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In non-Western societies, two-way communication between the bereaved and deceased is important in distinguishing adaptive versus maladaptive continuing bonds (CBs). We examined CBs expressed in dreams among Cambodian survivors during the Pol Pot era. Participants completed measures addressing dreams of the deceased, complicated grief (CG), and post-traumatic stress disorder (PTSD) symptoms. Participants who reported distressing dreams were more likely to have witnessed violent deaths of loved ones during the Pol Pot era and reported more severe CG and PTSD symptoms relative to those reporting other types of dreams. Distressing visitation dreams were shown to mediate the effect of violent loss on CG but not on PTSD. [ABSTRACT FROM AUTHOR]

Abstract: This study addressed the validity of the prolonged grief (PG) construct in a Cambodian context. Eighty mothers who lost a young adult daughter stemming from a crowd stampede incident during the annual water festival were interviewed at the six-month post-loss point along with a control group of similarly aged women who were not recently bereaved. Both groups were assessed for PG, PTSD, anxiety, and depression symptoms and well as for the number of distal losses experienced during the Khmer Rouge (KR) regime – knowing that all the women were old enough to have lived through the KR regime. Support for the discriminant validity of PG was shown in a factor analysis in which its core symptoms were distinguished from anxiety, depression, and PTSD symptoms. Also, support was found for its incremental validity as shown in the unique sensitivity of PG in distinguishing the two groups when controlling for the other symptoms. Lastly, a positive relationship was found between the number of distal deaths experienced during the KR regime and PG symptom severity among the group of recently bereaved mothers, providing support for the predictive validity of PG. Implications as well as study limitations are discussed. [Copyright &y& Elsevier]

The impact of parental styles in intergenerational transmission of trauma among mothers who survived the Khmer Rouge regime in Cambodia, in power from 1975 to 1979, and their teenaged children was examined in 2 studies. In Study 1, 46 Cambodian female high school students and their mothers were recruited. Each daughter completed anxiety and depression measures as well as assessment of her mother's role-reversing, overprotective, and rejecting parental styles, whereas the mothers completed measures of their trauma exposure during the Khmer Rouge regime and PTSD symptoms. In support of trauma transmission, the mother's PTSD symptoms were predictive of her daughter's anxiety. Moreover, the mother's role-reversing parental style was shown to mediate the relationship between her own and her daughter's symptoms. In support of their generalizability, the results were replicated in Study 2 in a Cambodian- American refugee sample comparing 15 mental health treatment-seeking mothers and their teenaged children with 17 nontreatment-seeking mother-child pairs. The implications of the findings within the larger literature on intergenerational trauma transmission stemming from genocide are discussed. [ABSTRACT FROM AUTHOR]

Abstract: This study examined the moderating role of self-esteem and neuroticism on the relationship between self-focused attention and mood using experience sampling methodology. 107 undergraduate participants were paged seven times each day over the course of a week and completed a set of measures that included items assessing current mood, focus of attention, and self-evaluative thoughts during these times. A significant within-person relationship was found between focus of attention and mood such that self-focus samplings were associated with a shift toward negative mood compared with samplings involving non-self-focus. As hypothesized, those with higher self-esteem and lower neuroticism showed less of a shift toward negative mood during self-focused attention relative to those with lower self-esteem and higher neuroticism. Moreover, the valence of self-evaluative thoughts during states of self-focused attention was shown to mediate the impact of these personality traits on mood. [Copyright &y& Elsevier]

This study examined the impact of changes in level of current grief over time on changes in memory for past grief. Following from previous work on the impact of current affective state on memory for past affectively salient events, bereaved individuals who underwent a greater reduction in grief over time were expected to show a similar pattern of changes in memory for past grief. A sample of conjugally bereaved participants completed measures of current grief and memory for past grief at the time of the loss of their spouse at each of the 2, 6, 13, and 30 month post-loss time periods. As predicted, those who reported greater reduction in grief over the course of the study were more likely to remember their past grief as progressively less severe relative to those who underwent less reduction in grief over time. A nonrecursive causal model analysis verified that changes in memory for past grief were explained by changes in current grief. These results were discussed in terms of contemporary reconstructive memory accounts of the effect of affective state on memory. [ABSTRACT FROM AUTHOR]

