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The aim of the present study was to assess the impact of past traumatic war experiences on preadolescents in the Gaza Strip, which could be useful for psychological intervention with current and future child victims. Participants were 521 preadolescents from United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA) schools, aged 11 and 13 years old. Sections I to IV from Iraqi Version-Arabic of Harvard Trauma Questionnaire was used to assess trauma experiences and Post-Traumatic Stress Disorder (PTSD). The results show that the preadolescents in the Gaza Strip witnessed the destruction of their homes and the murder of family members and friends. A quarter of the individuals assessed either suffered torture or witnessed others undergoing it, including sexual assaults. Almost half of them experienced a lack of food and clean water. The traumatic and torture experiences seriously affected preadolescents' mental health as 26.29% met criteria for the diagnosis of PTSD. The data analysis revealed two PTSD modalities, with the severity of impact depending on whether social implications were involved. Further research is required to check whether these two modalities fit to PTSD and complex PTSD. Understanding the effects of past wars on preadolescents in Gaza and distinguishing between different PTSD types could enhance comprehension of the impacts of current attacks on child victims. It can also aid in determining the type of intervention needed to minimize the impact on the mental health of Palestinian youth, enhancing their resilience through psychological and social support. [ABSTRACT FROM AUTHOR]

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

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

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

Current views of psychological therapies for trauma typically assume the traumatic event to be in the past. Yet, individuals who live in contexts of ongoing organized violence or experience intimate partner violence (IPV) may continue to be (re)exposed to related traumatic events or have realistic fears of their recurrence. This systematic review considers the effectiveness, feasibility, and adaptations of psychological interventions for individuals living with ongoing threat. PsychINFO, MEDLINE, and EMBASE were searched for articles that examined psychological interventions in contexts of ongoing threat of either IPV or organized violence and used trauma-related outcome measures. The search was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Data on study population, ongoing threat setting and design, intervention components, evaluation methods, and outcomes were extracted, and study quality was assessed using the Mixed-Method Appraisal Tool. Eighteen papers featuring 15 trials were included (12 on organized violence and 3 on IPV). For organized violence, most studies showed moderate to large effects in reducing trauma-related symptoms when compared to waitlists. For IPV, findings were varied. Most studies made adaptations related to culture and ongoing threat and found that providing psychological interventions was feasible. The findings, albeit preliminary with mixed methodological quality, showed psychological treatments can be beneficial and should not be withheld in the context of ongoing organized violence and IPV. Clinical and research recommendations are discussed. [ABSTRACT FROM AUTHOR]

This research paper explores the adverse impact of socio-political turmoil that has long been in existence in Assam society on the psyche of children with reference to Aruni Kashyap's The House with a Thousand Stories. The ethnic conflicts between the natives and the immigrants from other parts of India have caused several problems: loss of life and property, extra-judicial killings, and their resultant adverse impact on the socio-economic, cultural, and psychological spheres of the social lives of weaker sections in Assam. This research aims to identify and understand the various psychological issues that children are subject to in a society when it is afflicted with socio-political turmoil and its consequent violence unleashed on people due to the armed struggle of the ULFA and the repressive administration of the state. The objectives of this research are (i) to study the characterization of Mamoni and Mridul, (ii) to understand and analyse the impact of socio-political turmoil on the psyche of children with reference to the above-chosen characters, (iii) to explore the connectivity between the narrative and the author's political inclination in the novel, and (iv) to understand how objectively the historical incidents were reflected in the novel. The research is carried out by studying the chosen primary source against the pragmatic concepts of psychologists, journalists, social activists, and significant historical facts that appeared in reliable data sources such as journals, web studies, newspapers, and other publications. In conclusion, this research sheds light on the profound psychological repercussions experienced by children in Assam society amidst socio-political turmoil, as exemplified in Aruni Kashyap's "The House with a Thousand Stories." By delving into the characters of Mamoni and Mridul, analyzing the intricate interplay between narrative and political inclinations, and objectively examining historical incidents reflected in the novel, this study not only enhances our comprehension of the multifaceted impact on the psyche of children but also contributes valuable insights for policymakers, educators, and communities striving to address and mitigate the enduring consequences of such tumultuous environments on the younger generation. [ABSTRACT FROM AUTHOR]

