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

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

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

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

Objective: It is widely acknowledged that emotional states can influence skin conditions, yet limited research has delved into the impact of stress on skin cancer development. This retrospective study sought to expand the perspective on skin cancer risk factors by investigating the complex relationship between stressful life events and the incidence of skin cancer. Methods: The sample included 268 individuals followed‐up in a dermatological clinic, in three groups: Patients who had previously been diagnosed with cutaneous melanoma and are currently in remission (32%), those who had been diagnosed with non‐melanoma skin cancer (30%), and a control group who are at risk for skin cancer (38%). Participants filled in questionnaires regarding childhood and adulthood life events, and loss and gain of resources following their subjectively most stressful event in adulthood. Multinomial logistic regression was used to examine the associations of life events with skin cancer occurrence, and mediating and moderating effects of resource loss/gain. Results: Adverse childhood experiences were associated with melanoma occurrence, with the melanoma group reporting significantly more such experiences compared to the control group (p < 0.001). Resource loss from subjectively significant stressful life events in adulthood partially mediated the association between adverse childhood experiences and melanoma incidence. Conclusions: The findings suggest that there may be intricate connections between stress, life events, adaptation to change, and skin cancer, which future research may further unravel. This study underscores the need for a more comprehensive approach to stress management, coping strategies development, and skin cancer prevention in healthcare settings. [ABSTRACT FROM AUTHOR]

Objective: To compare the number and severity of neuropsychiatric symptoms (NPS) and associated caregiver distress between those with and without a noted history of psychological trauma among those referred to a specialised national dementia NPS support service. Methods: This was a 5‐year retrospective observational study of records from the Dementia Support Australia NPS support service. NPS were reported by formal or informal caregivers at service entry using the Neuropsychiatric Inventory Nursing Home version or Questionnaire version. A history of psychological trauma was recorded in the person's social or medical history and/or endorsed as a contributor to NPS by a trained dementia consultant after a comprehensive clinical review. Regression was used to examine the impact of a recorded history of psychological trauma on NPS severity and associated caregiver distress, controlling for age and sex. Results: Among 41,876 eligible referrals with dementia, 6% (n = 2529) had some reference in their records to a history of psychological trauma. Referrals with a recorded history of psychological trauma were rated with a higher rate of both NPS severity (mean = 12.0) and associated caregiver distress (mean = 16.5) at service entry than those without a recorded history of psychological trauma (means = 10.7 and 14.5, respectively). A recorded history of psychological trauma was associated with higher odds of psychotic symptoms, agitation/aggression, irritability, disinhibition, affective symptoms and night‐time behaviours. Conclusions: Traumatic stress symptoms may represent a neglected target for intervention to reduce the impact of NPS in people with dementia. Key points: Psychological trauma is a putative risk factor for dementia, and dementia onset can also trigger the re‐emergence or exacerbation of traumatic stress. However, little is known about how trauma contributes to neuropsychiatric symptoms (NPS) in dementia.People with dementia and a recorded history of psychological trauma were rated as having more frequent, more severe, and more distressing NPS than people without a recorded history of psychological trauma.Traumatic stress symptoms are modifiable and therefore may represent a neglected target for intervention to reduce the impact of NPS in people with dementia. [ABSTRACT FROM AUTHOR]

Aim: With high rates of trauma in the population, known links between trauma and perinatal distress, and the intimate and close nature of the nursing and midwifery roles, ensuring awareness and understandings of trauma is crucial for guiding practice. This paper aims to explore the relationship of trauma to the perinatal period, based on theory and practice, to consider on how nurses and midwives can deliver trauma‐sensitive interactions. Design and Methods: This discursive discussion draws on relevant research from the fields of trauma therapy, attachment theory and nursing and midwifery practice to consider elements of trauma‐sensitive practice in the perinatal period. Results: Nurses and midwives can foster safety for people who have experienced trauma through noticing and responding to triggers, supporting awareness of attachment and its relationships to trauma, undertaking psychosocial screening with care, supporting linearity and cohesion in narratives and developing collaborative care plans that maximise safety and agency. For nurses and midwives, understandings of the relationship between trauma, pregnancy, birth, early parenting and distress is crucial for effective care delivery. Delivering perinatal nursing or midwifery care of any kind, without universal trauma precautions risks reinforcing, misinterpreting or re‐enacting dynamics of trauma. To be trauma‐sensitive in this period requires nurses and midwives to have awareness of the dynamics of trauma in relation to pregnancy, birth and attachment. Implications for the Profession and/or Patient Care: This paper fills a gap in the translation of theory to practice for trauma‐sensitive care in the perinatal period, with a focus on the therapeutic relationship formed by nurses and midwives. The findings highlight that nurses and midwives can foster safety for people who have experienced trauma within their practice, when they hold a robust understanding of the relationship between trauma, pregnancy, birth, early parenting and distress. Patient or Public Contribution: No patient or public contribution. [ABSTRACT FROM AUTHOR]

Trauma‐informed care has gained increasing popularity in mental health services over the past two decades. Mental health nurses remain one of the largest occupations employed in acute mental health settings and arguably have a critical role in supporting trauma‐informed care in this environment. Despite this, there remains a limited understanding on how trauma‐informed care is applied to the context of mental health nursing in the hospital environment. The aim of this study was to explore what it means for mental health nurses to provide trauma‐informed care in the acute mental health setting. The study design was qualitative, using van Manen's (Researching lived experience: human science for an action sensitive pedagogy. State University of New York Press, 1990) approach to hermeneutic phenomenological inquiry. A total of 29 mental health nurses participated in this study. There were three overarching themes that emerged; these entail: embodied trauma‐informed milieu, trauma‐informed relationality and temporal dimensions of trauma‐informed mental health nursing. The study found that for mental health nurses, there are elements of trauma‐informed care that extend far beyond the routine application of the principles to nursing practice. For mental health nurses working in the acute setting, trauma‐informed care may offer a restorative function in practice back to the core tenants of therapeutic interpersonal dynamics it was once based upon. [ABSTRACT FROM AUTHOR]

