Background: There is a strong causal relationship between intimate partner violence and major depressive disorder, which partly endangers women's safety across the life course and potentially affects the development of future generations. The international community has placed a high priority on addressing the intimate partner violence and the resulting burden of mental illness. Data collection needs to be captured across the temporal trend and spatial distribution for major depressive disorder attributed to intimate partner violence, to reflect the priorities and expectations of survivors.Method: This research obtained raw disability-adjusted life years (DALYs) information for major depressive disorder attributed to intimate partner violence from the Global Burden of Disease 2019. Using estimated annual percentage change and two-way fixed effects models, a secondary spatio-temporal analysis of the age-standardized DALYs rate from 1990 to 2019 was performed.Results: In 2019, DALYs lost among women experiencing major depressive disorder (3.16 million) accounted for 37.18% of the DALYs lost worldwide due to intimate partner violence. The age-standardized DALYs rate of major depressive disorder attributed to intimate partner violence was 108.57 per 100,000. The highest was concentrated in the menopausal transition (45-55), with 133.61 per 100,000, and particularly distributed in Uganda (429.31 per 100,000). The early reproductive period (15-19) showed the increasing age-standardized DALYs rate from 1990 to 2019, which was mainly driven by Malaysia (3.73% per year). Furthermore, countries with higher initial levels of the age-standardized DALYs rate were growing faster than those with lower levels.Conclusions: The burden of major depressive disorder attributed to intimate partner violence showed biological and spatial inequality, prioritized intervention should be targeted at vulnerable stage women in their early reproductive period and menopausal transition. Combined political, socio-cultural as well as medical measures to prevent violence and treat major depressive disorder should be implemented and developed.
{"title":"Temporal and spatial convergence: the major depressive disorder burden attributed to intimate partner violence against women.","authors":"Pengfei Guo, Rizhen Wang, Jiacheng Li, Yinghua Qin, Nan Meng, Linghan Shan, Huan Liu, Jingjing Liu, Qunhong Wu","doi":"10.1080/20008066.2024.2386226","DOIUrl":"10.1080/20008066.2024.2386226","url":null,"abstract":"<p><p><b>Background:</b> There is a strong causal relationship between intimate partner violence and major depressive disorder, which partly endangers women's safety across the life course and potentially affects the development of future generations. The international community has placed a high priority on addressing the intimate partner violence and the resulting burden of mental illness. Data collection needs to be captured across the temporal trend and spatial distribution for major depressive disorder attributed to intimate partner violence, to reflect the priorities and expectations of survivors.<b>Method:</b> This research obtained raw disability-adjusted life years (DALYs) information for major depressive disorder attributed to intimate partner violence from the Global Burden of Disease 2019. Using estimated annual percentage change and two-way fixed effects models, a secondary spatio-temporal analysis of the age-standardized DALYs rate from 1990 to 2019 was performed.<b>Results:</b> In 2019, DALYs lost among women experiencing major depressive disorder (3.16 million) accounted for 37.18% of the DALYs lost worldwide due to intimate partner violence. The age-standardized DALYs rate of major depressive disorder attributed to intimate partner violence was 108.57 per 100,000. The highest was concentrated in the menopausal transition (45-55), with 133.61 per 100,000, and particularly distributed in Uganda (429.31 per 100,000). The early reproductive period (15-19) showed the increasing age-standardized DALYs rate from 1990 to 2019, which was mainly driven by Malaysia (3.73% per year). Furthermore, countries with higher initial levels of the age-standardized DALYs rate were growing faster than those with lower levels.<b>Conclusions:</b> The burden of major depressive disorder attributed to intimate partner violence showed biological and spatial inequality, prioritized intervention should be targeted at vulnerable stage women in their early reproductive period and menopausal transition. Combined political, socio-cultural as well as medical measures to prevent violence and treat major depressive disorder should be implemented and developed.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2386226"},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11448340/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142361337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-08-14DOI: 10.1080/20008066.2024.2386827
Stefanie Rita Balle, Christine Nothelfer, Roland Mergl, Sarah Miriam Quaatz, Svenja Hoffmann, Helena Hoffmann, Antje-Kathrin Allgaier, Kathryn Eichhorn
Background: Pregnancy loss (PL) is a common, yet rarely examined public health issue associated with an increased risk of impaired mental health, particularly depression.Objective: Previous research shows childlessness to be a correlate of depression after PL. First studies also indicate associations of the type of loss, multiple losses, relationship quality, and coping strategies with depression after the loss of a pregnancy. However, results are inconsistent and the few existing studies show methodological deficits. Therefore, we expect higher depression scores for women without living children, and we exploratively examine the associations between the type of loss, the number of losses, relationship quality, and coping strategies with depression scores for women who suffered a PL.Method: In an online setting, N = 172 women with miscarriage (n = 137) or stillbirth (n = 35) throughout the last 12 months completed the Patient Health Questionnaire (PHQ-D), Brief-COPE, and Partnerschaftsfragebogen (PFB), a German questionnaire measuring relationship quality.Results: In a multiple hierarchical regression analysis, stillbirth, β = 0.15, p = .035, presence of living children, β = -0.17, p = .022, and self-blame/emotional avoidance, β = 0.34, p < .001, are predictors of depression scores. However, there was no association between depression symptoms and other coping strategies, relationship quality, and multiple losses.Conclusions: Especially with regard to women who have no living children, have suffered a stillbirth, or are affected by self-blame/emotional avoidance, health care providers should monitor the presence of depressive symptoms. Our results indicate the need for specific instruments measuring coping style and relationship quality after PL, since the standard items of the PFB and the Brief-COPE seem inappropriate for this setting.
