Pub Date : 2025-10-04DOI: 10.1016/j.ejtd.2025.100599
David Casanovas , Bruno Faustino
This study explored the relationships between complex trauma, dialectical core schemas and emotional processing difficulties in a non-clinical sample. Drawing from schema theory and emotion-focused models, we examined how complex trauma contributes to the development of maladaptive self and other-representations and their impact on emotional functioning. A total of 185 participants (Mage = 35.16, SD = 12.10) completed validated self-report measures assessing trauma exposure, core schemas, emotional processing, and psychological symptomatology. Correlation analyses revealed that complex trauma was significantly associated with maladaptive self-schemas and all dimensions of emotional processing difficulties. An hierarchical regression model showed that complex trauma and emotional processing difficulties, but not core schemas, significantly predicted psychological distress. Mediation analysis further indicated that complex trauma mediated the relationship between maladaptive self-schemas and emotional processing difficulties. These findings highlight the role of complex trauma in shaping maladaptive cognitive-emotional structures and impairing emotional processing, underscoring the need to target trauma and emotion regulation in therapeutic interventions.
{"title":"Interplay between complex trauma, dialectical core schemas and emotional processing difficulties","authors":"David Casanovas , Bruno Faustino","doi":"10.1016/j.ejtd.2025.100599","DOIUrl":"10.1016/j.ejtd.2025.100599","url":null,"abstract":"<div><div>This study explored the relationships between complex trauma, dialectical core schemas and emotional processing difficulties in a non-clinical sample. Drawing from schema theory and emotion-focused models, we examined how complex trauma contributes to the development of maladaptive self and other-representations and their impact on emotional functioning. A total of 185 participants (Mage = 35.16, SD = 12.10) completed validated self-report measures assessing trauma exposure, core schemas, emotional processing, and psychological symptomatology. Correlation analyses revealed that complex trauma was significantly associated with maladaptive self-schemas and all dimensions of emotional processing difficulties. An hierarchical regression model showed that complex trauma and emotional processing difficulties, but not core schemas, significantly predicted psychological distress. Mediation analysis further indicated that complex trauma mediated the relationship between maladaptive self-schemas and emotional processing difficulties. These findings highlight the role of complex trauma in shaping maladaptive cognitive-emotional structures and impairing emotional processing, underscoring the need to target trauma and emotion regulation in therapeutic interventions.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100599"},"PeriodicalIF":1.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145324337","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 : 2025-10-04DOI: 10.1016/j.ejtd.2025.100597
Jürgen Schäfer
Depersonalization/derealization disorder is a dissociative disorder characterized by persistent unreality experiences and intact reality testing. It is presented as a primary disorder or conceptualized as a secondary disorder associated with another psychopathology, in which such secondary disorder supposes to be the main promoting factor in the condition. Dissociative disorders are understood broadly as posttraumatic phenomena, although literature reports have demonstrated certain difficulties in both treatment and accurate diagnosis especially concerning depersonalization/derealization. The present theoretical paper aims to present previous research data and a summarized theoretical corpus on trauma-related dissociation to characterize the phenomenon from a psychotraumatology standpoint, and elaborate an explanatory hypothesis on its mechanism, pointing to etiology, differential diagnosis, and adequate management issues based on historical and empirical research to date. As an attainable emotional reaction, the chronic egodystonic presentation requires a formal explanation in conformity with the theory of structural dissociation. Depersonalization/derealization disorder, as a dissociative disorder, although mostly would be precipitated by accumulative trauma, could be understood not always solely on that explanation, but as a multifactorial phenomenon in some cases. Nonetheless, an explanation centered in the disorder acquisition as a type of posttraumatic reaction will be emphasized, involving personality development and developmental psychopathology.
{"title":"Depersonalization/derealization disorder: A comprehensive theoretical formulation","authors":"Jürgen Schäfer","doi":"10.1016/j.ejtd.2025.100597","DOIUrl":"10.1016/j.ejtd.2025.100597","url":null,"abstract":"<div><div>Depersonalization/derealization disorder is a dissociative disorder characterized by persistent unreality experiences and intact reality testing. It is presented as a primary disorder or conceptualized as a secondary disorder associated with another psychopathology, in which such secondary disorder supposes to be the main promoting factor in the condition. Dissociative disorders are understood broadly as posttraumatic phenomena, although literature reports have demonstrated certain difficulties in both treatment and accurate diagnosis especially concerning depersonalization/derealization. The present theoretical paper aims to present previous research data and a summarized theoretical corpus on trauma-related dissociation to characterize the phenomenon from a psychotraumatology standpoint, and elaborate an explanatory hypothesis on its mechanism, pointing to etiology, differential diagnosis, and adequate management issues based on historical and empirical research to date. As an attainable emotional reaction, the chronic egodystonic presentation requires a formal explanation in conformity with the theory of structural dissociation. Depersonalization/derealization disorder, as a dissociative disorder, although mostly would be precipitated by accumulative trauma, could be understood not always solely on that explanation, but as a multifactorial phenomenon in some cases. Nonetheless, an explanation centered in the disorder acquisition as a type of posttraumatic reaction will be emphasized, involving personality development and developmental psychopathology.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100597"},"PeriodicalIF":1.9,"publicationDate":"2025-10-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145267181","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}
Background/Aim: Long-lasting psychological and physical problems have been reported in earthquake survivors. This study was planned to observe the relationship between mental symptoms and respiratory functions in university students exposed to earthquakes.
