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Few studies have addressed the influence of mass stressors in the context of couple relationships; therefore, understanding how unique constraints and stressors related to the COVID-19 pandemic influenced mental health distress and, in turn, loss in couple relationships is valuable. Because resource loss has been defined as the primary agent of stress, examining factors that may have shaped the degree of resource loss incurred during the pandemic will be vital. Previous research implies that early life adversity may be a form of resource loss and is linked to poorer mental health and relational outcomes in adulthood. Additionally, the stress sensitization hypothesis posits that childhood adversity may prime individuals to have a lower threshold for later life stress. As such, this study was designed to examine how family of origin stress (reported at the outset of pandemic related shutdowns in the US in April 2020) associated with posttraumatic stress (PTSS) 3 months later (July 2020) to, in turn, predict variation in resource losses associated with the COVID-19 pandemic reported 3 months later (October 2020) in 535 cisgender, heterosexual couples. Findings showed that individual's higher family of origin stress predicted higher levels of their own PTSS at wave 2, and higher PTSS at wave 2 predicted higher levels of couples' shared resource loss at wave 3. Additionally, family of origin stress is associated with higher levels of couples' shared experience of loss via higher levels of their own PTSS. [ABSTRACT FROM AUTHOR]

Disturbed sleep is a common feature after exposure to a traumatic event, especially when PTSD develops. However, although there is evidence suggesting a potential role of sleep disturbance in the progression of PTSD symptoms, the interrelationship between sleep and PTSD symptoms has yet to be determined. In order to address this knowledge gap, we have investigated the influence of initial sleep characteristics on the evolution of post-traumatic stress disorder (PTSD) symptoms over 4 years of follow-up among individuals exposed to the Brazilian Kiss nightclub fire. Participants were individuals exposed to the 2013 Kiss nightclub fire in Brazil. Sleep characteristics and PTSD symptoms were measured within the 4 years following the fire by self-report questionnaires, such as The Pittsburgh Sleep Quality Index (PSQI), and PTSD Checklist - Civilian version (PCL-C). Generalized estimating equations (GEE) models were used to examine the longitudinal associations (by estimating the relative effects of initial sleep problems on PTSD symptoms after adjusting for covariates). Comprehensive information concerning socio-demographic factors, health status, and sleep complaints were obtained. A total of 232 individuals were included. In GEE models, no significant interactions were observed between sociodemographic variables and PTSD symptoms in the follow-up period, however, associations were found between PTSD at baseline and the following factors: the female gender, the victim individuals and the existence of prior psychiatric disease. Initial subjective sleep parameters were strongly associated with PTSD symptoms over 4 years, mainly the presence of disturbed dreams (p = 0.012), increased sleep latency (p = 0.029), and reduced sleep duration (p = 0.012). Sleep complaints and PTSD symptoms were common among individuals after the disaster. The current study has found that the presence of sleep complaints, especially increased sleep latency, presence of disturbed dreams and short sleep duration, in the initial presentation after the fire was consistently associated with the perpetration of PTSD symptoms in the next 4 years of follow-up. These findings suggest that interventions addressing these sleep complaints have the potential to reduce the persistence and/or severity of PTSD symptoms. [ABSTRACT FROM AUTHOR]

Neuropeptide Y (NPY) is a 36-amino acid peptide that is widely expressed throughout the limbic system. Recent evidence has highlighted NPY as a marker of resilience to posttraumatic psychopathology, which may be due to its association with neural regions involved with emotion regulation. This study examined whether plasma NPY levels moderated the relationship between emotion regulation and psychopathology in a sample of adult survivors of childhood interpersonal trauma, a population known to be at high risk for psychopathology. Adults exposed to an interpersonal criterion A trauma during childhood (N = 54) were recruited from an urban population at a midwestern medical center and completed a baseline study visit as part of a larger clinical trial. Participants gave a blood sample in order to assess circulating levels of NPY and answered questions related to emotion regulation and mood-related pathology. Results of a moderated multiple regression showed that the overall model was significant R 2 = 0.26, F (5, 48) = 3.46, p <.01. Difficulties in emotion regulation was significantly predictive of psychopathology (unstandardized B = 0.032, p <.01), and this relationship was significantly moderated by levels of NPY (unstandardized B = −0.001, p <.05) such that the relationship between emotion regulation and psychopathology was weaker for those with higher levels of NPY. Results suggest that higher levels of NPY may lessen the association between emotion regulation and posttraumatic psychopathology in survivors of childhood interpersonal trauma. Further investigation of the contribution of NPY to psychopathology in this population is warranted. 02279290. • We assessed adult survivors of childhood interpersonal trauma. • Blood samples and self-report questionnaires were collected. • Higher neuropeptide-Y (NPY) was associated with better emotion regulation. • Better emotion regulation was associated with reduced mood-related symptoms. • NPY moderated the relationship between emotion regulation and mood-related symptoms. [ABSTRACT FROM AUTHOR]

Research in machine learning (ML) algorithms using natural behavior (i.e., text, audio, and video data) suggests that these techniques could contribute to personalization in psychology and psychiatry. However, a systematic review of the current state of the art is missing. Moreover, individual studies often target ML experts who may overlook potential clinical implications of their findings. In a narrative accessible to mental health professionals, we present a systematic review conducted in 5 psychology and 2 computer science databases. We included 128 studies that assessed the predictive power of ML algorithms using text, audio, and/or video data in the prediction of anxiety and posttraumatic stress disorder. Most studies (n = 87) were aimed at predicting anxiety, while the remainder (n = 41) focused on posttraumatic stress disorder. They were mostly published since 2019 in computer science journals and tested algorithms using text (n = 72) as opposed to audio or video. Studies focused mainly on general populations (n = 92) and less on laboratory experiments (n = 23) or clinical populations (n = 13). Methodological quality varied, as did reported metrics of the predictive power, hampering comparison across studies. Two-thirds of studies, which focused on both disorders, reported acceptable to very good predictive power (including high-quality studies only). The results of 33 studies were uninterpretable, mainly due to missing information. Research into ML algorithms using natural behavior is in its infancy but shows potential to contribute to diagnostics of mental disorders, such as anxiety and posttraumatic stress disorder, in the future if standardization of methods, reporting of results, and research in clinical populations are improved. [ABSTRACT FROM AUTHOR]

Trauma is an extreme event that offers us clues about individual differences in cognitive processes, including the development and maintenance of cognitive biases such as exaggerated probability estimates toward future traumatic events. The current study investigated probability estimate biases toward future traumatic events in 445 undergraduate students (93.9% Hispanic) who experienced one of the following traumatic events or no trauma: childhood interpersonal trauma, adult interpersonal trauma, accident, a family member's death due to COVID-19, or no trauma. Participants completed online questionnaires assessing probability estimates for two types of future traumas (interpersonal violence traumas and accidental traumas) and posttraumatic stress symptoms. The childhood trauma group generally showed the strongest probability estimate biases for future traumatic events among the four trauma-exposed groups. Similarly elevated probability estimates for future traumatic events were found in the other three trauma-exposed groups. Limited associations between levels of posttraumatic stress symptoms and probability estimate biases for future traumatic events were found. This study was the first to reveal the presence of biased probability estimates for future traumatic events in Hispanics exposed to a traumatic event. The results suggest that probability estimation biases developed in response to a specific traumatic event might become generalized to other types of traumatic events. [ABSTRACT FROM AUTHOR]