Experience with psychological trauma is overrepresented among substance use disorder (SUD) patients. SUDs may also be a risk factor for violent behaviors, suicidal ideation and suicide. This study proposes a link between these phenomena. Based on data from the EuropASI clinical interview of 137 SUD inpatients we computed a composite variable of trauma experience from being abused. We report descriptive data and cross tabulated problems controlling violent behavior, suicidal ideation or suicide attempts variables with trauma experience. Hypothesizing an association between experienced trauma and the outcome variables. We also examined the correlation between three outcome variables in inpatients. Our data suggested high incidents of experienced psychological trauma in the sample (66.7%). Chi‐square tests suggested a significant difference in controlling violent behavior, suicidal ideation and suicide attempts, dependent on trauma experience. Spearman Roh correlations suggested asscociations between suicdal ideation and suicide attempts, and suicdal ideation and problems controlling violent behavior, but not with suicide attempts. Our data suggests that past trauma is a risk factor for violent and suicidal behaviors in the SUD population. Based on our findings we propose that former trauma should be considered in risk assessments and help guide treatment interventions. [ABSTRACT FROM AUTHOR]

Objective: The aim of the present study was three‐fold. One, to assess the prevalence of medical traumatization in outpatients of a gynecologic department; two, to analyze the relationship of medical traumatization with adverse childhood events; and three, to investigate the extent to which medical traumatization affects the health outcomes of woman. Methods: Between January and September 2022, a prospective cross‐sectional study recruited patients of a gynecologic outpatient clinic at St. Gallen Cantonal Hospital in Switzerland. Medical trauma was a self‐reported item. The presence of adverse childhood events was assessed using the Childhood Trauma Questionnaire. The severity of post‐traumatic stress was evaluated using the Impact of Event Scale Revised questionnaire. Results: In total, 227 patients were recruited. Medical trauma was reported by 20% of the interviewees and it was strongly associated with obesity (A = 0.005). Undergoing surgery was most commonly the source of psychological distress (5.7%) followed by delivery (4.8%), pregnancy loss (4.8%), and cancer diagnosis (4.0%). Yet, fewer than 1% of the patients reached the threshold suggesting post‐traumatic stress disorder. Conclusions: We found no relationship between the medical trauma, adverse childhood events, cardiovascular disease, or substance abuse. The presence of medical trauma was associated with the patient's body mass index (calculated as weight in kilograms divided by the square of height in meters). Synopsis: We found that one in five women in our population reported having a medical psychological trauma. Its presence was associated with the patient's BMI. [ABSTRACT FROM AUTHOR]

Objective: Intrusive memories are a core feature of posttraumatic stress disorder and have transdiagnostic relevance across mental disorders. Establishing flexible methods to monitor intrusions, including patterns and characteristics, is a key challenge. A daily diary has been developed in experimental settings to provide symptom count data, without the need for retrospective self‐report over extended time periods (e.g., 1 week, 1 month). We conducted an exploratory, pre‐registered data synthesis investigating convergence between the diary and questionnaire measures of intrusive symptoms long used in clinical practice (Impact of Event Scale, IES, and revised version, IES‐R, Intrusion subscale). Results: Utilising datasets using the daily diary from 11 studies (4 real‐world trauma studies, seven analogue trauma studies; total N = 578), we found significant positive associations between the diary and IES/IES‐R Intrusion subscale. Exploratory analyses indicated that the magnitude of this association was stronger for the IES (vs. the IES‐R), and in individuals with real‐world (vs. analogue) trauma. Conclusion: This study provides first evidence of convergent validity of a daily diary for monitoring intrusions with a widely used questionnaire. A diary may be a more flexible methodology to obtain information about intrusions (frequency, characteristics, triggers, content), relative to questionnaires which rely on retrospective reporting of symptoms over extended timeframes. We discuss potential benefits of daily monitoring of intrusions in clinical and research contexts. [ABSTRACT FROM AUTHOR]

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

Objective: To explore care aide perceptions of caring for residents who aides perceived had past psychological trauma.Methods: Through cognitive interviews, we developed a definition of trauma for four survey questions about caring for residents with psychological trauma. We added these questions to our routine care aide survey in 91 care homes in Western Canada (September 2019 to February 2020). We asked if care aides perceived that they were caring for residents with trauma, how often, types of trauma experienced, and what indication led them to perceive a resident had experienced trauma. We analyzed data using content analysis (open-ended questions) and regression analyses (closed-ended questions).Results: Three thousand seven hundred and sixty five care aides responded (70% response rate) to the survey, and 53% perceived caring for one or more residents with a history of psychological trauma in the previous 2 weeks. Within six categories of traumatic events, abuse (35%) and war exposure (26%) were most common. Most common indications of trauma reported by care aides (five categories) were reliving the experience or having intrusive symptoms (28%) and avoidant behaviors (24%). Care aides were more likely to report caring for a resident who they perceived had experienced past psychological trauma if they were younger, spoke English as their first language, self-reported experiencing more aggression from residents, or who worked in not-for-profit homes.Conclusions: This preliminary study supports the need for further study of care aides' perceptions and experiences of caring for residents with past trauma, and the effects of caring for these residents on quality of work life. [ABSTRACT FROM AUTHOR]

Purpose: To investigate the associations between childhood psychological trauma, posttraumatic stress symptoms (PTSS), and mental health in adulthood and to identify the mediation of active and passive coping on these associations in Korean female undergraduates. Conclusions: Childhood psychological trauma had a direct association with current mental health in adulthood (β = 0.15, p < 0.001), which was mediated by PTSS (β = 0.34, p < 0.001). Each coping style partially mediated the relationship between (a) childhood psychological trauma and mental health and (b) PTSS and mental health. Practice Implications: It is necessary to develop nursing interventions to enhance coping strategies in female undergraduates to ensure better mental health and well‐being. [ABSTRACT FROM AUTHOR]

Objective: While Trauma-informed care (TIC) has the potential to improve the quality of aged and dementia care, the challenge remains in translating the principles of TIC into practice. This study aimed to characterise what trauma-informed aged care looks like in practice, by learning from an aged care service acknowledged as delivering trauma-informed aged care effectively.Method: We conducted an appreciative inquiry study within a residential aged care service catering for veterans and others with trauma histories. Observation of care behaviours, interviews with staff and residents, and organisational policy mapping were used to identify elements that maximised care safety and accessibility for trauma survivors. Data were analysed and triangulated using a framework analysis approach.Results: The aged care provider embedded the principles of TIC into its staff training (i) to promote understanding of how trauma may affect experiences in care, and (ii) to adapt care when appropriate to promote safety. The service promoted a calm atmosphere where residents could make choices and felt safe. Uniforms and signage provided consistency, clarity, and transparency for residents. Staff behaviours demonstrated respect, fostered trust, and anticipated needs without unnecessarily imposing care. Staff consistently offered choices, used residents' names, sought permission before providing care, and offered reassurance. Staff reported high morale with a commitment to delivering high quality care, and feedback to management. Effective communication promoted information sharing and trust among staff.Conclusion: Trauma-informed practice was facilitated through organisational policy, a dignified environment, and thoughtful staff behaviour creating safety, choice, and control for residents. [ABSTRACT FROM AUTHOR]

