European Journal of Psychotraumatology最新文献

Background: Children and adolescents who experience traumatic events can develop post-traumatic stress disorder (PTSD) and depression. Alterations in autobiographical memory quality have been identified in each of these disorders. However, the complex interplay between PTSD and depressive symptoms and their relationship with traumatic memory characteristics remains unclear. Trauma memory characteristics, including vividness, coherence, and sensory encoding, are central to cognitive models of PTSD, but their role in depression and cross-diagnostic symptom networks remains underexplored.Methods: We combined ten studies of trauma-exposed children and adolescents (ages 6-18) across diverse cultural contexts, resulting in a final dataset of 1,401 participants (6-18 years) from low - and high-income countries. PTSD symptoms, depressive symptoms, and trauma memory characteristics were harmonised across studies and examined using a regularised partial correlation network (EBICglasso) with Spearman correlations. Centrality analysis identified key symptoms and memory features, while community detection (EGA) assessed whether PTSD, depression, and memory formed distinct constructs. Finally, permutation and bootstrap tests evaluated whether memory characteristics were differentially linked to PTSD symptom clusters.Results: The estimated network demonstrated satisfactory stability. Physiological reactivity to trauma reminders, flashbacks, and difficulty concentrating emerged as central nodes in the network. Memory features were only linked to PTSD symptoms, not depression symptoms. PTSD symptoms, depressive symptoms, and memory features formed distinct clusters, although some cross-cluster connections were observed. Finally, trauma memory features were not more strongly associated with any PTSD symptom subcluster compared to the others.Conclusions: Trauma memory qualities appeared as a distinctly separate construct from psychopathology and may not be a strong mechanism underlying comorbidity between PTSD and depression. In children and adolescents experiencing PTSD and depressive symptoms following trauma, physiological reactivity to trauma reminders, flashbacks, and difficulties concentrating could be valuable targets for clinical intervention.

Background: Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD), which are moderately heritable, frequently co-occur and contribute to significant public health burdens, particularly among economically disadvantaged urban communities. There are noted sex differences in PTSD and AUD outcomes, with evidence suggesting women have heightened susceptibility to stress-related alcohol use. Preliminary PTSD-AUD ecological momentary assessment (EMA) findings support bidirectional associations across clinical outcomes. However, no studies to date have used PTSD-AUD comorbidity models as organizing frameworks to examine the temporal ordering and stability of within-person symptom dynamics underlying the maintenance or exacerbation of PTSD and AUD symptoms, including bidirectional and shared-liability processes. Moreover, this type of work has not been conducted in high-risk, socioeconomically disadvantaged Black individuals from urban communities or within a genetically informed framework that facilitates adjustment for shared genetic liability.Method: The current study will recruit 464 self-identified Black adults who report a history of at least one traumatic event, current PTSD symptoms, and a recent binge or hazardous drinking from a larger trauma-exposed urban cohort. Through intensive, repeated EMA over six months, this study will use established PTSD-AUD comorbidity models as organizing frameworks to characterize sex-specific, within-person symptom dynamics. We will examine the temporal stability of these dynamics and explore how social drivers of health and unique and shared genetic risk for PTSD and AUD are associated with the maintenance and exacerbation of comorbid symptomatology over time.Discussion: Study findings will provide valuable insight to guide targeted prevention and clinical treatment outcomes.

Background: Prolonged grief disorder (PGD) is included in the Diagnostic and Statistical Manual of Mental Disorders text-revised fifth edition (DSM-5-TR) and in the International Classification of Diseases Eleventh Edition (ICD-11). While PGD screening instruments exist for adults, these instruments are not applicable to children. Caretakers play a crucial role in screening for PGD in children.

Objective: We evaluated the psychometric properties of the Traumatic Grief Inventory-Kids-Caregiver-Report (TGI-K-CR) to screen for DSM-5-TR and ICD-11 PGD in children.

Method: On a website with information about grief, 196 Dutch caregivers (82% woman; Mage = 44) completed questions about their own and their child's (47% girls; Mage = 11; 44% lost a parent) background and loss-related characteristics (77% of deaths resulted from illness). Caregivers completed the TGI-K-CR and a self-report measure about their own PGD intensity. Factor structure and internal consistency of DSM-5-TR and ICD-11 PGD items were examined separately. T-tests and correlation analyses examined whether caregiver-ratings of PGD intensity in children differed as a function of background- and loss-related characteristics. Provisional cut-offs for both criteria sets were determined.

Results: Confirmatory factor analyses showed support for two distinct, but related, factors for DSM-5-TR and ICD-11 PGD items. We found strong internal consistency (ω = .85 for DSM-5-TR; ω = .87 for ICD-11), while some factor loadings were poor. In support of known-groups validity, DSM-5-TR and ICD-11 PGD intensity were higher in children when caregivers reported higher PGD intensity for themselves and when deaths occurred more recently. ROC analyses showed optimal cut-off scores of ≥46 and ≥52 to determine probable caseness for DSM-5-TR and ICD-11 PGD, respectively, when summing all 16 items.