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In this observational study, we assessed the extent to which a community-created pilot intervention, providing trauma-informed care for persons with HIV (PWH), affected HIV care retention and viral suppression among PWH attending an HIV Services Organization in the Southern US. PWH with trauma exposure and/or trauma symptoms (N = 166) were offered a screening and referral to treatment (SBIRT) session. Per self-selection, 30 opted-out, 29 received SBIRT-Only, 25 received SBIRT-only but reported receiving other behavioral health care elsewhere, and 82 participated in the Safety and Stabilization (S&S) Intervention. Estimates from multivariable logistic regression analyses indicated S&S Intervention participants had increased retention in HIV care (adjusted odds ratio [aOR] 5.46, 95% CI 1.70–17.50) and viral suppression (aOR 17.74, 95% CI 1.83–172), compared to opt-out participants. Some evidence suggested that PTSD symptoms decreased for intervention participants. A randomized controlled trial is needed to confirm findings. [ABSTRACT FROM AUTHOR]

IntroductionIt has been suggested that the COVID-19 pandemic was a potentially traumatic occurrence that may have induced generalized anxiety and discomfort, particularly in susceptible populations like individuals with mental illnesses. The therapeutic approach known as eye movement desensitization and reprocessing (EMDR) has been shown to be successful in helping patients process traumatic events and restore wellbeing. Nevertheless, little is known about the precise processes through which EMDR fosters symptom recovery. MethodsIn order to disentangle these issues, we conducted a randomized controlled trial (ClinicalTrials.gov Identifier NCT06110702) with 107 participants who were selected from university hospitals as a sample of investigation. Random assignments were applied to the participants in order to assign them to the experimental and control groups. The experimental group, but not the control group, underwent an 8-week EMDR intervention. Body perception, disgust, and emotions of guilt and shame, as well as mental contamination and posttraumatic and obsessive-compulsive symptoms, were investigated before and after the EMDR intervention.ResultsThe EMDR intervention was able to improve all of the variables investigated. Path analysis showed that body perception was able to predict both disgust and emotions of guilt and shame. Disgust was able to predict both mental contamination and obsessive-compulsive symptoms, while guilt and shame were able to predict post-traumatic symptoms. ConclusionsEMDR is an effective therapy for the treatment of post-traumatic and obsessive symptoms that acts through the promotion of improvement of the emotions of guilt/shame and disgust, respectively. Implications for clinical practice are examined.Clinical trial registrationhttps://www.clinicaltrials.gov, identifier NCT06110702.

Problem definition. The uncertainty of the consequences of situations related to stressful situations for the child's psyche actualizes the issue of introducing new approaches, methods and tools of psychological influence that would contribute to the preschooler's ability to overcome stress in a constructive way. Problem analysis. Childhood psychological trauma leaves its mark on the subconscious, can shape a person's worldview, beliefs, and identification of the self. And since trauma affects the levels of primary safety, it creates very powerful patterns in the mind. Signs of childhood trauma include mood swings, guilt, anxiety, feelings of abandonment, confusion and impaired concentration, and withdrawal. The conceptualization of traumatic experience is widely presented in scientific literature: theories of traumatic emotional experience (O.S. Kocharyan, R. Lanius, M. Massey, R. Hammer), conceptual foundations of the subverbal model of client-centered psychotherapy (O.S. Kocharyan), theories and typologies of infantile traumas (Johnson St. M., Burbo L., etc.), theoretical positions of procedural-experiential and emotionally-focused psychotherapy (Greenberg L. and Elliott R.), psychoanalytic theory according to Freud Z., ideas about the formation of early maladaptive schemes (Boterhoven de H., Christopher W., Fassbinder E., Hayes C., Katrina L., Yong J.) and others. However, solving many complex problems remains relevant, one of which includes psychological assistance to the most vulnerable population groups in extreme situations, one of which includes children and work with current traumatic experiences. The purpose of the study is to develop and test a multifunctional tool for working with childhood trauma in conditions of long-term traumatic circumstances. Conclusions. The stories about Hibuki, through which the child identified with the hero of the story, contribute to the restoration of internal mechanisms of the psyche, which help the process of restoring the child's psychological health. A psychologist can use these stories both to rehabilitate a child's psyche and to diagnose his or her emotional state.