Objective: Sexual assault, child abuse, and combat have been linked to eating disorders (EDs). However, noninterpersonal trauma is relatively understudied, and therefore it is unknown whether noninterpersonal trauma is associated with EDs. Furthermore, most previous studies do not account for multiple trauma exposures, or the relative association of traumatic events with EDs in the same statistical model. Method: Multinomial regression was used to examine the association of lifetime ED diagnosis (anorexia nervosa [AN], bulimia nervosa [BN], binge eating disorder [BED]) with trauma type (sexual interpersonal, other interpersonal, war/combat, and noninterpersonal) in a nationally representative dataset of US adults in bivariate and multivariable (i.e., with all trauma types) models. Results: Sexual interpersonal trauma was significantly positively associated with AN and BED in bivariate and multivariable models. In the multivariable model, only BED was found to be equally associated with sexual interpersonal, other interpersonal, and noninterpersonal trauma. Discussion: These results indicate a strong positive association between sexual trauma and EDs, even when controlling for experiences of other trauma events. Future research should examine longitudinal mediators between trauma and EDs, especially sexual trauma, to identify what factors may explain this relationship. Public significance statement: Individuals with eating disorders often experience traumatic events but it is unclear whether specific trauma types are more or less common in this population. This study found that only events such as rape and sexual assault are associated with anorexia nervosa, but that most trauma types are associated with binge eating disorder. Therefore, the relationship between trauma and binge eating disorder may function differently than other eating disorders. [ABSTRACT FROM AUTHOR]

Aim: Millions of Ukrainian children have been internally displaced or fled to other countries because of the Russian war. This systematic review focused on their health needs and future challenges for clinicians. Methods: A systematic literature search of the Medline, Embase and MedRxiv databases from 1 January 2010 to 31 March 2022 identified 1628 papers on the health of Ukrainian children and 112 were relevant to this review. Results: In 2019, under‐5 mortality was 8 per 1000 live births in Ukraine. Underweight and adverse childhood experiences, including child abuse, were frequent compared to other European countries, while childhood obesity seemed less common. Alcohol consumption was common in women of reproductive age, including during pregnancy, risking foetal alcohol syndrome. Neonatal screening programmes provided low coverage. Vaccine hesitancy was common and vaccination rates were low. Other concerns were measles, HIV, antibiotic resistance and multi‐resistant tuberculosis. Many children are expected to suffer from psychological and physical trauma due to the war. Other healthcare challenges include low COVID‐19 vaccination rates and a preference for secondary and tertiary care, rather than primary care. Many people cannot afford medication. Conclusion: Ukrainian children often have poor health and host countries need to be aware of their needs. [ABSTRACT FROM AUTHOR]

Introduction: Emerging evidence in depression suggests that blood–brain barrier (BBB) breakdown and elevated inflammatory cytokines in states of persistent stress or trauma may contribute to the development of symptoms. Signal‐to‐noise ratio afforded by ultra‐high field MRI may aid in the detection of maladaptations of the glymphatic system related to BBB integrity that may not be visualized at lower field strengths. Methods: We investigated the link between glymphatic neuroanatomy via perivascular spaces (PVS) and trauma experience in patients with major depressive disorder (MDD) and in healthy controls using 7‐Tesla MRI and a semi‐automated segmentation algorithm. Results: After controlling for age and gender, the number of traumatic events was correlated with total PVS volume in MDD patients (r = 0.50, p =.028) and the overall population (r = 0.34, p =.024). The number of traumatic events eliciting horror was positively correlated with total PVS volume in MDD patients (r = 0.50, p =.030) and the overall population (r = 0.32, p =.023). Age correlated positively with PVS count, PVS total volume, and PVS density in all participants (r > 0.35, p <.01). Conclusions: These results suggest a relationship between glymphatic dysfunction related to BBB integrity and psychological trauma, and that glymphatic impairment may play a role in trauma‐related symptomatology. [ABSTRACT FROM AUTHOR]

Mental health nurses, tasked with the constant care of clients undergoing mental health treatment, have faced unique challenges arising from the uncertain outcomes of the COVID‐19 pandemic. The shared exposure of both nurses and their patients to a traumatic event such this pandemic leads to additional challenges and ways of coping. The psychological effects of this shared trauma on mental health nurses arising from the pandemic are the subject of this study. An online survey was used to examine personal levels of anxiety and concern, personal and national resilience (NR), and posttraumatic growth (PTG) among 183 mental health nurses working in mental health services in Israel. Overall, the study revealed moderate levels of concern and relatively low levels of anxiety, with significant negative correlations between personal and NR and levels of concern and anxiety. Higher levels of personal and NR were related to lower levels of concern and anxiety, and there was a significant positive correlation between assessments of personal resilience and NR. A significant positive correlation was found between personal and NR and PTG. Higher religiosity was associated with higher resilience, and higher professional seniority was related to higher PTG. Finally, results for particular demographic subgroups indicate that in Israel, special attention should be given to those mental health nurses who have immigrated to Israel, are non‐Jews or have less professional experience. [ABSTRACT FROM AUTHOR]

Objective: Current concepts highlight the neurological and psychological heterogeneity of functional/dissociative seizures (FDS). However, it remains uncertain whether it is possible to distinguish between a limited number of subtypes of FDS disorders. We aimed to identify profiles of distinct FDS subtypes by cluster analysis of a multidimensional dataset without any a priori hypothesis. Methods: We conducted an exploratory, prospective multicenter study of 169 patients with FDS. We collected biographical, trauma (childhood and adulthood traumatic experiences), semiological (seizure characteristics), and psychopathological data (psychiatric comorbidities, dissociation, and alexithymia) through psychiatric interviews and standardized scales. Clusters were identified by the Partitioning Around Medoids method. The similarity of patients was computed using Gower distance. The clusters were compared using analysis of variance, chi‐squared, or Fisher exact tests. Results: Three patient clusters were identified in this exploratory, hypothesis‐generating study and named on the basis of their most prominent characteristics: A "No/Single Trauma" group (31.4%), with more male patients, intellectual disabilities, and nonhyperkinetic seizures, and a low level of psychopathology;A "Cumulative Lifetime Traumas" group (42.6%), with clear female predominance, hyperkinetic seizures, relatively common comorbid epilepsy, and a high level of psychopathology; andA "Childhood Traumas" group (26%), commonly with comorbid epilepsy, history of childhood sexual abuse (75%), and posttraumatic stress disorder, but also with a high level of anxiety and dissociation. Significance: Although our cluster analysis was undertaken without any a priori hypothesis, the nature of the trauma history emerged as the most important differentiator between three common FDS disorder subtypes. This subdifferentiation of FDS disorders may facilitate the development of more specific therapeutic programs for each patient profile. [ABSTRACT FROM AUTHOR]

