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

Objective: This study investigated trajectories of posttraumatic stress in Norwegian peacekeepers over a 23-year period, focusing on the prevalence and characteristics of late-onset posttraumatic stress disorder (PTSD), where symptoms develop or intensify long after deployment.

Method: We analyzed PTSD symptoms in 463 Norwegian peacekeepers who had deployed to Lebanon as part of the UN peacekeeping mission, UN Interim Force in Lebanon. PTSD symptoms were assessed using the Posttraumatic Symptom Scale-10 at two time points: a median of 7 years (T1) and 29 years (T2) postdeployment. Late-onset PTSD was defined as cases in which peacekeepers did not meet criteria for PTSD at T1 but met the criteria by T2. We used logistic regression to identify predictors of late-onset PTSD, including deployment and postdeployment factors.

Results: Estimated PTSD prevalence increased from 2.8% at T1 to 8.9% at T2, with 8.0% (95% confidence interval [5.5, 10.5]) showing a late-onset trajectory. At T1, those on a late-onset path reported more symptoms than their resilient counterparts. By T2, late-onset cases constituted 90.2% of all PTSD cases. Key predictors of late-onset PTSD included causal attribution of mental health issues to service, OR = 3.03, p < .001; number of deployments, OR = 1.56, p = .039; and postdeployment stressors, OR = 1.30, p = .049.

Conclusions: We found a significant rise in estimated PTSD prevalence among military peacekeepers over two decades, with causal attribution emerging as the strongest predictor of a late-onset trajectory. Interventions aimed at addressing these attributions could be important in mitigating long-term PTSD symptoms. (PsycInfo Database Record (c) 2026 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) 2026 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) 2026 APA, all rights reserved).

Objective: Veterans with posttraumatic stress disorder (PTSD) and moral injury often struggle with their spirituality and/or religion (S/R) in ways that hinder recovery from these conditions and perpetuate risk for suicide over time. Focusing on veterans who were engaged in a peer-led spiritual intervention program with a Veteran Service Organization, this brief report examined prospective roles of common forms of spiritual struggles (divine, doubt, interpersonal, moral, meaning) in risk for suicidal behavior (ideation, attempt probability) over a 1-year period.

Method: Participants completed self-report assessments of PTSD symptoms, moral injury outcomes, spiritual struggles, and suicidality at three points (baseline and 6-month and 12-month follow-ups).

Results: Initial analyses revealed baseline levels of all spiritual struggles were weakly to moderately concurrently associated (rs = .215-.491) with suicidality factors at this baseline assessment. However, ultimate meaning struggles at baseline emerged as the only salient predictor of future suicide ideation and perceived likelihood of attempting suicide across the bivariate and multivariate analyses. Specifically, veterans who were concerned their lives or existence in general may not have a deeper purpose or underlying meaning at the start of the intervention program were more uniquely likely to be thinking about suicide and perceiving a greater likelihood of attempting suicide in the future over the 1-year period.

Conclusion: Overall, these findings affirm the need for clinicians and researchers to attend to ultimate meaning struggles in their work with veterans and other trauma-exposed groups who might be at risk for suicide. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Grounded in a phenomenology framework, this qualitative case study interrogates the structural embedding of childhood trauma within the linguistic and phenomenological aspects of schizophrenia. It posits that traumatic experiences are not merely reflected in but actively reorganize communicative patterns, becoming grammatically and narratively encoded in psychotic discourse.

Method: A multilevel discourse analysis was applied to verbatim transcripts from two historical, publicly available recordings of a clinically diagnosed male patient: a structured clinical interview and an unstructured home visit. Employing a triangulation design, the analysis integrated patient narrative, clinician assessments, and familial observations. Coding was conducted through an iterative, deductive-inductive process focused on linguistic strata: syntactic structure, lexical semantics, narrative coherence, and dialogical dynamics.

