PTSD

Veterans' quality of life (QoL) can be drastically affected by posttraumatic stress disorder (PTSD). We compared prolonged exposure therapy (PET) with metacognitive therapy (MCT) in their effects on quality of life (QoL) among veterans with post-traumatic stress disorder (PTSD). Overall, 57 veterans with PTSD were randomly assigned to three groups MCT ( = 17), PET ( = 17), and Control ( = 23). The 36-item short-form survey (SF-36) was used to evaluate QoL pretest, posttest, and after a 3-month follow-up. The MCT was based on the practice of detached mindfulness, controlling rumination/anxiety, and challenging negative beliefs about symptoms. The PET was based on in-vivo and imaginal exposure to trauma-related events, and discontinuation of avoidance-oriented coping strategies. Both MCT and PET groups significantly improved QoL at posttest and follow-up, compared with the control group ( < .001); however, the MCT and PET groups showed no significant difference at posttest ( = .644) or follow-up ( = .646). Our results support the efficacy of PET as the standard for PTSD treatment, while also signifying the effectiveness of MCT at increasing the QoL in war-related PTSD at a 3-month follow-up.

Post-traumatic stress disorder (PTSD) and chronic low back pain (CLBP) are frequently co-morbid. Some research suggests that PTSD and CLBP may share common neurobiological mechanisms related to stress. Traditional biomedical education may be ineffective for PTSD and CLBP, especially when co-morbid. The purpose of this study is to determine if pain neuroscience education (PNE) is more effective than traditional education in reducing PTSD, disability, pain, and maladaptive beliefs in patients with CLBP. Participants with CLBP and possible PTSD/PTSD-symptoms were recruited for this study. Participants were randomly allocated to a PNE group or a traditional education group. The intervention included 30 minutes of education followed by a standardized exercise program once a week for 4-weeks with a 4 and 8-week follow-up and healthcare utilization assessed at 12-months. Forty-eight participants consented for this research study with 39 allocated to treatment (PNE n = 18, traditional n = 21). PNE participants were more likely to achieve a clinically meaningful reduction in PTSD symptoms and disability at short-term follow-up. At 12-months, the PNE group utilized healthcare with 76% lower costs. In participants with CLBP, PNE may reduce hypervigilance toward pain and improve PTSD symptoms. Participants who received PNE were more confident body-tissues were safe to exercise. These beliefs about pain could contribute to a decrease in perceived disability and healthcare consumption for CLBP.

As disasters increase due to climate change, population density, epidemics, and technology, information is needed about postdisaster consequences for people's mental health and how stress-related mental disorders affect multiple spheres of life, including labor-market attachment. We tested the causal hypothesis that individuals who developed stress-related mental disorders as a consequence of their disaster exposure experienced subsequent weak labor-market attachment and poor work-related outcomes. We leveraged a natural experiment in an instrumental variables model, studying a 2004 fireworks factory explosion disaster that precipitated the onset of stress-related disorders (posttraumatic stress disorder, anxiety, and depression) among individuals in the local community (N = 86,726). We measured labor-market outcomes using longitudinal population-level administrative data: sick leave, unemployment benefits, early retirement pension, and income from wages from 2007 to 2010. We found that individuals who developed a stress-related disorder after the disaster were likely to go on sickness benefit, both in the short- and long-term, were likely to use unemployment benefits and to lose wage income in the long term. Stress-related disorders did not increase the likelihood of early retirement. The natural experiment design minimized the possibility that omitted confounders biased these effects of mental health on work outcomes. Addressing the mental health and employment needs of survivors after a traumatic experience may improve their labor-market outcomes and their nations' economic outputs.

Sexual orientation and gender identity/expression change efforts (SOGIECEs) are discredited practices that are associated with serious negative effects and incompatible with modern standards for clinical practice. Despite evidence linking SOGIECEs with serious iatrogenic effects, and despite support for LGBTQ+-affirmative care alternatives, SOGIECE practices persist. In the 1970s and 1980s, Behavior Therapy published articles testing and/or endorsing SOGIECEs, thereby contributing to their overall development, acceptance, and use. The Behavior Therapy Task Force on SOGIECEs was assembled to conduct a rigorous review of the SOGIECE articles published in Behavior Therapy and to decide whether, and what, formal action(s) should be taken on these articles. This report provides a detailed review of the historic SOGIECE literature published in Behavior Therapy and outlines the Task Force's deliberative and democratic processes resulting in actions to: (1) add prominent advisory information to k = 24 SOGIECE papers in the form of digital "black box" disclaimers that caution readers that the SOGIECE practices tested or described in these papers are inconsistent with modern standards, (2) offset organizational financial benefits from the publication of these papers, and (3) promote LGBTQ+-affirmative practices. SOGIECEs are not the only concerning practices across the field's history, and the pages of today's scientific journals include practices that will be at odds with tomorrow's moral standards and ethical guidelines. This report calls for precautionary measures and editorial safeguards to minimize the future likelihood and impact of problematic published scholarship, including the need to fully include those with relevant lived experiences in all aspects of clinical science and peer review.

The present study investigates whether psychological factors influence the habituation or sensitization effect during repeated COVID-19 outbreaks.

Posttraumatic stress disorder (PTSD) and separation anxiety often show high comorbidity after trauma, which complicates the course of disease and treatment response. However, it is unclear how PTSD and separation anxiety comorbidity occur. According to the cognitive model of PTSD, rumination may be a key cognitive process linking the two constructs. Thus, this study aimed to examine the relation between PTSD and separation anxiety and to assess the mediating role of rumination in this relation among adolescents after trauma.

War and forced migration expose refugees to trauma and ongoing stress, often contributing to long-term psychological consequences. Typically, trauma exposure is assessed cumulatively; yet, trauma type may better predict psychological outcomes. This study examined the differential impact of cumulative trauma and trauma subtypes (victimization, death threat, accidental/injury) on postmigration trajectories of posttraumatic stress and anxiety in refugees.

Substance use is highly prevalent among women experiencing intimate partner violence (IPV) and has been associated with dysfunction of the hypothalamic-pituitary-adrenal (HPA) axis and resulting cortisol response. Posttraumatic stress disorder (PTSD) symptoms may play an important role in exacerbating the association between cortisol levels and substance use behaviors.

The existing theories of post-traumatic stress disorder (PTSD) have inspired large volumes of research and have contributed substantially to our current knowledge base. However, most of the theories are of a qualitative and verbal nature, and may be difficult to evaluate and compare with each other. In this paper, we propose that one way forward is to use computational modelling to formulate more precise theories of PTSD that can be evaluated by (1) assessing whether the model can explain fundamental phenomena related to PTSD, and (2) comparing simulated outcomes with real data. Computational modelling can force us to describe processes more precisely and achieve stronger theories that are viable for testing. Establishing the theoretical groundwork before undertaking empirical studies can help us to avoid doing research with low probability of valid results, and counteract the replicability crisis in psychology. In conclusion, computational modelling is a promising avenue for advancing the understanding and treatment of PTSD.

Demand for trauma-focused therapy continues to increase, especially in community mental health care settings where group treatment models can be cost-effective and increase access to care. The Internal Family Systems (IFS) model for posttraumatic stress disorder (PTSD) may offer an effective therapeutic approach. The purpose of this proof-of-concept study was to evaluate the feasibility and acceptability of a novel, trauma-focused, group-based treatment approach and investigate potential mechanisms of action.

Unhoused children and adolescents have high rates of adverse childhood experiences (ACEs). The objective of this study was to characterize a large cohort of unhoused children and investigate rates of psychiatric diagnoses, medical diagnoses, and utilization of emergency department (ED) resources depending on the presence of additional documented ACEs. A retrospective cohort of all unhoused children who presented to the ED of a large Midwestern health system from January 2014 to July 2019 were included. Unhoused status was determined by address field or ICD-10 code for homelessness (Z59.0). Demographics and ED visits were extracted from the electronic health record. Past medical history, ACEs, chief complaint (CC), length of stay (LOS), imaging, and labs were extracted by chart review. T-tests, chi square tests, and Fisher's exact tests were completed for each sub-analysis. Unhoused children with at least one additional ACE had higher odds of the following psychiatric disorders: depression (OR = 5.2, 95% CI = 3.4- 7.9), anxiety (OR = 3.4, 95% CI = 32.1-5.5), behavioral disorder (OR = 7.2, 95% CI = 35.1- 10.4), psychoses (OR = 6.0, 1.9-18.4), bipolar disorder (OR = 19.8, 95% CI = 34.6-84.9), suicidal ideation (OR = 8.0, 95% CI = 34.8-13.4), post-traumatic stress disorder (OR = 10.1, 95% CI = 35.4-18.6), and attention deficit hyperactive disorder (OR = 4.1, 3.0-5.7). Patients with additional documented ACEs were also more likely to have a prior psychiatric admission (p < 0.001). Unhoused children and adolescents with exposure to additional documented ACEs are more likely to have some serious psychiatric and medical diagnoses compared to other unhoused children.

