Pub Date : 2025-11-05DOI: 10.1016/j.ejtd.2025.100612
Rajat Mitra , Pankaj Singh , Nidhi Mitra
This research considers the psychological fragmentation of sexual assault survivors from the framework of structural dissociation (Van der Hart et al., 2006) by exploring the way trauma manifest in the survivors post sexual assault. This study engaged 31 sexual assault survivors (aged 18–30) across six Indian states, employing trauma informed practices to conduct in-depth semi-structured interviews. Data were analysed using Reflexive Thematic Analysis, revealing survivors' post-sexual assault experiences, with a focus on dissociation. The findings identified two dissociative states in the survivors—felt state (14 subthemes) and being state (10 subthemes). The Felt state consists of the survivors’ efforts to restore order and normality by using adaptive coping mechanisms; and the Being state as a process of frozen traumatic memories, somatically stored distress, and chronic perceptions of irreversible harm. The findings, based on qualitative analytical approach, show how cultural stories—such as the female chastity, culture, and honour (izzat) determine the reaction to trauma in Indian women. Clinically, the findings support phase-based interventions that initially establish stabilization through felt state coping strategies before targeting being state trauma. The research indicates the need for culturally sensitive trauma models that target both the psychological mediation of dissociation and oppressive social schemas. Further, the future research may examine the neurobiological underpinnings of dissociation subthemes and the development of culturally determined assessment tools. In combining survivor testimonies with theoretical frameworks, the study contributes to research on trauma in regions of the world where gender, caste, and mythical narratives intersect sexual violence.
本研究从结构性分离（Van der Hart et al., 2006）的框架出发，通过探究创伤在性侵犯幸存者身上的表现方式，来考虑性侵犯幸存者的心理分裂。本研究涉及印度6个邦的31名性侵幸存者（年龄在18-30岁），采用创伤知情实践进行深入的半结构化访谈。数据分析使用反身性主题分析，揭示幸存者的性侵犯后的经历，重点是分离。研究结果确定了幸存者的两种分离状态——感觉状态（14个子主题）和存在状态（10个子主题）。感知状态包括幸存者利用适应性应对机制努力恢复秩序和正常状态；而存在状态则是一个冻结创伤记忆的过程，身体上储存的痛苦，以及对不可逆转伤害的长期感知。研究结果基于定性分析方法，展示了文化故事——如女性贞洁、文化和荣誉（izzat）——如何决定印度女性对创伤的反应。在临床上，研究结果支持基于阶段的干预措施，即在针对状态创伤之前，首先通过感觉状态应对策略建立稳定。该研究表明，需要针对分离和压迫性社会图式的心理调解的文化敏感创伤模型。此外，未来的研究可能会检查分离子主题的神经生物学基础和文化决定评估工具的发展。通过将幸存者证词与理论框架相结合，该研究有助于研究世界上性别、种姓和神话叙事交织在一起的性暴力地区的创伤。
{"title":"Frozen in trauma, anchored in survival: A study of dissociative states in post-sexual assault survivors","authors":"Rajat Mitra , Pankaj Singh , Nidhi Mitra","doi":"10.1016/j.ejtd.2025.100612","DOIUrl":"10.1016/j.ejtd.2025.100612","url":null,"abstract":"<div><div>This research considers the psychological fragmentation of sexual assault survivors from the framework of structural dissociation (Van der Hart et al., 2006) by exploring the way trauma manifest in the survivors post sexual assault. This study engaged 31 sexual assault survivors (aged 18–30) across six Indian states, employing trauma informed practices to conduct in-depth semi-structured interviews. Data were analysed using Reflexive Thematic Analysis, revealing survivors' post-sexual assault experiences, with a focus on dissociation. The findings identified two dissociative states in the survivors—felt state (14 subthemes) and being state (10 subthemes). The Felt state consists of the survivors’ efforts to restore order and normality by using adaptive coping mechanisms; and the Being state as a process of frozen traumatic memories, somatically stored distress, and chronic perceptions of irreversible harm. The findings, based on qualitative analytical approach, show how cultural stories—such as the female chastity, culture, and honour (izzat) determine the reaction to trauma in Indian women. Clinically, the findings support phase-based interventions that initially establish stabilization through felt state coping strategies before targeting being state trauma. The research indicates the need for culturally sensitive trauma models that target both the psychological mediation of dissociation and oppressive social schemas. Further, the future research may examine the neurobiological underpinnings of dissociation subthemes and the development of culturally determined assessment tools. In combining survivor testimonies with theoretical frameworks, the study contributes to research on trauma in regions of the world where gender, caste, and mythical narratives intersect sexual violence.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100612"},"PeriodicalIF":1.9,"publicationDate":"2025-11-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519751","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 : 2025-11-04DOI: 10.1016/j.ejtd.2025.100614
Clara Mucci , Raffaella Adamo
At the time of Freud, Ferenczi was among the first to consider the consequences of interpersonal trauma and therefore to give full value to human connectedness (Mucci, 2014, 2020). With the concept of “fragmentation” he also described, ahead of his time, some of the most destructive consequences of trauma of human origin, leading also to a split of personality, which we today understand as the basis of severe psychopathology. On the contrary, Freud viewed repression as the basis of neuropathology (Mucci, 2021). We also owe to Ferenczi his revision of the concept of “identification with the aggressor,” with the internalization of the guilt and the aggressiveness of the persecutor, which also explains some of the destructive dynamics of severe psychopathology. Even the Oedipus complex and the theory of the death drive can be revised in light of Ferenczi’s views. In therapy with the traumatized, “embodied witnessing” (Mucci, 2018, 2022) is recommended.