Material and Methods: In 2024, the study included 118 university students from Suleyman Demirel University, Türkiye. Of these, 57 were classified as Group 1 (earthquake-exposed) and 61 as Group 2 (non-exposed). Post Traumatic Stress Disorder (PTSD) symptoms were evaluated with Posttraumatic Stress Disorder Checklist (PCL-5), depression tendency was assessed with Beck Depression Inventory (BDI), anxiety level was determined with Beck Anxiety Inventory (BAI), and sleep problems were evaluated with Jenkin's Sleep Scale. Respiratory functions were measured using a spirometer (COSMED Pony FX® Spirometry).
Results: In the group comparison, MIP, MEP, FEV1, FVC, PEF were significantly lower, PTSD symptoms, anxiety level and depression tendency were significantly higher in Group 1, while the FEV1/FVC was similar between the groups. In addition, within each group, certain mental symptoms were found to be associated with specific respiratory functions.
Conclusion: This study found correlation between mental symptoms and respiratory functions. It is recommended to observe this effect again after natural disasters and to examine the change with intermittent measurements.
{"title":"Evaluation of post-traumatic symptoms and respiratory functions in university students exposed to earthquake (6 February 2023 Kahramanmaraş earthquakes)","authors":"Caglayan Pinar Ozturk , Neriman Temel Aksu , Ferdi Baskurt , Zeliha Baskurt","doi":"10.1016/j.ejtd.2025.100592","DOIUrl":"10.1016/j.ejtd.2025.100592","url":null,"abstract":"<div><div>Background/Aim: Long-lasting psychological and physical problems have been reported in earthquake survivors. This study was planned to observe the relationship between mental symptoms and respiratory functions in university students exposed to earthquakes.</div><div>Material and Methods: In 2024, the study included 118 university students from Suleyman Demirel University, Türkiye. Of these, 57 were classified as Group 1 (earthquake-exposed) and 61 as Group 2 (non-exposed). Post Traumatic Stress Disorder (PTSD) symptoms were evaluated with Posttraumatic Stress Disorder Checklist (PCL-5), depression tendency was assessed with Beck Depression Inventory (BDI), anxiety level was determined with Beck Anxiety Inventory (BAI), and sleep problems were evaluated with Jenkin's Sleep Scale. Respiratory functions were measured using a spirometer (COSMED Pony FX® Spirometry).</div><div>Results: In the group comparison, MIP, MEP, FEV1, FVC, PEF were significantly lower, PTSD symptoms, anxiety level and depression tendency were significantly higher in Group 1, while the FEV1/FVC was similar between the groups. In addition, within each group, certain mental symptoms were found to be associated with specific respiratory functions.</div><div>Conclusion: This study found correlation between mental symptoms and respiratory functions. It is recommended to observe this effect again after natural disasters and to examine the change with intermittent measurements.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100592"},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145118541","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>Introduction</h3><div>Young’s Schema therapy has shown effectiveness in treating individuals diagnosed with Complex Post-Traumatic Stress Disorder (C-PTSD) (Ubico et al., 2025). Dissociative symptoms are frequently observed in this clinical presentation. However, how do they evolve over the course of treatment? To address this, we have developed a psychotherapeutic program that integrates group and individual therapy, grounded in Contextual Schema Therapy (Roediger et al., 2018). This program also draws on key principles from psychotraumatology, particularly the theory of structural dissociation of the personality (Van der Hart et al., 2006). While these theoretical frameworks share certain conceptual foundations, they differ in how they understand dissociation and in the therapeutic strategies they propose. Still, given the well-documented influence of therapeutic alliance and group cohesion on treatment outcomes, the common factors model of psychotherapy may offer a valuable, integrative lens. This raises a central question: What mechanisms of change can be observed in an individual with Complex PTSD undergoing a combined group and individual psychotherapy program?<!