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

Objective: Experiencing child sexual abuse (CSA) can be considered a traumatic experience. Many negative short- and long-term consequences are linked with CSA. Dissociative experiences are one such consequence. The goal of the present study was to investigate the differences in nonperitraumatic dissociative experiences in different types and circumstances of CSA.

Method: The present study utilized a representative sample of Lithuanians aged 18-29 (N = 2,000). The frequency of dissociative experiences was investigated between groups of participants who experienced different types of CSA (contact, noncontact, and verbal) and different circumstances of abuse (age of onset, number of perpetrators, and instances of abuse).

Results: Participants who indicated having experienced multiple types of CSA demonstrated a higher frequency of dissociative experiences compared to those with no indicated CSA or a single type of CSA. No significant differences were found between different types of CSA. Contrary to expectations, no significant differences were found based on age of onset, number of perpetrators, or number of CSA instances, even though their strength of relationship with dissociation differed. Notably, those unable to recall CSA experiences consistently reported a higher frequency of dissociative experiences.

Conclusions: Taken together, our findings confirm that there is a difference in frequency of dissociative experiences between those who experienced CSA and those who did not. Findings of the present study would suggest that different types of CSA should not be joined into one, since there may be important differences between them. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Survivors of military sexual assault (MSA) are at risk for experiencing intimate partner violence (IPV) and alcohol misuse. IPV and MSA survivors are also at elevated risk for suicide-related thoughts and behaviors (SRTB) compared to those without MSA. Heightened risk for suicide may occur through higher alcohol misuse, an association that may be significantly stronger among males given their higher propensity for both alcohol misuse and death by suicide. The present study examined whether alcohol use was a mechanism of the association between IPV experience and SRTB, and whether these effects varied by sex.

Method: Participants were an anonymous convenience sample of 343 veterans/service members (51% male) who completed self-report measures of past-year IPV, alcohol use, and SRTB. SRTB were regressed on IPV variables (any, physical, psychological, and sexual coercion), alcohol use, and covariates with an indirect effect of alcohol use specified. Sex was entered as a moderator of the "a" and "b" mediation paths.

Results: The regression of SRTB on any and each type of IPV accounted for 37%-39% of the variance. The indirect effects of alcohol use on any and each type of IPV experience and SRTB were significant (ps < .05), but the moderated effects of sex were nonsignificant (ps > .05). The strength of the mediated effect for males was stronger than the effect for females; however, this difference was not significantly different (ps > .05).

Conclusion: Interventions to decrease SRTB among people who have experienced IPV and MSA may consider incorporating strategies to prevent and reduce alcohol misuse. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Eye movement desensitization and reprocessing (EMDR) is strongly recommended for posttraumatic stress disorder (PTSD). Yet, few studies have evaluated EMDR in veterans, and no study has compared in-person (IP) to telehealth (TH) delivery among veterans. This study aimed to (a) evaluate the effectiveness of EMDR among veterans and (b) compare outcomes between IP and TH modalities.

Method: In this chart review, 279 veterans met inclusion criteria (IP n = 139; TH n = 140). Mixed effects and logistic regression models were used for continuous and categorical outcomes, respectively.

Results: PTSD (Cohen's d = 0.76) and depression (Cohen's d = 0.56) symptoms improved between EMDR initiation and termination. After controlling for covariates, the IP group (Cohen's d = 0.85) reported even greater PTSD symptom improvement from initiation to termination compared to the TH group (Cohen's d = 0.66). There were no differences between groups for treatment completion and achieving reliable change and clinically significant change in PTSD and depression symptoms.

Conclusions: Findings suggest that EMDR is an effective PTSD treatment for veterans. IP and TH modalities largely yielded similar outcomes, highlighting both modalities as effective. These results underscore the importance of further evaluating EMDR delivered via IP and TH to veterans. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Past research has identified links between experiences of trauma and the content of hallucinations. There has not been an investigation of differences between those with trauma who do and do not have hallucinations with trauma-related content. This study explored the phenomenology and clinical correlates of hallucinations that contain matching sensory-perceptual elements to trauma.

Method: 64 young people engaged with an early psychosis service completed assessments of trauma, psychosis, posttraumatic stress disorder (PTSD), and dissociation. A theoretically informed coding frame was developed to (a) identify matching sensory-perceptual elements in hallucinations, posttraumatic intrusions, and trauma memories and (b) explore the phenomenology of such hallucinations. Differences in the severity of childhood trauma, posttraumatic intrusions, hyperarousal, dissociation, and PTSD diagnoses for those with and without hallucinations containing matching sensory-perceptual elements from trauma were examined.

Results: Twenty percent (n = 12) of those with a history of trauma and hallucinations experienced a hallucination that contained a matching sensory-perceptual element to an experience of trauma or a posttraumatic intrusion. Seventy-one percent of hallucinations with a matching sensory-perceptual element to trauma also contained novel content. The two groups did not differ in the severity of childhood trauma, posttraumatic intrusions, hyperarousal, dissociation, or rates of PTSD diagnoses.

