Pub Date : 2025-06-30DOI: 10.1016/j.ejtd.2025.100574
Hannah Sansom
The aim of this review is to consider whether the NICE guidelines for Post-Traumatic Stress Disorder (PTSD) can appropriately guide professionals in meeting the needs of refugees, through evaluation, assessment and treatment. In particular, the limited consideration for culture within the guidelines is explored. Of key importance is that the NICE guidelines are based on the diagnostic model of PTSD, which may fail to appreciate the broader ways in which refugees may understand their traumatic experiences, and wish to address the impacts. Furthermore, there is a clear gap in literature concerning PTSD treatment for refugees (Lee & Bowles, 2023). Arguably, this brings into question the validity of the treatment recommendations within the NICE guidelines, for refugees. More broadly, within the global context, the application of western-based mental disorders has been disputed based on the cultural, and philosophical differences, varying interpretations of life and different traditions in relation to expressing distress and seeking support (Summerfield, 2013). This paper suggests that the NICE guidelines fail to consider the depth and complexity of the role of culture within trauma and recommend insufficient flexibility with regards to the mode of treatment delivery, including a lack of consideration for native and culturally grounded methods of intervention.
{"title":"Refugees: An examination of the Post-Traumatic Stress Disorder NICE guidelines","authors":"Hannah Sansom","doi":"10.1016/j.ejtd.2025.100574","DOIUrl":"10.1016/j.ejtd.2025.100574","url":null,"abstract":"<div><div>The aim of this review is to consider whether the NICE guidelines for Post-Traumatic Stress Disorder (PTSD) can appropriately guide professionals in meeting the needs of refugees, through evaluation, assessment and treatment. In particular, the limited consideration for culture within the guidelines is explored. Of key importance is that the NICE guidelines are based on the diagnostic model of PTSD, which may fail to appreciate the broader ways in which refugees may understand their traumatic experiences, and wish to address the impacts. Furthermore, there is a clear gap in literature concerning PTSD treatment for refugees (Lee & Bowles, 2023). Arguably, this brings into question the validity of the treatment recommendations within the NICE guidelines, for refugees. More broadly, within the global context, the application of western-based mental disorders has been disputed based on the cultural, and philosophical differences, varying interpretations of life and different traditions in relation to expressing distress and seeking support (Summerfield, 2013). This paper suggests that the NICE guidelines fail to consider the depth and complexity of the role of culture within trauma and recommend insufficient flexibility with regards to the mode of treatment delivery, including a lack of consideration for native and culturally grounded methods of intervention.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100574"},"PeriodicalIF":2.0,"publicationDate":"2025-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144535926","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}
Trauma emerges as a significant etiological factor associated with a wide range of psychopathologies, including anxiety, mood disorders, impulse dysregulation, psychosis, substance dependence, personality disorders, conduct issues, and suicidal behavior. Furthermore, trauma plays a central role in somatoform and alexithymic disorders, eating disorders, and self-injurious behaviors. Additionally, trauma is linked to the development of various physical health conditions such as cardiovascular, gastrointestinal, endocrine, and inflammatory diseases, as well as cancer. Thus, the negative health consequences of trauma extend beyond PTSD and often manifest in personalized, polysymptomatic, and polysyndromic ways, suggesting the utility of adopting transdiagnostic approaches.
This study focuses on validating the Arousal Modulation Model Questionnaire (AMMQ), grounded in Ogden and Minton's Arousal Modulation Model originating from Siegel's concept of the Window of Tolerance. The validation process encompasses multiple facets of questionnaire validation, including construct validity, reliability, and other psychometric properties.
Participants included a sample of 304 individuals recruited for this study, with a mean age of 39.36 years (SD = 12.88). Although participants may have experienced one or more traumatic events in their lives, they were currently not under the care of the National Health Service Psychiatry Centers.
Construct validity of the AMMQ was assessed through exploratory and confirmatory factor analyses.
Initial exploratory factor analysis revealed a coherent factor structure consistent with theoretical expectations derived from the Arousal Modulation Model, yielding four distinct factors: "Optimal Arousal Zone" (OAZ, 7 items), "Fight/Flight" (FF, 4 items), Freeze (Fr, 6 items), and "Feigned Death" (FD, 5 items). Subsequent confirmatory factor analysis supported this structure, demonstrating excellent model fit (χ²(203) = 381.738, p < 0.001; CFI = 0.94; TLI = 0.93; RMSEA = 0.05; SRMR = 0.05).