In February 2022, Ukraine suffered a devastating assault by Russia, leading to destruction, casualties, and displacement. Among those displaced were over 1.5 million families with children. War and displacement expose families to a heightened risk of mental health issues. These risks increase when both the parents and the children are exposed to trauma and develop mental health difficulties. This study investigated the prevalence of posttraumatic stress disorder (PTSD) and other mental health issues among parents and children and the associations between them.

Traumatic childhood events are some of the few identifiable and to some extent preventable causes of psychiatric illness. Children exposed to severely stressful events may react with post-traumatic stress disorder (PTSD) and this may impact their level of function in daily life, their future development and mental health. The traumatic stress model suggests that traumatic stress in the family, community violence, and other traumas are regarded as additive environmental factors that can outweigh protective compensatory factors and thus interact with individual vulnerabilities. This study is based on prospective panel data including the whole population of children born in Denmark from 1984 to 1994, who are followed from age 7 to age 18 (N = 679,000) in the window between 2001 and 2012. Risk factors for first-time diagnose with PTSD are analyzed by the discrete time log-odd model. We found a lifetime prevalence of 2.3% PTSD in school-age children (n = 15,636). In accordance with the model, indicators of traumatic stress in the family, family disintegration, community violence, and individual vulnerabilities predicted later diagnose with PTSD. Individual neurodevelopmental disorder - especially autism (adjusted Odds Ratio (OR 7.1) and ADHD (OR 10.7) - were predicative of PTSD. The results cooperated the traumatic stress model. Some results were inconsistent with the traumatic stress model e.g., parental substance abuse were associated with less than expected PTSD in school-age children when adjusted for other risk factors. This indicates that PTSD may be underestimated in these groups. PTSD diagnoses in administrative records underestimate the prevalence, systematically. Efforts to increase PTSD screening may allow for better management.

Foster care children are a highly vulnerable population and their experiences in care are considered crucial to their developmental and psychosocial wellbeing. Placement instability has been considered a possible risk factor for developmental difficulties due to its impact on the development of a reparative attachment relationship and sense of relational permanence. The current review synthesises the literature regarding the impact of placement instability on behavioural and mental health outcomes in foster care children. Three major databases and grey literature sources were searched for all relevant quantitative research published by July 2019. Titles and abstracts of 2419 articles were screened following searches, with full texts obtained for 51 studies and 14 included in the final review. All were subject to quality assessment by two independent reviewers. Results indicated that placement instability was a consistent predictor of externalising behaviour in children, although some evidence was counter-indicative in this regard. There was also evidence to suggest a relationship with internalising behaviours, and mental health difficulties, in particular PTSD symptoms. Methodological quality and design varied between studies which limited direct comparisons. Most notably, there was a lack of consensus on how to quantify and measure placement instability and many studies failed to control for potentially confounding care-related variables. The review highlights that instability seems to result in negative psychological outcomes, although the extent of this relationship remains unclear. The review's findings are discussed with reference to research and clinical implications.

PTSD treatment that focused on a sensory symptoms is increasing. The study aimed to explore symptoms and abnormalities in the five senses exhibited by persons with PTSD and to examine whether there are any differences depending on type of traumatic experience. Questionnaire was followed by interviews to clinical psychologists involved in the treatment of PTSD. 249 PTSD symptoms exhibited in the sensory organs were collected. Sensory symptoms were classified into three categories according to the type of symptoms and the type of traumatic events. Cluster 1 is a group formed by child abuse and violence together with audition, tactile, and hyperarousal. Cluster 2 is made up of natural disaster, accident, and sexual assault together with vision, olfaction and intrusion. Cluster 3 is made up of multiple traumas together with gustation and dissociation. It is speculated that the survivors of Child abuse and violence are hypersensitive to sounds, the presence of others, and physical contact because they try to quickly sense when a perpetrator is approaching. Natural disasters, accidents, and sexual assault are events with strong smell and severe visual impact, it is possible that they may easily cause reliving of the event in the form of shocking visual images and smells in flashbacks. Dissociation symptoms were related with complex trauma and taste. The mouth is the site of first contact between mother and child, and it is possible that gustatory dissociation may occur mainly in cases of severe and repeated trauma since early childhood.

Extant evidence indicates that exposure to adverse childhood experiences (ACE) tend to cluster among children and adolescents. Considering that adolescents from African countries present higher risk of being exposed to multiple ACE compared to other countries, the identification of victimization profiles in this population is clearly warranted. The aim of this study was to determine meaningful clusters of individuals with similar experiences of ACE in a sample of Kenyan adolescents. Latent class analysis (LCA) was conducted to identify latent classes of exposure to ACE. In addition, the relationships between the latent classes and gender, parental education, living arrangements and diagnosis of post-traumatic stress disorder (PTSD) were estimated. A three-class solution was found to be the best description of ACE, and the classes were labelled ''Low Risk'', ''Intermediate Risk'', and ''High Risk''. Compared with the Low-Risk class, the High-Risk class was found to be significantly more likely to have a diagnosis of PTSD and being a female may be an antecedent risk factor for high exposure to ACE. The Intermediate Risk class was significantly less likely to have parents with high school or college education. This paper indicates that Kenyan adolescents present higher risk of being exposed to multiple ACE and that trauma research may turn its focus on the individual as the unit of analysis rather than traumatic events.

The majority of children with traumatic experiences who seek treatment have had multiple traumatic experiences resulting in complex trauma. Complex trauma is associated with multiple adverse outcomes for children and caregivers. Treating complex trauma has the potential to significantly improve child mental and physical health, caregiver mental health, and reduce family conflict. One promising approach is the Attachment, Regulation, and Competency (ARC) Framework. Yet, there is limited research on the effectiveness of interventions using the ARC framework. The purpose of this rapid scoping review was to assess the state of the evidence of ARC and ARC adaptations. The databases APA PsycINFO, Social Work Abstracts, and Applied Social Sciences Index & Abstracts were searched. The search was limited to articles involving interventions using the ARC framework and written in English. To be as comprehensive as possible quantitative, qualitative and mixed methods designs were included and there was no date restriction. Ten articles were included in the review. Results show all studies were quasi experimental, half did not include a comparison group, and interventions using the ARC framework varied in duration (12-180 sessions), setting (outpatient therapy, residential treatment, community outreach and school-based intervention) and age (birth-22). Findings indicate the ARC framework shows promise in reducing children's trauma related symptoms including post-traumatic stress disorder (PTSD), externalizing, and internalizing problems, and improving trauma sensitive classroom environments. Additional outcomes included increased permanent placements, reduced caregiver stress and increased caregiver functioning. Future research is needed utilizing randomized controlled trials to establish efficacy of this promising intervention.

Exposure to chronic structural stressors (e.g., poverty, community violence, and discrimination) exacerbates posttraumatic stress disorder (PTSD) symptoms and reduces how adolescents benefit from trauma-focused interventions. However, current evidence-based PTSD interventions seldom include concrete guidance regarding how to target chronic structural stressors in care.

Digital terror refers to the use of digital technology to disseminate graphic images of acts of violence to frighten the public. On October 7, 2023, militants of the Palestinian organization Hamas launched a brutal attack on Israel and used digital terror to magnify their acts. Although the purposeful spreading of terror via digital means is not new, the Hamas attack was significant for the scope, immediacy, and widespread dissemination of its digital content. This column aims to describe and analyze the psychological significance of this new form of terror, the public mental health challenges raised, and the interventions needed to assist those exposed to digital terror.

Several primary studies examined the effectiveness of various psychotherapies in treating earthquake-related posttraumatic stress disorder (PTSD). Variations in methods, employed psychotherapy approaches, and differences across studies warrant a systematic review and meta-analysis.

This scoping review sought to investigate the association between pregnancy-related complications and post-traumatic stress disorder (PTSD) among postpartum women, then summarize effective psychological interventions for pregnancy-related PTSD or sub-PTSD.

Research in adults suggests that intrusive memories and intrusive thoughts (often referred to as intrusive cognitions) are common in members of the general population and are often seen in clinical disorders. However, little is known about the experience of intrusive cognitions in adolescents, particularly in adolescents with major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). The present study sought to gather fundamental data on these phenomena (i.e., frequency, characteristics and appraisals of intrusive cognitions) in adolescents with MDD and PTSD.

