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

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: This comprehensive review seeks to integrate knowledge on the dual role of time as a reactive and a constructive measure with literature on the distinctive encoding of traumatic memories. First, we discuss the dual role of time. Later, we show how encoding traumatic events may lead to chronic alteration in time perception. Finally, we review the potential of temporal metacognitive awareness as a therapeutic avenue to rectify chronic time dilation following trauma, ultimately mitigating posttraumatic symptoms.

Method: A systematic search of electronic databases was conducted using four main terms: time perception, temporal encoding of traumatic memories, temporal metacognitive awareness, and temporal learning tasks as clinical interventions.

Results: The review proposes that the interplay between the dual roles of time-reactive and constructive-alongside the elemental encoding of traumatic events can give rise to a self-perpetuating cycle. Within this cycle, overgeneralized fear could lead to neutral stimuli triggering and fortifying time dilation, thus contributing to the maintenance of posttraumatic stress disorder (PTSD) symptoms. Furthermore, we propose that cultivating temporal metacognitive awareness could potentially yield a positive impact on time dilation by embracing a more adaptable learning approach-one that places less emphasis on external signals and does not necessitate direct engagement with traumatic content. Strengthened temporal awareness might serve to mitigate chronic time dilation, potentially leading to a reduction in PTSD symptoms.

Conclusion: The review emphasizes the need for further research to examine whether enhancing temporal metacognitive awareness for time duration may offer an innovative and effective avenue for alleviating PTSD symptoms in trauma-exposed individuals. (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).

Racism and gender-based prejudice produce a synergistic and toxic effect that necessitates analysis. There is a need to conduct more research with Black men as their experiences with race-based trauma may differ, given their concurrent disproportionate exposure to other forms of violence.

Objective: The study's purpose was to develop items for and evaluate the factor structure and internal consistency of the Cultural Trauma Scale (CuTS) in an exclusive sample of Black men.

Method: Using the Yale Center for Clinical Investigation, Community Alliance for Research Engagement principles, the study was conducted in a context of community-engaged research. Data were collected from individual interviews and focus groups, subject matter experts, and a sample of 150 adult Black men. Principal axis factoring (PAF) was used to determine the factor structure of the scale items.

Results: Via PAF the final factor structure included five constructs addressing: American and its justice system: cognitive-emotional responses (Cronbach's α = .88), cognitive-behavioral coping (Cronbach's α = .77), willingness to seek cultural trauma treatment (Cronbach's α = .88), tripartite police fear (Cronbach's α = .81), and resilience (Cronbach's α = .61).

Conclusions: The CuTS represents psychometric advancement in the measurement of Black male social justice and healing from cultural trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Refugees are highly vulnerable to mental health disorders and head injuries. The primary aim of this study is to examine the impact of posttraumatic stress disorder (PTSD) and head injury on reactive and appetitive aggression in adult Syrian refugees in Lebanon.

Method: A cross-sectional study was conducted targeting adult Arab United Nations High Commissioner for Refugees-registered Syrian refugees residing in Beirut and southern regions of Lebanon. Eligible refugees completed a battery of questionnaires including the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, the Trauma Events and Head Injury sections of the Harvard Trauma Questionnaire, the Buss-Perry Aggression Questionnaire, and the Appetitive Aggression Scale.

Results: A total of 191 Syrian refugees participated in the study: 62.83% were females, and the mean age was 31.01 years (SD = 10.98). The severity of PTSD (adjusted B = 0.18, 95% CI [0.05, 0.31], p = .006), having experienced at least one head injury trauma event (adjusted B = 10.20, 95% CI [1.61, 18.79], p = .020), and the severity of somatic symptoms (adjusted B = 0.71, 95% CI [0.23, 1.20], p = .004) were significant risk factors of reactive aggression. As for appetitive aggression, males (females adjusted OR [aOR] = 0.06, 95% CI [0.02, 0.18], p < .001), younger individuals (aOR = 0.95, 95% CI [0.91, 0.99], p = .024), and higher severity of somatic symptoms (aOR = 1.20, 95% CI [1.09, 1.32], p < .001) were significant risk factors.

Conclusions: PTSD and head injury are independent risk factors for reactive aggression but not appetitive aggression in Syrian refugees in Lebanon, while the severity of somatic symptoms is an independent risk factor for both reactive and appetitive aggression. (PsycInfo Database Record (c) 2024 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) 2024 APA, all rights reserved).