This study examined pre- and post-loss levels of posttraumatic stress symptoms (intrusion and avoidance) in partners of metastatic/recurrent breast cancer patients, and the relationship of these symptoms to past, current, and anticipatory stressors. The results indicate that 34% (17/50) of the partners experienced clinically significant symptom levels prior to the patients' deaths. Prior to loss, partners' symptoms were positively associated with their current level of perceived stress and anticipated impact of the loss; whereas following loss, partners' symptoms were predicted by higher pre-loss levels of symptoms, past family deaths, and anticipated impact of the loss. Limitations and treatment implications of the present research and directions for future research are discussed. Copyright © 2004 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

An attachment theory based perspective on the continuing bond to the deceased (CB) is proposed. The value of attachment theory in specifying the normative course of CB expression and in identifying adaptive versus maladaptive variants of CB expression based on their deviation from this normative course is outlined. The role of individual differences in attachment security on effective versus ineffective use of CB in coping with bereavement also is addressed. Finally, the moderating influence of type of loss (e.g., death of a spouse vs. child), culture, and religion on type of CB expression within an overarching attachment framework is discussed. [ABSTRACT FROM AUTHOR]

Clinicians have documented the importance of loss of comrades during combat as a significant source of distress. However, empirical studies have not focused on unresolved grief as a possible outcome of combat experiences. Consequently, unresolved grief has often been treated “after the fact” in the context of treating PTSD and depressive symptoms. In this study, we therefore, sought to demonstrate the prominence of combat-related grief-specific symptoms in a sample of Vietnam veterans being treated for PTSD. Our results indicated that indeed this sample of veterans reported high levels of grief-specific symptoms comparable to that found in bereaved individuals whose spouse had recently died, verifying its prominence as an important component of combat-related stress. Furthermore, grief severity was uniquely associated with losses of comrades during combat whereas no such relationship was shown for trauma or depressive symptoms. The latter finding suggested that in fact higher levels of grief stemmed from interpersonal losses during the war and was not simply an artifact of current general distress level. [Copyright &y& Elsevier]

This study examined the impact of acculturation, operationalized in terms of the number of years living abroad, on stress response to the Gujarat Earthquake among first-generation Indian immigrants living in a large United States urban center. The results indicated that Indians who had resided longer in the United States reported significantly lower intrusion and avoidance stress symptoms, independent of damage and injury to relatives and friends from the earthquake. Moreover, they reported less guilt over the suffering of the earthquake victims and a tendency toward less use of nonmaterial causal explanations, such as attributing the cause of the earthquake to a divine being. Finally, guilt was found to partly mediate the impact of acculturation on stress symptoms. The results are discussed in terms of the impact of acculturation on changes in the Indian worldview belief in nonmaterial causes of suffering and collectivist values. [ABSTRACT FROM AUTHOR]

Thirty-nine bereaved individuals completed the Continuing Bonds Scale (CBS), assessing various aspects of the ongoing attachment to the deceased, at 60 months postloss in a longitudinal conjugal bereavement study. They also completed symptom measures at 6, 14, 25, and 60 months postloss. Higher CBS scores were associated with a more elevated grief-specific symptom pattern over the 5-year postloss period. Moreover, those who expressed greater helplessness and less blame toward the deceased during a monologue role-play involving their deceased spouse at 6 months postloss had higher CBS scores. Finally, greater satisfaction in the past relationship with the spouse was predictive of higher CBS scores. The results were discussed in relation to existing literature on the adaptiveness of continuing bonds. [ABSTRACT FROM AUTHOR]

This study examined the relationship between sexual revictimization and interpersonal problems in a sample of adult survivors of childhood sexual abuse diagnosed with post-traumatic stress disorder. Fifty-two treatment-seeking women participated in this study. Research participants completed the Sexual Experiences Survey to assess sexual revictimization within the past 6 months and completed the Inventory of Interpersonal Problems (IIP). Revictimized participants reported overall greater interpersonal problems compared with nonrevictimized participants. Post hoc analyses showed significantly higher interpersonal problem scores for revictimized participants on the Hard to Be Assertive and Too Responsible subscales. On the circumplex IIP, revictimized participants were more socially avoidant, nonassertive, and overly nurturant. [ABSTRACT FROM AUTHOR]

