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

Objective: The 2023 Veterans Affairs/Department of Defense Clinical Practice Guideline for posttraumatic stress disorder (PTSD; Veterans Affairs/Department of Defense, 2023) identified medications and specific psychotherapies as recommended or suggested treatments. Yet, more patients with PTSD receive general counseling than these recommended treatments (Cameron et al., 2023). We aimed to understand why different PTSD treatment options were preferred.

Method: This study examined the treatment preferences of 887 people who screened positive for PTSD, along with their reasons for the least and most preferred options (which were analyzed with content analysis).

Results: Evidence-based trauma-focused treatments as a whole were most often ranked first (45.4%), although examined individually, general counseling was most commonly ranked first (31.8%). Having a trauma focus was rarely listed as a reason to not want a treatment. People tended to prefer a treatment because of the content of the treatment or the way it was presumed to work, along with believing it would be a good personal fit or that they were familiar with it. Perceived effectiveness followed. The reasons for not preferring a treatment had to do with presumed aversiveness (including side effects, addiction, etc.) most often, along with a perceived lack of fit or something about the content or mechanism.

Conclusions: When presenting treatment options to patients, it may be helpful to discuss what matters to patients in a treatment and to assess their reasons for preferring a treatment both before and after they have done so, giving an opportunity to correct any misperceptions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Firefighters experience frequent traumatic events and occupational stressors, increasing risk for posttraumatic stress disorder (PTSD), insomnia, and nightmares, which are frequently comorbid and interrelated. However, firefighter schedules and mental health stigma limit engagement in weekly therapy. The present study was a randomized pilot feasibility trial of an integrated, accelerated, culturally adapted treatment for firefighters with clinically significant PTSD, insomnia, and nightmare symptoms.

Method: Participants (N = 49) were randomized to immediate or delayed treatment. Treatment integrated written exposure therapy for PTSD and cognitive behavioral therapies for insomnia and nightmares and was delivered in a 4-day group therapy "workshop" with one individual session before and after the workshop. Participants completed diagnostic interviews at baseline and 1-month posttreatment and self-report surveys through 3-month posttreatment.

Results: Most indices of program feasibility were positive despite logistical challenges impacting enrollment and treatment uptake. In addition, there were large group by time interaction effects for reductions in symptoms of PTSD (g = 1.70) and insomnia (g = 1.47) and a medium effect for nightmares (g = 0.72). Improvements in symptoms of all three targeted disorders and depressive symptoms were maintained through 3-month posttreatment.

Conclusions: This study supports the efficacy of accelerated, integrated PTSD and sleep disorder treatment. To our knowledge, this is the first controlled study of a culturally adapted mental health intervention for firefighters. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Racial trauma-the stressful impact or emotional pain that comes from experiencing racism-is associated with risk of anxiety, depression, general psychological distress, and suicidal ideation among Black youth. We adapted and piloted an evidence-based intervention for traumatic stress to address racial trauma among Black youth ages 12-17.

Method: Following the Assessment, Decision, Adaptation, Production, Topical Experts- Integration, Training, & Testing framework, we conducted focus groups, a survey, pretesting of intervention components, and engaged in consultation with topical experts to develop our adapted intervention, Healing through Education Affirmation and Rising Together (HEART). We then evaluated HEART through a mixed-method pilot study with Black youth ages 12-17 (n = 25).

Results: Our pilot study suggested HEART holds promise in reducing discrimination distress, improving racial identity, and improving hope for the future among Black youth. We also observed a nonsignificant trend toward reduced depressive symptoms for HEART participants, suggesting potential benefit worth further study. Findings indicate that HEART is culturally relevant to Black youth and feasible to implement using a task-sharing approach.

Conclusion: As research consistently documents the harm from racial trauma and limited access to mental health supports for Black youth, it is imperative to develop and implement accessible and relevant interventions. This study addressed a gap in existing interventions with an iterative process that centers the experiences of Black youth exposed to racial trauma. The response to the adapted intervention indicates HEART is a promising approach to reduce mental health inequities associated with racial trauma among Black youth. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Secondary traumatic stress (STS) can have significant deleterious effects on clinicians' personal and professional lives and hinder the quality of care they deliver. However, the STS research is currently limited by methodological inconsistencies in both how it is measured and the populations studied, making it difficult to draw comprehensive conclusions. This review's purpose is to provide an updated overview of how the concept of STS has been measured specifically in therapy-offering clinicians and offer recommendations for future research and clinical practice.