{"title":"The difference that Sándor Ferenczi made in the theory and treatment of trauma of human origin *","authors":"Clara Mucci , Raffaella Adamo","doi":"10.1016/j.ejtd.2025.100614","DOIUrl":"10.1016/j.ejtd.2025.100614","url":null,"abstract":"<div><div>At the time of Freud, Ferenczi was among the first to consider the consequences of interpersonal trauma and therefore to give full value to human connectedness (Mucci, 2014, 2020). With the concept of “fragmentation” he also described, ahead of his time, some of the most destructive consequences of trauma of human origin, leading also to a split of personality, which we today understand as the basis of severe psychopathology. On the contrary, Freud viewed repression as the basis of neuropathology (Mucci, 2021). We also owe to Ferenczi his revision of the concept of “identification with the aggressor,” with the internalization of the guilt and the aggressiveness of the persecutor, which also explains some of the destructive dynamics of severe psychopathology. Even the Oedipus complex and the theory of the death drive can be revised in light of Ferenczi’s views. In therapy with the traumatized, “embodied witnessing” (Mucci, 2018, 2022) is recommended.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100614"},"PeriodicalIF":1.9,"publicationDate":"2025-11-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519749","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}
In the context of persistent insecurity linked to terrorism, firefighters in Burkina Faso are exposed to recurrent traumatic events. However, data on their mental health, particularly with regard to post-traumatic stress disorder (PTSD), remain limited. The aim of this study is to determine the prevalence of PTSD and associated factors among firefighters in Burkina Faso
Methodology
A cross-sectional study was conducted from 9 February 2023 to 3 April 2023 among 217 firefighters. The screening tool used was the PCLS scale (threshold score ≥44). Logistic regression was used to identify factors associated with PTSD (significance level: p ≤ 0.05).
Results
The overall prevalence of PTSD was 17.05 % according to the PCLS. The most frequently reported events were terrorist attacks (36.40 %) and serious accidents (27.64 %). Female gender, family support, exposure to a terrorist attack, transport accidents and sexual assault were significantly associated with PTSD.
Conclusion
PTSD affects a significant proportion of Ouagadougou's firefighters. Specific prevention, screening and treatment measures need to be implemented to strengthen their psychological resilience.
{"title":"Prevalence and factors associated with post-traumatic stress disorder among firefighters exposed to terrorism in Burkina Faso","authors":"Boubacar BAGUE , Zeinabou CISSE , Mahamane Mobarak SALIFOU ABDOU , Désiré NANEMA , Oumar SOURABIE , Konsam Cédric Christel SAWADOGO , Nadège OUEDRAOGO , Nazinigouba OUEDRAOGO","doi":"10.1016/j.ejtd.2025.100613","DOIUrl":"10.1016/j.ejtd.2025.100613","url":null,"abstract":"<div><h3>Introduction</h3><div>In the context of persistent insecurity linked to terrorism, firefighters in Burkina Faso are exposed to recurrent traumatic events. However, data on their mental health, particularly with regard to post-traumatic stress disorder (PTSD), remain limited. The aim of this study is to determine the prevalence of PTSD and associated factors among firefighters in Burkina Faso</div></div><div><h3>Methodology</h3><div>A cross-sectional study was conducted from 9 February 2023 to 3 April 2023 among 217 firefighters. The screening tool used was the PCLS scale (threshold score ≥44). Logistic regression was used to identify factors associated with PTSD (significance level: p ≤ 0.05).</div></div><div><h3>Results</h3><div>The overall prevalence of PTSD was 17.05 % according to the PCLS. The most frequently reported events were terrorist attacks (36.40 %) and serious accidents (27.64 %). Female gender, family support, exposure to a terrorist attack, transport accidents and sexual assault were significantly associated with PTSD.</div></div><div><h3>Conclusion</h3><div>PTSD affects a significant proportion of Ouagadougou's firefighters. Specific prevention, screening and treatment measures need to be implemented to strengthen their psychological resilience.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100613"},"PeriodicalIF":1.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519750","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 : 2025-11-03DOI: 10.1016/j.ejtd.2025.100610
Anne Versluis , Nienke Peters-Scheffer , Carlo Schuengel , Liesbeth Mevissen , Ad de Jongh , Robert Didden
Background
This study explored the experiences of individuals with mild intellectual disability (MID: IQ 50–70) or borderline intellectual functioning (BIF: IQ 70–85), post-traumatic stress disorder (PTSD), and severe behavioural problems, with brief Intensive EMDR therapy delivered by a team of rotating therapists.
Purpose
Preliminary research indicates that Intensive EMDR therapy with a team of rotating therapists is effective in treating PTSD in individuals with MID-BIF. To optimise treatment outcomes, it is important to understand how they experience this treatment format.
Methods
In-depth semi-structured interviews were conducted with three adults with MID-BIF and severe behavioural problems, before and after therapy. Interviews with three professional caregivers (before and after therapy), three EMDR therapists (after therapy), and field notes were used to contextualise the experiences of the participants.
Results
Interpretative phenomenological analysis (IPA) revealed that participants started Intensive EMDR therapy with rotating therapists holding high expectations. One participant discontinued early, two completed treatment, and all reported positive experiences with both the intensive format and therapist rotation model. The intensity was seen to support continuity and engagement, particularly compared to weekly therapy sessions. Minimal involvement of the (professional) support systems was also observed.
