European Journal of Psychotraumatology最新文献

Background: Individuals bereaved by cancer face significant emotional challenges, often experiencing prolonged grief disorder (PGD), PTSD, depression, and anxiety. Effective interventions are needed to target these mental health problems. This study evaluates the outcomes of the specialist bereavement charity, The Loss Foundation's therapeutic group intervention designed for individuals grieving a cancer-related loss.Methods: A total of 68 participants, enrolled across five cohorts, received a short-term group intervention targeting cognitive-behavioural factors and self-compassion. Due to recruitment limitations, randomized analyses were underpowered, therefore a broader service evaluation was performed, combining data from 2016 and 2018 cohorts. The primary outcome was PGD symptoms measured by the PG-13, with secondary outcomes examining PTSD, depression, anxiety, and self-compassion. Process measures were memory characteristics, grief appraisals, maladaptive coping strategies, and social disconnection. Data were analysed using linear mixed-effects models.Results: Significant reductions were observed in symptoms of PGD (d = 0.65 at 3-month follow-up), PTSD, depression, and anxiety, with improvements in self-compassion (d = 0.53). Cognitive-behavioural process measures also showed significant changes, particularly in memory characteristics and negative appraisals, though social disconnection did not significantly change. Exploratory analyses indicated that lower baseline negative appraisals predicted better treatment outcomes. Attrition was minimal after the intervention began, though approximately 25% of participants did not provide follow-up data.Conclusions: The group intervention demonstrated positive effects on grief-related and mental health outcomes, supporting the use of cognitive-behavioural approaches in cancer bereavement. However, further randomized trials with larger samples are needed to confirm these findings and address limitations related to randomization and data completeness.

Introduction: Postmigration stress has been recognised as a significant factor negatively impacting the psychological well-being of forcibly displaced people (FDP), even independently of pre-migration trauma exposure. However, there is no study yet investigating its detrimental effects on psychological and somatic indicators of mental health in the daily life of FDP. Here, we present a study protocol to investigate the impact of postmigration stress in the daily lives of Arabic- and Farsi-speaking FDP living in Austria, using an ambulatory assessment (EMA) design.Methods: Sixty Arabic- and Farsi-speaking adult FDPs with a maximum of three years of stay in Austria will complete daily questionnaires on smartphones for 14 days. Participants will be prompted to report experienced postmigration stressors, perceived momentary stress levels, transdiagnostic symptoms of psychological distress, and positive and negative affect, at three fixed timepoints each day (i.e. 11 am, 3 pm, and 7 pm). In addition to subjective stress assessment, participants will provide saliva samples to measure somatic stress system functioning, indicated by salivary cortisol and alpha-amylase. Furthermore, participants will be asked to complete a self-initiated end-of-day questionnaire before going to bed. Our hypotheses will be tested using multilevel analysis and biochemical analyses of the human probes.Discussion: This study will advance understanding of how postmigration stress affects psychological and somatic aspects of mental health in FDP. Using a multimodal EMA approach, findings may guide the development of scalable, smartphone-based, just-in-time interventions for this highly mobile, underserved population.

Background: Since 2020, modern youth in Ukraine have faced an exceptionally challenging period, first enduring the burdens of the COVID-19 pandemic and then being thrust into the full-scale war, characterized by persistent traumatic exposure. Given the profound and lasting psychological consequences of such crises, it is essential to monitor the long-term impact of war on youth mental health. However, despite the urgency of this issue, longitudinal studies with large, diverse samples remain scarce.Objective: This study aims to track changes in anxiety, depression, and stress and explore their associations with demographic and educational variables among university students in Ukraine, from the COVID-19 pandemic through two years of full-scale war.Method: Data were collected online at three time points over four years from independent samples of students from 27 higher education institutions across 12 Ukrainian cities. A total of 757 students participated in 2020, 2,592 in 2023, and 838 in 2024, all completing anonymous questionnaires. A one-way analysis of variance (ANOVA) and a General Linear Model were used to analyse the results.Results: The findings revealed a significant increase in anxiety, depression, and stress levels among university students during the transition from the pandemic to wartime conditions. Women reported higher levels of anxiety, depression, and stress, while students aged 15-25 exhibited poorer mental health than those aged 26-55. Although students across all fields of study experienced heightened distress in 2023, those in technical disciplines were the only group to show a decline in 2024.Conclusions: Ukrainian youth have been living under high levels of distress for more than four years, with little indication of improvement. The results highlight the urgent need for targeted strategies in prevention, intervention, and treatment of anxiety, depression, and stress among university students and other vulnerable young adults.

Background: Research on bullying and child PTSD has traditionally been conducted separately. This study examines the association between bullying and posttraumatic stress symptoms (PTSS) in three international samples, comparing its impact to other potentially traumatic events (PTEs) and assessing whether bullying predicts PTSS when controlling for other PTEs.

