European Journal of Psychotraumatology最新文献

Background: A number of studies have tested the factor structure of the suggested ICD-11 symptom criteria for PTSD and complex PTSD (CPTSD) across various trauma populations, finding support for two different models in line with the ICD-11 theoretical rationale.Objective: Here, we aim to explore the factor structure of the Danish version of the International Trauma Questionnaire (ITQ) by testing two alternative factor models that have previously gained support in a large sample of treatment-seeking veterans.Method: Treatment-seeking Danish soldiers and veterans (N = 599) recruited from the Military Psychology Department in the Danish Defence completed the International Trauma Questionnaire (ITQ). Confirmatory factor analysis (CFA) was used to assess fit of a first-order and a second-order model.Results: Both models fit the data well but displayed latent variable correlations above 1 and negative variances (known as Heywood cases), indicating model misspecification or other problems. The specification problems included the latent variable Affect Dysregulation.Conclusions: Based on our results and results reported in previous CFAs of the ITQ, we suggest consideration of the proposed models. While many previous studies did find support for the models with no indications of misfit, others find Heywood cases concerning the same items and latent variables as our analysis. Hence, models of (C)PTSD based on the ITQ should be carefully evaluated and interpreted.

Background: People compare their current well-being to different comparison standards (e.g. social or temporal comparisons). These standards are considered as aversive if perceived as threatening to self-motives or appetitive if perceived as consistent with self-motives. However, it remains unknown whether the congruence (vs. incongruence) of aversive and appetitive well-being comparisons (high levels of both vs. preponderance of aversive comparisons over appetitive comparisons) is differentially related to symptoms of depression and post-traumatic stress disorder (PTSD) and self-esteem.Methods: We conducted response surface analysis (RSA) on data from a study with two-timepoints three months apart (N = 921). RSA tests whether the degree of (in-)congruence of two variables is positively or negatively related to an outcome variable. Here, baseline aversive and appetitive well-being comparisons (comparison frequency, discrepancy, and affective impact) served as the two predictor variables, while depression, PTSD, and self-esteem three months later served as outcomes.Results: Findings partially confirmed our hypotheses. Congruently high (vs. low) levels of aversive and appetitive comparison frequency and discrepancy predicted more depressive/PTSD symptoms and lower self-esteem. Some evidence indicated more pronounced depressive symptoms and lower self-esteem (but not PTSD) for the preponderance of aversive over appetitive comparisons.Conclusions: The effects of congruent and incongruent aversive and appetitive comparisons as well as a potentially more crucial role of aversive than appetitive well-being comparisons in depression and self-esteem align with comparison theory.

Background: Studies have shown that media exposure to critical public events can lead to secondary traumatic stress (STS). Personal trauma history, self-compassion and resilience are important factors influencing STS in healthy professionals. However, whether these variables are associated with social media-induced STS in college students and the underlying mechanisms remain unclear. The purpose of this study was to explore the complex relationship linking childhood trauma to social media-induced STS in a large sample of college students.Methods: A total of 1151 Chinese college students from Chengdu, Sichuan Province of China completed a web-based cross-sectional survey, which included standard assessments of childhood trauma, self-compassion, resilience and social media-induced STS, as well as sociodemographic questionnaires. The chain mediation model was tested using the PROCESS macro programme in SPSS software.Results: There was a moderate correlation between childhood trauma and social media-induced STS (r = 0.34, p < .001). This association was significantly mediated by self-compassion (indirect effect [95% CI] = 0.14[0.11, 0.17]) and resilience (indirect effect = 0.03[0.01, 0.04]), respectively. Further, a chained mediating effect was observed with self-compassion and resilience consecutively mediated the relationship between childhood trauma and social media-induced STS (indirect effect = 0.02[0.01, 0.03]). These results persisted after sociodemographic characteristics were included as controlling variables.Conclusions: Early life trauma impacts STS induced by exposure to traumatic materials on social media through self-compassion and resilience among Chinese college students. Psychological interventions targeting self-compassion and resilience can be implemented to reduce the risk of STS, especially in vulnerable individuals.

Background: Previous research suggests that psychotherapists' readiness to treat traumatized patients varies according to patient and therapist characteristics, including the patient's refugee background.Objective: This study aims to examine the relationship between psychotherapists' readiness to treat patients with symptoms of post-traumatic stress disorder and various patient and therapist characteristics, including refugee background and country of origin.Method: In our vignette study with a nationwide online survey in Germany (N = 871), we assessed the readiness of licensed psychotherapists (LPTs) and therapists in training (PiTs) to treat patients with PTSD. Vignettes described patients with PTSD who differed in gender, refugee background, and country of origin (Syria vs. Ukraine). Participants rated treatment readiness and expected treatment success based on the vignette they received.Results: Treatment readiness and expected success were significantly lower for refugee patients. There was no difference in treatment readiness between refugees from Syria and Ukraine, but therapists expected less therapeutic success for Syrian patients compared to Ukrainian patients. Gender did not influence the results.Conclusions: The study shows that refugee background and country of origin influence psychotherapists' readiness to treat PTSD and their expectations of treatment success. These findings highlight potential reasons for the undertreatment of refugees and suggest opportunities for intervention and training, such as informing therapists about effective treatments for refugee patients.