Conclusions
Participants with MID-BIF and severe behavioural problems generally reported positive experiences with brief Intensive EMDR therapy delivered by a team of rotating therapists.
本研究探讨了轻度智力残疾（MID: IQ 50-70）或边缘性智力功能障碍（BIF: IQ 70-85）、创伤后应激障碍（PTSD）和严重行为问题患者的经历，由一个轮转治疗师团队提供简短的强化EMDR治疗。目的：初步研究表明，在轮换治疗师团队的指导下，强化EMDR治疗可有效治疗中期bif患者的PTSD。为了优化治疗效果，重要的是要了解他们如何体验这种治疗形式。方法采用半结构化深度访谈法，对3名患有中度行为障碍和严重行为问题的成年人在治疗前后进行访谈。对三名专业护理人员（治疗前后），三名EMDR治疗师（治疗后）的访谈，以及现场记录用于将参与者的经历背景化。结果解释现象学分析（IPA）显示，参与者在轮转治疗师的高期望下开始强化EMDR治疗。一名参与者提前停止治疗，两名完成治疗，所有参与者都报告了强化形式和治疗师轮转模式的积极体验。强度被认为支持连续性和参与性，特别是与每周一次的治疗相比。还观察到（专业）支助系统极少参与。结论：中度bif和严重行为问题的参与者普遍报告了由轮换治疗师团队提供的简短强化EMDR治疗的积极体验。
{"title":"Brief intensive EMDR therapy with rotating therapists: Experiences of adults with mild intellectual disability or borderline intellectual functioning, PTSD, and severe behavioural problems","authors":"Anne Versluis , Nienke Peters-Scheffer , Carlo Schuengel , Liesbeth Mevissen , Ad de Jongh , Robert Didden","doi":"10.1016/j.ejtd.2025.100610","DOIUrl":"10.1016/j.ejtd.2025.100610","url":null,"abstract":"<div><h3>Background</h3><div>This study explored the experiences of individuals with mild intellectual disability (MID: IQ 50–70) or borderline intellectual functioning (BIF: IQ 70–85), post-traumatic stress disorder (PTSD), and severe behavioural problems, with brief Intensive EMDR therapy delivered by a team of rotating therapists.</div></div><div><h3>Purpose</h3><div>Preliminary research indicates that Intensive EMDR therapy with a team of rotating therapists is effective in treating PTSD in individuals with MID-BIF. To optimise treatment outcomes, it is important to understand how they experience this treatment format.</div></div><div><h3>Methods</h3><div>In-depth semi-structured interviews were conducted with three adults with MID-BIF and severe behavioural problems, before and after therapy. Interviews with three professional caregivers (before and after therapy), three EMDR therapists (after therapy), and field notes were used to contextualise the experiences of the participants.</div></div><div><h3>Results</h3><div>Interpretative phenomenological analysis (IPA) revealed that participants started Intensive EMDR therapy with rotating therapists holding high expectations. One participant discontinued early, two completed treatment, and all reported positive experiences with both the intensive format and therapist rotation model. The intensity was seen to support continuity and engagement, particularly compared to weekly therapy sessions. Minimal involvement of the (professional) support systems was also observed.</div></div><div><h3>Conclusions</h3><div>Participants with MID-BIF and severe behavioural problems generally reported positive experiences with brief Intensive EMDR therapy delivered by a team of rotating therapists.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100610"},"PeriodicalIF":1.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145465935","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 : 2025-11-03DOI: 10.1016/j.ejtd.2025.100609
Federica Visco-Comandini , Carolina Papa , Allison Uvelli , Francesco Mancini , Erica Pugliese
Objective
Imagery Rescripting (ImRs) has emerged as a promising, evidence-based intervention to process traumatic experiences. No prior review has systematically examined its application for Post Traumatic Stress Disorder (PTSD) and Complex PTSD (C-PTSD). Furthermore, there still is not a clear understanding of mechanisms of change involved in ImRs, which are crucial for trauma-focused treatments. This review addresses this gap by summarizing the effectiveness and change processes of ImRs in PTSD and C-PTSD.
Method
A systematic search was conducted across PubMed, Scopus, Web of Science, and PsycINFO. Eligible studies were published in English or Italian, included clinical populations aged 18 or older, and used experimental or quasi-experimental designs.
Results
Twenty-four studies met inclusion criteria. Across randomized, clinical, and multiple-baseline studies, ImRs was associated with consistent reductions in trauma-related symptoms, showing treatment effects consistent with its targeting of core transdiagnostic processes—modifying aversive memory representations in PTSD and fostering integration and emotional safety in C-PTSD.
Conclusions
This review offers a focused synthesis of the evidence of ImRs for trauma-related disorders, highlighting its potential as a brief, powerful clinical intervention operating through distinct mechanisms of change across varying symptom profiles.