Loneliness and posttraumatic stress (PTS) are common in adolescence. However, there has been little longitudinal research on their association. To address this deficit, this study examined the longitudinal association between these phenomena in a sample of U.S. school students while also exploring if gender was important in this context. Data were analysed from 2807 adolescents (52.1 % female; age at baseline 11–16 years (M = 12.79)) who were followed over a one-year period. Information was obtained on loneliness in year 1 using a single-item question, while PTS was assessed with the self-report Child Post-Traumatic Stress - Reaction Index (CPTS-RI). A full path analysis was performed to assess the across time associations. Almost one-third of the students reported some degree of loneliness while most students had 'mild' PTS. In the path analysis, when controlling for baseline PTS and other covariates, loneliness in year 1 was significantly associated with PTS in year 2 (β = 0.06, 95%CI: 0.02, 0.09). Similarly, PTS in year 1 was significantly associated with loneliness in year 2 (β = 0.19, 95%CI: 0.15, 0.23). An interaction analysis further showed that loneliness was higher in girls with PTS than in their male counterparts. The use of a single-item measure to assess loneliness that used the word 'lonely' may have resulted in underreporting. Loneliness and PTS are bidirectionally associated in adolescence. Efforts to reduce loneliness in adolescence may help in combatting PTS, while clinicians should intervene to address loneliness if detected in adolescents with PTS. • Longitudinal research on the loneliness-posttraumatic stress (PTS) link is limited. • Loneliness and PTS are linked bidirectionally in U.S. adolescents. • Loneliness was higher in girls with PTS than in their male counterparts. [ABSTRACT FROM AUTHOR]

AbstractUnderstanding the healthcare needs of bereaved individuals following terrorism is crucial for organizing healthcare services. This cross-sectional study examined the terror-related healthcare needs, healthcare utilization, and satisfaction with professional healthcare among 122 traumatically bereaved parents and siblings eight years after the 2011 Utøya terrorist attack in Norway. Results showed that over 50% of the participants currently needed help coping with their grief or with mental and somatic symptoms, and only 34% were actively utilizing healthcare related to the terror attack. Furthermore, 68% reported not getting sufficient help, suggesting a treatment gap. One-third rated the professional help and treatment as unsatisfactory, with 28% reporting that they had not received competent help. More somatic and posttraumatic stress symptoms were associated with higher healthcare needs, whilst higher levels of insomnia symptoms were associated with lower healthcare satisfaction. This emphasizes the need to recognize, professionally intervene, and provide competent support for traumatically bereaved individuals. [ABSTRACT FROM AUTHOR]

BackgroundMethodResultsConclusionSome researchers have posited that self-reports of PTG are often illusory, designed to help trauma survivors maintain positive views of the self. We examined whether participants might select an alternative, attractive option to reporting PTG that could similarly help maintain positive views of the self – reporting that the respondent experienced positive growth despite exposure to an adverse event, which we call Positive Change-Despite (PC-Despite).In two separate studies, after asking respondents about positive change they experienced following exposure to an adverse event, we then asked about the extent to which they experienced positive change because of the adverse event (PC-Because) or despite the adverse event (PC-Despite).We found that participants rated 40% (Study 1 – undergraduate sample) and 31% (Study 2 – first responder sample) of their positive change as PC-Despite. Further, in both studies PC-Despite scores were positively related to measures of distress and both adaptive and maladaptive coping, suggesting a link with an illusory form of PTG. In contrast, PC-Because was only related to adaptive coping.Participants chose an attractive alternative response to reporting PTG at substantial rates, supporting the notion that many self-reports of PTG reflect motivated biases and coping processes. [ABSTRACT FROM AUTHOR]

The risk of developing posttraumatic stress symptoms following exposure to traumatic events is well documented, however, emerging research also lends support to the potential development of growth in some people. Rumination and memory have been identified as important factors in post-trauma outcomes, yet, current research in this area is limited, particularly in the context of a multidimensional view of rumination (i.e., intrusive and deliberate rumination) and metamemory beliefs. This study explored the association between rumination styles, beliefs about memory, and posttraumatic stress symptoms and posttraumatic growth. Participants (N = 151) who experienced a traumatic event completed relevant measures online. Path analysis showed that intrusive rumination was significantly related to higher levels of posttraumatic stress symptoms (β = 0.19, p < 0.01), while deliberate rumination was related to higher levels of both posttraumatic growth (β =.52, p < 0.001) and posttraumatic stress symptoms (β = 0.15, p < 0.05). Additionally, negative beliefs about memory were significantly related to higher posttraumatic stress symptoms (β = 0.48, p < 0.001). No significant associations were found for positive beliefs about memory. The findings suggest that rumination may be understood as multidimensional, incorporating both adaptive and maladaptive processes. Further, the present study contributes to the limited literature concerning metamemory beliefs and may provide an increased understanding of factors contributing to stress or growth. [ABSTRACT FROM AUTHOR]

Sexual assault is a highly consequential public health issue associated with multiple mental health sequelae. Given the mental health impact of sexual assault, understanding the recovery strategies survivors utilize is critical. A growing body of work suggests that physical activity may represent a powerful recovery tool post-trauma. However, existing work has primarily focused on the benefits of yoga or cardio exercise. Martial arts may provide unique benefits to sexual assault survivors including increased self-defense self-efficacy, empowerment, and corrective experiences with trauma reminders. However, no extant research has examined the perceived benefits of recreational martial arts practice for sexual assault survivors. The current study utilized content analysis of responses to items assessing the perceived recovery benefits of martial arts among a sample of primarily cisgender women martial arts practitioners (n = 50) with sexual assault histories. Survivors described multiple recovery benefits to their practice. Some benefits described were similar to those associated with other forms of physical activity, such as access to social support, improved physical health, and improved well-being. Other benefits identified were martial arts-specific including survivors viewing martial arts practice as a tool to reclaim bodily autonomy, decrease perceived vulnerability to future sexual assault, and manage PTSD symptoms and triggers. Findings support the potential of martial arts as a powerful recovery tool for survivors. Future research should evaluate how martial arts practice can be structured to ensure that it is healing and empowering. [ABSTRACT FROM AUTHOR]

Background: Solid organ transplant recipients experience a period of unique vulnerability during adolescence, when normative developmental changes intersect with health‐related variables to influence psychological health. Methods: This article builds on previous reviews of psychological health in solid organ transplant recipients and proposes opportunities for clinical intervention during adolescence. Results: Transplant recipients often experience neurocognitive changes, particularly with respect to executive functions, that impact health management tasks and autonomous care. Recipients should be monitored for the development of anxiety, depression, and posttraumatic stress symptoms during adolescence, which in turn can negatively impact adherence to immunosuppression. Recent research in posttraumatic growth and resiliency factors may represent a promising avenue of intervention, leveraging normative developmental processes during this time period. Conclusions: As pediatric transplant providers, adolescence represents a developmental period for targeted interventions to foster adjustment and adherence and promote a successful transition to adult care. [ABSTRACT FROM AUTHOR]

Decades of disaster research support the influence parents have on their children's adaptation. Recently, research has shifted to focus on disasters as a whole family experience. Using the actor-partner interdependence model, this study examines maladaptive cognitive emotion regulation strategies in parents and children and how these strategies influence their own and one another's posttraumatic stress symptoms (PTSS). The present study includes 485 parent–child dyads who experienced the 2015–2016 Texas floods. The majority of parents identified as mothers (66.3%), with a male child (52.8%) whose average age was 13.75 years. Mplus was used to identify the models and evaluate differences between each cognitive emotion regulation strategy across parent–child dyads in the high disaster exposure group compared to all other levels of exposure (other-exposure). Odds ratios examined differences not captured by the actor-partner interdependence model. Support for interdependence was found for the other-exposure group, suggesting parents and children mutually influence each other's PTSS by their own cognitive emotion regulation. No interdependence was found in the high-exposure group. However, high-exposure child actor effects were found for self-blame and other-blame, and child partner effects were only found for self-blame. Parent actor effects were only significant for catastrophizing and parent partner effects for catastrophizing and rumination. Odds ratios for the high-exposure group found that only child self-blame influenced parent PTSS, and only parent rumination and catastrophizing influenced child PTSS. Implications for supporting families after disasters are discussed. [ABSTRACT FROM AUTHOR]

