Pub Date : 2025-12-23DOI: 10.1016/j.ejtd.2025.100628
Thelma Beatriz González-Castro , Jorge Arias de Dios , Nimrod Torres-León , Jorge Luis Hernández-Vicencio , Daina Pérez-Ramírez , Yazmín Hernández-Díaz , David Ruiz-Ramos , Germán Alberto Nolasco-Rosales , Isela Esther Juárez-Rojop , Carlos Alfonso Tovilla-Zárate , Maria Lilia López-Narváez
Several studies have indicated that brain-derived neurotrophic factor (BDNF) is correlated with posttraumatic stress disorder (PTSD) occurrence. However, this issue remains controversial. Therefore, we conducted an updated meta-analysis to investigate the role of BDNF in PTSD.
A systematic search and screening of relevant studies was performed in the PubMed, Scopus, and Web of Science databases. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to evaluate effect sizes.
Twenty-five eligible studies with 1283 cases and 1739 controls were included in the current meta-analysis. No significant differences in BDNF blood levels were found between PTSD patients and healthy controls when all studies were pooled into the meta-analysis (pooled SMD=-0.016, 95% CI=-0.088 to 0.057, p = 0.668). Meanwhile, subgroup analyses also showed no significant differences in BDNF levels between cases group and controls.
The results of the meta-analysis indicate no significant association between BDNF blood levels and PTSD risk.
多项研究表明，脑源性神经营养因子（BDNF）与创伤后应激障碍（PTSD）的发生有关。然而，这个问题仍然存在争议。因此，我们进行了一项最新的荟萃分析，以调查BDNF在PTSD中的作用。在PubMed、Scopus和Web of Science数据库中进行了相关研究的系统搜索和筛选。采用95%置信区间（ci）的标准化平均差异（SMDs）来评估效应大小。目前的荟萃分析纳入了25项符合条件的研究，包括1283例病例和1739例对照。将所有研究合并到meta分析中，PTSD患者与健康对照组血中BDNF水平无显著差异（合并SMD=-0.016, 95% CI=-0.088 ~ 0.057, p = 0.668）。同时，亚组分析也显示病例组与对照组之间BDNF水平无显著差异。荟萃分析结果显示BDNF血液水平与PTSD风险之间无显著关联。
{"title":"The relationship between BDNF blood levels and posttraumatic stress disorder: A systematic review and meta-analysis","authors":"Thelma Beatriz González-Castro , Jorge Arias de Dios , Nimrod Torres-León , Jorge Luis Hernández-Vicencio , Daina Pérez-Ramírez , Yazmín Hernández-Díaz , David Ruiz-Ramos , Germán Alberto Nolasco-Rosales , Isela Esther Juárez-Rojop , Carlos Alfonso Tovilla-Zárate , Maria Lilia López-Narváez","doi":"10.1016/j.ejtd.2025.100628","DOIUrl":"10.1016/j.ejtd.2025.100628","url":null,"abstract":"<div><div>Several studies have indicated that brain-derived neurotrophic factor (BDNF) is correlated with posttraumatic stress disorder (PTSD) occurrence. However, this issue remains controversial. Therefore, we conducted an updated meta-analysis to investigate the role of BDNF in PTSD.</div><div>A systematic search and screening of relevant studies was performed in the PubMed, Scopus, and Web of Science databases. Standardized mean differences (SMDs) with 95% confidence intervals (CIs) were used to evaluate effect sizes.</div><div>Twenty-five eligible studies with 1283 cases and 1739 controls were included in the current meta-analysis. No significant differences in BDNF blood levels were found between PTSD patients and healthy controls when all studies were pooled into the meta-analysis (pooled SMD=-0.016, 95% CI=-0.088 to 0.057, <em>p</em> = 0.668). Meanwhile, subgroup analyses also showed no significant differences in BDNF levels between cases group and controls.</div><div>The results of the meta-analysis indicate no significant association between BDNF blood levels and PTSD risk.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"10 1","pages":"Article 100628"},"PeriodicalIF":1.9,"publicationDate":"2025-12-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925866","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-22DOI: 10.1016/j.ejtd.2025.100631
Romain Fleury, Assia Ben Ammar, Pierre Antoine Gillouin, Alice Einloft Brunnet
Background
Dissociative disorders and schizophrenia spectrum disorders share some semiological similarities, particularly in terms of positive symptomatology. This proximity frequently contributes to diagnostic errors and inappropriate treatments. A better understanding of the semiological overlap and relationships between these two nosographic entities would help to improve assessment and management for the people concerned.