{"title":"Depression after pregnancy loss: the role of the presence of living children, the type of loss, multiple losses, the relationship quality, and coping strategies.","authors":"Stefanie Rita Balle, Christine Nothelfer, Roland Mergl, Sarah Miriam Quaatz, Svenja Hoffmann, Helena Hoffmann, Antje-Kathrin Allgaier, Kathryn Eichhorn","doi":"10.1080/20008066.2024.2386827","DOIUrl":"10.1080/20008066.2024.2386827","url":null,"abstract":"<p><p><b>Background:</b> Pregnancy loss (PL) is a common, yet rarely examined public health issue associated with an increased risk of impaired mental health, particularly depression.<b>Objective:</b> Previous research shows childlessness to be a correlate of depression after PL. First studies also indicate associations of the type of loss, multiple losses, relationship quality, and coping strategies with depression after the loss of a pregnancy. However, results are inconsistent and the few existing studies show methodological deficits. Therefore, we expect higher depression scores for women without living children, and we exploratively examine the associations between the type of loss, the number of losses, relationship quality, and coping strategies with depression scores for women who suffered a PL.<b>Method:</b> In an online setting, <i>N </i>= 172 women with miscarriage (<i>n</i> = 137) or stillbirth (<i>n</i> = 35) throughout the last 12 months completed the Patient Health Questionnaire (PHQ-D), Brief-COPE, and Partnerschaftsfragebogen (PFB), a German questionnaire measuring relationship quality.<b>Results:</b> In a multiple hierarchical regression analysis, stillbirth, β = 0.15, <i>p</i> = .035, presence of living children, β = -0.17, <i>p</i> = .022, and self-blame/emotional avoidance, β = 0.34, <i>p</i> < .001, are predictors of depression scores. However, there was no association between depression symptoms and other coping strategies, relationship quality, and multiple losses.<b>Conclusions:</b> Especially with regard to women who have no living children, have suffered a stillbirth, or are affected by self-blame/emotional avoidance, health care providers should monitor the presence of depressive symptoms. Our results indicate the need for specific instruments measuring coping style and relationship quality after PL, since the standard items of the PFB and the Brief-COPE seem inappropriate for this setting.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2386827"},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11328791/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141975446","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-08-30DOI: 10.1080/20008066.2024.2389702
Nadia A Daniel, Xin Liu, Elizabeth T Thomas, Emily Eraneva-Dibb, Al-Maz Ahmad, Carl Heneghan
Background: Refugees, asylum seekers, and internally displaced people experience a high burden of mental health problems owing to their experiencing traumas and stressful events.Objective: To summarise the available evidence and analyse the efficacy of brief psychological interventions (< 3 months) on improving mental health outcomes, including depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms in refugees.Method: We searched Medline, EMBASE, PsycINFO, CINAHL, and Global Index Medicus from inception to 19 December 2023. We included controlled studies using any cognitive behavioural therapy (CBT) or CBT-based therapies delivered over a short time (< 3 months), which reported mental health outcomes pre-and post-intervention. We conducted meta-analyses using random effects to derive pooled summary statistics. The quality of the evidence was assessed with the Cochrane Risk of Bias (RoB2) and ROBINS-I tools. This study is registered on the Open Science Framework, DOI 10.17605/OSF.IO/9CXU4.Results: 34 eligible studies across 37 publications were retrieved for analysis, and 33 studies with 4479 participants were included in the meta-analysis. There was an overall improvement in immediate mental health outcomes for all three domains, with analysis of 13 studies on anxiety outcomes (SMD -1.12, 95% CI -1.72 to -0.52), 20 studies on depression (SMD -1.04, 95% CI -1.97 to -0.11), and 24 studies on PTSD (SMD -0.82, 95% CI -1.20 to -0.45). At 3 to 6-month follow-up, however, analysis of mental health outcomes shows no significant change from baseline, with a SMD of 0.24 (95% CI -0.94 to 1.42) across 4 studies, -0.73 (95% CI -2.14 to 0.68) across 9 studies, and 0.29 (95% CI -0.94 to 1.53) across 12 studies for anxiety, depression, and PTSD respectively.Conclusion: Low-quality evidence shows brief psychological interventions have a positive immediate effect on refugees and internally displaced people's mental well-being. However, these effects do not persist in the short-term follow up. Heterogeneity was high, even among subgroups, impacting our findings' generalisability.