Method: Five databases (APA PsycInfo, Medline, Embase, Scopus, Web of Science) were searched for quantitative, peer-reviewed studies on STS in mental health clinicians published in English up to December 2024. A descriptive metasynthesis summarized means, standard deviations, and score ranges of commonly used measures. A reliability generalization analysis was conducted using extracted internal consistency coefficients.

Results: A total of 49 studies met the inclusion criteria, and seven different instruments used to measure STS were identified. The most popular measures were the Professional Quality of Life Scale (Stamm, 2010) and the Secondary Traumatic Stress Scale (Bride et al., 2004), which assess STS from different perspectives. The reliability generalization analysis suggested acceptable and excellent internal consistencies for these measures, respectively.

Conclusions: At present, no single measure is available to capture the entire domain of STS. It is recommended that the choice for the most appropriate outcome measure is guided by the desired emphasis on STS symptoms. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Survivors of human trafficking, including commercial sex and labor exploitation, benefit from comprehensive, trauma-informed services, but more research is needed to establish best practices and identify effective models and strategies. The present study explored the lived experiences of seven direct service providers in agencies that support the recovery and development of human trafficking survivors in Kentucky. The aim of this study was to inform our understanding of how trauma-informed care better addresses the needs of human trafficking survivors in health care and social services settings.

Method: Using qualitative, narrative inquiry methods, this study identified trauma-informed models and strategies currently employed in Kentucky agencies that serve trafficking survivors and participants' experiences with successful strategies and barriers to promoting trauma-informed care. The theoretical framework that guided this study is Bronfenbrenner's ecological systems theory. Participants' stories were collected through artifact presentations, semistructured interviews, guided questionnaires, and a focus group.

Results: Data analysis revealed the themes of (a) education and training, (b) responding to needs, (c) safety and transparency, (d) trusting relationships, and (e) standards of care.

Conclusions: Implications for legislation in Kentucky to implement standards of care and support preventative efforts are explored. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Refugees and other forcibly displaced populations are at high risk for mental health and psychosocial problems due to experiences of violence and trauma, compounded by displacement stressors. While there are mental health best practices and evidence-based approaches, many of these are highly specialized and clinically focused. There is a need for an integrated and expanded mental health service delivery framework to inform work across the multiple contexts where services are needed to improve the mental health and psychosocial well-being of forcibly displaced populations in the United States. To inform the development of such a framework, this review synthesized the literature on mental health service delivery models for populations impacted by trauma and/or displacement, including service components, workforce needs, and key theories and concepts.

Method: A scoping review approach was used, and 35 publications were retained for analysis. Content and thematic analysis approaches were used to analyze the data.

Results: Frameworks and service delivery models were identified for diverse, trauma-affected populations. Across frameworks, 11 different service categories were identified, inclusive of basic support, mental health promotion, and prevention and treatment services. Several workforce types implemented services, including community members, peers, school-based staff, government agents, and health professionals. Gaps included limited attention to whole systems approaches, stigma, and outcomes.

Conclusions: Overall, these findings and gaps can inform the development of a model to guide integrated delivery of mental health services for refugee and other forcibly displaced populations in the United States. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objectives: Few studies have examined protective strengths that promote adaptation among youth exposed to victimization and adversity. The resilience portfolio model (S. Hamby, Grych, & Banyard, 2018) proposes that assets across regulatory, interpersonal, and meaning-making domains foster adaptation following adversity. While primarily studied in U.S. adult populations, this study applied the model to examine protective factors linked to subjective well-being, physical well-being, and reduced trauma symptoms among Francophone youth from Quebec.

Method: Participants (n = 4,122; ages 14-25) completed an online survey including the French version of the Juvenile Victimization Questionnaire, a measure of adverse life events, and the Resilience Portfolio Model Packet for Youth (S. Hamby, Taylor, et al., 2018). Regression analyses entered age and gender in the first block, victimization and adversity in the second, and polystrength and 16 individual strengths in the third.

Results: Most youth reported at least one form of victimization or adversity. Victimization and adverse life events accounted for 6%-12% of the variance in outcomes. Adding strengths increased explained variance, with final models accounting for 59% of the variance in subjective well-being, 34% in trauma symptoms, and 22% in physical well-being. Sense of purpose, recovering positive affect, and mattering were the strongest predictors of thriving.