As the prevalence of post-traumatic stress disorder (PTSD) among children discharged from pediatric intensive care unit (PICU) continues to rise, corresponding research efforts have also increased. This scoping review aimed to review the PTSD prevalence, influencing factors, and tools used for PTSD measurements in children discharged from the PICU. This review employed the five-stage framework proposed by Arksey and O'Malley. The data sources included PubMed, Web of Science, Ovid, ScienceDirect, Springer, Scopus, CNKI, and WANFANG. Studies in English or Chinese published up to September 2023 were eligible for inclusion. The search yielded a total of 3536 results, with 31 articles meeting the inclusion criteria. The included studies reported that the prevalence of PTSD ranged from a minimum of 13% to a maximum of 84.6%. Risk factors for PTSD included medical interventions, child-related factors, and family environment. A total of 17 assessment tools for PTSD in PICU patients were reported. Given the significance of PTSD in this pediatric population, further attention, research, and intervention are warranted to help alleviate the burden of PTSD.

Approximately 20% to 50% of patients develop persistent pain after traumatic orthopaedic injuries. Psychosocial factors are an important predictor of persistent pain; however, there are no evidence-based, mind-body interventions to prevent persistent pain for this patient population.

Posttraumatic stress disorder (PTSD) has been extensively studied in patients who have experienced natural disasters or military conflict, but there remains a substantial gap in knowledge about the prevalence of PTSD after civilian orthopaedic trauma, especially as related to firearms. Gun violence is endemic in the United States, especially in urban centers, and the mental impact is often minimized during the treatment of physical injuries.

Post-traumatic stress disorder (PTSD) is a prevalent health condition among members of the military. Although the efficacy of pharmacological and psychiatric interventions for PTSD has been well studied, there are limited data on the effects of omega-3 (n-3) polyunsaturated fatty acid (PUFA) interventions on PTSD. The use of PUFAs shows promise because of their neuroprotective effects. Thus, this systematic review will synthesize the current state of the evidence regarding the effectiveness of PUFA treatment for PTSD.

Extinction of traumatic memory, a primary treatment approach (termed exposure therapy) in post-traumatic stress disorder (PTSD), occurs through relearning and may be subserved at the molecular level by long-term potentiation (LTP) of relevant circuits. In parallel, repetitive transcranial magnetic stimulation (rTMS) is thought to work through LTP-like mechanisms and may provide a novel, safe, and effective treatment for PTSD. Our recent failed randomized controlled trial (1) emphasizes the necessity of correctly identifying cortical targets, directionality of TMS protocol, and role of memory activation. Here we provide a systematic review of TMS for PTSD to further identify how, where, and when TMS treatment should be delivered to alleviate PTSD symptoms. We conducted a systematic review of the literature searching for rTMS clinical trials involving PTSD patients and outcomes. We searched MEDLINE through October 25, 2023 for "TMS and PTSD" and "transcranial magnetic stimulation and posttraumatic stress disorder." Thirty-one publications met our inclusion criteria (k=17 randomized controlled trials (RCTs), k=14 open label). RCT protocols were varied in TMS protocols, cortical TMS targets, and memory activation protocols. There was no clear superiority across protocols of low-frequency (k=5) vs. high-frequency protocols (k=6), or by stimulation location. Memory provocation or exposure protocols (k=7) appear to enhance response. Overall, TMS appears to be effective in treating PTSD symptoms across a variety of TMS frequencies, hemispheric target differences, and exposure protocols. Disparate protocols may be conceptually harmonized when viewed as potentiating proposed anxiolytic networks or suppressing anxiogenic networks.

A better understanding of the development of prolonged grief disorder can help professionals identify bereaved in need of intervention efforts and improve the efficiency of services. We aimed to examine the prevalence of and risk factors for prolonged grief disorder in a sample of young, bereaved terrorist attack survivors almost a decade postloss.

Due to occupational exposure to potentially traumatic events, health care workers (HCWs) may be at risk of developing posttraumatic stress (PTS) symptoms or probable posttraumatic stress disorder (PTSD). This study examined probable PTSD, coping, and resilience among national HCWs working in Greece. A total of 17.9% of the sample of participants (N = 112) met the screening criteria for probable PTSD. Logistic regression models were constructed to assess if trauma coping self-efficacy (CSE) and resilience predicted probable PTSD, and the results indicated that lower trauma CSE significantly predicted probable PTSD in unadjusted models (OR = 0.89, 95% CI, 0.82, 0.96, < 0.01) and adjusted models (OR = 0.90, 95% CI, 0.83, 0.97, < 0.01). Our study findings suggest that organizations that employ HCWs may support their workers through ongoing screening, assessment, and training that enhances coping self-efficacy.

We aimed to use real-world data to characterize the burden of psychiatric comorbidities in young people with eating disorders (EDs) relative to peers without EDs.

Cannabidiol (CBD), as one of the phytocannabinoids, has a wide range of therapeutic properties for various neuropsychiatric disorders due to central nervous system effects. These therapeutic properties demonstrated by preclinical and clinical studies encompass more than just anticonvulsant, anti-arthritic, analgesic, anti-inflammatory, antioxidant, antitumor, antiemetic, antipsychotic and neuroprotective effects. It has been hypothesized that CBD holds potential in the treatment of various neuropsychiatric and anxiety disorders. Thus, PRISMA was used as a guide for our systematic review. Eight of the 1550 articles screened in June 2023 were eligible for meta-analysis. Based on the 316 participants included in these eight articles, this meta-analysis revealed a substantial significant impact of CBD on anxiety with a considerable effect size (Hedges' g = -0.92, 95% CI -1.80 to -0.04). In addition, this meta-analysis focuses on the efficacy of CBD in treating anxiety disorders such as generalized anxiety disorder (GAD), social anxiety disorder (SAD), and post-traumatic stress disorder (PTSD). However, caution should be exercised in interpreting our findings due to the limited size of the clinical sample, and additional trials ought to be carried out if deemed necessary.

Posttraumatic stress disorder (PTSD) is a debilitating psychosomatic condition characterized by impairment of brain fear circuits and persistence of exceptionally strong associative memories resistant to extinction. In this study, we investigated the neural and behavioral consequences of inhibiting protein synthesis, a process known to suppress the formation of conventional aversive memories, in an established PTSD animal model based on contextual fear conditioning in mice. Control animals were subjected to the conventional fear conditioning task. Utilizing c-Fos neural activity mapping, we found that the retrieval of PTSD and normal aversive memories produced activation of an overlapping set of brain structures. However, several specific areas, such as the infralimbic cortex and the paraventricular thalamic nucleus, showed an increase in the PTSD group compared to the normal aversive memory group. Administration of protein synthesis inhibitor before PTSD induction disrupted the formation of traumatic memories, resulting in behavior that matched the behavior of mice with usual aversive memory. Concomitant with this behavioral shift was a normalization of brain c-Fos activation pattern matching the one observed in usual fear memory. Our findings demonstrate that inhibiting protein synthesis during traumatic experiences significantly impairs the development of PTSD in a mouse model. These data provide insights into the neural underpinnings of protein synthesis-dependent traumatic memory formation and open prospects for the development of new therapeutic strategies for PTSD prevention.

Astrocyte dysfunctions have been consistently observed in patients affected with depression and other psychiatric illnesses. Although over the years our understanding of these changes, their origin, and their consequences on behavior and neuronal function has deepened, many aspects of the role of astroglial dysfunction in major depressive disorder (MDD) and post-traumatic stress disorder (PTSD) remain unknown. In this review, we summarize the known astroglial dysfunctions associated with MDD and PTSD, highlight the impact of chronic stress on specific astroglial functions, and how astroglial dysfunctions are implicated in the expression of depressive- and anxiety-like behaviors, focusing on behavioral consequences of astroglial manipulation on emotion-related and fear-learning behaviors. We also offer a glance at potential astroglial functions that can be targeted for potential antidepressant treatment.

Anxiety disorders, including generalized anxiety, panic disorder, and post-traumatic stress, constitute the most frequent mental disorders and occur in about 14-18% of the overall population [...].

The mental health impact of disasters is substantial, with 30-40% of direct disaster victims developing post-traumatic stress disorder (PTSD). It is not yet clear why some people cope well with disaster-related trauma while others experience chronic dysfunction. Prior research on non-disaster trauma suggests that an individual's history of traumatic experiences earlier in the life course, prior to the disaster, may be a key factor in explaining variability in psychological responses to disasters. This study evaluated the extent to which pre-disaster trauma predicts PTSD trajectories in a sample of Hurricane Katrina survivors followed for 12 years after the storm. Four PTSD trajectories were identified using latent class growth analysis: Resistant (49.0%), Recovery (29.3%), Delayed-Onset (8.0%), and Chronic-High (13.7%). After adjusting for covariates, pre-Katrina trauma had only a small, positive impact on the probability of long-term, chronic Katrina-specific PTSD, and little effect on the probability of the Resistant and Delayed-Onset trajectories. Higher pre-Katrina trauma exposure moderately decreased the probability of being in the Recovery trajectory, in which Katrina-specific PTSD symptoms are initially high before declining over time. When covariates were added to the model one at a time, the association between pre-Katrina trauma and Chronic-High PTSD was attenuated most by the addition of Katrina-related trauma. Our findings suggest that while pre-disaster trauma exposure does not have a strong direct effect on chronic Katrina-specific PTSD, pre-Katrina trauma may impact PTSD through other factors that affect Katrina-related PTSD, such as by increasing the severity of Katrina-related trauma. These findings have important implications for the development of disaster preparedness strategies to diminish the long-term burden of disaster-related PTSD.