Internal consistency was high, with a mean categorical omega (ω) of 0.83 across all subscales, supporting the reliability of the AMMQ.
Convergent validity was assessed by examining the associations between each AMMQ subscale and a set of established external measures. The Optimal Arousal Zone (OAZ) subscale showed strong positive correlations with all dimensions of psychological well-being (PWB-SF) and negative correlations with emotional distress (DASS-21), dissociation (DES-II). Conversely, all three dysregulation subscales—Fight-or-Flight (FF), Freeze (Fr), and Feigned Death (FD)—were positively associated with anxiety, depression, stress, and dissociation, as well as with increased autonomic reactivity measured by the BPQ-22 (all p < 0.001). The AMMQ test-retest reliability was also good (0.83).
Overall, the validation results suggest that the A
{"title":"The Arousal Modulation Model Questionnaire (AMMQ): Development, validation, and transdiagnostic applications","authors":"Fabio D’Antoni , Alessio Matiz , Cristiano Crescentini","doi":"10.1016/j.ejtd.2025.100564","DOIUrl":"10.1016/j.ejtd.2025.100564","url":null,"abstract":"<div><div>Trauma emerges as a significant etiological factor associated with a wide range of psychopathologies, including anxiety, mood disorders, impulse dysregulation, psychosis, substance dependence, personality disorders, conduct issues, and suicidal behavior. Furthermore, trauma plays a central role in somatoform and alexithymic disorders, eating disorders, and self-injurious behaviors. Additionally, trauma is linked to the development of various physical health conditions such as cardiovascular, gastrointestinal, endocrine, and inflammatory diseases, as well as cancer. Thus, the negative health consequences of trauma extend beyond PTSD and often manifest in personalized, polysymptomatic, and polysyndromic ways, suggesting the utility of adopting transdiagnostic approaches.</div><div>This study focuses on validating the Arousal Modulation Model Questionnaire (AMMQ), grounded in Ogden and Minton's Arousal Modulation Model originating from Siegel's concept of the Window of Tolerance. The validation process encompasses multiple facets of questionnaire validation, including construct validity, reliability, and other psychometric properties.</div><div>Participants included a sample of 304 individuals recruited for this study, with a mean age of 39.36 years (SD = 12.88). Although participants may have experienced one or more traumatic events in their lives, they were currently not under the care of the National Health Service Psychiatry Centers.</div><div>Construct validity of the AMMQ was assessed through exploratory and confirmatory factor analyses.</div><div>Initial exploratory factor analysis revealed a coherent factor structure consistent with theoretical expectations derived from the Arousal Modulation Model, yielding four distinct factors: \"Optimal Arousal Zone\" (OAZ, 7 items), \"Fight/Flight\" (FF, 4 items), Freeze (Fr, 6 items), and \"Feigned Death\" (FD, 5 items). Subsequent confirmatory factor analysis supported this structure, demonstrating excellent model fit (χ²(203) = 381.738, <em>p</em> < 0.001; CFI = 0.94; TLI = 0.93; RMSEA = 0.05; SRMR = 0.05).</div><div>Internal consistency was high, with a mean categorical omega (ω) of 0.83 across all subscales, supporting the reliability of the AMMQ.</div><div>Convergent validity was assessed by examining the associations between each AMMQ subscale and a set of established external measures. The Optimal Arousal Zone (OAZ) subscale showed strong positive correlations with all dimensions of psychological well-being (PWB-SF) and negative correlations with emotional distress (DASS-21), dissociation (DES-II). Conversely, all three dysregulation subscales—Fight-or-Flight (FF), Freeze (Fr), and Feigned Death (FD)—were positively associated with anxiety, depression, stress, and dissociation, as well as with increased autonomic reactivity measured by the BPQ-22 (all <em>p</em> < 0.001). The AMMQ test-retest reliability was also good (0.83).</div><div>Overall, the validation results suggest that the A","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100564"},"PeriodicalIF":2.0,"publicationDate":"2025-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144313819","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}
While many trauma survivors recover, up to half of the population seeking mental health care are estimated to present with a clinical picture in line with complex PTSD (C-PTSD). As the disorder of C-PTSD is new, there is insufficient data to guide recommendations for treatment. However, to address problems related to symptoms of disturbances in self-organization, a group setting may be useful. The aim of this qualitative study was therefore to explore how outpatients with long-term posttraumatic reactions experienced their participation in a combined trauma treatment, which integrated group-based stabilization and skill training (SST) alongside individual treatment as usual (TAU).