目的意象处方（ImRs）已成为一种有前途的、基于证据的创伤经历处理干预手段。目前尚无文献系统地研究其在创伤后应激障碍（PTSD）和复杂创伤后应激障碍（C-PTSD）中的应用。此外，对于imr的变化机制仍然没有明确的认识，而imr对创伤治疗至关重要。本文通过总结ImRs在PTSD和C-PTSD中的有效性和变化过程来弥补这一空白。方法系统检索PubMed、Scopus、Web of Science和PsycINFO。符合条件的研究以英语或意大利语发表，纳入18岁或以上的临床人群，并采用实验或准实验设计。结果24项研究符合纳入标准。在随机、临床和多基线研究中，ImRs与创伤相关症状的持续减少有关，显示出与其针对核心跨诊断过程的治疗效果一致——在PTSD中改变厌恶记忆表征，在C-PTSD中促进整合和情绪安全。本综述重点综合了创伤相关障碍的ImRs证据，强调了其作为一种简短、强大的临床干预手段的潜力，这种干预手段通过不同症状特征的不同改变机制运作。
{"title":"Rewriting trauma: A systematic review of treatment effects of imagery rescripting for PTSD and complex PTSD","authors":"Federica Visco-Comandini , Carolina Papa , Allison Uvelli , Francesco Mancini , Erica Pugliese","doi":"10.1016/j.ejtd.2025.100609","DOIUrl":"10.1016/j.ejtd.2025.100609","url":null,"abstract":"<div><h3>Objective</h3><div>Imagery Rescripting (ImRs) has emerged as a promising, evidence-based intervention to process traumatic experiences. No prior review has systematically examined its application for Post Traumatic Stress Disorder (PTSD) and Complex PTSD (C-PTSD). Furthermore, there still is not a clear understanding of mechanisms of change involved in ImRs, which are crucial for trauma-focused treatments. This review addresses this gap by summarizing the effectiveness and change processes of ImRs in PTSD and C-PTSD.</div></div><div><h3>Method</h3><div>A systematic search was conducted across PubMed, Scopus, Web of Science, and PsycINFO. Eligible studies were published in English or Italian, included clinical populations aged 18 or older, and used experimental or quasi-experimental designs.</div></div><div><h3>Results</h3><div>Twenty-four studies met inclusion criteria. Across randomized, clinical, and multiple-baseline studies, ImRs was associated with consistent reductions in trauma-related symptoms, showing treatment effects consistent with its targeting of core transdiagnostic processes—modifying aversive memory representations in PTSD and fostering integration and emotional safety in C-PTSD.</div></div><div><h3>Conclusions</h3><div>This review offers a focused synthesis of the evidence of ImRs for trauma-related disorders, highlighting its potential as a brief, powerful clinical intervention operating through distinct mechanisms of change across varying symptom profiles.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100609"},"PeriodicalIF":1.9,"publicationDate":"2025-11-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145519752","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}
Rising stress and mental health disorders in Ukraine underscore the need for effective psychophysiological interventions in healthcare.
Objective
The aim of this study was to examine in detail the potential for integrating psychophysiological interventions into the mental health care system for patients.
Method
The methodology involved a comprehensive analysis of the available scientific literature and a review of experimental data, enabling the identification of key approaches to utilising biofeedback, meditation, and relaxation techniques in the development of a new conceptual model.
Results
The study concluded that psychophysiological technologies exert a positive influence on physiological indicators, such as blood cortisol levels and heart rate, as well as on psychological aspects, including anxiety levels and overall emotional state. The integration of these methods into daily routines – such as practising mindfulness meditation in the morning or before bedtime, using mobile applications for biofeedback during breaks at work or study, and employing relaxation techniques in stressful situations – can support long-term stress resilience and help prevent mental and physical disorders. A detailed examination of these technologies will facilitate the development of programmes and protocols tailored to the needs of different population groups. The introduction of biofeedback training in primary care centres would equip patients with tools to regulate physiological responses to stress. The organisation of group mindfulness meditation sessions in educational institutions and workplaces would foster emotional self-regulation skills among both young people and adults.
Conclusion
Mobile apps that combine relaxing techniques with interactive feedback would make them more accessible. These technologies used with pharmacological treatment could reduce pharmaceutical dosages, side effects, and treatment efficacy. Interdisciplinary teams of psychologists, physiologists, and doctors would treat psychosomatic diseases comprehensively. These actions would improve public mental health and align the healthcare system with worldwide norms.
{"title":"Integrating psychophysiological technologies for stress management: Challenges and solutions in the Ukrainian healthcare system","authors":"Sergii Boltivets , Anatolii V. Furman , Oksana Furman , Valentyna Korolchuk , Mykola Korolchuk","doi":"10.1016/j.ejtd.2025.100603","DOIUrl":"10.1016/j.ejtd.2025.100603","url":null,"abstract":"<div><h3>Background</h3><div>Rising stress and mental health disorders in Ukraine underscore the need for effective psychophysiological interventions in healthcare.</div></div><div><h3>Objective</h3><div>The aim of this study was to examine in detail the potential for integrating psychophysiological interventions into the mental health care system for patients.</div></div><div><h3>Method</h3><div>The methodology involved a comprehensive analysis of the available scientific literature and a review of experimental data, enabling the identification of key approaches to utilising biofeedback, meditation, and relaxation techniques in the development of a new conceptual model.</div></div><div><h3>Results</h3><div>The study concluded that psychophysiological technologies exert a positive influence on physiological indicators, such as blood cortisol levels and heart rate, as well as on psychological aspects, including anxiety levels and overall emotional state. The integration of these methods into daily routines – such as practising mindfulness meditation in the morning or before bedtime, using mobile applications for biofeedback during breaks at work or study, and employing relaxation techniques in stressful situations – can support long-term stress resilience and help prevent mental and physical disorders. A detailed examination of these technologies will facilitate the development of programmes and protocols tailored to the needs of different population groups. The introduction of biofeedback training in primary care centres would equip patients with tools to regulate physiological responses to stress. The organisation of group mindfulness meditation sessions in educational institutions and workplaces would foster emotional self-regulation skills among both young people and adults.</div></div><div><h3>Conclusion</h3><div>Mobile apps that combine relaxing techniques with interactive feedback would make them more accessible. These technologies used with pharmacological treatment could reduce pharmaceutical dosages, side effects, and treatment efficacy. Interdisciplinary teams of psychologists, physiologists, and doctors would treat psychosomatic diseases comprehensively. These actions would improve public mental health and align the healthcare system with worldwide norms.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100603"},"PeriodicalIF":1.9,"publicationDate":"2025-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361687","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}
Pre-traumatic stress is characterized by intrusiveness, avoidance, hyper-arousal and alterations of behaviors and cognitions related to future traumatic events that may actually occur. The main tool to self-assess pre-traumatic stress is the Pre-traumatic stress reactions Checklist (PreCL). To date, no study has assessed the psychometric properties of PreCL. In addition, no study has studied the pre-traumatic stress in population under the threat of natural catastrophes and the concurrent underlined mechanisms of these reactions.
