient’s trauma history is not evaluated as part of the protocol. The presence of violence or distress can potentially elicit a differential diagnosis, but what constitutes ‘severity’ is not articulated either, except to designate ‘partner violence’ as the primary example. Thus,pastrelational violence, sexual abuse and trauma are not explicitly considered – nor is the vast spectrum of gendered violations that many women describe experiencing on a regular basis. I examine potential problems with separating the trauma diagnoses (i.e., post-traumatic stress disorder, depersonalisation/derealisation disorder, and other trauma- and stressor-related or dissociative disorders) from FSIAD in theDSM-5. Drawing on interviews with low-desiring women who describe being violated, I elaborate how this diagnostic separation may be re-traumatising for women who have experienced such violence and have low sexual desire as a result. I also question the utility of framing psychological disorders and symptoms as co-morbid (i.e., concomitant but unrelated), and argue instead for more thorough aetiological or sequelic investigations of low desire. [ABSTRACT FROM AUTHOR]

Students utilize university counseling center services to address distress related to post-traumatic stress disorder (PTSD). Since counseling centers services such as group work or general psychotherapy may not address specific PTSD-symptom reduction, centers often give community referrals in such cases. Evidence-based therapies (EBTs), including Prolonged Exposure Therapy, have the potential to be offered within counseling center services, however. Prolonged exposure consistently provides significant symptom relief to patients with the most severe PTSD symptoms within 10–12 sessions. This article presents and examines two case examples of students who participated in a full prolonged exposure protocol within a counseling center clinic. [ABSTRACT FROM PUBLISHER]

This pilot study investigated the feasibility of treating people suffering from both post-traumatic stress disorder (PTSD) and poor working memory by employing a combination of computerized working memory training and transcranial direct current stimulation (tDCS). After treatment, all four participants showed clinically significant improvements on a range of cognitive and emotional performance measures. Moreover, these improvements were accompanied by theoretically significant neurophysiological changes between pre- and post-treatment electroencephalographic (EEG) recordings. Specifically, the P3a component of participants’ event related potentials (ERP) in response to novelty stimuli, characteristically abnormal in this clinical population, shifted significantly toward database norms. So, participants’ initially slow alpha peak frequency (APF), theorized to underlie impaired cognitive processing abilities, also increased in both frequency and amplitude as a result of treatment. On the basis of these promising results, more extensive controlled studies are warranted. [ABSTRACT FROM AUTHOR]

In the context of workplace burnout and suffering, this article advances an interdisciplinary approach to self-care and resilience. In particular, it extends workplace spirituality research and praxis by considering self-compassion. This approach seeks to reframe experience, reduce self-criticism, and increase self-acceptance and self-kindness. The author proposes that self-compassion psychology with its focus on mindfulness, common humanity, and personal well-being could augment existing treatments. Finally, a number of action outcomes and further research directions are offered to stimulate discussions in communities of research, pastoral care praxis, and management to assist those charged with recovery and treatment and those enabling resilience building. [ABSTRACT FROM PUBLISHER]

Background:Female Genital Mutilation/Cutting (FGM/C) is the procedure of removing healthy external genitalia from girls/women for socio-cultural reasons. There is much scientific literature on the adverse physical health complications that can result from having FGM/C, but little is known about its psychological impact and treatment.Objective:To identify psychological problems that may follow from a woman having FGM/C and success of treatment herein, and relate findings to the role of the maternity care professional.Study design:A structured narrative review, which identified 10 studies, was carried out.Findings:Eight of ten studies reported psychological consequences, such as Post-Traumatic Stress Disorder (PTSD) and affective disorders. Also identified were socio-cultural differences in the meaning of perceived consequences for different individuals. Two studies reported inconclusive results regarding the psychological impact of FGM/C on women’s lives.Key conclusion:While these findings provide an indication of adverse psychological effects of women/girls having FGM/C, more studies are needed. In particular, studies that focus on the role that cutting extent, circumstances surrounding the cutting, and girls’ level of knowledge of what was going to take place, and their relationships to psychological outcomes.Implications for Practice:Raising awareness of the risk of negative psychological consequences is important, with maternal health care professionals requiring training on how to treat and care for women/girls who are suffering problems that result from having FGM/C. [ABSTRACT FROM PUBLISHER]

The current study addressed treatment engagement, or lack thereof, for women in a residential substance use treatment facility who had co-occurring post-traumatic stress disorder (PTSD) and heroin dependency diagnoses. Results indicated that having previous drug treatment was positively related to treatment engagement and children in care was marginally positively related to engagement, while stressors related to employment and education were a detriment to remaining engaged in treatment. Trends in participants’ family history indicated that (1) participants who had received previous mental health treatment, had a family history of mental health problems, and (2) use of multiple substances was marginally associated with a family history of drug use. [ABSTRACT FROM PUBLISHER]

Large numbers of children are affected by child sexual abuse in South Africa. This study aimed to assess psychological adjustment of children post sexual assault. In-depth, semistructured interviews were conducted with caretakers, and structured interviews using mental health assessment screening tools were given to children at three intervals over a five-month period after presentation at a sexual assault center. Almost half of the children met clinical criteria for anxiety, and two-thirds met criteria for full symptom post-traumatic stress disorder two to four weeks post disclosure. With standard care, we observed some recovery; 43.3% of children still met full symptom post-traumatic stress disorder nearly six months postdisclosure. Our findings indicate that current practice in South Africa does not promote adequate recovery for children. [ABSTRACT FROM PUBLISHER]

