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

Objective: A growing body of research has emerged to characterize differences in posttraumatic stress disorder (PTSD) symptom presentations in individuals from diverse racial and ethnic groups. However, less research has examined if these observed differences can be attributed to bias within PTSD assessments. Knowledge about potential bias in PTSD assessment is essential for interpreting group differences. If PTSD assessments do not perform similarly across diverse demographic groups, then observed differences may be artificial products of inaccurate measurement, new assessments could be required for individuals from different demographic groups, and we would be unable to accurately detect PTSD treatment effects in patients from diverse groups.

Method: We evaluated PTSD assessment bias through tests of measurement invariance for the semistructured, clinician-administered AUDADIS-5 diagnostic assessment of participants in the National Epidemiologic Survey on Alcohol and Related Conditions-III. Participants included those who reported having experienced at least one potentially traumatic event in their lifetime (N = 23,936). Measurement invariance was assessed for participants who identified from several demographic groups (Asian, Native Hawaiian, or Pacific Islander; Hispanic; American Indian/Alaskan Native; and Black) compared to participants who identified as White (non-Hispanic).

Results: Overall, PTSD assessment was largely invariant across groups, while small amounts of measurement invariance were detected that can inform future research and clinical adaptations.

Conclusions: This work validates prior research that relies on a common conceptualization of PTSD, and it provides several paths for future improvement in research and clinical practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Despite the long-standing ongoing war in Ukraine, information regarding war-related negative mental health outcomes in children is limited. A nationwide sample of parents in Ukraine was surveyed to assess posttraumatic stress disorder (PTSD) symptoms in their children and to identify risk factors associated with child PTSD status.

Method: A nationwide opportunistic sample of 1,238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected approximately 6 months after the war escalation in February 2022. The prevalence of PTSD was estimated using the parent-reported Child and Adolescent Trauma Screen (CATS).

Results: Based on parental reports, 17.5% of preschoolers and 12.6% of school-age children met Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for PTSD. Delay in milestone development (AOR = 2.38, 95% confidence interval [CI] [1.38-4.08]), having a parent affiliated with the emergency services or army (AOR = 2.13, [1.28-3.53]), parental PTSD/complex PTSD status (AOR = 1.88, [1.22-2.89]), and mean changes in parental anxiety (AOR = 1.98, [1.44-2.72]) were among the strongest predictors of increased risk of pediatric PTSD.

Conclusion: Russia's war escalation in Ukraine resulted in an increased estimated prevalence of war-related PTSD in children of various ages. Urgent efforts to increase the capacity of national pediatric mental health services are critically needed to mitigate these challenges in an environment of limited financial and human resources. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: There is emerging evidence that first responders, like military personnel, are at risk for exposure to potentially morally injurious events. However, studies examining expressions of moral injury in first responders are nascent, in large part due to the limited number of measures validated for use in this population. To address this gap, the present study sought to investigate the psychometric properties of the Expressions of Moral Injury Scale-Military Version (EMIS-M) in a sample of first responders.

Method: The psychometric properties of the EMIS-M were investigated in a sample of 228 first responders to determine reliability, convergent validity, discriminative validity, and divergent validity. In addition, confirmatory factor analysis was conducted to test the bifactor model identified in a veteran sample (Currier et al., 2018).

Results: Results yielded an excellent fit for the bifactor model with correlated self-directed and other-directed subscales identified in the EMIS-M development study. In addition, the measure evidenced strong reliability, convergent validity, discriminative validity, and divergent validity.

Conclusions: The findings of the present study suggest that the Expressions of Moral Injury Scale-First Responder Version is a psychometrically sound measure capable of assessing self- and other-directed expressions of moral injury in first responders. The significance of these findings to our understanding of moral injury in first responders and their implications for future research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Exposure to psychological trauma is a well-accepted risk factor for the development of mental and somatic diseases. However, chronic stressors not fulfilling the criteria of traumatic experience can have similarly adverse health consequences. While the harmful impact of chronic stressors is generally recognized among researchers, there is a lack of acknowledgment within clinical, political, and societal entities. This becomes evident in the experiences of victims of political repression in the former German Democratic Republic (GDR), an authoritarian state in East Germany. Repression in the GDR included covert measures, such as "Zersetzung" (engl: disintegration), consisting of wiretapping, spreading rumors, or provoking failure in professional and social domains. It aimed to systematically undermine the psychosocial integrity of individuals, inducing anxiety, social isolation, and confusion.