Unprocessed collective trauma may create fertile soil for political manipulation. This article introduces a new concept, that of "substitutive trauma," which refers to the utilization of unprocessed collective traumatic experiences by political leadership to create shared feelings of victimhood and vengeful attitudes within a population. The analysis explores how a substitutive trauma-based psycho-political dynamic culminated in February 2022 in Russia’s war against Ukraine. The article argues that the community of traumatic stress professionals, studying and understanding macro-societal processes can contribute to reducing and ameliorating such destructive psycho-political developments.

Objectives: The objective of the research was to create the "Small ‘t’ Traumatic Experiences Identification Scale" for the purpose of identifying small ‘t’ traumatics experiences and to investigate the influence of psychological needs on small ‘t’ traumatic occurrences. Method: The study participants consisted of 549 individuals for the exploratory factor analysis, 307 for the confirmatory factor analysis, and 89 for the test-retest analysis, all over the age of 18. Exploratory and confirmatory factor analyses were employed to assess the construct validity of the newly developed scale. Reliability analyses of the scale were performed using test-retest and internal consistency coefficients. Following the creation of the scale, multiple linear regression analyses (MLRA) were conducted using data from 806 university students to ascertain the extent to which psychological needs, along with their sub-dimensions, predict small ‘t’ traumatic experiences. Findings: The goodness of fit indices were χ2/sd (3102.59/942) =3.29, p=.001, SRMR: .064; NNFI:96; IFI=.96; CFI=.96; RMSEA=.087. The internal consistency coefficients were .96 for ‘Small ‘t’ Trauma Related to Family Relationships’, .92 for ‘Small ‘t’ Trauma Related to Social Relationships’, and .76 for ‘Small ‘t’ Trauma Related to Physiological Needs’, and .96 for the total scale. Result: The findings of the study indicated that the developed scale exhibited a three-factor structure and demonstrated satisfactory levels of validity and reliability, supporting its suitability for application. Additionally, the study revealed that psychological needs emerged as a significant predictor of small ‘t’ traumatic experiences based on the obtained results.

Chronic pain and post-traumatic stress disorder (PTSD) frequently co-occur, and research suggests that these 2 conditions exacerbate one another producing greater impact on normal functioning in combination than separately. The influence of traumatic experiences on both pain and PTSD has been shown, but the nature of this interplay remains unclear. Although Criterion A trauma is required for the diagnosis of PTSD, whether the association between PTSD and chronic pain is dependent on Criterion A is underexplored. In this observational cohort study, we examined the association between pain and PTSD-like symptoms in the context of Criterion A trauma in 5,791 men from the Vietnam Era Twin Registry. Correlations and mixed-effects regression models were used to evaluate the relationship between PTSD Checklist-Civilian Version symptoms and multiple indicators of pain from the Short Form McGill Pain Questionnaire across trauma history and chronic pain conditions. 53.21% of the participants experienced trauma consistent with DSM-IV Criterion A for PTSD. The associations between pain indicators and PTSD-like symptoms was stronger for individuals with a history of trauma but remained robust for individuals without trauma history. Small but significant interactions between past trauma and pain indicators and PTSD-like symptoms were observed. Findings were similar in a subsample of participants with history of chronic pain conditions. The relationship between PTSD-like symptoms and indicators of pain were largely independent of trauma consistent with Criterion A, highlighting the need to better understand and address stressful life events in chronic pain patients and pain concerns in individuals reporting trauma. PERSPECTIVE: This article demonstrates that the relationship between PTSD-like symptoms and indicators of pain is largely independent of trauma consistent with Criterion A. This finding highlights the need to better understand and address stressful life events in chronic pain patients and pain concerns in individuals reporting trauma.