This paper tests the effects of lay beliefs that disaster victims who have been victimised by other events in the past will cope better with a new adverse event than first‐time victims. It is shown that believing that disaster victims can get habituated to suffering reduces helping intentions towards victims of repeated adversity, because repeatedly victimised victims are perceived to be less traumatised by a new adverse event. In other words, those who buy into habituation beliefs will impute less trauma and suffering to repeated victims compared to first‐time victims, and they will therefore feel less inclined to help those repeatedly victimised victims. This was demonstrated in a series of six studies, two of which were preregistered (total N = 1010). Studies 1, 2, and 3 showed that beliefs that disaster victims become habituated to pain do indeed exist among lay people. Such beliefs are factually inaccurate, because repeated exposure to severe adversity makes it harder, not easier, for disaster victims to cope with a new negative event. Therefore, we call this belief the 'habituation fallacy'. Studies 2, 3, and 4 demonstrated an indirect negative effect of a belief in the 'habituation fallacy' on 'helping intentions', via lesser 'trauma' ascribed to victims who had previously been victimised. Studies 5 and 6 demonstrated that a belief in the 'habituation fallacy' causally affects trauma ascribed to, and helping intentions towards, repeatedly victimised victims, but not first‐time victims. The habituation fallacy can potentially explain reluctance to donate to humanitarian causes in those geographical areas that frequently fall prey to disasters. [ABSTRACT FROM AUTHOR]

The objective of the current study was to complete a systematic review of the relationship between prenatal maternal stress due to potentially traumatic events (PTEs) and child temperament. Eligible studies through June 2020 were identified utilizing a search strategy in PubMed and PsycInfo. Included studies examined associations between prenatal maternal stress due to PTE and child temperament. Two independent coders extracted study characteristics and three coders assessed study quality. Of the 1969 identified studies, 20 met full inclusion criteria. Studies were classified on two dimensions: (1) disaster‐related stress and (2) intimate partner violence during pregnancy. For disaster‐related prenatal maternal stress, 75% (nine out of 12) of published reports found associations with increased child negative affectivity, 50% (five out of 10) also noted associations with lower effortful control/regulation, and 38% (three out of eight) found associations with lower positive affectivity. When considering prenatal intimate partner violence stress, 80% (four out of five) of published reports found associations with higher child negative affectivity, 67% (four out of six) found associations with lower effortful control/regulation, and 33% (one out of three) found associations with lower positive affectivity. Prenatal maternal stress due to PTEs may impact the offspring's temperament, especially negative affectivity. Mitigating the effects of maternal stress in pregnancy is needed in order to prevent adverse outcomes on the infant's socioemotional development. [ABSTRACT FROM AUTHOR]

Residents of urban American neighborhoods facing economic hardship often experience individual and collective adversities at high levels. This study explores how racially diverse adults experience stress, adversity, and trauma, and how they cope and heal in the context of their environment. Following a critical realist grounded theory methodology, four focus groups were conducted with African American, White and Latinx participants (N = 21) within an employment service program. Participants identified key stressors ranging from financial and job challenges, violence, and trauma. To cope with and heal from adversity, they practiced positivity, named trauma and its effects, sought social connection, envisioned community‐based resources, and addressed structural and systemic barriers. The data generated a theory of "a mutual process of healing self and healing the community" through intrapersonal, interpersonal, and structural change. The results of this study indicate a need for peer‐led, community‐engaged initiatives and holistic, trauma‐informed, healing‐centered practices. [ABSTRACT FROM AUTHOR]

Purpose: This study aimed to examine the factors affecting secondary traumatic stress on midwifery students. Design and Methods: This descriptive study was conducted between November and December 2018. Data were collected using information form and the Secondary Traumatic Stress Scale. Findings: The study found that 22.2% of midwifery students met all the trauma criteria for posttraumatic stress disorder according to the Secondary Traumatic Stress Scale. Midwifery students who were unhappy to continue their education and those who wished to switch to another profession after graduation respectively showed a 2.8‐ and a 4‐fold higher risk of meeting the trauma criteria (p < 0.05). Conclusion: The secondary traumatic stress rate in midwifery students is particularly high considering the fact that one in five students fulfills all of the Secondary Traumatic Stress criteria. However, to reduce their secondary traumatic stress rate, students should be thoroughly assessed by the educators who could provide the support necessary. Implications for nursing practice: Before graduation from the midwifery departments, students traumatic stress symptoms could be assessed mental health nursing courses, which might enable to change their attitudes towards to cope with this situation. Especially after traumatic childbirths, midwifery students should be supported by mental health nurses to cope with traumatic stress. Midwifery students should be encouraged each and every possible moment to express their feelings when they experience traumatic stress and thus their skills for effective coping can be reinforced. [ABSTRACT FROM AUTHOR]

Post‐traumatic stress disorder (PTSD) has always been controversial and highly politicized. Here, using a social identity approach, we review evidence that trauma and its aftermath are fundamentally linked to social position, sociopolitical capital, and power. We begin this contribution by demonstrating how a person's group memberships (and the social identities they derive from these memberships) are inherently linked to the experience of adversity. We then go on to consider how it is through group memberships that individuals are defined by their trauma risk and trauma histories—that is, a person's group memberships and their trauma are often inherently linked. Considering the importance of group memberships for understanding trauma, we argue that it is important to see these, and group processes more generally, as more than just "demographic" risk factors. Instead, we argue that when groups are defined by their trauma history or risk, their members will often derive some sense of self from this trauma. For this reason, attributes of group memberships are important in developing an understanding of adjustment and adaptation to trauma. In particular, groups' status, their recourse to justice, and the level of trust and solidarity within the group are all central to the impact of traumatic events on individual‐level psychological resilience. We review evidence that supports this analysis by focusing on the exacerbating effects of stigma and social mistrust on post‐traumatic stress, and the value of solidarity and strong identities for resilience. We conclude that because of these group‐related processes, trauma interweaves the personal with the political and that post‐traumatic stress is fundamentally about power, positionality, and politics. [ABSTRACT FROM AUTHOR]