Objectives
The aim of this systematic review is to define and characterize the semiological overlap between dissociative disorders and schizophrenia spectrum disorders, and to provide elements for clarifying the differential diagnosis between these diagnostic categories.
Method
The PRISMA method was applied, based on a search of three databases: APA PsycInfo, PubMed and ScienceDirect. The selection was then subjected to a quality assessment.
Results
639 articles were extracted from these databases, 14 were selected, and 2 additional articles were selected from a second, more recent search, giving a total of 16 articles selected.
Conclusions
With a mean quality of 89.34%, the results confirm the existence of a significant symptomatic overlap between DD and SSD, particularly between positive psychotic symptoms, dissociation and exposure to traumatic events. This systematic review supports the hypothesis of a dissociative subtype within SSD, and underpins the value of transdiagnostic perspectives in research and clinical work with patients affected by these disorders.
{"title":"Chevauchement sémiologique entre troubles dissociatifs et troubles du spectre de la schizophrénie: Revue systématique","authors":"Romain Fleury, Assia Ben Ammar, Pierre Antoine Gillouin, Alice Einloft Brunnet","doi":"10.1016/j.ejtd.2025.100631","DOIUrl":"10.1016/j.ejtd.2025.100631","url":null,"abstract":"<div><h3>Background</h3><div>Dissociative disorders and schizophrenia spectrum disorders share some semiological similarities, particularly in terms of positive symptomatology. This proximity frequently contributes to diagnostic errors and inappropriate treatments. A better understanding of the semiological overlap and relationships between these two nosographic entities would help to improve assessment and management for the people concerned.</div></div><div><h3>Objectives</h3><div>The aim of this systematic review is to define and characterize the semiological overlap between dissociative disorders and schizophrenia spectrum disorders, and to provide elements for clarifying the differential diagnosis between these diagnostic categories.</div></div><div><h3>Method</h3><div>The PRISMA method was applied, based on a search of three databases: APA PsycInfo, PubMed and ScienceDirect. The selection was then subjected to a quality assessment.</div></div><div><h3>Results</h3><div>639 articles were extracted from these databases, 14 were selected, and 2 additional articles were selected from a second, more recent search, giving a total of 16 articles selected.</div></div><div><h3>Conclusions</h3><div>With a mean quality of 89.34%, the results confirm the existence of a significant symptomatic overlap between DD and SSD, particularly between positive psychotic symptoms, dissociation and exposure to traumatic events. This systematic review supports the hypothesis of a dissociative subtype within SSD, and underpins the value of transdiagnostic perspectives in research and clinical work with patients affected by these disorders.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"10 1","pages":"Article 100631"},"PeriodicalIF":1.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925867","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-22DOI: 10.1016/j.ejtd.2025.100630
Pablo D. Valencia , Anabel de la Rosa-Gómez
Background
Post-traumatic stress disorder (PTSD) is a common outcome of sexual violence. Network analysis offers a novel approach to examine symptom interactions, though prior research in sexual trauma survivors has shown instability of centrality metrics.
Aim
This study examined the DSM-5 PTSD symptom network in women with sexual trauma histories, focusing on symptom communities, central symptoms, and strong edges.
Method
313 women (ages 18–58, M = 31.34), mainly survivors of child sexual abuse, completed the PTSD Checklist for DSM-5 (PCL-5). A Gaussian Graphical Model with GLASSO regularization estimated the network; community detection and node centrality were assessed.
