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ABSTRACTBackground: Resilience is a modulating factor in the development of PTSD and CPTSD after exposure to traumatic events. However, the relationship between resilience and ICD-11 CPTSD is not adequately understood in survivors of intimate partner violence (IPV).Objective: The aim of this study is to determine whether resilience has a mediating role in the relationship between severity of violence and severity of CPTSD symptoms.Method: A sample of 202 women IPV survivors completed self-rated questionnaires to assess CPTSD, severity of violence and resilience.Results: Mediation analyses indicated that there was a direct relationship between the severity of violence and the severity of CPTSD symptoms (β = .113, p

In an era of high need for humanitarian assistance, humanitarian aid workers face increased exposure to potentially traumatic events and, correspondingly, a greater risk of psychological distress (e.g., anxiety, depression, posttraumatic stress disorder [PTSD], and burnout). Less studied among humanitarian workers, however, are other known correlates of trauma-exposure: complex PTSD, risk-taking behaviours, and suicidality. The current study examined levels of trauma exposure and rates of trauma-related mental health disorders, risk-taking behaviour, and levels of suicidality among a sample (N = 232) of humanitarian workers located across 52 countries. Multiple linear regression analysis was used to determine which demographic (i.e., sex, age, cadre, years working as an aid worker), psychological (i.e., social support, personality traits), and trauma-related (trauma exposure, complex posttraumatic stress disorder [CPTSD] symptoms, and dissociation) variables were uniquely associated with risk-taking behaviours and suicidality. Overall, 12.9 % (95 % CI = 8.5 %, 17.2 %) of humanitarian workers met the diagnostic requirements for PTSD, and 8.6 % (95 % CI = 5.0 %, 12.2 %) met requirements for CPTSD. Higher risk-taking behaviours were significantly associated with being male, an international worker, greater trauma exposure, extraversion, neuroticism, and CPTSD symptoms. Suicidality was significantly associated with being an international staff member and higher levels of dissociation. Results are consistent with previous studies citing a high risk of psychological distress among humanitarian workers. Humanitarian aid agencies have a duty of care to their workers - both professional and volunteer - and greater safeguarding measures are necessary to mitigate the risk to mental health brought on by humanitarian work-related stressors.

During the postpartum period, fathers may be at risk of increased stress and loneliness, which may be offset or buffered by the provision of social support. This study aimed to explore fathers’ postpartum experiences of loneliness, perceived stress, and social support. A constructivist grounded theory approach was used to inform study design and analysis. Semistructured interviews were conducted to collect data from 12 fathers, living in the Republic of Ireland, who had an infant aged 6 months or younger. A grounded theory entitled “support for the supporter,” describing fathers’ experiences with social support, and loneliness during the postpartum period, was derived. Participants described experiencing increased financial pressure and having difficulty balancing the role of “breadwinner” with fatherhood. Participants described feeling excluded from maternity care and lacked avenues for information within the Irish health care system. Participants linked their experiences of loneliness to the lack of social support in the postpartum period. This study offers a novel insight into Irish fathers’ experiences with maternity care during the COVID-19 pandemic. This study is the first to qualitatively explore paternal postpartum loneliness and provides a good foundation for future research and intervention in this area. Findings suggest that it would be wise to promote social support from other experienced fathers, friends, family, and from partners to reduce paternal postpartum loneliness.

Abstract The aim was to assess the level of subjective control of emotional states among patients treated for dermatological and gastrointestinal somatic diseases compared to those with depressive and anxiety disorders. The results were related to the analyzed dimensions of emotion regulation in healthy subjects. Materials and methods The reports of the conducted studies were compiled for a total of 310 people, including 120 patients diagnosed with a somatic disease (psoriasis, rosacea, irritable bowel syndrome, and gastroesophageal reflux), as well as 96 patients diagnosed with depressive disorders and 30 patients with anxiety disorders. The control group consisted of healthy subjects (64 individuals). To assess the psychological variables analyzed, the subjects completed the Emotion Regulation Questionnaire developed by J. Brzeziński. Results The study showed that the patients suffering from a chronic somatic symptom disorder, similarly to those treated for depression and anxiety disorders, differed from the healthy individuals in most aspects of emotional control. The patients with dermatological and gastrointestinal diseases differed statistically significantly from the patients with depression and the patients with anxiety disorders in relation to three dimensions of emotional control. Patients with a somatic disease are characterized by higher emotional and rational motivation, lower emotional resilience and lower emotional arousal. Conclusions A chronic disease co-occurs with the emotional sphere of a person’s daily functioning. Regardless of the diagnosis in terms of somatic disorders and mental illnesses, the way in which emotional states are controlled can be an important factor in the onset of the disease, coping with it as well as the treatment process.

Abstract Background Very little is known about the mental health of the adult population of Ukraine following Russia’s full-scale invasion in February 2022. In this study, we estimated the prevalence of seven mental health disorders, the proportion of adults screening positive for any disorder, and the sociodemographic factors associated with meeting requirements for each and any disorder. Methods A non-probability quota sample (N = 2,050) of adults living in Ukraine in September 2023 was collected online. Participants completed self-report questionnaires of the seven mental health disorders. Logistic regression was used to determine the predictors of the different disorders. Results Prevalence estimates ranged from 1.5% (cannabis use disorder) to 15.2% (generalized anxiety disorder), and 36.3% screened positive for any of the seven disorders. Females were significantly more likely than males (39.0% vs. 33.8%) to screen positive for any disorder. Disruption to life due to Russia’s 2014 invasion of Ukraine, greater financial worries, and having fewer positive childhood experiences were consistent risk factors for different mental health disorders and for any or multiple disorders. Conclusion Our findings show that approximately one in three adults living in Ukraine report problems consistent with meeting diagnostic requirements for a mental health disorder 18 months after Russia’s full-scale invasion. Ukraine’s mental healthcare system has been severely compromised by the loss of infrastructure and human capital due to the war. These findings may help to identify those most vulnerable so that limited resources can be used most effectively.

ABSTRACTBackground: Grief is a multi-faceted experience including emotional, social, and physical reactions. Research in ICD-11 prolonged grief disorder (PGD) in different cultural contexts has revealed different or potentially missing grief symptoms that may be relevant.Objective: This study thus aimed to explore the prevalence of somatic symptom distress and its associations with grief and negative affect in a culturally diverse sample of bereaved individuals with symptoms of PGD.Methods: Based on cross-sectional survey data from the Measurement and Assessment of Grief (MAGIC) project, this study included 1337 participants (mean age 23.79 yrs, 76.1% female) from three regions (USA: 62.3%, Turkey/Iran: 24.2%, Cyprus/Greece: 13.5%), who experienced a loss of a significant other. Associations between somatic symptom distress (Somatic Symptom Scale, SSS-8), symptoms of PGD (International Prolonged Grief Disorder Scale, IPGDS-33), anxiety (Generalized Anxiety Disorder Questionnaire, GAD-7), depression (Patient Health Questionnaire, PHQ-9) as well as demographic and loss related characteristics were investigated. Three hundred and thirteen participants (23.4%) scored above the proposed cut-off for clinically severe PGD.Results: ‘High’ or ‘very high’ levels of somatic symptom distress were more frequent in a possible PGD group (58.2%), than in a non-PGD group (22.4%), p

Introduction: Loneliness is linked to negative physical and mental health outcomes. Therefore, it is important to employ reliable and valid screening measures for early detection and treatment. A widely used scale for assessing loneliness is the shortened six-item Jong Gierveld Loneliness Scale (DJGLS-6). Aims: To review and evaluate the factor structure of the DJGLS-6. Methods: Study 1 was a systematic review. To examine the factor structure of the DJGLS-6, peer-reviewed studies were reviewed in accordance with PRISMA guidelines. Study 2 tested the factor analytic models found in Study 1. Confirmatory factor analysis (CFA) was performed using data from a nationally representative sample of adults to assess the latent structure of the six-item scale. Results: In Study 1, findings from the two papers reviewed suggested that the scale measures two correlated dimensions: social and emotional loneliness. This finding was consistent with the results of Study 2. However, the fit statistics for the one and two-factor CFA models were not acceptable. Modification indices indicated that adding a cross-factor loading to allow item 2 (“I miss having people around”) of the social loneliness factor, to load on both the emotional and social factor, to load on both the emotional and social factors would significantly improve the fit of the model. Conclusions: The analysis failed to support previous findings concerning the robustness of the subscales. We recommend performing future evaluations of the scale and for the authors to consider changing item 2 accordingly.

