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Aims: Refugees and asylum-seekers are typically exposed to multiple potentially traumatic events (PTEs) in the context of war, persecution and displacement, which confer elevated risk for psychopathology. There are significant limitations, however, in extant approaches to measuring these experiences in refugees. The current study aimed to identify profiles of PTE exposure, and the associations between these profiles and key demographics, contextual factors (including ongoing stressors, method of travel to Australia and separation from family), mental health and social outcomes, in a large sample of refugees resettled in Australia. Methods: Participants were 1085 from Arabic, Farsi, Tamil and English-speaking refugee backgrounds who completed an online or pen-and-paper survey in their own language. Constructs measured included PTE exposure, demographics, pre-displacement factors, ongoing stressors, post-traumatic stress disorder symptoms, depression symptoms, anger reactions, plans of suicide and social engagement. Results: Latent class analysis identified four profiles of PTE exposure, including the torture and pervasive trauma class, the violence exposure class, the deprivation exposure class and the low exposure class. Compared to the low exposure class, participants in the trauma-exposed classes were more likely to be male, highly educated, from Farsi and Tamil-speaking backgrounds, have travelled to Australia by boat, experience more ongoing stressors and report both greater psychological symptoms and social engagement. Conclusions: This study found evidence for four distinct profiles of PTE exposure in a large sample of resettled refugees, and that these were associated with different demographic, psychological and social characteristics. These findings suggest that person-centred approaches represent an important potential avenue for investigation of PTE exposure in refugees, particularly with respect to identifying subgroups of refugees who may benefit from different types or levels of intervention according to their pre-migration PTE experiences. [ABSTRACT FROM AUTHOR]

Introduction and purpose: Post-traumatic stress disorder is a psychiatric condition following an extreme event that causes a near death of an involved individual. Since conventional treatments using selective serotonin reuptake inhibitors do not consistently yield therapeutic success, alternative substances are being explored as potential solutions. This study aims to compile information regarding the outcomes of utilizing psychedelics in individuals diagnosed with PTSD. Brief description of the state of knowledge: In July 2023, after a number of clinical trials and 20-year-long efforts to overturn the impact of a prohibition, Australia became the first country to allow doctors, in clinical development and under strict control, to use the 3,4-methyl enedioxy methamphetamine (MDMA) commonly known as ecstasy, as well as psylocybin in patients with post-traumatic stress disorder or depression [1]. There is a noticeable annual growth of inquiries on PubMed involving the keywords "psychedelics" and "therapeutic", amounting to 92 in 2000 and topped by 738 searches in 2023, whereas the total number of results consists of 8415 positions. Therapeutic effects of psychedelics are becoming more recognized over time. Summary: Post-Traumatic Stress Disorder (PTSD) is a complex condition that affects both the psychological and somatic aspects of the body. Thus, a multidimensional intervention is indicated. The use of psychedelics might contribute to improvements not only in the severity of PTSD but also in depression or pain. Further research on a larger group of participants should be carried out to assess the potential role of psychedelics in conventional medicine in the future, alongside psychotherapy. [ABSTRACT FROM AUTHOR]

Concussion or mild traumatic brain injury (mTBI) is associated with long-term impairments in military personnel. Diagnosis of the condition remains clinically challenging. Neurological examination and cognitive symptoms may not accurately map the nature and severity of underlying brain injury. Neuroimaging techniques, such as diffusion tensor imaging (DTI), show promise as an effective tool in delineating the microstructural neural changes and corresponding clinical consequences following mTBI. This paper discusses the diagnosis and management of concussion, in the military context, using two cases of veterans who suffered blast-related mTBI. Insights on an integrated approach to concussion in the military, incorporating thorough neurological and neuropsychological examination and application of advanced neuroimaging are presented. [ABSTRACT FROM AUTHOR]