Results
The DSM-5 structure lacked clear support, with some Cluster D symptoms aligning with Cluster E. Strong associations emerged between the avoidance symptoms and between hypervigilance and exaggerated startle. Negative emotional state and exaggerated startle were the most central and predictable symptoms; memory impairment was the least.
Conclusions
PTSD symptom structure in sexually traumatized women may not align with DSM-5 clusters. Central symptoms like negative emotion and exaggerated startle may be key intervention targets. Longitudinal research is needed to clarify symptom dynamics.
{"title":"Post-traumatic stress symptoms in women with a history of sexual trauma: A network approach","authors":"Pablo D. Valencia , Anabel de la Rosa-Gómez","doi":"10.1016/j.ejtd.2025.100630","DOIUrl":"10.1016/j.ejtd.2025.100630","url":null,"abstract":"<div><h3>Background</h3><div>Post-traumatic stress disorder (PTSD) is a common outcome of sexual violence. Network analysis offers a novel approach to examine symptom interactions, though prior research in sexual trauma survivors has shown instability of centrality metrics.</div></div><div><h3>Aim</h3><div>This study examined the DSM-5 PTSD symptom network in women with sexual trauma histories, focusing on symptom communities, central symptoms, and strong edges.</div></div><div><h3>Method</h3><div>313 women (ages 18–58, <em>M</em> = 31.34), mainly survivors of child sexual abuse, completed the PTSD Checklist for DSM-5 (PCL-5). A Gaussian Graphical Model with GLASSO regularization estimated the network; community detection and node centrality were assessed.</div></div><div><h3>Results</h3><div>The DSM-5 structure lacked clear support, with some Cluster D symptoms aligning with Cluster E. Strong associations emerged between the avoidance symptoms and between hypervigilance and exaggerated startle. Negative emotional state and exaggerated startle were the most central and predictable symptoms; memory impairment was the least.</div></div><div><h3>Conclusions</h3><div>PTSD symptom structure in sexually traumatized women may not align with DSM-5 clusters. Central symptoms like negative emotion and exaggerated startle may be key intervention targets. Longitudinal research is needed to clarify symptom dynamics.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"10 1","pages":"Article 100630"},"PeriodicalIF":1.9,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145925869","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-15DOI: 10.1016/j.ejtd.2025.100627
Erma Pratiwi Nufi
{"title":"When dissociation is mistaken for possession: Implications for adolescent mental health in Indonesia","authors":"Erma Pratiwi Nufi","doi":"10.1016/j.ejtd.2025.100627","DOIUrl":"10.1016/j.ejtd.2025.100627","url":null,"abstract":"","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"10 1","pages":"Article 100627"},"PeriodicalIF":1.9,"publicationDate":"2025-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791058","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Mental health professionals (MHPs) working with war-affected refugees are highly susceptible to Secondary Traumatic Stress (STS) an occupational hazard that mirrors post-traumatic reactions due to prolonged empathic engagement with trauma survivors. In Pakistan’s humanitarian context, this vulnerability is heightened by inadequate supervision, limited trauma-informed training, and persistent sociocultural stigma surrounding mental illness. This study explored the lived experiences of Pakistani MHPs exhibiting high levels of STS while providing psychological care to war-affected refugees.
Methods
A qualitative design grounded in reflexive thematic analysis was employed. Six clinicians actively engaged in refugee mental-health services participated in semi-structured interviews. The interviews were audio-recorded, transcribed verbatim, and analyzed inductively and reflexively to capture the emotional, moral, and systemic dimensions of STS within the Pakistani clinical and cultural context.
Results
Six overarching themes were identified: (1) immersion in humanitarian duty; (2) emotional saturation and empathic strain; (3) blurred boundaries between self and client; (4) professional isolation within unsupportive systems; (5) coping strategies and sources of resilience; and (6) transformation through suffering. Participants described moral over-responsibility, emotional exhaustion, and organizational neglect, yet also reported meaning-making, spiritual coping, and professional growth as pathways to resilience.