Methods
Semi-structured interviews were conducted with five women with long-term posttraumatic reactions who had completed the combined trauma treatment. Transcripts were analyzed using reflexive thematic analysis.
Results
Participants identified three key aspects of the combined treatment format that were essential for their process of recovery. First, cohesive relationships between group members and between patients and therapists gave the participants new interpersonal experiences which helped them to alleviate stigma, improve negative self-perceptions, reduce social isolation, as well as exposed them to their challenges in forming and maintain relationships. Second, skill training was perceived as challenging but helped the participants to find new ways to understand and relate to their trauma symptoms. Third, individual treatment complemented group-SST by allowing for tailored adjustments and extended support.
Conclusion
The participants’ descriptions support the perceived utility value of a combined stabilizing treatment approach for individuals with long-standing posttraumatic reactions. However, randomized controlled trials are needed to rigorously assess its short- and long-term effects.
{"title":"Combined individual and group-based stabilization and skill-training intervention: A thematic analysis of patients’ experiences","authors":"Torun Grøtte , Nina Jakhelln Laugen , Heidi Brattland , Anne E. Skjervold , Valentina R.C. Iversen , Katrine Høyer Holgersen","doi":"10.1016/j.ejtd.2025.100571","DOIUrl":"10.1016/j.ejtd.2025.100571","url":null,"abstract":"<div><h3>Background</h3><div>While many trauma survivors recover, up to half of the population seeking mental health care are estimated to present with a clinical picture in line with complex PTSD (C-PTSD). As the disorder of C-PTSD is new, there is insufficient data to guide recommendations for treatment. However, to address problems related to symptoms of disturbances in self-organization, a group setting may be useful. The aim of this qualitative study was therefore to explore how outpatients with long-term posttraumatic reactions experienced their participation in a combined trauma treatment, which integrated group-based stabilization and skill training (SST) alongside individual treatment as usual (TAU).</div></div><div><h3>Methods</h3><div>Semi-structured interviews were conducted with five women with long-term posttraumatic reactions who had completed the combined trauma treatment. Transcripts were analyzed using reflexive thematic analysis.</div></div><div><h3>Results</h3><div>Participants identified three key aspects of the combined treatment format that were essential for their process of recovery. First, cohesive relationships between group members and between patients and therapists gave the participants new interpersonal experiences which helped them to alleviate stigma, improve negative self-perceptions, reduce social isolation, as well as exposed them to their challenges in forming and maintain relationships. Second, skill training was perceived as challenging but helped the participants to find new ways to understand and relate to their trauma symptoms. Third, individual treatment complemented group-SST by allowing for tailored adjustments and extended support.</div></div><div><h3>Conclusion</h3><div>The participants’ descriptions support the perceived utility value of a combined stabilizing treatment approach for individuals with long-standing posttraumatic reactions. However, randomized controlled trials are needed to rigorously assess its short- and long-term effects.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100571"},"PeriodicalIF":2.0,"publicationDate":"2025-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144335722","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 : 2025-06-16DOI: 10.1016/j.ejtd.2025.100565
Jacqueline L. Kinley , Sandra M. Reyno
Background
Individual with histories of complex attachment (relational) trauma and comorbid mental illness often have significant treatment needs. The current study sought to explore the relative contribution of Complex PTSD symptom clusters on functional impairment in this population.
Methods
A convenience sample of 74 individuals admitted to a specialty treatment service for trauma-related disorders completed the International Trauma Questionnaire to assess Complex PTSD symptoms and functional impairment.
Results
Meeting diagnostic criteria for any of the Complex PTSD symptom clusters was significantly associated with meeting the functional impairment criterion. Nevertheless, the strength of associations differed between symptom clusters. Individuals endorsing diagnostic criteria for affective dysregulation or disturbances in relationships had a higher risk/probability of meeting criteria for DSO functional impairment, while those endorsing avoidance or sense of threat having a higher risk/probability of meeting criteria for PTSD functional impairment. Dimensional severity of all Complex PTSD symptom clusters was significantly associated with dimensional severity of functional impairments; however, only negative self-concept, disturbances in relationships and avoidance were found to be significant predictors of DSO or PTSD related severity of functional impairment when controlling for other symptom clusters.
Conclusions
Trauma symptoms have differential impacts on functional impairment. Prioritizing the most impactful symptoms may be critical for providing timely and efficient treatment of Complex PTSD. Negative self-concept, disturbances in relationships and avoidance stemming from traumatic experiences may be particularly crucial targets in interventions for individuals with histories of attachment trauma, Complex PTSD symptoms and comorbid mental illness.