--> </div></div><div><h3>Methodology</h3><div>This study employs a mixed-methods design grounded in Fishman’s (2017) pragmatic case study methodology. Standardized instruments were administered at four time points: pre-treatment (T0), mid-group therapy (T1; after 10 sessions), post-group therapy (T2; after 20 sessions), and at a three-month follow-up (T3). Variables assessed encompassed complex post-traumatic stress symptoms, psychoform and somatoform dissociative symptoms, quality of life, and the therapeutic alliance. Group cohesion was evaluated at the conclusion of each of the twenty group sessions. The clinician-researcher also conducted monthly assessments utilizing the Dimensions of Therapeutic Movement Instrument (DTMI) for complex trauma. At the conclusion of therapy (T2), an independent clinical psychologist conducted a research interview to explore various dimensions of change. A thematic analysis (Braun & Clarke, 2006) was conducted to identify emerging themes from the interview.</div></div><div><h3>Results</h3><div>The trajectory of the combined psychotherapy is delineated in detail. By the conclusion of treatment, a substantial reduction in complex post-traumatic symptoms, along with psychoform and somatoform dissociative symptoms, was observed, with these improvements sustained at follow-up. Quality of life also demonstrated notable enhancement. Regarding common therapeutic factors, the therapeutic alliance progressively strengthened throughout the course of treatment. In contrast, group cohesion declined sharply at the tenth session but subsequently improved and stabilized following the resolution of a rupture within the group. The research interview highlighted several therapeutic gains, including symptom reduction, the contribution of group therapy, t
杨氏图式疗法在治疗诊断为复杂创伤后应激障碍（C-PTSD）的个体方面显示出有效性（Ubico et al., 2025）。这种临床表现经常出现分离性症状。然而，它们在治疗过程中是如何演变的呢？为了解决这个问题，我们开发了一种基于情境图式疗法（Roediger et al., 2018）的心理治疗方案，将团体和个人治疗结合起来。该项目还借鉴了心理创伤学的关键原则，特别是人格结构分离理论（Van der Hart et al., 2006）。虽然这些理论框架共享某些概念基础，但它们在如何理解解离和提出的治疗策略方面有所不同。尽管如此，考虑到治疗联盟和团体凝聚力对治疗结果的良好影响，心理治疗的共同因素模型可能提供一个有价值的综合视角。这就提出了一个核心问题：在接受团体和个人联合心理治疗项目的复杂PTSD患者身上，可以观察到什么样的变化机制？本研究采用基于Fishman（2017）实用案例研究方法的混合方法设计。在四个时间点使用标准化工具：治疗前（T0）、组中治疗（T1； 10次治疗后）、组后治疗（T2； 20次治疗后）和三个月随访（T3）。评估的变量包括复杂的创伤后应激症状、精神和躯体形式的分离症状、生活质量和治疗联盟。小组凝聚力在20次小组会议结束时进行评估。临床研究人员还利用治疗运动仪器（DTMI）对复杂创伤进行了每月评估。在治疗结束时（T2），独立的临床心理学家进行了一次研究访谈，以探索变化的各个维度。进行主题分析（Braun & Clarke, 2006）以确定访谈中出现的主题。结果详细描述了综合心理治疗的发展轨迹。治疗结束时，观察到复杂的创伤后症状以及精神和躯体形式的分离症状显著减轻，这些改善在随访中持续存在。生活质量也有显著提高。在共同治疗因素方面，治疗联盟在整个治疗过程中逐渐增强。相比之下，集团凝聚力在第十届会议上急剧下降，但随后在解决集团内部的分裂后有所改善和稳定。研究访谈强调了几项治疗成果，包括症状减轻、团体治疗的贡献、综合方法的价值、对心理功能的深入了解、人际关系的改善、自信心的增强、情绪调节的增强、治疗工具的使用以及治疗关系的核心重要性。这些发现是在现有的关于创伤后和分离症状以及相关合并症的文献的背景下进行检验的。通过结构分离理论和Liotti对创伤性和分离性个体无组织依恋的概念分析了参与者的整合过程。该研究进一步证实了图式治疗技术的有效性，包括椅子工作和意象重写。此外，这些发现与现有的关于常见治疗因素的研究相一致，强调了情绪突出体验在促进心理变化方面的重要性。这一个案研究举例说明了两种有助于转变的治疗方式之间的相互作用和周期性相互作用：个体治疗，侧重于心理过程和创伤处理，团体治疗，侧重于人际动态。局限性和未来方向虽然单例设计限制了研究结果的普遍性，但本研究为未来的研究和临床创新提供了有希望的途径。
{"title":"Integrating group and individual psychotherapy for complex PTSD: A pragmatic case study","authors":"Emilie Ubico , Christelle Ziebel , Baptiste Alleaume , Caroline Vieilleribière , Christelle Anglade , Nathalie Duriez","doi":"10.1016/j.ejtd.2025.100593","DOIUrl":"10.1016/j.ejtd.2025.100593","url":null,"abstract":"<div><h3>Introduction</h3><div>Young’s Schema therapy has shown effectiveness in treating individuals diagnosed with Complex Post-Traumatic Stress Disorder (C-PTSD) (Ubico et al., 2025). Dissociative symptoms are frequently observed in this clinical presentation. However, how do they evolve over the course of treatment? To address this, we have developed a psychotherapeutic program that integrates group and individual therapy, grounded in Contextual Schema Therapy (Roediger et al., 2018). This program also draws on key principles from psychotraumatology, particularly the theory of structural dissociation of the personality (Van der Hart et al., 2006). While these theoretical frameworks share certain conceptual foundations, they differ in how they understand dissociation and in the therapeutic strategies they propose. Still, given the well-documented influence of therapeutic alliance and group cohesion on treatment outcomes, the common factors model of psychotherapy may offer a valuable, integrative lens. This raises a central question: What mechanisms of change can be observed in an individual with Complex PTSD undergoing a combined group and individual psychotherapy program?