European Journal of Psychotraumatology最新文献

Background: Moral injury (MI) is a clinical phenomenon that can emerge in the aftermath of engaging in or witnessing an event that transgresses an individual's deeply held moral beliefs. Research on MI assessments has yielded conflicting results regarding optimal structure, and there are very few comprehensive examinations of the clinical correlates of MI in diverse community samples.Objective: We examined psychometric properties of the Moral Injury Exposure and Symptoms Scale for Civilians (MIESS-C) and investigated clinical correlates of this measure. Method: In a community sample of N = 598 individuals (89.5% female; 67.1% African-American) with high rates of trauma exposure, we used exploratory and confirmatory analyses to adjudicate factor structure and investigated the bivariate and partialed relations between the MIESS-C scale and psychopathology indices such as PTSD, depression, anxiety and substance use.Results: A three-factor solution corresponding to MI caused by (1) self, (2) another person ('other'), or (3) betrayal by a trusted person or institution best fits the data. Large, positive correlations with relevant indices of psychopathology (i.e. PTSD, depression, anxiety) support the convergent validity of the MIESS-C, although no evidence emerged for specific, unique links between forms of MIESS-C subscales and particular mental health concerns. Relatively small correlations with a comprehensive measure of lifetime trauma suggest this measure is not redundant with assessments of trauma exposure.Conclusions: Moral injury is of considerable clinical interest, but more work is needed to support meaningful clinical decision-making based on the MIESS-C.

Background: Research on PTSD treatment in military populations is expanding rapidly; it's important to identify key research priorities and emerging trends from a comprehensive perspective.Objective: This study reviewed trends in intervention and treatment research on post-traumatic stress disorder (Peterson et al., 2023) in military populations over the past decade.Methods: A comprehensive search was conducted in the PubMed database for English-language articles published between 2014 and 2024, using the keywords 'intervention or treatment,' 'PTSD,' and 'military.' Studies were included if they focused on PTSD interventions targeting military personnel or veterans. A total of 1,280 relevant articles were identified and included in the analysis. Bibliometric methods - such as co-occurrence analysis, keyword clustering, and burst detection - were combined with a qualitative narrative synthesis to explore publication patterns and research hotspots.Results: Results showed steady growth in the number of publications and citations. The articles appeared in 327 journals, with the top 10 journals specialising in trauma, clinical psychology, psychiatry, and military medicine. The United States and the University of Texas Health Science Center at San Antonio were the most prolific contributors. Keyword clustering revealed major research themes, including Prolonged Exposure Therapy, Cognitive Processing Therapy, Cognitive Behavioral Therapy, and Virtual Reality. Burst word analysis highlighted emerging topics such as dual diagnosis and heart rate variability.Conclusions: The analysis revealed strong international and inter-institutional collaborations, reflecting a geographically and culturally diverse research landscape. These findings also provide valuable insights into the current state and future directions of PTSD intervention research in military populations.

Background: Working directly with traumatised individuals can result in secondary traumatic stress and vicarious trauma in staff. Less research has been conducted into the impact of working with trauma on an organisation, including teams and structures. The population of Northern Ireland has a history of socio-political conflict, and trauma services may be uniquely impacted due to the dual personal and professional exposure to trauma. This research explores the organisational culture of a trauma service in Northern Ireland, investigating 'What are the tangible and intangible elements of organisational culture of the Regional Trauma Network?'Methods: Semi-structured interviews (n = 10) were conducted with staff-grade and managerial Multi-Disciplinary Team staff across all five Health and Social Care Trusts. Reflexive Thematic Analysis identified three themes and respective subthemes that characterise the organisational culture of the service.Results: Theme one: 'Vision vs Reality' with two sub-themes: 'Vision of Excellence' and 'Absent Strategic Direction'. Theme two: 'Together We Stand' with two sub-themes: 'Psychological safety' and 'You're more than just a number'. Theme three: 'Them and Us' with three sub-themes: 'Mirroring the Historical Context', 'Fragmented Services' and 'Fear of Consequences'. There is hope in the vision for an excellent service, and this is demonstrated in the cohesive local trust teams, yet feels absent within the fragmented regional service.Conclusions: The history of the socio-political conflict may be mirrored within the Regional Trauma Network. Psychologically safe and close-knit local trust services work within a wider fragmented service, with limited communication between various parts. The cohesion and collaboration within the HSC Trust teams may help to inform regional service development going forward.