Background: The 11th version of the International Classification of Diseases (ICD-11) included revised formulations of single episode depressive disorder (DD) and generalized anxiety disorder (GAD). Consequently, the International Depression Questionnaire (IDQ) and International Anxiety Questionnaire (IAQ) have been developed as self-report measures which directly align with the ICD-11 description of DD and GAD, respectively. Objective: The current study sought to (1) test the factorial validity of the Turkish translations of the IDQ and IAQ, (2) evaluate their internal reliability, (3) determine how meeting diagnostic requirements for ICD-11 DD and ICD-11 GAD vary across different demographic variables, and (4) determine the convergent validity of the Turkish translations of the IDQ and IAQ. Methods: Participants were a community sample of 1455 Turkish adults and largely comprised of university students. This study used confirmatory factor analysis (CFA) to test the latent structure of both scales. Prevalence rates of ICD-11 GAD and DD were also estimated, and differences in prevalence rates according to gender and relationship status were examined. Results: The CFA results indicated that both scales were unidimensional. Both scales demonstrated high levels of internal consistency. The prevalence of ICD-11 DD and GAD was 26.6 % and 28.5 %, respectively. Rates of probable ICD-11 DD and GAD were highest for females and single participants. Convergent validity was indicated by strong associations with external measures of depression and anxiety. Conclusion: Findings from this study provide support for the validity and reliability of the Turkish versions of the IDQ and IAQ in a large community sample.

Abstract Background Understanding how pandemics differentially impact on the socio-protective and psychological outcomes of males and females is important to develop more equitable public health policies. We assessed whether males and females differed on measures of major depression and generalized anxiety during the COVID-19 the pandemic, and if so, which sociodemographic, pandemic, and psychological variables may affect sex differences in depression and anxiety. Methods Participants were a nationally representative sample of Irish adults (N = 1,032) assessed between April 30th to May 19th, 2020, during Ireland’s first COVID-19 nationwide quarantine. Participants completed self-report measures of anxiety (GAD-7) and depression (PHQ-9), as well as 23 sociodemographic pandemic-related, and psychological variables. Sex differences on measures of depression and anxiety were assessed using binary logistic regression analysis and differences in sociodemographic, pandemic, and psychological variables assessed using chi-square tests of independence and independent samples t-tests. Results Females were significantly more likely than males to screen positive for major depressive disorder (30.6% vs. 20.7%; χ 2 (1) = 13.26, p

Abstract Objectives Established in March 2020, the C19PRC Study monitors the psychological and socio‐economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 6 (August–September 2021). Methods The survey assessed: COVID‐19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adult participants from any previous wave (N = 3170) were re‐invited, and sample replenishment procedures helped manage attrition. Weights were calculated using a survey raking algorithm to ensure the on‐going original panel (from baseline) was nationally representative in terms of gender, age, and household income, amongst other factors. Results 1643 adults were re‐interviewed at Wave 6 (51.8% retention rate). Non‐participation was higher younger adults, those born outside UK, and adults living in cities. Of the adults recruited at baseline, 54.3% (N = 1100) participated in Wave 6. New respondent (N = 415) entered the panel at this wave, resulting in cross‐sectional sample for Wave 6 of 2058 adults. The raking procedure re‐balanced the longitudinal panel to within 1.3% of population estimates for selected socio‐demographic characteristics. Conclusions This paper outlines the growing strength of the publicly available C19PRC Study data for COVID‐19‐related interdisciplinary research.

Abstract Background The Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder scale (GAD-7) are self-report measures of major depressive disorder and generalised anxiety disorder. The primary aim of this study was to test for differential item functioning (DIF) on the PHQ-9 and GAD-7 items based on age, sex (males and females), and country. Method Data from nationally representative surveys in UK, Ireland, Spain, and Italy (combined N = 6,054) were used to fit confirmatory factor analytic and multiple-indictor multiple-causes models. Results Spain and Italy had higher latent variable means than the UK and Ireland for both anxiety and depression, but there was no evidence for differential items functioning. Conclusions The PHQ-9 and GAD-7 scores were found to be unidimensional, reliable, and largely free of DIF in data from four large nationally representative samples of the general population in the UK, Ireland, Italy and Spain.

Abstract Background Early studies of common mental disorders (CMDs) during the COVID-19 pandemic mainly report increases; however, more recent findings have been mixed. Also, studies assessing the effects of restriction measures on CMDs show varied results. The aim of this meta-analysis was to assess changes in levels of CMDs from pre-/early to during the pandemic and the effects of restriction policies in the European population. Methods We searched for studies assessing both pre-pandemic and peri-pandemic self-reported emotional distress and symptoms of depression or anxiety among nationally/regionally representative samples in Europe and collected microdata from those studies. Estimates of corona containment index were related to changes in CMDs using random-effects meta-regression. Results Our search strategy resulted in findings from 15 datasets drawn from 8 European countries being included in the meta-analysis. There was no evidence of change in the prevalence of emotional distress, anxiety, or depression from before to during the pandemic; but from early pandemic periods to later periods, there were significant decreases in emotional distress and anxiety. Increased school restrictions and social distancing were associated with small increases in self-reported emotional distress. Conclusions Despite initial concerns of increased emotional distress and mental illness due to the COVID-19 pandemic, the results from this meta-analysis indicate that there was a decrease in emotional distress and no change in anxiety or depression in the general population in Europe. Overall, our findings support the importance of strong governance when implementing periodic and robust restriction measures to combat the spread of COVID-19.

Abstract Objectives The COVID‐19 Psychological Research Consortium (C19PRC) Study was established in March 2020 to monitor the psychological and socio‐economic impact of the pandemic in the UK and other countries. This paper describes the protocol for Wave 5 (March–April 2021). Methods The survey assessed: COVID‐19 related experiences; experiences of common mental health disorders; psychological characteristics; and social and political attitudes. Adults who participated in any previous wave (N = 4949) were re‐invited to participate. Weights were calculated using a survey raking algorithm to ensure the longitudinal panel was nationally representative in terms of gender, age, and household income, amongst other factors. Results Overall, 2520 adults participated. A total of 2377 adults who participated in the previous survey wave (November–December 2020) were re‐interviewed at Wave 5 (61.5% retention rate). Attrition between these two waves was predicted by younger age, lower household income, children living in the household, and treatment for mental health difficulties. Of the adults recruited into the C19PRC study at baseline, 57.4% (N = 1162) participated in Wave 5. The raking procedure re‐balanced the longitudinal panel to within 1.5% of population estimates for selected socio‐demographic characteristics. Conclusion This paper outlines the growing strength of the publicly available C19PRC Study data for COVID‐19‐related interdisciplinary research.