BackgroundPosttraumatic stress disorder (PTSD) has been associated with increased cardiovascular risk, however, underlying mechanisms have not been fully specified. PTSD is associated with stress-related hormones, including dysregulated glucocorticoid activity. Dysregulation of aldosterone, a mineralocorticoid activated by psychological stress and implicated in cardiovascular damage, may be a relevant pathway linking PTSD and cardiovascular risk. Few studies to date have evaluated the association between PTSD and aldosterone, none with repeated measures of aldosterone. We examined if trauma and PTSD were associated with altered aldosterone levels relative to women unexposed to trauma.MethodsThe association of trauma exposure and chronic PTSD with plasma aldosterone levels was investigated in 521 middle-aged women in the Nurses' Health Study II. Aldosterone was assessed at two time points, 10-16 years apart, and trauma exposure and PTSD were also ascertained for both time points. Regarding exposure assessment, women were characterized based on a structured diagnostic interview as: having chronic PTSD (PTSD at both time points; n = 174); being trauma-exposed (trauma exposure at first time point but no PTSD; n = 174); and being unexposed (no trauma exposure at either time point; reference group for all analyses; n = 173). Linear mixed models examined associations of trauma and PTSD status with log-transformed aldosterone levels, adjusting for covariates and health-related variables that may confound or lie on the pathway between PTSD and altered aldosterone levels.ResultsAcross the sample, mean aldosterone concentration decreased over time. Adjusting for covariates, women with chronic PTSD had significantly lower aldosterone levels averaged over time, compared to women unexposed to trauma (β = - 0.08, p = 0.04). Interactions between trauma/PTSD group and time were not significant, indicating change in aldosterone over time did not differ by trauma/PTSD status. Post-hoc exploratory analyses suggested that menopausal status partially mediated the relationship between chronic PTSD status and aldosterone level, such that postmenopausal status explained 7% of the effect of PTSD on aldosterone.ConclusionsThese findings indicate that PTSD is associated with lower levels of aldosterone. Further work is needed to understand implications of this type of dysregulation in a key biological stress system for cardiovascular and other health outcomes previously linked with PTSD.

This research aimed to develop a scale for adolescent psychological health problems (APHP). The population consisted of parents of high school pupils in six provinces in 2016: Alborz, Kermanshah, East Azarbaijan, Sistan and Baluchistan, Fars, and Razavi Khorasan. For each province, two cities (the provincial center and a low-income city) were selected on purpose. The selection of six institutions in each city was based on a random sampling method, and the selection of parents was based on available sampling. There were 308 parents in the sample, including 195 mothers and 111 fathers. After the data were collected, they were input into the 18th version of the statistical software for social sciences (SPSS). 133 items were examined for their adequacy using seven indicators (mean, standard deviation, standard skew, standard kurtosis, deletion alpha coefficient, multiple correlation, and correlation coefficient with total score) during item analysis. The item analysis revealed that the majority of objects possessed appropriate properties. Exploratory factor analysis of the coefficient revealed six factors that explain 42% of the variance. Internal homogeneity coefficients for the subscales ranged from 0.78 (attention deficit hyperactivity disorder) to 0.95 (deficit in assignments and self-control) and 0.95 for the full scale. The results indicated that the preliminary version of the instrument has adequate psychometric properties.