Background: Figures from the Department of Veterans' Affairs indicate there may be over 30,000 Australian veterans that have or may yet develop some form of service-related mental illness. There is a growing body of evidence that there is a spiritual dimension to soldiers' wounds. Purpose: The purpose of this paper is to understand the causes, symptoms and healing pathways for spiritual wounds, Method and materials: Firstly, exploration of the nature of veteran spirituality, Secondly, how a veteran's spirit can be wounded and what form these wounds take will need to be understood, Finally, approaches to healing these spiritual wounds. Results: There is a strong and growing body of empirical evidence highlighting linkages between diminished spiritual functioning and mental health issues such as post-traumatic stress disorder (PTSD). Properly trained and accredited medical and psychological practitioners are required to deliver treatment in their space. Conclusion: There is limited evidence of any spiritual institution or facility of any nature making a significant contribution in the support of veterans whose Defence service has led to mental health issues with a spiritual or faith basis. Determining what role spiritual institutions or facilities should take will need to be a major area for further study. [ABSTRACT FROM AUTHOR]

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of European Journal of Psychotraumatology is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Accurate recall of exposure to traumatic events is essential for diagnosis, treatment and compensation However, in the context of military combat, reports of trauma exposure may not be stable over time Increased reporting over repeated assessments has been associated with PTSD and its re-experiencing (B) symptoms Other competing explanations emphasise poorer health This study reports on 388 Australian Vietnam veterans who were interviewed 21 and 36 years after repatriation Combat exposure was assessed using a 21- item American scale PTSD and the symptom clusters were assessed with standardised psychiatric diagnostic interviews, and self-administered measures of health were included Although total combat scores were highly correlated across the two assessments (r = 865), stability of individual items differed widely Sixty-eight per cent of responses were stable, 17 5% were unstable increased reports, and 14 5% were unstable decreased reports In hierarchical regression analyses, combat was the strongest predictor of stable reports but a weaker predictor of increased and decreased reports Having a history of PTSD, particularly intrusion symptoms, significantly predicted stable reports A history of PTSD was a significant but weaker predictor of increased reports of combat exposure Suggestions of intrusive symptoms and poorer health as explanations of increased reports of exposure were not supported. [ABSTRACT FROM AUTHOR]

Background: Pharmacological management of complex psychological conditions and physical comorbidities in Vietnam veterans can be challenging, particularly when there are multiple prescribing clinicians. Purpose: To investigate the incidence of psychotropic polypharmacy in a cohort of Australian Vietnam veterans with post-traumatic stress disorder (PTSD). Methods: Subanalysis of data from a cross-sectional study of Vietnam veterans conducted at Gallipoli Medical Research Foundation from 2014-2015. Relationships between psychotropic polypharmacy and health outcomes were assessed, and anticholinergic burden scores calculated. Results: Of 160 participants with PTSD, 107 (66.9%) were treated with psychotropic medications, with 53 (33.1%) prescribed two or more. The most common combination was antidepressants with anxiolytics (21.5% of those treated). Polypharmacy was significantly associated with PTSD symptom severity (p<0.01), comorbid depression (p<0.05) and current suicidality (p<0.01). Anticholinergic burden scores ranged from 0--7, with 37.5% of participants classed as medium risk (score = 1--2) and 16-9% as high risk (≥3). Conclusion: Psychotropic polypharmacy prevalence in Australian Vietnam veterans with PTSD is high. This condition is commonly refractory to pharmacotherapeutic intervention, often leading to trials of combination therapy without supportive scientific evidence. Further research would be beneficial in evaluating potential efficacy versus harm of combination therapies to assist in rationalising prescription of multiple medications. Conflict of Interest: No conflicts of interest to declare. [ABSTRACT FROM AUTHOR]

Aims: Despite the frequency that refugees suffer bereavement, there is a dearth of research into the prevalence and predictors of problematic grief reactions in refugees. To address this gap, this study reports a nationally representative population-based study of refugees to determine the prevalence of probable prolonged grief disorder (PGD) and its associated problems. Methods: This study recruited participants from the Building a New Life in Australia (BNLA) prospective cohort study of refugees admitted to Australia between October 2013 and February 2014. The current data were collected in 2015–2016, and comprised 1767 adults, as well as 411 children of the adult respondents. Adult refugees were assessed for trauma history, post-migration difficulties, probable PGD, post-traumatic stress disorder (PTSD) and mental illness. Children were administered the Strengths and Difficulties Questionnaire. Results: In this cohort, 38.1% of refugees reported bereavement, of whom 15.8% reported probable PGD; this represents 6.0% of the entire cohort. Probable PGD was associated with a greater likelihood of mental illness, probable PTSD, severe mental illness, currently unemployed and reported disability. Children of refugees with probable PGD reported more psychological difficulties than those whose parents did not have probable PGD. Probable PGD was also associated with the history of imprisonment, torture and separation from family. Only 56.3% of refugees with probable PGD had received psychological assistance. Conclusions: Bereavement and probable PGD appear highly prevalent in refugees, and PGD seems to be associated with disability in the refugees and psychological problems in their children. The low rate of access to mental health assistance for these refugees highlights that there is a need to address this issue in refugee populations. [ABSTRACT FROM AUTHOR]