Paranoia and conspiracy are terms typically used interchangeably. However, although the underlying content of these types of beliefs might be similar (e.g., seeing others as powerful and threatening), recent research suggests that these constructs differ in important ways. One important feature shared by both constructs is excessive mistrust but this aspect might play different roles in each belief system. In this study we explored the strength of associations of different trust predictors (i.e., trust in institutions, trust in sources of information, perceptual trust, and interpersonal trust) between conspiracy mentality and paranoid beliefs. We tested this association in a large representative multinational sample (United Kingdom n = 2025; Spain n = 1951; and Ireland n = 1041). Confirmatory factor analysis supported a two-factor model of conspiracy and paranoid beliefs in each nation sample. Path and equality of constraints analysis revealed that paranoia was more strongly associated with perceptual mistrust (bias towards mistrusting unfamiliar faces) whereas conspiracy was more strongly associated with mistrust in political institutions. Although interpersonal mistrust and trust in social sources of information were associated significantly with conspiracy their association with paranoid beliefs was stronger. These findings clarify the role of different trust processes in both belief systems. Limitations of this study are discussed.

Abstract The COVID-19 pandemic has brought about unprecedented global changes in individual and collective behaviour. To reduce the spread of the virus, public health bodies have promoted social distancing measures while attempting to mitigate their mental health consequences. The current study aimed to identify cognitive predictors of social distancing adherence and mental health symptoms, using computational models derived from delay discounting (the preference for smaller, immediate rewards over larger, delayed rewards) and patch foraging (the ability to trade-off between exploiting a known resource and exploring an unknown one). In a representative sample of the UK population (N = 442), we find that steeper delay discounting predicted poorer adherence to social distancing measures and greater sensitivity to reward magnitude during delay discounting predicted higher levels of anxiety symptoms. Furthermore, under-valuing recently sampled information during foraging independently predicted greater violation of lockdown guidance. Our results suggest that those who show greater discounting of delayed rewards struggle to maintain social distancing. Further, those who adapt faster to new information are better equipped to change their behaviour in response to public health measures. These findings can inform interventions that seek to increase compliance with social distancing measures whilst minimising negative repercussions for mental health.

Hesitancy and resistance towards vaccination is a challenge for public health. Here the authors determine psychological characteristics associated with COVID-19 vaccine hesitancy or resistance attitudes in the UK and Ireland.

The beginning of the COVID-19 pandemic had a profound effect on all aspects of daily life and triggered a swell of anxiety across the world. Some suggest this emotional response to the pandemic can be explained through death anxiety (DA), a transdiagnostic dimension associated with numerous psychological disorders. However, it remains unclear as to whether DA is a unidimensional or multidimensional construct. The primary aim of this study was to examine the underlying structure of the Death Anxiety Inventory-Revised (DAI-R; Tomás-Sábado et al., 2005) and assess its associations with mental health and demographic variables during the COVID-19 pandemic. To achieve these aims, we utilized data from Waves 1 (N = 2205: collected between March 23 and March 28, 2020) and 2 (N = 1406: collected between April 22 and May 1, 2020) of the COVID-19 Psychological Research Consortium (C19PRC), a multi-wave nationally representative study. Results showed that a 4-factor model provided the best fit to the data compared to a unidimensional and 4-factor second-order model. Further analyses showed that DA at Wave 1 was positively associated with somatic symptoms, paranoia, depression, anxiety, and traumatic stress symptoms at Wave 2, supporting previous research that suggests that the fear of death is predictive of psychopathology. Significantly, the factor labelled ‘Thoughts about Death’ at Wave 1 was the strongest predictor of the five main psychological variables at Wave 2, after statistically controlling for the other latent variables. These findings highlight the transdiagnostic nature of DA and support this important diagnostic construct becoming a measure of mental health more generally within the population. It is hoped that this research will shine a light on those suffering from DA and become a catalyst for increased therapeutic intervention, funding, and research in this area.

The 11th revision of the International Classification of Diseases has endorsed substantial changes in Post-Traumatic Stress Disorder (PTSD) and has introduced Complex PTSD (cPTSD). The objective of this study was to assess the symptom and network structure of PTSD and cPTSD using the International Trauma Questionnaire- Italian version (ITQ) and the prevalence of PTSD and cPTSD in a community sample of late adolescents enriched with exposure to a destructive earthquake. A 1,010 high school students participated to the study. Confirmatory Factor Analysis supports that a six first-order correlated factors was the best fitting model of ICD-11 PTSD/cPTSD. The network analysis supports a clear separation between core PTSD symptoms and disturbances in self-organization (DSO) symptoms, avoidance, and negative self-concept were the most central items. The prevalence of PTSD and cPTSD was 9.11 and 4.06%, respectively. Female participants reported higher rates of both PTSD and cPTSD. This is the first study to report on ICD-11 PTSD and cPTSD rates on an Italian adolescence community sample. Consistent with other community samples, we found higher rates of PTSD compared to cPTSD. The results confirmed the factorial validity of the ITQ. The network structure highlights the importance of negative self-concept in cPTSD and avoidance in PTSD.

Abstract Objectives This paper outlines fieldwork procedures for Wave 4 of the COVID‐19 Psychological Research Consortium (C19PRC) Study in the UK during November–December 2020. Methods Respondents provided data on socio‐political attitudes, beliefs, and behaviours, and mental health disorders (anxiety, depression, and posttraumatic stress). In Phase 1, adults (N = 2878) were reinvited to participate. At Phase 2, new recruitment: (i) replenished the longitudinal strand to account for attrition; and (ii) oversampled from the devolved UK nations to facilitate robust between‐country analyses for core study outcomes. Weights were calculated using a survey raking algorithm to ensure the longitudinal panel was representative of the baseline sample characteristics. Results In Phase 1, 1796 adults were successfully recontacted and provided full interviews at Wave 4 (62.4% retention rate). In Phase 2, 292 new respondents were recruited to replenish the panel, as well as 1779 adults from Wales, Scotland, and Northern Ireland, who were representative of the socio‐political composition of the adult populations in these nations. The raking procedure successfully re‐balanced the longitudinal panel to within 1% of population estimates for selected socio‐demographic characteristics. Conclusion The C19PRC Study offers a unique opportunity to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID‐19 pandemic.

This paper serves to alert IJPDS readers to the availability of a major new longitudinal survey data resource, the COVID-19 Psychological Research Consortium (C19PRC) Study, which is being released for secondary use via the Open Science Framework. The C19PRC Study is a rich and detailed dataset that provides a convenient and valuable foundation from which to study the social, political, and health status of European adults during an unprecedented time of change as a direct result of the COVID-19 pandemic and Brexit. Here, we provide an overview of the C19PRC Study design, with the purpose of stimulating interest about the study among social scientists and maximising use of this resource.

Objectives This study examined the association between perceived manageability of debt and risk of depression, anxiety, and mental health help-seeking among a nationally representative sample of adults living in the United Kingdom (UK). Methods Data was derived from the COVID-19 Psychological Research Consortium (C19PRC) Study Wave 6 (August/September 2021) which examined the psychological, social, and economic effects of the COVID-19 pandemic on the UK adult population. Bivariate and logistic regression analyses were conducted to determine the association between different levels of perceived debt manageability (i.e., “easily manageable”, “some problems”, “quite serious problems”, “very serious problems”, “cannot manage at all”) and mental health related outcomes. Results Almost a quarter of the sample (24%, n = 494) reported debt management problems, and debt manageability associated with higher levels of anxiety, depression, and mental health help-seeking. After adjusting for demographic variables (e.g. income, receipt of benefits), logistic regression analysis demonstrated a dose-response association between increasing levels of debt manageability problems and mental health outcomes. Specifically, adjusted odds ratios for anxiety ranged from 2.28 (‘some problems’) to 11.18 (‘very serious problems’), for depression ranged from 2.80 (‘some problems’) to 16.21 (‘cannot manage at all’), and for mental health help-seeking ranged from 1.69 (‘some problems’) to 3.18 (‘quite serious problems’, ‘very serious problems’). Conclusion This study highlights that debt manageability problems represent a robust predictor of depression, anxiety, and mental-health help seeking.