Introduction: There are approximately 1.7 million adolescents living with HIV (ALHIV, ages 10 to 19) globally, including 110,000 in Kenya. While ALHIV experience poor retention in care, limited data exist on factors underlying disengagement. We investigated the burden of trauma among disengaged ALHIV in western Kenya, and its potential role in HIV care disengagement. Methods: We performed in‐depth qualitative interviews with ALHIV who had disengaged from care at two sites, their caregivers and healthcare workers (HCW) at 10 sites, from 2018 to 2020. Disengagement was defined as not attending clinic ≥60 days past a missed scheduled visit. ALHIV and their caregivers were traced through phone calls and home visits. Interviews ascertained barriers and facilitators to adolescent retention in HIV care. Dedicated questions elicited narratives surrounding traumatic experiences, and the ways in which these did or did not impact retention in care. Through thematic analysis, a conceptual model emerged for a cascade from adolescent experience of trauma to disengagement from HIV care. Results: Interviews were conducted with 42 disengaged ALHIV, 34 caregivers and 28 HCW. ALHIV experienced a high burden of trauma from a range of stressors, including experiences at HIV disclosure or diagnosis, the loss of parents, enacted stigma and physical or sexual violence. A confluence of factors – trauma, stigma and isolation, and lack of social support – led to hopelessness and depression. These factors compounded each other, and resulted in complex mental health burdens, poor antiretroviral adherence and care disengagement. HCW approaches aligned with the factors in this model, suggesting that these areas represent targets for intervention and provision of trauma‐informed care. Conclusions: Trauma is a major factor underlying disengagement from HIV care among Kenyan adolescents. We describe a cascade of factors representing areas for intervention to support mental health and retention in HIV care. These include not only the provision of mental healthcare, but also preventing or addressing violence, trauma and stigma, and reinforcing social and familial support surrounding vulnerable adolescents. In this conceptualization, supporting retention in HIV care requires a trauma‐informed approach, both in the individualized care of ALHIV and in the development of strategies and policies to support adolescent health outcomes. [ABSTRACT FROM AUTHOR]

Being a cross‐cultural systemic therapist, clinical supervisor, and educator means that culture and language are central to my work. They provide a scaffold to develop deeper understanding, increased trust, and connection between myself and my supervisees, students, and clients and facilitate a process for the latter to connect to their own selves and values. Given the fear and uncertainty generated by the COVID‐19 pandemic, there exists a pervasive activation of the sympathetic nervous system in the community. In this article, I present two case studies as examples of a cross‐cultural/cross‐linguistic approach that facilitates two clients to find a place of comfort and calmness and consequently a balancing activation of the para‐sympathetic nervous system. First is a client who, due to the overwhelming pandemic chaos, suddenly exhibited a host of signs and symptoms of a functional neurological nature, which she experienced as a lack of control and disconnection from her body, her primary language, and herself. Within a trusted therapeutic relationship that draws on the culture and primary language of the therapist, the client regains connection with language and enhances her ability to communicate and connect with her body. Second is an international student who is encouraged to use her culture of origin and primary language to induce calmness, reconnect with herself, and return to the familiar as a 'known' collectively inclusive, comforting, and nurturing environment. [ABSTRACT FROM AUTHOR]

Background: Hospital readmissions due to illness among geriatric patients result in human suffering and psychological trauma. Resilience in chronic illness protects geriatric patients from outcomes of trauma leads to psychological and physical well‐being and enables bouncing back to life. While communication has been linked to improved health outcomes, little is known about communication pathways in the context of postdischarge resilience. Aim and objective: To explore the role of communication pathways that acute‐care clinicians used with geriatric patients in postdischarge resilience. Methodological design and justification: Participants were ten geriatric patients who were readmitted several times in the past year. Twenty narrative interviews were conducted, one upon discharge and the other a month thereafter. Data for each phase of interviews were analysed using methods of selection mechanisms and Bricolage. Ethical issues: The ethics committee approved the study. Participants signed an informed‐consent form for participation and publication. Findings: Communication in acute care that enhanced health literacy, perceived control and reflection, contributed to higher comprehensibility and manageability during the hospitalisation and postdischarge meaningfulness postdischarge, contributing resilience. Participants who experienced other forms of communication demonstrated anxiety and helplessness with lingering psychological trauma postdischarge. Conclusions: Acute care may provide clinicians with opportunities to alleviate the suffering of geriatric patients and contribute to their postdischarge resilience. The suggested T.E.R model delineates communication pathways to fuel the trajectory from psychological trauma to postdischarge resilience in practice. [ABSTRACT FROM AUTHOR]

The current worldwide so‐called "refugee crisis" has led to an unprecedented increase in migration globally. Because of stigma and language barriers, mental health care for refugees is limited. There is a need for novel, scalable psychological interventions. We investigated whether a brief behavioural intervention involving a memory reminder cue and Tetris gameplay on a smartphone reduces intrusive memories in refugees using a single case (N = 4) ABAB withdrawal design. The baseline phase (A) included a no‐intervention week; the intervention phase (B) included an in‐person session with the researchers, comprised of the behavioural intervention followed by self‐guided use in daily life the following week. All participants reported a decrease in intrusive memories after the intervention, as well as functional improvements (e.g., in concentration). Importantly, participants rated the intervention as feasible and acceptable. As one in‐person session was effective in persistent intrusion reduction, ABAB proved not to be the optimal design as intrusions did not rebound in the withdrawal phase. Findings are promising and highlight the need for further evaluation of novel interventions for mental health problems in refugees. [ABSTRACT FROM AUTHOR]

Narrative exposure therapy (NET) is an intervention for trauma spectrum disorders. Originally developed to treat refugee populations, NET has since been tested for efficacy across different settings. In this review, the NET evidence base is examined through a retrieval, synthesis and appraisal of randomized controlled trials (RCTs) published since 2002. Two independent reviewers (S. R. and N. S.) searched online databases including EMBASE, PsycINFO and PubMed. Twenty‐four RCTs were selected for a meta‐analysis of three outcomes: post‐traumatic stress disorder (PTSD) diagnosis and PTSD and depression symptoms. All outcomes were analysed at short‐term (3–4 months), midterm (6–7 months) and long‐term (≥12 months) data points. A random‐effects model was applied to yield standardized mean differences (SMDs) and odds ratios (ORs) as indicators of NET treatment effect. Subgroup analyses for type of trauma and type of control groups were conducted to examine potential heterogeneity. For the NET group, moderate effect sizes for PTSD symptom severity were observed at midterm and long term and at midterm for depression symptom severity. The number of PTSD diagnoses decreased significantly in the short term for the NET condition, but this was not sustained at the long term. Caution must be exercised when interpreting these results due to high heterogeneity estimates and low quality of evidence across trials. Potential small‐study effects further complicate the interpretation of the findings. Recommendations are made for augmenting statistical significance research with qualitative analyses of NET efficacy to better inform clinical practice. [ABSTRACT FROM AUTHOR]