Conclusions: The psychometric properties of the TGI-K-CR seem promising, but more research among larger samples is needed. This caregiver screening tool for PGD in children (aged 8-18) may advance child bereavement research and care.

Background: People compare their current well-being to different comparison standards (e.g. social or temporal comparisons). These standards are considered as aversive if perceived as threatening to self-motives or appetitive if perceived as consistent with self-motives. However, it remains unknown whether the congruence (vs. incongruence) of aversive and appetitive well-being comparisons (high levels of both vs. preponderance of aversive comparisons over appetitive comparisons) is differentially related to symptoms of depression and post-traumatic stress disorder (PTSD) and self-esteem.Methods: We conducted response surface analysis (RSA) on data from a study with two-timepoints three months apart (N = 921). RSA tests whether the degree of (in-)congruence of two variables is positively or negatively related to an outcome variable. Here, baseline aversive and appetitive well-being comparisons (comparison frequency, discrepancy, and affective impact) served as the two predictor variables, while depression, PTSD, and self-esteem three months later served as outcomes.Results: Findings partially confirmed our hypotheses. Congruently high (vs. low) levels of aversive and appetitive comparison frequency and discrepancy predicted more depressive/PTSD symptoms and lower self-esteem. Some evidence indicated more pronounced depressive symptoms and lower self-esteem (but not PTSD) for the preponderance of aversive over appetitive comparisons.Conclusions: The effects of congruent and incongruent aversive and appetitive comparisons as well as a potentially more crucial role of aversive than appetitive well-being comparisons in depression and self-esteem align with comparison theory.

ABSTRACTBackground: European health care workers recently experienced serious challenges to their mental health. Following the extremely stressful experience of the COVID-19 pandemic, the war in Ukraine caused a humanitarian influx of refugees in need of social and healthcare. We aimed to explore: (1) how working with refugees has affected the mental well-being of health care workers in the context of the COVID-19 pandemic, and (2) the nature of health care workers' emotional strain related to the refugee situation and the war in Ukraine.Methods: We used a combination of quantitative regression analyses and qualitative content analysis to assess data collected by an online questionnaire in 2022. The study included 1121 health care workers from the Czech arm of the international HEROES Study.Results: Quantitative findings did not indicate that working with Ukrainian refugees was reliably associated with a greater occurrence of symptoms of depression, anxiety, distress, or burnout. Qualitative analysis revealed five categories of emotional strain: impacts on working conditions, emotional reactions to refugees and the war, comparisons with the COVID-19 pandemic, and coping strategies.Conclusions: This study highlights the resilience of health care workers but also points to the need for ongoing support to address the complex emotional challenges they face during health crises.

Background: Dissociative symptoms are suggested to compete with the effectiveness of psychotherapeutic treatment and frequently co-occur with early life trauma and self-harm patterns, including self-injury, suicidal ideation, and suicide attempts, which are characteristic for borderline personality disorder (BPD).Objective: We explore the connections between dissociation and other BPD features like self-harm and childhood traumatization and examine the impact of trait dissociation on both immediate and follow-up psychotherapy outcomes.Method: In this naturalistic prospective evaluation study, we investigated psychopathology including general psychological distress (SCL-90), depression (BDI-II), and borderline-specific pathology (BSL) in 131 patients with BPD pre and post of a certified 8-week inpatient Dialectical Behaviour Therapy (DBT), as well as 3- and 6-month post inpatient treatment. Prior to therapy, we evaluated trait dissociation (Dissociative Experience Scale), early life trauma (Childhood Trauma Questionnaire), and self-harm patterns (clinical interview). We performed a network analysis to explore the interplay between dissociation, self-harm, and childhood traumatization. To analyse the influence of dissociation on treatment outcomes, we employed linear mixed models.Results: Psychopathology (SCL-90, BDI-II and BSL) exhibited significant reductions at post-treatment and follow-up assessments when compared to baseline measurements. Higher levels of trait dissociation were consistently related to higher psychopathology but did not suggest poorer symptom reduction during DBT. However, trait dissociation predicted reduced 6-month follow-up benefits from DBT, regardless of the baseline symptom burden. The network analysis revealed a close association between self-injury and derealization/depersonalization, while the frequency of suicide attempts was more closely connected to childhood emotional abuse, which was identified as a central node of the network.Conclusions: Dissociation was not related to poorer outcomes regarding inpatient DBT. However, trait dissociation predicted reduced follow-up benefits, highlighting the need to address dissociation during psychotherapeutic interventions. Based on the estimated network structure, treating dissociative symptoms could potentially mitigate self-injury while especially childhood emotional abuse was linked with suicide attempts.