This study examined the role of attachment style in adjustment to bereavement. Midlife bereaved individuals whose spouse had died in the previous year completed the Reciprocal Attachment Questionnaire (RAQ; West & Sheldon-Keller, 1994) and a measure assessing aspects of appraising and coping with the loss. They also were administered repeated symptom measures at 6, 14, 25, and 60 months post-bereavement. Complete symptom measures data over the course of the 5-year period were available for 32 participants. The RAQ compulsive care-seeking measure of anxious attach-ment was predictive of appraised inability to cope with the loss and of more severe symptomatology over the course of 5 years. Furthermore, appraised inability to cope with the loss was shown to mediate the relationship between compulsive care-seeking and symptoms. The RAQ compulsive self-reliance measure of avoidant attachment was not related to symptomatology, however. Finally, the RAQ angry withdrawal measure of ambivalent attachment was predictive of 6 and 14 months post-loss symptoms, but not of 25- or 60-month symp-toms. The differences in the pattern of findings for compulsive care-seeking and angry withdrawal are discussed in the context of previous findings in the bereavement literature on the role of dependency and ambivalence in bereavement-related adjustment. [ABSTRACT FROM AUTHOR]

At 6 months postloss, 37 midlife bereaved participants engaged in an empty-chair monologue role play involving their deceased spouses. Judges rated the extent of self- and deceased-blame in participants' monologue discourse, and forms of continuing attachment to the deceased were assessed. Participants completed outcome measures at 14, 25, and 60 months postloss. Self-blame was uniquely predictive of grief-specific symptoms across 60 months postloss. Furthermore, the relationship between self-blame and grief-specific symptoms was mediated by a maladaptive form of continuing attachment involving hanging onto the deceased's possessions. In contrast, deceased-blame was uniquely related to general symptoms at 14 months postloss but was not predictive of symptoms later on after the death. It was also negatively related to use of the fond memories form of continuing attachment. The results were interpreted in terms of differing motivational consequences of self- versus deceased-blame on the continuing attachment. [ABSTRACT FROM AUTHOR]

Traditional bereavement theories emphasize that it is crucial to work through the emotional meanings of a loss and that the failure to do so typically results in delayed grief symptoms. This article reports data examining these assumptions prospectively across the first 5 years of bereavement. Based on previous validity data, elevated symptoms were defined in terms of 6-month median scores for each measure. Delayed elevations were observed on isolated measures for 3 (7%) participants. However, these elevations were more parsimoniously explained by random measurement error Furthermore, when a weighted grief-depression composite score was used to maximize the probability of capturing the true (latent) grief variable, not a single case of delayed symptom elevations was observed. Finally, data on emotional processing of the loss at 6 months failed to support the traditional assumption that minimal emotional processing of the loss would lead to delayed grief. [ABSTRACT FROM AUTHOR]

Examines the impact of subjective and objective expectancy of spousal death on adjustment to conjugal bereavement in a study conducted in the San Francisco Bay Area, California. Symptoms of depression; Differences in the response of each widowed person; Perspective of a stressful life event.

Bereaved individuals who had lost a spouse through death (on average 7.2 months previously) engaged in an “empty-chair” monolog task in which they imagined that they had one last opportunity to speak to their deceased spouse. The verbal content of their monolog speech was rated by judges on the appraisal categories deceased as blameworthy and self as blameworthy. As predicted, deceased as blameworthy was associated with greater anger toward the deceased, whereas self as blameworthy was related to greater guilt on a repeated measure assessing affective experience when thinking about the deceased in daily life. In addition, these appraisal categories were positively correlated with measures of symptomatic distress; specifically, deceased as blameworthy was related to general psychological symptoms, whereas self as blameworthy correlated with grief-specific symptoms. Furthermore, deceased as blameworthy was predictive of 14 months post-loss general psychological distress symptoms when statistically controlling for these symptoms at the time of the monolog in a hierarchical regression analysis, thus providing support for its mediating role in later adjustment. The implications of the findings for the assessment of grief outcome and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Examines the role of continuing attachment in adjustment to conjugal loss. Assessment of different forms of continuing attachment at six months postloss; Engagement in monologue role-play with deceased spouse; Behavioral measure of grief-related distress; Correlation between the use of spouse's possessions to gain comfort with concurrent distress in role-play.

A semantic space perspective on representations of self and other was applied to investigate the perceived quality of the past relationship with the spouse in relation to adjustment in conjugal bereavement. According to this perspective, the proximity, or extent to which representations of self and others share similar trait content features, may have important affective implications. Forty-seven bereaved individuals rated different representations of themselves and important others on a set of idiographic features as a basis for determining proximities among the representations. Proximities addressing the quality of the past relationship with the spouse were predictive of the extent and type of blame-related emotions (anger versus guilt) aroused in an empty-chair role-play involving their deceased spouse. These proximities were also predictive of the SCL-90-R global severity index measure of psychological adjustment, and the results indicated that this relationship was partly mediated by the blame-related emotions in the role-play. [ABSTRACT FROM AUTHOR]

Assesses unresolved grief and its relation to later adjustment using the Gestalt empty-chair technique. Procedure of the Gestalt empty-chair technique; Description of the monologue questionnaire measure; Assessment of the presence and severity of various affective, cognitive, motivational, vegetative and psychomotor symptoms of depression.