<!--> </div></div><div><h3>Methodology</h3><div>This study employs a mixed-methods design grounded in Fishman’s (2017) pragmatic case study methodology. Standardized instruments were administered at four time points: pre-treatment (T0), mid-group therapy (T1; after 10 sessions), post-group therapy (T2; after 20 sessions), and at a three-month follow-up (T3). Variables assessed encompassed complex post-traumatic stress symptoms, psychoform and somatoform dissociative symptoms, quality of life, and the therapeutic alliance. Group cohesion was evaluated at the conclusion of each of the twenty group sessions. The clinician-researcher also conducted monthly assessments utilizing the Dimensions of Therapeutic Movement Instrument (DTMI) for complex trauma. At the conclusion of therapy (T2), an independent clinical psychologist conducted a research interview to explore various dimensions of change. A thematic analysis (Braun & Clarke, 2006) was conducted to identify emerging themes from the interview.</div></div><div><h3>Results</h3><div>The trajectory of the combined psychotherapy is delineated in detail. By the conclusion of treatment, a substantial reduction in complex post-traumatic symptoms, along with psychoform and somatoform dissociative symptoms, was observed, with these improvements sustained at follow-up. Quality of life also demonstrated notable enhancement. Regarding common therapeutic factors, the therapeutic alliance progressively strengthened throughout the course of treatment. In contrast, group cohesion declined sharply at the tenth session but subsequently improved and stabilized following the resolution of a rupture within the group. The research interview highlighted several therapeutic gains, including symptom reduction, the contribution of group therapy, t","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100593"},"PeriodicalIF":1.9,"publicationDate":"2025-09-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145096067","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 : 2025-08-26DOI: 10.1016/j.ejtd.2025.100591
Bronwyn Milkins , Jeneva L. Ohan , Maryam Boutrus , Giulia Pace , Helen Milroy
Background
Dissociative symptoms are associated with a range of negative outcomes, yet little is understood about how adolescents experience dissociation in their daily lives.
Objective
This study aimed to describe adolescents’ dissociative symptoms from the perspective of adolescents, their parents, and their treating clinicians.
Methods
Semi-structured interviews were conducted with 13 participants about adolescents’ experiences of dissociation. Participants were 6 female adolescent patients (aged 14–17 years, M = 15.67) from a psychiatric outpatient service, 3 parents, and 4 clinicians. Reflexive thematic analysis was used to analyse interview data.
Results
Dissociative experiences varied in frequency, duration, and type (theme 1, Dissociation is Diverse: “It can vary a lot”). However, commonalities were also observed: intense emotions experienced during dissociation were described as qualitatively different from typical emotional dysregulation (theme 2, Emotion Takes Over: “It’s like it just consumes me”). During dissociation, adolescents reported a pronounced detachment from the present moment (theme 3, Disconnecting from the Present: “I don’t really exist here” with subthemes of Affective Disconnection and Bodily Disconnection). The dissociative state, not reality, felt real (theme 4, Reality Feels Unreal: “I didn’t feel real”). Finally, a marked decline in memory and attention was described (theme 5, Problems with Memory and Attention: “My brain stops working”).
Conclusions
This study is the first to examine adolescent dissociative experiences from the perspective of adolescents, their parents, and their clinicians. Adolescents’ dissociative symptoms mostly aligned with symptoms for dissociative disorders in the DSM-5-TR/ICD-11. However, identity disruption appeared absent, while the presence of fantasy elements was potentially unique and warrants replication and clarification through formal assessment. Findings can inform the refinement of symptom criteria in diagnostic guides and the development of adolescent-focused assessment tools. This may support earlier and more accurate identification of dissociation and enable tailored interventions to improve clinical outcomes for this population.
