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

Objective: Family strain, which reflects the overall function of the family system, could play an important role in routine posttraumatic stress disorder (PTSD) care. We examined how high/low family strain influences perceptions of a family-involved intervention for Veterans with PTSD to inform the design and implementation of family-centered interventions in routine PTSD care.

Method: Sequential explanatory mixed methods study that analyzed qualitative exit interview data from a three-session family-involved pilot study stratified by Veteran baseline scores of family strain (Veteran n = 16; support partner [SP] n = 12). Themes were identified via rapid qualitative analysis of interview data categorized by high/low strain.

Results: Eleven Veterans (nine associated SPs) were classified as experiencing high and five Veterans (three associated SPs) were classified as experiencing low family strain. While nearly 50% of Veterans reported belonging to a non-White racial group, all of the Veterans were men. Themes reflected preintervention expectations, intervention experiences, and postintervention changes. Differences in intervention experiences were observed with different family strain levels. Participants in the high strain group articulated concrete goals for the intervention and provided more details about benefits, including an enhanced understanding of PTSD, improved family communication, and increased social support. Participants in the high strain group reported more discomfort with the intervention process, especially the conjoint sessions.

Conclusions: Family-involved interventions for Veterans with high family strain are feasible and may have even greater benefits than for Veterans reporting low family strain. Future research is needed to empirically test this hypothesis and to understand the experiences of female Veterans. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Interpersonal violence is a common barrier to reintegration into civilian life in post-9/11 veterans. Alcohol use and anger, also common among veterans, are both risk factors for violence. The present study used longitudinal data to examine relationships between these factors.

Method: Post-9/11-era veterans (N = 302) were assessed via clinical interviews and self-report questionnaires at baseline, 6 months, and 12 months on alcohol use, anger, violence, and posttraumatic stress disorder (PTSD) symptom severity. Multilevel structural modeling was used to compare two different mediation models across the three waves of data.

Results: The indirect effect of changes in alcohol use on violence via changes in anger was significant (p = .046). When covarying for PTSD symptom severity, the effects of Path A and Path B were consistent; however, the indirect effect between alcohol use and violence was no longer significant (p = .076). The indirect effect of changes in anger on violence via changes in alcohol use was not significant (p = .074).

Conclusions: Alcohol use, anger, and violence are variables closely influencing one another. The association between changes in anger and subsequent violence was not mediated by changes in alcohol use. The association between changes in alcohol use and subsequent violence was mediated by changes in anger; however, this mediating effect disappeared when controlling for PTSD severity. These findings shed light on the importance of anger and PTSD as contributors to the relationship between alcohol use and violence. They suggest that assessing and treating anger may reduce violence among veterans with problematic alcohol use. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Chronic pain often co-occurs with posttraumatic stress disorder (PTSD). The mutual maintenance hypothesis proposes that there may be shared underlying mechanisms of symptoms of pain exacerbating PTSD, and vice versa. The association between PTSD and pain intensity remains understudied. To elucidate the relationship, the present study examined the temporality of changes in PTSD severity and pain intensity in veterans undergoing intensive PTSD treatment.

Method: Data from 332 veterans undergoing intensive 2-week cognitive processing therapy- (CPT-) based treatment (ITP) with adjunctive components (i.e., mindfulness, art therapy). Random intercepts cross-lagged panel models (RI-CLPMs) were used to examine within-subjects relationships between pain intensity and PTSD severity over the course of the program.

Results: Veterans experienced large PTSD severity reductions (Essg = 1.20; p < .001) and small pain severity reductions (Essg = 0.21; p < .001) over the course of treatment, despite pain not being a treatment target. RI-CLPMs revealed that PTSD severity significantly predicted subsequent pain severity. Results indicate the absence of a bidirectional relationship in that changes in pain intensity did not predict later PTSD severity improvement during the ITP. Time trends for both PTSD severity and pain intensity were generally consistent with respect to baseline demographic characteristics.