Adolescents involved in the juvenile legal system (JLS) report high rates of traumatic event exposure and posttraumatic stress symptoms. Due to such elevated rates of exposure to potentially traumatic events and posttraumatic stress, it has been recommended that adolescents involved in the JLS receive access to trauma-focused screening upon each contact with the system. Implementing trauma-focused screening within the JLS raises several considerations for systems who have yet to implement this evidence-based practice. This article applies the Exploration, Preparation, Implementation, and Sustainment (EPIS) framework to discuss important decisions and potential ethical issues that arise when trauma-focused screening is implemented within the JLS, from the initial planning stages, to implementation, to long-term sustainment. This article discusses decision points that JLS leadership and administrators must consider when determining whether to implement trauma-focused screening or in the initial stages of implementation, as well as several practical suggestions for individual practitioners who work within the JLS, including clinical and non-clinical staff. [ABSTRACT FROM AUTHOR]

Background: Posttraumatic stress disorder (PTSD) symptomatology and poorer pulmonary function are highly prevalent psychiatric and medical conditions. In the present study, we tested for the individual, additive, and modifying associations of PTSD symptomatology and pulmonary function with cognitive performance. Methods: In this cross‐sectional study, a total of 1,401 World Trade Center (WTC) responders (mean age = 53, SD = 8 years, 92% males) participated in the study. Cogstate assessment measured cognitive performance. PTSD symptomatology was measured using the trauma‐specific version of the posttraumatic stress disorder checklist (PCL‐17) adapted for the WTC attacks. The 1‐second forced expiratory volume and forced vital capacity (FEV1/FVC) ratio was used to measure pulmonary function. Linear regressions with cognitive performance as the outcome were conducted to assess individual, additive, and moderating associations of PTSD symptomatology and pulmonary function. Results: Higher PTSD symptomatology and poorer pulmonary function were negatively associated with cognitive performance. A 10% increase on the FEV1/FVC ratio moderated the association between PTSD symptomatology and cognition, whereby its association with cognition was stronger when PTSD symptomatology was higher (est. = 0.01, 95%CI = 0.004, 0.01, p < 0.001). When stratified by responder type, these associations persisted in trained (est. = 0.01, 95%CI = 0.01, 0.02, p < 0.001), but not in non‐trained (est. = 0.004, 95% C.I. = −0.01, 0.02, p = 0.39) responders. Conclusions: In the presence of higher PTSD, better pulmonary functioning is associated with better cognitive performance. Early intervention efforts to mitigate preventable cognitive decline in high‐risk populations should be studied, especially since intervention in one modality may have an impact on others. [ABSTRACT FROM AUTHOR]

Introduction: Alcohol-involved sexual assault (AISA) survivors who were drinking at the time of the assault may be at risk of internalizing victim-blaming myths and stigma. Cognitive-behavioral models posit the link between AISA and negative emotional outcomes may be explained through maladaptive appraisals and coping - i.e., characterological and behavioral self-blame, shame, low self-compassion (i.e., high self-coldness, low self-caring), and fear of selfcompassion. Methods: Using a cross-sectional design and community sample of younger adults (N = 409 Canadians, M = 28.2 years old, 51.3% women), we examined these mechanisms' unique effects in mediating the associations between AISA and posttraumatic stress, general anxiety, and depressive symptoms, respectively. Results: In terms of gender differences, AISA was more common, self-coldness higher, and general anxiety symptoms more frequent in women, and fear of self-compassion was higher in men. Using structural equation modeling that controlled for gender and the overlap between outcomes, shame emerged as the strongest mediator linking AISA with all emotional outcomes. Fear of selfcompassion also partially mediated the AISA-posttraumatic stress symptom association, self-coldness partially mediated the AISA-general anxiety symptom association, and characterological self-blame fully mediated the AISA-depressive symptom association. Conclusion: Avoidance-based processes, ruminative/worry-based cognitions, and negative self-evaluative cognitions may be distinctly relevant for AISArelated posttraumatic stress, general anxiety, and depressive symptoms, respectively, after accounting for the overarching mediation through shame. These internalized stigma-related mechanisms may be useful to prioritize in treatment to potentially reduce AISA-related negative emotional outcomes, particularly for AISA survivors with posttraumatic stress, general anxiety, and/or depressive symptoms. [ABSTRACT FROM AUTHOR]

This qualitative study aimed to capture the lived experiences of first responders (FRs) combatting the opioid epidemic in an effort to better understand how the increase in opioids, opioid-related harm, and opioid-related death has affected the FR profession. FRs (N = 30) from Tennessee partook in semi-structured interviews investigating the impact of responding to opioid-related incidents. Using a phenomenological approach, three response themes emerged including (1) opioid epidemic burden on FR mental health, (2) variable availability and effectiveness of resources, and (3) identified roles of FRs in reducing the impact of the epidemic. The findings indicate that FRs are experiencing posttraumatic stress and secondary traumatic stress symptoms due to a shift in their duties, as well as repeated exposures to the adverse impacts of opioid use. This study finds a deficit in resources and support to combat the mental health repercussions FRs have experienced due to the epidemic. Given that FRs are often directly involved in preventing opioid-related deaths, ensuring that they are well resourced is an essential component of harm reduction and will ultimately augment care for individuals experiencing opioid-related harm. [ABSTRACT FROM AUTHOR]

There has been little scientific effort to evaluate the associations between cigarette smoking and cessation-related constructs and exposure to traumatic events, posttraumatic stress, and Posttraumatic Stress Disorder (PTSD) symptoms among Hispanic persons who smoke in the United States (US). Such trauma-related factors may pose unique difficulties for Hispanic persons who smoke and possess a desire to quit. As such, the present investigation sought to fill this gap in the literature and examine posttraumatic stress and probable PTSD in terms of their relations with several clinically significant smoking constructs among trauma-exposed Hispanic persons who smoke from the United States. Participants included 228 Spanish-speaking Hispanic persons who endorsed prior traumatic event exposure and smoked combustible cigarettes daily (58.3% female, Mage= 32.1 years, SD = 9.65). Results indicated that posttraumatic stress symptoms were related to increased cigarette dependence, perceived barriers for smoking cessation, and more severe problems when trying to quit with effect sizes ranging from small to moderate in adjusted models. Additionally, Hispanic persons who smoke with probable PTSD compared to those without probable PTSD showcased a statistically effect for perceived barriers for cessation (p <.008) and a severity of problems when trying to quit (p <.001). No effect was evident for cigarette dependence after alpha correction. Overall, the present study offers novel empirical evidence related to the role of posttraumatic stress symptoms and PTSD among Hispanic persons who smoke in the US. Such findings highlight the need to expand this line of research to better understand the role of posttraumatic stress and PTSD among Hispanic persons who smoke which can inform smoking cessation treatments for Hispanic persons who smoke experiencing trauma-related symptomology. [ABSTRACT FROM AUTHOR]

Background: Exposure to extreme weatherly events potentially develops mental disorders among affected individuals. Aim: To synthesize the burden of mental disorders following impact of extreme weather events in South-east Asian (SEA) countries. Methods: Proposal was registered in PROSPERO register [CRD42023469788] and reported as per PRISMA-2020 guidelines. Studies reporting prevalence of mental health disorders following extreme weather events from SEA countries during 1990 and 2023 were searched on Embase, PubMed, and Scopus databases. Study quality was assessed using Appraisal tool for Cross-Sectional Studies. Overall pooled prevalence was computed using DerSimonian-Laird method for random-effects model and reported as 95% confidence intervals. Results: On screening 12,046 records, we included 155 studies (2,04,474 participants) for analysis. Overall burden of mental disorders was 35.31% (95%CI: 30.42%-40.21%). In subgroup analysis, studies on cyclones, India, local residents, children and adolescents, rural settings, and community settings reported higher burden of mental disorders. Depression (28.58%; 95%CI: 24.05%-33.1%) and PTSD (29.36%; 95%CI: 26.26%-32.46%) had similar prevalence. Visiting tourists to SEA region experienced fear, fear of recurrence of tsunami, nightmares, and sense of helplessness. Mental health outcomes were relatively higher in studies conducted within 1 year of events. Heterogeneity and possibility of publication bias exists among the reported studies. Conclusion: With the significant rise in episodes of extreme weather events in SEA region over the last three decades, mental disorders are documented in different proportions. We suggest prioritizing well-informed policies to formulate inclusive and resilient strategies on effectively identifying and treating mental health concerns among victims of extreme weather events. [ABSTRACT FROM AUTHOR]