背景:难民、寻求庇护者和境内流离失所者由于经历创伤和压力事件,心理健康问题的负担很重:总结现有证据,分析简短心理干预(小于 3 个月)对改善难民心理健康结果(包括抑郁、焦虑和创伤后应激障碍 (PTSD) 相关症状)的效果:我们检索了 Medline、EMBASE、PsycINFO、CINAHL 和 Global Index Medicus 从开始到 2023 年 12 月 19 日的资料。我们纳入了使用任何认知行为疗法(CBT)或基于 CBT 的短期疗法(< 3 个月)的对照研究,这些研究报告了干预前后的心理健康结果。我们使用随机效应进行了荟萃分析,得出了汇总统计结果。证据质量采用 Cochrane Risk of Bias (RoB2) 和 ROBINS-I 工具进行评估。本研究已在开放科学框架(Open Science Framework)上注册,DOI 10.17605/OSF.IO/9CXU4.Results:检索了 37 份出版物中 34 项符合条件的研究,其中 33 项研究共 4479 名参与者被纳入荟萃分析。通过对 13 项焦虑结果研究(SMD-1.12,95% CI -1.72 至 -0.52)、20 项抑郁研究(SMD-1.04,95% CI -1.97 至 -0.11)和 24 项创伤后应激障碍研究(SMD -0.82,95% CI -1.20 至 -0.45)的分析,所有三个领域的即时心理健康结果均有总体改善。然而,在3至6个月的随访中,心理健康结果分析显示与基线相比没有显著变化,4项研究的SMD为0.24(95% CI -0.94至1.42),9项研究的SMD为-0.73(95% CI -2.14至0.68),12项研究的焦虑、抑郁和创伤后应激障碍的SMD分别为0.29(95% CI -0.94至1.53):低质量的证据显示,简短的心理干预对难民和境内流离失所者的心理健康有积极的直接影响。结论:低质量的证据显示,简短的心理干预措施对难民和境内流离失所者的心理健康有积极的直接影响,但这些影响在短期的后续治疗中不会持续。即使在亚群体中,异质性也很高,这影响了我们研究结果的普遍性。
{"title":"Brief CBT-based psychological interventions to improve mental health outcomes in refugee populations: a systematic review and meta-analysis.","authors":"Nadia A Daniel, Xin Liu, Elizabeth T Thomas, Emily Eraneva-Dibb, Al-Maz Ahmad, Carl Heneghan","doi":"10.1080/20008066.2024.2389702","DOIUrl":"10.1080/20008066.2024.2389702","url":null,"abstract":"<p><p><b>Background:</b> Refugees, asylum seekers, and internally displaced people experience a high burden of mental health problems owing to their experiencing traumas and stressful events.<b>Objective:</b> To summarise the available evidence and analyse the efficacy of brief psychological interventions (< 3 months) on improving mental health outcomes, including depression, anxiety, and post-traumatic stress disorder (PTSD)-related symptoms in refugees.<b>Method:</b> We searched Medline, EMBASE, PsycINFO, CINAHL, and Global Index Medicus from inception to 19 December 2023. We included controlled studies using any cognitive behavioural therapy (CBT) or CBT-based therapies delivered over a short time (< 3 months), which reported mental health outcomes pre-and post-intervention. We conducted meta-analyses using random effects to derive pooled summary statistics. The quality of the evidence was assessed with the Cochrane Risk of Bias (RoB2) and ROBINS-I tools. This study is registered on the Open Science Framework, DOI 10.17605/OSF.IO/9CXU4.<b>Results:</b> 34 eligible studies across 37 publications were retrieved for analysis, and 33 studies with 4479 participants were included in the meta-analysis. There was an overall improvement in immediate mental health outcomes for all three domains, with analysis of 13 studies on anxiety outcomes (SMD -1.12, 95% CI -1.72 to -0.52), 20 studies on depression (SMD -1.04, 95% CI -1.97 to -0.11), and 24 studies on PTSD (SMD -0.82, 95% CI -1.20 to -0.45). At 3 to 6-month follow-up, however, analysis of mental health outcomes shows no significant change from baseline, with a SMD of 0.24 (95% CI -0.94 to 1.42) across 4 studies, -0.73 (95% CI -2.14 to 0.68) across 9 studies, and 0.29 (95% CI -0.94 to 1.53) across 12 studies for anxiety, depression, and PTSD respectively.<b>Conclusion:</b> Low-quality evidence shows brief psychological interventions have a positive immediate effect on refugees and internally displaced people's mental well-being. However, these effects do not persist in the short-term follow up. Heterogeneity was high, even among subgroups, impacting our findings' generalisability.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2389702"},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105731","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-09-02DOI: 10.1080/20008066.2024.2393061
Ruben Vonderlin, Kathlen Priebe, Meike Müller-Engelmann, Thomas Fydrich, Regina Steil, Patricia A Resick, Christian Schmahl, Petra Lindauer, Nikolaus Kleindienst, Martin Bohus
Background: The complexity of posttraumatic stress disorder (PTSD) symptoms related to childhood abuse (CA) present challenges for effective psychotherapeutic treatment. Consequently, there is great interest in the long-term effectiveness of psychological treatments for this population.Objective: This study aims to investigate the long-term outcomes of Dialectical Behaviour Therapy for PTSD (DBT-PTSD) and Cognitive Processing Therapy (CPT) 9 months after treatment termination.Method: This is a long-term analysis from a randomised-controlled trial of DBT-PTSD versus CPT (registration number DRKS00005578). Initially, 193 individuals with CA-related PTSD were randomly allocated to receive either DBT-PTSD (n = 98) or CPT (n = 95). The primary outcome the Clinician-administered PTSD-Scale for DSM-5 (CAPS-5) was administred at baseline, treatment completion (15 months post-randomization) and at the 9-month follow-up. Secondary outcomes included self-reported PTSD severity (PCL-5), dissociation (DSS), severity of borderline symptoms (BSL-23), and psychosocial functioning (GAF).Results: No significant changes were observed in the primary (CAPS) and all other outcomes from post-intervention to 9-months follow-up in both the DBT-PTSD (CAPS: Mpost = 15.60, Mfollow-up = 14.93) and CPT group (CAPS: Mpost = 18.80, Mfollow-up = 17.41). Between-group analyses at 9-months follow-up were significantly in favour of DBT-PTSD compared to CPT with small to medium effect sizes on all outcomes ranging from d = 0.35 on the CAPS to d = 0.57 on the BSL-23 and GAF.Conclusions: Our results indicate that treatment effects of psychotherapy addressing complex presentations of PTSD persist 9 months after treatment termination. In addition, the superiority of DBT-PTSD as compared to CPT found at treatment termination, was confirmed at 9-months follow-up.Trial registration: German Clinical Trials Register identifier: DRKS00005578..