Method: This article integrates findings on repression in the GDR with existing trauma and chronic stress literature.

Results: "Zersetzung" shares key features with severe psychosocial chronic stressors. Like trauma, experiencing "Zersetzung" likely dysregulated the biological stress systems, thereby predisposing victims to the health consequences they frequently experience to the present day.

Conclusion: Certain severe chronic stressors, such as "Zersetzung," do not appear to differ in their negative health consequences from Criterion A traumatic events. Identifying the biological and psychological impact of political repression techniques is essential, not only for public acknowledgment, and proper health care of victims of GDR repression, but also for those individuals suffering from similar repression methods today. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Experiencing traumatic events places children and adolescents at risk for developing posttraumatic stress disorder (PTSD), often leading to adverse mental health consequences. Although well-validated measures of PTSD are available, very brief screening tools are needed to assess PTSD when resources are limited. This study was conducted to develop and validate the four-item University of California at Los Angeles (UCLA) PTSD Reaction Index for DSM-5-Very Brief Form (RI-5-VBF) to be used in settings requiring rapid and efficient screening.

Method: Item response theory (IRT) models were used to derive RI-5-VBF scores from the UCLA PTSD Reaction Index for DSM-5 and assess its internal consistency using a sample of 1,785 youth (M_age = 12.32 years, SD = 2.78) seeking support at an academic medical center clinic or bereavement center. Receiver operating characteristic (ROC) analyses and diagnostic efficiency statistics were used to assess discriminant groups validity and screening utility of the RI-5-VBF scores. Differential item functioning (DIF) analyses were used to examine possible bias across age, gender, race, ethnicity, and clinical setting versus bereavement center setting.

Results: IRT models identified four items with the highest discrimination within each PTSD subscale. The RI-5-VBF scores exhibited acceptable internal consistency (α = .74). ROC analyses indicated that an RI-5-VBF score of 9 maximized sensitivity and specificity. DIF analyses did not find evidence of bias across age, gender, race, ethnicity, or clinical versus bereavement center settings.

Conclusion: These findings provide support for the reliability and validity of the RI-5-VBF. Findings highlight the utility of the RI-5-VBF as a brief screening measure for PTSD in children and adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: To advance understanding of the development of complex posttraumatic stress disorder (CPTSD) symptoms longitudinally and facilitate future treatments, the present study investigated changes in the network of CPTSD symptoms among Chinese college students with childhood trauma.

Method: A longitudinal study was conducted with college students, following them three times at 3-month intervals. CPTSD symptoms were measured using the International Trauma Questionnaire, and childhood trauma was assessed by the revised Adverse Childhood Experiences Scale. The final sample consisted of 294 participants with childhood trauma at baseline measurement (28.9% were males, M_age = 20.76 years). Comparisons of cross-sectional networks and cross-lagged panel network (CLPN) analysis were performed to characterize the features and changes of interactions among CPTSD symptoms.

Results: Sense of failure and isolation were the core symptoms in the cross-sectional networks of CPTSD symptoms. The comparison of cross-sectional networks indicated that the global network strength was stable, and no node's strength centrality and only one edge weight changed significantly from Time 1 (T1) to Time 3 (T3). The findings of the CLPN model reveal that worthlessness, difficulties with intimacy, and flashbacks have the highest out-expected influence. In the T1-T3 network, the strongest edge was from worthlessness to sense of failure.

Conclusions: Cross-sectional network analyses and comparisons revealed the characteristics of CPTSD networks at multiple time points, while the CLPN analysis identified the longitudinal dynamics of CPTSD symptoms. These provide insights for designing more targeted intervention plans for college students with childhood trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Background: Data from some countries showed a worrisome increase in domestic violence but a paradoxical decrease in divorce during the early months of the COVID-19 pandemic. We investigated the impact of the pandemic on domestic violence and divorce in Taiwan in 2020-2021.