Substance use disorders (SUDs) are highly prevalent and have deleterious effects on one's health and well‐being. Inpatient treatment for SUDs reduces patient relapse, which subsequently ameliorates these negative effects on the individual and society. Additionally, those who complete treatment are less likely to relapse compared to those who do not complete treatment. Thus, maintaining patient engagement in treatment and reducing the rates of those leaving against medical advice (AMA) is particularly important. Examining the factors and comorbidities that may contribute to treatment dropout has the potential to identify at‐risk patients in need of additional individualized intervention. The current study aimed to examine comorbid anxiety, depression, and posttraumatic stress disorder (PTSD) symptoms as predictors of dropout AMA in a residential substance use treatment population. Results showed that patients with social anxiety were more likely to leave treatment AMA, while those with PTSD were more likely to complete treatment. Findings suggest that PTSD‐specific treatment, as offered in this facility, may help with patient retention, while group focused therapy may be distressing to those with social anxiety. Clinical implications of this research may include incorporating evidence‐based practice for social anxiety early during inpatient treatment to reduce anxiety such that patients may better engage with SUDs treatment. [ABSTRACT FROM AUTHOR]

The purpose of this cross-sectional study was to examine the influence of subthreshold posttraumatic stress disorder (PTSD) and full PTSD on quality of life following mild traumatic brain injury (mTBI). Participants were 734 service members and veterans (SMV) classified into two injury groups: uncomplicated mild TBI (MTBI; n = 596) and injured controls (IC, n = 139). Participants completed a battery of neurobehavioral measures, 12-or-more months post-injury, that included the PTSD Checklist Civilian version, Neurobehavioral Symptom Inventory, and select scales from the TBI-QOL and MPAI. The MTBI group was divided into three PTSD subgroups: No-PTSD (n = 266), Subthreshold PTSD (n = 139), and Full-PTSD (n = 190). There was a linear relationship between PTSD severity and neurobehavioral functioning/quality of life in the MTBI sample. As PTSD severity increased, significantly worse scores were found on 11 of the 12 measures (i.e., MTBI: Full-PTSD > Sub-PTSD > No-PTSD). When considering the number of clinically elevated scores, a linear relationship between PTSD severity and neurobehavioral functioning/quality of life was again observed in the MTBI sample (e.g., 3-or-more elevated scores: Full-PTSD = 92.1 %, Sub-PTSD = 61.9 %, No-PTSD = 19.9 %). Limitations included the use of a self-report measure to determine diagnostic status that may under/overcount or mischaracterize individuals. PTSD symptoms, whether at the level of diagnosable PTSD, or falling short of that because of the intensity or characterization of symptoms, have a significant negative impact on one's quality of life following MTBI. Clinicians' treatment targets should focus on the symptoms that are most troubling for an individual and the individual's perception of quality of life, regardless of the diagnosis itself. [ABSTRACT FROM AUTHOR]

Background: Originally designed for use with adolescents in group-based settings, there has been limited evaluation of Trauma and Grief Component Therapy (TGCT) with respect to its use with individual patients across a wide age range of children and adolescents. Objectives: This study describes a pilot open trial of individually administered TGCT, an assessment-driven, modularized treatment for traumatized and/or bereaved children and adolescents. Key outcomes measures include posttraumatic stress, depressive symptoms, and maladaptive grief reactions. Method: The sample consisted of 58 treatment-seeking children and adolescents who experienced trauma and/or bereavement (ages 7–17 years, M = 12.78, SD = 2.93; 68.4% female; 45.6% Hispanic, 14.0% Black, 22.8% White, 14.0% Multiracial). The study used a single-group open trial design. Youth referred to the study due to experiencing a potentially traumatic event or death of a loved one completed self-report measures of posttraumatic stress, depressive symptoms, and maladaptive grief reactions (when applicable). Measures were also completed following Module 1 of the treatment. Results: Bayesian regression models revealed youth who completed TGCT Module 1 reported substantial reductions from baseline, with large effect sizes for posttraumatic stress, depressive symptoms, and maladaptive grief reactions. Rates of reliable improvement ranged from 42 to 65% across treatment outcomes with 69% of youth demonstrating reliable improvement in at least one outcome. Conclusions: The present study provides preliminary evidence supporting TGCT as an individual treatment for traumatized and/or bereaved children and adolescents experiencing posttraumatic stress, depressive symptoms, and/or maladaptive grief reactions. [ABSTRACT FROM AUTHOR]

There is evidence that anxiety and avoidance toward close relationships (i.e., insecure attachment orientations), as well as posttraumatic stress symptoms (PTSSs), are linked to a poor quality of life. The current study aimed to investigate the potential mediating effects of PTSSs on the associations between insecure attachment orientations and domains of quality of life. A convenience sample of 497 adults (375 females, 75.5%), ranging in age between 18 and 65 years old (M = 32.48, SD = 13.26), was recruited. Participants were administered self-report instruments assessing attachment anxiety and avoidance, PTSSs, and domains of quality of life, including physical health, psychological status, social relationships, and environment. A series of mediation analyses were performed to test the mediating role of PTSSs in the relationships between attachment orientations and domains of quality of life. Results showed that attachment anxiety was related to decreased levels of quality of life in all domains, and that their associations were mediated by PTSSs. Also, attachment avoidance was related to a worse quality of psychological status and social relationships, and PTSSs were a significant mediating variable in these associations. Prevention programs and clinical interventions focused on promoting effective strategies for managing distress might be critical in reducing the impact of distressing events on the quality of life of individuals with insecure attachment.

Abstract The risk of developing posttraumatic stress symptoms following exposure to traumatic events is well documented, however, emerging research also lends support to the potential development of growth in some people. Rumination and memory have been identified as important factors in post-trauma outcomes, yet, current research in this area is limited, particularly in the context of a multidimensional view of rumination (i.e., intrusive and deliberate rumination) and metamemory beliefs. This study explored the association between rumination styles, beliefs about memory, and posttraumatic stress symptoms and posttraumatic growth. Participants (N = 151) who experienced a traumatic event completed relevant measures online. Path analysis showed that intrusive rumination was significantly related to higher levels of posttraumatic stress symptoms (β = 0.19, p

Background: Exposure to extreme weatherly events potentially develops mental disorders among affected individuals. Aim: To synthesize the burden of mental disorders following impact of extreme weather events in South-east Asian (SEA) countries. Methods: Proposal was registered in PROSPERO register [CRD42023469788] and reported as per PRISMA-2020 guidelines. Studies reporting prevalence of mental health disorders following extreme weather events from SEA countries during 1990 and 2023 were searched on Embase, PubMed, and Scopus databases. Study quality was assessed using Appraisal tool for Cross-Sectional Studies. Overall pooled prevalence was computed using DerSimonian–Laird method for random-effects model and reported as 95% confidence intervals. Results: On screening 12,046 records, we included 155 studies (2,04,474 participants) for analysis. Overall burden of mental disorders was 35.31% (95%CI: 30.42%–40.21%). In subgroup analysis, studies on cyclones, India, local residents, children and adolescents, rural settings, and community settings reported higher burden of mental disorders. Depression (28.58%; 95%CI: 24.05%–33.1%) and PTSD (29.36%; 95%CI: 26.26%–32.46%) had similar prevalence. Visiting tourists to SEA region experienced fear, fear of recurrence of tsunami, nightmares, and sense of helplessness. Mental health outcomes were relatively higher in studies conducted within 1 year of events. Heterogeneity and possibility of publication bias exists among the reported studies. Conclusion: With the significant rise in episodes of extreme weather events in SEA region over the last three decades, mental disorders are documented in different proportions. We suggest prioritizing well-informed policies to formulate inclusive and resilient strategies on effectively identifying and treating mental health concerns among victims of extreme weather events.