Background: Major depressive disorder (MDD) is a leading cause of disability worldwide, yet its early and objective diagnosis remains challenging due to the lack of reliable biomarkers. Recent advances in high-throughput transcriptomics and machine learning provide new opportunities for systematic biomarker discovery.Methods: We integrated gene expression datasets from the Gene Expression Omnibus (GEO) to identify differentially expressed genes (DEGs) in MDD. Functional enrichment analyses were performed to explore biological relevance. To enhance robustness, two complementary machine learning algorithms - LASSO and SVM-RFE - were applied to screen candidate biomarkers. Diagnostic performance was assessed using receiver operating characteristic (ROC) curve analysis. Immune relevance was examined by CIBERSORT and validated in single-cell RNA sequencing (scRNA-seq) data. Finally, expression of hub genes was experimentally verified in a chronic unpredictable mild stress (CUMS) rat model.Results: A total of 122 DEGs were identified, primarily enriched in immune and inflammatory pathways. Four hub genes - DDIT4, DHRS9, FKBP5, and GPER - were consistently selected across machine learning approaches. These genes exhibited strong diagnostic accuracy (AUC values ranging from 0.82-0.91) and were predominantly expressed in immune cell populations. scRNA-seq further confirmed their upregulation in specific immune cell subtypes. Experimental validation showed significantly elevated expression of these genes in the prefrontal cortex of depressed rats.Conclusion: This study identifies DDIT4, DHRS9, FKBP5, and GPER as immune-related biomarkers with high diagnostic potential for MDD. By integrating bioinformatics, machine learning, and experimental validation, our work provides novel insights into the immune mechanisms underlying MDD and establishes a translational framework for precision diagnosis and personalised intervention.

Background: In 2024, Super Typhoon Yagi made landfall in Hainan, China, causing severe damage. Focusing on the change patterns and risk and protective factors of post-disaster psychological symptoms is of great significance for psychological assistance for disasters. However, existing research has primarily targeted adults.Objectives: This study aimed to examine changes in adolescents' psychological symptoms (posttraumatic stress, depression, and anxiety) after Typhoon Yagi and identify risk and protective factors.Methods: Two-wave longitudinal surveys were conducted at one and a half and six months post-disaster with 734 adolescents (60.22% female) from severely affected areas in Hainan Province. Three latent change score models were used separately for posttraumatic stress, depression, and anxiety symptoms to estimate changes in symptoms over time and identify risk and protective factors.Results: Adolescents' posttraumatic stress symptoms remained generally stable, with depressive and anxiety symptoms showing a non-significant declining trend within six months. Higher initial symptom levels were predicted by direct disaster exposure, family members' fear, and previous super typhoon exposure, whereas optimism and hope, family support, and safe shelter after the typhoon served as protective factors. Regarding changes in symptoms, female sex predicted slower recovery, whereas higher coping self-efficacy predicted greater symptom reduction.Conclusion: These findings deepen the understanding of adolescents' psychological symptom trajectories, highlighting the importance of optimism and hope, coping self-efficacy, and perception of family members' fear and support. The study provides new insights for tailoring targeted psychological interventions based on distinct adaptation patterns.

Background: Foster children have an increased risk of psychological distress because they often experienced multiple traumatizing events. Untreated trauma and behavioural problems are important risk factors for breakdown of foster placements. Unfortunately, the application of first-choice trauma treatment is often complicated due to avoidance, dysregulation and motivational problems.Objective: The present study investigates whether the group intervention Tame your Dragon improves behavioural functioning and emotion regulation skills in children with trauma-related problems, who are unable or unwilling to start trauma treatment. It also examines whether this results in facilitating subsequent evidence-based trauma treatment.Method: In total, 7 intervention groups with 29 foster children participated in pre-test (T1) and post-test (T2) measurements. Questionnaires on child post-traumatic stress symptoms (PTSS), behavioural problems and emotion regulation strategies were administered. Treatment advices for a subsequent intervention after completing the group were collected by file research.Results: Foster parents reported a significant increase in child adaptive emotion regulation strategies, but no changes in children's behaviour, PTSS and maladaptive emotion regulation strategies. Self-report showed no change in PTSS, adaptive - and maladaptive emotion regulation strategies. After group intervention, 45% of the children was able to proceed with an evidence-based trauma treatment.Conclusion: This study provides initial evidence that a group intervention for foster children who are not willing or not able to enter evidence-based trauma treatment can be effective in strengthening adaptive emotion regulation strategies according to foster parents. Also there are indications that the group intervention enables almost half of the participants to proceed to trauma treatment.