Two theoretical perspectives have been proffered to explain changes in alcohol use during the pandemic: the 'affordability-availability' mechanism (i.e., drinking decreases due to changes in physical availability and/or reduced disposable income) and the 'psychological-coping' mechanism (i.e., drinking increases as adults attempt to cope with pandemic-related distress). We tested these alternative perspectives via longitudinal analyses of the COVID-19 Psychological Consortium (C19PRC) Study data (spanning three timepoints during March to July 2020). Respondents provided data on psychological measures (e.g., anxiety, depression, posttraumatic stress, paranoia, extraversion, neuroticism, death anxiety, COVID-19 anxiety, intolerance of uncertainty, resilience), changes in socio-economic circumstances (e.g., income loss, reduced working hours), drinking motives, solitary drinking, and 'at-risk' drinking (assessed using a modified version of the AUDIT-C). Structural equation modelling was used to determine (i) whether 'at-risk' drinking during the pandemic differed from that recalled before the pandemic, (ii) dimensions of drinking motives and the psychosocial correlates of these dimensions, (iii) if increased alcohol consumption was predicted by drinking motives, solitary drinking, and socio-economic changes. The proportion of adults who recalled engaging in 'at-risk' drinking decreased significantly from 35.9% pre-pandemic to 32.0% during the pandemic. Drinking to cope was uniquely predicted by experiences of anxiety and/or depression and low resilience levels. Income loss or reduced working hours were not associated with coping, social enhancement, or conformity drinking motives, nor changes in drinking during lockdown. In the earliest stage of the pandemic, psychological-coping mechanisms may have been a stronger driver to changes in adults' alcohol use than 'affordability-availability' alone.

The COVID-19 Psychological Research Consortium (C19PRC) study was established to determine the impact of the COVID-19 pandemic on the population of multiple countries. Here, we provide a methodological overview, cohort profile, data access, and summary of key findings from the Republic of Ireland arm of the C19PRC study. A longitudinal internet panel survey was designed to collect data from a nationally representative sample of Irish adults (N = 1041) who were tracked from March/April 2020 to March/April 2021. Quota sampling methods were used to produce a sample that was representative of the population with respect to sex, age, and regional distribution. Data were collected in five waves, and new participants were recruited at follow-up waves to cover sample attrition and produce nationally representative samples at various points during the first year of the pandemic. A comprehensive battery of measures was used throughout the project to assess an array of sociodemographic, political, social, psychological, physical health, COVID-19, and mental health variables. Analyses were conducted to compare sample characteristic to known population parameters from available census data. These analyses showed that the sample was representative of the general adult population of Ireland on the three quota variables and was reasonable representative of the population across a diverse range of sociodemographic variables. These data representative the first and only nationally representative, longitudinal survey of the mental health of the Irish population. These data are made freely available to interested users (https://osf.io/2huzd/files/) and the findings of this study provide a methodological basis for the future use of these data.

Abstract Objectives The COVID‐19 Psychological Research Consortium (C19PRC) Study aims to assess the impact of the COVID‐19 pandemic in the adult population in multiple countries. This paper describes the third wave of the UK survey (the ‘parent’ strand of the Consortium) during July‐August 2020. Methods Adults (N = 2025) who participated in the baseline and/or first follow‐up surveys were reinvited to participate in this survey, which assessed: (1) COVID‐19 related knowledge, attitudes, and behaviours; (2) the occurrence of common mental disorders; as well as the role of (3) psychological factors and (4) social and political attitudes, in influencing the public’s response to the pandemic. Weights were calculated using a survey raking algorithm to ensure that the cross‐sectional sample is nationally representative in terms of gender, age, and household income, and representative of the baseline sample characteristics for household composition, ethnicity, urbanicity and born/raised in UK. Results 1166 adults (57.6% of baseline participants) provided full interviews at Wave 3. The raking procedure successfully re‐balanced the cross‐sectional sample to within 1% of population estimates across selected socio‐demographic characteristics. Conclusion This paper demonstrates the strength of the C19PRC Study data to facilitate and stimulate interdisciplinary research addressing important public health questions relating to the COVID‐19 pandemic.

Background: : In this study, we compared the prevalence of posttraumatic stress disorder (PTSD), depression, and generalized anxiety disorder (GAD) before and during the COVID-19 pandemic across nationally representative samples of Irish adults. Methods: : Participants were sampled in February 2019 (N = 1,020), April 2020 (N = 1,041), May 2020 (N = 1,032), and December 2020 (N = 1,100) using the same self-report measures. Results: : The prevalence of PTSD significantly increased from 12.5% in 2019 to 18.0% in April 2020, to 22.0% in May, and returning to 17.6% in December 2020. PTSD increases were most consistently observed in males, those aged 18–34 years, those without a university qualification, and those living in the Leinster region of Ireland, where the capital city of Dublin is located. There were no significant changes in the prevalence of depression or GAD. Limitations: : The 2020 samples were not completely independent of one another and while the analysis took this into account, this bias cannot be completely removed. Conclusions: : These findings show an increase in PTSD during the initial stages of the COVID-19 pandemic compared to the pre-pandemic period and suggest specificity in mental health responses to the COVID-19 pandemic.

COVID-19 conspiracy theories have proliferated during the global pandemic, and their rapid spread among certain groups may jeopardize the public health response (e.g., undermining motivation to engage in social distancing and willingness to vaccinate against the virus). Using survey data from two waves of a nationally representative, longitudinal study of life in lockdown in the United Kingdom (N = 1,406), we analyze the factors associated with belief in three origin theories related to COVID-19, namely that it 1) originated in a meat market in Wuhan, China; 2) was developed in a lab in Wuhan, China; and 3) is caused by 5G mobile networks. Our findings suggest that political-psychological predispositions are strongly associated with belief in conspiracy theories about the virus, though the direction and effect sizes of these predictors vary depending on the specific content of each origin theory. For instance, belief in the Chinese lab conspiracy theory is strongly associated with right-wing authoritarianism (RWA), social dominance orientation (SDO), and general conspiracy ideation, as well as less reliable news sources, distrust in scientists, and anxiety about the pandemic. Belief in the 5G network conspiracy theory is strongly associated with SDO, distrust in scientists, while less strongly with conspiracy ideation and information from social networks/media; RWA is strongly negatively associated with belief in the 5G conspiracy theory, with older and more wealthy individuals somewhat less likely to endorse it. The meat market origin theory is predicted by intolerance of uncertainty, ethnocentrism, COVID-19 anxiety, and less so by higher income, while distrust in scientists is negatively associated with this origin story. Finally, belief in COVID-19 conspiracy theories is associated with negative public health behaviors such as unwillingness to social distance and vaccinate against the virus. Crucially, our findings suggest that the specific content of COVID-19 conspiracy theories likely determines which individuals may be most likely to endorse them.

[Background] Prolonged grief disorder (PGD) is a new disorder included in the 11th edition of the International classification of diseases (ICD-11). An important remit of the new ICD-11 is the global applicability of the mental health disorder guidelines or definitions. Although previous definitions and descriptions of disordered grief have been assessed worldwide, this new definition has not yet been systematically validated. [Method] Here we assess the validity and applicability of core items of the ICD-11 PGD across five international samples of bereaved persons from Switzerland (N = 214), China (N = 325); Israel (N = 544), Portugal (N = 218) and Ireland (N = 830). [Results] The results confirm that variation in the diagnostic algorithm for PGD can greatly impact the rates of disorder within and between international samples. Different predictors of PGD severity may be related to sample differences. Finally, a threshold for diagnosis of clinically relevant PGD symptoms using a new scale, the International Prolonged Grief Disorder Scale (IPGDS), in three samples was confirmed. [Conclusions] Although this study was limited by lack of questionnaire data points across all five samples, the findings for the diagnostic threshold and algorithm iterations have implications for clinical use of the new ICD-11 PGD criteria worldwide.