Abstract Background Trauma is an emotional response to distressing events where coping and subsequent recovery are absent. Adverse Childhood Experiences (ACEs) are traumas, occurring before the age of 18 years, such as child abuse or neglect, caregiver instability, and household dysfunction. Sixty-four percent of the U.S. population report experiencing at least one ACE, with over 1 billion children experiencing abuse and neglect annually worldwide. Chronic exposure to stressful circumstances or multiple traumatic events has negative physiologic impacts. Persons who experience 3 or more ACEs in childhood are at greater risk of poor mental health outcomes and may be more likely to engage in high-risk behaviors, predisposing them to long-term health impacts, such as metabolic diseases, anxiety, depression, substance use, and chronic pain. Trauma informed care (TIC) is a recommended approach to healthcare delivery across professions, especially when a trauma history is suspected. This commentary aims to increase awareness of the impact of ACEs on health outcomes and introduce TIC concepts as they may apply to chiropractic care for adults with a history of ACEs. Discussion This commentary reviews an introductory model (4R's: realize, recognize, respond, resist re-traumatization) as one TIC framework used by healthcare practitioners. Prior trauma can lessen trust, alter perceptions of physical touch, and hands-on examinations and chiropractic treatments may trigger stress responses. Using TIC after appropriate training, includes referrals to multidisciplinary providers to address trauma-related concerns outside the scope of chiropractic, and screening for ACEs if deemed appropriate. Creating safe spaces, communicating clearly, avoiding victimizing language, explaining procedures, asking for consent before physical contact, and giving patients choice and control in their own care may avoid triggering prior traumas. Conclusion Given the high worldwide prevalence of persons experiencing 3 or more ACEs, TIC principles are practical adaptations to chiropractic care for use with many patient populations. As TIC and ACEs are emerging concepts within chiropractic, students and practitioners are encouraged to undertake additional training to better understand these complex and sensitive topics. Exploratory research on the incidence, presentation, and impacts of various trauma types, including ACEs, to support adoption of TIC in chiropractic settings is essential.

Background: Ongoing evidence of trauma in nurses, beginning in nursing school, requires educators to take a trauma-informed approach to teaching and learning to minimize re-traumatization and to ultimately achieve socially-just student outcomes. Methods: The purpose of this study was to evaluate the outcomes of trauma-informed educational practices (TIEP) on nursing students and the trauma-informed climate in the classroom using an intervention comparison group pre-posttest design. Results: Secondary traumatic stress (STS) scores declined for both groups pre- to post-test. There was a statistically significant difference in STS change scores between intervention and comparison groups (p < 0.05), but not in the direction hypothesized. Conclusion: Findings from this study indicate that other factors in the nursing classroom might have contributed significantly to a reduction in STS. In addition to outcomes, future TIEP evaluations should explore student awareness and experiences of trauma, resilience, professional preparation, and learning outcomes in the classroom setting.

Research on the neuroscience of fear in both humans and non-humans has suggested that a lack of acquisition of safety cues might be a biological hallmark of posttraumatic stress disorder (PTSD). Danger perception, and in particular, feeling as one's own life is in danger, is thought to represent a major predictor of PTSD. Persistent danger perception is concurrently associated with a persistence of lack of safety. However, despite several research efforts, no validated psychometric tools exist regarding psychological safety as a unique core construct in the domain of a soothing-contentment system. By including social, compassionate, and bodily components, the Neuroception of Psychological Safety Scale (NPSS), neurophysiologically rooted in the polyvagal theory, aims to specifically assess psychological safety. Originally developed in English, we employed a rather large non clinical sample to validate our Italian translation of the NPSS (n = 338) and the scale was found to retain a three-factor structure. In light of its positive moderate correlations with the Unconditional Self-Kindness Scale (ρ = 0.376) and the Self-Compassion Scale-Short-Form (ρ = 0.481), good convergent validity and robust psychometric properties were shown by the NPSS. The Subjective Traumatic Outlook Questionnaire (ρ = −0.283) and the three subscales of the Body Perception Questionnaire-22—Body Awareness (ρ = −0.103), Supradiaphragmatic Reactivity (ρ = −0.234), and Body Awareness/Subdiaphragmatic Reactivity (ρ = −0.146)—were found to have weak negative correlations with the NPSS, which further demonstrated its good discriminant validity. Eventually, the NPSS was found to show good test-retest reliability (intraclass correlation coefficient = 0.922; three-week time interval), and its usage is fostered in clinical and research contexts where the evaluation of psychological safety is of relevance.

