Journal of traumatic stress最新文献

Exposure to traumatic events is associated with biases in the perception of emotional facial expressions. By bridging research on trauma exposure and emotion recognition, the present study investigated the impact of war-related trauma on the recognition of facial expressions of emotions in a sample of war trauma–exposed refugees (N = 108) from West Asian countries. Through a forced-choice facial emotion recognition experiment, we assessed how trauma exposure and face gender influenced accuracy and biases in identifying six primary emotions. Participants judged facial expressions of anger, sadness, fear, disgust, surprise, and happiness displayed by a set of 240 faces corresponding to 20 female and 20 male models from the Karolinska Directed Emotional Faces dataset. Expressions consisted of short videos showing each face's transition from neutral to full emotion. The results showed impaired recognition of negative emotions, with fear being the least accurately recognized emotion, suggesting the avoidance of negative affective states as a coping mechanism putatively associated with war-related trauma. For main effects, partial eta-squared effect sizes ranged from .159 to .573, and effect sizes for interaction effects ranged from .027 to .189, with most effects being in the medium-to-large range. Furthermore, the biases in emotion recognition observed in the present study may reflect gender stereotypes and social norms that shape how individuals perceive and interpret emotional expression in men and women.

Treating posttraumatic stress disorder (PTSD) in military-affiliated populations, including veterans, active duty service members, and their families, remains a significant challenge in the mental health field. Most research on PTSD treatment outcomes has been conducted in controlled trials or within VA and military settings, limiting its generalizability to other clinical environments. This study examined treatment outcomes for 2,717 military-affiliated clients receiving treatment for PTSD within a community mental health network. Treatments included cognitive processing therapy (CPT), eye movement desensitization and reprocessing (EMDR), or prolonged exposure (PE), with outcomes measured using the PTSD Checklist for DSM-5 (PCL-5) throughout treatment. Clients who attended at least four sessions showed substantial symptom reductions for CPT (ΔM = 19.3), d = 0.98; EMDR (ΔM = 16.6), d = 0.86; and PE (ΔM = 17.4), d = 0.87, all of which exceeded improvements seen with other treatments (ΔM = 12.6), d = 0.71. Analyses of clinically meaningful change thresholds showed similar results across treatments, with 51.9% of CPT, 47.8% of EMDR, and 53.1% of PE clients experiencing a PCL-5 score reduction of at least 18 points after four or more sessions. Dropout prior to four sessions was notable, with 27.5%–40.1% of clients across treatment groups discontinuing treatment before reaching this threshold. Overall, the findings provide real-world evidence supporting the effectiveness of CPT, EMDR, and PE in military-affiliated populations and validate their continued use in community mental health settings.

Sexual assault on college campuses remains a pervasive issue, with students who consume alcohol at heightened risk for more frequent and severe victimization. A history of childhood trauma and specific drinking motives may increase this vulnerability, yet little research has examined how these factors interact to inform the impact of sexual assault frequency and severity during college. In this study, we used Bayesian multiple regression and random forest modeling to analyze the impact of childhood trauma and drinking motives on sexual assault among college students (N = 624). Bayesian regression analysis showed that risky alcohol consumption was the strongest predictor of sexual assault, B = 12.22, 95% CI [3.63, 5.35]. Other credible predictors included childhood sexual abuse, B = 4.87, 95% CI [1.27, 8.41]; childhood physical abuse, B = 8.78, 95% CI [4.43, 13.18]; childhood physical neglect, B = 7.28, 95% CI [2.34, 12.34]; and conformity drinking motives, B = 9.19, 95% CI [5.40, 13.02]. The random forest model achieved an R² value of .68 and identified risky alcohol consumption as the most important predictor, followed by childhood sexual abuse, childhood physical abuse, and conformity motives. These findings were consistent across both analytic approaches. By integrating hypothesis-driven Bayesian modeling with prediction-oriented machine learning, this study provides a nuanced understanding of how risky alcohol consumption, childhood trauma, and drinking motives shape the severity and frequency of sexual assault victimization in college. Results underscore the need for trauma-informed and substance use–focused prevention strategies to reduce the impact of campus sexual assault.