This article explores moral injury, a concept from military mental health professionals, which refers to the emotional effects on soldiers of actions taken as part of their military obligations that violate the dictates of their moral compass (Boudreau, 2011; Shay, 2011). This article will trace the history and current knowledge of moral injury and apply a social cognitive model of understanding the concept (Litz et al., 2009) to vignettes from the authors' civilian clinical practice, in the hope of raising awareness within clinical social work and other mental health professions of the complexities of moral injury. By brining the concept of moral injury into the mainstream social work arena, it is the authors' hope that clinicians will be able to distinguish it from post-traumatic stress disorder (PTSD) and understand the role of shame in the experience of moral injury in their own clients. [ABSTRACT FROM PUBLISHER]

In June 2011, a ministerial Review of Injury Management Practices in the New South Wales Police Force revealed a rapidly growing epidemic of psychiatric disorder. It mirrors a previous Australian epidemic of pseudo-illness impelled by forensic forces known as RSI. The history of its development and eventual demise provides insights into the influences behind the current epidemic. [ABSTRACT FROM AUTHOR]

The paper presents a case study of short-term music therapy intervention administered to three groups of pre-school children in the aftermath of a forced evacuation from their homes. The setting relates the effects of the unilateral Israeli disengagement from the Gaza Strip in 2005 and the post-trauma treatment of the evacuees. The group treatment process is described in the context of Uprooting to rePlanting (UP) model and the broader Basic Ph model of Group Coping developed for dealing with community stress. Initial results point to the role of music in building post-trauma resilience and in reducing the vulnerability of pre-schoolers to traumatic events. The case study highlights the use of music therapy for post-traumatic stress disorder (PTSD) treatment with young children and stresses the way in which the community and family fabric can be harnessed in order to strengthen the coping of the individual. [ABSTRACT FROM AUTHOR]

Prior studies have sometimes demonstrated facilitated acquisition of classically conditioned responses and/or resistance to extinction in post-traumatic stress disorder (PTSD). However, it is unclear whether these behaviors are acquired as a result of PTSD or exposure to trauma, or reflect preexisting risk factors that confer vulnerability for PTSD. Here, we examined classical eyeblink conditioning and extinction in veterans self-assessed for current PTSD symptoms, exposure to combat, and the personality trait of behavioral inhibition (BI), a risk factor for PTSD. A total of 128 veterans were recruited (mean age 51.2 years; 13.3% female); 126 completed self-assessment, with 25.4% reporting a history of exposure to combat and 30.9% reporting current, severe PTSD symptoms (PTSS). The severity of PTSS was correlated with current BI ( R2 == 0.497) and PTSS status could be predicted based on current BI and combat history (80.2% correct classification). A subset of the veterans ( n == 87) also completed the eyeblink conditioning study. Among veterans without PTSS, childhood BI was associated with faster acquisition; veterans with PTSS showed delayed extinction, under some conditions. These data demonstrate a relationship between current BI and PTSS, and indicate that the facilitated conditioning sometimes observed in patients with PTSD may partially reflect personality traits such as childhood BI that pre-date and contribute to vulnerability for PTSD. [ABSTRACT FROM AUTHOR]

Given that more than one third of some cohorts of cancer survivors exhibit post-traumatic stress disorder (PTSD) symptomatology, this study examines how trauma outcomes might relate to quality of life (QOL). Eight hundred thirty survivors of adult lymphoma were assessed for PTSD, post-traumatic growth (PTG) and QOL. Structural equation modeling revealed that QOL was best explained by the model in which stressors (e.g., co-morbidities) were mediated by PTSD and PTG. Trauma outcomes mediated the relationship between specific stressors and QOL. These findings support using PTSD and PTG as a diagnostic framework in understanding symptomatology in survivors. [ABSTRACT FROM AUTHOR]

Background: Building on previous research with disaster-exposed children and adolescents, a randomised clinical trial was performed in the treatment of trauma-related symptoms. In the current study two active treatments were compared among children in a broad age range and from a wide diversity of ethnic populations. Objective: The primary aim was to compare the effectiveness and efficiency of Cognitive Behavioural Therapy (CBT) and Eye Movement Desensitisation and Reprocessing (EMDR). Design: Children (n=52, aged 4--18) were randomly allocated to either CBT (n=26) or EMDR (n=26) in a disaster mental health after-care setting after an explosion of a fireworks factory. All children received up to four individual treatment sessions over a 4--8 week period along with up to four sessions of parent guidance. Blind assessment took place pre- and post-treatment and at 3 months follow-up on a variety of parent-rated and self-report measures of post-traumatic stress disorder symptomatology, depression, anxiety, and behaviour problems. Analyses of variance (general linear model repeated measures) were conducted on the intention-to-treat sample and the completers. Results: Both treatment approaches produced significant reductions on all measures and results were maintained at follow-up. Treatment gains of EMDR were reached in fewer sessions. Conclusion: Standardised CBT and EMDR interventions can significantly improve functioning of disasterexposed children. [ABSTRACT FROM AUTHOR]

After a devastating earthquake hit Sichuan, China, the Analytical Psychology Group (members of the IAAP Developing Group, the Chinese Association of Analytical Psychology) went to Sichuan and set up three "Gardens of the Heart-Soul." During the working process, we put our hearts and love at the center of our work. Through accompanying and active listening, through Ci-bei (loving-grief ), and especially the sandplay therapy, we achieved the aim of creativity and transformation to some extent. This article summarizes our work at the first anniversary of the earthquake. We plan to continue our work in the stricken area. [ABSTRACT FROM AUTHOR]