AbstractBackgroundPosttraumatic stress disorder (PTSD) is traditionally understood as a disorder that occurs more commonly in women than in men, and in younger age groups than in older age groups. The objective of this study was to determine if these patterns are also observed in relation to International Classification of Diseases (ICD-11) PTSD and complex PTSD (CPTSD).MethodsSecondary data analysis was performed using data collected from three nationally representative samples from the Republic of Ireland (N = 1,020), the United States (N = 1,839), and Israel (N = 1,003), and one community sample from the United Kingdom (N = 1,051).ResultsEstimated prevalence rates of ICD-11 PTSD were higher in women than in men in each sample, and at a level consistent with existing data derived from Diagnostic and Statistics Manual of Mental Disorders (DSM)-based models of PTSD. Furthermore, rates of ICD-11 PTSD were generally lower in older age groups for men and women. For CPTSD, there was inconsistent evidence of sex and age differences, and some indication of a possible interaction between these two demographic variables.ConclusionsDespite considerable revisions to PTSD in ICD-11, the same sex and age profile was observed to previous DSM-based models of PTSD. CPTSD, however, does not appear to show the same sex and age differences as PTSD. Theoretical models that seek to explain sex and age differences in trauma-related psychopathology may need to be reconsidered given the distinct effects for ICD-11 PTSD and CPTSD.

ObjectivesExamine the effects of the COVID-19 pandemic on the mental health and loneliness in the general population. More specifically, the study focused on prevalence of anxiety and depression symptoms, the extent to which individuals with existing symptoms recovered or not, the prevalence of subtypes of loneliness, and the extent to which loneliness before and during this pandemic was associated with anxiety and depression symptoms.MethodsData was extracted from the longitudinal LISS panel, based on a probability sample of the Dutch population, with assessments on loneliness in October 2019 (T1) and June 2020 (T4), and anxiety and depression symptoms in November 2019 (T2), March 2020 (T3) and June 2020 (T4; Ntotal = 4,084). Loneliness was examined with the De Jong Gierveld Loneliness Scale and anxiety and depression symptoms with the Mental Health Inventory (MHI-5).ResultsRepeated measures multivariate logistic regression analyses (RMMLRA) showed a statistical significant lower prevalence of anxiety and depression symptoms after the outbreak (T4 = 15.3%) than before (T2 = 16.8%) and during the COVID-19 outbreak (T3 = 17.2%). According to the Reliable Change Index, the distribution of recovery categories (remission, improvement, unchanged and worsening symptoms) after the outbreak did not differ significantly from the distribution of these categories before the outbreak. RMMLRA revealed that the prevalence of emotional loneliness increased significantly after the outbreak (T1 = 18.4%, T4 = 24.8%). Among individuals who were not lonely before and after the outbreak the prevalence of symptoms decreased significantly (T2 = 7.0%, T4 = 4.4%) and, likewise, among those who were not lonely anymore after the outbreak (T2 = 21.5%, T4 = 14.5%). However, the prevalence of symptoms increased significantly among those who became lonely during the pandemic (T2 = 17.9%, T4 = 26.3%).ConclusionsFindings suggest that this pandemic did not negatively affect the prevalence of anxiety and depression symptoms nor the normal recovery of symptoms among the general population during the first four months, but that emotional loneliness increased.

The over-purchasing and hoarding of necessities is a common response to crises, especially in developed economies where there is normally an expectation of plentiful supply. This behaviour was observed internationally during the early stages of the Covid-19 pandemic. In the absence of actual scarcity, this behaviour can be described as 'panic buying' and can lead to temporary shortages. However, there have been few psychological studies of this phenomenon. Here we propose a psychological model of over-purchasing informed by animal foraging theory and make predictions about variables that predict over-purchasing by either exacerbating or mitigating the anticipation of future scarcity. These variables include additional scarcity cues (e.g. loss of income), distress (e.g. depression), psychological factors that draw attention to these cues (e.g. neuroticism) or to reassuring messages (eg. analytical reasoning) or which facilitate over-purchasing (e.g. income). We tested our model in parallel nationally representative internet surveys of the adult general population conducted in the United Kingdom (UK: N = 2025) and the Republic of Ireland (RoI: N = 1041) 52 and 31 days after the first confirmed cases of COVID-19 were detected in the UK and RoI, respectively. About three quarters of participants reported minimal over-purchasing. There was more over-purchasing in RoI vs UK and in urban vs rural areas. When over-purchasing occurred, in both countries it was observed across a wide range of product categories and was accounted for by a single latent factor. It was positively predicted by household income, the presence of children at home, psychological distress (depression, death anxiety), threat sensitivity (right wing authoritarianism) and mistrust of others (paranoia). Analytic reasoning ability had an inhibitory effect. Predictor variables accounted for 36% and 34% of the variance in over-purchasing in the UK and RoI respectively. With some caveats, the data supported our model and points to strategies to mitigate over-purchasing in future crises.

COVID-19 continues to pose a threat to global public health. Multiple safe and effective vaccines against COVID-19 are available with one-third of the global population now vaccinated. Achieving a sufficient level of vaccine coverage to suppress COVID-19 requires, in part, sufficient acceptance among the public. However, relatively high rates of hesitance and resistance to COVID-19 vaccination persists, threating public health efforts to achieve vaccine-induced population protection. In this study, we examined longitudinal changes in COVID-19 vaccine acceptance, hesitance, and resistance in two nations (the United Kingdom and the Republic of Ireland) during the first nine months of the pandemic, and identified individual and psychological factors associated with consistent non-acceptance of COVID-19 vaccination. Using nationally representative, longitudinal data from the United Kingdom (UK; N = 2025) and Ireland (N = 1041), we found that (1) COVID-19 vaccine acceptance declined in the UK and remained unchanged in Ireland following the emergence of approved vaccines; (2) multiple subgroups existed reflecting people who were consistently willing to be vaccinated (‘Accepters’: 68% in the UK and 61% in Ireland), consistently unwilling to be vaccinated (‘Deniers’: 12% in the UK and 16% in Ireland), and who fluctuated over time (‘Moveable Middle’: 20% in the UK and 23% in Ireland); and (3) the ‘deniers’ and ‘moveable middle’ were distinguishable from the ‘accepters’ on a range of individual (e.g., younger, low income, living alone) and psychological (e.g., distrust of scientists and doctors, conspiracy mindedness) factors. The use of two high-income, Western European nations limits the generalizability of these findings. Nevertheless, understanding how receptibility to COVID-19 vaccination changes as the pandemic unfolds, and the factors that distinguish and characterise those that are hesitant and resistant to vaccination is helpful for public health efforts to achieve vaccine-induced population protection against COVID-19.

Individual differences in the response to trauma are influenced by numerous contextual factors such as one’s cultural background, the environment in which trauma occurs, the meanings attached to traumatic experiences, and various other social and cultural determinants both before and after traumatic exposure. This special issue of the European Journal of Psychotraumatology presents a series of papers conducted as part of the Collaborative Network for Training and Excellence in Psychotraumatology (CONTEXT); a programme of research which seeks to advance our understanding of the impact of trauma within diverse populations who are highly trauma exposed. Applying a context-specific focus, CONTEXT prioritised working closely with service users and those organisations delivering critical support in the wake of trauma exposure. The seven papers presented in this special issue are divided into those who are exposed to trauma either: (i) directly (survivors of childhood adversity in the USA; LGB youth in Northern Ireland; refugees and asylum seekers in the EU; and members of the general population exposed to conflict in Israel) or (ii) vicariously (fire fighters in the UK, humanitarian aid volunteers in Sudan, and child protection workers in Denmark). Together, findings from these studies demonstrate that social support, in its many different forms, is a universally important factor in the response to trauma. We discuss how traumatic stress can be compounded when, and can thrive within, contexts where necessary social support is absent or inadequate. We also emphasize the importance of recognizing the context specificity of trauma exposure and trauma response, as well as the need for collaboration between psychotrauma researchers and organisations who deliver support to traumatized populations to ensure rapid and effective translation of research findings into practice.