Background: As refugee numbers grow worldwide, understanding prevalence and determinants of mental illness in this population becomes increasingly important. Methods: We used longitudinal data to examine the initial years of resettlement in Australian refugees with a focus on ethnic-like social support. Three annual waves from a longitudinal, nationally representative cohort of 2,399 humanitarian migrants recently resettled in Australia were examined for two mental illness outcomes: post-traumatic stress disorder indicated by positive PTSD-8 screen and "high risk of severe mental illness" (HR-SMI) by Kessler Psychological Distress Scale (K6) ≥19. Generalized linear mixed models examined demographic and resettlement factors. Findings: Contrary to predictions, high prevalence of positive screens for mental illness persisted over 3 years. At baseline, 30.3% (95% CI, 28.5–32.2) screened positive for post-traumatic stress disorder (PTSD), and 15.4% (95% CI, 14.0–16.9) had HR-SMI. Over the 3 years, 52.2% met screening criteria for mental illness. PTSD was associated with older age, females, Middle Eastern birthplace, increasing traumatic events, more financial hardships, having a chronic health condition, and poor self-rated health. HR-SMI was associated with females, Middle Eastern birthplace, unstable housing, more financial hardships, having a chronic health condition, poor self-rated health, and discrimination. Also contrary to predictions, like-ethnic social support was positively associated with PTSD (OR, 1.51; 95% CI, 1.10–2.09). Interpretation: There is high prevalence of positive screens for mental illness throughout initial years of resettlement for refugees migrating to Australia. Our unexpected finding regarding like-ethnic social support raises future avenues for research. Predictors of mental illness in the post-migration context represent tangible opportunities for intervention and are likely relevant to similar resettlement settings globally. [ABSTRACT FROM AUTHOR]

Background: International studies suggest that high-dose opioid use is more common in veterans with posttraumatic stress disorder (PTSD) than those without in the treatment of musculoskeletal pain. Purpose: This article aims to examine the use of analgesics by Australian veterans with musculoskeletal pain by conducting a drug utilisation evaluation and to examine use by PTSD status. Methods: A cross-sectional study of Vietnam veterans with musculoskeletal pain was conducted using Australian Government Department of Veterans' Affairs (DVA) data. The study reviewed the proportion of dispensed prescription analgesics between 1 July 2015 and 30 June 2016. The volume of opioids dispensed per veteran was calculated as oral morphine equivalents (OME). Results were stratified by PTSD status. Results: 10 318 Vietnam veterans with musculoskeletal pain were included and 59% were dispensed analgesics. The most frequently dispensed analgesics were paracetamol (dispensed to 31% of veterans with PTSD and 28% without PTSD; p<0.01) and paracetamol with 30 mg codeine (19% of veterans with PTSD and 16% without; p<0.0001). Opioid analgesics were more likely to be dispensed to veterans with PTSD than without (35% v 32%, p=0.002); however, there was no significant difference in the volume dispensed (median of 1.2 [interquartile range (IQR) 0.4-5.8] OMEs per veteran per day for those with PTSD, compared to median 1.3 OMEs [IQR 0.4-6.3] per veteran per day for those without, p=0.3). Conclusion: Many veterans with service-related musculoskeletal pain did not receive prescription analgesics. Veterans with PTSD were more likely to be dispensed analgesics than those without, but PTSD did not appear to influence the volume of opioid dispensed. [ABSTRACT FROM AUTHOR]