There is a knowledge gap regarding the link between disaster exposure and adolescent mental health problems in developing countries. This study examines the case of Sri Lanka to investigate (a) the immediate and long-term mental health impact of the 2004 tsunami disaster on adolescents and (b) the potential moderating effects of unique cultural and family practices that prevail in Sri Lanka. This study used a random sample of 160 adolescents (ages 12-19) and their mothers who were exposed to the tsunami disaster while living in a southern Sri Lankan village and provided prospective data immediately after the disaster (2005) and three years later (2008). A cross-culturally validated instrument assessed adolescent-mother dyads' tsunami exposure, stressful loss, family cultural rituals and familism, and adolescent mental health. Structural equation modeling analysis showed that exposure and perceptions of tsunami-induced stressful experiences were associated with early and later mental health problems in adolescents. In addition, this study found that unique cultural practices and familism moderated the link between adolescent tsunami exposure, stressful experiences, and levels of PTSD and depressive symptoms. The findings of this study could be utilized to develop prevention and intervention programs that are contextually and culturally valid and empirically supported, which would be more effective for trauma-exposed adolescents in developing countries.

Post-traumatic stress disorder (PTSD) occurs when an individual experiences a traumatic event that exceeds the limits of psychological endurance. Many veterans experience PTSD. PTSD can negatively impact veterans' quality of life, functioning, life satisfaction, and overall well-being. It is important to analyze the concept of PTSD in the veteran population. This concept analysis aimed to investigate the defining attributes, a model case, antecedents, consequences, and empirical referents related to the concept of PTSD among veterans. Walker and Avant's method was used to guide this concept analysis of PTSD. The results showed that three attributes were determined from the analysis: intrusive memories of traumatic events, feelings of isolation and estrangement, and negative cognitions. PTSD is conceptualized as a collection of symptoms that arise from highly traumatic experiences. The military environment predisposes veterans to traumatic events that should be identified or acknowledged. A better understanding of the concept of PTSD can facilitate the development of effective interventions for the veteran population and enhance their mental health.

The ongoing Ukraine-Russia war triggered significant mental health consequences, particularly posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). A population study with 1895 Ukrainians explored the association between negative war-related beliefs and risk for PTSD and CPTSD. Negative war-related beliefs were shown to be significantly linked to increased risks for PTSD and more so for CPTSD. Interventions that address negative war-related beliefs could mitigate the mental health impact of war.

The incidence rate of Posttraumatic stress disorder (PTSD) is currently increasing due to wars, terrorism, and pandemic disease situations. Therefore, accurate detection of PTSD is crucial for the treatment of the patients, for this purpose, the present study aims to classify individuals with PTSD versus healthy control.

To examine a) the development of PTSD symptoms and pain over five months post-spinal cord injury (SCI); b) the directional effects of PTSD symptoms and pain across five months post-SCI; and c) the prediction of chronic pain two-years post-SCI by PTSD symptoms and pain severity in the first five months post-SCI.

This analysis explored relationships between mental health symptoms and conditions and cognitive function in a cohort of Vietnam-era women veterans from the Health of Vietnam Era Veteran Women's Study (HealthViEWS). Vietnam-era women veterans completed a mail survey assessing self-reported symptom severity of posttraumatic stress disorder (PTSD) and depression. A telephone-based structured interview assessed mental health conditions and cognitive function (telephone interview for cognitive status [TICS]). Participants were categorized using a TICS threshold of ≤29 to designate possible cognitive impairment versus nonimpaired. Separate logistic regression models were used to determine associations between possible cognitive impairment and each self-reported and interviewer-rated assessment of PTSD and depression while adjusting for age, education, race, marital status, and wartime service location. The sample consisted of 4,077 women veterans who were ≥60 years old and completed the TICS. Of these women, 7.20% were categorized with possible cognitive impairment. Logistic regression models indicated that self-reported PTSD and depression symptom severity were each significantly associated with higher odds of possible cognitive impairment (adjusted odds ratios [aOR]: 1.03 [95% confidence interval [CI]: 1.02-1.04] and 1.07 [95% CI: 1.04-1.09], respectively). Women veterans with a probable diagnosis of depression had higher odds of possible cognitive impairment compared to those without depression (aOR: 1.61 [95% CI: 1.07-2.42]). No association was found for probable diagnosis of PTSD. Although further examination remains necessary, results suggest that Vietnam-era women veterans with self-reported PTSD and depression symptom severity or a probable diagnosis of depression may benefit from screening of cognitive function to inform clinical care.

This systematic review and meta-analysis address the evidence on the association of psychological stressors with onset of multiple sclerosis, inflammatory disease activity (relapses or new disease activity on magnetic resonance imaging, MRI) and disability progression.

The aim of this study is to conduct network analysis to identify the posttraumatic stress disorder (PTSD) symptoms network structures in adolescents across three types of trauma events.

Chronic pain and opioid misuse are a prevalent comorbidity with deleterious health outcomes. Growing work indicates that posttraumatic stress disorder (PTSD) can increase the risk for chronic pain and opioid misuse and dependence. However, there is little understanding of social determinants of health (SDoH) that may account for interrelations of PTSD with chronic pain and opioid misuse and dependence. Health literacy is one relevant SDoH construct, reflecting the ability to gather, process, and comprehend health-related information required to engage in a healthcare setting.

Suicide-bereaved individuals are often confronted with profound grief reactions and have an increased risk for mental health disorders. Little is known about the development of complex post-traumatic stress disorder (CPTSD) following a loss by suicide. This paper aims to assess the prevalence of CPTSD, PTSD, prolonged grief disorder (PGD), and depression as well as to identify sociodemographic and loss-related factors regarding their development. A total of 161 suicide loss survivors (91.3% female) completed a questionnaire, which collected symptoms of grief (TGI-SR+), PTSD, CPTSD (ITQ), and depression (PHQ-D). In total, 12.4% met the diagnosis for CPTSD, 5.0% for PTSD. A total of 22.0% fulfilled the diagnosis for PGD. 41.6% showed at least moderate symptoms of depression. Pearson's correlation showed that time since loss was negatively associated with PG and PTSD symptoms, kinship to the deceased was associated with PG severity. The sample scored high on all disturbances in self-organization (DSO) symptom clusters typical for CPTSD. A focus on symptoms of CPTSD may be a necessary component in the care of survivors of suicide loss.

Post-traumatic stress disorder (PTSD) can lead to complications such as depression and grief, which are more prevalent in veterans than in the general population. Recently, art-making, including mandala coloring, has gained attention as a potential treatment for PTSD patients.

Alcohol misuse and posttraumatic stress disorder (PTSD) co-occur at high rates among first responders (e.g., law enforcement, firefighters, paramedics), underscoring the need to better understand these relations to inform intervention efforts. Identifying malleable processes relevant to the association between PTSD and alcohol among first responders could inform tailored interventions. An example of such a malleable process is spirituality. As such, the current study examined the unique relationships between PTSD symptom clusters and alcohol misuse, while also accounting for the role of select demographics and religion/spirituality, in a sample of first responders. A national online sample of first responders (N = 320) completed measures of PTSD symptomology, alcohol misuse, religion/spirituality and demographics. Hierarchical linear regression analyses revealed that PTSD Intrusion (Cluster B) symptom severity was associated with greater alcohol misuse and PTSD Avoidance (Cluster C) was associated with lower alcohol misuse. Additionally, positive and negative spiritual coping were also associated with alcohol misuse. In the context of similar research among military samples, findings suggest potentially unique associations between PTSD symptom clusters and alcohol misuse among first responders. Additionally, findings highlight the potentially protective role of religion/spirituality in this population. Future research should explore nuanced relationships between PTSD symptom clusters and alcohol misuse as well as the salience of spirituality/religion in this unique population.