Results: The analysis delineated a distinct psycholinguistic configuration indicative of trauma reorganization. Dominant themes include the following: (a) syntactic reenactment-rigid, persecutory interrogatives fossilizing victim-perpetrator frameworks; (b) lexical hypervigilance-a semantically constrained lexicon centered on violation and somatic threat; (c) narrative dissociation-abrupt thematic shifts and displaced trauma disclosures that disrupt autobiographical coherence; and (d) dialogical rupture-interlocutor-specific speech patterns reenacting attachment conflicts. These markers form a coherent, trauma-organized communicative system persistent across contexts.

Conclusions: Trauma in schizophrenia may operate as a structural determinant of communication, not a comorbid overlay. Personalized, linguistically informed, trauma-focused interventions may reduce the accompanying interpersonal distress. We provide an outline for studying discursive markers to investigate therapies targeting trauma-derived syntactic and narrative frameworks. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: When an institution fails to fulfill its obligations to prevent violence from occurring or to respond adequately to violence, it commits institutional betrayal, which can compound a survivor's distress. One proposed strategy to reduce the harm caused by institutional betrayal is institutional courage, which involves supportive and transparent institutional actions that prioritize the needs of institutional members. The objective of the present study is to examine the unique relationships between the theoretical constructs of institutional betrayal, institutional courage, and trauma-related mental health outcomes among campus sexual assault survivors within one university institution.

Method: Self-report questionnaire data were collected from a sample of campus sexual assault survivors enrolled at a large, public university in the Pacific Northwest (N = 85).

Results: There were no statistically significant bivariate relationships among institutional betrayal, institutional courage, and trauma symptoms. Consistent with hypotheses, institutional courage moderated the relationship between institutional betrayal and trauma symptoms. Institutional betrayal was positively related to trauma symptoms among students who reported low and moderate levels of institutional courage, but institutional betrayal was no longer linked to trauma symptoms among students who reported high levels of institutional courage.

Conclusion: This finding suggests that institutional courage may attenuate the negative influence of institutional betrayal. Overall, institutional courage may be a helpful approach to combat the harms of both sexual violence and institutional betrayal. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: The impact of cannabis use on evidence-based posttraumatic stress disorder (PTSD) treatment outcomes remains inconclusive. Further, few studies to date have examined these relationships in intensive PTSD treatment settings, with existing literature being similarly inconclusive. The present study assessed the role of cannabis use frequency prior to and concurrent with treatment on self-reported PTSD and depressive symptoms in two samples of veterans undergoing distinct (3-week and 2-week) Cognitive Processing Therapy-based intensive treatment programs (ITPs; N_3-week = 488; N_2-week = 253).

Method: Cannabis use frequency over the past 2 weeks was self-reported by veterans. PTSD and depression symptoms were assessed before, during, and following the ITP using the PTSD Checklist for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition and Patient Health Questionnaire-9, respectively. Linear mixed-effects models were used to analyze the effect of cannabis use frequency prior to and concurrent with treatment on PTSD and depressive symptom change over time.

Results: Individuals in the 3- and 2-week ITPs reported low rates of cannabis use prior to and concurrent with treatment. Across models, frequency of cannabis use was not significantly related to PTSD symptoms over time. Findings surrounding the impact of cannabis use on depressive symptom severity were only found in the 2-week ITP and not replicated in the 3-week ITP.

Conclusion: Infrequent and/or recreational cannabis use frequency prior to or concurrent with treatment did not meaningfully impact intensive PTSD treatment outcomes. Findings associated with concurrent use need to be interpreted with caution due to the small subsample. Future research should explore whether more frequent cannabis use and the dosage differentially impact PTSD treatment outcomes. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: The research on posttraumatic stress disorder and psychosis has now shown that these experiences can be bidirectional and actually potentiate each other. This scientific knowledge provides the field invaluable insight about points of prevention for either condition so that the risk for onset of the other mental health challenge does not occur, as well as diverse information for when the experiences are fully comorbid. In this article, a conceptual model is provided outlining practical conceptual and clinical applications.