Objective
This study aims to analyze the psychometric properties of PreCL, and the underlying mechanisms of pre-traumatic stress reactions in a group of participants living in the Campi Flegrei (Italy), a densely populated area which is cyclically affected by bradyseism and at high risk of volcanic eruptions.
Methods
Recruitment involved 432 participants. Exploratory and Confirmatory Factor Analysis (EFA/CFA) was used to assess and re-define the factorial structure of PreCL. Structural equation model was used to test the mediation effect of intensity and frequency of worry about bradyseism on the relationship between the intolerance of uncertainty’s dimensions and the pre-traumatic stress factors.
Results
From the EFA/CFA, a two-independent factor structure emerged: Pre-traumatic reactive responses (PreCL-R) and Pre-traumatic alterations of mood and cognitions (PreCL-A). The frequency of worry about bradyseism fully mediated the relationship between the prospective intolerance of uncertainty and PreCL-R, while the intensity of worry partially mediates between inhibitory intolerance of uncertainty and PreCL-R. No mediation effect was found for PreCL-A.
Conclusion
This study provides a stable structure of PreCL supporting its use in future research, and insights into the relationship between pre-traumatic reactions, current worry, and intolerance of uncertainty —findings that are relevant for both research and clinical practice.
{"title":"Pre-traumatic stress and environmental hazard in a bradyseism volcanic area. Psychometric properties of the Pre-traumatic stress reactions Checklist (PreCL) and concurrent underline mechanisms of pre-traumatic stress","authors":"Alessia Caffieri , Raffaella Esposito, Giorgia Margherita","doi":"10.1016/j.ejtd.2025.100604","DOIUrl":"10.1016/j.ejtd.2025.100604","url":null,"abstract":"<div><h3>Background</h3><div>Pre-traumatic stress is characterized by intrusiveness, avoidance, hyper-arousal and alterations of behaviors and cognitions related to future traumatic events that may actually occur. The main tool to self-assess pre-traumatic stress is the <em>Pre-traumatic stress reactions Checklist (PreCL).</em> To date, no study has assessed the psychometric properties of <em>PreCL</em>. In addition, no study has studied the pre-traumatic stress in population under the threat of natural catastrophes and the concurrent underlined mechanisms of these reactions.</div></div><div><h3>Objective</h3><div>This study aims to analyze the psychometric properties of PreCL, and the underlying mechanisms of pre-traumatic stress reactions in a group of participants living in the Campi Flegrei (Italy), a densely populated area which is cyclically affected by bradyseism and at high risk of volcanic eruptions.</div></div><div><h3>Methods</h3><div>Recruitment involved 432 participants. Exploratory and Confirmatory Factor Analysis (EFA/CFA) was used to assess and re-define the factorial structure of PreCL. Structural equation model was used to test the mediation effect of intensity and frequency of worry about bradyseism on the relationship between the intolerance of uncertainty’s dimensions and the pre-traumatic stress factors.</div></div><div><h3>Results</h3><div>From the EFA/CFA, a two-independent factor structure emerged: <em>Pre-traumatic reactive responses</em> (PreCL-R) and <em>Pre-traumatic alterations of mood and cognitions</em> (PreCL-A). The frequency of worry about bradyseism fully mediated the relationship between the prospective intolerance of uncertainty and PreCL-R, while the intensity of worry partially mediates between inhibitory intolerance of uncertainty and PreCL-R. No mediation effect was found for PreCL-A.</div></div><div><h3>Conclusion</h3><div>This study provides a stable structure of PreCL supporting its use in future research, and insights into the relationship between pre-traumatic reactions, current worry, and intolerance of uncertainty —findings that are relevant for both research and clinical practice.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100604"},"PeriodicalIF":1.9,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361686","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 : 2025-10-15DOI: 10.1016/j.ejtd.2025.100608
Karine Veilleux , Miguel M. Terradas , Guadalupe Puentes-Neuman , Olivier Didier , Maxime Labonté
<div><h3>Introduction</h3><div>La maltraitance perpétrée par les principales figures de soins engendre des conséquences sévères sur l’attachement de l’enfant qui risque ainsi de présenter un attachement insécurisant ou désorganisé. Or, la capacité de mentalisation de l’enfant en souffrirait également comme un attachement sécurisant serait propice au développement sain de la mentalisation.</div></div><div><h3>Objectifs</h3><div>La présente recherche exploratoire vise d’abord à détailler et comparer les représentations d’attachement et la capacité de mentalisation entre les deux groupes à l’étude. Elle cible également l’exploration des liens unissant ces mêmes variables en considérant l’ensemble des enfants indépendamment de leur groupe d’appartenance.</div></div><div><h3>Méthode</h3><div>Les deux groupes sont respectivement composés de 35 enfants ayant vécu de la maltraitance et hébergés en contexte de protection de la jeunesse et de 38 enfants issus de la population générale, tous âgés de 7 à 12 ans. Les représentations d’attachement ont été évaluées à l’aide des Histoires d’attachement à compléter (HAC) et d’un entretien semi-structuré (<em>Child Attachement Interview</em> [CAI]). Quant à elle, la capacité de mentalisation de l’enfant a été mesurée à partir des réponses de l’enfant à ce même entretien, grâce à l’échelle de cotation de la capacité de mentalisation.</div></div><div><h3>Résultats</h3><div>Les résultats révèlent des différences significatives entre les deux groupes d’enfants quant à la sécurité d’attachement envers la mère et la capacité de mentalisation. La capacité de mentalisation corrèle significativement et dans le sens attendu avec les mesures des représentations d’attachement à l’étude, à l’exception de l’échelle des HAC concernant les représentations de la mère comme étant rejetante et les échelles du CAI concernant la colère préoccupée envers la mère.