Conclusion: Our findings support the mutual maintenance regarding the association between PTSD and pain intensity. Future research should investigate temporal associations in other evidence-based PTSD treatments and formats and evaluate the long-term impacts of PTSD treatment on pain intensity. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Military sexual trauma (MST) has gained national attention since the Navy Tailhook scandal, in which 90 service members reported being sexually assaulted and/or harassed by military personnel (Monteith et al., 2015). Screenings administered in the early 2000s revealed that approximately one in five women and one in 100 men seen in Veteran Affairs medical hospitals screen positive for MST (Schweitzer, 2013). The current literature has advanced our understanding of the prevalence of MST and the impact sexual trauma has on the overall health and well-being of MST survivors. Additionally, the literature on moral injury has expanded inquiry into how perpetration of and failure to prevent violence is associated with psychiatric distress and decreased functioning. However, there is a dearth of research on service members who perpetrate MST and those who fail to intervene or report sexual trauma, and the psychiatric effects of these actions or inactions on these individuals. This commentary explores the possible benefits and risks of expanding the assessment of MST to include perpetration and failing to intervene or report MST. We discuss this within the larger context of MST assessment, future research, and prevention and intervention efforts. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Although the link between childhood trauma and depression has previously been established, more protective factors have yet to be explored. This study examined the moderating effects of career satisfaction on the relationship between childhood trauma and depressive symptoms.

Method: A convenience sample of young adults (N = 340) aged 18 to 24 in a survey project. Participants completed validated screening measures for childhood trauma and depressive symptoms, as well as their level of career satisfaction at baseline (T1), then reported their depressive symptoms again at follow-up (T2) after 3 months. Multiple regression and moderation analyses were used to analyze the data.

Results: After controlling for demographic variables and T1 depressive symptoms, childhood trauma (β = .284, p < .001) and career satisfaction (β = -.081, p = .043) significantly predicted T2 depressive symptoms. Moreover, career satisfaction also moderated the effects of childhood trauma on T2 depressive symptoms-childhood trauma predicted T2 depressive symptoms only when the level of career satisfaction was low (B = .514, p = .001).

Conclusions: This study provides evidence that career satisfaction could buffer the effects of childhood trauma on subsequent depressive symptoms. Screening for depressive symptoms and counseling services at the workplace might be beneficial to young adults with childhood trauma. Future studies are needed to evaluate the efficacy of trauma-informed career counseling interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: While increasing attention has been paid to the negative ramifications of military service on female veterans, little is known about the factors that support positive adaptation and posttraumatic growth (PTG) in this population. This study examined how military-related risk factors (combat exposure, sexist hostility), outcomes (posttraumatic stress disorder symptoms), and psychological strengths (self-efficacy, self-esteem, psychological flexibility, prosocial intentions, gratitude, hope, and meaning-centered coping) contribute to PTG among Israeli female combat and noncombat veterans.

Method: A cross-sectional study was conducted with 808 Israeli female veterans (combat: n = 450; noncombat: n = 358) who completed self-report measures online.

Results: Combat veterans reported significantly higher levels of combat exposure, sexist hostility, posttraumatic stress disorder symptoms, and PTG as compared with noncombat veterans. Among combat veterans, posttraumatic stress disorder symptoms were negatively associated with PTG. In regression models, among combat veterans, psychological strengths (especially self-efficacy, prosocial intentions, hope, and meaning-centered coping) were associated with higher PTG beyond military-related risk factors. Among noncombat veterans, only hope was significantly associated with PTG.

Conclusions: These findings highlight the dual nature of trauma in military service, both as a source of distress and a potential catalyst for growth. Psychological strengths serve as robust correlates of PTG and may offer promising targets for interventions aimed at fostering recovery and personal development among female veterans. Strength-based approaches that cultivate hope, meaning-making, and interpersonal capacities may enhance healing and resilience following military trauma. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Posttraumatic stress disorder and depression occur at high rates among college students, making it critical to identify modifiable factors that confer risk or protective effects. Psychological inflexibility (PI; a rigid pattern of thinking and behavior) predicts worse posttraumatic stress and depression (PTS-D) symptoms, whereas perceived social support (PSS) is a robust protective factor. No studies have examined interrelationships among PI, PSS, and PTS-D, which was the aim of this study.

Method: College students (n = 1,184) who endorsed experiencing a potentially traumatic event completed an online survey assessing trauma exposure, posttraumatic stress disorder symptoms, depression symptoms, PI, and PSS. Due to the high correlation between measures, a PTS-D symptoms factor was created using principal components analysis.

