Psychological trauma : theory, research, practice and policy最新文献

Objective: Among psychotherapeutic treatments for posttraumatic stress disorder, prolonged exposure, and cognitive processing therapy have distinguished themselves with their high efficacy and strong backing in the treatment literature. However, low patient retention undermines the benefit of these evidence-based psychotherapies. Underrepresentation of Latinx and American Indian/Alaska Native (AI/AN) veterans in posttraumatic stress disorder research has rendered it difficult to determine ethno-racial disparities in patient retention. Despite serving in the U.S. military at high rates, Latino and AI/AN veterans are especially underrepresented in the existing research regarding engagement and efficacy of evidence-based psychotherapies for posttraumatic stress disorder.

Method: This study examined treatment selection, initiation, receipt of minimally adequate care, and completion among 708 male White, Latino, and AI/AN veterans seeking prolonged exposure or cognitive processing therapy in an outpatient Veterans Health Administration specialty clinic.

Results: Analyses revealed levels of treatment retention differed significantly between ethnoracial groups. After selecting treatment, AI/AN veterans were more likely to never attend any protocol sessions and had a shorter time to attrition compared with White veterans.

Conclusion: The results of this study demonstrate barriers to treatment engagement and retention experienced by different ethnoracial groups and inform culturally sensitive considerations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Efforts to achieve optimal outcomes in patients with chronic pain (CP) are impeded by unaddressed psychological trauma. Primary care offers a practical opportunity to identify patients with unresolved trauma through screening. However, the extent of such screenings in clinical practice remains unclear. This exploratory study aimed to assess trauma screening practices among Arizona primary care providers, examine their understanding of the trauma-CP connection, and investigate perceived barriers and opportunities for improving integration into primary care workflows.

Method: We conducted a cross-sectional survey of Arizona primary care providers in family and internal medicine. Data on providers' practices, comfort levels, beliefs, and perceived barriers were analyzed.

Results: The final sample comprised 71 survey respondents, with some variability in item response rates. Nearly all respondents (93.4%) acknowledged the connection between unresolved psychological trauma and CP, but only 23.9% consistently screened patients with CP for trauma. Screening rates for trauma among patients with CP were significantly lower compared to screening for anxiety/depression, social determinants of health, and substance use disorder. Reported barriers included feasibility concerns related to time and staffing, lack of patient-provider trust, and limited behavioral health access.

Conclusions: While awareness of the CP-trauma link is widespread, trauma screening in Arizona primary care remains insufficient. Systemic barriers, rather than individual provider factors, appear most influential. Addressing time, staffing, and behavioral health integration challenges is critical for improving screening rates. Future research should focus on systemic factors to develop scalable, sustainable solutions for integrating trauma screening into primary care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Understanding judges' views is crucial to the successful adoption of a trauma-informed (TI) approach in the U.S. court system, yet little is known on this topic. We explored judges' attitudes of and experiences with TI practice to help fill this gap.

Method: We surveyed 91 North Carolina district court judges, assessing their attitudes related to TI practice, use of trauma-informed practices (TIPs), previous trauma education, and support for different justice goals. We conducted independent-samples t tests and Poisson regression analyses to compare attitudes, use of TIPs, and education experiences between judges working in juvenile justice and those not in juvenile justice; descriptive statistics to examine rates of engagement with different TIPs; and bivariate correlation analyses to assess associations between TI practice outcomes and justice goals.

Results: Analyses revealed more favorable attitudes toward a TI approach and greater engagement with trauma education among judges working in juvenile versus adult courts; TIPs with the lowest levels of engagement related to policies and procedures; and strong positive correlations between favorable TI practice attitudes and support for rehabilitation and restoration.

Conclusion: Findings highlight areas for growth in the movement to create more TI courts, such as strengthening support for TI practice in the adult criminal system and implementing TIPs related to policies, procedures, and outcomes, not just communication. Findings also support the connection between a TI approach and less punitive justice practices, signaling the potential role that TI judicial practice can play in shifting our legal system toward more transformative forms of justice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Not all women experience the same changes in depression from pregnancy through the years following childbirth, but the patterns of prenatal and postnatal depression are underexplored. This study investigated the trajectories and associated predictors of depressive symptoms in women from pregnancy through the first 3 years postpartum.

Method: We followed 340 pregnant women from an antenatal clinic in Hong Kong, first at 20-24 weeks of gestation, then at 4 weeks after childbirth, and again at 3 years after childbirth. Pregnant women reported their depressive symptoms whether they had intimate partner violence, health conditions, adverse childhood experiences, family support, and perceived partner involvement. Latent class growth analysis was applied to identify distinct trajectories of depression, and binary logistic regressions were performed to analyze predictors of trajectories.

