European Journal of Psychotraumatology最新文献

Introduction: A host of cross-sectional studies have identified problematic substance use and post-traumatic stress symptoms as risk factors for repeated interpersonal violence (revictimization) in college samples. However, it remains unclear which factors are associated with revictimization for patients who meet diagnostic criteria for both substance use disorder (SUD) and post-traumatic stress disorder (PTSD). The identification of factors associated with revictimization is an important step towards preventing violence against people with psychiatric disorders and can inform treatment.Method: Data were based on the Treatment of PTSD and Addiction (TOPA) study, a randomized controlled trial including N = 209 patients that received inpatient and outpatient treatment for SUD and PTSD. We selected participants who had experienced interpersonal victimization at baseline (N = 203) and assessed revictimization across the 9-month follow-up period. Revictimization included: physical violence, violence with a gun, sexual violence, and 'other unwanted sexual experience'. The risk factors we investigated were severity of PTSD, severity of alcohol and drug use disorder, interpersonal difficulties, sex, and age. We analysed the data using logistic regression analyses with multiple imputation for missing data.Results: Physical violence was the most common type of revictimization during the study period (26.0%), closely followed by 'other unwanted sexual experience' (20.0%). The severity of PTSD and age were univariate predictors for revictimization; however, only age was robustly related to revictimization while accounting for other study variables. We conducted sensitivity analyses with complete cases and observed data.Discussion: Approximately two in five individuals experienced revictimization across the 9-month follow-up period, underscoring it as a clinically relevant issue. Since age emerged as the only risk factor for revictimization in our sample, future research should focus on identifying modifiable factors associated with age, e.g. impulsivity and novelty seeking. These factors may be addressed in interventions aimed at reducing the risk of revictimization.

Background: Prolonged Grief Disorder (PGD) affects a significant minority of bereaved individuals and is associated with persistent distress, comorbidity, and functional impairment. Access to evidence-based treatment remains limited. This study introduces and evaluates Internet Cognitive Therapy for Prolonged Grief (iCT-PG), a therapist-assisted digital intervention adapted from iCT-PTSD.Objective: To assess preliminary feasibility, acceptability, and clinical outcomes of iCT-PG, and to examine changes in key cognitive maintenance mechanisms of PGD (memory characteristics, negative appraisals, unhelpful coping strategies, and a sense of social disconnection).Methods: Eight adults assessed at interview to meet diagnostic criteria for PGD completed the 12-session iCT-PG programme remotely (e.g. browser, tablet, smartphone) over 14 weeks. The intervention targeted loss-related memory characteristics, negative grief appraisals, a sense of social disconnection, and unhelpful coping strategies, and used a personalised digital modular approach and therapist support through weekly calls and messages. Outcomes were assessed at pre-treatment, post-treatment, and 3-month follow-up using validated measures.Results: All participants completed treatment. Large reductions in PGD symptoms and comorbid symptoms of PTSD, depression, anxiety, and functional impairment were observed. At post-treatment, 87.5% (7/8) demonstrated both reliable improvement in PGD symptoms on the Reliable Change Index, and recovery below clinical cut-offs. There was no reliable deterioration on any measure. Process measures showed large pre-post treatment effect sizes (d = 1.29-1.64), with the strongest improvements in loss-related memory characteristics (d = 2.61). Therapeutic gains were maintained at 3-month follow-up. Average therapist time was approximately 10 h per participant.Conclusions: iCT-PG was feasible, well-accepted, and associated with substantial clinical improvement. The intervention successfully targeted mechanisms known to maintain PGD, supporting its theoretical foundation. Though uncontrolled and small in sample size, findings support further evaluation in larger trials to determine efficacy and scalability.

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: 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: 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.

Introduction: Healthcare workers (HCWs) are routinely exposed to distressing and potentially traumatic events during frontline care, yet receive limited structure training to manage such exposure. Psychological first aid (PFA) training has been widely disseminated among emergency responders and is increasingly being adapted for HCWs; however, its acceptability, implementation, and use in routine care remain underexplored. This study aimed to explore how an adapted PFA training programme was perceived, implemented, and used by HCWs in routine care, and to identify the mechanisms and contextual factors that influenced its impact.Method: A qualitative process evaluation was conducted alongside the delivery of the READ-Y (Rapport, Evaluation, Aid, Disposition, Yourself) PFA training programme in a Chinese tertiary hospital. Data collection included 3 months of observations of training delivery and 19 semi-structured interviews with HCW trainees, ward managers, and trainers/facilitators. Data were analysed using framework analysis.Results: Training was logistically feasible, consistently delivered, and characterized by high engagement in simulation and debriefing. Key fidelity elements of PFA training were maintained. Five key themes emerged: (1) positive reception of the adapted, blended-format training; (2) PFA was viewed as a pragmatic, stepwise tool for strengthening basic psychosocial support in routine care; (3) reported improvement in empathy, communication, and normalization of self-care among staff; (4) targeted skills development and peer learning as key mechanisms of reported change, fostering a shared language and support; and (5) multi-level contextual enablers (e.g. leadership endorsement, protected time) were identified and structural barriers (e.g. workload, burnout) existed that may hinder uptake.Conclusion: The adapted PFA training programme was perceived as feasible, relevant, and acceptable for HCWs, facilitating the integration of psychosocial support into routine care while promoting their own well-being. System-level integration and longitudinal evaluation of PFA training are recommended to assess sustained impact on patient and staff outcomes.

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.