{"title":"Long-term effects of dialectical behaviour therapy for posttraumatic stress disorder and cognitive processing therapy 9 months after treatment termination.","authors":"Ruben Vonderlin, Kathlen Priebe, Meike Müller-Engelmann, Thomas Fydrich, Regina Steil, Patricia A Resick, Christian Schmahl, Petra Lindauer, Nikolaus Kleindienst, Martin Bohus","doi":"10.1080/20008066.2024.2393061","DOIUrl":"10.1080/20008066.2024.2393061","url":null,"abstract":"<p><p><b>Background:</b> The complexity of posttraumatic stress disorder (PTSD) symptoms related to childhood abuse (CA) present challenges for effective psychotherapeutic treatment. Consequently, there is great interest in the long-term effectiveness of psychological treatments for this population.<b>Objective:</b> This study aims to investigate the long-term outcomes of Dialectical Behaviour Therapy for PTSD (DBT-PTSD) and Cognitive Processing Therapy (CPT) 9 months after treatment termination.<b>Method:</b> This is a long-term analysis from a randomised-controlled trial of DBT-PTSD versus CPT (registration number DRKS00005578). Initially, 193 individuals with CA-related PTSD were randomly allocated to receive either DBT-PTSD (<i>n</i> = 98) or CPT (<i>n</i> = 95). The primary outcome the Clinician-administered PTSD-Scale for DSM-5 (CAPS-5) was administred at baseline, treatment completion (15 months post-randomization) and at the 9-month follow-up. Secondary outcomes included self-reported PTSD severity (PCL-5), dissociation (DSS), severity of borderline symptoms (BSL-23), and psychosocial functioning (GAF).<b>Results:</b> No significant changes were observed in the primary (CAPS) and all other outcomes from post-intervention to 9-months follow-up in both the DBT-PTSD (CAPS: <i>M<sub>post</sub></i> = 15.60, <i>M</i><sub>follow-up </sub>= 14.93) and CPT group (CAPS: <i>M<sub>post</sub></i> = 18.80, <i>M<sub>follow-up</sub></i> = 17.41). Between-group analyses at 9-months follow-up were significantly in favour of DBT-PTSD compared to CPT with small to medium effect sizes on all outcomes ranging from <i>d </i>= 0.35 on the CAPS to <i>d </i>= 0.57 on the BSL-23 and GAF.<b>Conclusions:</b> Our results indicate that treatment effects of psychotherapy addressing complex presentations of PTSD persist 9 months after treatment termination. In addition, the superiority of DBT-PTSD as compared to CPT found at treatment termination, was confirmed at 9-months follow-up.<b>Trial registration:</b> German Clinical Trials Register identifier: DRKS00005578..</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2393061"},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11370672/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142105732","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-06-25DOI: 10.1080/20008066.2024.2364998
David J Eberle, Andreas Maercker, Yafit Levin, Celestin Mutuyimana, Jun Wen, Nino Makhashvili, Darejan Javakhishvili, Ana Papava, Xinyi Yu, Wenli Qian, Jianping Wang, Stephen Asatsa, Rahel Bachem
Introduction: Cultural factors were shown to be particularly relevant for the development and expression of posttraumatic stress. Recently, the concept of cultural scripts of trauma has been introduced, which proposes that trauma sequelae elements may be sequentially linked and specifically associated with cultural factors. Furthermore, a cascade model is proposed, including trauma exposure, demographic characteristics, cultural affiliation, and trauma-related value orientations as influencing factors of posttraumatic development. The purpose of this Network Project is to investigate cultural psychological factors that contribute to the expression of posttraumatic stress.Methods: The present Network Project implements a mixed methods approach and will be conducted in 5 different study sites, including Switzerland, Israel, Georgia, China, and East Africa. In sub-study I, the cultural scripts of traumatic stress inventories (CSTIs) will be developed. These scales provide a pool of trauma sequelae elements for each cultural group. For this purpose, focus groups with trauma survivors and trauma experts will be conducted and analysed using qualitative research methods. Sub-study II implements a validation analysis of the CSTIs and the empirical investigation of a cultural cascade model. This quantitative approach will include a larger sample of individuals who experienced traumatic life events.Discussion: This contribution is timely and enriches the knowledge of trauma and culture. Future publications of this Network Project will address trauma sequelae from a cultural perspective and provide diagnostic and psychotherapeutic implications.