Excessive or inappropriate fear responses can lead to anxiety-related disorders, such as post-traumatic stress disorder (PTSD). Studies have shown that microglial activation occurs after fear conditioning and that microglial inhibition impacts fear memory. However, the role of microglia in fear memory recall remains unclear. In this study, we investigated the activated profiles of microglia after the recall of remote-cued fear memory and the role of activated microglia in the extinction of remote-cued fear in adult male C57BL/6 mice. The results revealed that the expression of the microglia marker Iba1 increased in the medial prefrontal cortex (mPFC) at 10 min and 1 h following remote-cued fear recall, which was accompanied by amoeboid morphology. Inhibiting microglial activation through PLX3397 treatment before remote fear recall did not affect recall, reconsolidation, or regular extinction but facilitated recall-extinction and mitigated spontaneous recovery. Moreover, our results demonstrated reduced co-expression of Iba1 and postsynaptic density protein 95 (PSD95) in the mPFC, along with decreases in the p-PI3K/PI3K ratio, p-Akt/Akt ratio, and KLF4 expression after PLX3397 treatment. Our results suggest that microglial activation after remote fear recall impedes fear extinction through the pruning of synapses in the mPFC, accompanied by alterations in the expression of the PI3K/AKT/KLF4 pathway. This finding can help elucidate the mechanism involved in remote fear extinction, contributing to the theoretical foundation for the intervention and treatment of PTSD.

Mental health problems after discharge from the intensive care unit (ICU) interfere with physical recovery and seriously affect daily life. Social support has been suggested to be associated with mental health but has not been sufficiently characterised. This study aimed to evaluate the association of social support before ICU admission with mental health after ICU discharge.

The present study sought to investigate whether gender moderates the relationship between military sexual trauma (MST) and posttraumatic stress disorder (PTSD) treatment utilization, among veterans with clinically significant PTSD symptoms. Participants were 2,664 veterans with probable PTSD from a nationwide, population-based survey. Participants reported sociodemographic information, history of MST (including military sexual harassment and military sexual assault), and lifetime receipt of PTSD psychotherapy and medication treatment. We found that gender significantly moderated relationships between (a) military sexual harassment and PTSD psychotherapy, (b) military sexual assault and PTSD psychotherapy, and (c) military sexual harassment and PTSD medication. For women, MST was associated with a greater likelihood of receiving treatment, but for men, MST was not associated with PTSD treatment. Future research is needed to better understand gender differences in how experiences of MST may affect engagement in PTSD treatment. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

This article discusses a dichotomous operationalization of suicide attempts. Each year, millions of individuals worldwide make a suicide attempt (SA). Because of their obvious importance, clinicians and researchers commonly assess for a SA history by asking face-valid questions about whether an individual has engaged in any selfinjurious behavior with the intent to die within a given timeframe. Response options are typically dichotomous (yes/no), such that if an individual reported nonzero intent to die associated with their behavior(s) or if there were other indicators suggestive of intent, the individual would be considered to have attempted suicide. Regardless of the method of ascertainment, it is generally accepted that patients and study participants either do or do not have a SA history. The intention is not to suggest that more serious SAs-whether by the level of intent to die, means used, actual medical consequences, or chronicity criterion-are more worthy of clinical and scientific attention than less serious SAs. Instead, the intention is to bring greater awareness to considering-in theory testing and refinement, the design, analysis, and interpretation of research findings, and clinical practice-SAs as multidimensional behaviors that vary in levels of intent to die, means used, actual medical consequences, and chronicity. By doing so, the clinical impact of scientific findings will be more readily discernable. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

There is inadequate evidence regarding the symptom profile of people who have posttraumatic stress disorder (PTSD) over time. The goal of this study was to determine the consistency of symptoms in people with PTSD over successive assessments.

Adverse childhood experiences (ACEs) and financial hardship are associated with increased likelihood of heavier alcohol use and health challenges in adulthood among persons living with HIV (PWH). We examined whether retrospectively captured lifetime drinking trajectories are a pathway through which childhood hardships affect current health in a sample of 365 adult PWH. Childhood economic hardship and ACEs were used as main predictors. Measures of alcohol use included age at first drink and lifetime drinking trajectories. Health indicators included health-related quality of life, frailty, number of comorbidities, and symptoms of anxiety, depression, and post-traumatic stress disorder (PTSD). Structural equation modeling (SEM) was applied to estimate both direct and indirect pathways between childhood hardship and physical and mental health. Participants were mostly male; Black (84%); and averaged 48 years of age. SEM results supported both direct and indirect pathways between childhood experiences and adult health. ACEs were connected to physical health directly and mental health both directly and indirectly through age at first drink and drinking heaviness during ages 10-20. Childhood economic hardship related to mental health indirectly through higher drinking levels during ages 10-20. Childhood adverse experiences, economic hardship, and early drinking patterns appear to accumulate, resulting in later life physical and mental health concerns for PWH. Findings support taking a life course approach to health. This includes considering individual trauma histories in HIV care engagement and taking preventative approaches which support the economic and social well-being of vulnerable children to improve health in subsequent decades.

Children and adolescents, after natural and man-made disasters, often exhibit various psychological, emotional, and behavioral issues, showing a range of clinical symptoms related to post-traumatic stress disorder (PTSD) and depression. This review used a network meta-analysis (NMA) approach to compare and rank psychological interventions for PTSD and depression in children and adolescents after exposure to natural and man-made disasters.

Previous studies have reported inconsistent findings regarding the association between post-traumatic stress (PTS) and post-traumatic growth (PTG). Three major issues could account for this inconsistency: (1) the lack of information about mental health problems before the disaster, (2) the concept of PTG is still under scrutiny for potentially being an illusionary perception of personal growth and (3) the overlooking of PTS comorbidities as time-dependent confounding factors. To address these issues, we explored the associations of PTS and PTG with trauma-related diseases and examined the association between PTS and PTG using marginal structural models to address time-dependent confounding, considering pre-disaster covariates, among older survivors of the 2011 Japan Earthquake and Tsunami.

Parental support has been suggested to mitigate mental and physical consequences following childhood sexual abuse (CSA). However, many CSA survivors experience parental rejection post-CSA.

In South Africa, there is limited mental health infrastructure and resources. Valid screening tools are needed to facilitate identification and linkage to care. We evaluated the performance of Patient Health Questionnaire-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7), Primary Care Post Traumatic Stress Disorder Screen for DSM-5 (PC-PTSD-5), and the Columbia Suicide Severity Rating Scale (C-SSRS) among adults in South Africa against a diagnostic gold standard.

Administration mode of patient-reported outcome measures (PROMs) may influence responses. We assessed if Patient Health Questionnaire-9 (PHQ-9), Edinburgh Postnatal Depression Scale (EPDS) and Hospital Anxiety and Depression Scale - Depression subscale (HADS-D) item responses and scores were associated with administration mode. We compared (1) self-administration versus interview-administration; within self-administration (2) research or medical setting versus private; and (3) pen-and-paper versus electronic; and within interview-administration (4) in-person versus phone. We analysed individual participant data meta-analysis datasets with item-level data for the PHQ-9 (N = 34,529), EPDS (N = 16,813), and HADS-D (N = 16,768). We used multiple indicator multiple cause models to assess differential item functioning (DIF) by administration mode. We found statistically significant DIF for most items on all measures due to large samples, but influence on total scores was negligible. In 10 comparisons conducted across the PHQ-9, EPDS, and HADS-D, Pearson's correlations and intraclass correlation coefficients between latent depression symptom scores from models that did or did not account for DIF were between 0.995 and 1.000. Total PHQ-9, EPDS, and HADS-D scores did not differ materially across administration modes. Researcher and clinicians who evaluate depression symptoms with these questionnaires can select administration methods based on patient preferences, feasibility, or cost.

Posttraumatic stress disorder (PTSD) is a common consequence of traumatic injury, yet certain biological factors contributing to PTSD are poorly understood. The gut microbiome may influence mental health outcomes, but its role in heterogeneous PTSD presentations requires elucidation.

The purpose of this study was to examine the impact of childhood trauma exposure, posttraumatic stress disorder, and trauma-related comorbid diagnoses on the risk for readmission to juvenile detention among youth in a large metropolitan area ( = 1282). The following research questions were addressed: 1) Does a greater number of childhood traumas increase the risk for readmission to detention following release? 2) Does the risk for readmission differ by type of trauma? 3) Do PTSD and other co-morbid diagnoses increase the risk for readmission? and 4) What role do demographic factors play in the relationship between trauma-related variables and risk for readmission? This study utilized the screening results of 1282 youth who were voluntarily screened for PTSD, depressive symptoms and substance use during their initial intake to detention. More than half of the sample was readmitted during the three-year study period, with readmissions most likely to occur within one year of release. Returning to detention within one year was also associated with increased risk for multiple readmissions. Youth readmitted to detention were more likely to have a history of sexual abuse and problematic substance use. No other significant relationships were found between risk for readmission and trauma-related variables. Although trauma-related symptoms may be crucial targets for treatment, focusing solely on trauma exposure and traumatic stress symptoms without considering the impact of other risk factors may not be enough to decrease the likelihood of readmission for youth of color in a large urban environment.

