European Journal of Psychotraumatology最新文献

Background: Child maltreatment (CM) covers various forms of physical, emotional, and sexual abuse and neglect. Although the scientific literature has extensively documented that exposure to sexual abuse and/or neglect during childhood can cause long-term harm to an individual's overall well-being, the psycho-biological impact of these specific forms of CM requires further exploration. This pilot study tested the hypothesis that experiencing childhood neglect and sexual abuse are associated with psychological alterations as well as biological alterations, namely blood gene expression changes.Methods: This study encompasses a group of volunteer university students, who completed a battery of questionnaires to evaluate the presence of neglect and sexual abuse experience during childhood (CTQ-SF) and psychological distress (SCL-90-R; BDI-II). Both subsets were compared with control groups. Peripheral blood mononuclear cells were collected from all groups to extract RNA and perform genome wide expression analyses.Results: Neglected and sexually abused individuals showed evidence of biological alterations. Through a genome wide transcriptomic analysis, combined with multivariate nomogram analysis, we identified two groups of 5 genes, the changes in expression of each group identified a subject who experienced either neglect or sexual abuse, with a probability of 95%. Among the first group of genes, the expression of ARMC1 correlated significantly with depressive scores in neglected individuals. Among the second group of genes, the expression of ABTB1 correlated significantly with general psychological distress in sexually abused individuals.Conclusion: These results support that childhood neglect and sexual abuse are associated with gene expression changes and psychological outcomes, underscoring the importance of refining the diagnostic process with more objective screening and assessment tools.

Background: Adverse childhood experiences (ACEs) often exhibit an intergenerational cycle within families, although the transgenerational effects tend to be small to moderate. Many families seem to be able to break this cycle.Objective: This study aimed to examine how many emerging adults remain in the same ACE group as their parents, show improvement, or experience deterioration, and to identify factors associated with these transgenerational changes.Method: Data from 316 families participating in the 18-year German longitudinal study 'Future Family' were analyzed. The dataset included information from mothers (average age: 54 years), fathers (57 years), and their emerging adults (22 years). Descriptive statistics, Pearson correlation coefficients, and a multinomial regression model were computed.Results: Small correlations were found between the total ACE scores of parents and emerging adults. Approximately half of the emerging adults belonged to the same ACE group as their parents, while the other half experienced a shift in group membership across generations. Lower levels of dysfunctional maternal parenting behaviour in early childhood were associated with improvements in emerging adults' ACE group status, while a higher maternal socioeconomic status was linked to a reduced likelihood of deterioration. Many emerging adults of parents in the high-risk group (reporting ≥4 ACEs) reported fewer ACEs themselves, indicating that high-risk families are able to break the cycle of adversity.Conclusions: The main findings support existing prevention efforts, particularly the strengthening of parenting skills and the enhancement of families' economic resources. Future research should examine the intergenerational transmission of ACEs with a sex-sensitive approach and place greater emphasis on the role of fathers.

Background: Research consistently shows that gender influences both the likelihood of encountering potentially traumatic events (PTEs) and their psychological consequences. Exposure to PTEs, defined as life-threatening or severely harmful situations, can accumulate over time and undermine an individual's ability to cope with stress. Based on these assumptions, the current study examined the co-occurrence of PTEs separately in women and men and explored their specific associations with mental health.Methods: A cross-sectional, group-level network analysis was used to empirically cluster PTEs based on their co-occurrence, in a sample of 782 women and 401 men (n = 1183). Psychological distress was measured using the Depression, Anxiety and Stress Scale 21 (DASS 21), event-related distress was assessed with the Impact of Event Scale - Revised (IES-R) and Resilience Scale 11 (RS-11).Results: Both men and women networks exhibited similar overall connectivity, with four distinct clusters emerging from the network analysis in each sample. In women, a cluster related to assault-related trauma showed a strong connection to higher levels of depression, anxiety, and stress. Additionally, the relationships between trauma exposure and resilience in women revealed both positive and negative associations, highlighting the complexity of their interplay. In men, a cluster related to physical assault was associated with higher levels of anxiety, whereas resilience was positively associated with exposure to accidental trauma.Discussion: Overall, the study suggests gender-related patterns, with trauma-related clusters significantly linked to mental health outcomes. Future research should aim to replicate these findings in larger samples, explore a broader range of mental health indicators, and examine longitudinal dynamics to better understand gender-specific patterns and inform targeted interventions.