{"title":"The relationship between Complex PTSD symptoms and functional impairment in individuals with attachment trauma and comorbid mental illness","authors":"Jacqueline L. Kinley , Sandra M. Reyno","doi":"10.1016/j.ejtd.2025.100565","DOIUrl":"10.1016/j.ejtd.2025.100565","url":null,"abstract":"<div><h3>Background</h3><div>Individual with histories of complex attachment (relational) trauma and comorbid mental illness often have significant treatment needs. The current study sought to explore the relative contribution of Complex PTSD symptom clusters on functional impairment in this population.</div></div><div><h3>Methods</h3><div>A convenience sample of 74 individuals admitted to a specialty treatment service for trauma-related disorders completed the International Trauma Questionnaire to assess Complex PTSD symptoms and functional impairment.</div></div><div><h3>Results</h3><div>Meeting diagnostic criteria for any of the Complex PTSD symptom clusters was significantly associated with meeting the functional impairment criterion. Nevertheless, the strength of associations differed between symptom clusters. Individuals endorsing diagnostic criteria for affective dysregulation or disturbances in relationships had a higher risk/probability of meeting criteria for DSO functional impairment, while those endorsing avoidance or sense of threat having a higher risk/probability of meeting criteria for PTSD functional impairment. Dimensional severity of all Complex PTSD symptom clusters was significantly associated with dimensional severity of functional impairments; however, only negative self-concept, disturbances in relationships and avoidance were found to be significant predictors of DSO or PTSD related severity of functional impairment when controlling for other symptom clusters.</div></div><div><h3>Conclusions</h3><div>Trauma symptoms have differential impacts on functional impairment. Prioritizing the most impactful symptoms may be critical for providing timely and efficient treatment of Complex PTSD. Negative self-concept, disturbances in relationships and avoidance stemming from traumatic experiences may be particularly crucial targets in interventions for individuals with histories of attachment trauma, Complex PTSD symptoms and comorbid mental illness.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100565"},"PeriodicalIF":2.0,"publicationDate":"2025-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298047","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 : 2025-06-15DOI: 10.1016/j.ejtd.2025.100570
Shun Sasaki , Hideki Ohira , Masahiro Kawahara
Background
Dissociative absorption is a dissociative experience characterized by deep immersion in activities such as imagination and daydreaming, leading to a diminished awareness of surroundings. Previous research has suggested that dissociative experiences may be associated with lower cortical functional connectivity.
Purpose
This study aimed to investigate the relationship between dissociative absorption tendency and resting-state electroencephalographic (EEG) functional connectivity using the weighted Phase Lag Index (wPLI).
Methods
Forty-four healthy participants underwent resting-state EEG recordings. Dissociative absorption tendency was assessed using the Dissociative Experiences Scale (DES). Functional connectivity was analyzed across multiple frequency bands using wPLI, and spectral power was also examined.
Results
Significant negative partial correlations were found between dissociative absorption tendency and functional connectivity in the delta (C3–P3, C3–T6, T4–T6) and theta (P4–O1) bands, with Bayes factors exceeding 3. In contrast, positive partial correlations were observed in the alpha2 (Fp1–T3, F3–T3) band. Spectral power analysis further indicated higher delta power in individuals with higher dissociative absorption tendency.
Conclusions
The lower functional connectivity in the delta and theta bands is consistent with previous research. In contrast, the alpha2 band exhibited a higher connectivity pattern, suggesting the need for a more comprehensive investigation of its relationship with cortical neural activity across different frequency bands. Based on our findings, the relationship between dissociative absorption, functional connectivity, and a mixed state between wakefulness and sleep is discussed.
