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

Objective: Pediatric traumatic injury (PTI) is associated with a high risk for psychiatric sequelae. Most trauma centers do not adequately address the emotional needs of children and their caregivers. Technology-based programs offer a low-cost and low-burden opportunity to track and potentially enhance families' emotional recovery following PTI. This feasibility pilot project was designed to examine caregivers' usage of and feedback on a text message-based symptom monitoring service.

Method: Participants included 25 caregivers of PTI patients under age 12. Caregivers received up to four texts daily for 30 days postdischarge from the automated system: one symptom-based question to capture the current mental health status of the caregiver and child, respectively, and a corresponding educational tip each time a symptom was endorsed. Data analyses describe the number of questions to which caregivers responded on behalf of themselves and their children. A semistructured qualitative interview was used to assess caregivers' reactions and suggested improvements for the service.

Results: Almost all caregivers (91.1%) responded to at least one text message, and two thirds (66.6%) responded to over half of the messages. Themes from the qualitative interviews indicated that caregivers perceived the timing and content of the text messaging service facilitated their own and their child's emotional recovery following PTI. Caregivers suggested that the service could be improved by providing an option to interact directly with mental health care providers.

Conclusions: Text message-based symptom monitoring services offer an opportunity to bridge the gap in mental health services during the acute recovery phase for families of traumatically injured children. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Few studies have identified validity tests that are appropriate for use in individuals with dissociative identity disorder (DID). This study investigated whether the Morel Emotional Numbing Test (MENT) could distinguish between genuine and simulated DID.

Method: Thirty-five participants with DID diagnosed via a semistructured interview were compared to 88 participants taking an abnormal psychology course who were instructed to simulate DID. Group comparison analyses were conducted to examine differences in the MENT errors. Univariate logistic regression and receiver operating characteristic curve analyses examined how well the MENT errors discriminated between groups and identified a cutoff optimizing sensitivity while maintaining high specificity.

Results: Simulators had significantly more errors across all three MENT sets compared to genuine DID participants. The total number of MENT errors across sets most strongly and significantly predicted genuine versus simulated DID groups. Receiver operating characteristic curve analyses indicated that the MENT could discriminate between genuine and simulated DID with outstanding classification accuracy (area under the curve = .95). A cutoff of ≥ 10 total errors on the MENT yielded an optimal balance of sensitivity (.86) and specificity (.94). However, the previously defined cutoff of ≥ 8 total errors also demonstrated high sensitivity (.87) and specificity (.89).

Conclusions: Findings provide preliminary evidence for the MENT as a validity test for DID populations. Although the commonly used cutoff of ≥ 8 errors on the MENT demonstrated excellent psychometric properties, we recommend using a cutoff of ≥ 10 errors for individuals with DID to minimize the risk of false positives while maintaining strong sensitivity. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: The present study was designed to provide the first in-depth, academically peer-reviewed assessment of sexual victimization among Royal Canadian Mounted Police (RCMP).

Method: A representative sample of RCMP (n = 1,324; 76.5% men) completed the self-report survey.

Results: Participants reported a higher overall lifetime history of sexual assault than would be expected for the general population (p < .05). Women participants reported a higher prevalence of lifetime history of sexual assault (p < .05). Participants reported being sexually assaulted during the RCMP Cadet Training Program (CTP; n = 27), with comparable proportions of men and women. Participants reported being sexually assaulted while on duty (n = 168), with a greater proportion of women reporting being sexually assaulted than men (p < .05). Women more often reported being sexually assaulted while on duty by a superior, coworker or peer, or subordinate, whereas men more often reported being sexually assaulted by a civilian. Participants (n = 94) reported being sexually harassed during the CTP and while on duty (n = 282), with a greater proportion of women reporting being sexually harassed during the CTP and while on duty.

Conclusions: RCMP cadets appear to be sexually assaulted and sexually harassed less frequently than Canadian university and military college students, whereas RCMP appear to be sexually assaulted more often while on duty than Canadian men and women in the general population while at work; however, direct comparisons are problematic because of differing frames for questions and time spans. The current results help quantify sexual victimization among RCMP, which can support ongoing and novel prevention and intervention strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: To identify traumatic stress symptoms among expectant parents with a confirmed congenital anomaly and describe the ways in which a maternal-fetal care center, with an embedded multidisciplinary psychosocial support team, provides specific trauma-informed strategies to mitigate psychological distress from the first patient contact throughout prenatal care practice.

Method: Traumatic stress symptoms in response to the confirmed congenital anomaly were assessed using the Impact of Events Scale-Revised. With Institutional Review Board approval, a total of 4,391 pregnant parents and 3,570 partners were analyzed based on routine universal screening performed in a single maternal-fetal care center. Exploratory, descriptive analyses examined rates of overall traumatic stress symptoms and subscale scores.