Introduction: Because lifetime trauma exposure has been linked to multiple adverse pregnancy outcomes, there is a need for all perinatal care providers to be versed in trauma‐informed care practices. However, there are few data to guide trauma‐informed practice during the perinatal period. The objective of this study was to refine ongoing development of a trauma‐informed care framework for perinatal care by conducting a qualitative study of all trauma experiences and preferred screening practices of pregnant patients at an urban prenatal clinic. Methods: In this qualitative study, we conducted semistructured interviews with 30 women receiving prenatal care at an urban clinic. Participants also completed a trauma history questionnaire. Inductive coding was used to generate themes and subthemes. Results: Participants described multiple lifetime traumatic exposures as well as background exposure to community violence. Not all participants desired routine trauma screening; factors limiting disclosure included fear of retraumatization and belief that prior trauma is unrelated to the current pregnancy. Strong therapeutic relationships were identified as critical to any trauma history discussion. Discussion: This study supports a trauma‐informed care approach to caring for pregnant women with prior traumatic exposures, including trauma screening without retraumatization and trusting patient‐provider relationships. [ABSTRACT FROM AUTHOR]

Aim: This exploratory study aimed to examine differences in rates of self and clinician-reports of trauma in youth at clinical high risk for psychosis (CHR) and whether rates of reporting differed by ethnicity., Methods: Self-reported history of trauma was collected at intake amongst youth at CHR enrolled in Coordinated Specialty Care (CSC) services (N = 52). A structured chart review was conducted for the same sample to identify clinician-reported history of trauma throughout treatment in CSC., Results: For all patients, frequency of self-reported trauma at intake to CSC (56%) was lower compared to clinician-reports of trauma throughout treatment (85%). Hispanic patients self-reported trauma at intake (35%) less frequently than non-Hispanics (69%) (p = .02). No differences were found in clinician reported exposure to trauma by ethnicity throughout treatment., Conclusion: Whilst further research is needed, these findings suggest the need for formalised, repeated, and culturally appropriate assessments of trauma within CSC., (© 2023 The Authors. Early Intervention in Psychiatry published by John Wiley & Sons Australia, Ltd.)

Hepatitis C Virus (HCV), a blood borne pathogen capable of causing severe liver disease, disproportionately affects veterans in the United States. While there are antiviral medications to treat HCV, stigma and trauma in this population may lead to avoidance of care. Those veterans who do undergo treatment have certain illness representations about HCV and its treatment. They undergo treatment even while facing stigma and trauma. The Common‐Sense Model may be useful in elucidating how such representations, when matched to an appropriate illness prototype, may inform an action plan of how to respond to HCV. An exploration of the illness representations among veterans with HCV, and the effects of stigma and trauma on these representations, may help to explain how they exercise the choice to undergo treatment and may inform interventions to encourage treatment in veterans who have yet to do so. [ABSTRACT FROM AUTHOR]

Background: Viral bronchiolitis is a common respiratory infection that often affects term, otherwise healthy infants. A small literature suggests maternal stress during pregnancy is associated with bronchiolitis. However, the association between maternal exposure to lifetime traumatic stress, including traumatic events occurring in childhood or throughout the life course, and bronchiolitis has not been studied previously.Objectives: To investigate the association between maternal exposure to total lifetime and childhood traumatic stress events and infant bronchiolitis.Methods: We studied mother-infant dyads enrolled in a prospective prenatal cohort, recruited 2006-2011, and Tennessee Medicaid. During pregnancy, we assessed maternal lifetime exposure to types of traumatic events by questionnaire. We captured bronchiolitis diagnoses in term, non-low birthweight infants' first 12 months using linked Medicaid data. In separate models, we assessed the association of maternal lifetime traumatic events (0 to 20 types) and a subset of traumatic events that occurred during childhood (0 to 3: family violence, sexual, and physical abuse) and infant bronchiolitis using multivariable log-binomial models.Results: Of 629 women, 85% were African American. The median count (interquartile range) of lifetime traumatic events was 3 (2, 5); 42% reported ≥1 childhood traumatic event. Among infants, 22% had a bronchiolitis diagnosis (0 to 2 lifetime traumatic events: 24%; 3 events: 20%; 4 to 5 events: 18%; 6 or more events: 24%). Total maternal lifetime traumatic events were not associated with bronchiolitis in multivariable analyses. For maternal childhood traumatic events, the risk of infant bronchiolitis increased with number of event types reported: adjusted Risk ratios were 1.12 (95% confidence interval [CI] 0.80, 1.59), 1.31 (95% CI 0.83, 2.07), and 2.65 (95% CI 1.45, 4.85) for 1, 2, and 3 events, respectively, vs none.Conclusions: Infants born to women reporting multiple types of childhood trauma were at higher risk for bronchiolitis. Further research is needed to explore intergenerational effects of traumatic experiences. [ABSTRACT FROM AUTHOR]

Much of the theoretical focus in post‐traumatic stress disorder has been on the role of the amygdala, the hippocampus and the prefrontal cortex. Crucially, in unresolved traumatic experiences that underlie clinical presentations, this focus misses the brain areas key to the defence responses of fight, flight and freeze—and the associated affects of anger, fear and grief. The periaqueductal gray in the midbrain, with the hypothalamus, is essential for these somatic and emotional responses to traumatic experiences. We argue that when treatment approaches thought to work at the higher brain levels have been ineffective, it is because they have failed to engage the midbrain and hypothalamic sources of the affective responses to the trauma and to the memory of it. Basic affects have been so overwhelming that dissociation, or a similarly protective neurochemical capping mechanism, has prevented full resolution of the affective content of the adversity. Treatment with the Comprehensive Resource Model® (CRM) aims to clear the clinically relevant residues of adverse experiences by resolving the emotional responses accessed through the body memories. When the trauma has led to overwhelming distress, and/or dissociation, there is a necessity for robust resourcing to be in place before the emotional intensity of that distress is accessed. Resourcing needs to be as proximal to the re‐experience as possible to promote complete resolution and in some psychotherapy modalities, the supports provided are somewhat remote from the crucial moments of processing. Therefore, we describe how the CRM seeks to have robustly resourced states present concurrently with traumatised states to avoid overwhelming emotional distress. This allows safe entry into the deepest pain residual from the traumatic event so that it is not overwhelming during processing of the memory, and does not lead to further dissociation, allowing the individual to remain fully present throughout. This "stepping into the affect" can then be so rapidly effective that we also argue that CRM is not an exposure treatment; re‐orientation to the deepest content of the experience resolves the residual distress quickly and permanently through memory reconsolidation. Re‐learning at upper brain levels will then follow from the revoking of the affective power, which has previously driven stimulus/context and response learning in the amygdala, hippocampus and prefrontal cortex. [ABSTRACT FROM AUTHOR]