Objective: Posttraumatic stress disorder (PTSD) and life satisfaction phenotypes are inversely related on a phenotypic level. Given these established relations, researchers have begun to examine possible shared genetic contributions to these outcomes, though the existing genetic literature is sparse and examines these relations via univariate methods. We sought to examine the genetic architecture of PTSD and six life satisfaction and well-being phenotypes (i.e. subjective well-being, friend satisfaction, life satisfaction, family satisfaction, work satisfaction, and financial satisfaction) using a multivariate approach.Method: We used Genomic Structural Equation Modeling (gSEM) to analyze summary-level genetic data from large-scale GWAS of the European Ancestry.Results: Findings show that a two, correlated factors model fit the data best, in which PTSD and life satisfaction phenotypes load on separate but correlated factors.Conclusions: Findings suggest that, using multivariate methods, a latent factor capturing many different positive phenotypes is genetically related to PTSD. This finding confirms and extends prior phenotypic work demonstrating that PTSD and positive phenotypes are inversely related.

ABSTRACTBackground: European health care workers recently experienced serious challenges to their mental health. Following the extremely stressful experience of the COVID-19 pandemic, the war in Ukraine caused a humanitarian influx of refugees in need of social and healthcare. We aimed to explore: (1) how working with refugees has affected the mental well-being of health care workers in the context of the COVID-19 pandemic, and (2) the nature of health care workers' emotional strain related to the refugee situation and the war in Ukraine.Methods: We used a combination of quantitative regression analyses and qualitative content analysis to assess data collected by an online questionnaire in 2022. The study included 1121 health care workers from the Czech arm of the international HEROES Study.Results: Quantitative findings did not indicate that working with Ukrainian refugees was reliably associated with a greater occurrence of symptoms of depression, anxiety, distress, or burnout. Qualitative analysis revealed five categories of emotional strain: impacts on working conditions, emotional reactions to refugees and the war, comparisons with the COVID-19 pandemic, and coping strategies.Conclusions: This study highlights the resilience of health care workers but also points to the need for ongoing support to address the complex emotional challenges they face during health crises.

Background: Dissociative symptoms are suggested to compete with the effectiveness of psychotherapeutic treatment and frequently co-occur with early life trauma and self-harm patterns, including self-injury, suicidal ideation, and suicide attempts, which are characteristic for borderline personality disorder (BPD).Objective: We explore the connections between dissociation and other BPD features like self-harm and childhood traumatization and examine the impact of trait dissociation on both immediate and follow-up psychotherapy outcomes.Method: In this naturalistic prospective evaluation study, we investigated psychopathology including general psychological distress (SCL-90), depression (BDI-II), and borderline-specific pathology (BSL) in 131 patients with BPD pre and post of a certified 8-week inpatient Dialectical Behaviour Therapy (DBT), as well as 3- and 6-month post inpatient treatment. Prior to therapy, we evaluated trait dissociation (Dissociative Experience Scale), early life trauma (Childhood Trauma Questionnaire), and self-harm patterns (clinical interview). We performed a network analysis to explore the interplay between dissociation, self-harm, and childhood traumatization. To analyse the influence of dissociation on treatment outcomes, we employed linear mixed models.Results: Psychopathology (SCL-90, BDI-II and BSL) exhibited significant reductions at post-treatment and follow-up assessments when compared to baseline measurements. Higher levels of trait dissociation were consistently related to higher psychopathology but did not suggest poorer symptom reduction during DBT. However, trait dissociation predicted reduced 6-month follow-up benefits from DBT, regardless of the baseline symptom burden. The network analysis revealed a close association between self-injury and derealization/depersonalization, while the frequency of suicide attempts was more closely connected to childhood emotional abuse, which was identified as a central node of the network.Conclusions: Dissociation was not related to poorer outcomes regarding inpatient DBT. However, trait dissociation predicted reduced follow-up benefits, highlighting the need to address dissociation during psychotherapeutic interventions. Based on the estimated network structure, treating dissociative symptoms could potentially mitigate self-injury while especially childhood emotional abuse was linked with suicide attempts.