{"title":"“I don’t really exist here”: A reflexive thematic analysis of dissociative symptoms described by adolescents and their parents and clinicians","authors":"Bronwyn Milkins , Jeneva L. Ohan , Maryam Boutrus , Giulia Pace , Helen Milroy","doi":"10.1016/j.ejtd.2025.100591","DOIUrl":"10.1016/j.ejtd.2025.100591","url":null,"abstract":"<div><h3>Background</h3><div>Dissociative symptoms are associated with a range of negative outcomes, yet little is understood about how adolescents experience dissociation in their daily lives.</div></div><div><h3>Objective</h3><div>This study aimed to describe adolescents’ dissociative symptoms from the perspective of adolescents, their parents, and their treating clinicians.</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with 13 participants about adolescents’ experiences of dissociation. Participants were 6 female adolescent patients (aged 14–17 years, <em>M</em> = 15.67) from a psychiatric outpatient service, 3 parents, and 4 clinicians. Reflexive thematic analysis was used to analyse interview data.</div></div><div><h3>Results</h3><div>Dissociative experiences varied in frequency, duration, and type <em>(theme 1, Dissociation is Diverse: “It can vary a lot”)</em>. However, commonalities were also observed: intense emotions experienced during dissociation were described as qualitatively different from typical emotional dysregulation (<em>theme 2, Emotion Takes Over: “It’s like it just consumes me”)</em>. During dissociation, adolescents reported a pronounced detachment from the present moment (<em>theme 3, Disconnecting from the Present: “I don’t really exist here”</em> with subthemes of <em>Affective Disconnection</em> and <em>Bodily Disconnection)</em>. The dissociative state, not reality, felt real (<em>theme 4, Reality Feels Unreal: “I didn’t feel real”)</em>. Finally, a marked decline in memory and attention was described <em>(theme 5, Problems with Memory and Attention: “My brain stops working”).</em></div></div><div><h3>Conclusions</h3><div>This study is the first to examine adolescent dissociative experiences from the perspective of adolescents, their parents, and their clinicians. Adolescents’ dissociative symptoms mostly aligned with symptoms for dissociative disorders in the DSM-5-TR/ICD-11. However, identity disruption appeared absent, while the presence of fantasy elements was potentially unique and warrants replication and clarification through formal assessment. Findings can inform the refinement of symptom criteria in diagnostic guides and the development of adolescent-focused assessment tools. This may support earlier and more accurate identification of dissociation and enable tailored interventions to improve clinical outcomes for this population.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100591"},"PeriodicalIF":1.9,"publicationDate":"2025-08-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144917033","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 : 2025-08-25DOI: 10.1016/j.ejtd.2025.100590
Aurore Roland
Introduction
Research on nightmares and psychiatric disorders has predominantly focused on post-traumatic stress disorder (PTSD). This case report aims to explore the impact of treating post-traumatic nightmares on obsessive compulsive disorder (OCD) symptoms that emerged following a traumatic experience.
Case
A woman in her mid-twenties with PTSD, post-traumatic nightmares and OCD symptoms was treated with exposure, relaxation and rescripting therapy (ERRT). This therapy consists of altering one’s nightmares and repeatedly imagining the new dream during wakefulness, supplemented with sleep hygiene, time-in-bed restriction, stimulus control, exposure to the nightmares and relaxation techniques.
Results
The results indicate that utilizing ERRT for Laura's post-traumatic nightmares has resulted in the remission of PTSD, comorbid OCD symptoms, nightmares, insomnia symptoms and stress, along with a significant reduction in anxiety.
Conclusion
This case study illustrates that treating post-traumatic nightmares through ERRT in an individual with comorbid post-traumatic OCD symptoms is feasible and can positively impact both nightmares and OCD symptoms. The underlying mechanism is hypothesized to be that improving sleep enhances both fear extinction learning and emotion regulation—two processes known to be impaired in OCD. In this particular case, the reduction in evening hyperarousal and anxiety, resulting from the time-in-bed restriction, likely also contributed to a decrease in obsessive thoughts.
{"title":"Remission of PTSD and comorbid OCD symptoms through psychotherapy for nightmares: A case report","authors":"Aurore Roland","doi":"10.1016/j.ejtd.2025.100590","DOIUrl":"10.1016/j.ejtd.2025.100590","url":null,"abstract":"<div><h3>Introduction</h3><div>Research on nightmares and psychiatric disorders has predominantly focused on post-traumatic stress disorder (PTSD). This case report aims to explore the impact of treating post-traumatic nightmares on obsessive compulsive disorder (OCD) symptoms that emerged following a traumatic experience.</div></div><div><h3>Case</h3><div>A woman in her mid-twenties with PTSD, post-traumatic nightmares and OCD symptoms was treated with exposure, relaxation and rescripting therapy (ERRT). This therapy consists of altering one’s nightmares and repeatedly imagining the new dream during wakefulness, supplemented with sleep hygiene, time-in-bed restriction, stimulus control, exposure to the nightmares and relaxation techniques.</div></div><div><h3>Results</h3><div>The results indicate that utilizing ERRT for Laura's post-traumatic nightmares has resulted in the remission of PTSD, comorbid OCD symptoms, nightmares, insomnia symptoms and stress, along with a significant reduction in anxiety.</div></div><div><h3>Conclusion</h3><div>This case study illustrates that treating post-traumatic nightmares through ERRT in an individual with comorbid post-traumatic OCD symptoms is feasible and can positively impact both nightmares and OCD symptoms. The underlying mechanism is hypothesized to be that improving sleep enhances both fear extinction learning and emotion regulation—two processes known to be impaired in OCD. In this particular case, the reduction in evening hyperarousal and anxiety, resulting from the time-in-bed restriction, likely also contributed to a decrease in obsessive thoughts.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100590"},"PeriodicalIF":1.9,"publicationDate":"2025-08-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144908863","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 : 2025-08-06DOI: 10.1016/j.ejtd.2025.100585
Jacqueline L. Kinley , Sandra M. Reyno
Background
Complex trauma experiences can result in a range of chronic and impairing Complex PTSD symptoms and co-morbid mental illness.