Results: We found that 26.5% of women showed clinical depressive symptoms at 20-24 weeks of gestation, 9.7% at 4 weeks after childbirth, and 12.6% at 3 years after childbirth. Two classes were identified: a low-stable group (86.2%) and a relapsing/remitting group (13.8%). Women with a history of trauma (i.e., intimate partner violence and adverse childhood experiences) and mental health difficulties were more likely to be classified in the relapsing/remitting group than in the low-stable group. Family support and partner emotional involvement appeared to protect the women from suffering relapsing/remitting depression.

Conclusions: The findings highlight the importance of screening for depression throughout pregnancy and extending several years postpartum. Distinguishing the different trajectories of depression and identifying its associated factors are critical to providing targeted interventions to the most vulnerable women (i.e., a relapsing/remitting group in the present study). (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Experiences of discrimination have been shown to negatively impact mental health. These experiences include, but are not limited to, discrimination based on race, gender, sexual orientation, age, and socioeconomic status. Because experienced discrimination (ED) has been shown to produce similar negative downstream impacts (i.e., elevated posttraumatic stress disorder [PTSD] symptoms, depression, stress, and anxiety) as more conventional potentially traumatic events (CPTEs; e.g., sexual assault, natural disaster, car accidents), researchers have argued that discrimination events should be considered as qualifying for Criterion A for PTSD.

Method: The current preregistered study directly compared the psychological impact of ED versus CPTEs. Using a within-subjects design, we asked a sample of 154 college students who reported ED to indicate their type of ED and their most distressing CPTE. Participants then completed measures of PTSD symptoms, perceived posttraumatic growth, and perceived posttraumatic depreciation in response to both their ED and their CPTE.

Results: Results indicated that, when compared with CPTEs, ED was associated with lower levels of PTSD symptoms and higher levels of both perceived posttraumatic growth and perceived posttraumatic depreciation. Further, PTSD symptoms from ED evidenced a nonsignificant trend of predicting general mental health outcomes above and beyond the variance explained by PTSD symptoms from CPTEs.

Conclusions: We argue that discrimination events are underrepresented in trauma research and should be included when considering common types of potentially traumatic events. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: No validated instrument for assessing childbirth-related posttraumatic stress disorder (CB-PTSD) according to the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition criteria is available in Ukraine. As prior experiences of trauma elevate the risk of developing CB-PTSD, there is a need for tools facilitating the identification of affected mothers in war-affected regions. This study aimed to test the bifactor latent structure and alternative models, internal consistency, and convergent and divergent validity of the Ukrainian adaptation of the City Birth Trauma Scale (City BiTS).

Method: In a cross-sectional study, 320 women completed online questionnaires, including the City BiTS, the Edinburgh Postnatal Depression Scale, the Generalized Anxiety Disorder, the Impact of Event Scale-Revised questionnaire, and a sociodemographic questionnaire.

Results: Confirmatory analyses were conducted to assess the fit of two-factor, four-factor, and bifactor models. The bifactor model was the best fitting one. The examination of the bifactor indices supported the computation of a total CB-PTSD score and the use of the General Symptoms subscale, both of which emerged as distinct and well-defined factors. Both subscales (the Birth-Related Symptoms subscale and the General Symptoms subscale) and the total scale demonstrated high internal consistency (Cronbach's α = .88, .91, and .92, respectively). Convergent and divergent validity testing indicated robust validity, particularly of the General Symptoms subscale score. The prevalence of CB-PTSD in Ukraine was 6.2% (n = 16).

Conclusion: City BiTS proved to be a reliable and valid measure, recommended for use among Ukrainian women in the postpartum period as a screening tool. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Readiness among laypeople to classify ordinary adversities as "trauma" may activate cognitive, social, and behavioral patterns that either promote proactive help-seeking or exacerbate mental health difficulties. Clinical understandings of trauma have expanded across recent decades to encompass a wide range of aversive experiences. While some have suggested lay understandings of trauma have expanded in parallel, minimal data directly reveal how the lay public conceptualize trauma. This study sought to establish the range of adversities that laypeople classify as traumatic.

Method: In an online survey, U.K. participants (N = 214) rated the traumatic nature of 80 adversities, half of which represented prototypical precursors of trauma (e.g., physical assault and sexual abuse), and half of which involved other adversities, not typically invoked in clinical definitions of trauma.