This systematic review aimed to explore sex differences in exposure to traumatic events and posttraumatic stress disorder (PTSD) symptomatology among refugees, internally displaced persons (IDPs), and asylum seekers. A comprehensive search was conducted across three databases (PubMed, PsychInfo, and Embase), which yielded 2,255 studies. A total of 15 studies were included for trauma exposure assessment, and 8 studies for PTSD symptomatology assessment. The review revealed significant sex differences in trauma exposure, with women experiencing higher rates of sexual violence, while men faced greater risks of imprisonment and torture. In terms of PTSD symptomatology, our findings showed that women tend to exhibit greater symptoms of arousal and specific symptoms of avoidance such as loss of interest and avoidance of activities reminding of trauma, while men were more likely to experience estrangement and detachment. Findings regarding symptoms of reexperiencing were not entirely consistent. This review emphasizes the importance of considering sex-specific symptoms in trauma assessment among displaced populations and advocates for further research into targeted interventions, especially regarding sexual violence.

Post-traumatic stress disorder (PTSD) is a persistent psychiatric condition that arises following exposure to traumatic events such as warfare, natural disasters, or other catastrophic incidents, typically characterized by heightened anxiety, depressive symptoms, and cognitive dysfunction. In this study, animals subjected to single prolonged stress (SPS) were administered evodiamine (EVO) and compared to a positive control group receiving sertraline. The animals were then assessed for alterations in anxiety, depression, and cognitive function. Histological analysis was conducted to examine neuronal changes in the hippocampus. In order to predict the core targets and related mechanisms of evodiamine intervention in PTSD, network pharmacology was used. The metabolic markers pre- and post-drug administration were identified using nontargeted serum metabolomics techniques, and the intersecting Kyoto Encyclopedia of Genes and Genomes (KEGG) pathways were screened. Finally, the core targets were validated through molecular docking, enzyme-linked immunosorbent assays, and immunofluorescence staining to confirm the anti-PTSD effects and mechanisms of these targets. As well as improving cognitive impairment, evodiamine reversed anxiety- and depression-like behaviors. It also inhibited the reduction in the number of hippocampal neuronal cells and Nissl bodies in SPS mice inhibited angiotensin converting enzyme (ACE) levels in the hippocampus of SPS mice, and modulated the renin angiotensin pathway and its associated serum metabolites in brain tissue. Evodiamine shows promise as a potential candidate for alleviating the symptoms of post-traumatic stress disorder.

The purpose of the study was to compare lesbian, gay, bisexual, transgender, queer+ (LGBTQ+) veterans' and nonveterans' prevalence of potentially traumatic events (PTEs) and other stressor exposures, mental health concerns, and mental health treatment.

In addition to trauma-focussed psychotherapy, pharmacological treatment is often unavoidable, especially in patients with severe posttraumatic stress disorder (PTSD). As long as comorbid disorders do not dictate the pharmacotherapy approach, sertraline and paroxetine, along with other off-label prescribable substances approved in Germany, can be used for the treatment of PTSD. Venlafaxine, in particular, has shown good effectiveness in studies, whereas risperidone has shown lower effectiveness in augmentation. Overall, only a small to medium effect size is to be expected for all substances. Psychopharmacotherapy plays an important role in addressing sleep disorders, which are highly prevalent in PTSD. Treatment of trauma-related nightmares can be attempted with doxazosin or clonidine. In contrast, there are limited empirical data available for sleep disorders associated with PTSD, but the pharmacological treatment of insomnia can provide some guidance.

The aim of this article is to summarize the current state of research on the effectiveness of psychotherapeutic treatment of posttraumatic stress disorder (PTSD).

Examine whether concussion mechanism of injury (high-level blast [HLB] vs impact) affects the likelihood of persistent sleep problems in a post-deployment military population.

Obstructive sleep apnea (OSA) is a common condition in older adult (aged >65 years) populations, but more mechanistic research is needed to individualize treatments. Previous evidence has suggested an association between OSA and posttraumatic stress disorder (PTSD) but is limited by possible selection bias. High-quality research on this association with a careful evaluation of possible confounders may yield important mechanistic insight into both conditions and improve treatment efforts.

Religion/spirituality (R/S) is an important and commonly used resource for coping with difficult experiences and has been shown to reduce the development of posttraumatic stress disorder (PTSD) symptoms following a trauma. However, it is not clear how R/S affects response to treatment of PTSD.

A quarter of women and 11% of men report being survivors of intimate partner violence (IPV) during their lifetimes in the United States. Despite being victims themselves, people who kill their IPV abuser can still be subject to criminal proceedings. Given this complexity, the law has employed battered spouse syndrome (BSS) as a tool used in some jurisdictions to support a claim that an IPV survivor killed in self-defense. A defendant who is attempting to claim self-defense using BSS may introduce testimony of post-traumatic stress disorder (PTSD). However, a diagnosis of PTSD can pose problems in admission during litigation as the occurrence of a traumatic event is often what is being decided. The present study examined how college students, living on the U.S.-México border, perceive survivors-turned-defendants in a BSS mock trial. Specifically, we had each participant read a written trial transcript of a mock trial where gender of the defendant and clinical diagnosis of PTSD were manipulated. The current study hypothesized that jurors would be more lenient toward female defendants than male defendants (), jurors would be influenced by a PTSD diagnosis of the defendant (), and female jurors would be more lenient than male jurors (). We also wanted to examine the impact of victim blaming, sexism, stigma of PTSD, and prior exposure to IPV on decision-making (. Findings showed jurors were more lenient with female defendants than male defendants, however there was no effect of clinical diagnosis except on difficulty of decision. Implications of the role defendant gender has in decision-making is discussed.

Pediatric critical illness exposes family members to stressful experiences that may lead to subsequent psychological repercussions.

Autism Spectrum Disorder (ASD) occurs in 1-1.5% of the general population and possibly in up to 20% of psychiatric outpatients. Post Traumatic Stress Disorder (PTSD) occurs at some point in life in 4% of the general population and in 14-20% of psychiatric outpatients. Knowledge about how PTSD manifests in people with ASD is important in order for it to be correctly diagnosed and intervened for.

The present bibliometric analysis used traditional measures and network science techniques to examine how the COVID-19 pandemic influenced research in Clinical Psychology. Publication records from the Web of Science (WoS) were obtained for journal articles published prior to (2015 and 2018), during (2020), and at the end of the pandemic (2022) for the search terms "men and mental health" and "women and mental health". Network analyses of author-provided keywords showed that COVID-19 co-occurred with fear, anxiety, depression, and stress for both men and women in 2020. In 2022, COVID-19 co-occurred with topics related to world-wide lockdowns (e.g., alcohol use, substance use, intimate partner violence, loneliness, physical activity), and to more fundamental topics in Clinical Psychology (e.g., eating disorders and post-traumatic stress disorder). Although the COVID pandemic was associated with several changes in the research topics that were examined in Clinical Psychology, pre-existing disparities in the amount of mental health research on men compared to women did not appear to increase (in contrast to increases associated with COVID in pre-existing gender disparities observed in other areas of society).

Fear-related disorders, including post-traumatic stress disorder (PTSD), and anxiety disorders are pervasive psychiatric conditions marked by persistent fear, stemming from its dysregulated acquisition and extinction. The primary treatment for these disorders, exposure therapy (ET), relies heavily on fear extinction (FE) principles. Adolescence, a vulnerable period for developing psychiatric disorders, is characterized by neurobiological changes in the fear circuitry, leading to impaired FE and increased susceptibility to relapse following ET. Ketamine, known for relieving anxiety and reducing PTSD symptoms, influences fear-related learning processes and synaptic plasticity across the fear circuitry. Our study aimed to investigate the effects of ketamine (10 mg/kg) on FE in adolescent male C57 BL/6 mice at the behavioral and molecular levels. We analyzed the protein and gene expression of synaptic plasticity markers in the hippocampus (HPC) and prefrontal cortex (PFC) and sought to identify neural correlates associated with ketamine's effects on adolescent extinction learning. Ketamine ameliorated FE in the adolescent males, likely affecting the consolidation and/or recall of extinction memory. Ketamine also increased the Akt and mTOR activity and the GluA1 and GluN2A levels in the HPC and upregulated BDNF exon IV mRNA expression in the HPC and PFC of the fear-extinguished mice. Furthermore, ketamine increased the c-Fos expression in specific brain regions, including the ventral HPC (vHPC) and the left infralimbic ventromedial PFC (IL vmPFC). Providing a comprehensive exploration of ketamine's mechanisms in adolescent FE, our study suggests that ketamine's effects on FE in adolescent males are associated with the activation of hippocampal Akt-mTOR-GluA1 signaling, with the vHPC and the left IL vmPFC as the proposed neural correlates.

Stress is associated with alcohol drinking, and epidemiological studies document the comorbidity of alcohol use disorder (AUD) and post-traumatic stress disorder (PTSD), with higher comorbid prevalence in females than in males. The aim of this paper is to highlight information related to sex differences in stress-enhanced alcohol drinking from clinical studies and from preclinical studies utilizing an animal model of traumatic stress.