Background: Australia is a multicultural nation with a humanitarian program that welcomes a large number of Iraqi refugees. Despite the high prevalence of trauma related disorders, professional help-seeking in this group is very low. This study sought to evaluate a face-to-face mental health literacy (MHL) Course that teaches community-based workers how to provide initial help to Iraqi refugees with depression and post-traumatic stress disorder (PTSD) related problems. Methods: An uncontrolled pre, post and follow-up design was used to measure improvement in MHL in community- based workers assisting Iraqi refugees. Results: Eighty-six participants completed the pre- and post-training questionnaires. Forty-five (52%) completed all 3-time point questionnaires. Fifty-six percent (48/86) of participants were able to correctly recognise 'PTSD' as the problem depicted in a vignette before the training. This increased to 77% (66/86) after training and was maintained at follow-up with 82% (37/45) correctly recognising the problem (p = 0.032). Recognition of depression also increased from 69% (59/86) at pre-training to 83% (71/86) after training and to 82% (37/45) at follow-up. There was a significant increase in perceived helpfulness of professional treatments for depression after training (p < 0.001 at post-training, p = 0.010 at follow-up). Significant changes were reported in confidence of participants when helping an Iraqi refugee with PSTD (p < 0.001 at post-training, p < 0.001 at follow-up) and depression (p < 0.001 at post-training, p = 0.003 at follow-up). A decrease were also found on social distance mean scores associated with PTSD (p = 0.006 at post-training, p < 0.001 at follow-up) and depression (p = 0.007 at follow-up). Changes were not significant following training for offering help and helping behaviours in both PSTD and depression vignettes and, the 'dangerous/unpredictable' subscale in the depression vignette. Conclusion: This training is a recommendable way to improve and better equip staff on how to respond to mental health crises and offer Mental Health First Aid in a culturally sensitive manner to Iraqi refugees. [ABSTRACT FROM AUTHOR]

An abstract of the article "The ADF Theatre Project: A performing arts rehabilitation project" by Alison Creagh is presented.

Background: Recent conflicts in the Middle East have seen rapid developments in the use of unmanned aerial vehicles (UAV). The Australian Government plans to acquire a number of UAVs to perform a range of operations. Purpose: To determine whether UAV operators are exposed to greater or special risks to their mental health than other combatants. Method: A non-systematic, narrative literature search was undertaken into the mental health of UAV operators. Results: The adverse effect of occupational stressors, such as long working hours, on well-being and mental health outcomes emerged strongly. Prevalence rates of clinically significant symptoms of PTSD (Post Traumatic Stress Disorder) for UAV operators were found to be low, ranging between 2 - 5%. Conclusion: These outcomes were consistent with occupational stressors found in the military context and previous findings on other military personnel with low combat exposure. This review is a first step towards establishing an evidence base to inform the management of mental health problems in UAV operators. [ABSTRACT FROM AUTHOR]

The author reflects on the Four Corners program on post-traumatic stress disorder in the Australian Defence Force (ADF). He mentions the development of a one-day workshop by the Australian Military Medicine Association (AMMA) featuring topics related to the military health services and personnel. The author provides information on the joint conference of AMMA and Controversies in Civilian and Military Trauma.

Background: Motor vehicle related moderate-severe orthopaedic trauma has a major impact on the burden of injury. In Australia, all states and territories provide access to financial compensation following injury in a motor vehicle crash. The aim of this study was to investigate the influence of seeking financial compensation (i.e., making a claim) on injury recovery following motor vehicle related moderate-severe orthopaedic trauma.Methods: Patients admitted with upper/lower extremity fractures after a motor vehicle crash were recruited from two trauma hospitals. Baseline data were collected in person by written questionnaire within two weeks of injury. Follow up data were collected by a mailed written questionnaire at six, 12 and 24 months. Additional (demographic/injury-related) information was collected from hospital databases, all other measures were self-reported. Outcomes were: Short Form-36 Version 2.0 (SF36v2), Physical/Mental Component Scores (PCS/MCS); Post Traumatic Stress Disorder (PTSD) Checklist Civilian Version (PCL-C); and Global Rating of Change (GRC) scale. Analysis involved descriptive statistics and linear mixed models to examine the effect of compensation status on injury recovery over time.Results: There were 452 study participants. Baseline characteristics showed: mean age 40 years (17.1 Standard Deviation [SD]); 75 % male; 74 % worked pre-injury; 67 % in excellent-very good pre-injury health; 56 % sustained serious injuries, Injury Severity Score (ISS) 9-15; 61 % had a low-middle range household income. Overall, after controlling for possible confounders, the compensable group had poorer recovery compared to the non-compensable group for PCS (-2.97 Mean Difference (MD), 95 % CI -4.73, -1.22); MCS (-3.44 MD, 95 % CI -5.62, -1.26); PCL-C (3.42MD, 95 % CI 0.87, 5.99); and GRC (-0.66MD, 95 % CI -1.15, -0.17). Injury recovery over time for all participants showed: PCS improved from 6-12 and 12-24 months; MCS and GRC improved from 6-12 months; and PCL-C did not significantly improve from 6-12 and 12-24 months. Injury recovery over time continued for compensable and non-compensable groups but compensable participants had poorer scores at each time period, especially MCS and PCL-C.Conclusions: Making a claim was associated with poor injury recovery following motor vehicle related orthopaedic trauma, mainly for mental health. Irrespective of claim status, the majority had poor injury recovery, especially for mental health. [ABSTRACT FROM AUTHOR]