{"title":"The cortical functional connectivity basis of dissociative absorption tendency: A study using weighted Phase Lag Index","authors":"Shun Sasaki , Hideki Ohira , Masahiro Kawahara","doi":"10.1016/j.ejtd.2025.100570","DOIUrl":"10.1016/j.ejtd.2025.100570","url":null,"abstract":"<div><h3>Background</h3><div>Dissociative absorption is a dissociative experience characterized by deep immersion in activities such as imagination and daydreaming, leading to a diminished awareness of surroundings. Previous research has suggested that dissociative experiences may be associated with lower cortical functional connectivity.</div></div><div><h3>Purpose</h3><div>This study aimed to investigate the relationship between dissociative absorption tendency and resting-state electroencephalographic (EEG) functional connectivity using the weighted Phase Lag Index (wPLI).</div></div><div><h3>Methods</h3><div>Forty-four healthy participants underwent resting-state EEG recordings. Dissociative absorption tendency was assessed using the Dissociative Experiences Scale (DES). Functional connectivity was analyzed across multiple frequency bands using wPLI, and spectral power was also examined.</div></div><div><h3>Results</h3><div>Significant negative partial correlations were found between dissociative absorption tendency and functional connectivity in the delta (C3–P3, C3–T6, T4–T6) and theta (P4–O1) bands, with Bayes factors exceeding 3. In contrast, positive partial correlations were observed in the alpha2 (Fp1–T3, F3–T3) band. Spectral power analysis further indicated higher delta power in individuals with higher dissociative absorption tendency.</div></div><div><h3>Conclusions</h3><div>The lower functional connectivity in the delta and theta bands is consistent with previous research. In contrast, the alpha2 band exhibited a higher connectivity pattern, suggesting the need for a more comprehensive investigation of its relationship with cortical neural activity across different frequency bands. Based on our findings, the relationship between dissociative absorption, functional connectivity, and a mixed state between wakefulness and sleep is discussed.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100570"},"PeriodicalIF":2.0,"publicationDate":"2025-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144366127","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 : 2025-06-14DOI: 10.1016/j.ejtd.2025.100572
Shahar Almog , Albert Garcia-Romeu , Kathryn A. Walker , Michelle Weiner , Meredith S. Berry
Introduction
Post-traumatic stress disorder (PTSD) presents severe symptomology and often co-occurs with depression, warranting novel treatment approaches to address both conditions simultaneously. Ketamine has emerged as a rapid antidepressant and potential treatment for PTSD, with some real-world evidence for effectiveness regardless of comorbidities. The purpose of this secondary analysis was to explore the perceived and self-reported outcomes of ketamine treatment in real-world patients with comorbid PTSD.
Methods
In an anonymous online survey with quantitative and qualitative items, real-world patients (N = 202) completed measures of depression, anxiety, and sleep disturbance twice, reflecting retrospective pre-ketamine initiation and current symptoms. Patients with comorbid PTSD elaborated on their experiences of changes in symptoms of PTSD. We described subjective experiences regarding PTSD outcomes and potential underlying processes of ketamine’s therapeutic effects. We compared patients diagnosed with PTSD versus those without, on pre-ketamine and current depression, anxiety, and sleep.
Results
Participants with comorbid PTSD (n = 98) described improvements in multiple PTSD symptoms. They reported more severe/frequent depression, anxiety, and sleep disturbance prior to ketamine compared to patients without PTSD (ps<0.017) but responded to ketamine just as well, with no differences in current scores (ps>0.259). Most PTSD patients reported receiving adjunct therapy, mostly psychotherapy, however, similar improvements were also reported by those receiving none.
Discussion
As perceived by real-world patients, ketamine successfully improved an array of symptoms and allowed reprocessing of the trauma. Targeted longitudinal and qualitative research is needed in larger, more diverse samples on the role and effects of other adjunct psychological and somatic therapies to inform and optimize PTSD treatment protocols.