Aim
This study aimed to evaluate the efficacy of a pilot virtual, group treatment program for individuals with Complex PTSD and comorbid depression and anxiety symptoms.
Method
The study employed a within group, pre-post design with 3-month follow-up. Participants completed self-report measures of Complex PTSD symptoms, dissociative symptoms, negative beliefs about self and others, emotion regulation, psychological symptoms (anxiety, depression, stress), resilience, and progress in psychotherapy.
Results
Participants reported significant positive changes in severity of psychological symptoms, emotion regulation, beliefs about self and others, resilience, dissociative symptoms, as well as PTSD, DSO (disturbances in self-organization) and Complex PTSD symptoms at post-treatment. These gains were maintained at follow-up except for dissociative symptoms. Participants were significantly less likely to meet diagnostic criteria for PTSD, DSO, and Complex PTSD at post-treatment and for DSO and Complex PTSD (but not PTSD) at follow-up.
Conclusion & Implications
Findings suggest that the Dynamic attachment-focused Relational Treatment (DaRT) program is an effective intervention for individuals with Complex-PTSD and comorbid mental illness. The treatment may have significant implications for enhancing service capacity for individuals struggling with the chronic and pervasive residual impacts of complex trauma.
{"title":"Examining the Efficacy of a Pilot Virtual Group Treatment for Survivors of Complex Trauma","authors":"Jacqueline L. Kinley , Sandra M. Reyno","doi":"10.1016/j.ejtd.2025.100585","DOIUrl":"10.1016/j.ejtd.2025.100585","url":null,"abstract":"<div><h3>Background</h3><div>Complex trauma experiences can result in a range of chronic and impairing Complex PTSD symptoms and co-morbid mental illness.</div></div><div><h3>Aim</h3><div>This study aimed to evaluate the efficacy of a pilot virtual, group treatment program for individuals with Complex PTSD and comorbid depression and anxiety symptoms.</div></div><div><h3>Method</h3><div>The study employed a within group, pre-post design with 3-month follow-up. Participants completed self-report measures of Complex PTSD symptoms, dissociative symptoms, negative beliefs about self and others, emotion regulation, psychological symptoms (anxiety, depression, stress), resilience, and progress in psychotherapy.</div></div><div><h3>Results</h3><div>Participants reported significant positive changes in severity of psychological symptoms, emotion regulation, beliefs about self and others, resilience, dissociative symptoms, as well as PTSD, DSO (disturbances in self-organization) and Complex PTSD symptoms at post-treatment. These gains were maintained at follow-up except for dissociative symptoms. Participants were significantly less likely to meet diagnostic criteria for PTSD, DSO, and Complex PTSD at post-treatment and for DSO and Complex PTSD (but not PTSD) at follow-up.</div></div><div><h3>Conclusion & Implications</h3><div>Findings suggest that the Dynamic attachment-focused Relational Treatment (DaRT) program is an effective intervention for individuals with Complex-PTSD and comorbid mental illness. The treatment may have significant implications for enhancing service capacity for individuals struggling with the chronic and pervasive residual impacts of complex trauma.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100585"},"PeriodicalIF":1.9,"publicationDate":"2025-08-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828121","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}
The tendency to re-experience abusive relationships (TREAR) is a maladaptive relational pattern linked to early adverse experiences and ingrained cognitive-emotional schemas. While prior studies have examined these constructions separately, the combined contribution of adverse childhood experiences (ACEs) and early maladaptive schemas (EMS) to TREAR remains underexplored, especially in non-Western populations. The aim of this study was to determine the relationship of the tendency to re-experience abusive relationships with adverse childhood experiences and early maladaptive schemas in Iranians.
Methods
The research design was cross-sectional, descriptive, and correlational. The statistical population consisted of individuals over 18 years old residing in Gilan province, Iran. Data were gathered in 2024 using an internet-based convenience sampling method. An online survey was conducted to collect data and included the following instruments: Demographic Characteristics Questions, the Adverse Childhood Experiences–Abuse Short Form (ACE-ASF), the Early Maladaptive Schemas Questionnaire (YSQ-S3), and the Tendency to Re-experience Abusive Relationships Scale (TREARS). A total of 894 individuals received the survey, but only 272 participated in the research. Of the participants, 72.1% were female, 28.3% were married.