Background: Research indicates that exposure to war-related traumatic events impacts on the mental health of refugees and leads to higher rates of posttraumatic stress disorder (PTSD), depression, and anxiety symptoms. Furthermore, stress associated with the migration process has also been shown to impact negatively on refugees' mental health, but the extent of these experiences is highly debatable as the relationships between traumatic events, migration, and mental health outcomes are complex and poorly understood. Objective: This study aimed to examine the influence of trauma-related and post-migratory factors on symptoms of PTSD, depression, and anxiety in two samples of Bosnian refugees that have resettled in two different host nations--Austria and Australia. Method: Using multiple recruitment methods, 138 participants were recruited to complete self-report measures assessing acculturative stress, PTSD, depressive, and anxiety symptoms. Results: Hierarchical regressions indicated that after controlling for age, sex, and exposure to traumatic events, acculturative stress associated with post-migratory experiences predicted severity of PTSD and anxiety symptoms, while depressive symptoms were only predicted by exposure to traumatic events. This model, however, was only significant for Bosnian refugees resettled in Austria, as PTSD, depressive, and anxiety symptoms were only predicted by traumatic exposure in the Bosnian refugees resettled in Australia. Conclusion: These findings point toward the importance of assessing both psychological and social stressors when assessing mental health of refugees. Furthermore, these results draw attention to the influence of the host societyon post-migratory adaptation and mental health of refugees. Further research is needed to replicate these findings among other refugee samples in other host nations. [ABSTRACT FROM AUTHOR]

The objective of the current study was to examine whether exposure to trauma in the form of a history of physical, mental, emotional or sexual abuse or violence predicted new onset of coronary heart disease (CHD) in women. In addition, this study aimed to examine the mediation effects of psychological, lifestyle and health related factors in the abuse-CHD relationship. Data from 6 surveys over 15 years, from the Australian Longitudinal Study on Women's Health, a large prospective cohort study, were used. Participants from the 1946-1951 cohort who did not self-report heart disease at surveys 1 (1996) and 2 (1998) and who had provided information on other variables were included (n = 9,276). After adjusting for age, women who reported trauma exposure at baseline were 1.54 times more likely (95 % confidence interval 1.29-1.83) to report new onset of CHD than those who did not report trauma exposure. The association between trauma and CHD was largely explained by psychological factors, suggesting a direct pathway between exposure to trauma and risk of CHD. [ABSTRACT FROM AUTHOR]