Background: Studies have shown that media exposure to critical public events can lead to secondary traumatic stress (STS). Personal trauma history, self-compassion and resilience are important factors influencing STS in healthy professionals. However, whether these variables are associated with social media-induced STS in college students and the underlying mechanisms remain unclear. The purpose of this study was to explore the complex relationship linking childhood trauma to social media-induced STS in a large sample of college students.Methods: A total of 1151 Chinese college students from Chengdu, Sichuan Province of China completed a web-based cross-sectional survey, which included standard assessments of childhood trauma, self-compassion, resilience and social media-induced STS, as well as sociodemographic questionnaires. The chain mediation model was tested using the PROCESS macro programme in SPSS software.Results: There was a moderate correlation between childhood trauma and social media-induced STS (r = 0.34, p < .001). This association was significantly mediated by self-compassion (indirect effect [95% CI] = 0.14[0.11, 0.17]) and resilience (indirect effect = 0.03[0.01, 0.04]), respectively. Further, a chained mediating effect was observed with self-compassion and resilience consecutively mediated the relationship between childhood trauma and social media-induced STS (indirect effect = 0.02[0.01, 0.03]). These results persisted after sociodemographic characteristics were included as controlling variables.Conclusions: Early life trauma impacts STS induced by exposure to traumatic materials on social media through self-compassion and resilience among Chinese college students. Psychological interventions targeting self-compassion and resilience can be implemented to reduce the risk of STS, especially in vulnerable individuals.

Background: Parental post-traumatic stress disorder (PTSD) can impact parenting and child psychosocial wellbeing. Complementing trauma-focused psychotherapy with parenting interventions can thus have important preventive value. Understanding parents' lived experiences is necessary to tailor such interventions to their needs.Objective: This study addressed the question: how can preventive parenting support be shaped to the needs of parents entering specialized psychotherapy for PTSD? To answer this question, we investigated parenting challenges, parent-child communication about PTSD, strengths, and social support experiences of parents with PTSD.Method: The sample included 14 parents seeking PTSD treatment at a tertiary mental healthcare institution, while parenting children aged 4-17. Data were collected using semi-structured interviews and analysed using reflexive thematic analysis.Results: On the one hand, parental dysregulation (e.g. exploding or shutting down) was an important challenge. On the other hand, parents' attempts to remain regulated (e.g. through overcontrol and overprotectiveness) also affected family life. When talking to their child about PTSD, parents were guided by what they considered beneficial for the child to know. An important strength was that parents tried to remain attuned to the child's needs, regardless of their own struggles. Parents also described experiences that could be understood as post-traumatic growth through parenting. Generally, parents experienced a lack of social support.Conclusion: Our findings illustrate that parents entering PTSD treatment are highly motivated to do what is best for their child. Based on parents' lived experiences, preventive parenting interventions should address the impacts of both dysregulation and overcontrolling regulation attempts. Another important goal is reducing feelings of incompetence. Integrating the parenting role in psychotherapy for PTSD could also be beneficial. For example, setting parenting-related therapy goals can be motivating. Furthermore, parent-child interactions can be a mirror that reflects the parents' inner state: considering these interactions can help recognize changes in symptomatology.

Background: The ongoing conflict in Ukraine has led to a rise in stress-related symptoms, including anxiety and depression, among veterans, necessitating accessible and effective mental health interventions. Traditional rehabilitation resources are often limited, prompting exploration into alternative therapies.Objective: This paper aims to assess the effectiveness of immersive 360° video-based Virtual Reality (VR) therapy as an enhancement to standard rehabilitation programmes for Ukrainian veterans experiencing anxiety and depression.Method: A randomised controlled trial (RCT) was conducted with 69 participants, who were randomly assigned to either the experimental group (n = 34), receiving daily VR sessions alongside standard rehabilitation, or the control group (n = 35), following standard rehabilitation alone. Anxiety and depression were assessed using the Hospital Anxiety and Depression Scale (HADS) both at baseline and post-intervention. Additionally, momentary changes in anxiety and mood were measured immediately before and after each VR session to evaluate the immediate effects. The VR intervention was designed with veteran and expert feedback to enhance emotional regulation and stress resilience, integrating evidence-based psychotherapeutic techniques.Results: Results demonstrate significant rapid improvement in mood and reduction in anxiety following each session, along with significant reductions in anxiety (up to 14.5%) and depression (up to 12.3%) upon programme completion. Consistent results across all study iterations confirmed the reliability and scalability of 360-VR therapy as a short-term rehabilitation tool.Conclusions: Immersive VR therapy presents an effective, accessible solution for managing the psychological impact of war, particularly within the limitations of Ukraine's healthcare system.

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.