Introduction: Major gaps remain in our knowledge regarding childhood sexual abuse (CSA) related symptoms in adolescent psychiatric inpatients, as well as potential resilience factors like mentalizing. CSA is a risk factor for the early emergence of borderline personality features, posttraumatic stress, and sexual concerns. Mentalizing, which involves the capacity to understand our reactions and that of others in psychological terms, is a resilience factor for self and interpersonal functioning. The aim of this study was to address knowledge gaps by examining the contributions of CSA and mentalizing in a latent factor composed of borderline personality features, posttraumatic stress, and sexual concerns in a sample of adolescent psychiatric inpatients. We hypothesized that CSA and mentalizing would independently explain the variance in this latent factor. Method: Participants were 273 adolescents aged 12-17 recruited from an adolescent inpatient psychiatric clinic. They completed the Reflective Function Questionnaire for Youth (RFQ-Y), the Trauma Symptom Checklist for Children (TSCC), and the Borderline Personality Features Scale for Children (BPFS-C). CSA was assessed using the Child Attachment Interview (CAI), the Computerized Diagnostic Interview Schedule for Children (C-DISC), as well as the Childhood Trauma Questionnaire (CTQ). Results: 27.5% of adolescent psychiatric inpatients reported CSA. CSA and mentalizing were independently associated with a latent factor consisting of posttraumatic stress, borderline personality features, and sexual concerns. CSA explained 5.0% and RF explained 16.7% of the variance of the latent factor. When we consider both the unique and the shared contribution of CSA and mentalizing, the model explained 23.0% of the variance of this factor. Discussion: CSA and mentalizing independently explained variance in a latent factor constituted of borderline personality features, posttraumatic stress, and sexual concerns. The direct effect of mentalizing was stronger and mentalizing explained comparatively more variance of trauma-related symptoms in adolescent psychiatric inpatients. The findings are consistent with the theory that mentalizing is an internal resilience factor in adolescent psychiatric inpatients. By implication, clinical interventions focused on promoting the development of mentalizing, such as Mentalization Based Treatment, may palliate mental health difficulties manifested by adolescent psychiatric inpatients including those associated with CSA. [ABSTRACT FROM AUTHOR]

Introduction: Psychological distress in pregnant and postpartum women increased during the COVID‐19 pandemic. However, the impact of the pandemic in perinatal women at the end of the health emergency has been rarely studied. This study is aimed at investigating the psychological health of pregnant and postpartum women at the end of the COVID‐19 public health emergency, hypothesizing that the COVID‐19‐related fears influence perinatal psychological distress via the mediation of the COVID‐19‐related posttraumatic impact and loneliness. Methods: A total of 200 women in the perinatal period, of which 125 were pregnant and 75 were postpartum, participated in an online survey at the end of the COVID‐19 public health emergency in Italy. Depression, anxiety, stress, loneliness, posttraumatic impact of COVID‐19 pandemic and COVID‐19‐related fears were assessed. To test the hypotheses, robust serial mediation analyses were performed. Results: Increased levels of COVID‐19‐related fears were associated with an increase in perinatal depression, anxiety and stress indirectly through the serial mediation of COVID‐19 posttraumatic impact and loneliness. Loneliness played a stronger role in mediating the relationship between COVID‐19‐related fears and depression than anxiety and stress outcomes. Conclusions: This study should be considered exploratory for its methodological characteristics and nonreplicability of the pandemic condition. However, this study suggests the importance of assessing posttraumatic reactions to 'collective' crises in pregnant and postpartum women for research and clinical practice. In addition, it sustains the role of loneliness as a transversal construct that should be greatly considered in targeting psychological interventions for women in the perinatal period. [ABSTRACT FROM AUTHOR]

Background: Trauma is a significant risk factor for developing psychosis. Nevertheless, psychosis is often considered grounds for not receiving trauma‐focused therapy due to concerns of exacerbating psychotic symptoms. Prolonged exposure (PE) is a recognized and effective evidence‐based therapy modality for the treatment of severe trauma. Objective: To assess the available empirical evidence for PE as a feasible treatment programme for posttraumatic stress disorder (PTSD) in patients with psychotic symptoms. Method: A systematic literature search was conducted using the databases Scopus, PsycINFO (OVID) and PubMed MEDLINE in December 2023 with a priori defined eligibility criteria. The literature search identified 1226 articles, of which eight met the eligibility criteria. Five studies exploring the effects of PE treatment on patients diagnosed with PTSD and suffering from comorbid psychotic experiences were included. Three studies containing follow‐up data or secondary analysis on PTSD and psychotic symptoms from original studies fulfilling the inclusion and exclusion criteria were included. Each study was assessed for quality to estimate the risk of bias. Results: Acknowledging the scarcity of available evidence, the results of the scoping review indicate that PE may be an effective treatment approach for reducing PTSD symptoms in patients with PTSD and comorbid psychotic symptoms. The reviewed studies found no iatrogenic effects, including no increase in psychotic symptoms. Conclusion: PE appears to be a possibly effective PTSD treatment for patients suffering from PTSD and comorbid psychotic symptoms or disorders. However, the evidence is scarce, and larger confirmative trials are required for more conclusive evidence. [ABSTRACT FROM AUTHOR]

Romantic relationship dissolutions (RRDs) are associated with posttraumatic stress symptoms (PTSS). Functional magnetic resonance imaging in RRD studies indicate overlapping neural activation similar to posttraumatic stress disorder. These studies combine real and hypothetical rejection, and lack contextual information and control and/or comparison groups exposed to non-RRD or DSM-5 defined traumatic events. We investigated blood oxygen level dependent (BOLD) activation in the hippocampus, amygdala, and insula of participants with RRDs compared with other traumatic or non-trauma stressors. Emerging adults (mean age = 21.54 years; female = 74.7 %) who experienced an RRD (n = 36), DSM-5 defined trauma (physical and/or sexual assault: n = 15), or a non-RRD or DSM-5 stressor (n = 28) completed PTSS, depression, childhood trauma, lifetime trauma exposure, and attachment measures. We used a general and customised version of the International Affective Picture System to investigate responses to index-trauma-related stimuli. We used mixed linear models to assess between-group differences, and ANOVAs and Spearman's correlations to analyse factors associated with BOLD activation. BOLD activity increased between index-trauma stimuli as compared to neutral stimuli in the hippocampus and amygdala, with no significant difference between the DSM-5 Trauma and RRD groups. Childhood adversity, sexual orientation, and attachment style were associated with BOLD activation changes. Breakup characteristics (e.g., initiator status) were associated with increased BOLD activation in the hippocampus and amygdala, in the RRD group. RRDs should be considered as potentially traumatic events. Breakup characteristics are risk factors for experiencing RRDs as traumatic. Future studies should consider more diverse representation across sex, ethnicity, and sexual orientation. • Non-marital breakups are associated with significant posttraumatic stress symptoms. • Ex-partner images elicit increased BOLD activation in the hippocampus and amygdala. • Activations were comparable to those in response to physical/sexual assault images. • Breakup characteristics place students at an increased risk of a trauma response. • Breakups can be considered potential traumatic events among emerging adults. [ABSTRACT FROM AUTHOR]