Conclusions
STS among MHPs in Pakistan reflects a multifaceted interplay between emotional, cultural, and institutional factors. The findings underscore the need for culturally attuned supervision, trauma-informed training, and systemic organizational support to protect clinician well-being and sustain ethical, effective humanitarian mental-health practice. This study contributes to a broader cross-cultural understanding of STS by situating clinicians’ experiences within their moral, cultural, and institutional contexts.
{"title":"Secondary traumatic stress among mental health professionals working with war refugees in Pakistan: A qualitative exploration of lived experiences","authors":"Momina Khalid Butt , Rizwana Amin , Neringa Grigutytė , Jonas Eimontas","doi":"10.1016/j.ejtd.2025.100626","DOIUrl":"10.1016/j.ejtd.2025.100626","url":null,"abstract":"<div><h3>Introduction</h3><div>Mental health professionals (MHPs) working with war-affected refugees are highly susceptible to Secondary Traumatic Stress (STS) an occupational hazard that mirrors post-traumatic reactions due to prolonged empathic engagement with trauma survivors. In Pakistan’s humanitarian context, this vulnerability is heightened by inadequate supervision, limited trauma-informed training, and persistent sociocultural stigma surrounding mental illness. This study explored the lived experiences of Pakistani MHPs exhibiting high levels of STS while providing psychological care to war-affected refugees.</div></div><div><h3>Methods</h3><div>A qualitative design grounded in reflexive thematic analysis was employed. Six clinicians actively engaged in refugee mental-health services participated in semi-structured interviews. The interviews were audio-recorded, transcribed verbatim, and analyzed inductively and reflexively to capture the emotional, moral, and systemic dimensions of STS within the Pakistani clinical and cultural context.</div></div><div><h3>Results</h3><div>Six overarching themes were identified: (1) immersion in humanitarian duty; (2) emotional saturation and empathic strain; (3) blurred boundaries between self and client; (4) professional isolation within unsupportive systems; (5) coping strategies and sources of resilience; and (6) transformation through suffering. Participants described moral over-responsibility, emotional exhaustion, and organizational neglect, yet also reported meaning-making, spiritual coping, and professional growth as pathways to resilience.</div></div><div><h3>Conclusions</h3><div>STS among MHPs in Pakistan reflects a multifaceted interplay between emotional, cultural, and institutional factors. The findings underscore the need for culturally attuned supervision<strong>,</strong> trauma-informed training<strong>,</strong> and systemic organizational support to protect clinician well-being and sustain ethical, effective humanitarian mental-health practice. This study contributes to a broader cross-cultural understanding of STS by situating clinicians’ experiences within their moral, cultural, and institutional contexts.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"10 1","pages":"Article 100626"},"PeriodicalIF":1.9,"publicationDate":"2025-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145791059","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.ejtd.2025.100624
Jordyn M. Tipsword , Grace M. Seymour , Christal L. Badour
Purpose
Self-disgust has been linked to contact contamination (i.e., experiences of dirtiness caused by exposure to a contaminant), mental contamination (i.e., experiences of dirtiness that occur absent a contaminant), and PTSD symptoms in theoretical work. Separate lines of research have also linked higher affect intensity (i.e., the tendency to experience emotions strongly) to negative mental health outcomes, including more severe PTSD symptoms. However, empirical research examining associations between self-disgust and both contamination concerns and PTSD symptoms remains limited, and these associations may differ as a function of affect intensity.
Method
The current study evaluated main and interactive effects of self-disgust and affect intensity as predictors of contact contamination, mental contamination, and PTSD symptoms among 217 undergraduates with mixed trauma histories. Participants completed an online survey assessing lifetime trauma history, self-disgust, affect intensity, contact and mental contamination, PTSD symptoms, and depressive symptoms.
Results
After adjusting for sex assigned at birth and depressive symptoms, self-disgust predicted more severe contact contamination. Two unexpected interactions also revealed that self-disgust was only associated with more severe PTSD symptoms among individuals low in affect intensity and was more strongly positively associated with mental contamination among those low in affect intensity than those high in affect intensity.
