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

Objective: Individuals who experienced childhood maltreatment show an increased sensitivity to stressful events and are at greater risk for adult psychopathology. Leveraging the natural event of unintended pregnancy, this study aimed (a) to examine heterogeneity in posttraumatic stress disorder (PTSD) trajectories in the context of a stressful life event and (b) to increase our understanding of traumatized individuals' perinatal mental health to inform mental health care integration into abortion and maternity service settings.

Method: 189 individuals who either terminated (41%) an unintended pregnancy or carried it to term (59%) completed a self-report questionnaire of childhood maltreatment and a clinician-administered interview to assess lifetime trauma exposure and PTSD symptoms in the month prior to and 12 months after the end of the pregnancy. Hierarchical multiple regression analysis, t-tests, and change score analysis were conducted to investigate the interrelationships among childhood maltreatment, trauma exposure, and PTSD symptoms.

Results: Participants most frequently reported sexual violence (25.83%), birth trauma (18.54%), or physical assault (16.56%) as their index trauma. Individuals with childhood maltreatment showed increased lifetime trauma exposure and exhibited greater PTSD symptoms 12 months after the unintended pregnancy. Childhood maltreatment did not predict a change in PTSD symptoms from pre- to postpregnancy.

Conclusions: Childhood maltreatment is linked to increased PTSD symptoms that persist up to 1 year after an unintended pregnancy. These results have clinical implications for the inclusion of trauma-informed practices into reproductive care. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Racial trauma is, understandably, associated with negative emotionality and particularly depression and anxiety for Black Americans. To inform trauma-related intervention, insights into mechanisms associated with racial trauma, depression, and anxiety are paramount. One potential mechanism is alexithymia, or one's capacity to identify and describe emotions. The purpose of this study was to examine alexithymia as a possible influence in the association of racial trauma and negative emotionality among Black adults.

Method: Study participants were 133 Black American adults (M = 35.02 years; SD = 14.43 years) who reported at least one racially traumatic event. Participants completed a self-report questionnaire battery.

Results: As predicted, the association of racial trauma and negative emotionality was statistically significant though only for respondents who reported heightened levels of alexithymia.

Conclusion: These findings provide insights into the importance of emotional expression for influencing responses to race-based traumatic events. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Although evidence-based trauma treatments (EBTT) are broadly disseminated, implementation remains inconsistent. Mental health providers' implementation skills are rarely assessed posttraining, and many fail to complete certification requirements. For over 10 years, the evidence-based Core Curriculum on Childhood Trauma (CCCT) has been delivered with EBTT training for graduate-level trainees, and trainers have reported benefits to EBTT mastery. This study was designed to assess whether CCCT training impacted EBTT mastery.

Method: We used a quasi-experimental mixed-method design including post-EBTT training surveys, tracking completion of EBTT certification requirements, and qualitative interviews with EBTT trainers.

Results: Limited statistically significant quantitative differences emerged for EBTT learning outcomes; however, some small positive effect sizes were seen. Qualitative interviews identified several areas where CCCT-trained providers excelled, including recognizing/managing secondary traumatic stress responses, increased capacity to hear trauma disclosures, reduced resistance to start the EBTT, enhanced integration of case information and case conceptualization, improved confidence, and better fidelity to the EBTT.

Conclusions: Although quantitative data showed limited statistically significant impacts, qualitative findings aligned with earlier anecdotal reports by identifying benefits from CCCT training. Further refinement of quantitative measures and additional data collection may enhance the detection of measurable impacts of CCCT training on EBTT. Given the significant cost and importance of training providers to implement EBTT and improve outcomes of child trauma treatment, developing methods and strategies to improve EBTT training and evaluate its outcomes is vital. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: To quantify the strength of the relationship between trauma exposure in adulthood and suicidal experiences in military individuals.

Method: We searched three databases, namely, Medline, APA PsycINFO, and Embase, until the end of April 2022; we updated our searches twice, in October 2022 and in April 2024. We performed a systematic review and meta-analysis. We also applied univariate metaregressions whenever applicable.