</div></div><div><h3>Conclusion</h3><div>Les enfants maltraités ont des représentations d’attachement davantage insécurisantes et une plus faible capacité de mentalisation. Ces résultats enrichissent la compréhension des besoins et des difficultés vécus par les enfants hébergés quant à ces variables et permettent d’ajuster les interventions mises en place. La présence de certaines limites est constatée comme notamment la petite taille de l’échantillon, le fait que les deux groupes d’enfants se distinguent significativement au niveau de l’âge et du sexe de l’enfant et le fait que deux variables ont été mesurées par un même outil. Les implications et les forces de l’étude ainsi que les pistes de recherches futures sont détaillées dans l’article.</div></div><div><h3>Introduction</h3><div>Abuse perpetrated by primary caregivers has severe consequences on the child's attachment, which may lead to insecure or disorganized attachment patterns. Moreover, the child's mentalizing capacity could also be affected, as a secure attachment would be associated with the development of mentaliza
{"title":"Représentations d’attachement et capacité de mentalisation d’enfants d’âge scolaire hébergés en contexte de protection de l’enfance et issus de la population générale","authors":"Karine Veilleux , Miguel M. Terradas , Guadalupe Puentes-Neuman , Olivier Didier , Maxime Labonté","doi":"10.1016/j.ejtd.2025.100608","DOIUrl":"10.1016/j.ejtd.2025.100608","url":null,"abstract":"<div><h3>Introduction</h3><div>La maltraitance perpétrée par les principales figures de soins engendre des conséquences sévères sur l’attachement de l’enfant qui risque ainsi de présenter un attachement insécurisant ou désorganisé. Or, la capacité de mentalisation de l’enfant en souffrirait également comme un attachement sécurisant serait propice au développement sain de la mentalisation.</div></div><div><h3>Objectifs</h3><div>La présente recherche exploratoire vise d’abord à détailler et comparer les représentations d’attachement et la capacité de mentalisation entre les deux groupes à l’étude. Elle cible également l’exploration des liens unissant ces mêmes variables en considérant l’ensemble des enfants indépendamment de leur groupe d’appartenance.</div></div><div><h3>Méthode</h3><div>Les deux groupes sont respectivement composés de 35 enfants ayant vécu de la maltraitance et hébergés en contexte de protection de la jeunesse et de 38 enfants issus de la population générale, tous âgés de 7 à 12 ans. Les représentations d’attachement ont été évaluées à l’aide des Histoires d’attachement à compléter (HAC) et d’un entretien semi-structuré (<em>Child Attachement Interview</em> [CAI]). Quant à elle, la capacité de mentalisation de l’enfant a été mesurée à partir des réponses de l’enfant à ce même entretien, grâce à l’échelle de cotation de la capacité de mentalisation.</div></div><div><h3>Résultats</h3><div>Les résultats révèlent des différences significatives entre les deux groupes d’enfants quant à la sécurité d’attachement envers la mère et la capacité de mentalisation. La capacité de mentalisation corrèle significativement et dans le sens attendu avec les mesures des représentations d’attachement à l’étude, à l’exception de l’échelle des HAC concernant les représentations de la mère comme étant rejetante et les échelles du CAI concernant la colère préoccupée envers la mère.</div></div><div><h3>Conclusion</h3><div>Les enfants maltraités ont des représentations d’attachement davantage insécurisantes et une plus faible capacité de mentalisation. Ces résultats enrichissent la compréhension des besoins et des difficultés vécus par les enfants hébergés quant à ces variables et permettent d’ajuster les interventions mises en place. La présence de certaines limites est constatée comme notamment la petite taille de l’échantillon, le fait que les deux groupes d’enfants se distinguent significativement au niveau de l’âge et du sexe de l’enfant et le fait que deux variables ont été mesurées par un même outil. Les implications et les forces de l’étude ainsi que les pistes de recherches futures sont détaillées dans l’article.</div></div><div><h3>Introduction</h3><div>Abuse perpetrated by primary caregivers has severe consequences on the child's attachment, which may lead to insecure or disorganized attachment patterns. Moreover, the child's mentalizing capacity could also be affected, as a secure attachment would be associated with the development of mentaliza","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100608"},"PeriodicalIF":1.9,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362266","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 : 2025-10-15DOI: 10.1016/j.ejtd.2025.100606
Kalliopi Megari , Eleana Argyriadou
Correctional psychology and public health have been increasingly concerned with the mental health and psychological well-being of those who are incarcerated. Numerous psychological stressors, such as loneliness, loss of autonomy, exposure to violence, and disconnection from social support networks, are linked to incarceration. These pressures have a major role in the high rates of mental health conditions like depression, anxiety, PTSD, and substance use disorders that are found in prison populations. This narrative review summarizes the body of research on the mental health issues that prisoners encounter, looking at both institutional and individual factors that affect psychological outcomes while incarcerated. It also looks at how the prison environment, coping mechanisms, and emotional control affect the wellbeing of convicts. Particular focus is placed on how mental illness intersects with pre-incarceration trauma, gender, and race. The evaluation also identifies crucial gaps in care as well as effective methods in the present mental health services provided in correctional settings. The results highlight the necessity of thorough, trauma-informed mental health treatments that go beyond symptom relief to attend to the more extensive social and emotional requirements of those who are incarcerated. Enhancing mental health services in prisons helps inmates' psychological health and aids in their effective rehabilitation and reintegration into society after release. In order to build compassionate and encouraging prison settings, this review highlights the significance of staff training, policy changes, and ongoing research. It also argues for a systemic change in the way mental health is emphasized within correctional facilities.