Conclusions: Results are consistent with literature showing that a clinically significant minority of those with trauma and hallucinations experience hallucinations that contain intrusions of traumatic memories. The presence of novel content within these same hallucinations suggests multiple processes may work together to inform the content of one hallucination. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Treatment guidelines recommend only a few medications for the treatment of posttraumatic stress disorder (PTSD). There is substantial guideline-nonconcordant treatment for individuals with PTSD, including antipsychotics and mood stabilizers, which have potentially serious adverse side effects. As part of health system monitoring, we examined patient and clinical factors that may be associated with prescribing these medications among Veterans Health Administration (VHA) patients diagnosed with PTSD and without diagnosed comorbid bipolar or psychotic disorders.

Method: The study cohort included all VHA patients with PTSD diagnoses in fiscal year 2019 who did not have comorbid diagnoses of schizophrenia, psychotic spectrum disorders, bipolar disorder, or major depressive disorder with psychotic features in fiscal year 2019 or the prior two fiscal years (N = 122,292). Logistic regressions assessed demographic (e.g., age, race) and clinical (e.g., psychiatric diagnosis, health care engagement) factors associated with antipsychotic and mood stabilizer prescription receipt.

Results: 11.9% of the cohort received an antipsychotic, the strongest predictors of which were the presence of a suicide risk flag (adjusted odds ratio [aOR] = 1.57) and benzodiazepine prescription (aOR = 1.79). 12.4% of the cohort received a mood stabilizer, the strongest predictors of which were a service-connected disability above 70% (aOR = 1.56) and a comorbid personality disorder diagnosis (aOR = 1.76).

Conclusions: VHA patients with PTSD who have psychiatric comorbidity and receive multiple psychiatric medications were more likely to receive guideline-nonconcordant mood stabilizers and antipsychotics. Additional work is needed to better understand the impact of these prescribing practices to help providers balance the risks and benefits of these medication combinations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: This study examined individual differences in affect during nonsuicidal and suicidal states among 116 military personnel and veterans diagnosed with posttraumatic stress disorder.

Method: Current affect and suicidal ideation were assessed four times per day for 14 consecutive days via ecological momentary assessment using the Positive and Negative Affect Scale-Short Form and Scale for Suicidal Ideation (SSI) items. Positive and Negative Affect Scale-Short Form items were used to create four affect states based on the circumplex model of core affect: pleasant activation (e.g., excited), activated pleasure (e.g., proud), unpleasant activation (e.g., aroused), and activated displeasure (e.g., anxious). Mixed-effects regression modeling was used to assess variability in mean affect scores across active (SSI Item 4) and passive (SSI Item 5) suicidal states and variability in the correlation between affect and severity of suicidal ideation.

Results: Mean pleasant activation, F(2,7) = 4.8, p = .043, and activated pleasure, F(2, 5) = 22.0, p = .003, were significantly lower during active suicidal versus nonsuicidal states. Mean unpleasant activation, F(2, 7) = 19.9, p = .001, and activated displeasure, F(2, 9) = 42.3, p < .001, were higher during active suicidal versus nonsuicidal states. Activated pleasure was less variable, χ²(1) = 6.3, p = .012, but unpleasant activation, χ²(1) = 8.0, p = .005, and activated displeasure were more variable, χ²(2) = 15.7, p < .001, during active suicidal versus nonsuicidal states. Severity of suicidal ideation was significantly correlated with all four affect states; all correlations varied significantly across participants.

Conclusion: Reported affect during suicidal states varies across military personnel and veterans with posttraumatic stress disorder, suggesting suicidal states are heterogeneous. Differentiating affective arousal from affective valence can provide more nuanced understandings of suicide risk. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Major earthquakes often cause extensive physical, emotional, and social disruptions, potentially triggering posttraumatic stress symptoms (PTSS) as well as posttraumatic growth (PTG). This study examined PTSS and PTG among adults affected by two high-magnitude earthquakes (Mw 7.7 and 7.6) that struck the Kahramanmaras region of Türkiye, a seismically active area located along a major fault line.

Method: This cross-sectional and correlational study was conducted from April to July 2023 and involved 178 participants living in temporary dormitory shelters. Data collection included a personal information form, the Posttraumatic Stress Symptoms Scale, and the Posttraumatic Growth Inventory.

Results: More than half the participants reported severe fear (53.1%), loss of relatives (50.3%), relatives who were injured (53.1%), or financial loss due to the earthquake (50.8%). The most commonly reported PTSS symptom cluster was hyperarousal. Mean PTSS and PTG scores were 84.51 ± 22.24 and 60.73 ± 22.19, respectively. Regression analysis showed that intense fear during the earthquake significantly predicted higher PTSS scores, while a history of preexisting mental illness was associated with lower PTSS. No significant correlation was found between PTSS and PTG, suggesting these outcomes may develop independently in the early stages of disaster recovery.