Results: Overall, we found that military sexual trauma was associated with an up to twofold increased likelihood for engagement in suicidal thoughts and behaviors (ORs ranging between 1.91 and 2.57). Our metaregressions showed that such military sexual trauma increased the likelihood of suicide attempts (b = -0.74, p = .01) in females and active military personnel (b = -1.08, p = .02). Other traumatic events, especially those that occurred prior to joining the military forces, also were associated with an increased likelihood for suicidal ideation and attempts. Exposure to combat scenes was also associated with an increased likelihood for suicidal ideation and attempts.

Conclusions: This is the first study of its kind to identify and quantify traumatic events encountered in adulthood as risk factors for suicidal acts within this vulnerable population. Our findings call for an immediate attention when recruiting military personnel and suggest that all these crucial factors are assessed. We also recommend frequent follow-up assessments and the use of qualitative and mix-method approaches to understand the mechanisms underlying these relationships. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: To examine (a) change in chronic neurobehavioral symptoms in service members/veterans (SMVs) with an uncomplicated mild traumatic brain injury (MTBI) at two time points over 3 years and (b) the influence of intimate partner (IP) health-related quality of life (HRQOL) risk factors for chronic neurobehavioral symptoms.

Method: IPs (N = 175) completed measures of SMV neurobehavioral adjustment symptoms and 13 IP HRQOL risk factors at Time 1 (T1) ≥ 12 months post-TBI and Time 2 (T2) 3 years later. Scores on the risk factor measures were classified into four IP HRQOL symptom trajectory categories based on clinically elevated (≥ 60 T) symptoms: (a) persistent (T1 + T2 ≥ 60T), (b) developed (T1 < 60T + T2 ≥ 60T), (c) improved (T1 ≥ 60T + T2 < 60T), and (4) asymptomatic (T1 + T2 < 60T).

Results: There was little change in mean SMV adjustment scores or the percentage of clinically elevated scores from T1 to T2. The percentage of clinically elevated adjustment scores was 30% at T1 and T2; 14.3% at T1 only; and 5.7% at T2 only. The IP HRQOL symptom trajectories had a stronger effect on mean SMV adjustment than within-group change in adjustment, which was largely driven by the persistent and asymptomatic IP HRQOL categories. The strongest effects were found for caregiving and social HRQOL risk factors, followed by psychological, and then physical HRQOL risk factors.

Conclusion: A range of clinically elevated IP HRQOL constructs emerged as long-term risk factors for chronic neurobehavioral symptoms in SMVs post-MTBI. More attention to the role that family distress has on poor warfighter recovery and return to duty following an MTBI is required. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: The present study examined the role of racism-based traumatic stress (RBTS) symptoms (i.e., traumatic stress reactions in direct response to experiences of racial discrimination) and suicide-related risk in a national sample of U.S. Black and Latine adolescents.

Method: Study participants were recruited from an online survey panel (N = 559), self-identified as Black (54.7%) and/or Latine (45.3%), and were between 12 and 17 years old (M = 14.54, SD = 1.64). Logistic regression analyses were used to test the association between RBTS symptoms and past-year suicidal ideation, plans, and attempts, accounting for conventional and racism-based potentially traumatic exposures (PTEs) and posttraumatic stress disorder symptoms.

Results: Findings suggest that adolescents with higher levels of RBTS symptoms were at elevated risk for past-year suicide attempts, adjusted odds ratio [confidence intervals] = 1.54, 95% CI [1.02, 2.31], p = .04, above and beyond reported levels of PTEs, racism-based potentially traumatic exposures, and posttraumatic stress disorder symptoms. This association was not observed with past-year suicidal ideation, adjusted odds ratio = 1.30, 95% CI [0.92, 1.84], p = .14, or past-year suicide plans, adjusted odds ratio = 1.07, 95% CI [0.72, 1.61], p = .73.

Conclusion: RBTS symptoms may be relevant in identifying suicide-related risk, particularly suicide attempts, among Black and Latine adolescents. While these findings provide insights into the relationship between RBTS and suicide-related risk, the cross-sectional design limits causal inference, and the use of a convenience sample may limit generalizability to the broader Black and Latine populations. Tailored interventions that address the nuanced effects of racial trauma on suicide risk are needed among youth of color. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: This study explored psychological distress in communities impacted by mass trauma, focusing on the effects of sustained missile attacks.

Method: The psychological effects of exposure to the October 7, 2023, Hamas attacks were assessed in 173 participants, measuring stress, anxiety, depression, and general health.