Introduction: Post‐traumatic stress disorder (PTSD) is a chronic, disabling psychiatric disorder prevalent among civilian and military personnel in the United States (US) and United Kingdom (UK). Current trauma‐focused psychotherapies may place high emotional demands and lengthy treatment commitment that may hinder successful treatment completion for some patients. Accelerated resolution therapy (ART) is an emerging trauma‐focused psychotherapy that is briefer than most current treatments. Materials and Methods: This review describes the ART clinical protocol and theoretical underpinnings, its relationship to current treatments and formal established treatment guidelines and empirical research data. Also presented are new subgroup data for the use of ART among clients with PTSD and concomitant traumatic brain injury (TBI), and among US Special Operations Forces (SOF) personnel with extensive combat‐related trauma exposure. Treatment response was defined as ≥10‐point reduction on the 17‐item PCL‐M (PTSD Checklist). Results: In subgroup analyses, mean treatment with ART consisted of approximately four sessions. Among 202 US service members/veterans, intention‐to‐treat response rates (assuming no response for non‐completers) by TBI status were as follows: no TBI (58.1%, n = 105), mild TBI (60.4%, n = 48), moderate/severe TBI (46.9%, n = 49). Among 141 US service members/veterans, intention‐to‐treat response rates by SOF status were as follows: non‐SOF (54.3%, n = 116), SOF (60.0%, n = 25). Conclusion: The ART protocol aligns closely with established first‐line trauma‐focused psychotherapies and clinical guidelines. It appears to provide frequent clinical relief of symptoms of PTSD in an average of four sessions among military personnel with challenging clinical presentations, including concomitant TBI and extensive operational combat‐related trauma. [ABSTRACT FROM AUTHOR]

Abstract: In the past several years Serbia has been in the center of the so‐called “Balkan route”, a pathway for refugees from the Middle East and Central Asia. In March 2016 the Balkan route was closed and this measure reduced the number of daily arrivals and prolonged the stay of refugees in Serbia. A brief overview of the current situation is given, together with some previous experiences in psychosocial programs for the displaced population during wars in former Yugoslavia and current psychosocial programs and interventions. Several short examples are presented to point out some aspects of those experiences that might have relevance to our understanding of the psychological trauma and possible ways of treatment. [ABSTRACT FROM AUTHOR]

The article focuses on concept of a duty to warn and protect refers to circumstances wherein physicians are expected to breach confidentiality to protect a named person who might be under serious threat from their patient. It mentions Canada's Supreme Court decision in the case Smith v Jones has provided some guidance on the legal obligations of physicians regarding the duty to warn. It also mentions law has mainly focused on risk of bodily harm.

The history of psychological trauma is neglected in the psychiatric literature in comparison with other mental diseases. Most mental disorders have a long documented history (e.g. depressive disorders and anxiety disorders), and boast scores of medical sources since ancient times. Although scarce, there is evidence of psychological trauma in historical, literal, mythical and medical manuscripts. These fragments provide us with hints of psychological trauma throughout human history, shedding a bit of light on the concept of psychological trauma. The author presents evidence of psychological trauma from antiquity to the Renaissance era. The paper has four parts. Each part corresponds to a different historical period. The four periods in human history are: antiquity, ancient Greece and Rome, the dark and medieval ages and the European Renaissance era until the 16th century. The author inquires as to why psychological trauma was neglected and remained obscure for centuries, and whether there was a common denominator of psychological trauma that is beyond culture, race, gender and time. The paper aimed to address these inquires. In conclusion, these aspects in the history of psychological trauma are of scholastic and practical importance, and may also contribute to the broader understanding of modern psychotraumatology. Copyright © 2010 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

The current conflicts in Iraq and Afghanistan have resulted in a large cohort of military personnel exposed to combat-related psychological trauma as well as biomechanical trauma, including proximity to blast events. Historically, the long-term effects of both types of trauma have been viewed as having different neural substrates, with some controversy over the proper attribution of such symptoms evident after each of the major conflicts of the last century. Recently, great effort has been directed toward distinguishing which neuropsychiatric sequelae are due to which type of trauma. Of interest, however, is that the chronic effects of exposure to either process are associated with a significant overlap in clinical symptoms. Furthermore, similar brain regions are vulnerable to the effects of either psychological or biomechanical trauma, raising the possibility that shared mechanisms may underlie the clinically observed overlap in symptom profile. This paper reviews the literature on the neural substrate of biomechanical and psychological injury and discusses the implications for evaluation and treatment of the neuropsychiatric sequelae of these processes. [ABSTRACT FROM AUTHOR]

It is well known that several psychiatric disorders may be related to childhood psychological trauma. Recent studies have associated childhood exposure to trauma to some skin diseases. Our study aimed at exploring whether psoriasis is related to the reported positive and negative traumatic life events in different age intervals beginning from early childhood to adulthood. Furthermore, we investigated differences between psoriatics with early and late onset according to traumatic experiences in different age intervals. Also, we investigated the possible correlation of traumatic experiences with the disease severity. One hundred patients with psoriasis and 101 controls (patients with skin conditions considered to be “non-psychosomatic”) were enrolled in the study. All participants completed a specific questionnaire measuring traumatic life experiences (Traumatic Antecedents Questionnaire, TAQ). The TAQ assesses positive personal experiences (competence and safety) and negative personal experiences (neglect, separation, secrets, emotional, physical and sexual abuse, trauma witnessing, other traumas and exposure to alcohol/drugs) from early childhood to adulthood. The severity of psoriasis was estimated according to the Psoriasis Area and Severity Index (PASI), a standardized measuring instrument. The amount of positive experiences did not differ significantly among groups, except for safety scores that were higher in controls compared with both psoriatic groups (early and late onset). On the other side, negative traumatic experiences appeared more frequently in patients with psoriasis during all developmental periods. We found no correlation between severity of psoriasis and traumatic experiences. The present study demonstrates an increased history of childhood and adulthood negative traumatic experiences in patients with psoriasis compared to the control group. Our findings suggest a relationship between retrospectively reported negative traumatic experiences and psoriasis. [ABSTRACT FROM AUTHOR]