Conclusion: Programs should foster strengths across domains to support youth resilience. Investing in strength-based approaches may offer a promising pathway to enhance well-being in vulnerable youth. Emphasizing purpose, positive affect recovery, and mattering may be particularly effective in promoting thriving among those facing adversity. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Among psychotherapeutic treatments for posttraumatic stress disorder, prolonged exposure, and cognitive processing therapy have distinguished themselves with their high efficacy and strong backing in the treatment literature. However, low patient retention undermines the benefit of these evidence-based psychotherapies. Underrepresentation of Latinx and American Indian/Alaska Native (AI/AN) veterans in posttraumatic stress disorder research has rendered it difficult to determine ethno-racial disparities in patient retention. Despite serving in the U.S. military at high rates, Latino and AI/AN veterans are especially underrepresented in the existing research regarding engagement and efficacy of evidence-based psychotherapies for posttraumatic stress disorder.

Method: This study examined treatment selection, initiation, receipt of minimally adequate care, and completion among 708 male White, Latino, and AI/AN veterans seeking prolonged exposure or cognitive processing therapy in an outpatient Veterans Health Administration specialty clinic.

Results: Analyses revealed levels of treatment retention differed significantly between ethnoracial groups. After selecting treatment, AI/AN veterans were more likely to never attend any protocol sessions and had a shorter time to attrition compared with White veterans.

Conclusion: The results of this study demonstrate barriers to treatment engagement and retention experienced by different ethnoracial groups and inform culturally sensitive considerations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Efforts to achieve optimal outcomes in patients with chronic pain (CP) are impeded by unaddressed psychological trauma. Primary care offers a practical opportunity to identify patients with unresolved trauma through screening. However, the extent of such screenings in clinical practice remains unclear. This exploratory study aimed to assess trauma screening practices among Arizona primary care providers, examine their understanding of the trauma-CP connection, and investigate perceived barriers and opportunities for improving integration into primary care workflows.

Method: We conducted a cross-sectional survey of Arizona primary care providers in family and internal medicine. Data on providers' practices, comfort levels, beliefs, and perceived barriers were analyzed.

Results: The final sample comprised 71 survey respondents, with some variability in item response rates. Nearly all respondents (93.4%) acknowledged the connection between unresolved psychological trauma and CP, but only 23.9% consistently screened patients with CP for trauma. Screening rates for trauma among patients with CP were significantly lower compared to screening for anxiety/depression, social determinants of health, and substance use disorder. Reported barriers included feasibility concerns related to time and staffing, lack of patient-provider trust, and limited behavioral health access.

Conclusions: While awareness of the CP-trauma link is widespread, trauma screening in Arizona primary care remains insufficient. Systemic barriers, rather than individual provider factors, appear most influential. Addressing time, staffing, and behavioral health integration challenges is critical for improving screening rates. Future research should focus on systemic factors to develop scalable, sustainable solutions for integrating trauma screening into primary care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Objective: Understanding judges' views is crucial to the successful adoption of a trauma-informed (TI) approach in the U.S. court system, yet little is known on this topic. We explored judges' attitudes of and experiences with TI practice to help fill this gap.

Method: We surveyed 91 North Carolina district court judges, assessing their attitudes related to TI practice, use of trauma-informed practices (TIPs), previous trauma education, and support for different justice goals. We conducted independent-samples t tests and Poisson regression analyses to compare attitudes, use of TIPs, and education experiences between judges working in juvenile justice and those not in juvenile justice; descriptive statistics to examine rates of engagement with different TIPs; and bivariate correlation analyses to assess associations between TI practice outcomes and justice goals.

Results: Analyses revealed more favorable attitudes toward a TI approach and greater engagement with trauma education among judges working in juvenile versus adult courts; TIPs with the lowest levels of engagement related to policies and procedures; and strong positive correlations between favorable TI practice attitudes and support for rehabilitation and restoration.

Conclusion: Findings highlight areas for growth in the movement to create more TI courts, such as strengthening support for TI practice in the adult criminal system and implementing TIPs related to policies, procedures, and outcomes, not just communication. Findings also support the connection between a TI approach and less punitive justice practices, signaling the potential role that TI judicial practice can play in shifting our legal system toward more transformative forms of justice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).