Findable, Accessible, Interoperable, and Reusable (FAIR) data advances are becoming more common and more important across research fields given the large amount of research data in need of synthesis and application. Many novel methods improve the efficiency and accuracy of data reuse, combination, and synthesis, which is necessary given that there are over 500 published randomized controlled trials of posttraumatic stress disorder treatments in adults; however, these methods are still relatively new to the field of traumatic stress research. We provide a brief overview of relevant FAIR data efforts from other fields and within trauma health care and research; share examples of trauma-related FAIR data efforts to demonstrate recent advances and challenges; and suggest potential next steps to continue making trauma data more FAIR. These topics were originally presented as part of an International Society for Traumatic Stress Studies (ISTSS) Pre-Meeting Institute organized by the Global Collaboration on Traumatic Stress FAIR Data Workgroup and conducted in conjunction with the 2024 ISTSS 40th Annual Meeting in Boston (MA, USA), titled, “How to Find, Re-use, and Share Data for Broader Impact: Practical Tools and Tips for FAIR Data.” Our discussion underscores the need for ongoing research and collaboration in trauma data science to enhance the effectiveness of interventions for individuals facing the challenges of traumatic stress and its comorbidities. Advancing FAIR data methods can serve as the groundwork for more efficient, accurate, and evidence-based health care for the field of traumatic stress research, advancing precision medicine and learning health systems approaches to care.

This retrospective cohort study evaluated the effectiveness of prolonged exposure therapy (PE) across trauma types (combat, terror, civilian) and veteran status (military veterans vs. civilians) in a real-world clinical setting. We hypothesized that individuals who experienced combat- and terror-related trauma would have higher baseline posttraumatic stress disorder (PTSD) symptom scores than those who experienced civilian trauma but that PE would result in comparable symptom reductions across all groups. Participants were 98 patients with chronic PTSD who were treated at two community mental health centers in Israel by clinicians trained and supervised in PE. Participants were categorized by trauma type combat: n = 34, terror: n = 25, civilian: n = 39) and veteran status (military veteran: n = 43, civilian: n = 55). PTSD symptoms were assessed using the PTSD Symptom Scale-Interview Version (PSS-I). Participants showed significant symptom reductions across all trauma types and veteran statuses. No interaction effects were detected for trauma type or veteran status. Effect sizes were large across all groups, ds = 2.20-2.28. The findings support the hypothesis that PE is effective in reducing PTSD symptoms regardless of trauma type or veteran status. These results are particularly significant given that modern conflicts often occur in civilian-populated areas rather than traditional battlefields, making the findings relevant to various regions worldwide, including Israel, Ukraine, and Gaza.

The use of defective concrete in the construction of buildings in Ireland has led to widespread property deterioration, displacement, financial loss, and psychological distress for thousands of families. No research to date has examined mental health outcomes or associated risk factors among affected individuals. This study aimed to generate estimates of probable major depressive disorder (MDD), probable generalized anxiety disorder (GAD), probable posttraumatic stress disorder (PTSD), probable complex PTSD (CPTSD), and suicidal ideation in a sample of this population and to identify crisis-related stressors associated with outcomes, while adjusting for trauma history, sociodemographic characteristics, and social support. A convenience sample of 393 adults completed a self-report survey between March and September 2024. Estimates were 30.4% for MDD, 26.2% for GAD, 4.9% for PTSD, and 15.5% for CPTSD. Suicidal ideation, experienced after a property was suspected to have defective concrete, was present in 35.5% of the sample. Safety fears were associated with CPTSD, MDD, and suicidal ideation, odds ratios (ORs) = 2.09–4.39, whereas GAD was associated with relocating, OR = 2.25. These findings highlight the substantial psychological impact of the crisis and identify specific stressors associated with increased risk for adverse outcomes.