Conclusions
Findings suggest that self-disgust may be relevant in understanding both trauma- and contamination-related concerns. Future research should explore mechanisms by which self-disgust contributes to these outcomes.
{"title":"Main and Interactive effects of self-disgust and affect intensity in predicting the severity of mental contamination, contact contamination, and PTSD symptoms","authors":"Jordyn M. Tipsword , Grace M. Seymour , Christal L. Badour","doi":"10.1016/j.ejtd.2025.100624","DOIUrl":"10.1016/j.ejtd.2025.100624","url":null,"abstract":"<div><h3>Purpose</h3><div>Self-disgust has been linked to contact contamination (i.e., experiences of dirtiness caused by exposure to a contaminant), mental contamination (i.e., experiences of dirtiness that occur absent a contaminant), and PTSD symptoms in theoretical work. Separate lines of research have also linked higher affect intensity (i.e., the tendency to experience emotions strongly) to negative mental health outcomes, including more severe PTSD symptoms. However, empirical research examining associations between self-disgust and both contamination concerns and PTSD symptoms remains limited, and these associations may differ as a function of affect intensity.</div></div><div><h3>Method</h3><div>The current study evaluated main and interactive effects of self-disgust and affect intensity as predictors of contact contamination, mental contamination, and PTSD symptoms among 217 undergraduates with mixed trauma histories. Participants completed an online survey assessing lifetime trauma history, self-disgust, affect intensity, contact and mental contamination, PTSD symptoms, and depressive symptoms.</div></div><div><h3>Results</h3><div>After adjusting for sex assigned at birth and depressive symptoms, self-disgust predicted more severe contact contamination. Two unexpected interactions also revealed that self-disgust was only associated with more severe PTSD symptoms among individuals low in affect intensity and was more strongly positively associated with mental contamination among those low in affect intensity than those high in affect intensity.</div></div><div><h3>Conclusions</h3><div>Findings suggest that self-disgust may be relevant in understanding both trauma- and contamination-related concerns. Future research should explore mechanisms by which self-disgust contributes to these outcomes.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"10 1","pages":"Article 100624"},"PeriodicalIF":1.9,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738196","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-03DOI: 10.1016/j.ejtd.2025.100625
Yi Xu , Qiwen Ye , Cynthia Zhou , Wei Chen , Junru Guo , Chengqi Cao , Li Wang
Introduction
Dissociation is a significant topic on contemporary research, yet there is a scarcity of validated scales for its assessment. The Dissociative Experiences Measure, Oxford (DEMO) is a novel instrument designed to evaluate dissociative experiences. The current study aims to develop a Simplified Chinese version of the DEMO and assess its psychometric properties.
Method
A total of 2321 college students were recruited to complete the questionnaire. Structural validity was tested with confirmatory factor analyses (CFA). The test-retest reliability was then calculated for intervals of 2 weeks and intervals of more than 2 weeks. Cronbach’s alpha and McDonald’s omega were calculated to evaluate internal consistency. Additionally, convergent and divergent validity were assessed by computing correlations between the scores on the DEMO and those on the Dissociative Experiences Scale-Ⅱ (DES-Ⅱ), the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder scale (GAD-7).
Results
The CFA results support a 5-factor model with the factors ‘Unreality’, ‘Numb and Disconnected’, ‘Memory Blanks’, ‘Zoned Out’, and ‘Vivid Internal World’. The test-retest reliability, Cronbach's alpha, and Mcdonald's omega for the total scale were 0.85, 0.95, and 0.96, respectively. The correlation of the DEMO scores with the DES-II scores (0.73) was significantly higher than the correlation with the PHQ-9 (0.65) and the GAD-7 (0.62).
Discussion
The current study developed the Simplified Chinese version of the DEMO and validated its psychometric properties in a Chinese sample. The study provides a novel tool for the screening of dissociative symptoms in China and provides probable cross-cultural evidence.