简介文化因素被证明与创伤后应激反应的发展和表现特别相关。最近,人们提出了 "创伤文化脚本 "的概念,认为创伤后遗症的要素可能与文化因素有顺序的联系和具体的关联。此外,还提出了一个级联模型,包括创伤暴露、人口特征、文化归属和与创伤相关的价值取向,这些都是创伤后发展的影响因素。本网络项目旨在研究导致创伤后应激表现的文化心理因素:本网络项目采用混合方法,将在瑞士、以色列、格鲁吉亚、中国和东非等 5 个不同的研究地点进行。子研究 I 将开发创伤压力文化脚本清单(CSTIs)。这些量表为每个文化群体提供了创伤后遗症要素库。为此,将与创伤幸存者和创伤专家进行焦点小组讨论,并采用定性研究方法进行分析。子研究 II 将对 CSTI 进行验证分析,并对文化级联模型进行实证调查。这种定量研究方法将包括更多经历过创伤性生活事件的个人样本:这一贡献非常及时,丰富了有关创伤和文化的知识。该网络项目未来的出版物将从文化角度探讨创伤后遗症,并提供诊断和心理治疗方面的启示。
{"title":"Cultural psychological factors in posttraumatic symptom development and expression: a study protocol.","authors":"David J Eberle, Andreas Maercker, Yafit Levin, Celestin Mutuyimana, Jun Wen, Nino Makhashvili, Darejan Javakhishvili, Ana Papava, Xinyi Yu, Wenli Qian, Jianping Wang, Stephen Asatsa, Rahel Bachem","doi":"10.1080/20008066.2024.2364998","DOIUrl":"10.1080/20008066.2024.2364998","url":null,"abstract":"<p><p><b>Introduction:</b> Cultural factors were shown to be particularly relevant for the development and expression of posttraumatic stress. Recently, the concept of cultural scripts of trauma has been introduced, which proposes that trauma sequelae elements may be sequentially linked and specifically associated with cultural factors. Furthermore, a cascade model is proposed, including trauma exposure, demographic characteristics, cultural affiliation, and trauma-related value orientations as influencing factors of posttraumatic development. The purpose of this Network Project is to investigate cultural psychological factors that contribute to the expression of posttraumatic stress.<b>Methods:</b> The present Network Project implements a mixed methods approach and will be conducted in 5 different study sites, including Switzerland, Israel, Georgia, China, and East Africa. In sub-study I, the cultural scripts of traumatic stress inventories (CSTIs) will be developed. These scales provide a pool of trauma sequelae elements for each cultural group. For this purpose, focus groups with trauma survivors and trauma experts will be conducted and analysed using qualitative research methods. Sub-study II implements a validation analysis of the CSTIs and the empirical investigation of a cultural cascade model. This quantitative approach will include a larger sample of individuals who experienced traumatic life events.<b>Discussion:</b> This contribution is timely and enriches the knowledge of trauma and culture. Future publications of this Network Project will address trauma sequelae from a cultural perspective and provide diagnostic and psychotherapeutic implications.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2364998"},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11207911/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141445940","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-05-15DOI: 10.1080/20008066.2024.2341577
Helen P A Driessen, Sid Morsink, Jan J V Busschbach, Witte J G Hoogendijk, Leonieke W Kranenburg
Background: Literature points towards the potential benefits of the application of Eye Movement and Desensitization Processing (EMDR)-therapy for patients in the medical setting, with cancer and pain being among the domains it is applied to. The field of applying EMDR-therapy for patients treated in the medical setting has evolved to such an extent that it may be challenging to get a comprehensive overview.Objective: This systematic literature review aims to evaluate the use and effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy in patients treated in the medical setting.Methods: We performed a literature search following the PRISMA guidelines. Studies were included if the effectiveness of EMDR-therapy was assessed in adult patients treated in a medical setting. Excluded were patients exclusively suffering from a mental health disorder, without somatic comorbidity. A risk of bias analysis was performed. This review was registered on PROSPERO (CRD42022325238).Results: Eighty-seven studies, of which 26 (pilot)-RCTs were included and categorized in 14 medical domains. Additionally, three studies focusing on persistent physical complaints were included. Most evidence exists for its application in the fields of oncology, pain, and neurology. The overall appraisal of these studies showed at least moderate to high risks of bias. EMDR demonstrated effectiveness in reducing symptoms in 85 out of 87 studies. Notably, the occurrence of adverse events was rarely mentioned.Conclusions: Overall, outcomes seem to show beneficial effects of EMDR on reducing psychological and physical symptoms in patients treated in a medical setting. Due to the heterogeneity of reported outcomes, effect sizes could not be pooled. Due to the high risk of bias of the included studies, our results should be interpreted with caution and further controlled high-quality research is needed.