Background: There is no universally optimal cutoff score for identifying probable PTSD, which makes reliable PTSD diagnosis challenging not only across different populations but also in different settings. Reliable outcomes require tailoring cutoff scores to the population, intended use (clinical, research, or prevalence estimation), and appropriate statistical methods to ensure their validity.Objective: While previously little emphasis has been placed on thorough methodological evaluation and purpose-driven cutoff selection, this work addresses these gaps by evaluating optimal PCL-5 cutoff scores for clinical use, prevalence estimation, and research in a German-speaking clinical sample.Methods: Previously published data from 443 trauma-exposed individuals in Germany were re-analyzed for this purpose. PTSD was assessed using the PCL-5 and with CAPS-5 clinical interview. Optimal cutoffs were identified using ROC analysis, applying standard estimation methods and prioritising diagnostic utility based on specific objectives.Results: After evaluating various cutoff points for different purposes, we identified the following as most suitable for this sample: a cutoff of 34 for clinical use (sensitivity: 0.892, specificity: 0.645, PPV: 0.824, NPV: 0.763); 38 for prevalence estimation (sensitivity: 0.840, specificity: 0.703, PPV: 0.840, NPV: 0.703); and 42 or 43 for identifying clear-cut cases in research or resource-limited settings (sensitivity: 0.774-0.760, specificity: 0.742-0.761, PPV: 0.848-0.855, NPV: 0.639-0.631). The originally intended cutoffs of 31-33 yielded acceptable to excellent diagnostic utility parameters but were not identified as optimal for any specific purpose.Conclusion: This study highlights the variability in optimal PCL-5 cutoffs, linking selection to specific clinical or research aims. It provides validated cutoffs for PTSD prevalence in a German clinical sample, with limitations regarding generalizability to lower-prevalence populations. Future research should refine cutoffs for diverse populations and improve diagnostic precision.

Background: Even though evidence-based treatments are generally effective in reducing post-traumatic stress disorder (PTSD) in youth, many still experience elevated symptoms after treatment. A better understanding of how PTSD develops throughout treatment can increase efficiency and reduce residual symptoms.Objective: This study investigated which PTSD symptom clusters and symptoms within these clusters changed the most and least through trauma-focused cognitive behavioural therapy (TF-CBT), and identified common residual symptoms after treatment.Method: Latent growth curve modelling was used to identify differences in intercepts and slopes of symptoms, and residual symptoms were identified with McNemar tests in a sample of 517 youth (aged 6-19 years, 75.6% girls) receiving TF-CBT.Results: We found small but statistically significant differences in slopes across clusters. Avoidance both reduced the most and demonstrated most residual symptoms. Also, within clusters, many of the symptoms that reduced the most, such as psychological cue reactivity, persistent negative emotional state, and difficulties sleeping and concentrating, had the highest symptom levels before treatment and the most residual symptoms after treatment.Conclusions: Overall, symptoms of PTSD were reduced throughout TF-CBT. Symptoms rated highest at treatment start decreased the most but also tended to persist as common residual symptoms. Symptoms such as psychological cue reactivity, persistent negative emotional state, and negative beliefs that were common residual symptoms and are known to be central in the development and maintenance of PTSD are of particular clinical relevance. Research based on frequent symptom measurements during treatment could capture subtler changes, increasing understanding of the mechanisms of effective trauma treatment.