Background To examine levels of psychological distress and help seeking behaviour in resettled refugees attending English tuition classes in Australia, and their associations with participants' demographic characteristics. Methods Data was collected by bilingual interviewers between March and November 2013. A volunteer sample of attendees of Adult Migrant English Programs (AMEP) in Western Sydney were recruited. Participants were two hundred and twenty five Iraqi refugees resettled in Western Sydney, who had left Iraq no earlier than 1991, were fluent in Arabic and/or English, and were between the ages of 18 and 70. The chief outcome measures used were the Kessler Psychological Distress Scale (K-10) as well as The Harvard Trauma Questionnaire (HTQ). Results On the K-10, 39.8% of participants had severe psychological distress, 19.4% moderate distress, and 40.7% had low to mild distress. Ninety-five percent of participants reported having experienced one or more potentially traumatic event (PTE) as defined by the HTQ prior to leaving Iraq, with a mean of 14.28 events (SD = 8.69). Thirty-one percent of participants met the threshold (=2.5) for clinically significant PTSD symptomatology, with a significantly higher occurrence among participants with lower education attainment (? 2 (3) = 8.26, p = .04). Of those participants with clinically significant PTSD symptomatology according to the HTQ, only 32.9% reported ever having ever sought help for a mental health problem. Conclusions The high level of distress found in this sample, combined with low uptake of mental health care, highlights the need for programs targeted to promote help-seeking among Iraqi refugees who have resettled in Australia. Further, the higher level of PTSD symptomatology found amongst those with lower education attainment has mental health promotion and treatment implications. Specifically, in designing service and treatment programs, consideration should be given to the possible impact excessive levels of psychological distress may have on learning in refugees, to ensure that those who have been unable to develop proficiency in the English language receive effective care. [ABSTRACT FROM AUTHOR]

Objective This study tested theoretical models of the relationship between pain and posttraumatic stress disorder (PTSD) in children with traumatic brain injury (TBI). Methods Participants consisted of 195 children aged 6–15 years presenting to 1 of 3 Australian hospitals following a mild–severe TBI. Children were assessed at 3, 6, and 18 months after their accident for PTSD (via the Clinician-Administered PTSD Scale for Children and Adolescents [CAPS-CA] clinical interview) as well as physical pain (via the Child Health Questionnaire, 50-item version [CHQ-PF50]). Trained clinicians administered the CAPS-CA at home visits, and the CHQ-PF50 was collected through questionnaires. Results Structural equation modeling found the data supported the mutual maintenance model and also the nested perpetual avoidance model. Conclusions Both models indicate PTSD is driving the presence of pain, and not vice versa. A fourth model stating this was proposed. Therefore, it may be useful to address PTSD symptoms in treating child pain for expediting recovery. [ABSTRACT FROM AUTHOR]

Background: Rates of trauma and Posttraumatic Stress Disorder (PTSD) were examined in order to compare the profile in clients of an Australian Public Mental Health Service with that reported in the international literature for clients with major mental illness and to explore the effect of this on client health outcomes. Potential factors contributing to increased levels of trauma/PTSD in this group of clients and the issue of causality between PTSD and subsequent mental illness was also explored. Methods: A convenience sample of 29 clients was screened for trauma and PTSD using the Posttraumatic Stress Diagnostic Scale™ (PDS) and selected outcome measures. Paired and independent samples t-test and ANOVA were applied to the data. Results: High levels of undocumented trauma and PTSD were found. Twenty clients, (74%) reported exposure to multiple traumatic events; 33.3% (9) met DSM IV diagnostic criteria for PTSD. Significant difference was found for PTSD symptomatology, severity and impairment and for client and clinician-rated scores of Quality of Life (QOL) outcomes in the PTSD group. No effect for PTSD symptomatology on the Working Alliance (WA) was found. Factors that may influence higher rates of PTSD in this group were identified and included issues associated with the population studied, the predominance of assaultive violence found, and vulnerability and risks factors associated with re-traumatisation within the social and treating environments. Conclusion: A similar trauma and PTSD profile to that reported in the international literature, including greater levels of trauma and PTSD and a poorer QOL, was found in this small sample of clients. It is postulated that the increased levels of trauma/PTSD as reported for persons with major mental illness, including those found in the current study, are primarily related to the characteristics of the population that access public mainstream psychiatric services and that these factors have specific implications for service delivery, and raise issues of efficiency and effectiveness of resource use in achieving successful outcomes in public mental health services for clients with co-morbid PTSD. Further research with a more rigorous design is needed to test these preliminary findings within Australian Community Mental Health Services. [ABSTRACT FROM AUTHOR]

The article discusses the diagnosis of post-traumatic stress disorder (PTSD) among the officers of the Australian Defense Force (ADF). It states that PTSD may appear in different ways such as depressed mood and poor performance in the workplace. Its pre-morbid aspects include mood disorders, alcoholism, and disciplinary problems and can also be triggered by the memories. It also mentions that the prevalence of PTSD on the ADF is overestimated.

