European Journal of Psychotraumatology最新文献

Background: Posttraumatic stress disorder (PTSD) and cannabis use disorder (CUD) are commonly comorbid and are associated with many negative public health outcomes. One plausible explanation for this comorbidity comes from a self-medication framework, which suggests people use cannabis to cope with PTSD symptoms. Despite theoretical and empirical evidence for PTSD-related cannabis use to cope, no measure of this construct exists.Objective: We sought to address this gap by developing and validating a novel measure of PTSD-specific cannabis self-medication, which we have termed the Trauma-Related Cannabis Use to Cope (TRCU) questionnaire.Method: The psychometric properties of the TRCU and how it relates to relevant constructs were examined among a diverse sample of 345 trauma-exposed undergraduate cannabis users (M_age = 22.19, SD = 6.45; 46.7% White; 79.7% woman-identifying) using structural equation modelling in Mplus.Results: Study findings indicate that the TRCU is a more precise and targeted measure of cannabis use to cope with PTSD symptomology, as compared to existing measures of cannabis coping motives. Furthermore, our data support the use of the TRCU as a four-factor scale, assessing cannabis use to cope with the four DSM-5 PTSD symptom clusters (χ²(164) = 257.83, p < .001; CFI = .969; TLI = .965; RMSEA = .041). We also found strong evidence supporting the construct and criterion validity of the TRCU, specifically in relation to PTSD symptoms, cannabis use, and cannabis-related issues and dependence.Conclusions: Results support the use of the TRCU in future self-medication research and as a clinically useful screening tool for identifying individuals with PTSD who are at risk for developing CUD.

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

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

Background: This study aims to elucidate the causal relationship between childhood maltreatment (CM) and subsequent mental health outcomes, including major depressive disorder (MDD), anxiety (ANX), post-traumatic stress disorder (PTSD), suicide attempts, and non-fatal self-harm. Utilising Mendelian Randomisation (MR) and genome-wide association studies (GWAS) data from individuals of European descent, this research applies a rigorous analytical methodology to large-scale datasets, overcoming the confounding variables inherent in previous observational studies.Methods: Genetic data were obtained from publicly available GWAS on individuals of European ancestry, focusing on Childhood Maltreatment (CM), Major Depressive Disorder (MDD), Anxiety (ANX), Post-Traumatic Stress Disorder (PTSD), Age at First Episode of Depression, Number of Depression Episodes, Non-fatal self-harm, and Suicide Attempts. Mendelian Randomisation (MR) analyses were conducted to investigate the causal impact of CM on these outcomes. Sensitivity analyses included IVW, MR Egger, WM, and MR-PRESSO. FDR corrections were applied to account for multiple testing. Results were presented as odds ratios (ORs) with confidence intervals (CIs).Results: Significant associations were identified between CM and the likelihood of developing MDD (IVW: OR = 2.28, 95% CI = 1.66-3.14, P_FDR< .001), ANX (IVW: OR = 1.01, 95% CI = 1.00-1.02, P_FDR =.032), and PTSD (IVW: OR = 2.29, 95% CI = 1.43-3.67, P_FDR =.001). CM was also linked to increased non-fatal self-harm (IVW: OR = 1.06, 95% CI = 1.04-1.08, P_FDR <.001), higher frequency of depressive episodes (IVW: β=0.31, 95% CI = 0.17-0.46, P_FDR <.001), and earlier onset of depression (IVW: β=-0.17, 95% CI = -0.32 to - 0.02, P_FDR =.033). No significant association was found between CM and suicide attempts (IVW: OR = 1.09, 95% CI = 0.81-1.45, P_FDR =.573).Conclusion: This study provides robust evidence that CM is a significant causal factor for MDD, ANX, PTSD, and non-fatal self-harming behaviours. It is associated with a higher frequency of depressive episodes and earlier onset of depression. These findings highlight the need for early intervention and targeted prevention strategies to address the long-lasting psychological impacts of CM.