{"title":"Self-reported improvements in comorbid post-traumatic stress disorder symptoms, depression, anxiety, and sleep among real-world patients receiving medical ketamine: Exploring the role of adjunct therapies","authors":"Shahar Almog , Albert Garcia-Romeu , Kathryn A. Walker , Michelle Weiner , Meredith S. Berry","doi":"10.1016/j.ejtd.2025.100572","DOIUrl":"10.1016/j.ejtd.2025.100572","url":null,"abstract":"<div><h3>Introduction</h3><div>Post-traumatic stress disorder (PTSD) presents severe symptomology and often co-occurs with depression, warranting novel treatment approaches to address both conditions simultaneously. Ketamine has emerged as a rapid antidepressant and potential treatment for PTSD, with some real-world evidence for effectiveness regardless of comorbidities. The purpose of this secondary analysis was to explore the perceived and self-reported outcomes of ketamine treatment in real-world patients with comorbid PTSD.</div></div><div><h3>Methods</h3><div>In an anonymous online survey with quantitative and qualitative items, real-world patients (<em>N</em> = 202) completed measures of depression, anxiety, and sleep disturbance twice, reflecting retrospective pre-ketamine initiation and current symptoms. Patients with comorbid PTSD elaborated on their experiences of changes in symptoms of PTSD. We described subjective experiences regarding PTSD outcomes and potential underlying processes of ketamine’s therapeutic effects. We compared patients diagnosed with PTSD versus those without, on pre-ketamine and current depression, anxiety, and sleep.</div></div><div><h3>Results</h3><div>Participants with comorbid PTSD (<em>n</em> = 98) described improvements in multiple PTSD symptoms. They reported more severe/frequent depression, anxiety, and sleep disturbance prior to ketamine compared to patients without PTSD (<em>p</em>s<0.017) but responded to ketamine just as well, with no differences in current scores (<em>p</em>s>0.259). Most PTSD patients reported receiving adjunct therapy, mostly psychotherapy, however, similar improvements were also reported by those receiving none.</div></div><div><h3>Discussion</h3><div>As perceived by real-world patients, ketamine successfully improved an array of symptoms and allowed reprocessing of the trauma. Targeted longitudinal and qualitative research is needed in larger, more diverse samples on the role and effects of other adjunct psychological and somatic therapies to inform and optimize PTSD treatment protocols.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100572"},"PeriodicalIF":2.0,"publicationDate":"2025-06-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144480805","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 : 2025-06-09DOI: 10.1016/j.ejtd.2025.100567
Adriana Gutiv , Jérémie Mattatia
Case presentation
Sexual Assaults (SA) frequently lead to post-traumatic stress disorder (PTSD), with psychological and physical repercussions. This case report describes the effect of osteopathic treatment in regulating these symptoms in a woman who reported having been the victim of several assaults.
Materials and methods
The patient received five osteopathic treatments in response to neck and shoulder pain, nocturnal bruxism, sleep disorders, headaches and various musculoskeletal pains that the patient correlated chronologically with her various episodes of sexual and physical aggression.
Results
A significant improvement was observed in this patient using the PCL-5 scale. The patient also showed a marked improvement in her various somatic symptoms from the third consultation onwards.
Discussion
Osteopathy could be considered as a complementary, non-substitutive approach to psychological care. Several studies relating to PTSD have highlighted the added value of a bodily approach in helping patients progress towards recovery. This therapy has already been the subject of clinical cases with similar results in the context of war trauma.
Conclusion
The osteopathic approach could be a valuable aid in the management of post-traumatic stress linked to sexual assault. It notably could be a means of evoking in a different way the various physical sufferings that are sometimes imperceptible to imaging and to the various medical physical examinations.
{"title":"An osteopathic approach to post-traumatic stress disorder in sexually abused women: a case report","authors":"Adriana Gutiv , Jérémie Mattatia","doi":"10.1016/j.ejtd.2025.100567","DOIUrl":"10.1016/j.ejtd.2025.100567","url":null,"abstract":"<div><h3>Case presentation</h3><div>Sexual Assaults (SA) frequently lead to post-traumatic stress disorder (PTSD), with psychological and physical repercussions. This case report describes the effect of osteopathic treatment in regulating these symptoms in a woman who reported having been the victim of several assaults.</div></div><div><h3>Materials and methods</h3><div>The patient received five osteopathic treatments in response to neck and shoulder pain, nocturnal bruxism, sleep disorders, headaches and various musculoskeletal pains that the patient correlated chronologically with her various episodes of sexual and physical aggression.</div></div><div><h3>Results</h3><div>A significant improvement was observed in this patient using the PCL-5 scale. The patient also showed a marked improvement in her various somatic symptoms from the third consultation onwards.</div></div><div><h3>Discussion</h3><div>Osteopathy could be considered as a complementary, non-substitutive approach to psychological care. Several studies relating to PTSD have highlighted the added value of a bodily approach in helping patients progress towards recovery. This therapy has already been the subject of clinical cases with similar results in the context of war trauma.</div></div><div><h3>Conclusion</h3><div>The osteopathic approach could be a valuable aid in the management of post-traumatic stress linked to sexual assault. It notably could be a means of evoking in a different way the various physical sufferings that are sometimes imperceptible to imaging and to the various medical physical examinations.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100567"},"PeriodicalIF":2.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144321317","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 : 2025-06-09DOI: 10.1016/j.ejtd.2025.100568
Yalan Liu, Lin Zhang, Hua Zong, Zejing Wei, Rui Zhang, Shihao Fu
Purpose
To investigate the association between excessive earphone use among college students and the risk of developing depressive symptoms, thereby providing valuable data to inform the evaluation and management of depressive symptoms within this demographic.