{"title":"Simplified Chinese version of the dissociative experiences measure, Oxford","authors":"Yi Xu , Qiwen Ye , Cynthia Zhou , Wei Chen , Junru Guo , Chengqi Cao , Li Wang","doi":"10.1016/j.ejtd.2025.100625","DOIUrl":"10.1016/j.ejtd.2025.100625","url":null,"abstract":"<div><h3>Introduction</h3><div>Dissociation is a significant topic on contemporary research, yet there is a scarcity of validated scales for its assessment. The Dissociative Experiences Measure, Oxford (DEMO) is a novel instrument designed to evaluate dissociative experiences. The current study aims to develop a Simplified Chinese version of the DEMO and assess its psychometric properties.</div></div><div><h3>Method</h3><div>A total of 2321 college students were recruited to complete the questionnaire. Structural validity was tested with confirmatory factor analyses (CFA). The test-retest reliability was then calculated for intervals of 2 weeks and intervals of more than 2 weeks. Cronbach’s alpha and McDonald’s omega were calculated to evaluate internal consistency. Additionally, convergent and divergent validity were assessed by computing correlations between the scores on the DEMO and those on the Dissociative Experiences Scale-Ⅱ (DES-Ⅱ), the 9-item Patient Health Questionnaire (PHQ-9), and the 7-item Generalized Anxiety Disorder scale (GAD-7).</div></div><div><h3>Results</h3><div>The CFA results support a 5-factor model with the factors ‘Unreality’, ‘Numb and Disconnected’, ‘Memory Blanks’, ‘Zoned Out’, and ‘Vivid Internal World’. The test-retest reliability, Cronbach's alpha, and Mcdonald's omega for the total scale were 0.85, 0.95, and 0.96, respectively. The correlation of the DEMO scores with the DES-II scores (0.73) was significantly higher than the correlation with the PHQ-9 (0.65) and the GAD-7 (0.62).</div></div><div><h3>Discussion</h3><div>The current study developed the Simplified Chinese version of the DEMO and validated its psychometric properties in a Chinese sample. The study provides a novel tool for the screening of dissociative symptoms in China and provides probable cross-cultural evidence.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"10 1","pages":"Article 100625"},"PeriodicalIF":1.9,"publicationDate":"2025-12-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738198","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Dissociative experiences are increasingly conceptualized as a transdiagnostic phenomenon. Sleep-related processes—particularly nightmares, which are affectively intense and REM-related—have been implicated in dissociation through pathways such as emotion regulation difficulties and insomnia severity. This study, therefore, examined whether emotion regulation difficulties and insomnia severity mediate the association between nightmare distress and dissociative experiences.
Methods
Adults from Tehran (N = 378) completed the Nightmare Distress Questionnaire (NDQ), Dissociative Experiences Scale–II (DES-II), Difficulties in Emotion Regulation Scale–16 (DERS-16), and Insomnia Severity Index (ISI). Structural equation modeling (SEM) evaluated whether emotion regulation and insomnia severity mediated the nightmare–dissociation association; indirect effects were tested with 2000 bootstrap resamples.
Results
The structural equation model showed acceptable fit. Nightmare distress strongly predicted dissociation and was also associated with both emotion regulation difficulties and insomnia severity. Emotion regulation difficulties, in turn, had a small but significant association with dissociation, whereas insomnia severity did not. Mediation analysis indicated a significant indirect effect through emotion regulation but not through insomnia. The model explained 46 % of the variance in dissociation.
Conclusions
This study provides novel evidence that difficulties in emotion regulation partly explain the association between nightmare distress and dissociative experiences, whereas insomnia severity contributes little to this link. These findings highlight the primacy of affective and REM-related processes in dissociation, underscoring the need for future longitudinal and experimental research using objective sleep measures.
