European Journal of Psychotraumatology最新文献

Trauma is a global issue and public health concern. Political decisions may directly impact rates of trauma exposure, be it individual trauma or mass disaster, and guide how we deal with the consequences of trauma. In this editorial, we warn that the current U.S. administration's decisions are impacting exposure to and consequences of trauma worldwide as well as disrupting the field of traumatic stress in research and practice.

Background: If the patient does not speak the national language, access to the healthcare system is usually only possible via an interpreter. The need for evaluated training for interpreters working in this field is emphasized in the literature, particularly in the context of psychotherapeutic treatment. This study evaluates a TF-CBT-specific training course for interpreters over a period of one year.Methods: The TF-CBT-specific training was conducted in the form of webinars via the online communication provider Zoom in 10 sessions with 10-15 participants each. The content of the training included the topics of trauma and PTSD, how to establish a constructive working relationship with the therapist, and the modules of TF-CBT with an explanation of the therapeutic principles. In a previous study knowledge gain and a change of an attitude that is more conductive to good cooperation was archived by the workshop in prä-post-tests. In this study the training was evaluated at the 6-month and 12-month follow-up using hierarchical linear regression.Results: Results show that attitude change remained stable over the one-year period. Knowledge and psychotherapy support were statistically significant predictors. Knowledge gained during training decreased over time. Attitude and psychotherapy support were identified as statistically significant predictors.Discussion: The evaluated training for interpreters, who were willing to interpret in a TF-CBT for children and adolescents, showed a stable improvement in attitudes regarding good cooperation with the therapist. Knowledge about PTSD and TF-CBT, did not remain stable over the period of one year after the training. In other comparable training courses, this could be compensated for by consolidation in supervision meetings.

Background: While many studies link psychological abuse and neglect to mental health issues in adolescents, they often overlook the internal heterogeneity of these factors. This study aims to explore the characteristics of psychological abuse and neglect among adolescents in Western China and examine their relationship with depression and anxiety, providing insights for targeted interventions.Methods: A survey was conducted on 18,350 students in Western China using the Child Psychological Abuse and Neglect Scale (CPANS), the Patient Health Questionnaire Depression Scale (PHQ-9), and the Generalized Anxiety Disorder Scale (GAD-7). Latent profile analysis was used to classify the characteristics of adolescent psychological abuse and neglect. Chi-square tests and variance analysis were employed to explore demographic differences among different characteristic groups. Additionally, the BCH method was used to compare whether differences in depression and anxiety existed across each profile.Results: Latent profile analysis revealed three categories for psychological abuse ('no abuse,' 'at risk,' 'abuse') and neglect ('no neglect,' 'at risk,' 'neglect'). Older adolescents, females, those experiencing parental absence, and those from broken homes were more likely to be in the 'abuse'/'neglect' categories. Adolescents in these groups had higher levels of depression and anxiety compared to those in the 'at risk' groups. Additionally, those in the 'at risk' groups exhibited higher levels of depression and anxiety than those in the 'no abuse'/'no neglect' categories.Conclusion: The characteristics of psychological abuse and neglect can predict depression and anxiety levels. These findings highlight the value of latent profile analysis in understanding the complex relationship between psychological abuse, neglect, and mental health issues in adolescents.

Background and objectives: In the last decade, Europe has witnessed a substantial increase in asylum applications, resulting in a growing backlog of cases. The prolonged wait has been associated with elevated risks of mental disorders, diminished psychological well-being, and reduced quality of life. Existing systematic reviews focus on multiple post-migration factors; however, delay was identified as a key contributor to poor mental health and decreased emotional wellbeing. Our review focuses on this factor and builds on existing literature.Methods: We conducted a systematic review and narrative synthesis focusing on the impact of extended waiting periods on the mental health of asylum seekers. Searches were conducted on MEDLINE and PsycINFO, resulting in a total of sixteen studies. These studies were qualitative, quantitative, and mixed methods designs, all focusing on the duration of the asylum process and its effects on mental well-being. The overall quality of these studies ranged from adequate to low.Results: Several adverse mental health outcomes associated with prolonged asylum waiting times were identified, including an increased risk of depression, anxiety, and post-traumatic stress disorder, and worsening of pre-existing mental illnesses. The extended wait exacerbated suicidal ideation due to frustration stemming from an inability to engage in meaningful activities, social isolation, and perceived discrimination from others. The ambiguity surrounding asylum procedures, caseworker reluctance to provide updates or clear timelines, and prolonged family separation also negatively impacted asylum seekers' mental health.Conclusion: These findings highlight the importance of reforming current asylum procedures to create a more humane and efficient process that protects the mental health of asylum seekers.

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.