ObjectiveTraumatic experiences are a significant risk factor for psychological disturbances, including disorders such as complex posttraumatic stress disorder, emotion-processing problems, and trauma-related dissociative experiences. The present investigation examined the coexistence of these symptoms using a network analysis model.MethodThis study included a sample of 406 people referred to comprehensive health centers in Tehran from September to December 2023 with psychopathological syndromes. Variables were assessed using The International Trauma Questionnaire, International Measurement of Exposure to Traumatic Event checklist, Baker Emotional Processing Questionnaire, and Dissociative Experiences. A regularized partial correlation network and Glasso algorithm, in combination with Extended Bayesian information criteria, were applied to estimate the network structure.ResultsSigns of unprocessed emotions and disturbance in self-organization symptoms were the most important symptoms in the symptom network, forming strong connections with other nodes. Thereby, these two symptoms can be regarded as the most important clinical manifestations in the symptom network following traumatic experiences. Three distinct symptom communities were identified: the community of traumatic experiences (childhood, adolescence, adulthood), the community of dissociative experiences (amnesia, depersonalization/derealization, and absorption), and the community of emotional processing (suppression, unpleasant emotional experience, Signs of unprocessed emotions, avoidance, and emotional control, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms). The strongest edges observed were between childhood trauma-adolescence trauma (0.473) in the community of traumatic experiences, between amnesia and depersonalization/derealization (0.644) in the community of dissociative experiences, and between disturbance in self-organization symptoms and unprocessed emotions (0.324) in the community of emotional processing, indicating the recurrent occurrence of these symptoms.ConclusionIn this study, disturbance in self-organization symptoms was identified as the central psychopathologic symptom in individuals experiencing traumas at different developmental stages. It seems that adolescent trauma and not childhood trauma plays a more decisive role in the symptoms that a person manifests after traumatic experiences. Also, posttraumatic stress disorder symptoms and disturbance in self-organization symptoms were recognized in the cluster of emotional processing symptoms and can have substantial roles in prioritizing therapeutic measures.

Functional neurological disorder is a condition in which a person experiences physical symptom that cannot be fully explained by a medical condition. In Pakistan, domestic violence as well as emotional, physical and sexual abuse in children are prevalent. Despite legal and social support for victims, stigmatisation regarding seeking psychological help complicates the challenge. Some of the research culminated that patients with fneurological disorder reported high level of sexual abuse and trauma. The symptomatology of functional neurological disorder is being ignored in Asian countries due to indigenous factors like poverty, lack of information on reporting abuse, poor law-enforcement and victim blaming. Functional neurological disorder can be manifested in various ways in the human body, such as blindness, paralysis, dystonia, swallowing difficulties, difficulty walking, motor symptoms affecting limbs, ---continue

Medical trauma is a profound concern for those with chronic conditions like inflammatory bowel disease (IBD), especially young adults. This trauma, arising from both the disease itself and necessary medical interventions, manifests as an accumulation of traumatic experiences impacting a patient’s physical and psychological well-being. The Crohn’s and Colitis Young Adults Network (CCYAN) conducted a roundtable discussion involving young adult IBD patients and healthcare professionals focused on medical trauma and its implications in the treatment of young adults with IBD. This article summarizes the key insights from this discussion, including medical trauma in IBD as an accumulation of ‘micro-traumas,’ the impacts of such trauma and disruptions in care regardless of post-traumatic stress diagnosis, the role of adverse childhood experiences and trauma-informed care, practical strategies to cultivate trust during individual patient encounters, and recommendations for providing trauma-informed care within the clinical setting.

The experience of psychological trauma is common and has become even more prevalent during the COVID-19 pandemic for both health care workers and the general population. Traumatic experiences can have varied and lasting physical and mental health effects on patients, beyond what we are privy to in the acute environment of the emergency department. The effects of these prior traumatic experiences can be exacerbated by interaction with the healthcare system, and yet emergency medicine physicians have no standardized methods for working with patients in a trauma-informed way. The systematic implementation of trauma-informed care (TIC) practice requires the cooperation of multiple domains within the health care system, including focus on the physical environment, direct care, and administrative practices. Here we provide recommendations specific to emergency medicine for the development and implementation of TIC in the regular patient-clinician interaction, situated within the context of the TIC framework as outlined by the Substance Abuse and Mental Health Services Administration (SAMHSA). [ABSTRACT FROM AUTHOR]