Method: We analyzed three large clinical samples of children and adolescents referred for mental health care in Norway (N = 3370, 63.4% female, Mage = 14.0), the Netherlands (N = 952, 68.7% female, Mage = 15.57), and Germany (N = 707, 39.0% female, Mage = 13.25), using the Child and Adolescent Trauma Screen (CATS or CATS-2) to measure bullying, PTEs, and PTSS. Two linear regression models were compared per sample: one with variable regression weights and one with constrained weights. We also evaluated unique R² shares to determine the distinct variance each PTE contributed to PTSS.

Results: Bullying was reported by 56.2% (Norway), 53.2% (the Netherlands), and 52.6% (Germany); cyberbullying was reported by 17.0% (Germany). Moderate correlations with PTSS severity were found (r = .17-.37 for bullying; r = .36 for cyberbullying). Clinically elevated PTSS were reported by 57.4%-73.1% of those bullied and 78.3% of cyberbullied youth. Bullying remained a significant predictor of PTSS, explaining 3.8% to 22.9% of variance after controlling for other PTEs, age, and gender.

Conclusions: From a socio-emotional developmental perspective, bullying is a significant risk factor for child PTSS. This association was stronger when bullying items included threat-based language. Specifying the nature of bullying is crucial in determining whether it meets trauma criteria.

Background: Anxiety Sensitivity (AS), the belief that anxiety experiences have negative implications, is a prospective predictor of posttraumatic stress disorder (PTSD) and has been linked to changes in PTSD in experimental studies. AS is comprised of three sub-components: cognitive, physical, and social concerns. PTSD is moderately heritable and parental PTSD may increase risk for these AS facets both directly and through environmental influences like reduced social support.Objective: The present study will examine whether Parent PTSD is associated with reduced social support and in turn facets of AS.Method: Participants were recruited from an ongoing longitudinal study of college student mental health; 94 individuals with current alcohol use disorder (AUD), PTSD, both, or neither (i.e. trauma-exposed controls) were included.Results: Cross-sectional analyses revealed that offspring of parents with PTSD reported less social support in their families of origin, which was associated with higher AS-cognitive concerns. There was a direct effect of parent PTSD on physical concerns, but no effects of parent PTSD or support on social concerns.Conclusions: Offspring of parents with PTSD who perceive less family support may be at higher risk for internalising problems via increased negativity, and may not feel that their caregivers are reliable sources of emotional regulation. Therefore, reduced support may explain the path between parent PTSD and cognitive AS concerns. In contrast, it is possible that simply having a parent with PTSD who perhaps displays outward symptoms of anxiety increases risk for more AS physical concerns. Together, these findings suggest that offspring of parents with PTSD are a high-risk group on whom family-based interventions bolstering social support and AS (cognitive)-based interventions ought to be focused.

Background: Machine learning approaches are being increasingly tested as a potential means of identifying mental health conditions. Narrative features of trauma memories are proposed to play a significant role in the development of post-traumatic stress disorder (PTSD), meaning that trauma narratives provide an excellent context in which to test machine learning capabilities. The potential for children's trauma narratives to predict post-traumatic stress remains particularly poorly studied. Here, we tested whether the application of machine learning to trauma narrative characteristics can predict PTSD symptoms in young individuals exposed to trauma.Study methodology: Two pre-trained large language models and two benchmark models were fine-tuned and trained to predict PTSD symptom severity from children's autobiographical narratives of a traumatic event. Data comprised narratives collected one month post-trauma from 400 individuals aged 7-17 years old who experienced a psychological trauma that led to attendance at emergency departments in the United Kingdom (N = 178) and South Africa (N = 222), as well as self-reported PTSD symptoms and trauma memory features.Findings: Both pre-trained and benchmark models demonstrated poor predictive performance across trauma narratives in the United Kingdom, South Africa, and the combined datasets (e.g. RoBERTa R²  =  -.05; LASSO R² ≈ 0). However, adding self-reported trauma memory features, disorganisation, and sensory vividness improved the benchmark models' performances, especially in the UK dataset (e.g. LASSO R² = .57; XGBoost R² = .45).Conclusions: These findings indicate that while trauma narratives alone offer limited predictive value, incorporating self-reported trauma memory characteristics substantially enhances model performance, highlighting the importance of focusing on subjective reports to develop scalable automated tools for PTSD risk prediction in youth.