Method: Data for reported domestic violence and divorce by month and county/city (2017-2021) were from Taiwan government's registries. We used random-effects negative binomial regression to estimate the rate ratios (RRs) and their 95% confidence intervals (CIs) between the observed numbers of domestic violence cases and divorces in 2020-2021 and the expected numbers based on prepandemic trends (2017-2019). We calculated RRs for the two outbreak periods (First: January-May 2020; Second: May-July 2021) and the two postoutbreak periods (First: June 2020-April 2021; Second: August-December 2021) and each month in 2020-2021.

Results: The number of overall domestic violence cases was greater than expected during the first COVID-19 outbreak-a 3% increase (95% CI [0.3%-6%])-and the two postoutbreak periods-a 9% increase ([6%-12%]) and a 12% increase ([8%-16%]), respectively. Intimate partner violence was the main contributor to the increases. The number of divorces was lower than expected throughout the pandemic (a 5%-24% decrease).

Conclusion: Reported domestic violence cases were higher than expected during the pandemic, particularly during the postoutbreak periods when the outbreak control measures were relaxed and people's movement resumed. Tailored prevention and intervention measures may be needed to address the increased vulnerability to domestic violence and restricted access to support during the outbreaks. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The present study investigated the level of anxiety among Ukrainian and Romanian civilians brought about by the war that started in Ukraine on February 24, 2022, using a model for the impact of traumatic experiences. We aimed to test the mediating effect of daily stressors on the relationships between trauma centrality and anxiety.

Method: The research was conducted on a sample of 720 people (24.3% males and 75.7% females, M_age = 35.61, SD = 12.59). Participants were civilians who lived either in Ukraine or outside Ukraine but at a maximum distance of 100 km from the border when the conflict started. They filled out questionnaires that measure anxiety, trauma centrality-indicating how central an event is to an individual's identity and life story, and daily stressors-predisposing factor for negative mental health outcomes.

Results: The outcomes highlighted the direct relationship between trauma centrality and anxiety, but also the mediating effect of daily stressors on the aforementioned relationships (in the overall sample, Ukrainian sample, and Romanian sample). Our research also underlined that there are significant differences in anxiety levels between people who have children and those who do not (in the overall sample and the Ukrainian sample, but not among Romanian civilians).

Conclusions: The present work contributes by enhancing knowledge about the relationships between trauma centrality, daily stressors, and anxiety within a war context, and the particularization of Carlson and Dalenberg's model (2000) in the context of the Russo-Ukrainian war. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Though research on secondary traumatic stress (STS) has greatly increased in the past decade, to date the field lacks a coherent set of guiding principles for practice that behavioral health providers and organizations can use to mitigate the occurrence and impact of STS. As such it is important to identify effective strategies, grounded in research and professional experience, to reduce the occurrence and impact of STS among behavioral health professionals and organizations.

Method: We conducted a four-stage modified Delphi survey. Thirty-one international STS experts were invited to participate, with a minimum of 19 responding in each round. Thematic analysis was conducted on qualitative data, which was incorporated into revisions of the principles.

Results: Consensus was achieved on 14 principles, seven targeted at individual professionals, and seven targeted at organizations.

Conclusions: This is the first effort to delineate principles for practice intended to reduce the occurrence and impact of STS in individual and organizational practice in behavioral health services. The principles are intended to inform best practices for individuals and organizations providing services to persons and communities who have experienced trauma and thereby improve the quality and effectiveness of services to traumatized populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: To determine whether moral awareness leadership moderated the relationship between combat experiences and soldier mental health symptoms following deployment.

Method: The Leadership in Moral Awareness Scale (LIMAS) was evaluated using anonymous surveys completed by 177 U.S. Army National Guardsmen. The survey also assessed general leadership, combat experiences, and posttraumatic stress disorder (PTSD), anxiety, and depression symptoms. Following factor analyses of the LIMAS, moderated regression models examined interactions between the LIMAS and combat experiences on mental health symptoms.

Results: Six items were selected to comprise the LIMAS. No main effect of the LIMAS was found for mental health variables after adjusting for general leadership. There were significant interaction effects between the LIMAS and combat experiences for depression and anxiety symptoms. Soldiers with higher levels of combat experiences reported fewer mental health symptoms if their leaders were rated highly on the LIMAS.

Conclusions: The LIMAS may offer a useful tool for assessing leader behaviors that can counteract negative mental health outcomes associated with combat. Findings provide support for encouraging leaders to focus on moral awareness during deployment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).