BACKGROUND: Around one-third of women experience childbirth trauma, with 3%--15% developing postpartum posttraumatic stress disorder (PP-PTSD). AIM: Explore birth satisfaction and health perception across two groups of postnatal women with either high or low trauma scores. METHOD: Forty postnatal women were divided into groups dependent upon Posttraumatic Stress Disorder Checklist (PCL-5) scores: high severity (n = 20; range 25-57) or low severity (n = 20; range 0-7). Semi-structured interviews explored women's childbirth experiences related to birth satisfaction and reports of postnatal health. Thematic analysis was performed. FINDINGS: Narrative content differed appreciably between high (A) and low (B) scoring groups. Group A narratives were more negative (A1: Overall, a negative recall), referencing lack of autonomy, support, or being heard (A2: Missing needs) and negative influences (A3: Disrupting my bubble). Group B recalled more birth satisfaction (B1: Mostly positive recall) associated with (B2: Autonomy; B3: Being cared for; B4: Intuition, instinct, and primal force). Group A narratives focused strongly on mental health (A4: Reduced awareness; A6: Experiencing PTSD; A7: Needing help), with some focus on physical health (A5: How I feel physically); Group B spoke less about health (B5: My health). DISCUSSION: High-quality psychological care during labor, with continuity, choice, support, and control, alongside postnatal health follow-up may improve birth satisfaction and reduce the incidence of PP-PTSD. CONCLUSION: To increase birth satisfaction and reduce trauma, maternity care providers must be supported to prioritize high-quality psychological care to women during labor, providing choice, control, and continuity within trusting relationships. Trusting relationships are key to ongoing conversations regarding health and seeking/receiving help. Routine birth satisfaction screening and education for care providers about signs of trauma are important. [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]

Background: Psychosocial stress has been associated with the development and progression of atherosclerotic cardiovascular disease (CVD). Previously, we reported subtle differences in global longitudinal strain in somatically healthy women with a psychiatric diagnosis of borderline personality disorder (BPD). This study aimed to investigate the impact of BPD on segmental myocardial wall motion using speckle tracking echocardiography (STE) analysis. Methods: A total of 100 women aged between 18 and 38 years were included in this study. Fifty patients meeting the diagnostic criteria for BPD were recruited from the Department of Psychiatry (LWL-University Hospital Bochum) and compared with fifty age-matched healthy control subjects without previous cardiac disease. Laboratory tests and STE were performed with segmental wall motion analysis. Results: The BPD group had a higher prevalence of risk factors for CVD, with smoking and obesity being predominant, when compared with the control group. Other cardiovascular parameters such as blood pressure, glucose, and cholesterol levels were also elevated, even though not to pathological values. Moreover, in the STE analysis, the BPD group consistently exhibited decreased deformation in nine myocardial wall regions compared with the control group, along with a shift toward higher values in the distribution of peak pathological segments. Additionally, significantly higher values of free thyroxine concentration and thyroid's secretory capacity were observed in the BPD group, despite falling within the (high-) normal range. Conclusions: BPD is associated with chronic stress, classical risk factors, and myocardial wall motion abnormalities. Further exploration is warranted to investigate the relationship between high-normal thyroid metabolism, these risk factors, and myocardial function in BPD patients. Long-term follow-up studies would be valuable in confirming the potential for predicting adverse events. [ABSTRACT FROM AUTHOR]

Dance therapy is thought to improve mental and physical health by activating psychological and physiological processes such as motor coordination, and expression of emotions. Some currently used mind–body interventions for posttraumatic symptoms address both mental and physical health. Although some studies have evaluated the efficacy of dance therapy for posttraumatic symptoms, a systematic review of extant research has not been conducted. To identify the effects of dance therapy in adults with psychological trauma as well as the barriers and facilitators associated with its therapeutic use. Articles published between 2000 and March 2023 have been selected with the help of six relevant keyword combinations applied on seven databases. Two reviewers independently screened 119 titles and abstracts against inclusion and exclusion criteria. Bias evaluation has been conducted with the help of the NIH study quality assessment tools and JBI's critical appraisal tools. A report of the results has been organized with the help of a thematic analysis. Of the 15 articles included, only one case study directly reports a diminution of pathognomonic symptoms of trauma. Other studies present improvements in the key aspects of trauma therapy: bodily sensations and perceptions, psychological processes, and interpersonal skills. These improvements depend on the stability of the intervention, the applied method (dance as therapy or dance/movement therapy), and likely, the skill set of the therapists. However, the reviewed studies lacked uniformity in assessments of adherence and its effect on therapeutic outcomes. Dance therapy may be a useful technique for improving both psychological and physiological symptoms associated with trauma exposure, such as avoidance and dissociative phenomena. To complement the results of this qualitative systematic review, further quantitative and qualitative research on the impact of dance therapy interventions as a trauma treatment should be conducted. Dance therapy may be a promising approach for the therapeutic management of psychological trauma as it can address both psychological and physical symptoms. Therapist skills and training may be important factors to consider in evaluating the impact of dance therapy on posttraumatic symptoms. Dance/movement therapy, a specific type of dance therapy, appears to be associated with improvements in sensory-motor perceptions and motor skills. To date, examination of dance therapy as a trauma treatment in an adult population has been limited primarily to women and people facing migration. [ABSTRACT FROM AUTHOR]