{"title":"Eye Movement Desensitization and Reprocessing (EMDR) treatment in the medical setting: a systematic review.","authors":"Helen P A Driessen, Sid Morsink, Jan J V Busschbach, Witte J G Hoogendijk, Leonieke W Kranenburg","doi":"10.1080/20008066.2024.2341577","DOIUrl":"10.1080/20008066.2024.2341577","url":null,"abstract":"<p><p><b>Background:</b> Literature points towards the potential benefits of the application of Eye Movement and Desensitization Processing (EMDR)-therapy for patients in the medical setting, with cancer and pain being among the domains it is applied to. The field of applying EMDR-therapy for patients treated in the medical setting has evolved to such an extent that it may be challenging to get a comprehensive overview.<b>Objective:</b> This systematic literature review aims to evaluate the use and effectiveness of Eye Movement Desensitization and Reprocessing (EMDR) therapy in patients treated in the medical setting.<b>Methods:</b> We performed a literature search following the PRISMA guidelines. Studies were included if the effectiveness of EMDR-therapy was assessed in adult patients treated in a medical setting. Excluded were patients exclusively suffering from a mental health disorder, without somatic comorbidity. A risk of bias analysis was performed. This review was registered on PROSPERO (CRD42022325238).<b>Results:</b> Eighty-seven studies, of which 26 (pilot)-RCTs were included and categorized in 14 medical domains. Additionally, three studies focusing on persistent physical complaints were included. Most evidence exists for its application in the fields of oncology, pain, and neurology. The overall appraisal of these studies showed at least moderate to high risks of bias. EMDR demonstrated effectiveness in reducing symptoms in 85 out of 87 studies. Notably, the occurrence of adverse events was rarely mentioned.<b>Conclusions:</b> Overall, outcomes seem to show beneficial effects of EMDR on reducing psychological and physical symptoms in patients treated in a medical setting. Due to the heterogeneity of reported outcomes, effect sizes could not be pooled. Due to the high risk of bias of the included studies, our results should be interpreted with caution and further controlled high-quality research is needed.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2341577"},"PeriodicalIF":5.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11097707/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140921805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-05-22DOI: 10.1080/20008066.2024.2350217
Jaco Rossouw, Sharain Suliman, Jani Nothling, Carl Lombard, Erine Bröcker, Maryke Hewett, Candice Simmons, Gillian W Shorter, Soraya Seedat, Melissa E Milanak, Cherie Armour
Background: Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.Method: Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).Results: There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = -2.18, p = .029), mean slope = -0.2 (95% CI: -0.37 to -0.02) (p = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: -18.00 to -0.21), p = .045 and the 1-month follow-up contrast - 11.22 (95%CI: -22.43 to -0.03), p = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (n = 10; 32%) and control (n = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.Conclusions: Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.
{"title":"A pilot randomised control study to investigate the effect of the South African Adolescence Group Sleep Intervention (SAASI) on adolescent sleep and PTSD.","authors":"Jaco Rossouw, Sharain Suliman, Jani Nothling, Carl Lombard, Erine Bröcker, Maryke Hewett, Candice Simmons, Gillian W Shorter, Soraya Seedat, Melissa E Milanak, Cherie Armour","doi":"10.1080/20008066.2024.2350217","DOIUrl":"10.1080/20008066.2024.2350217","url":null,"abstract":"<p><p><b>Background:</b> Trauma exposure prevalence and consequent post-traumatic stress disorder among South African adolescents are significant. Sleep disturbances are among the most frequently reported difficulties faced by those dealing with PTSD. The current study examined the feasibility and preliminary efficacy of the South African Adolescence Group Sleep Intervention on PTSD symptom severity and sleep disturbance.<b>Method:</b> Sixty-one adolescents with PTSD diagnoses and sleep disturbance were randomly assigned (1:1) to one individual and four group sessions of a sleep intervention (SAASI) or a control group. Participants completed the Child PTSD symptom scale for DSM5 (CPSS-5) and the Pittsburgh Sleep Quality Index (PSQI) among other sleep and psychiatric measures. The trial was registered on the Pan African Trial Registry (PACTR202208559723690).<b>Results:</b> There was a significant but similar decrease in PSQI scores in both groups over time indicating no overall intervention effect (Wald test = -2.18, <i>p</i> = .029), mean slope = -0.2 (95% CI: -0.37 to -0.02) (<i>p</i> = .583). On the CPSS-5, interaction between groups was also not significant (p = .291). Despite this overall finding, the mean difference in CPSS-SR-5 scores increased over time, with the difference between groups post-treatment -9.10 (95%CI: -18.00 to -0.21), <i>p</i> = .045 and the 1-month follow-up contrast - 11.22 (95%CI: -22.43 to -0.03), <i>p</i> = .049 suggesting that PTSD symptom severity decreased more in the intervention group than the control group. The dropout rate was higher than expected for both the intervention (<i>n</i> = 10; 32%) and control (<i>n</i> = 8; 26.7%) groups. Dropout were mostly school commitments or travel related.<b>Conclusions:</b> Early findings suggest a trend towards dual improvement in sleep quality and PTSD symptom severity in adolescents with a sleep disturbance and PTSD receiving a group sleep intervention (SAASI). Further investigation in a properly powered RCT with detailed retention planning is indicated.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2350217"},"PeriodicalIF":5.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11123447/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141075840","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-10-17DOI: 10.1080/20008066.2024.2407733
Aubrey A Knoff, Jennifer J Vasterling, Mieke Verfaellie
Background: Using narratives to reflect on experiences, emotions, and thoughts is associated with better health, enhanced mood, and improved symptoms of posttraumatic stress disorder (PTSD). Prior research examining narrative characteristics thought to reflect cognitive styles associated with PTSD has focused on trauma narratives, but the characteristics of nontrauma narratives in relation to PTSD are not fully understood.Objective: We reviewed the PTSD literature examining linguistic characteristics of nontrauma narratives, focusing on affective content, personal pronouns, and cognitive processing words.Method: We searched online databases for both laboratory and social media studies examining these characteristics of nontrauma narratives in relation to PTSD diagnostic status and/or PTSD symptom severity.Results: Following SWiM guidelines [Campbell et al., 2020. Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline. British Medical Journal, 368, l6890], there was moderate evidence for differential use of emotion words in nontrauma narratives in relation to PTSD symptom cluster severity. More severe avoidance/numbing symptoms were associated with greater use of negative emotion words and less use of positive emotion words. Results were mixed for other linguistic elements reviewed.Conclusions: Differential use of emotional language in trauma narratives generalises to nontrauma narratives in individuals with PTSD. Additional research is needed to elucidate the use of personal pronouns and cognitive processing words in nontrauma narratives.