On February 3, 2023, a Norfolk Southern train derailed in East Palestine, Ohio, releasing toxic compounds into the surrounding air, water, and soil. Technological chemical disasters represent potentially traumatic events capable of influencing mental disorders, such as posttraumatic stress disorder (PTSD) and major depression (MD). This study reports the first comprehensive investigation of the prevalence and correlates of mental disorders among potentially exposed residents of Ohio, Pennsylvania, and West Virginia 9 months postderailment. In this cross-sectional study, a nonprobability sample of 1,000 adults living within 65 miles of the derailment site completed a self-administered clinical survey interview assessing PTSD and MD, physical health symptoms, negative derailment-related beliefs and experiences, and preexisting psychiatric risk factors. Analyses were demographically weighted to yield estimates representative of the 65 mile–radius population. Most respondents were concerned about potential toxic exposure (73.9%) and associated health problems (92.1%), and half did not fully trust the information public health officials provided about the event (52.1%); half (49.7%) also reported at least one new or worsening physical health symptom since the derailment. Presumptive PTSD (15.4%) and MD (13.3%) were prevalent 9 months postderailment. Closer proximity to the derailment site was associated with greater endorsement of health concerns and symptoms, ds = 0.21–0.22, but not with greater mental disorder, OR = 1.02. Chemical disasters could have psychological consequences even without documented exposures, potentially due to uncertainty regarding exposure and associated health effects. The East Palestine community may benefit from increased attention to mental health services as a component of disaster response.

In many parts of the globe, regional professional societies have developed local traumatic stress organizations and have become affiliate societies of the International Society for Traumatic Stress Studies (ISTSS). At the ISTSS 40th Annual Meeting in September 2024, delegates from the ISTSS and five ISTSS-affiliate societies—Asociación Chilena de Estrés Traumático (ACET), the Australasian Society for Traumatic Stress Studies (ASTSS), Deutschsprachige Gesellschaft für Psychotraumatologie (DeGPT), the Japanese Society for Traumatic Stress Studies (JSTSS), and the Korean Society for Traumatic Stress Studies (KSTSS)—gathered for a panel discussion entitled “Roles, Challenges, and Possibilities of ISTSS Affiliated Organizations Around the World: A Panel Discussion.” Each panelist shared insights into their organization's structure, goals, ongoing projects, and challenges in addressing traumatic stress in their regions. These societies shared a collective need for progressing evidence-based treatments for trauma-related conditions and minimizing disparities in care provision, advocacy, and public education. The societies reported differences in health care systems, types of common traumatic events, and geopolitical and socioeconomic characteristics. Given these similarities and differences, the panel agreed on the need for enhancing collaborations within and between societies.

Tetris has been shown to reduce intrusions following exposure to experimentally induced and actual traumatic events. However, no study has systematically investigated whether multiple sessions of Tetris produce greater reductions in intrusions than a single session. In this study, 94 participants (58.5% female) watched a trauma film in the laboratory and were then randomly assigned to one of three groups: no Tetris (inactive control), a single session of Tetris (15 min on Day 1), or multiple sessions of Tetris (15 min per day on Days 1, 2, and 3). Participants recorded film-related intrusions in a daily diary over 1 week. The results showed that the trauma film effectively induced intrusions. In terms of group differences, a single Tetris session was associated with a 22.0% reduction in intrusions compared to the control group, Exp(B) = 0.78; and multiple Tetris sessions were associated with a 13.3% increase in intrusions compared to the control group, Exp(B) = 1.13, and a 45.4% increase compared to the single-session group, Exp(B) = 1.45. However, none of these differences were statistically significant, p = .380. These findings may be partially explained by methodological factors, such as administering Tetris remotely via smartphones without researcher supervision and the repeated use of reminder cues. Alternatively, Tetris may not effectively reduce intrusions when played unsupervised in uncontrolled settings.

Posttraumatic stress disorder (PTSD) is a prevalent and debilitating condition, yet many individuals face substantial barriers to accessing evidence-based interventions. Advances in generative artificial intelligence (AI), particularly large language models (LLMs), have generated optimism about improving access and care. We present five emerging use cases for clinical AI tools in the context of PTSD treatment, some of which were presented as part of a symposium at the 40th Annual Meeting of the International Society for Traumatic Stress Studies. The first two use cases involve AI-assisted training tools. The third use case focuses on an AI-assisted automated fidelity rating system aimed at improving adherence to evidence-based PTSD protocols. The last two use cases feature AI-assisted therapy tools. Although AI-based innovations hold the promise of enhancing the reach and consistency of evidence-based PTSD interventions, they also raise important ethical and safety challenges, including risk of bias, threats to patient privacy, and the question of how to incorporate clinical oversight. Ongoing collaboration among multidisciplinary teams involving clinicians, researchers, and technology developers will be essential to ensuring that AI tools remain patient-centered, ethically sound, and effective.