European Journal of Psychotraumatology最新文献

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.

Background: Peritraumatic dissociation is thought to contribute to posttraumatic symptoms like intrusions and memory disturbances. However, trauma-analogue studies that examined effects of experimental dissociation-induction on intrusions and memory were inconclusive. To better understand this, a necessary first step is to more systematically compare various induction methods.Objective: We evaluate different dissociation-induction-methods regarding their effectiveness, the intensity and quality of induced dissociation, and their effects on intrusions and memory in a pre-registered randomised-controlled online experiment.Method: Healthy participants (N = 213) were randomised to one of six dissociation-induction-methods: audio-photic stimulation, hypnotic-suggestion, or spiral-staring, each for one-minute or three-minute duration. Participants also completed two further conditions: a non-dissociation-inducing picture task (control condition) and the comparison dissociation-induction-method dot-staring (benchmark condition). Each condition was followed by an aversive ('trauma') film. Peri-film dissociation intensity (measured using an adapted version of the Peritraumatic Dissociative Experiences Questionnaire) and quality, as well as film-specific intrusion-load and memory performance, were assessed. Dissociation-induction-methods were deemed successful if they elicited dissociation levels higher than the control condition and at least as high as the benchmark condition. Only successful dissociation-induction-methods were examined further.Results: Three minutes of hypnotic-suggestion and one minute of spiral-staring successfully induced dissociation during the film, while other methods did not meet the effectiveness threshold. Hypnotic-suggestion led to a greater increase in dissociation intensity than spiral-staring, dissociation induced by spiral-staring was perceived as more uncontrollable and unpleasant. Results did not support an adverse effect of dissociation-induction or dissociation intensity on intrusion-load, but they did support an adverse effect on self-reported and objectively assessed memory performance.Conclusions: Results indicate that hypnotic-suggestion and spiral-staring constitute effective, easy-to-implement, and in principle, neuroimaging-compatible dissociation-induction-methods that allow studying dissociation in the laboratory. The present data did not support the notion that dissociation fosters intrusion formation but provides causal support for effects of dissociation on trauma memory.

Background: The mental health impact of the COVID-19 pandemic is well documented. However, only a few studies investigated mental health in later phases of the pandemic and after its official end. Moreover, little is known about people's psychological burden related to the pandemic and other global crises post-pandemic.Objective: Study's first objective was to compare mental health outcomes in the general population over the course of the pandemic and ten months post-pandemic. The second objective was to explore people's psychological burden regarding the pandemic, in comparison to current wars, climate crises, inflation, and poor government management and/or corruption in the post-pandemic era.Method: Participants from the general population of Austria, Croatia, Germany, Greece, and Portugal (68.8% female, M_age = 41.55) were assessed online up to four times between June 2020 and March 2024 (baseline sample: N = 7913). Adjustment Disorder New Module - 8 (ADNM-8), Patient Health Questionnaire (PHQ-2), and World Health Organization-Five Well-Being Index (WHO-5) were used to measure adjustment disorder, depression, and well-being. Prevalence rates were calculated and repeated measures ANOVAs applied to assess mental health at four time points. One-way repeated measures ANOVA was run to explore how the different global crises were related to participants' burden.Results: Temporal variations in mental health were evident across four assessment waves, with highest levels of probable adjustment disorder and depression in winter 2020/2021 (T2). A slight improvement of mental health was found at later time points. Current wars and inflation were the greatest sources of psychological burden at the post-pandemic assessment, revealing some cross-country differences.Conclusion: Although mental health differences in the general population were not as pronounced as in the acute phase of the pandemic, psychosocial support is still needed post-pandemic. This is likely to be due to other global crises that take a toll on people's mental health.

Background: The International Trauma Questionnaire (ITQ) is a validated measure supporting the diagnosis of ICD-11 post-traumatic stress disorder (PTSD) and complex PTSD (cPTSD). It has been translated into 35 languages, also into Polish. Due to the lack of information in the literature about its validation, new Polish version has been re-adapted and validated in the Polish non-clinical and clinical samples of the present study.Objective: The study aimed (1) to adapt the ITQ for use in Polish, (2) to assess the construct validity of ICD-11 PTSD and cPTSD in the Polish ITQ, and (3) to examine the convergent and discriminant validity of the Polish ITQ.Method: The study sample comprised of 452 adults: a non-clinical sample, N = 314, (completed the online version of the questionnaire) and a clinical sample, N = 138, (used a pen-and-paper version). Confirmatory Factor Analysis (CFA) and Latent Class Analysis (LCA) were performed to assess the structure of the ITQ.Results: The CFA supported a two-factor second-order model as the best fit to the data. All factor loadings were statistically significant and reached a satisfactory level. Cronbach's alpha for ITQ (α = 0.887), PTSD (α = 0.810) and DSO (α = 0.875) were good. The LPA revealed four classes: (1) a cPTSD class with elevated PTSD and DSO symptoms; (2) a PTSD class with elevated PTSD symptoms but low scores on the DSO; (3) a DSO class with elevated DSO symptoms but low scores on the PTSD; and (4) a low symptom class with low scores on all symptoms.Conclusion: The amended Polish ITQ has good internal consistency and psychometric properties. The model is well fitted to differentiating PTSD/cPTSD diagnoses according to ICD-11 and is a reliable measure of support for the making of a PTSD/cPTSD diagnosis in the conduct of clinical interview.