Emergency first responders (police, fire, paramedic, dispatch) engage in work that includes multiple traumas, sometimes leading to posttraumatic stress. Due to work spillover at home, spouses are susceptible to vicarious and secondary trauma. While there are debriefings for traumatic calls for first responders, no such thing exists for the spouses who are the first to provide support at home. There is a lack of availability of resources supporting first responder spouses, particularly those whose first responders are diagnosed with posttraumatic stress disorder. Stepping into this gap is a unique 6-day residential treatment program provided in a secluded location in Northern California, where a small number of clients engage in a program directed by peers who have been through the program themselves, culturally competent clinicians, and chaplains. The therapeutic milieu is supported by psychoeducation, group processing, nutritious meals, daily activity, and an optional daily chapel program. Based on a dissertation, and using Gass' wheel of change as a framework, this article shares the results of a qualitative study of eight participants' experiences of the program gleaned from in-depth interviews, a review of program agendas, and self-assessment scores pre- and postprogram. Inductive analysis resulted in common themes including a reduction in isolation, anxiety, and depression symptoms, normalization of experiences, and community. Like the insider-researcher author, individuals finding that they have "lost themselves" in the role of first responder spouse identify this residential treatment experience as a "back to myself" program. Further research on program effectiveness via program evaluation is recommended. [ABSTRACT FROM AUTHOR]

In contrast to adults, there is considerably less research on childhood or adolescent exposure to sexual harassment (CAESH), its lasting psychological correlates, and whether such experiences should be included in definitions of childhood sexual abuse. The current study examined the prevalence and symptomatic sequels of unwanted flirting, being "checked out" sexually, unwanted sexual attention, sexual comments, propositions, and related noncontact behaviors that occurred before age 18, as well as the multivariate relationship between CAESH and contact child sexual abuse (C-CSA) in a diverse online sample of 528 individuals. CAESH was very common, with over 95% of women and 64% of men reporting at least one experience of noncontact sexual harassment before age 18. When childhood sexual abuse was operationalized as the presence of either C-CSA or a total CAESH score of 18 or higher (corresponding to an average score of "3–5 times" prior to age 18), the prevalence was 67% for women and 26% for men, more than three times higher than C-CSA alone. This expanded definition was associated with significantly more anxiety, depression, and posttraumatic stress relative to C-CSA alone. These results suggest that CAESH is a significant source of symptoms in adults and support the emerging perspective that childhood sexual abuse may be best understood as including both contact and noncontact events. [ABSTRACT FROM AUTHOR]

AbstractIntroductionMethodsResultsConclusionsWildland firefighters are posited to have a higher suicide rate than general firefighters and the general population. However, the rates and risk factors of suicide among wildland firefighters is not fully understood.For this preregistered study, 564 participants were recruited from Facebook to obtain a final sample of 246 participants with valid data who were current or former wildland firefighters in the United States. Participants completed online measures of suicidal ideation, history of suicidal behaviors, posttraumatic stress disorder (PTSD) symptoms, problematic alcohol use, and occupational exposure to suicide.In this sample, 22% of wildland firefighters reported a history of at least one suicide attempt, and 36.7% reported current suicidal ideation. PTSD symptoms, but not problematic alcohol use or exposure to suicide, were positively associated with suicidal ideation and a history of suicide attempts. Additionally, PTSD symptoms explained significantly more variance in suicidal ideation than depression symptoms alone.Wildland firefighters demonstrate rates of suicide attempts that exceed those of non-wildland firefighters and of the general population at large. In addition, PTSD symptoms may contribute to suicidal thoughts and behaviors (STB) in this population. This is the largest study of STB in wildland firefighters to date. [ABSTRACT FROM AUTHOR]

Combat soldiers are exposed to various potentially traumatic events and face high risk of developing military-related psychopathology, such as depression, posttraumatic stress and grief (PTSS). However, a strong body of research shows that resilience is the default in the aftermath of trauma and indeed, many veterans do not develop high symptomatic levels. To explicate this inconsistency, the current study examined the associations among PTSS, resilience, and patterns of emotional-approach coping. A sample of 595 male combat veterans filled out questionnaires on trauma exposure, PTSS, depressive symptoms, resilience, and emotional-approach coping. Their data were analyzed using structural equation modeling path analysis. Participants reported high exposure to potentially traumatic events during service. Mean scores were high for resilience and relatively low for PTSS and depressive symptoms; 13% had a clinical level of posttraumatic stress disorder. Structural equation modeling revealed that emotional-approach coping strategies mediated the relationship between resilience and PTSS. However, emotional expression was associated with lower PTSS levels, whereas emotional processing was associated with higher PTSS levels. These results suggest that although emotional-approach coping was related to higher resilience, emotional expression (an intrapersonal coping strategy) might have a more positive effect than self-oriented emotional coping strategies. Providing veterans with supportive opportunities and a wider repertoire of emotional coping skills might enhance their well-being, reduce post-service emotional distress while not harming veterans’ resilience levels. [ABSTRACT FROM AUTHOR]

Background: Child and adolescent mental health problems have increased after the COVID-19 pandemic. The objective of this study was to establish the association of the presence and intensity of posttraumatic stress due to COVID-19 with the presence of (1) self-harm and suicide risk, (2) depressive and anxious symptoms, (3) eating disorders and (4) problematic Internet and video game use. Methods: A cross-sectional analysis was performed on a sample of second–fourth grade secondary school students (14 to 16 years old) from Navarra and the Canary Islands recruited at the SESSAMO project. Validated questionnaires were used to assess the intensity of posttraumatic stress due to COVID-19, risk of suicide and presence of self-harm, symptoms of mental disorder and problematic use of the Internet and video games. Results: Out of 1423 participants analyzed, those with the highest level of posttraumatic stress showed a significant increase in the risk of suicide (OR = 5.18; 95% CI = 2.96–9.05) and in the presence of eating disorder symptoms (OR = 3.93; 95% CI = 2.21–7.00), and higher anxiety and depression scores (b coefficient for anxiety = 11.1; CI = 9.7–12.5; for depression = 13.0; CI = 11.5–14.5) as compared to those with the lowest level. Participants with a high level of posttraumatic stress were almost 10 times more likely to present problematic video game use (OR = 9.49; 95% CI = 3.13–28.82). Conclusions: Years after the pandemic, posttraumatic stress derived from it continues to impact the mental health of adolescents. Further long-term research is needed, as well as close follow-up and intervention in this population. [ABSTRACT FROM AUTHOR]

Background: Parental psychopathology is associated with their children's posttraumatic stress symptoms (PTSS). However, the mechanisms through which this occurs remain unclear. We hypothesized that exposure to childhood adversities is the mechanism linking parental psychopathology to child PTSS and that parenting practices moderated these associations. Methods: Participants (N = 1,402) with an average age of 24.03 years old (SD = 2.20), were all Puerto Ricans (50% Male and 50% Female) from the Boricua Youth Study, which is a four‐wave longitudinal study spanning almost 20 years, following individuals from childhood (ages 5–13 at Wave 1) to young adulthood. Measured variables include parental psychopathology at Wave 1, childhood adversities and parenting practices at Waves 2–3, and PTSS at Wave 4. A traditional mediation model estimated the association between parental psychopathology and child PTSS via childhood adversities. A moderated mediation model was used to examine whether parenting practices moderated this mediation model. Results: Results showed that the total effect of parental psychopathology at Wave 1 on PTSS at Wave 4 was fully mediated by childhood adversities at Waves 2–3 (direct effect b = 1.72, 95% CI = [−0.09, 3.83]; indirect effect b = 0.40, 95% CI = [0.15, 0.81]). In addition, the magnitude of this pathway varied by levels of parenting practices (i.e. parental monitoring and parent–child relationship quality). Specifically, the indirect effect of additional adversities in the psychopathology‐PTSS link was stronger with higher levels of parental monitoring but weaker with higher parent–child relationship quality scores. Conclusions: Intergenerational continuity of psychopathology may be mitigated through the prevention of additional childhood adversities via upstream interventions, emphasizing providing parents with mental health needs with parenting tools. Family‐based interventions focused on providing families with the tools to improve parent–child relationships may reduce the negative impact of childhood adversities on mental health across the life course. [ABSTRACT FROM AUTHOR]