Background: The International Trauma Questionnaire (ITQ) is a validated measure that assesses ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). An important task is to determine whether the ITQ is an appropriate evaluative measure for clinical trials. Objective: To assess the psychometric properties of the ITQ in the context of treatment and determine if the ITQ measures reliable and clinically significant change over the course of a psychosocial intervention. Method: Analyses were based on data from an online skills training programme delivered to 254 U.S. Veterans. Reliability and validity of the ITQ scores were assessed at baseline. Changes in symptom scores and probable diagnostic rates were compared at pre-, mid- and post-treatment. A reliable change index (RCI) score was computed to classify participants as improved, unchanged, or worsened. The PCL-5 was used as a comparison measure. Results: Baseline concurrent and factorial validity was similar to previous studies. Internal consistency at each assessment was excellent and comparable to the PCL-5. Decline in symptoms from pre-to-post-treatment was significant for PTSD and CPTSD symptom profiles. Rate of probable disorder (PTSD or CPTSD) declined significantly from pre-treatment to post-treatment. Pre-to-post treatment declines exceeded the critical RCI values for the ITQ. Clinically significant changes were observed where most participants improved, some stayed the same, and few worsened. The performance of the ITQ was consistent with the PCL-5 regarding sensitivity to change. Conclusion: This study provides the first demonstration that the ITQ measures reliable and clinically significant treatment-related change of ICD-11 PTSD and CPTSD symptoms.

Background: Numerous studies found robust associations between psychosis and posttraumatic stress disorder (PTSD), but few have examined the relationships between psychosis and recently formulated ICD-11 Complex PTSD (CPTSD). Further, no known study has examined the effects of different traumatic life events on CPTSD and psychotic-like symptoms in a manner that permits gender-specific effects to be identified. Objective: Using a nationally representative sample of 1,020 Irish adults, we examined gender-differences in (a) psychotic-like symptoms, CPTSD, and exposure to 21 different traumatic life events, and (b) the unique associations between different traumas with CPTSD and Psychosis. Method: Bivariate analyses and structural equation modelling were performed. Results: Consistent with the literature, no gender differences were observed in psychotic-like symptoms. Females reported slightly higher levels of CPTSD and were more likely to be exposed to sexual and emotional abuse, whereas men reported greater exposure to physical violence, accidents, and disasters. Psychosis symptoms were explained by trauma exposure to a considerate degree and at a level similar to CPTSD; a moderate correlation was also found between CPTSD and Psychosis. Physical/emotional neglect was the only traumatic life event that significantly and most strongly predicted both conditions. Two gender-specific associations between different traumatic life events and CPTSD and Psychosis were identified out of the 42 possible effects modelled. Conclusions: The present investigation provides initial evidence that psychotic-like symptoms and CPTSD are moderately correlated constructs in the general population. Results also highlight the importance of conducting a detailed assessment of trauma history for all clients presenting with symptoms of CPTSD, psychosis, or both.

Background: Existing research on post-traumatic sequelae suggests a positive association between fatalism and symptoms of post-traumatic stress disorder (PTSD). However, the associations between fatalism and the new ICD-11 diagnosis of complex PTSD (CPTSD) have never been explored before. Objective: The current study explored the association between fatalism and PTSD and CPTSD in samples from three African countries. Methods: A total of 2,524 participants from Nigeria (n = 1018), Kenya (n = 1006), and Ghana (n = 500) completed measures of fatalism (non-judgemental fatalism, current fatalism, pessimistic fatalism, prospective fatalism) and the International Trauma Questionnaire (ITQ). A combination of a multinomial regression and path analysis was used to identify fatalism predictors of PTSD and CPTSD versus no diagnosis, and CPTSD versus PTSD, adjusted for demographic variables and trauma exposure. Results: While PTSD was not predicted by any of the fatalism types, compared to no diagnosis, CPTSD was significantly predicted by pessimistic, non-judgemental and current fatalism, both compared to no diagnosis and PTSD. Conclusions: The results broaden the knowledge on potential correlates of the new diagnosis of CPTSD. Addressing fatalistic beliefs by empowering people to think that they can choose their fate should be further explored as a possible target for intervention in the treatment of CPTSD.

Background: People identifying as lesbian, gay or bisexual (LGB) have been shown to experience more trauma and poorer mental health than their heterosexual counterparts, particularly in countries with discriminatory laws and policies. Northern Ireland is a post-conflict region with high rates of trauma and mental health problems, as well as significant levels of prejudice against the LGB community. To date, no studies in Northern Ireland have compared trauma exposure, social support and mental health status of LGB students to their heterosexual peers. Objective: The present study aimed to assess whether LGB status was associated with more trauma exposure and poorer mental health, and whether social support mediated these associations. Method: The sample was comprised of 1,116 university students. Eighty-nine percent (n = 993) identified as heterosexual and 11% (n = 123) identified as LGB. Path analysis was used to test the hypotheses. Results: LGB status was significantly associated with increased trauma exposure and with symptoms of PTSD, depression and anxiety, but not with problematic alcohol use. These associations were mediated by social support from family only. Conclusions: These results evidence vulnerabilities among Northern Irish students identifying as LGB in relation to trauma and mental health compared with their heterosexual peers. However, social support from family has the potential to mitigate risk. Educational initiatives should raise awareness of the importance of familial support for LGB youth, and those young people who lack family support should be considered an at-risk group, warranting particularly intensive targeting by relevant supports.

Background: Adverse childhood experiences (ACEs) have been identified as an important public health problem with serious implications. Less well understood is how distinct configurations of childhood adversities carry differential risks for mental health, emotional, and social outcomes later in life. Objective: To determine if distinct profiles of childhood adversities exist for males and females and to examine if unique associations exist between the resultant latent profiles of childhood adversities and multiple indicators of mental health and social and emotional wellbeing in adulthood. Method: Participants (N = 1,839) were a nationally representative household sample of adults currently residing in the USA and the data were collected via online self-report questionnaires. Latent class analysis was used to identify the optimal number of classes to explain ACE co-occurrence among males and females, separately. ANOVAs, chi-square tests, and t-tests were used to compare male and female classes across multiple mental health, emotional, and social wellbeing variables in adulthood. Results: Females were significantly more likely than males to report a range of ACEs and mental health, social, and emotional difficulties in adulthood. Two- and four-class models were identified as the best fit for males and females, respectively, indicating more complexity and variation in ACE exposures among females. For males and female, ACEs were strongly associated with poorer mental health, emotional, and social outcomes in adulthood. Among females, growing up in a dysfunctional home environment was a significant risk factor for adverse social outcomes in adulthood. Conclusions: Males and females have distinct patterns of childhood adversities, with females experiencing more complex and varied patterns of childhood adversity. These patterns of ACEs were associated with numerous negative mental, emotional, and social outcomes among both sexes.