{"title":"Mental health and psychological well-being of incarcerated individuals: A narrative review","authors":"Kalliopi Megari , Eleana Argyriadou","doi":"10.1016/j.ejtd.2025.100606","DOIUrl":"10.1016/j.ejtd.2025.100606","url":null,"abstract":"<div><div>Correctional psychology and public health have been increasingly concerned with the mental health and psychological well-being of those who are incarcerated. Numerous psychological stressors, such as loneliness, loss of autonomy, exposure to violence, and disconnection from social support networks, are linked to incarceration. These pressures have a major role in the high rates of mental health conditions like depression, anxiety, PTSD, and substance use disorders that are found in prison populations. This narrative review summarizes the body of research on the mental health issues that prisoners encounter, looking at both institutional and individual factors that affect psychological outcomes while incarcerated. It also looks at how the prison environment, coping mechanisms, and emotional control affect the wellbeing of convicts. Particular focus is placed on how mental illness intersects with pre-incarceration trauma, gender, and race. The evaluation also identifies crucial gaps in care as well as effective methods in the present mental health services provided in correctional settings. The results highlight the necessity of thorough, trauma-informed mental health treatments that go beyond symptom relief to attend to the more extensive social and emotional requirements of those who are incarcerated. Enhancing mental health services in prisons helps inmates' psychological health and aids in their effective rehabilitation and reintegration into society after release. In order to build compassionate and encouraging prison settings, this review highlights the significance of staff training, policy changes, and ongoing research. It also argues for a systemic change in the way mental health is emphasized within correctional facilities.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100606"},"PeriodicalIF":1.9,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145361621","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}
<div><h3>Background</h3><div>Despite the existence of effective, evidence-based therapies, the shortage of mental health professionals limits the possibility of reaching those in need of help. A solution to meet this demand is to train para- and allied professionals and scale up trauma treatment interventions that are based on task-shifting principles. The Traumatic Stress Relief (TSR) program, developed by the Global Initiative for Stress and Trauma Treatment (GIST-T) has been developed to provide an effective, safe, and early intervention for traumatic stress reduction in humanitarian settings. This study aims to explore the acceptability and feasibility of both the training of staff and treatment program with internal refugees and members of the host community, as well as with trained healthcare workers in northern Burkina Faso.</div></div><div><h3>Method</h3><div>17 mental health workers, nurses, and midwives attended a TSR training course, upskilling the participants to use psychoeducation, evidence-based stabilization techniques, grounding, and the Frontline Worksheet Protocol (F-WSP). Qualitative and quantitative evaluation of the training content and a follow-up of the implementation in the field were conducted and monitored over 3 months. Then 92 users of the Ministry of Health structures supported by ALIMA NGO participated voluntarily in the F-WSP intervention, including 3 F-WSP sessions provided by the trained staff. Their levels of traumatic stress and of resilience were assessed with respectively the ITQ and the BRS, before, after one week, and at follow-up after one month. Demographic data were captured and Wilcoxon signed-rank tests were performed to compare pre- and post-TSR intervention outcomes.</div></div><div><h3>Results</h3><div>Acceptability and feasibility of both the training and the intervention were good. Participants appreciated the cultural adaptations made, such as the metaphors used for stress and relaxation. Psychoeducation was rated as a necessary and helpful step in stabilization and acceptability. Grounding and stabilization techniques were well received by participants. The 92 participants of the F-WSP intervention reported a significant reduction in levels of traumatic stress (<em>Z</em> = 3726,5; <em>p</em> < .0001; Cohen’s <em>d</em> = 2973), including symptoms associated with complex trauma (<em>Z</em> = 3583; <em>p</em> < 0.0001; Cohen’s <em>d</em> = 2,90), as well as increased levels of resilience (<em>Z</em> = 783.5; <em>p</em> < 0.001; <em>Cohen’s d</em> = -1,34) after one week, with scores continuing to improve after one month. These preliminary results are only exploratory as there was no comparison group.</div></div><div><h3>Conclusion</h3><div>The results are promising and suggest that TSR is a feasible and acceptable program that could add to the existing MHPSS tools in treating persons reporting with high levels of traumatic stress in Burkina Faso and similar settings. Future comparative s