Background: Parental post-traumatic stress disorder (PTSD) can impact parenting and child psychosocial wellbeing. Complementing trauma-focused psychotherapy with parenting interventions can thus have important preventive value. Understanding parents' lived experiences is necessary to tailor such interventions to their needs.Objective: This study addressed the question: how can preventive parenting support be shaped to the needs of parents entering specialized psychotherapy for PTSD? To answer this question, we investigated parenting challenges, parent-child communication about PTSD, strengths, and social support experiences of parents with PTSD.Method: The sample included 14 parents seeking PTSD treatment at a tertiary mental healthcare institution, while parenting children aged 4-17. Data were collected using semi-structured interviews and analysed using reflexive thematic analysis.Results: On the one hand, parental dysregulation (e.g. exploding or shutting down) was an important challenge. On the other hand, parents' attempts to remain regulated (e.g. through overcontrol and overprotectiveness) also affected family life. When talking to their child about PTSD, parents were guided by what they considered beneficial for the child to know. An important strength was that parents tried to remain attuned to the child's needs, regardless of their own struggles. Parents also described experiences that could be understood as post-traumatic growth through parenting. Generally, parents experienced a lack of social support.Conclusion: Our findings illustrate that parents entering PTSD treatment are highly motivated to do what is best for their child. Based on parents' lived experiences, preventive parenting interventions should address the impacts of both dysregulation and overcontrolling regulation attempts. Another important goal is reducing feelings of incompetence. Integrating the parenting role in psychotherapy for PTSD could also be beneficial. For example, setting parenting-related therapy goals can be motivating. Furthermore, parent-child interactions can be a mirror that reflects the parents' inner state: considering these interactions can help recognize changes in symptomatology.

Objective: The aim of this study is to investigate the psychometrics of the Dutch version of the Child and Adolescent Trauma Screener (CATS-2). By this, an international recognized instrument to screen symptoms of post-traumatic stress (PTSS) in children and adolescents according to the Diagnostic and Statistical Manual for Mental Disorders, 5th edition (DSM-5) becomes available for Dutch youth.Procedure and Method: Based on the validated CATS-2 we established the Dutch version, named the KJTS. A total of 587 children and adolescent, age 7-21, and 658 caregivers referred to mental health care services in Amsterdam was included in the study to examine psychometric properties. The construct was tested by confirmatory factor analysis (CFA). Furthermore reliability, convergent-divergent patterns and diagnostic test accuracy were examined.Results: The underlying DSM-5 factor structure with four symptom clusters (re-experiencing, avoidance, negative alterations in mood and cognitions, hyperarousal) was supported by CFA showing a good fit for the selfreport (CFI = .95, TLI = .94), and an acceptable fit for the caregiver report (CFI = .90, TLI = .89). The KJTS showed excellent reliability (alpha = .92) on both selfreport and caregiver report. The convergent-discriminant validity pattern showed medium to strong correlations with measures of internalization problems, such as anxiety and affective problems (r = .44-.72) and low to medium correlations with externalizing symptoms (r = .21-.36). The ROC-curve analysis has proven a good accuracy (AUC = .81; n = 106).Discussion and conclusion: This study demonstrates the psychometric accuracy of the KJTS in a Dutch clinical population. The KJTS reflects adequately the dimensionality of PTSD as described in the DSM-5, with a good fit for selfreports, an acceptable fit for caregiver reports, excellent reliability and sufficient validity. Limitations are described. The outcomes support the use of the KJTS in research and clinical practice for screening and monitoring of PTSS.

Background: Sleep disturbances are highly prevalent in traumatized refugees and often persist despite treatment, and adapted scalable interventions are needed. The group intervention 'Sleep Training adapted for Refugees' (STARS) is a culturally- and context-sensitive approach based on evidence-based treatments for sleep disturbances (e.g. CBT-I, IRT). This study evaluated the feasibility, acceptability, and effectiveness of STARS.Method: A randomized-controlled trial (STARS vs. waitlist) with 47 young male Afghan refugees was conducted in a routine clinical setting (DRKS-ID: DRKS00024419) with pre-, post- and 3-month follow-up assessments. The primary outcome was insomnia severity (Insomnia Severity Index); secondary outcomes included PTSD, anxiety and depression symptoms, nightmares, coping with nightmares, fear of sleep, selected sleep diary measures, and quality of life. The data were analysed using mixed models.Results: Adherence to STARS was high (dropout = 17.4%, average attended sessions = 77%) as was client satisfaction (M_CSQ-4 = 12.74, SD_CSQ-4 = 2.08). A medium to large significant effect of time was observed for insomnia severity (d = 0.96) and most secondary measures (except nightmares and fear of sleep). However, there was no significant interaction with condition at post-treatment for the primary outcome (d = 0.29) and most secondary outcomes; the only exceptions were increased coping with nightmares, decreased daytime sleep, and time in bed.Conclusions: STARS appears feasible for treating sleep disturbances in traumatized refugees in a routine clinical setting, showing moderate to large within-group effects. However, it was not superior to the waitlist, likely due to unexpected improvements in the waitlist group. Adjustments to STARS may enhance its efficacy. Further research is needed to determine how STARS can be a scalable add-on treatment for sleep disturbances in traumatized refugees and asylum seekers.Trial registration: German Clinical Trials Register identifier: DRKS00024419..