Conclusions: These findings underscore the need for psychosocial support tailored to postearthquake circumstances, particularly given the reported high PTSS levels. Larger scale research is recommended to refine these insights and to guide targeted interventions. Mental health professionals (i.e., psychiatrists, psychiatric nurses, and psychologists) play pivotal roles in delivering comprehensive care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Research on the sequelae of intimate partner violence (IPV) among women predominantly focuses on overall physical and mental health. A better understanding of IPV's implications for sexual health is needed, especially among women veterans who experience high risk for IPV. This brief report examines the associations between recent and lifetime IPV, including physical, psychological, and sexual IPV, and sexual health among women veterans.

Method: Women veterans (n = 141) drawn from a larger national web-based longitudinal study completed surveys at several timepoints that assessed lifetime IPV and recent IPV (i.e., past 9-10 months) and sexual health concerns. Various forms of sexual function, including sexual desire, arousal, lubrication, orgasm, satisfaction, and pain, were regressed on (a) any recent IPV and (b) recent physical, psychological, and sexual IPV, while accounting for lifetime IPV, military sexual trauma, and age.

Results: Recent, but not lifetime, IPV was negatively associated with all forms of sexual function (B = -0.02 to -0.11, ps < .05) and remained significant (Bs = -0.03 to -0.13, ps < .05) after accounting for covariates. Recent psychological IPV was specifically related to all forms of worse sexual function (Bs = -0.03 to -0.13, ps < .05), whereas physical and sexual IPV were not after adjusting for lifetime IPV, military sexual trauma, and age.

Conclusions: Recent psychological IPV is detrimental to women's sexual function. Clinicians should assist these individuals with improving their sexual function after ensuring safety. The nonsignificant association of physical and sexual IPV with sexual function may be due to low frequency of endorsement. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Brief integrated care settings hold promise for accessible and effective trauma-informed interventions. However, clinicians often have difficulty efficiently forecasting who is most appropriate for interventions in such settings and how to target individualized care. Multidimensional and transdiagnostic evaluations may provide valuable information to improve stepped-care and treatment practices for veterans.

Method: A middle-out approach was used to concurrently evaluate self-reported posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, and physical health problems using cross-sectional (latent profile analysis) and longitudinal (latent growth mixture modeling) analyses that identified unique symptom profiles, trajectories of traumatic stress reactions, and correlates of these health outcomes. Data from 234 veterans who participated in a randomized controlled trial of primary care PTSD intervention were analyzed at 0, 8, 16, and 24 weeks.

Results: Latent profile analysis identified two homogenous baseline profiles: global symptoms (33.8%); low dysphoria-lower negative cognitions, mood, and depressive symptoms (66.2%). Low dysphoria participants reported more social relationships (OR = 1.32) and fewer environmental (OR = 0.89) and financial (OR = 0.23-0.35) stressors. Latent growth mixture modeling identified three trajectories: (a) reducing symptoms ("responders"; 21.3%) and chronic symptoms of (b) moderate (59.6%) and (c) high (19.1%) severity. Low dysphoria participants were 4.35 times more likely to be responders over time compared to participants with moderate severity symptoms.

Conclusions: Findings indicated that veterans with moderate PTSD symptoms and physical health problems but low dysphoria may respond best to trauma-informed intervention in brief integrated care settings, while others may require further individualized stepped care. Findings demonstrate unique traumatic stress reactions that support individualized stepped care and may offer greater treatment utilization, retention, and efficacy. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Trauma exposure is associated with elevated risk for psychotic-like experiences, including subthreshold hallucinations and delusions. Dissociative symptoms may link these two experiences and warrant further exploration.

Method: The present study examined if dissociative symptoms accounted for additional variance in the association between posttraumatic stress disorder (PTSD) symptoms and hallucinations and delusions in a sample of patients (n = 63) seeking treatment for PTSD using the Dissociative Subtype of PTSD Scale; PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; and Diagnostic Interview for Anxiety, Mood, and Obsessive-Compulsive Disorder and Related Neuropsychiatric Disorders hallucinations and delusions screener in a sample of predominantly White women, the majority of whom met criteria for PTSD. Exploratory analyses were conducted to examine if the postpartum subsample endorsed our variables of interest more frequently than our overall sample.

Results: As hypothesized, PTSD symptoms and dissociative symptoms exhibited a small, significant correlation with psychotic-like experiences. Furthermore, dissociative symptoms accounted for additional variance in our models in psychotic-like experiences; however, the additional variance accounted for did not reach the level of significance. However, this study was limited by cross-sectional data with a predominantly White, woman sample. Future studies should examine these associations longitudinally among marginalized groups.

Conclusions: Clinicians must provide thorough assessments to parse out PTSD symptoms, dissociative symptoms, and psychotic-like experiences, especially for clients seeking treatment for complex PTSD and/or a history of traumatic birth experience. Clinicians must conduct thorough assessments using validated tools like the Dissociative Experiences Scale and the Structured Interview for Psychosis-Risk Syndromes and could use interventions such as narrative exposure therapy that address maladaptive thoughts and dissociative experiences related to traumatic experiences. (PsycInfo Database Record (c) 2026 APA, all rights reserved).