Results: Prototypical precursors were judged significantly more traumatic than nonprototypical adversities, but many nonprototypical adversities were also deemed likely to cause trauma (e.g., facial disfigurement or being falsely accused of a crime). Individual variation in the propensity to interpret adversities as traumatic was significantly predicted by participants' age, ethnicity, and political orientation.

Conclusions: This original evidence regarding the content and predictors of lay conceptions of trauma is relevant for sensitive delivery of clinical interventions, tailoring of other supports for populations experiencing adversity, and anticipating social responses to victims of specific adversities. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: The way we interpret information shapes our perception of reality. Predictive processing frameworks propose that the ability to update interpretations based on disconfirming information is key to recovery from potentially traumatic events (PTEs). However, direct evidence for this assumption is scarce and comes from studies using paradigms with low ecological validity.

Method: Here, we investigate the association between inflexible interpretation updating (IIU) and symptoms of posttraumatic stress disorder (PTSD) in a comprehensive sample (N = 1,238 participants with work-related PTEs) using a scenario-based task, which exposed participants to danger-related situations that are representative of everyday life.

Results: Our preregistered analyses yielded inconclusive findings regarding the relative link between PTSD symptoms and biased interpretations and interpretation updating, respectively. After conducting additional analyses to derive uncorrelated indices of biased interpretations and IIU, we found that both indices independently predicted higher PTSD symptoms. Moreover, IIU was found to moderate the association between work-related PTE exposure and PTSD symptoms such that individuals with highly flexible updating did not show a significant increase in PTSD symptoms with a rise in work-related PTE exposure.

Conclusions: Our findings provide further indications that biased interpretations and IIU may be involved in the pathogenesis of PTSD. In addition, they suggest that interpretation updating may be a promising target for the prevention of PTSD symptoms in contexts of repeated PTE exposure (e.g., in high-risk occupations). (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: The goal of this study was to (a) examine the association between childbirth-related posttraumatic stress disorder (CB-PTSD) symptoms and possible risk factors of previous trauma, individual characteristics (neuroticism, anxiety sensitivity, and resilience), type of birth, and birth satisfaction and (b) explore whether birth satisfaction moderates any association between individual characteristics and CB-PTSD symptoms.

Method: This was a longitudinal questionnaire study during pregnancy and postpartum. Pregnant women (N = 396) were recruited from antenatal clinics and completed questionnaires during mid-late pregnancy (Time 1) and 6-12 weeks after childbirth (Time 2). Time 1 questionnaires measured anxiety sensitivity (Anxiety Sensitivity Index), neuroticism (International Personality Item Pool-50, Neuroticism subscale), resilience (Brief Resilience Scale), and trauma history. Time 2 questionnaires measured birth satisfaction and CB-PTSD (Birth-Related and General Symptoms subscales).

Results: Regression analysis showed that previous sexual trauma, higher levels of neuroticism, and lower levels of birth satisfaction predicted higher levels of CB-PTSD symptoms. Anxiety sensitivity and resilience were not significant predictors of CB-PTSD. Additionally, birth satisfaction moderated the relationship between higher neuroticism and higher levels of CB-PTSD (total and general symptoms) and between lower resilience and higher CB-PTSD general symptoms. Effects were stronger when low birth satisfaction was reported.

Conclusions: Individual characteristics and birth satisfaction interact in the development of posttraumatic stress disorder following childbirth, with previous traumatic experiences playing an additional role. These findings can inform screening and care pathways for women at greater risk. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Empirical studies reveal that interpersonal violence victimization is a highly prevalent phenomena in youth and is associated with a host of difficulties, including mental, physical, and behavioral issues. Sleep, a developmentally fundamental process, is implicated in these unfavorable effects. Despite this, little is known about the interplay between interpersonal violence victimization, sleep, and mental health in adolescent girls, who are at greater risk of victimization, sleep problems, and mental health difficulties than boys.

Objective: The aim of the current study was to identify distinct patterns of sleep problems to understand how they are associated with interpersonal violence victimization and key mental health outcomes, namely dissociation and emotional dysregulation.

Method: Latent class analyses were conducted on a sample of 706 adolescent girls aged 14-18 (88% of Canadian descent), who completed an online survey.

Results: Three classes of sleep were identified: poor-, moderate-, and high-quality sleep. Controlling for posttraumatic stress disorder, classes were found to differ regarding childhood sexual abuse, community violence, and emotional abuse. In addition, exposure to community violence was associated with dissociation only among girls in the poor-quality sleep class, indicating a moderation effect of sleep.

Conclusion: The findings of this study, while awaiting replication with a more diverse sample, highlight the continued need to understand the interplay between interpersonal violence and sleep quality, which can help to inform trauma-focused clinical interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).