Background: Populations affected by war, genocide, political violence, and forced displacement endure severe psychosocial disruption. Resilience is increasingly recognized as key to recovery, yet its definitions, measurement, and mechanisms of transmission in collective trauma contexts remain inconsistently addressed.Objective: This review aimed to synthesize how resilience is conceptualized, measured, and transmitted in the context of collective trauma, and to quantitatively assess the association between trauma exposure and resilience.Methods: Following PRISMA 2020 guidelines and registered in PROSPERO (CRD420250651118), we searched seven databases (e.g. Scopus, Embase, PubMed, PsycINFO) and screened 16,447 records. Eligible studies examined both man-made collective trauma exposure and resilience as an outcome or process. After full-text review, 53 studies were included: 16 qualitative studies and 9 reviews underwent thematic synthesis and 28 were included in a three-level random-effects meta-analysis of 43 effect sizes. Moderator analyses explored demographic and conceptual influences on the association.Results: Three integrative models of resilience were identified: (1) intrapersonal resource models (e.g. coping, emotional regulation), (2) multisystemic and relational process models (e.g. family, community support), and (3) sociocultural continuity and identity models (e.g. collective memory, tradition). These were derived from seven definitions categories, seven domains of protective and risk factors, and five measurement categories. The meta-analysis showed a significant negative association between trauma exposure and resilience (r = -0.109, 95%CI [-0.163, -0.055], p < .0001; I² = 82.3%), robust after outlier adjustment (r = -0.121). Stronger associations were observed in predominantly male samples (r = -0.176) and in intrapersonal or national resilience frameworks (r = -0.136), compared to relational models (r = -0.038), and across age in a quadratic pattern (QM[2] = 11.21, p = .0037). Trauma type, timing, and measurement method were not significant moderators.Conclusion: Resilience following collective trauma is best conceptualized as a multidimensional, context-sensitive process involving psychological, social, and cultural dimensions. Findings support an integrative framework and call for culturally grounded and system-oriented interventions.

Background: People seeking refuge and asylum must often endure diverse adversities before, during, and after migration, making them more susceptible to develop psychological problems. The effect of post-migration stressors on responsiveness to psychological treatment is unclear.Objectives: To: (1) evaluate the scope of the literature on the relation between post-migration stressors (e.g. struggles related to legal status in the context of resettlement) and outcomes of interventions targeting PTSD and comorbid conditions, in adult refugees and asylum seekers; (2) identify conceptual and methodological limitations of the literature; and (3) present limitations and recommendations for future research.Methods: This review follows the guidelines of PRISMA-ScR for Scoping Reviews, and the Population, Concept, and Context (PCC) framework for identifying concepts pertaining to the review question and the search strategy.Results: From 1,151 studies found through PsycINFO, PubMed, Web of Science Select, and review of sources, we assessed the 14 studies that fulfilled our criteria and found various post-migration barriers and facilitators of treatment success. Obtaining a more secure immigration status, reported in four studies, was the most emphasized factor associated with clinical improvement. Although the quality of the studies was overall high, there were frequent study limitations including small sample sizes and inconsistent post-stressor measures.Conclusion: Recommendations for future research include more robust methodologies, including mixed and longitudinal designs, and consistently using valid tools to assess post-migration stressors. The studies provide evidence for the effectiveness of psychological treatment in reducing symptoms of distress, despite being implemented in the context of post-migration stress. Post-migration stressors, although they may hamper treatment results, are not an indication to withhold treatment but a sign that additional services may be needed, but uniform and consistent evaluation of post-migration stressors should be implemented.

Background: The Russian invasion of Ukraine has resulted in forced displacement, with over six million Ukrainian refugees across Europe, of whom 81,770 are residing in Norway. This displacement and, in many cases, preceding war experiences, has led to increased vulnerability to trauma and mental health challenges. There is to date little knowledge about the extent to which structured mental health interventions can mitigate symptoms in Ukrainian refugees. Narrative Exposure Therapy (NET), a short-term trauma-focused intervention, has demonstrated efficacy in reducing post-traumatic stress disorder (PTSD), depression and dissociation symptoms among individuals exposed to organized violence and war.Aim: The protocol aims to assess the clinical effects of NET on PTSD, dissociation, and depression symptoms among Ukrainian refugees in Norway and to facilitate training and supervised praxis for Ukrainian health professionals in using NET.Methods: This study employs a pretest-posttest randomized controlled experimental design (RCT). Ukrainian health workers in Norway will receive a total of 450 hours of NET training through an online course. As a part of the training, they will, under supervision, administrate NET to Ukrainian refugees. Participants will be screened and assessed at three time points: baseline, immediately after treatment, and at a 6-month follow-up. Validated instruments in Ukrainian and Russian will be used to assess trauma experiences, symptoms, and comorbidities. Exclusion criteria: active psychotic spectrum disorders, neurodevelopmental disorders and concurrent trauma therapy. The study also contains an embedded qualitative sub study that will involve phronetic iterative thematic analysis of anonymized therapy narratives collected during NET sessions, aiming to understand how participants construct meaning from traumatic events, how narrative coherence evolves throughout therapy, and how identity reconstruction occurs post-trauma.Trial registration: ClinicalTrials.gov identifier: NCT07062042..