OBJECTIVES: To evaluate the mortality risk associated with exposure to the Nazi regime 6 decades after the war. DESIGN: A national representative survey with 7-year follow-up data. SETTING: A national representative survey of Israeli Jews aged 60 and older conducted in 1997 and 1998. PARTICIPANTS: Four thousand one hundred seventy-nine Israeli Jews participated in the study. To evaluate the mortality risk associated with exposure to the Nazi regime, Cox proportional-hazards models were used, controlling for age, sex, education, religiousness, mental health, sleep disturbance, and baseline health. MEASUREMENTS: A 7-year follow-up of all-cause mortality. RESULTS: Of the 4,179 Israeli Jews who participated in the study, 1,472 (35%) self-identified as being exposed to the Nazi regime, defined as having lived in a country that was under the Nazi occupation or directly ruled by the Nazi regime. There was no statistically significant difference in mortality rate between those exposed to the Nazi regime (29.8%) and those who were not (27.5%) (adjusted hazard ratio=1.01, 95% confidence interval=0.88–1.15). CONCLUSION: Israeli Jews who survived exposure to the Nazi regime are not at greater risk for death than the general population of Israeli Jews in later life. It is unclear whether these individuals represent a particularly resilient group or whether the risks of psychological trauma on mortality are mitigated over time. [ABSTRACT FROM AUTHOR]

To explore the effect of experiencing a road crash on aspects of psychological meaning. A 12-month repeated measures prospective design was used. Data were collected from admissions to a hospital in central Victoria. Seventy-two injured road crash victims took part in the study. Three measures of psychological trauma and the World Assumptions Scale. World Assumptions Scale scores did not change significantly over the year, despite improvements in other trauma scores. This study does shed some light on the psychological effects of road trauma, but further research is needed to create more sophisticated measures. [ABSTRACT FROM AUTHOR]

The early historical evolution of the concept of psychological trauma is relevant to the establishment of PTSD as a syndrome. The authors conducted selective computerized and manual reviews of the literature concerning the history of trauma-related disorders. Exposure to overwhelming terror can lead to troubling memories, which has been a central theme in the literature since the time of Gilgamesh. Reexperiencing was well known and conversion reactions were described, but until the 18th century chroniclers and philosophers essentially reported anecdotes. Nostalgia and traumatic neurosis were first identified during the American Civil War and after the first railway crashes in the 19th century. The isolated anecdote thus evolved into a clinical entity whose medical and psychiatric complexity underwent large-scale development during and immediately after World War I. An historical approach of traumatic disorders identification provides an integrated view of multiple psychological symptoms, some included and others not included in current post-traumatic syndromes. Copyright © 2003 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Abstract Psychological distress in 248 evacuees from a volcanic eruption was evaluated using a 30-item General Health Questionnaire (GHQ-30) at four time points after evacuation: 6 months, 12 months, 24 months and 44 months. The proportion of evacuees with psychological distress (defined as a GHQ score ≥ 8) significantly decreased from 66.1% (6 months) to 45.6% (44 months). The GHQ mean score significantly improved from 12.6 to 8.9. Investigation of each factor on the GHQ showed progressive improvement over time in ‘anxiety, tension and insomnia’ and ‘anergia and social dysfunction’. However, ‘depression’ began to improve only after 44 months and ‘interpersonal dysfunction’ started to worsen after 12 months. The dysfunction in interpersonal relationships continued at 44 months. Examination of the relation between GHQ mean scores and age group showed that recovery from psychological distress was more difficult in middle-aged and older evacuees than in younger evacuees. [ABSTRACT FROM AUTHOR]

The percentage of evacuees showing a high score (≥8), the mean General Health Questionnaire (GHQ) scores and the scores of the five subscales derived from the GHQ-30 in evacuees of the Mt Unzen volcanic eruptions were obtained at three intervals, 6 months, 12 months and 24 months after evacuation. The percentage of evacuees showing a high score as well as mean GHQ scores had significantly improved by the second investigation, and this trend was continued at the third investigation. However, at the third investigation the percentage of evacuees with a high score was 57.3%, and the mean GHQ score was still 11.21, representing extremely high values. Factor 1 (Anxiety, Tension, Insomnia) was significantly improved in both males and females at the second investigation. A difference by sex was seen in Factor 2 (Anergia, Social Dysfunction). which had improved significantly in females, whereas no improvement was seen in males. There were no remarkable changes in Factor 3 (Depression) or Factor 4 (Anhedonia). but Factor 5 (Interpersonal Dysfunction) had significantly worsened in both males and females over the course of time. It is suggested that these results are due to the disruption of community functions and weakened community consciousness induced by prolonged evacuation to a temporary dwelling despite escaping from a potentially fatal situation. [ABSTRACT FROM AUTHOR]

This paper presents an ecological view of psychological trauma and trauma recovery. Individual differences in posttraumatic response and recovery are the result of complex interactions among person, event, and environmental factors. These interactions define the interrelationship of individual and community and together may foster or impede individual recovery. The ecological model proposes a multidimensional definition of trauma recovery and suggests that the efficacy of trauma-focused interventions depends on the degree to which they enhance the person-community relationship and achieve "ecological fit" within individually varied recovery contexts. In attending to the social, cultural and political context of victimization and acknowledging that survivors of traumatic experiences may recover without benefit of clinical intervention, the model highlights the phenomenon of resiliency, and the relevance of community intervention efforts. [ABSTRACT FROM AUTHOR]

Studies concerning the development of a post-traumatic stress disorder related to severe illness are scarce. The confrontation with myocardial infarction may be a very stressful event. Twenty-three patients consecutively admitted for first myocardial infarction were studied. After two years 1 of 18 survivors had been suffering from a partial post-traumatic stress disorder. Similarities and differences in the psychological reactions following potential traumatic events are discussed. [ABSTRACT FROM AUTHOR]

The purpose of this study was to test the validity and utility of distinguishing symptoms of anxiety from those of depression and grief in recently spousally bereaved elders. We also examined pathways from baseline (six months or less post-spousal death) to follow-up (12 and 18 months post-death) levels of anxiety, depression and grief-related symptoms. Baseline and follow-up data were available from 56 recently widowed elderly subjects recruited for an investigation of physiological changes in bereavement. Confirmatory factor analyses indicated that a model in which anxiety was specified as a third factor, apart from depression and grief factors, fit the data well and significantly better than either the one or tow factor models. Path analyses revealed that both baseline severity of grief and anxiety had significant lagged effects and predicted follow-up severity of depression. Symptoms of anxiety appeared distinct from those of depression and grief, and the anxiety, depression and grief factors differentially predicted subsequent symptomatology. These findings suggest a need for more specific identification and treatment of anxiety, depression and grief symptoms within the contest of late-life spousal bereavement. [ABSTRACT FROM AUTHOR]