{"title":"Exploring the mediating roles of insomnia and emotion regulation in the relationship between nightmares and dissociative experiences","authors":"Shiva Mayeli, Hoda Doosalivand, Banafsheh Mohajerin","doi":"10.1016/j.ejtd.2025.100622","DOIUrl":"10.1016/j.ejtd.2025.100622","url":null,"abstract":"<div><h3>Background</h3><div>Dissociative experiences are increasingly conceptualized as a transdiagnostic phenomenon. Sleep-related processes—particularly nightmares, which are affectively intense and REM-related—have been implicated in dissociation through pathways such as emotion regulation difficulties and insomnia severity. This study, therefore, examined whether emotion regulation difficulties and insomnia severity mediate the association between nightmare distress and dissociative experiences.</div></div><div><h3>Methods</h3><div>Adults from Tehran (<em>N</em> = 378) completed the Nightmare Distress Questionnaire (NDQ), Dissociative Experiences Scale–II (DES-II), Difficulties in Emotion Regulation Scale–16 (DERS-16), and Insomnia Severity Index (ISI). Structural equation modeling (SEM) evaluated whether emotion regulation and insomnia severity mediated the nightmare–dissociation association; indirect effects were tested with 2000 bootstrap resamples.</div></div><div><h3>Results</h3><div>The structural equation model showed acceptable fit. Nightmare distress strongly predicted dissociation and was also associated with both emotion regulation difficulties and insomnia severity. Emotion regulation difficulties, in turn, had a small but significant association with dissociation, whereas insomnia severity did not. Mediation analysis indicated a significant indirect effect through emotion regulation but not through insomnia. The model explained 46 % of the variance in dissociation.</div></div><div><h3>Conclusions</h3><div>This study provides novel evidence that difficulties in emotion regulation partly explain the association between nightmare distress and dissociative experiences, whereas insomnia severity contributes little to this link. These findings highlight the primacy of affective and REM-related processes in dissociation, underscoring the need for future longitudinal and experimental research using objective sleep measures.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"10 1","pages":"Article 100622"},"PeriodicalIF":1.9,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-12-02DOI: 10.1016/j.ejtd.2025.100623
Marina Beckwith , David Turgoose , Gary Latchford , Dominic Murphy
Background
Increased exposure to adverse childhood experiences (ACEs) is noted amongst military veterans, who also face unique occupational stressors during military service. Veterans are at increased risk of exposure to potentially morally injurious experiences (PMIE) and Moral Injury.
Objective
To explore the relationship between ACEs and Moral Injury in a sample of UK treatment-seeking veterans.
Participants and Setting
428 treatment-seeking veterans who accessed veterans’ mental health charity Combat Stress between 2019–2020 completed a patient experience survey.
Methods
A secondary analysis of cross-sectional survey data previously collected by Combat Stress explored the relationship between ACEs and Moral Injury using linear regression analysis. Further correlational analysis explored associations between ACEs, Moral Injury and social support.
Results
The majority of respondents experienced at least one ACE (74.6 %), with 35 % classed as high risk (4+ ACEs). Over half (57.1 %) reported exposure to a PMIE. ACEs were associated with Moral Injury (r[239] = 0.207, p<.001), with Personal Abuse ACEs explaining 4.4 % of the variance in Moral Injury scores (F(1239) = 11.086, p = .001, 95 % CI [29.30, 33.35]). 72.2 % of respondents reported low perceived social support, with social support being negatively correlated with both ACEs and Moral Injury.
Conclusions
ACEs may be a vulnerability factor increasing the risk of Moral Injury following experience of PMIEs during military service.