尽管存在有效的循证治疗方法，但精神卫生专业人员的短缺限制了向需要帮助的人提供帮助的可能性。满足这一需求的一个解决方案是培训辅助和联合专业人员，并扩大基于任务转移原则的创伤治疗干预措施。创伤压力缓解（TSR）项目由全球压力和创伤治疗倡议（GIST-T）开发，旨在为人道主义环境下的创伤压力减轻提供有效、安全、早期的干预措施。本研究旨在探讨在布基纳法索北部对内部难民和收容社区成员以及训练有素的保健工作者进行工作人员培训和治疗方案的可接受性和可行性。方法17名精神卫生工作者、护士和助产士参加了TSR培训课程，提高了参与者使用心理教育、循证稳定技术、接地和前线工作表协议（F-WSP）的技能。对培训内容进行了定性和定量评价，并对实地执行情况进行了跟踪，为期3个月。随后，由非政府组织ALIMA支助的92名卫生部机构的使用者自愿参加了F-WSP的干预，其中包括由受过培训的工作人员提供的3次F-WSP会议。分别在一周前、一周后和一个月后的随访中，用ITQ和BRS评估他们的创伤应激水平和恢复能力。收集人口统计数据，并进行Wilcoxon sign -rank检验，比较tsr干预前后的结果。结果培训和干预的可接受性和可行性均较好。参与者对所做的文化适应表示赞赏，例如用于压力和放松的隐喻。心理教育被认为是稳定和可接受性的必要和有益的步骤。接地和稳定技术受到了与会者的好评。F-WSP干预的92名参与者报告了创伤应激水平的显著降低（Z = 3726,5; p < 0.0001; Cohen 's d = 2973），包括与复杂创伤相关的症状（Z = 3583; p < 0.0001; Cohen 's d = 2,90），以及恢复能力水平的增加（Z = 783.5; p < 0.001; Cohen 's d = -1,34），一个月后得分继续提高。这些初步结果只是探索性的，因为没有对照组。结论TSR是一种可行和可接受的方案，可以添加到现有的MHPSS工具中，用于治疗布基纳法索和类似环境中报告有高水平创伤应激的人。建议将来使用正式验证的工具进行比较研究，以评估干预措施的效果。
{"title":"Feasibility, acceptability, and outcomes of the traumatic stress relief training program (GIST-T TSR) for paraprofessionals and allied mental health professionals in Burkina Faso: A series of case studies","authors":"Adeline Pupat , Dodo Ilunga Diemu , Harouna Yacoubou , Valérie Chanfreau , Susanne Young","doi":"10.1016/j.ejtd.2025.100607","DOIUrl":"10.1016/j.ejtd.2025.100607","url":null,"abstract":"<div><h3>Background</h3><div>Despite the existence of effective, evidence-based therapies, the shortage of mental health professionals limits the possibility of reaching those in need of help. A solution to meet this demand is to train para- and allied professionals and scale up trauma treatment interventions that are based on task-shifting principles. The Traumatic Stress Relief (TSR) program, developed by the Global Initiative for Stress and Trauma Treatment (GIST-T) has been developed to provide an effective, safe, and early intervention for traumatic stress reduction in humanitarian settings. This study aims to explore the acceptability and feasibility of both the training of staff and treatment program with internal refugees and members of the host community, as well as with trained healthcare workers in northern Burkina Faso.</div></div><div><h3>Method</h3><div>17 mental health workers, nurses, and midwives attended a TSR training course, upskilling the participants to use psychoeducation, evidence-based stabilization techniques, grounding, and the Frontline Worksheet Protocol (F-WSP). Qualitative and quantitative evaluation of the training content and a follow-up of the implementation in the field were conducted and monitored over 3 months. Then 92 users of the Ministry of Health structures supported by ALIMA NGO participated voluntarily in the F-WSP intervention, including 3 F-WSP sessions provided by the trained staff. Their levels of traumatic stress and of resilience were assessed with respectively the ITQ and the BRS, before, after one week, and at follow-up after one month. Demographic data were captured and Wilcoxon signed-rank tests were performed to compare pre- and post-TSR intervention outcomes.</div></div><div><h3>Results</h3><div>Acceptability and feasibility of both the training and the intervention were good. Participants appreciated the cultural adaptations made, such as the metaphors used for stress and relaxation. Psychoeducation was rated as a necessary and helpful step in stabilization and acceptability. Grounding and stabilization techniques were well received by participants. The 92 participants of the F-WSP intervention reported a significant reduction in levels of traumatic stress (<em>Z</em> = 3726,5; <em>p</em> < .0001; Cohen’s <em>d</em> = 2973), including symptoms associated with complex trauma (<em>Z</em> = 3583; <em>p</em> < 0.0001; Cohen’s <em>d</em> = 2,90), as well as increased levels of resilience (<em>Z</em> = 783.5; <em>p</em> < 0.001; <em>Cohen’s d</em> = -1,34) after one week, with scores continuing to improve after one month. These preliminary results are only exploratory as there was no comparison group.</div></div><div><h3>Conclusion</h3><div>The results are promising and suggest that TSR is a feasible and acceptable program that could add to the existing MHPSS tools in treating persons reporting with high levels of traumatic stress in Burkina Faso and similar settings. Future comparative s","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100607"},"PeriodicalIF":1.9,"publicationDate":"2025-10-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145362265","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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