Background: Toxic stress contributes to socioeconomic and racial health disparities that persist across generations. Developing and implementing prenatal interventions that reduce toxic stress and associated comorbidities is warranted. Dialectical Behavior Therapy (DBT) Skills Training group interventions have demonstrated efficacy for depression and posttraumatic stress disorder (PTSD) and are scalable in diverse settings. Implementing DBT skills group interventions for African American pregnant women with adverse childhood experiences (ACEs) and current depression or PTSD symptoms is novel and has the potential to interrupt the intergenerational cycle of toxic stress by improving maternal mental health. Yet, much remains to be understood about barriers that may impact feasibility.Objective: This mixed-method pilot randomized controlled trial (RCT) examined barriers and attitudes toward mental health treatment, feasibility, and acceptability of an adapted 8-week DBT Skills Training group for mothers-to-be (DBTMTB) compared to waitlist control (WLC) for African American pregnant women with a history of expanded ACEs and current depression or PTSD symptoms (n = 30; n = 15 for DBTMTB, n = 15 for WLC).Methods: The study was delivered in a prenatal clinic of an urban public hospital or virtually. Pre-treatment quantitative and qualitative measures of treatment barriers and attitudes toward mental health treatment were obtained. Feasibility was measured through treatment and study retention rates. Acceptability was measured through qualitative responses on intervention acceptability.Results: We found a high level of barriers identified by women; stigma and time constraints were endorsed most often. Approximately half of women were receiving professional help and many reported stigma about asking others for help. Feasibility (treatment retention) was poor; only 26.7% (n = 4) of participants randomized to DBTMTB completed the intervention (≥6 sessions). Acceptability among treatment completers was high.Conclusions: Poor completion rates suggest challenges to feasibility and acceptability of DBTMTB in this population that must be addressed.

Objective: Children in conflict zones face repeated and cumulative trauma exposure, increasing their risk for post-traumatic stress disorder (PTSD). Despite the critical role of empathy in coping with trauma, research on how children's cognitive and affective empathy relates to their psychological adjustment remains limited. Adult studies suggest that cognitive empathy may support better coping, whereas affective empathy could increase vulnerability to PTSD symptoms. However, it remains unclear whether this differential pattern holds in children and how it interacts with levels of trauma exposure. This study investigated the moderating role of cognitive and affective empathy in the relationship between cumulative trauma exposure and PTSD symptoms in children.Method: Sixty-two children (Mean age = 9.64, SD = 1.15) from regions with varying proximity to conflict zones completed self-report questionnaires to evaluate cumulative trauma exposure, empathy, and anxiety, and were interviewed to assess PTSD symptoms.Results: While cognitive empathy moderated the relationship between cumulative trauma exposure and PTSD symptoms, it did not serve as a protective factor as hypothesised. Specifically, children with low cognitive empathy demonstrated a positive relationship between trauma exposure and PTSD symptom severity, whereas those with high cognitive empathy exhibited consistently high PTSD symptoms, regardless of exposure level. Affective empathy did not moderate this relationship but was positively associated with PTSD.Conclusions: High cognitive and affective empathy emerged as vulnerability factors for PTSD, potentially due to developmental challenges in its adaptive use during childhood. These findings question the traditional view of cognitive empathy as universally protective, highlighting the need to monitor its role throughout development.