Results: 28.7% of pregnant parents and 24.2% of expectant partners reported elevated traumatic stress symptoms in response to their confirmed congenital anomaly, with clinically significant risk endorsed among 16.2% and 13.4%, respectively. Symptoms of intrusion and avoidance were most notable among parents. Methods of trauma-informed care provided by the multidisciplinary care team in collaboration with the psychosocial support team to identify, support, and intervene with high-risk parents are described.

Conclusions: Recognizing that expectant parents who receive a prenatal diagnosis of a congenital anomaly are at heightened risk for experiencing traumatic stress symptoms, multidisciplinary care teams should offer trauma-informed strategies and psychosocial support services, including parental mental health screening, psychosocial assessment, and clinical intervention, as part of routine prenatal care to reduce the negative effect of emotional distress in the expectant parents prior to birth. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Objective: Although highly intensive trauma treatment programs show promising results in the treatment of patients with posttraumatic stress disorder (PTSD), it remains uncertain if patients with complex forms of PTSD can benefit equally from these intensive programs. To investigate whether patients with the dissociative subtype of PTSD (PTSD + DS) and patients with probable complex PTSD (CPTSD) draw equal benefits from a highly intensive trauma treatment program as patients with PTSD.

Method: In this clinical cohort study, patients were included who attended a 5-day intensive program consisting of eye movement desensitisation reprocessing, exposure in vivo and trauma-sensitive yoga components. PTSD with DS was assessed with the Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, fifth edition (CAPS-5), and a provisional diagnosis of CPTSD was assessed with the International Trauma Questionnaire. Primary outcome measure was self-reported PTSD-symptom severity measured by PTSD Checklist for DSM-5 at the start of the program (T1) and a week after the program (T2).

Results: Both groups, PTSD + DS (d = 0.85) and probable CPTSD (d = 0.85) benefitted significantly in terms of PTSD-symptom severity reduction and the size of the decrease was not significantly different from that of patients with PTSD.

Conclusions: Patients with both forms of PTSD complexity can benefit even from a very brief intensive treatment program, which extends previous studies. The diagnoses of PTSD + DS and CPTSD seem helpful to assess the initial severity of the symptoms, but do not imply contra-indications to benefit from intensive treatment. Highly intensive treatment programs are promising interventions to effectively treat complex forms of PTSD and should be studied further in randomized clinical trials. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Reports an error in "Ayahuasca in the treatment of posttraumatic stress disorder: Mixed-methods case series evaluation in military combat veterans" by Brandon Weiss, Lê-Anh L. Dinh-Williams, Nick Beller, Ian M. Raugh, Gregory P. Strauss and William K. Campbell (Psychological Trauma: Theory, Research, Practice, and Policy, Advanced Online Publication, Dec 07, 2023, np). In the original article, there was an error in the calculations that led to the overstatement of the symptom severity of the veteran sample. Specifically, sum scores for the posttraumatic stress disorder (PTSD) symptom checklist (PCL-5) were scored using a 1-5 Likert scale rather than the appropriate 0-4 Likert scale. As a result, although it was stated that participants in the veteran sample exhibited clinical levels of PTSD based on the >33 PCL-5 threshold associated with a PTSD diagnosis, the levels actually reflected moderate posttraumatic stress symptoms. In addition, estimates of significantly reliable change in PCL-5 scores after an ayahuasca intervention (from 87.5% to 71.4%) were modified, and the threshold criteria for clinically significant changes (posttreatment scores <28) were removed because several participants met these criteria at baseline, thus impacting the interpretation of treatment outcomes. (The following abstract of the original article appeared in record 2024-34611-001).

Objective: Although ayahuasca-a plant-based psychedelic-is discussed as promising in the treatment of posttraumatic stress disorder (PTSD), evidence so far remains limited to retrospective case reports and qualitative surveys. No study to date has examined whether ayahuasca results in prospective and clinically meaningful changes in trauma symptoms across individuals with PTSD symptoms.

Method: To address this gap, we conducted a convergent mixed-methods case series study on eight military veterans with PTSD who participated in a 3-day ayahuasca intervention in Central America. Clinically meaningful changes from pre- to posttreatment and at a 3-month follow-up were assessed in three ways using: (a) PTSD checklist-5 (PCL-5); (b) experience sampling measurement of momentary PTSD and mood symptoms; and (c) an open-ended survey on perceived benefits.

Results: The majority (87.5%; 7/8) of participants demonstrated reliable and/or clinically significant changes in PCL-5 symptoms by posttreatment, which were maintained by 70% (5/7) of veterans by the 3-month follow-up. On average, veterans also reported significant improvements in momentary PTSD symptoms, as well as negative and positive affect in daily life posttreatment, with 63% (5/8) reporting moderate-to-large improvements in these domains. Broad themes characterizing the perceived benefits of ayahuasca included deep positive emotions, decentering/acceptance, and purpose in life; adverse acute experiences were, however, reported.

Conclusions: