Clinical psychology & psychotherapy最新文献

The DSM-5 classifies posttraumatic stress disorder (PTSD) symptomatology into four distinct clusters and numerous studies have examined the psychosocial risk factors predicting these clusters across various types of trauma. However, no research has specifically explored the unique predictors of PTSD clusters in women survivors of intimate partner violence (IPV) This retrospective study analysed the DSM-5-proposed psychosocial predictors of PTSD symptom clusters (severity of violence, previous trauma, social support, emotional regulation, coping strategies and blame) in 333 women who had filed a police report for IPV. Through linear step regression analysis, five models were estimated for the four clusters and the PTSD diagnosis dissociation specifier. The findings showed both common and specific factors associated with the different PTSD clusters. Unsatisfactory emotional processing and negative self-focussing emerged as the predominant factors common to PTSD clusters and, to a lesser extent, emotional impoverishment and emotions of guilt. Childhood trauma was identified as a risk factor in all clusters, although its influence was attenuated when emotional regulation was considered. The severity of violence was a specific predictor for the intrusion cluster, and emotional avoidance predicted the PTSD cluster of avoidance symptoms. Social support acted as a protective factor for the cluster of mood disorders. The adjusted R² for the models ranged from 0.23 to 0.45. Taken together, the results highlight the need to distinguish specific symptom categories within the overall diagnosis of PTSD and offer an empirical perspective for better understanding and more accurate treatment for women survivors of IPV with PTSD.

Both refugees and asylum seekers exhibit poorer mental health and higher rates of mental disorders, particularly posttraumatic stress disorder (PTSD), for which EMDR therapy has been shown to be effective. This review analyses the efficacy of EMDR in reducing PTDS in refugees or asylum seekers using randomized controlled studies (RCTs). A systematic review and meta-analysis published in PROSPERO (CRD42024595506) using the databases PubMed, PsycINFO and Web of Science were conducted. The authors independently reviewed the articles to maintain double blind. A total of 10 articles met the criteria for inclusion. The analysis of these studies revealed that a nonsignificant effect of EMDR on PTSD symptoms was observed at the end of the intervention period and the effect sizes reflect interaction effects between treatment/control over time on outcome, and these represent changes over time. It should be interpreted with awareness of the potential limitations introduced by excluding other study designs due to heterogeneity.

Nonsuicidal self-injury (NSSI), which involves the deliberate destruction of body tissue without suicidal intent, is strongly associated with an increased risk of later suicidal behaviour. Disclosing the risk factors for NSSI is therefore vital to prevent the progression to suicide. While documented evidence links NSSI to childhood trauma, depression, social support, a comprehensive perspective that integrates these factors together is lacking. To bridge this gap, we leveraged a chain-mediating model in this study, to examine the mediating effect of social support and depression on the relationship between childhood trauma and NSSI. As expected, NSSI behaviours were positively correlated with depression scores (r = 0.492, p_adj < 0.001), childhood trauma scores (r = 0.306, p_adj < 0.001), and negatively correlated with the social support scores (r = −0.168, p_adj = 0.020). Importantly, in the chain-mediating model, increased childhood trauma was associated with decreased social support (β = −0.532, t = −9.086, p < 0.001), which in turn was linked with increased depressive symptoms (β = −0.193, t = −2.957, p < 0.01), ultimately contributing to greater odds of NSSI behaviours. Our findings elucidated the complex psychological mechanisms underlying the interplay between childhood trauma, social support and depression severity, suggesting that improving social support and intervening early in depression may be potential ways to reduce the risk of NSSI.

Posttraumatic stress disorder (PTSD) is a prevalent psychiatric condition, particularly among US Veterans. PTSD-diagnosed patients are more likely to experience suicidal ideation, suicide attempts and death by suicide when compared to non-PTSD-diagnosed patients. The US Department of Veterans Affairs (VA) emphasizes evidence-based psychotherapy (EBP) for PTSD, including prolonged exposure and cognitive processing therapy. This study focuses on how suicide risk impacts PTSD by evaluating utilization of nondifferentiated psychotherapy and EBP in a national sample of VA patients diagnosed with PTSD who died by suicide in 2017–2018.

The study used a dataset of VA patients diagnosed with PTSD who died by suicide and received psychotherapy in the year before death (cases) and patients who had comparable diagnoses, demographics and received psychotherapy during the same interval and remained alive (controls). Cases and controls were matched on suicide risk (high, moderate and low). The study tracked nondifferentiated psychotherapy and EBP and analyzed cases and control utilization rates across risk-tiers.

The final sample included high-risk (cases = 171; controls = 2052), moderate-risk (cases = 428; controls = 4280) and low-risk (cases = 53; controls = 529) patients. EBP utilization was markedly low, especially among cases. Higher proportions of moderate- and low-risk controls received EBP and received more sessions than matched cases.

Even with VA efforts to promote EBPs, usage remains limited, particularly among patients who die by suicide. Further research is needed to understand utilization barriers and improve EBP delivery to better support PTSD-diagnosed patients and reduce their suicide risk.