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

Linguistic racism explores the varied ideologies that may generate and endorse monolingual, native, and normative language practices, while reinforcing the discrimination and injustice directed towards language users whose language and communicative repertoires are not necessarily perceived as standard and normal. This article, thus, investigates linguistic racism, as a form of existing, but newly defined, racism against unconventional ethnic language practices experienced by Eastern-European immigrant women in the Australian workplace. Our ethnographic study shows that, once these women directly or subtly exhibit their non-nativism, through a limited encounter with local expressions, non-native language skills, and ethnic accents, they become victims of covert and overt linguistic racism in the form of social exclusion, mockery, mimicking, and malicious sarcasm in the hierarchical power environment of the workplace. As a result, these migrants can suffer from long-lasting psychological trauma and distress, emotional hurdles, loss of credibility, and language-based inferiority complexes. We, as researchers, need to highlight the importance of combatting workplace linguistic racism and revealing language realities of underprivileged communities. In that way, we can assist them in adapting to host societies and help them regain some degree of power equality in their institutional environments. [ABSTRACT FROM AUTHOR]

The study aimed to provide a preliminary evaluation of the acceptability and effectiveness of online eye movement desensitization and reprocessing (EMDR) compared with a waitlist control (WLC). A pilot nonrandomized controlled trial was conducted. Eighteen adults experiencing chronic pain completed the study (n EMDR = 10; n control = 8). The intervention group received up to 10 weekly sessions of online EMDR. The control group received treatment as usual. Participants completed baseline and post-intervention measures assessing posttraumatic stress, pain severity, interference, and catastrophizing, and depression levels. Additionally, the online EMDR group participants provided feedback on intervention acceptability and satisfaction. The online EMDR group demonstrated significant reductions in both trauma and pain-related outcomes; depression levels did not significantly change. No significant change was observed in any outcome within the control group. After the WLC also received the intervention, additional analysis results demonstrated similar effects but did not reach statistical significance, except for depression. Overall, online EMDR appeared acceptable and positively received by participants. The study provides preliminary support that online delivery of EMDR may reduce trauma- and pain-related outcomes in individuals experiencing chronic pain. Further large-scale research is warranted to substantiate these findings. Limitations and implications are discussed. REC ref: 2020/HCSREC/04 [ABSTRACT FROM AUTHOR]

Uvalde Tragedy has shaken the United States which took place on the premise of Robb Elementary School on May 24, 2022. 21 people, including 19 children and 2 high school teachers, lost their lives in the incident. The children were the first-hand victims of this shooting violence. Few studies have explored the mental trauma of the victims. This study conducted qualitative research followed by a purposive sampling method. Ten children were selected directly affected by shooting. This research features an in-depth interview of the children elaborating their psychological trauma in the aftermath of the incident along with the expressions of their parents. The result showed the participants experiencing a variety of traumas such as stress, anxiety, and post-traumatic stress disorder. Open discussions were conducted to holistically understand the psychological impacts. [ABSTRACT FROM AUTHOR]

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Copyright of Journal of Ahmet Kelesoglu Educational Faculty is the property of Journal of Ahmet Kelesoglu Educational Faculty 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.)