Post-traumatic stress disorder (PTSD) is associated with increased rates of incident ischemic heart disease (IHD) in women.

The experience of several adverse childhood experiences (ACEs) has been shown to be associated with Post-Traumatic Stress Disorder (PTSD) and Disturbances in Self-Organization (DSO) symptoms among adolescents. Defense mechanisms and coping styles are psychological processes involved in the association of ACEs with PTSD and DSO symptoms. However, there is a lack of research on the joint association of these variables among Faroese adolescents.

Disaster-related psychiatric disorders (DRPD) present a significant challenge to mental health professionals, yet there is a notable lack of emphasis on the preparedness of psychiatrists in managing these conditions within post-graduate medical education.

Global climate change is resulting in dramatic increases in wildfires. Individuals exposed to wildfires experience a high burden of posttraumatic stress disorder (PTSD), and the cost-effectiveness of the treatment options to address PTSD from wildfires has not been studied. The objective of this study was to conduct a cost-utility analysis comparing screening followed by treatment with paroxetine or trauma-focused cognitive behavioral therapy (TF-CBT) versus no screening in Canadian adult wildfire evacuees. Using a Markov model, quality-adjusted life-years (QALYs) and costs were evaluated over a 5-y time horizon using health care and societal perspectives. All costs and utilities in the model were discounted at 1.5%. Probabilistic and deterministic sensitivity analyses examined the uncertainty in the incremental net monetary benefit (INMB) under a willingness-to-pay threshold of $50,000. From a societal perspective, no screening (NMB = $177,641) was dominated by screening followed by treatment with paroxetine (NMB = $180,733) and TF-CBT (NMB = $181,787), with TF-CBT having the highest likelihood of being cost-effective at a willingness-to-pay threshold of $50,000 per QALY (probability = 0.649). The initial prevalence of PTSD, probability of acceptance of treatment, and costs of productivity had the largest impact on the INMB of both paroxetine or TF-CBT versus no screening. Neither intervention was cost-effective at a willingness-to-pay threshold of $50,000 per QALY from a health care perspective. Screening followed by treatment with paroxetine or TF-CBT compared with no screening was found to be cost-saving while providing additional QALYs in wildfire evacuees. Governments should consider funding screening programs for PTSD followed by treatment with TF-CBT for wildfire evacuees.

Post-traumatic stress disorder (PTSD) is a psychiatric disorder triggered by exposure to a life-threatening or sexually violent traumatic event, and is characterized by symptoms involving intrusive re-experiencing, persistent avoidance of associated stimuli, emotional and cognitive disturbances, and hyperarousal for long periods after the trauma has occurred. These debilitating symptoms induce occupational and social impairments that contribute to a significant clinical burden for PTSD patients, and substantial socioeconomic costs, reaching approximately $20,000 dollars per individual with PTSD each year in the US. Despite increased translational research focus in the field of PTSD, the development of novel, effective pharmacotherapies for its treatment remains an important unmet clinical need.

Diagnosing a non-epileptic seizure is difficult in the absence of a video electroencephalogram. The expert commission of the international league against epilepsy proposes a diagnostic approach allowing the diagnosis to be made according to a degree of certainty with or in the absence of a video electroencephalogram. Our objective was to determine the hospital frequency of psychogenic non-epileptic seizures in the absence of video-electroencephalogram. Using the outpatient registry, we identified patients followed for epilepsy with two normal interictal electroencephalographies, between January 2020 and October 2021. A review of the patients' medical records and an assessment of the validity of the diagnosis were carried out. Out of 64 patients evaluated with normal interictal electroencephalogram, 19 were included as suffering from psychogenic non-epileptic seizures, i.e. 26.68%. The average age was 23.94 +/- 9.4 years. Women represented 68.4%. Patients followed in neurology represented 84%. A history of childhood trauma was found in (47.4%). The first crisis was preceded by stressful events in 47.36%. Post-traumatic stress disorder was the most represented with 73.7% of cases. The average age was 20.95 +/- 9.8 years for the first crisis and the average duration of evolution of the crises was 3 years +/- 2 years. This study illustrates the possibility of making a presumptive diagnosis of psychogenic non-epileptic seizure in the absence of video-electroencephalogram.

A significant portion of individuals exposed to combat-related trauma will develop posttraumatic stress disorder (PTSD), a severe, debilitating disorder with adverse impacts on both mental and physical functioning. Current treatments are effective for many individuals, however, there is a need for new treatment approaches to improve outcomes in PTSD and address the many existing barriers to seeking or completing treatment.

Post-traumatic stress disorder (PTSD) is characterized by heightened stress and anxiety after experiencing a traumatic event. While numerous studies have been conducted to investigate the magnitude and factors associated with PTSD, there is limited evidence available on specific study populations of military personnel.

Studies suggest a relationship between the emotional evocativeness of visual imagery and viewer responses, however, there is limited understanding of these associations, especially as they relate to viewers' personal experiences of adversities.

Stimulants are the first-line pharmacological treatment for attention deficit hyperactivity disorder (ADHD). We present the unique case of a patient who developed a chewing compulsion when taking mixed amphetamine salts (MAS). A 32-year-old female patient with a past medical history of gastroesophageal reflux disease (GERD), gastroparesis, and migraines was seen for initial psychiatric assessment due to concerns for irritability. She was diagnosed with post-traumatic stress disorder (PTSD); generalized anxiety disorder; ADHD, inattentive type; and unspecified bipolar disorder. Lamotrigine was started and titrated to 25mg twice per day, with improved mood stability. MAS immediate-release (IR) was started at 2.5mg and titrated to 5mg daily for ADHD. She then experienced an uncontrollable urge to chew, finding relief when chewing on a child's teething necklace, which provided satisfaction and a reduction in anxiety. She denied jaw tightness or teeth grinding. The dose of MAS IR was reduced to 2.5mg daily with improvement in symptoms and later increased again to 5mg daily, which she was then able to tolerate. Stereotyped biting behaviors have been observed in rats with the use of amphetamines, and the onset of compulsive behavior has emerged in children with the use of dextroamphetamine. However, this is the first known case of compulsive chewing or biting movements reported in humans with MAS use. This case highlights the need to assess patients for adverse events, such as compulsive biting and chewing movements or other oral facial stereotypies, after commencement of stimulants, including MAS.

We aimed to examine the hypothesized negative associations between childbirth post-traumatic stress disorder (PTSD) symptoms (using the two-factor model of birth-related and general symptoms), social support, and a couple's relationship quality at 8-12 weeks postpartum. This analysis considered the longitudinal positive shared variance with acute stress disorder (ASD) symptoms measured shortly after birth, while accounting for obstetric and demographic variables.

Asylum seekers, migrants, and refugees from African countries may have significant health needs, resulting in economic implications for receiving countries around the world. The risk of mental illness is higher in these communities because of factors like violence, deprivation, and post-immigration challenges.

Bilateral stimulation is a core element of Eye Movement Desensitization and Reprocessing Therapy, a psychotherapeutic intervention for the treatment of Posttraumatic Stress Disorder (PTSD). Promising previous findings showed measurable physiological effects of bilateral stimulation in healthy individuals, but studies that replicated these findings in PTSD patients are sparse.

Mental health disorders and chronic health diseases are highly prevalent and impactful consequences of distressful experiences among refugees, yet a comprehensive conceptual model encompassing biopsychosocial factors is lacking. This study aims to assess the relevance of widowhood to PTSD and major depression maintenance as well as to adverse health outcomes in a cohort of Bosnian refugees.

Hospitalization for Covid-19 has been recognized as a potentially traumatic experience. This longitudinal cohort study assessed the impact of psychological intervention for Covid-19 patients on anxiety, depression, and post-traumatic stress disorder (PTSD).

There is controversy regarding the comorbidity of posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI). The present study translated the PTSD Checklist for DSM-5 (PCL-5) to Spanish and validated it in a sample of patients with TBI 6 months after the injury.

Cervical sympathetic or stellate ganglion blocks (SGBs) have been commonly used in the treatment of painful conditions like complex regional pain syndrome (CRPS). However, there is literature to suggest its utility in managing non-painful conditions as well. The focus of this literature review is to provide an overview of indications for SGB for painful and non-painful conditions. We identified published journal articles in the past 25 years from Embase and PubMed databases with the keywords "cervical sympathetic block, stellate ganglion blocks, cervical sympathetic chain, and cervical sympathetic trunk". A total of 1556 articles were obtained from a literature search among which 311 articles were reviewed. Among painful conditions, there is a lack of evidence in favor of or against the use of SGB for CRPS despite its common use. SGB can provide postoperative analgesia in selective surgeries and can be effective in temporary pain control of refractory angina and the acute phase of herpes zoster infection. Among non-painful conditions, SGB may have beneficial effects on the management of post-traumatic stress disorder (PTSD), refractory ventricular arrhythmias, hot flashes in postmenopausal women, and breast cancer-related lymphedema. Additionally, there have been various case reports illustrating the benefits of SGB in the management of cerebral vasospasm, upper limb erythromelalgia, thalamic and central post-stroke pain, palmar hyperhidrosis, orofacial pain, etc. In our review of literature, we found that SGB can be useful in the management of various non-painful conditions beyond the well-known treatment for CRPS, although further studies are required to prove its efficacy.