Objective: This exploratory study examined the self representations of 27 women sexually abused in childhood and their association with symptomatology. Method: Twenty-seven self-identified female survivors of childhood sexual abuse completed the Trauma Symptom Checklist-40, Beck Depression Inventory, State-Trait Anxiety Inventory and a measure designed to elicit subjects' self-generated descriptors of selves. Results: Discrepancies in views of current self when compared to ideal or future selves were positively correlated with all symptom measures. Discrepancies in representations of current self compared to views of who they were when they were with their perpetrator were negatively correlated with trait anxiety. Self integration, as defined in this study, was negatively correlated with symptoms. Conclusions: This study suggests that cognitive representations of self are an important indicator of adjustment in survivors of childhood sexual abuse. [ABSTRACT FROM AUTHOR]

This article describes a semantic space model of personality. According to the model, representations of facets of the self (e.g., actual self, ideal self) and of others are arrayed in a semantic space, with proximities among representations predicted to be associated with mood, self-evaluation, and broad personality dimensions. The relation of proximities among pairs of representations to personality and mood measures was found to be mediated by the spatial proximity of other representations, indicating that the representations constitute dynamic systems. Proximities among representations were shown to predict self-esteem and self-evaluative moods even after controlling for the contribution of the personality dimensions of Neuroticism, Extraversion, and Agreeableness. Generally, the semantic space model led to better predictions than did several related models concerning representations of self and other. [ABSTRACT FROM AUTHOR]

The impact of chronic trauma can be longstanding, affecting survivor affect regulation, consciousness, interpersonal functioning, perceptions of self and others, self-regulation, and somatic experience. There is a growing consensus that multimodal and staged approaches to treatment are necessary to promote healing. However, empirical investigations of such treatments are still needed. The current study used a naturalistic design to examine the impact of a brief, yet intensive, outpatient program on complex PTSD symptoms and attachment classification among women with histories of chronic trauma. Fifty-four women were assessed and followed over an 8-week intervention and six-month follow-up. Significant improvement over time was found for PTSD symptoms, dissociation, emotion regulation, interpersonal problems, sexual problems, alexithymia, and posttraumatic growth. Nearly, all women met criteria for PTSD at baseline, a third of the women who completed the measures no longer had PTSD post-treatment, and 60% showed a clinically significant reduction in PTSD symptoms. Finally, thirty-six women were classified as unresolved on the Adult Attachment Projective. Post-treatment, nine of 26 women who provided follow-up data were no longer classified as unresolved. Notably, those women whose attachment category changed also showed the greatest improvement in all other outcomes. Altogether, these findings suggest that an intensive, stage 1, and multimodal treatment program can benefit women with histories of chronic traumatization. [ABSTRACT FROM PUBLISHER]

This article presents findings from a study on the impact of a child's death on parents. We explored the prominence and adaptiveness of parents' continuing bonds expressions, psychological adjustment, and grief reactions. A qualitative case study methodology was used to describe six cases. Participants were classified into two groups based on scores on the Inventory of Complicated Grief. Commonalities in themes on the Continuing Bonds Interview and projective drawings were assessed. Those in the Non-Complicated Grief Group reported internalization of positive qualities and identification with the deceased child as a role model, whereas participants in the Complicated Grief Group did not report these experiences. In addition, the drawings of those in the Non-Complicated Grief Group were evaluated as more adaptive than those in the Complicated Grief Group. [ABSTRACT FROM AUTHOR]

At 6 months following the death of their spouse, 37 participants reported their grief-related symptoms and thoughts, and then, approximately 4.5 years later, they attempted to recall how they felt at the time of the 6-month report. Although participants were far less distressed at recall than initially, they recalled their 6-month grief rather accurately. Participants did however overestimate prior grief-related intrusive ideation. Participant's current level of grief predicted what they recalled slightly better than the actual initial grief. Conversely, what they recalled predicted current levels of grief across various measures. Participants whose grief diminished relatively little over time tended to overestimate prior grief more. The retrospective reappraisal that one's past grief was not severe may indicate effective coping. [ABSTRACT FROM AUTHOR]