Background: Counterfactual thinking (CFT), involves mental simulations of alternative outcomes to past events (e.g. 'What if … ' or 'If only … '), and is commonly observed after trauma. While CFT can be adaptive, it is also linked to psychological distress, including posttraumatic stress reactions (PTSR).Objective: The present study aims to examine the relationship between the frequency and vividness of upward and downward counterfactual thoughts and PTSR, in the recent aftermath of sexual assault (SA).Method: The sample consisted of 327 women who had experienced SA within the last year. PTSR was measured using the International Trauma Questionnaire (ITQ), while CFT was assessed through self-reported frequency and vividness of upward (event could have been less severe or avoided) and downward (event could have been worse) counterfactual thoughts.Results: The results revealed a significant difference in the distribution of upward versus downward CFT. Specifically, more participants reported engaging in upward CFT 'Very Often' and 'Often,' while downward CFT was reported less frequently. Vividness was higher for downward CFT. Both frequency and vividness of upward and downward counterfactuals were significantly associated with higher levels of PTSR.Conclusion: The present findings highlight the role of counterfactual thinking in post-assault distress and emphasize the need for targeted interventions addressing CFT in the aftermath of trauma.

Background: The ICD-11 distinguishes Complex Post-Traumatic Stress Disorder (CPTSD) as a separate trauma-related disorder from PTSD. While numerous studies have examined these conditions globally, no nationwide research has yet investigated their one-month prevalence and associated factors in the general population of China.Objective: This study aimed to determine the one-month prevalence of ICD-11 CPTSD and identify associated factors within a general adult sample in mainland China.Methods: A total of 2,115 adults living in mainland China participated in an online survey. PTSD and CPTSD were assessed using the International Trauma Questionnaire (ITQ) based on ICD-11 criteria. Trauma exposure was measured via the International Trauma Exposure Measure (ITEM). Multinomial logistic regression identified associated factors for PTSD and CPTSD.Results: Among participants, 88.2% reported at least one traumatic exposure. The prevalence of PTSD and CPTSD was 4.9% and 4.5%, respectively. Shared predictors for both conditions included a greater number of siblings, broader interpersonal trauma exposure during adolescence, and more frequent and recent index trauma events. Specific predictors for CPTSD included female gender, older age, being left behind by migrant parents, lower socioeconomic status, and broader trauma exposure in adulthood.Conclusion: This study provides the first estimates of ICD-11 PTSD and CPTSD prevalence in the general population of mainland China, revealing relatively high rates compared to other mental disorders. Findings highlight key associated factors and offer intervention recommendations for at-risk groups.

Introduction: The majority of grief research has assessed Prolonged Grief (PG) symptoms using cross-sectional surveys, which are limited in capturing within-person changes in daily grief reactions. These dynamic PG reactions can be more effectively assessed using Experience Sampling Methodology (ESM). Accordingly, this data note presents a Findable, Accessible, Interoperable, and Reusable (FAIR) archive comprising three existing ESM projects investigating PG reactions in daily life.Methods: Participants in this archive completed three data collection phases: baseline measures (including sociodemographic and loss characteristics, and psychopathology measures), a 14-day ESM phase (rating PG reactions and contextual factors up to five times daily), and follow-up psychopathology assessments. The participants provided explicit digital consent for the use and reuse of their data in scientific research.Results: In total, 315 people are included in this archive, with a total of 22,050 ESM-measurement points. The majority of the participants were middle-aged, identified as women, and had completed higher education. Almost half of the sample (48.73%) experienced the loss of a partner or child, the majority of these losses were due to natural causes (70.06%), and happened less than a year ago (59.24%). The data are stored in a trusted repository.Discussion: This archive demonstrates that it is feasible to develop a FAIR archive including existing data on PG reactions in daily life. Given the resource-intensive nature and richness of these data, we encourage researchers to reuse and/or share ESM-data through this archive, helping to deepen our understanding of grief in natural settings.

Background: Bullying can be associated with emotional and social difficulties, but not all individuals experience enduring negative effects.Objective: This study aimed to explore beliefs about bullying, self, and other people among young adults who were bullied that may be associated with ongoing anxiety and distress related to those experiences.Method: Semi-structured interviews with 20 people, aged 18-29 years, who had experienced bullying were analysed using thematic analysis. The sample was split, by current symptoms of social anxiety and post-traumatic stress related to bullying, into a lower symptoms group (n = 12) and a higher symptoms group (n = 8).Results: Participants reported multiple types of bullying, including online. Four superordinate themes were identified in negative beliefs related to bullying experiences: personal deficiency (i.e. victimization was due to own low value or undesirable traits), social threat (i.e. wariness of others due to their negative motives or traits), acceptance is fragile (i.e. being accepted by others is transient and requires effort), and minimizing (i.e. downplaying severity and impact of past experiences). These were evident in both groups but were more frequently endorsed in the higher symptoms group.Conclusion: Negative appraisals related to bullying can persist into young adulthood and may influence social interactions and mental health. Interventions targeting these beliefs could mitigate negative outcomes and bolster resilience among individuals affected by bullying. Further research should explore these themes to inform effective therapeutic strategies for young adults who have been bullied.