Methods
Data were collected from a sample of 1186 college students through stratified whole cluster random sampling. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and data on earphone use were gathered. Multiple regression analysis and threshold effects analysis were employed to investigate the relationship between excessive earphone use and depressive symptoms, with a focus on gender differences.
Results
Among the college students surveyed, 17.9 % exhibited depressive symptoms. Earphone users demonstrated a 50 % increased risk of depressive symptoms (OR = 1.5, 95 % CI: 1.1–2.1, P = 0.022). A later onset of earphone use in childhood was associated with a 40 % reduction in the risk of depressive symptoms during college (OR = 0.6, 95 % CI: 0.4–0.9, P = 0.011). Male students who used earphones for more than 20 min at a time experienced a 90 % increased risk of depressive symptoms for each additional minute of use (OR = 1.9, 95 % CI: 1.4–2.6, P < 0.05).
Conclusions
In males, early exposure to earphone use during childhood is associated with an elevated risk of developing depressive symptoms in adolescence. The likelihood of experiencing depressive symptoms may be exacerbated by prolonged and inappropriate use of earphones. Further research is warranted to develop targeted interventions.
目的探讨大学生过度使用耳机与抑郁症状发生风险之间的关系，为该人群抑郁症状的评估和管理提供有价值的数据。方法采用分层整群随机抽样的方法，对1186名在校大学生进行调查。使用流行病学研究中心抑郁量表评估抑郁症状，并收集使用耳机的数据。采用多元回归分析和阈值效应分析探讨过度使用耳机与抑郁症状之间的关系，重点关注性别差异。结果17.9%的受访大学生表现出抑郁症状。耳机使用者表现出抑郁症状风险增加50% （OR = 1.5, 95% CI: 1.1-2.1, P = 0.022）。儿童期较晚开始使用耳机与大学期间抑郁症状风险降低40%相关（OR = 0.6, 95% CI: 0.4-0.9, P = 0.011）。每次使用耳机超过20分钟的男生，每多使用一分钟，抑郁症状的风险增加90% (OR = 1.9, 95% CI: 1.4-2.6, P <；0.05)。结论：在男性中，儿童期早期接触耳机与青春期出现抑郁症状的风险增加有关。长时间不恰当地使用耳机可能会加重抑郁症状。有必要进一步研究以制定有针对性的干预措施。
{"title":"The relationship between earphone use duration and depressive symptoms among Chinese college students: a threshold effect analysis","authors":"Yalan Liu, Lin Zhang, Hua Zong, Zejing Wei, Rui Zhang, Shihao Fu","doi":"10.1016/j.ejtd.2025.100568","DOIUrl":"10.1016/j.ejtd.2025.100568","url":null,"abstract":"<div><h3>Purpose</h3><div>To investigate the association between excessive earphone use among college students and the risk of developing depressive symptoms, thereby providing valuable data to inform the evaluation and management of depressive symptoms within this demographic.</div></div><div><h3>Methods</h3><div>Data were collected from a sample of 1186 college students through stratified whole cluster random sampling. Depressive symptoms were assessed using the Center for Epidemiologic Studies Depression Scale, and data on earphone use were gathered. Multiple regression analysis and threshold effects analysis were employed to investigate the relationship between excessive earphone use and depressive symptoms, with a focus on gender differences.</div></div><div><h3>Results</h3><div>Among the college students surveyed, 17.9 % exhibited depressive symptoms. Earphone users demonstrated a 50 % increased risk of depressive symptoms (OR = 1.5, 95 % CI: 1.1–2.1, <em>P</em> = 0.022). A later onset of earphone use in childhood was associated with a 40 % reduction in the risk of depressive symptoms during college (OR = 0.6, 95 % CI: 0.4–0.9, <em>P</em> = 0.011). Male students who used earphones for more than 20 min at a time experienced a 90 % increased risk of depressive symptoms for each additional minute of use (OR = 1.9, 95 % CI: 1.4–2.6, <em>P</em> < 0.05).</div></div><div><h3>Conclusions</h3><div>In males, early exposure to earphone use during childhood is associated with an elevated risk of developing depressive symptoms in adolescence. The likelihood of experiencing depressive symptoms may be exacerbated by prolonged and inappropriate use of earphones. Further research is warranted to develop targeted interventions.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100568"},"PeriodicalIF":2.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144271467","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 : 2025-06-09DOI: 10.1016/j.ejtd.2025.100569
Oria Vaknin, Vered Ne'eman-Haviv
Recent research has increasingly focused on the role of moral frameworks in understanding trauma and traumatic events, leading to the recognition of "moral injury" as a clinical syndrome. Although various definitions exist, there is still a lack of consensus on the nature and consequences of moral injury. This article proposes a new theoretical model that broadens the study of moral injury to include diverse populations, suggesting it arises not only from traumatic experiences but also from conflicts between moral ideals and reality. By integrating concepts such as prescriptive cognitions, post hoc thinking, and cognitive flexibility, the model portrays moral injury as existing on a continuum, affecting a wide range of individuals. The article explores implications for treatment and emphasizes the need for follow-up empirical studies to validate the proposed model. It also suggests the possibility that moral injury is on a continuum, in addition to the possibility of explaining this process. This approach offers new insights into prevention and intervention strategies, highlighting the broader applicability of moral injury beyond military contexts.