The current study examined Posttraumatic Growth (PTG) experienced by bereaved pet owners in the United States, French-Canada, Japan, and Hong Kong following the death of their pet. Using qualitative methodology, we analyzed responses of participants who answered "yes" to a question about experiencing PTG and explored to what extent the cross-cultural responses mapped onto the five factors of the Posttraumatic Growth Inventory (PTGI). For the U.S. sample, 58% of responses mapped onto the PTGI. For French-Canada, 72% of responses mapped onto the PTGI. For Japan, 50% of responses mapped onto the PTGI and for Hong Kong, 39% of responses mapped onto the PTGI. We also explored emergent categories related to PTG for individuals who have lost a pet and discerned the unique aspects for PTG across cultures. [ABSTRACT FROM AUTHOR]

Research demonstrates that children exposed to domestic violence experience a myriad of internalising and externalising symptoms. The current study examines this pathway within a Cambodian sample, specifically determining if the effect of witnessing domestic violence on the child’s tendency to bully or to be bullied is mediated by symptoms of posttraumatic stress disorder (PTSD). The PTSD Checklist - Civilian Version, a revised version of a12-item bullying and victimisation questionnaire, and the Revised Conflict Tactics Scale were administered to 206 high school students in Phnom Penh. A significant mediational effect of PTSD symptoms was found for victimisation (being bullied); no such mediational model was supported for bullying as the outcome variable. However, controlling for emotional, physical, and sexual child abuse resulted in the mediation effect being non-significant. Implications and directions for future research are discussed. [ABSTRACT FROM AUTHOR]

Research has shown that pet loss can be a devastating and complex experience for some human survivors, yet this loss may not be fully recognized by friends, partners, or acquaintances as a significant bereavement. The objectives of the current study were to consider how continuing bonds (CB) expressions relate to psychosocial functioning and to identify perceived social constraints as well as areas of resilience associated with efforts to cope with recent pet loss. Through an anonymous online survey, participants (n= 4,336) who had lost a pet to death within the past year were recruited via bereavement support groups and associated websites across the US. Findings in this severely bereaved sample demonstrated the utilization of a wide range of CB (e.g., reflecting on fond memories, holding onto possessions), which were experienced as comforting or distressing to varying extents across the sample. In addition, social constraints were associated with more negative mental health and functional outcomes, while post traumatic growth was in some cases associated with lower mental health and functional complaints. Results are discussed in terms of similarities in patterns of bereavement in human and pet loss samples as well as the importance of considering likely idiosyncratic patterns of response to loss. For example, distress and comfort associated with different efforts to maintain a connection to a deceased pet may occur simultaneously. Given the cross-sectional nature of the current study, experimental and longitudinal research is recommended to determine whether increasing CB efforts experienced as comforting may be a potentially adaptive, growth-enhancing aspect of bereavement. [ABSTRACT FROM PUBLISHER]

The current study examined posttraumatic growth (PTG) experienced by bereaved pet owners following the death of their pet. Using qualitative methodology, we analyzed responses of 308 participants who answered yes to a question about experiencing PTG. Within the five factors model of PTG, the most endorsed included the following: Relating to Others (n=76), Appreciation of Life (n=52), Personal Strength (n=51), Spiritual Change (n=32), and New Possibilities (n=29). Other themes not captured by the PTG included as follows: relating to animals (n=70), continuing bonds (n=53), attachment relationship (n=44), and unconditional love (n=13). Our findings support the notion that PTG occurs for people who have experienced pet loss, with new emergent themes. [ABSTRACT FROM AUTHOR]

Objectives: Ambulatory assessment data collection methods are increasingly used to study behavior, experiences, and patient-reported outcomes (PROs), such as emotions, cognitions, and symptoms in clinical samples. Data collected close in time at frequent and fixed intervals can assess PROs that are discrete or changing rapidly and provide information about temporal dynamics or mechanisms of change in clinical samples and individuals, but clinical researchers have not yet routinely and systematically investigated the reliability and validity of such measures or their potential added value over conventional measures. The present study provides a comprehensive, systematic evaluation of the psychometrics of several proximal intensive assessment (PIA) measures in a clinical sample and investigates whether PIA appears to assess meaningful differences in phenomena over time.Methods: Data were collected on a variety of psychopathology constructs on handheld devices every 4 h for 7 days from 62 adults recently exposed to traumatic injury of themselves or a family member. Data were also collected on standard self-report measures of the same constructs at the time of enrollment, 1 week after enrollment, and 2 months after injury.Results: For all measure scores, results showed good internal consistency across items and within persons over time, provided evidence of convergent, divergent, and construct validity, and showed significant between- and within-subject variability.Conclusions: Results indicate that PIA measures can provide valid measurement of psychopathology in a clinical sample. PIA may be useful to study mechanisms of change in clinical contexts, identify targets for change, and gauge treatment progress. [ABSTRACT FROM AUTHOR]