背景:使用叙述来反思经历、情绪和想法与改善健康、提高情绪和改善创伤后应激障碍(PTSD)症状有关。之前对被认为反映与创伤后应激障碍相关的认知方式的叙述特征的研究主要集中在创伤叙述上,但对与创伤后应激障碍相关的非创伤叙述的特征还不完全了解:我们回顾了研究非创伤叙事语言特点的创伤后应激障碍文献,重点关注情感内容、人称代词和认知加工词:我们在网上数据库中搜索了实验室研究和社交媒体研究,这些研究考察了非创伤叙事的这些特征与创伤后应激障碍诊断状态和/或创伤后应激障碍症状严重程度的关系:根据 SWiM 指南[坎贝尔等人,2020 年。系统综述中的无荟萃分析(SWiM)综合:报告指南。英国医学杂志》(British Medical Journal),368,l6890],有中等程度的证据表明,非创伤叙事中情绪词的不同使用与创伤后应激障碍症状群的严重程度有关。更严重的回避/麻木症状与更多地使用消极情绪词和较少使用积极情绪词有关。对其他语言要素的研究结果不一:结论:创伤后应激障碍患者在创伤叙事中情感语言使用的差异会延伸到非创伤叙事中。需要进行更多的研究来阐明非创伤叙事中人称代词和认知加工词的使用情况。
{"title":"Beyond trauma: a review of content and linguistic characteristics of nontrauma narratives in posttraumatic stress disorder.","authors":"Aubrey A Knoff, Jennifer J Vasterling, Mieke Verfaellie","doi":"10.1080/20008066.2024.2407733","DOIUrl":"https://doi.org/10.1080/20008066.2024.2407733","url":null,"abstract":"<p><p><b>Background:</b> Using narratives to reflect on experiences, emotions, and thoughts is associated with better health, enhanced mood, and improved symptoms of posttraumatic stress disorder (PTSD). Prior research examining narrative characteristics thought to reflect cognitive styles associated with PTSD has focused on trauma narratives, but the characteristics of nontrauma narratives in relation to PTSD are not fully understood.<b>Objective:</b> We reviewed the PTSD literature examining linguistic characteristics of nontrauma narratives, focusing on affective content, personal pronouns, and cognitive processing words.<b>Method:</b> We searched online databases for both laboratory and social media studies examining these characteristics of nontrauma narratives in relation to PTSD diagnostic status and/or PTSD symptom severity.<b>Results:</b> Following SWiM guidelines [Campbell et al., 2020. Synthesis without meta-analysis (SWiM) in systematic reviews: Reporting guideline. <i>British Medical Journal</i>, <i>368</i>, l6890], there was moderate evidence for differential use of emotion words in nontrauma narratives in relation to PTSD symptom cluster severity. More severe avoidance/numbing symptoms were associated with greater use of negative emotion words and less use of positive emotion words. Results were mixed for other linguistic elements reviewed.<b>Conclusions:</b> Differential use of emotional language in trauma narratives generalises to nontrauma narratives in individuals with PTSD. Additional research is needed to elucidate the use of personal pronouns and cognitive processing words in nontrauma narratives.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2407733"},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11488194/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142461187","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-01-23DOI: 10.1080/20008066.2023.2299618
Milan Rusmir, Shauna L Rohner, Andreas Maercker, Aileen N Salas Castillo, Myriam V Thoma
Objective: There is a lack of research on complex post-traumatic stress disorder (CPTSD) in older individuals, with little known about the temporal course of CPTSD. Therefore, this study assessed and compared the demographic characteristics, adverse childhood experiences (ACE), and well-being of Swiss older adults with and without probable CPTSD. The (in-)stability of probable CPTSD was also examined in relation to the predictive value of various emotion-related factors.Methods: A longitudinal study was conducted in Switzerland with N = 213 participants (Mage = 69.98 years, SD = 10.61; 45.5% female). Data was collected via face-to-face assessments at baseline and follow-up, 21 months apart. The German version of the International Trauma Questionnaire was used to screen for (C)PTSD. Standardized instruments were used to assess ACE as well as the predictors anger, embitterment, emotion regulation, and meaning in life.Results: From the total sample, n = 16 participants (7.5%) were identified as having probable CPTSD, with only five of these (31.25%) having probable CPTSD at both baseline and follow-up. Individuals with and without probable CPTSD differed significantly regarding age and employment status. Significant predictors of probable CPTSD were anger (β = 0.16), embitterment (β = 0.06), cognitive reappraisal (β = -0.41), and the presence of meaning in life (β = -0.10).Conclusions: Probable CPTSD appears to be relatively unstable over the course of a 21-month period in older individuals. The links between CPTSD and emotion-related predictors highlight potential targets for intervention.