Background: The ICD-11 classifies posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as two distinct diagnoses. Few studies have tested the validity of ICD-11 CPTSD in non-Western settings, particularly in Asia. Objective: This study assessed the factorial, concurrent, and discriminant validity of CPTSD symptoms with four samples of young adults from mainland China, Hong Kong, Japan, and Taiwan. Method: Young adults aged 18–24 years were recruited by convenience sampling and provided their data anonymously online. Study measures included the International Trauma Questionnaire (ITQ) to measure PTSD and CPTSD, and measures of childhood adversity, depression, anxiety, age, and sex. Confirmatory factor analysis (CFA) was performed for each sample to evaluate the validity of two CPTSD measurement models. Structural equation modelling (SEM) was used to determine the multivariate associations between study variables for the full sample. Results: A total of 1,346 young adults completed the survey. CFA showed both models of CPTSD examined fit the data well across all four samples. SEM findings showed that number of childhood adversities significantly associated with both PTSD and CPTSD factors; depression significantly associated with CPTSD factors but not PTSD, whereas anxiety significantly associated with both. Conclusions: Study findings provide evidence for PTSD and CPTSD as separate and valid diagnoses in Asia. More cross-cultural comparisons are needed to understand whether risks for either condition differ by geographical or sociocultural norms.

Background: The Global Forum for Health Research, with the support of the World Health Organization, highlighted the need to prioritize mental health research in Africa. The introduction of revised descriptions of Posttraumatic Stress Disorder (PTSD) and Adjustment Disorder, along with new diagnoses of Complex PTSD and Prolonged Grief Disorder, in the ICD-11 creates a need for additional national-level epidemiological studies on the prevalence of stress-related disorders. Methods: The prevalence rates of these four ICD-11 stress disorders were assessed in three African countries including Nigeria (N = 1006), Kenya (N = 1018), and Ghana (N = 500). Participants completed disorder-specific measures for each disorder. Findings: Across the entire sample, the current prevalence rate of probable Adjustment Disorder was 8.4% (95% C.I. = 7.4%, 9.6%), probable PTSD was 18.6% (95% C.I. = 17.2, 20.2%), probable Complex PTSD was 15.9% (95% C.I. = 14.5%, 17.4%) and probable Prolonged Grief Disorder was 3.7% (95% C.I. = 3.1%, 4.5%). Interpretation: The results are applicable primarily to well-educated urban and suburban adults in these African countries. Results indicated that Adjustment Disorder, PTSD, and CPTSD are highly prevalent in these three African countries. There is now a pressing need to develop culturally sensitive interventions to enable recovery from these conditions.

This letter provides an update on the activities of “The Global Collaboration on Traumatic Stress” (GC-TS) as first described by Schnyder et al. in 2017. It presents in further detail the projects of the first theme, in particular the development of and initial data on the Global Psychotrauma Screen (GPS), a brief instrument designed to screen for the wide range of potential outcomes of trauma. English language data and ongoing studies in several languages provide a first indication that the GPS is a feasible, reliable and valid tool, a tool that may be very useful in the current pandemic of the coronavirus disease 2019 (COVID-19). Further multi-language and cross-cultural validation is needed. Since the start of the GC-TS, new themes have been introduced to focus on in the coming years: a) Forcibly displaced persons, b) Global prevalence of stress and trauma related disorders, c) Socio-emotional development across cultures, and d) Collaborating to make traumatic stress research data “FAIR”. The most recent theme added is that of Global crises, currently focusing on COVID-19-related projects.

This letter to the editor responds to a recent EJPT editorial and following commentary which express concerns about the validity of the ICD-11 complex PTSD (CPTSD) diagnosis. Achterhof and colleagues caution that latent profile analyses and latent class analyses, which have been frequently used to demonstrate the discriminative validity of the ICD-11 PTSD and CPTSD constructs, have limitations and cannot be relied on to definitively determine the validity of the diagnosis. Ford takes a broader perspective and introduces the concept of ‘cPTSD’ which describes a wide ranging set of symptoms identified from studies related to DSM-IV, DSM-V and ICD-11 and proposes that the validity of the ICD-11 CPTSD is in question as it does not address the multiple symptoms identified from previous trauma-related disorders. We argue that ICD-11 CPTSD is a theory-driven, empirically supported construct that has internal consistency and conceptual coherence and that it need not explain nor resolve the inconsistencies of past formulations to demonstrate its validity. We do agree with Ford and with Achterhof and colleagues that no one single statistical process can definitively answer the question of whether CPTSD is a valid construct. We reference several studies utilizing many different statistical approaches implemented across several countries, the overwhelming majority of which have supported the validity of ICD-11 as a unique construct. We conclude with our own cautions about ICD-11 CPTSD research to date and identify important next steps.

The present systematic review examined post-migration variables impacting upon mental health outcomes among asylum-seeking and refugee populations in Europe. It focuses on the effects of post-settlement stressors (including length of asylum process and duration of stay, residency status and social integration) and their impact upon post-traumatic stress disorder, anxiety and depression. Twenty-two studies were reviewed in this study. Length of asylum process and duration of stay was found to be the most frequently cited factor for mental health difficulties in 9 out of 22 studies. Contrary to expectation, residency or legal status was posited as a marker for other explanatory variables, including loneliness, discrimination and communication or language problems, rather than being an explanatory variable itself. However, in line with previous findings and as hypothesised in this review, there were statistically significant correlations found between family life, family separation and mental health outcomes.

Background There is very little work on the role of positive or benevolent childhood experiences and how such events might offer protection from the insidious effects of adverse experiences in childhood or later in life. Objectives We set out to test, using latent variable modelling, whether adverse and benevolent childhood experiences could be best described as a single continuum or two correlated constructs. We also modelled the relationship between adverse and benevolent childhood experiences and ICD-11 PTSD and Complex PTSD (CPTSD) symptoms and explored if these associations were indirect via psychological trauma. Methods Data were collected from a trauma-exposed sample (N = 275) attending a specialist trauma care centre in the UK. Participants completed measures of childhood adverse and benevolent experiences, traumatic exposure, and PTSD and CPTSD symptoms. Results Findings suggested that adverse childhood experiences operate only indirectly on PTSD and CPTSD symptoms through lifetime trauma exposure, and with a stronger effect for PTSD. Benevolent childhood experiences directly predicted only CPTSD symptoms. Conclusions Benevolent and traumatic experiences seem to form unique associations with PTSD and CPTSD symptoms. Future research is needed to explore how benevolent experiences can be integrated within existing psychological interventions to maximise recovery from traumatic stress.

Background: Despite concerns of conceptual similarity, increasing evidence supports the discriminant validity of Complex Posttraumatic Stress Disorder (CPTSD) and Borderline Personality Disorder (BPD). However, all studies to date have assumed a categorical model of psychopathology. In contrast, dimensional models of psychopathology, such as the Hierarchical Taxonomy of Psychopathology model (i.e. HiTOP model), recognise shared vulnerability across supposedly discrete disorders. Accounting for shared vulnerability between CPTSD and BPD symptoms may help to better reveal what is unique about these constructs. Objective: To identify the distinct and shared features of CPTSD and BPD via the application of dimensional modelling procedures. Method: Confirmatory bifactor and confirmatory factor analysis were employed to identify the optimal latent structure of CPTSD and BPD symptoms amongst a convenience sample of Israeli adults (N = 617). Additionally, structural equation modelling was used to identify risk factors associated with these constructs. Results: The latent structure of CPTSD and BPD symptoms was best explained by a bifactor model including one ‘general’ factor (i.e. vulnerability to all symptoms) and three ‘specific’ correlated factors (i.e. vulnerability to PTSD, DSO, and BPD symptoms, respectively). CPTSD symptoms were more readily distinguished from the general factor whereas BPD symptoms were not as easily distinguished from the general factor. CPTSD symptoms reflecting a negative self-concept and BPD symptoms reflecting an alternating self-concept were the most distinctive features of CPTSD and BPD relative to the general factor, respectively. Most of the risk factors were associated with the general vulnerability factor, consistent with the predictions of dimensional models of psychopathology regarding shared risk across supposedly distinct psychiatric constructs. Conclusion: Consistent with a dimensional model of psychopathology, CPTSD and BPD shared a common latent structure but were still distinguishable. CPTSD and BPD symptoms may be most effectively distinguished based on the phenomenology of self-concept symptoms.