The current cross-cultural study investigated grief reactions of bereaved individuals following the death of a pet. We used qualitative methodology to compare, analyze, and report responses of U.S. and French Canadian participants to the last open-ended question on our online pet loss survey. We explored the degree to which our data illustrated pet loss as disenfranchised grief and asked whether there are differences and commonalities in the expression of grief between the two samples. Four major themes emerged: lack of validation and support; intensity of loss; nature of the human pet relationship; and continuing bonds. Findings confirm that, for both the U.S. and French Canadian participants, pet loss is often disenfranchised grief and there are ways to facilitate expressions of grief. Many participants wrote that the survey was therapeutic. Our survey allowed participants to express their grief in an anonymous, safe way by serving as empathic bridging and a willingness to help others. [ABSTRACT FROM AUTHOR]

The article discusses a study which assessed the correlation of posttraumatic stress disorder (PTSD) and disability with perceived justice, desire for revenge and knowledge and attitudes toward the trials among adults in Cambodia. The study assembled a national probability sample of 1017 adults in Cambodia who had been exposed and had not been exposed to the Khmer Rouge era, and interviews were conducted with them between December 2006 and August 2007. It was revealed that the probable PTSD prevalence was 11.2% overall, 7.9% in the younger group and 14.2% in the older group. The study also concluded that probable PTSD was associated with mental disability.

Context: Millions of Cambodians suffered profound trauma during the Khmer Rouge era (1975 to 1979). A joint United Nations-Cambodian tribunal (the "Khmer Rouge trials") was empanelled in 2006 to prosecute top Khmer Rouge leaders and began substantive hearings in March 2009.Objectives: To establish the prevalence of probable posttraumatic stress disorder (PTSD) among adult Cambodians and to assess correlates of PTSD symptoms and disability with perceived justice, desire for revenge, and knowledge of and attitudes toward the trials.Design, Setting, and Participants: A national probability sample of 1017 Cambodians was assembled using a multistage, stratified cluster design, including 813 adults older than 35 years who had been at least 3 years old during the Khmer Rouge era and 204 adults aged 18 to 35 years who had not been exposed to the Khmer Rouge era. Face-to-face interviews were conducted between December 2006 and August 2007.Main Outcome Measures: Prevalence of probable PTSD using the PTSD Checklist, Civilian version (cutoff score of 44), and mental and physical disability using the Medical Outcomes Study 12-item Short Form Health Survey.Results: The prevalence of current probable PTSD was 11.2% (95% confidence interval [CI], 8.6%-13.9%) overall and 7.9% (95% CI, 3.8%-12.0%) among the younger group and 14.2% (95% CI, 11.0%-17.3%) in the older group. Probable PTSD was significantly associated with mental disability (40.2% vs 7.9%; adjusted odds ratio [AOR], 7.80; 95% CI, 3.90-15.60) and physical disability (39.6% vs 20.1%; AOR, 2.60; 95% CI, 1.26-5.39). Although Cambodians were hopeful that the trials would promote justice, 87.2% (n = 681) of those older than 35 years believed that the trials would create painful memories for them. In multivariate analysis, respondents with high levels of perceived justice for violations during the Khmer Rouge era were less likely to have probable PTSD than those with low levels (7.4% vs 12.7%; AOR, 0.54; 95% CI, 0.34-0.86). Respondents with high levels of desire for revenge were more likely to have probable PTSD than those with low levels (12.0% vs 7.2%), but the difference was not statistically significant in the multivariate analysis (AOR, 1.76; 95% CI, 0.99-3.11).Conclusions: Probable PTSD is common and associated with disability in Cambodia. Although Cambodians had positive attitudes toward the trials, most were concerned that the trials would bring back painful memories. Now that the trials have begun, longitudinal research is needed to determine the impact of the trials on Cambodians' mental health. [ABSTRACT FROM AUTHOR]