Cultural factors were shown to be particularly relevant for the development and expression of posttraumatic stress. Recently, the concept of cultural scripts of trauma has been introduced, which proposes that trauma sequelae elements may be sequentially linked and specifically associated with cultural factors. Furthermore, a cascade model is proposed, including trauma exposure, demographic characteristics, cultural affiliation, and trauma-related value orientations as influencing factors of posttraumatic development. The purpose of this Network Project is to investigate cultural psychological factors that contribute to the expression of posttraumatic stress. The present Network Project implements a mixed methods approach and will be conducted in 5 different study sites, including Switzerland, Israel, Georgia, China, and East Africa. In sub-study I, the cultural scripts of traumatic stress inventories (CSTIs) will be developed. These scales provide a pool of trauma sequelae elements for each cultural group. For this purpose, focus groups with trauma survivors and trauma experts will be conducted and analysed using qualitative research methods. Sub-study II implements a validation analysis of the CSTIs and the empirical investigation of a cultural cascade model. This quantitative approach will include a larger sample of individuals who experienced traumatic life events. This contribution is timely and enriches the knowledge of trauma and culture. Future publications of this Network Project will address trauma sequelae from a cultural perspective and provide diagnostic and psychotherapeutic implications.

Serious games are increasingly being applied within healthcare, but their integration in psychotherapeutic settings is less documented.

Reductions in default mode (DMN) connectivity strength have been reported in posttraumatic stress disorder (PTSD). However, the specificity of DMN connectivity deficits in PTSD compared to major depressive disorder (MDD), and the sensitivity of these alterations to acute stressors are not yet known. 52 participants with a primary diagnosis of PTSD ( = 28) or MDD ( = 24) completed resting-state functional magnetic resonance imaging immediately before and after a mild affective stressor. A 2 × 2 design was conducted to determine the effects of group, stress, and group*stress on DMN connectivity strength. Exploratory analyses were completed to identify the brain region(s) underlying the DMN alterations. There was significant group*stress interaction ( = 0.03), reflecting stress-induced reduction in DMN strength in PTSD ( = 0.02), but not MDD ( = 0.50). Nodal exploration of connectivity strength in the DMN identified regions of the ventromedial prefrontal cortex and the precuneus potentially contributing to DMN connectivity deficits. The findings indicate the possibility of distinct, disease-specific, patterns of connectivity strength reduction in the DMN in PTSD, especially following an experimental stressor. The identified dynamic shift in functional connectivity, which was perhaps induced by the stressor task, underscores the potential utility of the DMN connectivity and raises the question whether these disruptions may be inversely affected by antidepressants known to treat both MDD and PTSD psychopathology.

Police officers encounter various potentially traumatic events (PTEs) and may be compelled to engage in actions that contradict their moral codes. Consequently, they are at risk to develop symptoms of Posttraumatic Stress Disorder (PTSD), but also moral stress or moral injury (MI). To date, MI in police officers has received limited attention. The present study sought to identify classes of MI appraisals and PTSD symptoms among police officers exposed to PTEs, while also investigating potential clinical differences between these classes. For this study, 421 trauma-exposed police officers were assessed on demographics and several clinical measurements including MI appraisals (self-directed and other-directed), PTSD severity, and general psychopathology. Latent class and regression analyses were conducted to examine the presence of different classes among trauma-exposed police officers and class differentiation in terms of demographics, general psychopathology, PTSD severity, mistrust, guilt, self-punishment, and feelings of worthlessness. The following five classes were identified: (1) a 'Low MI, high PTSD class' (28%), (2) a 'High MI, low PTSD class' (11%), (3) a 'High MI, high PTSD class' (17%), (4) a 'Low MI, low PTSD class' (16%), and (5) a 'High MI-other, high PTSD class' (27%). There were significant differences between the classes in terms of age, general psychopathology, PTSD severity, mistrust, guilt, and self-punishment but no differences for gender and feelings of worthlessness. In conclusion, we identified five classes, each exhibiting unique patterns of cognitive MI appraisals and PTSD symptoms. This underscores the criticality of measuring and identifying MI in this particular group, as it allows for tailored treatment interventions.

Childhood maltreatment (CM) can be divided into: emotional abuse (EA), physical abuse (PA), sexual abuse (SA), emotional neglect (EN), and physical neglect (PN). CM is associated with (Complex)Posttraumatic stress disorder (PTSD/CPTSD) and substance use disorder (SUD). This cross-sectional study examined the relationships between CM-subtypes with PTSD-severity and CPTSD in patients with SUD-PTSD. Participants ( = 209) were treatment-seeking SUD-PTSD patients who completed the Childhood Trauma Questionnaire-short form, the Clinician-Administered PTSD Scale for DSM-5 and the International Trauma Questionnaire. Regression analyses and a model selection procedure to select an optimal model were used to examine CM-subtypes as predictors of (C)PTSD, adjusted for sex and age. Total CM and all CM-types significantly predicted PTSD-severity in the univariate regression analysis, with EA begin the strongest predictor. In the multiple regression only SA predicted PTSD-severity. Subsequently, model selection indicated that the optimal model to predict PTSD-severity included EA and SA. In the univariate analyses total CM, EA, and PN significantly predicted CPTSD-classification, and total CM and all CM-types significantly predicted CPTSD-severity. In the multiple regression for CPTSD-classification only EA and PA were significant predictors and for CPTSD-severity EA, PA and SA were significant predictors. In post-hoc multiple regression analyses, only EA was a significant predictor of CPTSD-classification and CPTSD-severity. Finally, in the model selection the most parsimonious model only included EA for both CPTSD-classification and CPTSD-severity. Sex was not a moderator in the relationship between CM and PTSD, nor in CM and CPTSD. These findings indicate that for SUD-PTSD patients, several CM-types have predictive value for (C)PTSD-severity, however SA and especially EA appear to contribute to these complaints. Since EA does not constitute an A-criterion, it is generally more overlooked in PTSD treatment. Its impact should therefore be underlined, and clinicians should be attentive to EA in their treatment.

Exposure to earthquakes can cause adverse effects on the mental health of survivors, including an increased risk of PTSD. This systematic review aims to analyse the previous secondary studies to identify the risk factors for PTSD from children to elderly earthquake survivors. In addition, it aims to consider the complexity of the joint effects of the individual, relational, and contextual risk factors, to also detect the most at-risk families. After reviewing and screening studies from the literature search through PubMed, Web of Science, Scopus, and EBSCO under the guidance of PRISMA guidelines, ten eligible secondary studies were identified that examine the risk factors for PTSD in individuals (from children to elderly) affected by worldwide earthquakes. The analysis of the included studies allowed the identification of a series of socio-demographic, pre-traumatic, peri-traumatic, and post-traumatic PTSD risk factors in children, adolescents, youth, adults, and elderly survivors. The results represent the complexity of the joint effects of these risk factors at individual, relational, and contextual levels. The consideration of the PTSD risk factors highlights the importance of individual characteristics and the type of experiences and exposure in the period before, during, and after the earthquake. This knowledge could allow the early identification of at-risk individuals of different ages and families and the implementation of intervention programmes.

Identifying intervention methods that target sleep characteristics involved in memory processing is a priority for the field of cognitive aging. Older adults with greater sleep efficiency and non-rapid eye movement slow-wave activity (SWA) (0.5-4 Hz electroencephalographic activity) tend to exhibit better memory and cognitive abilities. Paradoxically, long total sleep times are consistently associated with poorer cognition in older adults. Thus, maximizing sleep efficiency and SWA may be a priority relative to increasing mere total sleep time. As clinical behavioral sleep treatments do not consistently enhance SWA, and propensity for SWA increases with time spent awake, we examined with a proof-of concept pilot intervention whether a greater dose of time-in-bed (TiB) restriction (75% of habitual TiB) would increase both sleep efficiency and SWA in older adults with difficulties staying asleep without impairing memory performance.

In times of war, mental health professionals are at an increased risk of developing psychological problems, including posttraumatic stress disorder (PTSD). The effects of conflicts or wars on mental health professionals in Palestine and their coping methods of dealing with these challenges remain unknown. This study aimed to assess the prevalence of PTSD symptoms and strategies for coping among mental health professionals in Palestine, in light of the ongoing Gaza war and political violence.