Background The COVID-19 pandemic has created an unprecedented global crisis, necessitating drastic changes to living conditions, social life, personal freedom and economic activity. No study has yet examined the presence of psychiatric symptoms in the UK population under similar conditions. Aims We investigated the prevalence of COVID-19-related anxiety, generalised anxiety, depression and trauma symptoms in the UK population during an early phase of the pandemic, and estimated associations with variables likely to influence these symptoms. Method Between 23 and 28 March 2020, a quota sample of 2025 UK adults aged 18 years and older, stratified by age, gender and household income, was recruited by online survey company Qualtrics. Participants completed standardised measures of depression, generalised anxiety and trauma symptoms relating to the pandemic. Bivariate and multivariate associations were calculated for demographic and health-related variables. Results Higher levels of anxiety, depression and trauma symptoms were reported compared with previous population studies, but not dramatically so. Anxiety or depression and trauma symptoms were predicted by young age, presence of children in the home, and high estimates of personal risk. Anxiety and depression were also predicted by low income, loss of income and pre-existing health conditions in self and others. Specific anxiety about COVID-19 was greater in older participants. Conclusions This study showed a modest increase in the prevalence of mental health problems in the early stages of the pandemic, and these problems were predicted by several specific COVID-related variables. Further similar surveys, particularly of those with children at home, are required as the pandemic progresses.

Abstract Background The global scale-up of community health workers (CHWs) depends on supportive management and supervision of this expanding cadre. Existing tools fail to incorporate the perspective of the CHW (i.e. perceived supervision) in terms of supportive experiences with their supervisor. Aligned to the WHO’s strategy on human resources for health, we developed and validated a simple tool to measure perceived supervision across seven low and middle-income countries. Methods Phase 1 was carried out with 327 CHWs in Sierra Leone. Twelve questions, informed by the extant literature on health worker supervision, were reduced to six questions using confirmatory factor analysis. Phase 2 employed structural equation modelling with 741 CHWs in six countries (Bangladesh, Ethiopia, Indonesia, Kenya, Malawi, Mozambique), to assess the factorial validity, predictive validity, and internal reliability of the questions at three time-points, over 8-months. Results We developed a robust, 6-item measure of perceived supervision (PSS), capturing regular contact, two-way communication, and joint problem-solving elements as being critical from the perspective of CHWs. When assessed across the six countries, over time, the PSS was also found to have good validity and internal reliability. PSS scores at baseline positively and significantly predicted a range of performance-related outcomes at follow-up. Conclusion The PSS is the first validated tool that measures supervisory experience from the perspective of CHWs and is applicable across multiple, culturally-distinct global health contexts with a wide range of CHW typologies. Simple, quick to administer, and freely available in 11 languages, the PSS could assist practitioners in the management of community health programmes.

This study examines the concept of volunteer work engagement in a sample of 334 community health workers in Bonthe District, Sierra Leone. Structural equation modelling was used to validate both the 9-item and the 17-item Utrecht Work Engagement Scale (UWES-9 and UWES-17, respectively). Results assessing the UWES-17 invalidated the three-factor structure within this cohort of community health workers, as high correlations were found between latent factors. Findings for the validity of the UWES-9 were largely consistent with those of the UWES-17. Model fit for the UWES-9 were generally equivalent for the one-factor, three-factor, and bifactor solutions, however the three-factor model was once again rejected due to high factor correlations. Based on these results, the current sample provides evidence that work engagement is best represented as a unidimensional construct in this context. Findings are considered alongside previous research to offer support for the utilization of the shortened UWES-9 in this context, as it appears to provide a good representation of work engagement and possess a parsimonious unidimensional scoring scheme.

Background: Two stress-related disorders have been proposed for inclusion in the revised ICD-11: Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). The International Trauma Questionnaire (ITQ) is a bespoke measure of PTSD and CPTSD and has been widely used in English-speaking countries. Objective: The primary aim of this study was to develop a Chinese version of the ITQ and assess its content, construct, and concurrent validity. Methods: Six mental health practitioners and experts rated the Chinese translated and back-translated items to assess content validity. A sample of 423 Chinese young adults completed the ITQ, the WHO Adverse Childhood Experiences International Questionnaire, and the Hospital Anxiety and Depression Scale. Among them, 31 participants also completed the English and Chinese versions of the ITQ administered in random order at retest. Four alternative confirmatory factor analysis models were tested using data from participants who reported at least one adverse childhood experience (ACE; N = 314). Results: The Chinese ITQ received excellent ratings on relevance and appropriateness. Test–retest reliability and semantic equivalence across English and Chinese versions were acceptable. The correlated first-order six-factor model and a second-order two-factor (PTSD and DSO) both provided an acceptable model fit. The six ITQ symptoms clusters were all significantly correlated with anxiety, depression, and the number of ACEs. Conclusions: The Chinese ITQ generates scores with acceptable psychometric properties and provides evidence for including PTSD and CPTSD as separate diagnoses in ICD-11.

Background: The recently published ICD-11 includes substantial changes to the diagnosis of posttraumatic stress disorder (PTSD) and introduces the diagnosis of Complex PTSD (CPTSD). The International Trauma Interview (ITI) has been developed for clinicians to assess these new diagnoses but has not yet been evaluated. Objectives: To evaluate the psychometric properties of the Swedish translation of the ITI by examining the interrater agreement, latent structure, internal consistency, and convergent and discriminant validity. Methods: In a prospective study, 186 adults who had experienced a potentially traumatic event were assessed with the ITI and answered questionnaires for symptoms of posttraumatic stress, other psychiatric disorders, functional disability, and quality of life (QoL). Results: The diagnostic rate was 16% for PTSD and 6% for CPTSD. Interrater agreement was satisfactory (α = .76), and confirmatory factor analysis indicated that a two-factor second-20 order model consistent with the ICD-11 model of CPTSD provided acceptable fit to the data. Composite reliability analysis demonstrated that the ITI possessed acceptable internal reliability, and associations with measures of other psychiatric disorders, insomnia, functional disability, and QoL supported the concurrent validity of the ITI. Conclusion: Swedish ITI shows promise as a clinician-administered instrument to assess and diagnose ICD-11 PTSD and CPTSD.

Background: Seafarers are amongst occupational groups with the highest risk for stress, a factor known to impact on mental health. Psychological issues such as depression, anxiety, suicide, and alcohol or drug dependence are recognized health problems within the maritime sector. The primary aim of this study was to identify which individual and occupational factors, known to impact on psychological functioning across the maritime industry and other sectors, best predict perceived stress and job satisfaction among a sample of merchant seafarers.Methods: Secondary data analysis was conducted using a work experiences and attitudes questionnaire administered by a large shipping company to seafarers within their organization. Structural equation modeling was conducted using a proposed theoretical model of perceived stress and job satisfaction in a sample of merchant seafarers.Results: While the structural equation model produced acceptable fit to the sample data according to numerous goodness-of-fit statistics, the comparative fit index and Tucker-Lewis index results indicated less than satisfactory model fit. The model explained 23.8% of variance in the criterion variable of perceived stress, and the strongest predictive effect was for dispositional resilience. The model explained 70.6% of variance in the criterion variable of job satisfaction, and the strongest predictive effect was for instrumental work support.Conclusion: When addressing the psychosocial well-being of merchant seafarers, findings of this study suggest that dispositional resilience may be a particularly important factor with regards to perceived stress, while instrumental work support appears to be a critical factor in relation to job satisfaction. Importantly, however, an overall work environment that is perceived by employees as supportive, equal and just is a cornerstone for the psychosocial well-being of seafarers.