Results
A large number of participants (81%) reported abuse in childhood, and more than half (56.3%) had high TREAR scores. People with a history of physical, emotional, or sexual abuse were more likely to show signs of TREAR. We found strong links between TREAR and EMS (r = 0.705, p < 0.001), across all 18 schema domains. While demographic factors alone explained just 11% of TREAR, including ACE scores raised this to 18.3%. However, once EMS scores were added, the model explained 55.1% of TREAR, demonstrating that EMS plays a large role in perpetuating this cycle.
Conclusion
The result indicated that early maladaptive schemas play a key role in the relationship between adverse childhood experiences and adult revictimization tendencies. These results showed the necessity of combining schema-targeted and trauma-sensitive therapies to stop re-experiencing abusive relationships and help people build safer and healthier relationships.
重新体验虐待关系的倾向（TREAR）是一种适应不良的关系模式，与早期的不良经历和根深蒂固的认知-情感图式有关。虽然先前的研究已经分别研究了这些结构，但不良童年经历（ace）和早期适应不良图式（EMS）对TREAR的综合贡献仍未得到充分探讨，特别是在非西方人群中。本研究的目的是确定伊朗人再次经历虐待关系的倾向与不良童年经历和早期适应不良图式之间的关系。方法采用横断面、描述性、相关性研究设计。统计人口包括居住在伊朗吉兰省的18岁以上的个人。数据收集于2024年，采用基于互联网的便捷抽样方法。通过在线调查收集数据，包括以下工具：人口统计学特征问题、不良童年经历-虐待简短表格（ACE-ASF）、早期适应不良图式问卷（YSQ-S3）和再体验虐待关系倾向量表（TREARS）。共有894人接受了调查，但只有272人参与了研究。在参与者中，72.1%为女性，28.3%为已婚。结果大量参与者（81%）报告童年受虐待，超过一半（56.3%）的TREAR得分较高。有身体、情感或性虐待史的人更有可能表现出TREAR的迹象。我们发现TREAR和EMS之间存在很强的联系（r = 0.705, p < 0.001），跨越所有18个模式域。虽然人口因素只解释了11%的TREAR，但包括ACE分数在内，这一比例上升到了18.3%。然而，一旦加入EMS分数，该模型解释了55.1%的TREAR，表明EMS在延续这一循环中发挥了重要作用。结论早期适应不良图式在儿童不良经历与成人再受害倾向的关系中起关键作用。这些结果表明，有必要将针对图式和创伤敏感的治疗相结合，以阻止再次经历虐待关系，并帮助人们建立更安全、更健康的关系。
{"title":"From childhood trauma to intimate harm: the role of maladaptive schemas in re-experiencing abusive relationships","authors":"Parisa Khanbeigi , Fatemeh SadeghMohammadi , Kosar Shafiei Rezvani Nejad , Zinat sadat Mirpour","doi":"10.1016/j.ejtd.2025.100584","DOIUrl":"10.1016/j.ejtd.2025.100584","url":null,"abstract":"<div><h3>Background</h3><div>The tendency to re-experience abusive relationships (TREAR) is a maladaptive relational pattern linked to early adverse experiences and ingrained cognitive-emotional schemas. While prior studies have examined these constructions separately, the combined contribution of adverse childhood experiences (ACEs) and early maladaptive schemas (EMS) to TREAR remains underexplored, especially in non-Western populations. The aim of this study was to determine the relationship of the tendency to re-experience abusive relationships with adverse childhood experiences and early maladaptive schemas in Iranians.</div></div><div><h3>Methods</h3><div>The research design was cross-sectional, descriptive, and correlational. The statistical population consisted of individuals over 18 years old residing in Gilan province, Iran. Data were gathered in 2024 using an internet-based convenience sampling method. An online survey was conducted to collect data and included the following instruments: Demographic Characteristics Questions, the Adverse Childhood Experiences–Abuse Short Form (ACE-ASF), the Early Maladaptive Schemas Questionnaire (YSQ-S3), and the Tendency to Re-experience Abusive Relationships Scale (TREARS). A total of 894 individuals received the survey, but only 272 participated in the research. Of the participants, 72.1% were female, 28.3% were married.</div></div><div><h3>Results</h3><div>A large number of participants (81%) reported abuse in childhood, and more than half (56.3%) had high TREAR scores. People with a history of physical, emotional, or sexual abuse were more likely to show signs of TREAR. We found strong links between TREAR and EMS (<em>r</em> = 0.705, <em>p</em> < 0.001), across all 18 schema domains. While demographic factors alone explained just 11% of TREAR, including ACE scores raised this to 18.3%. However, once EMS scores were added, the model explained 55.1% of TREAR, demonstrating that EMS plays a large role in perpetuating this cycle.</div></div><div><h3>Conclusion</h3><div>The result indicated that early maladaptive schemas play a key role in the relationship between adverse childhood experiences and adult revictimization tendencies. These results showed the necessity of combining schema-targeted and trauma-sensitive therapies to stop re-experiencing abusive relationships and help people build safer and healthier relationships.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 4","pages":"Article 100584"},"PeriodicalIF":1.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145007831","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 : 2025-08-05DOI: 10.1016/j.ejtd.2025.100587
Amanda M. Raines , Joseph W. Boffa , Chelsea R. Ennis , Jason T. Goodson , Michael J. McDermott
Introduction
Safety aids, also known in the literature as safety behaviors, are maladaptive cognitive and behavioral strategies designed to prevent or reduce anxiety and/or distress. Research has shown that repeated use of such behaviors (e.g., hypervigilance, situational avoidance, checking behaviors, thought suppression) contributes to the development and maintenance of various anxiety and related disorders. However, less work has examined the role of safety aids in posttraumatic stress.