{"title":"Beyond right and wrong: A new theoretical model for understanding moral injury","authors":"Oria Vaknin, Vered Ne'eman-Haviv","doi":"10.1016/j.ejtd.2025.100569","DOIUrl":"10.1016/j.ejtd.2025.100569","url":null,"abstract":"<div><div>Recent research has increasingly focused on the role of moral frameworks in understanding trauma and traumatic events, leading to the recognition of \"moral injury\" as a clinical syndrome. Although various definitions exist, there is still a lack of consensus on the nature and consequences of moral injury. This article proposes a new theoretical model that broadens the study of moral injury to include diverse populations, suggesting it arises not only from traumatic experiences but also from conflicts between moral ideals and reality. By integrating concepts such as prescriptive cognitions, post hoc thinking, and cognitive flexibility, the model portrays moral injury as existing on a continuum, affecting a wide range of individuals. The article explores implications for treatment and emphasizes the need for follow-up empirical studies to validate the proposed model. It also suggests the possibility that moral injury is on a continuum, in addition to the possibility of explaining this process. This approach offers new insights into prevention and intervention strategies, highlighting the broader applicability of moral injury beyond military contexts.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100569"},"PeriodicalIF":2.0,"publicationDate":"2025-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144298048","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 : 2025-06-08DOI: 10.1016/j.ejtd.2025.100563
Alexandra Tamiolaki , Argyroula Kalaitzaki
The COVID-19 pandemic, a highly challenging life experience, may also be a chance for posttraumatic growth (PTG). This scoping review aimed to summarise the available evidence on PTG among children and adolescents induced by COVID-19 by reporting rates and identifying potential influencing factors. The literature search yielded twenty-one articles from eleven countries which were eventually included. Findings revealed heterogenous PTG prevalence rates, ranging from low to moderate/high, and scattered facilitators, including socio-demographic, psychological, and COVID-19-related factors, with relational factors (i.e., social support) consistently highlighted. Gaps in the literature were also identified, with the lack of robust longitudinal studies and the exploration of the illusory PTG being fundamental. These findings can inform public health authorities, policymakers, and clinicians to design and implement interventions to promote children's and adolescents’ growth in times of similar crises.
{"title":"Posttraumatic growth in children and adolescents induced by the COVID-19 pandemic: A scoping review","authors":"Alexandra Tamiolaki , Argyroula Kalaitzaki","doi":"10.1016/j.ejtd.2025.100563","DOIUrl":"10.1016/j.ejtd.2025.100563","url":null,"abstract":"<div><div>The COVID-19 pandemic, a highly challenging life experience, may also be a chance for posttraumatic growth (PTG). This scoping review aimed to summarise the available evidence on PTG among children and adolescents induced by COVID-19 by reporting rates and identifying potential influencing factors. The literature search yielded twenty-one articles from eleven countries which were eventually included. Findings revealed heterogenous PTG prevalence rates, ranging from low to moderate/high, and scattered facilitators, including socio-demographic, psychological, and COVID-19-related factors, with relational factors (i.e., social support) consistently highlighted. Gaps in the literature were also identified, with the lack of robust longitudinal studies and the exploration of the illusory PTG being fundamental. These findings can inform public health authorities, policymakers, and clinicians to design and implement interventions to promote children's and adolescents’ growth in times of similar crises.</div></div>","PeriodicalId":29932,"journal":{"name":"European Journal of Trauma & Dissociation","volume":"9 3","pages":"Article 100563"},"PeriodicalIF":2.0,"publicationDate":"2025-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144291427","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}
扫码关注我们
求助内容：
应助结果提醒方式：
京公网安备 11010802042870号