Objective: This study is aimed to test the association of the Subjective Traumatic Outlook (STO) concept for distinguishing between posttraumatic stress disorder (PTSD) and complex PTSD. Focusing on identity dimensions within identity theory, the research aims to understand how subjective factors influence psychological outcomes, especially in the context of trauma during prolonged war. Findings can inform our understanding of the perception of trauma during wartime.

Method: We examined a national sample of 1,895 Ukrainians during the Russian invasion, who completed the International Trauma Questionnaire and the STO. Statistical analyses, including analysis of variance, analysis of covariance, and contrast measurement, were conducted to examine associations while controlling for demographic factors.

Results: Our study highlights distinct STO levels associated with varying degrees of trauma-related disorders. Lower STO scores relate to reduced disorder likelihood, while higher STO levels indicate greater risk, particularly for complex PTSD. These distinctions persist even when considering demographic variables associated with wartime conditions.

Conclusion: Our research contributes to the understanding of PTSD/complex PTSD during ongoing conflict and underscores the applicability of identity aspects in elucidating the influence of subjective factors on psychological outcomes. This exploration of STO represents another approach to understanding internal perspectives in trauma-related disorders. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: While mobile delivery can help increase access to evidence-based treatment for veterans with posttraumatic stress disorder (PTSD), feasibility and acceptability are of concern with the potential for high attrition rates and limited participation. The Mantram Repetition Program (MRP), a meditation-focused approach with documented efficacy for reducing symptoms of PTSD and insomnia, was adapted as a brief, mobile-delivered MRP (mMRP) training. This study assessed implementation indicators of mMRP and compared self-directed users of mMRP versus users who received additional text message support.

Method: Thirty-six veterans with clinically significant PTSD symptoms (M_age = 50.50 years; 83.3% male; 72.2% White; 88.9% heterosexual) completed four weekly training video modules. Participants completed questions related to program satisfaction, mantram repetition use, clinical measures, and a 30-min individual interview.

Results: Participants reported using their mantram between 4 and 5 days per week. Participants indicated that mMRP was generally acceptable, appropriate, and feasible across quantitative and qualitative data. On clinical measures, change from pre- to postintervention was significant for the brief symptom screen, PTSD symptoms, and Personal Health Inventory but not for depression or insomnia symptoms. No significant differences were found between the self-directed and supported conditions; however, data suggest that participants primarily engaged with the support for administrative needs. Qualitative data highlighted suggestions for mMRP improvement, including alternative methods for receiving support and more content on how to use the skills taught.

Conclusions: Findings suggest that mMRP can be delivered in a brief format, with veterans learning and using mantram repetition. Developing additional ways of individualizing the mMRP and further testing are warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Not all women experience the same changes in depression from pregnancy through the years following childbirth, but the patterns of prenatal and postnatal depression are underexplored. This study investigated the trajectories and associated predictors of depressive symptoms in women from pregnancy through the first 3 years postpartum.

Method: We followed 340 pregnant women from an antenatal clinic in Hong Kong, first at 20-24 weeks of gestation, then at 4 weeks after childbirth, and again at 3 years after childbirth. Pregnant women reported their depressive symptoms whether they had intimate partner violence, health conditions, adverse childhood experiences, family support, and perceived partner involvement. Latent class growth analysis was applied to identify distinct trajectories of depression, and binary logistic regressions were performed to analyze predictors of trajectories.

Results: We found that 26.5% of women showed clinical depressive symptoms at 20-24 weeks of gestation, 9.7% at 4 weeks after childbirth, and 12.6% at 3 years after childbirth. Two classes were identified: a low-stable group (86.2%) and a relapsing/remitting group (13.8%). Women with a history of trauma (i.e., intimate partner violence and adverse childhood experiences) and mental health difficulties were more likely to be classified in the relapsing/remitting group than in the low-stable group. Family support and partner emotional involvement appeared to protect the women from suffering relapsing/remitting depression.

Conclusions: The findings highlight the importance of screening for depression throughout pregnancy and extending several years postpartum. Distinguishing the different trajectories of depression and identifying its associated factors are critical to providing targeted interventions to the most vulnerable women (i.e., a relapsing/remitting group in the present study). (PsycInfo Database Record (c) 2024 APA, all rights reserved).