Research has established a negative association between parental posttraumatic stress symptoms (PTSS), including subthreshold symptoms, and child physical and behavioral health outcomes. Such intergenerational transmission of risk has multiple possible mechanisms, including lack of positive parenting, increased negative parenting, shared environmental and contextual risks, and potential biological components such as shared genetics or even transmission of epigenetic risk. This study examined 93 parent-child dyads (n = 171 participants total) from a mixed Urban-Suburban US metropolitan area to investigate the relations between parental PTSS and child-perceived parenting and child PTSS. We sought to examine interactions between parental PTSS and parenting on child PTSS. We found an association between parent and child PTSS, consistent with prior literature showing increased risk for children of trauma survivors. Interestingly, we found effects of positive parenting on diminished child PTSS symptoms only in parents without PTSS, whereas the effect of positive parenting on buffering child symptoms was absent in parents with PTSS. Limitations. The present findings are tempered by the use of self-report data to assess parent and child PTSS, which is not as reliable as clinician assessment of symptoms. Further, the use of survey data limits what is known about the extent of trauma exposure in parents and children, and different measures were used to assess PTSS in parents and kids, which limits comparability of these reported symptoms. Limitations notwithstanding, findings suggest joint attention paid to parenting practices and to a parent's recovery, even from subthreshold symptoms of PTSS, as two different but important ways to support trauma survivor parents in their efforts to most optimally parent and protect their children from intergenerational risk. • Parent and child posttraumatic stress symptoms were positively associated. • Parent posttraumatic stress symptoms were not linked with parenting behaviors. • Parenting moderated child symptoms only in the absence of parent symptoms. [ABSTRACT FROM AUTHOR]

Following the COVID-19 pandemic we sought to determine the relationships between anxiety, hopelessness, alcohol use, perceived vulnerability to infection, resilience, traumatic stress, and satisfaction with life amongst university students at three tertiary higher education institutions in South Africa. Our participants were a convenience sample (N = 803) of South African students attending three universities. Participants completed an online survey that contained a battery of psychological measures that measured fear of COVID-19, Perceived Vulnerability to Disease, Resilience, Satisfaction with Life Scale, Hopelessness, Anxiety, PTSD, Alcohol Use, Traumatic Stress, and worry about infection with COVID-19. The mean age of participants was 25 (SD = 8.22), most of whom were female (51%). An increase in age amongst respondents was significantly positively correlated with hopelessness and life satisfaction, but also significantly negatively associated with symptoms of anxiety, PTSD, and alcohol use. Multivariate analysis showed that women reported significantly higher levels of fear of COVID-19, perceived vulnerability to disease, PTSD, and COVID-19 related worries compared to men and those identifying as "other." Students at the urban university reported higher levels of fear of COVID-19, perceived vulnerability to disease, and COVID-19 related worries but lower levels of anxiety compared to those at the peri-urban and rural university. Students at the rural institution reported greater levels of alcohol use compared to those at the other institutions. Psychological distress among students was exacerbated during the pandemic. It may be useful to identify students in the first term who are struggling academically and to direct them to both academic and counseling support services. [ABSTRACT FROM AUTHOR]

Tedeschi & Calhoun's model of posttraumatic growth (PTG) suggests that intrusive thoughts about a traumatic event, in combination with helpful coping strategies, facilitates PTG. This manuscript applies this model to a sample of breast cancer survivors, augments it to conceptualize coping strategies as "active" or "avoidant," and extends it to include health-related quality of life (HRQOL). This is a secondary analysis of a subset of breast cancer patients (N = 123) in a randomized clinical trial of Tibetan yoga, which examines the associations of coping at study entry with PTG, PTSS (i.e., intrusive thoughts and avoidance), and HRQOL (physical (PCS) and mental (MCS) component scales) reported 9 and 15 months later. Mediation analyses revealed that higher baseline active coping predicted higher 9-month PTG, which in turn predicted higher 15-month PCS [effect =.46, 95% CI (.06, 1.07)]. Exploratory moderated mediation analyses revealed that higher baseline intrusive thoughts about cancer predicted lower 9-month PTG, which in turn predicted lower 15-month PCS, but only for those reporting low active coping [effect = −.06, 95% CI (−.16, −.003)]. Active coping may play a critical role of fostering PTG and improving subsequent HRQOL in the presence of rumination about cancer. [ABSTRACT FROM AUTHOR]

BACKGROUND: The Australian Health Practitioners Registration Agency (AHPRA) records 98.7% of the 32,000 registered midwives as female. In 2021, Australia recorded 309,996 births, and one in three women experienced birth trauma. While the exact proportion of midwives who have given birth is unknown, it is likely the majority. As a consequence, 5,000–11,000 midwives may have experienced primary birth trauma (PBT). Little is known about midwives' personal experience of birth trauma and its relationship to factors that affect their experience of the maternity workplace setting. AIMS: This study aimed to explore mental health morbidity and factors associated with the severity of PBT in Australian midwives and the relationships between these factors and professional quality of life. METHODS: Australian registered midwives 12 months post birth trauma experience and having returned to the maternity workplace without restrictions to their AHPRA registration were included. Data were collected via an online survey with four validated tools and general demographic information. FINDINGS: Midwives who have experienced PBT have symptomology for posttraumatic stress disorder, depression, anxiety, and burnout. Midwives with these symptomologies work within maternity settings with little known about the implications of accumulative symptoms, their impact on care provision or clinical decision-making, and overall long-term personal and professional well-being and health. CONCLUSION: This study found that midwives experience psychological, professional, and personal issues and trauma symptomology associated with their own primary birth trauma. Further research exploring simplified symptomatology identification and appropriate interventions both inside and outside the work environment is required to improve midwives' mental health, rates of retention in the workplace, and job satisfaction. [ABSTRACT FROM AUTHOR]

Objectives Design Methods Results Conclusions While 5%–10% of children exposed to natural disasters develop PTSD, few children access support. This paper reports on the proactive ‘screen‐and‐treat’ approach deployed following devastating floods in Queensland, Australia, in 2011 and presents results for children in the Lockyer Valley (the most impacted community).Open treatment study (2011–2012) within a government‐funded post‐disaster service response.One hundred and fifty children (7–12 years) completed pencil‐and‐paper screening (PTSD, anxiety and depression) at school. Eighty children endorsing either clinical levels of PTSD, or moderate levels of PTSD and clinical levels of either anxiety or depression, and their parents, completed a structured diagnostic interview. Forty‐eight children were offered a free trauma‐focused CBT intervention. The parents of 19 children accepted this offer. Most clinicians were clinical psychology trainees from local universities. All measures were repeated at post‐treatment, 6‐ and 12‐month follow‐up. Note: The term ‘parents’ is used to refer to the wide variety of people serving as a child's primary caregiver.Pre‐treatment, all children met diagnostic criteria for full (N = 17) or sub‐clinical PTSD. By post‐treatment, 10.5% met criteria for PTSD, with 0% meeting criteria at the 12‐month follow‐up. The incidence of anxiety and depressive disorders also reduced significantly. There were no differences in outcomes for children seen by trainees compared to experienced clinicians.A school‐based screen‐and‐treat approach offers potential as a means of identifying and treating children following natural disaster exposure. However, engagement of families at the outset, and when offering intervention was challenging. Postgraduate trainees represent an effective potential workforce in a post‐disaster environment. [ABSTRACT FROM AUTHOR]

Posttraumatic stress disorder (PTSD) and sleep disturbance are highly comorbid and repetitive negative thinking (RNT) is associated with both sleep disturbance and PTSD. However, few studies have examined the association between RNT and sleep disturbance in individuals exposed to trauma, with and without PTSD. Associations between trait-level and trauma-related RNT, insomnia, and sleep quality were investigated in a trauma-exposed MTurk (N = 342) sample. Additionally, PTSD symptom severity was tested as a moderator of the associations between RNT and insomnia and sleep quality. Trait-level RNT predicted poorer sleep quality and greater insomnia, regardless of PTSD severity. Trauma-related RNT was also associated with greater insomnia, though the effect was moderated by PTSD severity such that it was significant for participants with low and moderate, but not severe, PTSD. Both trait- and trauma-related RNT were associated with several specific aspects of sleep quality, including: sleep disturbances, daytime dysfunction, use of sleep medications, sleep onset latency, and subjective sleep quality. This study demonstrates significant associations linking RNT with insomnia and sleep disturbance in trauma-exposed individuals. Clinically, results suggest that it may be helpful to target both general and trauma-related RNT in sleep interventions for trauma-exposed individuals with insomnia. [ABSTRACT FROM AUTHOR]