Background: Psychophysiological dysregulations and negative alterations in cognitions and mood characterize post traumatic stress disorder (PTSD) and complex PTSD (C-PTSD), contributing to an increased risk of disorder persistence and chronic health problems. However, understanding the differences in physiological stress reactivity and negative cognitive-emotional patterns between adolescents with PTSD and C-PTSD remains a notable research gap.Objective: This study examined group differences in autonomic nervous system (ANS) reactivity during the sharing of a short trauma narrative, including resting and recovery phases, and compared subjective experiences of stress, shame, and guilt among adolescents with PTSD, C-PTSD, and trauma-exposed controls.Methods: In a repeated-measures design, 52 adolescents (14-18 years) with PTSD (n = 17), C-PTSD (n = 18), and a control group (n = 17) were assessed for heart rate, heart rate variability, and subjective experiences of stress, shame, and guilt during a standardized trauma interview, as well as during baseline and recovery phases.Results: Linear mixed-effects models revealed a significant interaction between group and time point (F = 4.134, p < .001). The C-PTSD group exhibited a significantly higher heart rate in the recovery phase compared to the PTSD (p = .010) and control groups (p = .036), alongside significantly higher subjective stress, guilt, and shame experiences. Main effects of group were identified for perceived stress (F = 7.543, p = .002), guilt (F = 21.779, p < .001), and shame (F = 19.309, p < .001), with the C-PTSD group exhibiting higher levels compared to PTSD and control groups across all conditions.Conclusions: Prolonged stress responses and elevated experiences of shame and guilt in adolescents with C-PTSD align with the diagnostic criteria of affective dysregulation and negative self-concept. Objective stress measures during trauma interviews may support the diagnosis of C-PTSD. Findings highlight the importance of phase-based trauma therapies that target emotional dysregulation, shame, and guilt.

Background: Several psychosocial interventions have shown promising effects in treating people affected by childhood maltreatment (CM); however, their comparative efficacy on social functioning remains largely unknown. To address this issue, a systematic review and network meta-analysis (NMA) will be conducted to investigate the comparative efficacy of different psychosocial interventions on global social functioning and specific domains of social functioning, including behavioural, emotional, cognitive and physiological processes. We aim to develop a hierarchical ranking of existing psychosocial interventions concerning their efficacy and acceptability which could inform treatment guidelines.Methods: Randomised controlled trials (RCTs) investigating psychosocial interventions for individuals with exposure to CM when they were younger than age 18 will be included. Primary outcomes will be global and domains of social functioning (measured up to 3, 6, 12 months and at the longest follow-up). Study drop-out will be a secondary outcome that will serve as a measure of acceptability. Study selection and data extraction will be performed by at least two independent reviewers. We will assess the risk of bias for each study using the Cochrane Risk of Bias tool 2 (RoB2) and evaluate the confidence in the results using Confidence in Network Meta-Analysis (CINeMA). The effects of potential moderators, such as age (children/adolescents vs. adults), population type (clinical vs. non-clinical samples), or sex (% males), socioeconomic status (low-income vs. middle-high-income countries), and intervention characteristics (individual vs. group training, number of sessions) will be analysed using subgroup-analyses or meta-regressions. Other candidate moderators/mediators (personality, post-traumatic symptoms, brain structure/function, cognitive reserve) will also be explored and narratively summarised. Sensitivity analyses will be conducted to explore further heterogeneity and assess the robustness of our findings.Discussion: This systematic review and NMA aims to compare multiple existing psychosocial interventions in individuals affected by CM and establish the relative rankings of these interventions for social functioning. Our results may provide practical guidance concerning the most effective psychosocial interventions to reduce the societal burden associated with CM.Protocol registration: PROSPERO CRD42022347034.