Results: An indirect effects model using Hayes PROCESS Model 4 (mediation; 5,000 bootstrapped samples) was conducted, controlling for sex, to evaluate both the direct effects of PI on PTS-D and the indirect effect of PI on PTS-D through its influence on worse PSS. A significant direct effect was observed between PI and PTS-D (b = 0.055, SE = .002, p < .001). There was a significant indirect effect, demonstrating higher PI was associated with lower PSS, which was associated with higher PTS-D (b = 0.003, SE = 0.001, 95% CI [0.002, 0.004]). Thus, the potential positive effects of PSS on PTS-D were diminished by the negative influence of PI on lowering PSS.

Conclusions: Future longitudinal studies are needed to prospectively test mediation and whether PI and PSS should be addressed as concurrent treatment targets to positively impact PTS-D symptoms. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Serving as a health care worker (HCW) during war exposes individuals to increased risks of moral distress (MD) and moral injury (MI), capturing these phenomena encourages further exploration of their causes and consequences and informs the development of tailored interventions. This study aimed to validate two comprehensive tools for measuring MD and MI experienced by Arabic-speaking HCWs in the context of Gaza war, namely, the Moral Distress Instrument (MDI) and the Moral Injury Events Scale (MIES).

Method: Our research team conducted a cross-sectional study over 3 months (January-April 2025). The recruitment of participants took place at primary health care centers and hospitals in the Gaza Strip.

Results: A two-factor structure of the MIES ("perceived transgressions" and "perceived betrayals") yielded acceptable fit indices, with excellent α coefficient values for the total score (.95) and the two factors (0.93-0.94). As for the MDI, we were able to replicate the two-factor structure of the original instrument ("frequency" and "discomfort"). Additionally, reliability findings indicated an excellent Cronbach's α for the two subscales of the MDI (.84-.87). Measurement invariance of the MDI and the MIES was established across sex categories. Greater levels of MD and MI were positively associated with more severe depression, anxiety, posttraumatic stress symptoms and suicidal ideation, supporting good concurrent validity.

Conclusions: The two scales now made available to clinicians and researchers should encourage future endeavors to identify, assess, monitor, and mitigate MD and MI in professionals of diverse disciplines working in different settings. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Dissociative disorders (DDs) are trauma-related conditions marked by disruptions in memory, identity, and consciousness. Despite high prevalence, DDs are underdiagnosed and undertreated. This study explores the experiences of adults with DD participating in a 31-week Finding Solid Ground psychoeducational group.

Method: Participants (N = 72) were mostly women (81%) who experienced a DD or posttraumatic stress disorder dissociative subtype, along with multiple mental health comorbidities. Eight groups (seven virtual, one in-person) completed 31 weekly 90-min sessions based on the Finding Solid Ground curriculum as adjunctive to individual psychotherapy. Thematic qualitative analysis was used to analyze participants' hopes, challenges, helpful and unhelpful aspects, and perceived changes in self during group participation.

Results: Participants noted improved self-awareness, internal system communication, self-compassion, emotion regulation, hope, and overall functioning, as well as reductions in isolation, shame and self-blame, dissociative symptoms, and trauma symptoms.

Conclusions: These findings emphasize the potential benefits of Finding Solid Ground and suggest that trauma-informed group interventions should be further researched, as they could be a scalable method of providing treatment for this underserved population. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Embarrassment, guilt, and shame are negative self-evaluations (NSEs) implicated in a number of psychiatric conditions, including posttraumatic stress disorder (PTSD). Despite their conceptual differences, evidence suggests that each NSE shares considerable variance, complicating efforts to understand their unique contribution to psychopathology and treatment progress. To address this limitation, we developed the Embarrassment, Guilt, and Shame Scale (EGSS), a brief tool designed to assess all three NSEs simultaneously for use in clinical and research settings.

Method: One hundred one veterans referred for PTSD treatment completed the EGSS as part of a standard intake process, which included both clinician- and self-reported measures of PTSD symptom severity. Both exploratory and confirmatory factor analyses were used to identify and then validate the best fitting model.

Results: Controlling for age and sex, results supported a three-factor model, confirming the distinctiveness of embarrassment, guilt, and shame. Each NSE yielded significant correlations with PTSD symptoms at intake. Significant but moderate correlations with other validated measures provided evidence for convergent validity.

Conclusions: The EGSS shows promise as a psychometrically sound measure that assesses three distinct NSEs linked to PTSD symptoms. It also offers promise for improving treatment planning by identifying emotional barriers to recovery. However, findings are based on a single veteran sample. Replications with more diverse populations are necessary to strengthen the generalizability and reliability of the EGSS across psychiatric conditions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).