{"title":"Exploring the relationship between adverse childhood experiences, moral injury and social support in a clinical sample of UK military veterans","authors":"Marina Beckwith , David Turgoose , Gary Latchford , Dominic Murphy","doi":"10.1016/j.ejtd.2025.100623","DOIUrl":"10.1016/j.ejtd.2025.100623","url":null,"abstract":"<div><h3>Background</h3><div>Increased exposure to adverse childhood experiences (ACEs) is noted amongst military veterans, who also face unique occupational stressors during military service. Veterans are at increased risk of exposure to potentially morally injurious experiences (PMIE) and Moral Injury.</div></div><div><h3>Objective</h3><div>To explore the relationship between ACEs and Moral Injury in a sample of UK treatment-seeking veterans.</div></div><div><h3>Participants and Setting</h3><div>428 treatment-seeking veterans who accessed veterans’ mental health charity Combat Stress between 2019–2020 completed a patient experience survey.</div></div><div><h3>Methods</h3><div>A secondary analysis of cross-sectional survey data previously collected by Combat Stress explored the relationship between ACEs and Moral Injury using linear regression analysis. Further correlational analysis explored associations between ACEs, Moral Injury and social support.</div></div><div><h3>Results</h3><div>The majority of respondents experienced at least one ACE (74.6 %), with 35 % classed as high risk (4+ ACEs). Over half (57.1 %) reported exposure to a PMIE. ACEs were associated with Moral Injury (r[239] = 0.207, <em>p</em><.001), with Personal Abuse ACEs explaining 4.4 % of the variance in Moral Injury scores (<em>F</em>(1239) = 11.086, <em>p</em> = .001, 95 % CI [29.30, 33.35]). 72.2 % of respondents reported low perceived social support, with social support being negatively correlated with both ACEs and Moral Injury.</div></div><div><h3>Conclusions</h3><div>ACEs may be a vulnerability factor increasing the risk of Moral Injury following experience of PMIEs during military service.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"10 1","pages":"Article 100623"},"PeriodicalIF":1.9,"publicationDate":"2025-12-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145683754","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-11-26DOI: 10.1016/j.ejtd.2025.100619
Bruno Faustino , João Delgado , Mariana Luís
Affective dysregulation and dissociation are central transdiagnostic processes that contribute to the onset and maintenance of complex psychopathology. Drawing from both clinical and neuroscientific frameworks, this study tested two exploratory mediation models to investigate how psychological distress and well-being interact with dissociative symptoms and dysfunctions in large-scale neural networks. A sample of adults (N = 179) completed validated self-report measures assessing affective states, dissociation, and neural network dysfunction. In Model 1, dissociation emerged as a significant mediator of the relationship between distress and neural network dysfunction, particularly through depersonalization/derealization. Well-being exerted a direct protective effect on neural function, while distress exerted an indirect detrimental effect. In Model 2, neural networks, particularly the Default Mode Network (DMN) and Amygdaloid–Hippocampal Memory Network (AHMN), mediated the effects of affective states on dissociation. Distress predicted increased DMN dysfunction, which in turn predicted higher dissociation; well-being showed the opposite pattern. These results underscore the bidirectional interplay between affective dysregulation, dissociation, and brain network dysfunction. Clinically, the findings support targeting dissociation and fostering psychological well-being as strategies to enhance neural integration.
{"title":"Affective dysregulation, dissociation, and complex neural networks: Two exploratory mediation models","authors":"Bruno Faustino , João Delgado , Mariana Luís","doi":"10.1016/j.ejtd.2025.100619","DOIUrl":"10.1016/j.ejtd.2025.100619","url":null,"abstract":"<div><div>Affective dysregulation and dissociation are central transdiagnostic processes that contribute to the onset and maintenance of complex psychopathology. Drawing from both clinical and neuroscientific frameworks, this study tested two exploratory mediation models to investigate how psychological distress and well-being interact with dissociative symptoms and dysfunctions in large-scale neural networks. A sample of adults (<em>N</em> = 179) completed validated self-report measures assessing affective states, dissociation, and neural network dysfunction. In Model 1, dissociation emerged as a significant mediator of the relationship between distress and neural network dysfunction, particularly through depersonalization/derealization. Well-being exerted a direct protective effect on neural function, while distress exerted an indirect detrimental effect. In Model 2, neural networks, particularly the Default Mode Network (DMN) and Amygdaloid–Hippocampal Memory Network (AHMN), mediated the effects of affective states on dissociation. Distress predicted increased DMN dysfunction, which in turn predicted higher dissociation; well-being showed the opposite pattern. These results underscore the bidirectional interplay between affective dysregulation, dissociation, and brain network dysfunction. Clinically, the findings support targeting dissociation and fostering psychological well-being as strategies to enhance neural integration.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"10 1","pages":"Article 100619"},"PeriodicalIF":1.9,"publicationDate":"2025-11-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145738197","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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