Background: Traumatizing experiences significantly impact mental health outcomes, underscoring the need for a concise yet comprehensive assessment tool. The Global Psychotrauma Screen (GPS) was developed to address this gap. Although the GPS has been translated into over 30 languages, including Greek, its cross-cultural validity remains unexamined.Aim: The aim of this study was to evaluate the validity and reliability of the Greek GPS.Method: Study 1 involved 1418 participants who completed an online questionnaire, which assessed trauma-related symptoms using the GPS, the Posttraumatic Stress Disorder Checklist for DSM-5, the International Trauma Questionnaire, the Symptom Checklist-90-R, the Brief-Coping Orientation to Problems Experienced Inventory, the Brief Resilience Scale and the Multidimensional Scale of Perceived Social Support. The dataset from Study 1 was utilized for exploratory factor analysis. Study 2 included a dataset of 971 participants drawn from the Greek adaptation of the CARTS protocol, which was used to conduct confirmatory factor analysis.Results: The results showed satisfactory internal consistency as well as test-retest reliability, convergent and divergent validity of the GPS. The exploratory and confirmatory factor analyses supported a univariate structure of the GPS-Symptoms, with all symptom items exhibiting moderate to high loadings on the underlying factor and the solution accounting for 63.6% and 48.1% of the total variance in study 1 and study 2, respectively, and the univariate model fit indices being X²(112) = 282.349, p < .001, CFI = . 947, SRMR = .039, RMSEA = .040 [90% CI: 0.34-0.045], ECVI = .376 [90% CI: 0.33-.43]. All risk factors were significantly related to each of the GPS-Symptoms. Regression analyses revealed that gender and risk factors significantly predicted GPS-Symptoms.Conclusion: The current study provides preliminary evidence supporting the use of the Greek GPS as a valid and reliable tool for assessing transdiagnostic symptoms following trauma exposure.

Background: Child maltreatment (CM), i.e. neglect and abuse of children by their caregivers, has been linked to reduced psychological safety and a sense of disrupted body boundaries (DBB), both of which have been proposed to impair social functioning. However, evidence-based interventions to increase psychological safety and to reduce DBB are lacking.Objectives: We conducted two experiments across two separate studies. Study I examined the effect of a brief (60-minute) body-oriented intervention, derived from Somatic Experiencing (SE), on psychological safety. Study II investigated the effect of the same intervention on DBB.Methods: In both studies, adults with varying levels of CM exposure, based on total self-report scores across subtypes, were randomized to an SE group or to a psychoeducation control group. Study I included participants with a lack of psychological safety (n = 89); Study II included participants with DBB (n = 55).Results: In Study I, compared to controls, the SE group showed an increase in psychological safety (d = -.95, p < .001). SE group-specific changes were also found for different types of positive and negative affect and for social connectedness. Heart Rate (HR) decreased, and Heart Rate Variability (HRV) increased across groups. In Study II, compared to controls, the SE group showed a reduction in DBB (d = 1.13, p < .001) and an increase in interoceptive awareness, a proposed mechanism of action.Conclusions: A brief, SE-based intervention can facilitate momentary states of perceived safety and improve social connectedness in adults with different levels of CM. Future research should explore longer-lasting positive effects of SE.

Introduction: Forced migration exposes civilians to multiple potentially traumatic events. Personality traits may shape individual differences in adjustment, yet their role in refugee populations remains underexplored.Methods: We conducted a cross-sectional study of 160 Ukrainian civilian refugees (75% female; M_age = 33.0, SD = 13.9) who completed standardized measures of personality, attachment, posttraumatic stress symptoms, and posttraumatic growth (PTG).Results: Emotional Stability showed a large negative association with PTSD symptoms. In regression models, personality traits explained 26% of the variance in PTSD symptoms, increasing to 30% when attachment styles were included. By contrast, traits explained only 6% of variance in posttraumatic growth, rising to 9% after accounting for parental-closeness variables.Conclusions: Emotional Stability is a robust correlate of PTSD severity in this refugee sample, while personality and attachment play a limited role in posttraumatic growth. These findings suggest that trait-informed screening may help identify individuals at risk for severe posttraumatic distress.

Background: Homeless-experienced women face disproportionately high rates of trauma exposure and posttraumatic stress disorder (PTSD) compared to the general population. Despite this, there is little research into the effectiveness of accessible, trauma-focused interventions for this population.Objective: This pilot study sought to determine the feasibility and preliminary effects of Narrative Exposure Therapy (NET) on PTSD and co-occurring mental health symptoms in homeless-experienced women.Methods: We conducted a single-arm, open pilot study of NET with 53 women in three urban women's homelessness organisations. Feasibility was assessed via intervention and study protocol completion rates. We used linear mixed effects models and effect size metrics to analyse pre - to post-NET changes and strength in effects in primary (PTSD, PCL-5) and secondary outcomes variables (depressive symptoms, PHQ-9; anxiety, GAD-7; somatisation, SSS-8) in all participants who completed NET.Results: Fifty-three women began the NET protocol; 43 completed at least one outcome measurement, and 36 of these women completed the full protocol (81% treatment completion rate, 68% study protocol completion rate). We observed significant symptom reductions in all measured symptom domains one-week post-NET. Participants showed large changes in PTSD symptoms (PCL-5 change: 20.8 points, p < .001, d = 0.9) and medium changes in depressive symptoms (PHQ-9 change: 3.1 points, d = 0.57), anxiety (GAD-7 change: 3.8 points, d = 0.7), and somatisation (SSS-8 change: 3.7 points, d = 0.49).Conclusions: NET may be a feasible and clinically pragmatic intervention for reducing PTSD and co-occurring mental health symptoms in HEW. A fully powered, randomised trial to evaluate NET in this population is necessary to definitively determine intervention effects.