Method: By using an innovative conceptual model, this article provides more insight about understanding and using the literature we know to inform prevention of co-occurrence and a diverse approach when both disorders are present in comorbidity, actually potentiating each other, and how to then address the situation holistically, rather than in silos.

Results: Using the innovative conceptual model, this article is able to help systems and providers move toward more effective treatment of the bidirectionality of posttraumatic stress disorder and psychosis holistically and equally rather than treating either of the conditions solely, in silos, or treating one condition over the other, as this is a risk that is reductionistic and negates the true capabilities of our clinical interventions. Practical clinical applications are provided as part of this conceptual piece.

Conclusion: This conceptual model is innovative as common practice in many settings is to still prioritize one diagnosis, and this failure in treatment falls short of adequately targeting every element that makes up the complexity of experience for individuals who experience comorbid posttraumatic stress disorder and psychosis. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Background: There is growing evidence that stellate ganglion block (SGB) combined with trauma-focused therapy may help veterans with posttraumatic stress disorder (PTSD) whose symptoms have not responded to traditional treatments. By combining SGB with in vivo exposure, veterans may be more able to fully engage in treatment and see improvement in their overall functioning.

Objective: The primary aim of this project was to conduct a nonrandomized pilot trial on the feasibility and acceptability of delivering SGB paired with individual psychotherapy to veterans with combat-related PTSD.

Method: Eligible veterans (N = 14) constructed a hierarchy of in vivo exposure exercises, received the SGB procedure, and attended four additional weekly psychotherapy sessions with a focus on exposure exercises. Participants completed measures at baseline, weekly during treatment, and follow-up assessments immediately posttreatment and 1-month later.

Results: The recruitment target was easily met, session attendance was strong, and dropout was relatively low (21.4%). SGB was well tolerated with only mild, transient side effects. Participants reported satisfaction with the treatment they received as measured by the Client Satisfaction Questionnaire (M = 28.8). Paired t test analyses revealed a significant decrease in PTSD symptoms as measured by the PTSD Checklist for DSM-5. We also observed a significant reduction in PTSD symptoms as measured by the Clinician-Administered PTSD Scale for DSM-5 in mixed models, F(2, 13) = 8.68, p = .004. There were no significant improvements in psychosocial functioning or quality of life.

Conclusion: SGB paired with psychotherapy is feasible and acceptable to veterans and holds promise for symptom reduction among veterans with combat-related PTSD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Bullying is common in childhood. Identifying developmental periods most sensitive to bullying may improve understanding of the link between bullying and psychotic disorders.

Method: Forty-six individuals with schizophrenia spectrum disorders (schizophrenia or schizoaffective disorder; SZ), 53 with psychotic bipolar disorder (BP), and 51 healthy control (HC) participants completed the Maltreatment and Abuse Chronology of Exposures questionnaire. We tested for differences in the rates and severity of emotional and physical bullying across diagnostic groups, and also calculated odds ratios (OR's) for emotional and physical bullying in SZ and BP versus HC. As a primary goal of the study, we also examined associations between diagnosis, the timing of bullying in childhood, and bullying severity using nonlinear mixed effects models.

Results: Patients with SZ (OR range = 3.41-21.88) and BP (OR range = 2.48-11.63) reported both emotional and physical bullying at higher rates than HC. In general, emotional bullying severity increased between ages 5-11 years, peaked at age 11, then decreased between ages 11-17. Notably, there was a Timing × Diagnosis interaction for both SZ (β = 0.09, p_FDR < .01) and BP (β = 0.09, p_FDR < .01) for the interval spanning ages 5-11. For physical bullying severity, only SZ patients showed a Timing × Diagnosis interaction for the period spanning 5-11 compared with HC (β = 0.05, p_FDR < .01).

Conclusions: Retrospective reports of childhood bullying suggest that the developmental period spanning ages 5-11 years may be a vulnerable period when emotional and physical bullying are most severe for people with psychotic disorders. (PsycInfo Database Record (c) 2026 APA, all rights reserved).