Background: Yearning is a core symptom of prolonged grief disorder (PGD), typically manifesting as vivid counterfactual thoughts and bittersweet emotions. However, current self-report measures fail to capture the dynamic nature of yearning and are often compromised by social desirability bias. This highlights the critical need for accurate and objective tools to assess this complex emotional experience.Objective: This study aimed to develop and validate the Yearning Induction Task (YIT), an innovative experimental paradigm designed to induce yearning in bereaved individuals from China and Switzerland. We also sought to explore how cultural differences shape emotional and cognitive responses following experimentally induced yearning.Methods: A total of 231 bereaved participants (130 from China and 101 from Switzerland) were recruited. After completing baseline measures, participants were randomly assigned to either the yearning or control condition of the YIT. Momentary yearning and emotion responses were assessed both pre- and post-induction. Data were analysed using ANCOVA to examine cultural differences in the induction effect of the task.Results: The task demonstrated good interrater reliability across cultures but did not significantly alter momentary yearning levels. However, significant cultural differences emerged in emotional responses. Swiss participants predominantly showed increases in negative emotions, such as sadness, anger, and loneliness, following the yearning induction. In contrast, Chinese participants experienced a decrease in positive emotions, including happiness. In the control condition, Swiss participants reported declines in positive emotions (e.g. gratitude, love), while Chinese participants experienced an increase in happiness and a reduction in overall negative emotions.Conclusion: This study provided preliminary evidence for the reliability and validity of a novel task to induce yearning among Swiss and Chinese bereaved individuals. Cultural differences emerged in emotional responses to induced yearning, although construct validity was only partially supported. These findings highlight the importance of culturally sensitive assessment tools and interventions for yearning in PGD.

Background: Intensive treatment programmes (ITP) have emerged as a treatment option for Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) during the last decade. Results are promising, but further studies with control group are needed.Objective: To compare the effect of an 8-day ITP with traditionally spaced treatments for PTSD.Method: Participants with PTSD or CPTSD (n = 101) in a Swedish psychiatric outpatient clinic received either 8-day ITP, including prolonged exposure, eye movement desensitisation and reprocessing therapy, physical activity and psychoeducation, or traditionally spaced treatment (TAU). Participants were allocated by shared decision-making.Results: A significant reduction in PTSD symptoms was observed at posttreatment, with large effect sizes in both conditions. Symptom reduction was maintained at follow-up. There was no significant difference between treatment groups in degree of symptom reduction at posttreatment and follow-up. In the ITP, 73.3% did not meet criteria for PTSD at follow-up, and 74.4% in TAU. There was a significant difference in dropout rates between treatment groups: 4.3% in ITP and 24.1% in TAU.Conclusions: Results indicate that ITP can be considered an effective treatment in healthcare settings where multiple treatment options are available. Randomised control studies to isolate treatment effects and finding underlying factors explaining the difference in dropout rates are important directions for future research.

Background: Traumatic loss refers to the loss of a loved one in a context of potentially traumatizing circumstances and may give rise to psychopathology or complicated grief. Homicide is considered a traumatic loss as it occurs unexpectedly and under violent circumstances, particularly in the context of blood feuds, which are vendettas, prolonged series of violent attacks between two clans or families. The phenomenon of blood feuds is a tradition intended to defend and preserve the honour of the tribe. Consequently, men are the most vulnerable to blood feud-related homicides and the perpetrator of a blood feud-related murder converts all the members of his clan into the next potential targets of the opposing clan's vendetta. Despite the high rate of homicide in the Arab sector in Israel, little is known about the grief experience of Arab parents bereaved by homicide due to blood feuds.Objective: The study's goal was to gain an in-depth understanding of the grief experience of Muslim parents bereaved by blood feuds using Neimeyer's meaning reconstruction framework.Methods: Employing a qualitative narrative approach, in-depth interviews were held with 12 Arab parents bereaved by blood feuds. The data were analyzed using thematic and form analyses.Results: The analysis revealed three themes: fear (of the assassin and of the future consequences) and shame - both of which involved the process of silencing. The third theme involved a yearning for judgment day ('Qayama'). It appeared that silencing adds an additional emotional burden to bereaved Arab parents' grief.Conclusions: The findings are discussed in light of Neimeyer's meaning reconstruction framework. The study highlights the additional grief-related burden stemming from bereaved parents' traumatic loss circumstances, as well as from their sociocultural context. Hence, culturally sensitive inquiry is required. These insights can inform mental health professionals and policymakers working with bereaved families in conflict-affected communities.