Method
Using a trauma-exposed sample of undergraduate students, the current study sought to examine mean levels of safety aid usage among individuals with (n = 35) and without probable PTSD (n = 57).
Results
Results revealed a significant difference between the two groups on overall safety aid usage and escape/avoidance and monitoring/vigilance behaviors. In particular, mean levels were higher among trauma-exposed individuals with probable PTSD compared to trauma-exposed individuals without probable PTSD.
Discussion
Findings are discussed with regard to prior research and treatment recommendations.
{"title":"Associations between safety aid usage and posttraumatic stress symptoms in trauma-exposed young adults","authors":"Amanda M. Raines , Joseph W. Boffa , Chelsea R. Ennis , Jason T. Goodson , Michael J. McDermott","doi":"10.1016/j.ejtd.2025.100587","DOIUrl":"10.1016/j.ejtd.2025.100587","url":null,"abstract":"<div><h3>Introduction</h3><div>Safety aids, also known in the literature as safety behaviors, are maladaptive cognitive and behavioral strategies designed to prevent or reduce anxiety and/or distress. Research has shown that repeated use of such behaviors (e.g., hypervigilance, situational avoidance, checking behaviors, thought suppression) contributes to the development and maintenance of various anxiety and related disorders. However, less work has examined the role of safety aids in posttraumatic stress.</div></div><div><h3>Method</h3><div>Using a trauma-exposed sample of undergraduate students, the current study sought to examine mean levels of safety aid usage among individuals with (<em>n</em> = 35) and without probable PTSD (<em>n</em> = 57).</div></div><div><h3>Results</h3><div>Results revealed a significant difference between the two groups on overall safety aid usage and escape/avoidance and monitoring/vigilance behaviors. In particular, mean levels were higher among trauma-exposed individuals with probable PTSD compared to trauma-exposed individuals without probable PTSD.</div></div><div><h3>Discussion</h3><div>Findings are discussed with regard to prior research and treatment recommendations.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100587"},"PeriodicalIF":1.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828151","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 : 2025-08-05DOI: 10.1016/j.ejtd.2025.100586
B. Uysal, M.S. Tepedelen, Z.Z. Kablama-Yardım, E. Akyüz, F.B. Bircan, M.F. Cinisli, M. Yanık
On February 6, 2024, following two major earthquakes in Türkiye, over 35,000 buildings collapsed, and approximately 50,000 people lost their lives. In response, our university psychology department established a psychotherapy center in the affected region as a social responsibility project, providing services for seven months. During this period, 820 clients were reached, and dissociative identity disorder (DID) was identified in 16 of them (around 2%). The identification was made possible by a team experienced in DID, who incorporated it into routine differential diagnosis. The clients, aged 12 to 37, included 13 females. Analysis revealed that DID symptoms worsened for 11 clients after the earthquake, with increased issues such as anger and, in some cases, the emergence of new alternate identities. One child client experienced the first appearance of an alternate identity after the earthquake. These findings emphasize the necessity of monitoring DID patients after disasters and delivering treatments specifically tailored to their needs.
{"title":"What happens to DID clients after an earthquake: A case series","authors":"B. Uysal, M.S. Tepedelen, Z.Z. Kablama-Yardım, E. Akyüz, F.B. Bircan, M.F. Cinisli, M. Yanık","doi":"10.1016/j.ejtd.2025.100586","DOIUrl":"10.1016/j.ejtd.2025.100586","url":null,"abstract":"<div><div>On February 6, 2024, following two major earthquakes in Türkiye, over 35,000 buildings collapsed, and approximately 50,000 people lost their lives. In response, our university psychology department established a psychotherapy center in the affected region as a social responsibility project, providing services for seven months. During this period, 820 clients were reached, and dissociative identity disorder (DID) was identified in 16 of them (around 2%). The identification was made possible by a team experienced in DID, who incorporated it into routine differential diagnosis. The clients, aged 12 to 37, included 13 females. Analysis revealed that DID symptoms worsened for 11 clients after the earthquake, with increased issues such as anger and, in some cases, the emergence of new alternate identities. One child client experienced the first appearance of an alternate identity after the earthquake. These findings emphasize the necessity of monitoring DID patients after disasters and delivering treatments specifically tailored to their needs.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100586"},"PeriodicalIF":1.9,"publicationDate":"2025-08-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144828150","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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