Background: Eye movement desensitization and reprocessing (EMDR) is an evidenced-based treatment for posttraumatic stress disorder (PTSD). Forensic mental health services provide assessment and treatment of people with mental illness and a history of criminal offending, or those who are at risk of offending. Forensic mental health services include high, medium, and low-security inpatient settings as well as prison in-reach and community outpatient services. There is a high prevalence of PTSD in forensic settings and posttraumatic experiences can arise in people who violently offend in the context of serious mental illness (SMI). Successful treatment of PTSD may reduce the risk of relapse and improve clinical outcomes for this population. This study aims to assess the efficacy, risk of harm, and acceptability of EMDR within forensic and rehabilitation mental health services, as compared to treatment as usual (routine care).Methods: This is a single-blind, randomized controlled trial comparing EMDR therapy to the waiting list (routine care). Adult forensic mental health service users (n = 46) with SMI and meeting the criteria for PTSD will be included in the study. Participants will be randomized after baseline assessment to either treatment as usual plus waiting list for EMDR or to treatment as usual plus EMDR. The EMDR condition comprises nine sessions, around 60 min in length delivered weekly, the first of which is a case conceptualization session. The primary outcomes are clinician and participant-rated symptoms of PTSD, and adverse events. Secondary outcomes include psychotic symptoms, social functioning, level of disability, self-esteem, depressive symptoms, post-trauma cognitions, and broad domains of complex posttraumatic difficulties. A trained assessor blinded to the treatment condition will assess outcomes at baseline, 10 weeks, and 6 months. Additionally, grounded theory qualitative methods will be used to explore participant experience of EMDR for a subset of participants.Discussion: This study will contribute to the currently limited evidence base for EMDR for PTSD in forensic settings. It is the first randomized clinical trial to assess the efficacy, risk of harm, and acceptability of EMDR for PTSD in people with SMI in either forensic, mental health inpatient, or custodial settings.Trial Registration: Australia and New Zealand Clinical Trials Network, ACTRN12618000683235. Registered prospectively on 24 April 2018. [ABSTRACT FROM AUTHOR]

Background: Refugees and asylum-seekers are often exposed to multiple types of potentially traumatic events (PTEs) and report elevated rates of psychological disorders, including posttraumatic stress disorder (PTSD). Considering this, refugee populations merit continued research in the field of traumatic stress to better understand the psychological impact of these experiences. The symptom structure of PTSD underwent a major revision in the recent formulation in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5), and this reformulation has yet to be comprehensively investigated in the context of PTSD arising from traumatic events experienced by refugees. The current study assessed the construct validity of the DSM-5 PTSD structure in a refugee sample from a variety of cultural backgrounds alongside four alternate models commonly identified in western populations, namely the four-factor Dysphoria model, the five-factor Dysphoric Arousal model, and the six-factor Anhedonia and Externalising Behaviours models. Methods: A total of 246 refugees settled in Australia were assessed using the Harvard Trauma Questionnaire, to measure exposure to potentially traumatic events (PTEs), and the Posttraumatic Diagnostic Scale, to assess symptoms of PTSD based on DSM-5 criteria. All measures were translated into Arabic, Farsi or Tamil using rigorous translation procedures, or provided in English. Results: Findings from five confirmatory factor analyses (CFAs) revealed that all models demonstrated acceptable model fit. However, an examination of relative fit revealed that the DSM-5 model provided the poorest fit overall for our sample. Instead, we found preliminary evidence in support of the six-factor Anhedonia model, comprising the symptom clusters of re-experiencing, avoidance, negative affect, anhedonia, dysphoric arousal and anxious arousal, as the superior model for our data. Conclusions: Our findings offer preliminary support for the applicability of the Anhedonia model to a culturally diverse refugee sample, and contribute to a growing body of studies which indicate that the DSM-5 model may not best represent the symptom structure of PTSD found across non-western conflict-affected populations. [ABSTRACT FROM AUTHOR]

The article focuses on the opinion piece published in the "Journal of Military and Veterans' Health" (JMVH's) April 2010 edition. It states that the opinion aims to stimulate the debate on post traumatic stress disorder (PTSD), addressing the trouble in both the general and health community on the accurate diagnosis of PTSD of the returning veterans. It contends that the piece may cause further distress to genuine PTSD sufferers who have placed their lives in danger in service to Australia.