Results: Analyses of covariance showed that participants directly exposed to Hamas attacks reported higher levels of stress, anxiety, and depression and lower general health compared to nonexposed participants. Moderated mediation analysis indicated that stress mediated the relationship between exposure and psychological distress (anxiety, depression, and general health), with stronger effects among those exposed to intense missile attacks. Gender and marital status significantly were related to psychological distress, with women and married participants reporting higher stress and anxiety.

Conclusions: The findings suggest that sustained terror is associated with heightened psychological distress after mass trauma, emphasizing the importance of considering such contexts in psychological assessments. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Childhood maltreatment (CM) is an early risk factor for posttraumatic reactions in youth. Psychological resilience plays a significant role in these processes. However, the role of positive childhood experiences (PCEs) is less known. We aimed to explore how CM and PCEs jointly affect posttraumatic reactions via psychological resilience in young CM survivors.

Method: The participants were 2,669 Chinese youth with CM experiences (53.6% female, 51.2% ≤ 18 years) who completed three-wave assessments over 1 year. We used structural equation modeling to examine the mediating roles of psychological resilience between CM and complex posttraumatic stress symptoms, posttraumatic growth, and posttraumatic depreciation. We also examined the moderating roles of PCEs in the relationship between CM types and psychological resilience.

Results: Psychological resilience mediated the relationship between emotional abuse/PCEs and posttraumatic growth. Moreover, PCEs showed different interactive effects with emotional and sexual abuse on psychological resilience and further influenced posttraumatic growth. With low PCEs, emotional abuse had a positive indirect association with posttraumatic growth. With high PCEs, sexual abuse had a positive indirect association with posttraumatic growth.

Conclusions: CM and PCEs can jointly affect the posttraumatic growth of young CM survivors via psychological resilience. The specific role of PCEs is contingent upon the type of CM. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Childhood maltreatment (CM) is associated with disorganized attachment which, in turn, is linked to a range of negative outcomes including posttraumatic stress disorder (PTSD). When maltreatment within the family leads to out-of-home placement, examining the effects of multiple attachment relationships on children's outcomes seems appropriate. This study examined whether (a) attachment to each biological parent mediates the association between CM and PTSD and whether (b) attachment to a foster parent mitigates the effects of CM and of attachment to biological parents on PTSD.

Method: Ninety-six adults placed during childhood responded to the Attachment Multiple Model Interview to assess attachment to each biological parent and to the foster parent, the Mini International Neuropsychiatric Interview for PTSD, and the Childhood Trauma Questionnaire for CM. Past records were used to substantiate responses on factual information regarding CM.

Results: Partial Least Squares Path Modeling analyses show that (a) attachment (insecurity and disorganization) with the biological mother partially mediates the link between maltreatment and PTSD and that (b) attachment to the foster parent moderates the link between attachment to the mother and PTSD. Although attachment insecurity to the father is associated with maltreatment severity, it does not mediate its effect on PTSD.

Conclusions: Findings suggest that secure and organized attachment with the mother or with an alternative caregiver is associated with a reduced risk of PTSD following maltreatment. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Objective: Many digital mental health technologies have been developed to address the psychological needs of trauma survivors and those with posttraumatic stress disorder (PTSD), and recent efforts have been aimed at improving the implementation of such technologies. Despite several overlapping expert summaries and recommendations for procedures and processes necessary to deploy digital mental health solutions for the public, there remains a need for a comprehensive, at-scale model that guides ongoing optimization of digital mental health technologies once created and deployed.

Method: The National Center for PTSD (NCPTSD) Model for Digital Mental Health has been developed to address existing gaps and has been used to achieve broad reach, positive reception, and measurable public health benefit in the United States and around the world. The NCPTSD Model for Digital Mental Health is outlined, highlighting key elements and using examples to provide guidance to other programs intent on implementing digital health tools.

Results: Strategies are provided to facilitate wider use of the model in a variety of settings, particularly those with limited resources, as well as key challenges and potential paths forward.

Conclusions: The NCPTSD Model for Digital Mental Health provides an evidence-based and pragmatic approach for how digital mental health technologies can be optimized to improve the lives of veterans and members of the public who are living with the psychological consequences of trauma. (PsycInfo Database Record (c) 2025 APA, all rights reserved).