A stress-is-enhancing mindset is associated with lower perceived stress and better coping. However, work examining the prospective associations of stress mindset on perceived traumatic stress symptoms during a stressful real-world life event is limited. The present prospective study explored whether stress-is-enhancing mindset measured before the onset of the COVID-19 global pandemic was associated with later traumatic stress symptoms in response to the COVID-19 global pandemic. University students (N = 179; 68% female; Mage = 19.31, SD = 0.79 years) completed the Stress Mindset Measure (SMM) prior to COVID-19 pandemic onset as part of a larger study. The Impact of Event Scale-Revised (IES-R) with respect to the COVID-19 pandemic was completed 1 year into the pandemic. SMM negatively predicted the IES-R subscales intrusion, avoidance, and hyperarousal such that a more stress-is-enhancing mindset was associated with lower intrusion, avoidance, and hyperarousal following the onset of COVID-19. Results suggest a more positive stress mindset is associated with fewer traumatic stress symptoms following a traumatic life event. Altering stress mindset may be an avenue for future interventions to cope with stress. [ABSTRACT FROM AUTHOR]

IntroductionAlcohol-involved sexual assault (AISA) survivors who were drinking at the time of the assault may be at risk of internalizing victim-blaming myths and stigma. Cognitive-behavioral models posit the link between AISA and negative emotional outcomes may be explained through maladaptive appraisals and coping – i.e., characterological and behavioral self-blame, shame, low self-compassion (i.e., high self-coldness, low self-caring), and fear of self-compassion.MethodsUsing a cross-sectional design and community sample of younger adults (N = 409 Canadians, M = 28.2 years old, 51.3% women), we examined these mechanisms’ unique effects in mediating the associations between AISA and posttraumatic stress, general anxiety, and depressive symptoms, respectively.ResultsIn terms of gender differences, AISA was more common, self-coldness higher, and general anxiety symptoms more frequent in women, and fear of self-compassion was higher in men. Using structural equation modeling that controlled for gender and the overlap between outcomes, shame emerged as the strongest mediator linking AISA with all emotional outcomes. Fear of self-compassion also partially mediated the AISA-posttraumatic stress symptom association, self-coldness partially mediated the AISA-general anxiety symptom association, and characterological self-blame fully mediated the AISA-depressive symptom association.ConclusionAvoidance-based processes, ruminative−/worry-based cognitions, and negative self-evaluative cognitions may be distinctly relevant for AISA-related posttraumatic stress, general anxiety, and depressive symptoms, respectively, after accounting for the overarching mediation through shame. These internalized stigma-related mechanisms may be useful to prioritize in treatment to potentially reduce AISA-related negative emotional outcomes, particularly for AISA survivors with posttraumatic stress, general anxiety, and/or depressive symptoms.

BACKGROUND: Identification of genetic risk factors may inform the prevention and treatment of posttraumatic stress disorder (PTSD). This study evaluates the associations of polygenic risk scores (PRS) with patterns of posttraumatic stress symptoms following combat deployment. METHOD: US Army soldiers of European ancestry (n = 4900) provided genomic data and ratings of posttraumatic stress symptoms before and after deployment to Afghanistan in 2012. Latent growth mixture modeling was used to model posttraumatic stress symptom trajectories among participants who provided post-deployment data (n = 4353). Multinomial logistic regression models tested independent associations between trajectory membership and PRS for PTSD, major depressive disorder (MDD), schizophrenia, neuroticism, alcohol use disorder, and suicide attempt, controlling for age, sex, ancestry, and exposure to potentially traumatic events, and weighted to account for uncertainty in trajectory classification and missing data. RESULTS: Participants were classified into low-severity (77.2%), increasing-severity (10.5%), decreasing-severity (8.0%), and high-severity (4.3%) posttraumatic stress symptom trajectories. Standardized PTSD-PRS and MDD-PRS were associated with greater odds of membership in the high-severity v. low-severity trajectory [adjusted odds ratios and 95% confidence intervals, 1.23 (1.06-1.43) and 1.18 (1.02-1.37), respectively] and the increasing-severity v. low-severity trajectory [1.12 (1.01-1.25) and 1.16 (1.04-1.28), respectively]. Additionally, MDD-PRS was associated with greater odds of membership in the decreasing-severity v. low-severity trajectory [1.16 (1.03-1.31)]. No other associations were statistically significant. CONCLUSIONS: Higher polygenic risk for PTSD or MDD is associated with more severe posttraumatic stress symptom trajectories following combat deployment. PRS may help stratify at-risk individuals, enabling more precise targeting of treatment and prevention programs.

Abstract Background Pregnant women who have undergone pregnancy loss often display both posttraumatic stress (PTS) and posttraumatic growth (PTG). However, the precise relationship and structure of symptomatic levels of PTS and PTG have not been well understood. This study aimed to assess the associations between PTS and PTG symptoms in women during subsequent pregnancies following a previous pregnancy loss. Methods A total of 406 pregnant women with a history of pregnancy loss were included in this study. The Impact of Events Scale-6 (IES-6) and the Posttraumatic Growth Inventory Short Form (PTGI-SF) were used to assess symptoms of PTS and PTG, respectively. The Graphical Gaussian Model was employed to estimate the network model. Central symptoms and bridge symptoms were identified based on “expected influence” and “bridge expected influence” indices, respectively. The stability and accuracy of the network were examined using the case-dropping procedure and nonparametric bootstrapped procedure. Results The network analysis identified PTG3 (“Ability to do better things”) as the most central symptom, followed by PTS3 (“Avoidance of thoughts”) and PTG6 (“New path for life”) in the sample. Additionally, PTS3 (“Avoidance of thoughts”) and PTG9 (“Perception of greater personal strength”) were bridge symptoms linking PTS and PTG clusters. The network structure was robust in stability and accuracy tests. Conclusions Interventions targeting the central symptoms identified, along with key bridge symptoms, have the potential to alleviate the severity of PTS experienced by women with a history of pregnancy loss and promote their personal growth.

Posttraumatic stress disorder (PTSD) is associated with functional impairment and poor quality of life (QoL) across multiple domains, such as social functioning, occupational and educational attainment, physical health, and overall life satisfaction and wellbeing. Yet, there is limited evidence for which PTSD symptom clusters may be more strongly associated with functional impairment and decreased QoL. We used a seven-factor model of PTSD (re-experiencing, avoidance, negative alterations, anhedonia, externalizing, dysphoric arousal, and anxious arousal) to predict QoL using a latent regression model in a sample (N = 537) of adult patients participating in exposure-based PTSD partial hospitalization programs (PHP). QoL was measured by the Quality-of-Life Satisfaction Questionnaire—Short Form (Q-LES-Q-SF). Among posttraumatic symptoms, anhedonia emerged as the only significant predictor in the model (β = −8.60, SE = 3.02, p = 0.004), when controlling for depression scores. The overall model accounted for 40% of the variance in QoL. Depression was also significantly associated with QoL (β = −1.67, SE = 0.15, p < 0.001), controlling for PTSD symptoms. Our findings are congruent with prior research supporting the role of anhedonia and emotional numbing in functional impairment, yet differ in that other factors of PTSD (e.g., re-experiencing, avoidance, negative alterations) were not significant. Understanding which PTSD symptom clusters are more strongly associated with QoL may inform treatment approaches or allow clinicians to tailor treatments. We discuss implications for treatment and future research.