{"title":"Predictors and (in-)stability of ICD-11 complex posttraumatic stress disorder in older adults: findings from a longitudinal study in Switzerland.","authors":"Milan Rusmir, Shauna L Rohner, Andreas Maercker, Aileen N Salas Castillo, Myriam V Thoma","doi":"10.1080/20008066.2023.2299618","DOIUrl":"10.1080/20008066.2023.2299618","url":null,"abstract":"<p><p><b>Objective:</b> There is a lack of research on complex post-traumatic stress disorder (CPTSD) in older individuals, with little known about the temporal course of CPTSD. Therefore, this study assessed and compared the demographic characteristics, adverse childhood experiences (ACE), and well-being of Swiss older adults with and without probable CPTSD. The (in-)stability of probable CPTSD was also examined in relation to the predictive value of various emotion-related factors.<b>Methods:</b> A longitudinal study was conducted in Switzerland with <i>N</i> = 213 participants (<i>M</i><sub>age</sub> = 69.98 years, <i>SD</i> = 10.61; 45.5% female). Data was collected via face-to-face assessments at baseline and follow-up, 21 months apart. The German version of the <i>International Trauma Questionnaire</i> was used to screen for (C)PTSD. Standardized instruments were used to assess ACE as well as the predictors anger, embitterment, emotion regulation, and meaning in life.<b>Results:</b> From the total sample, <i>n</i> = 16 participants (7.5%) were identified as having probable CPTSD, with only five of these (31.25%) having probable CPTSD at both baseline and follow-up. Individuals with and without probable CPTSD differed significantly regarding age and employment status. Significant predictors of probable CPTSD were anger (<i>β</i> = 0.16), embitterment (<i>β</i> = 0.06), cognitive reappraisal (<i>β</i> = -0.41), and the presence of meaning in life (<i>β</i> = -0.10).<b>Conclusions:</b> Probable CPTSD appears to be relatively unstable over the course of a 21-month period in older individuals. The links between CPTSD and emotion-related predictors highlight potential targets for intervention.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2299618"},"PeriodicalIF":4.2,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10810634/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139520450","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-04-29DOI: 10.1080/20008066.2024.2314442
Anna Harwood-Gross, Andreas Espetvedt Nordstrand, Hans Jakob Bøe, Christer Lunde Gjerstad
Background: The peacekeeper role is different to that of traditional combat, however, peacekeepers, like combat soldiers, may also be exposed to high levels of dangerous and/or potentially morally injurious events (PMIEs).Objective: It was hypothesized that given the centrality of societal approval for the peacekeeping mission, in addition to the known relevance of perceived social support, perceived societal recognition would influence PTSD symptoms (PTSS) and depression. It was hypothesized that perceived societal recognition would moderate the effect of exposure to potentially traumatic events and PMIEs on psychological outcomes.Method: 8341, predominantly male, former UNIFIL peacekeepers, almost three decades following deployment, answered a survey to determine the impact of perceived social support and perceived societal recognition, on PTSS and depression symptoms. Hierarchical regression analyses were performed for PTSS and depression separately and moderation analysis was performed for perceived societal recognition.Results: Exposure to potentially traumatic events showed the greatest predictive value for PTSS and exposure to PMIEs and potentially traumatic events were equally predictive of depression symptoms. While perceived social support presented the strongest buffer for PTSS and depression symptoms following UNIFIL deployment, perceived societal recognition also significantly contributed to the prediction of both PTSS and depression symptoms. There was a weak moderation effect of perceived societal recognition on trauma type in the development of PTSS.Conclusions: Even decades following peacekeeping deployment, military experiences have a significant impact on psychological functioning. This impact is both from the types of events experienced and from the perception of social and societal support upon return home.
{"title":"How do you see me? The impact of perceived societal recognition on PTSD symptoms amongst Norwegian peacekeepers.","authors":"Anna Harwood-Gross, Andreas Espetvedt Nordstrand, Hans Jakob Bøe, Christer Lunde Gjerstad","doi":"10.1080/20008066.2024.2314442","DOIUrl":"https://doi.org/10.1080/20008066.2024.2314442","url":null,"abstract":"<p><p><b>Background</b>: The peacekeeper role is different to that of traditional combat, however, peacekeepers, like combat soldiers, may also be exposed to high levels of dangerous and/or potentially morally injurious events (PMIEs).<b>Objective</b>: It was hypothesized that given the centrality of societal approval for the peacekeeping mission, in addition to the known relevance of perceived social support, perceived societal recognition would influence PTSD symptoms (PTSS) and depression. It was hypothesized that perceived societal recognition would moderate the effect of exposure to potentially traumatic events and PMIEs on psychological outcomes.<b>Method</b>: 8341, predominantly male, former UNIFIL peacekeepers, almost three decades following deployment, answered a survey to determine the impact of perceived social support and perceived societal recognition, on PTSS and depression symptoms. Hierarchical regression analyses were performed for PTSS and depression separately and moderation analysis was performed for perceived societal recognition.<b>Results</b>: Exposure to potentially traumatic events showed the greatest predictive value for PTSS and exposure to PMIEs and potentially traumatic events were equally predictive of depression symptoms. While perceived social support presented the strongest buffer for PTSS and depression symptoms following UNIFIL deployment, perceived societal recognition also significantly contributed to the prediction of both PTSS and depression symptoms. There was a weak moderation effect of perceived societal recognition on trauma type in the development of PTSS.<b>Conclusions</b>: Even decades following peacekeeping deployment, military experiences have a significant impact on psychological functioning. This impact is both from the types of events experienced and from the perception of social and societal support upon return home.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"15 1","pages":"2314442"},"PeriodicalIF":5.0,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11060006/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140859784","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}