Background: Immigrant and refugee adolescents often face traumatic experiences and are vulnerable to mental health problems, such as post-traumatic stress disorder (PTSD), anxiety and depression. Yet, they also show remarkable resilience in the face of these stressors. Research is still scarce on how both mental health problems and resilience dynamically interplay in immigrant and refugee adolescents' development.Objective: We aimed to identify latent profiles of immigrant and refugee adolescents' wellbeing, consisting of externalizing and internalizing symptoms, PTSD (intrusion and avoidance), and resilience, and analyse the demographic and contextual determinants of these profiles.Method: We employed cross-sectional survey data from the RefugeesWellSchool project for 1607 immigrant and refugee adolescents (mean age 15.3 years, SD 2.15, 42.3% girls) from six European countries: Belgium, Denmark, Finland, Norway, Sweden, and the United Kingdom. Latent profile analysis and three-step procedure with BCH weights were used to identify the wellbeing profiles and their determinants.Results: Results identified four adolescent wellbeing profiles: (1) Low symptoms (49.7%, n = 791); (2) High symptoms with intrusion (10.6%, n = 169); (3) Moderate symptoms (26.9%, n = 428); and (4) Resilient avoidant (12.8%, n = 203). Older participants, those with refugee background, shorter residence in the host country, more experiences of daily stressors or discrimination, or low family support were less likely to belong to the Low symptoms or Resilient avoidant groups (p ≤ .001).Conclusions: The profiles reflected distinct differentiation of intrusive and avoidance dimensions of the PTSD-symptoms. Intrusion clustered with high level of other mental health problems, whereas avoidance co-occurred with high resilience. Experiences related to immigration, stressors, and family support were crucial determinants of the wellbeing profile membership. Future interventions should utilize information obtained by person-centered studies to create better targeted and tailored support for immigrant and refugee adolescents.

Background: Posttraumatic stress disorder (PTSD) and chronic pain are devastating conditions that often co-occur. Current understanding of comorbid PTSD and chronic pain is limited, and treatment options are undereffective.Objective: This paper presents a theoretical basis for conceptualising chronic pain symptoms within Emotional Processing Theory (EPT), the foundation for Prolonged Exposure (PE), an effective treatment for PTSD. EPT conceptualises the development and treatment of PTSD using a trauma structure that strongly overlaps with pain's neurobiology.Method: This paper proposes a model of shared aetiology and treatment of comorbid PTSD and chronic pain, emphasising these shared neurobiological underpinnings. Discussion details how the comorbidity is maintained through parallel avoidance processes focused on: (1) trauma memories and reminders in PTSD preventing reduction of negative affect (extinction) and inhibitory learning, and (2) physical pain in chronic pain fuelling increased pain and reduced function.Results: A conceptualisation is presented on how PTSD and chronic pain symptomology can be addressed within the EPT framework, increasing the confidence of providers and patients while addressing an important gap in the literature. Finally, recommendations for providers using PE with patients with PTSD and pain are provided including a case example and treatment plan based on real patients.Conclusions: This model provides a clinically useful understanding of the underlying neurobiology for the co-occurrence of PTSD and chronic pain and offers direction for future research.

Background: Post-traumatic stress disorder (PTSD) is a complex condition linked to inflammation. The causality between inflammatory cytokines and PTSD risk remains unclear.Methods: We conducted a bidirectional two-sample Mendelian randomization (MR) study using genome-wide association study (GWAS) data from 41 inflammatory cytokines and PTSD. Additional analyses included differential gene expression, protein-protein interaction, and functional enrichment to explore underlying mechanisms.Results: MR analysis indicated that higher levels of stem cell factor (SCF) and interleukin-4 (IL-4) are associated with a reduced risk of PTSD. Genes POGZ and LRIG2 were identified as mediators, implicated in the TGF-beta signalling pathway.Conclusion: Our findings suggest a protective role of certain cytokines against PTSD and highlight potential molecular mediators. This knowledge could inform future therapeutic strategies for PTSD.