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There has been concern about adolescent mental health during the pandemic. The current study examined adolescent mental health during the initial phase of the COVID-19 pandemic in the UK. Using indicator of psychological distress, wellbeing and resilience, latent profile analysis was used to identify homogeneous mental health groups among young people aged 13–24 (N = 1971). Multinomial logistic regression was then used to examine which sociodemographic and psychosocial variables predicted latent class membership. Four classes were found. The largest class (Class 1, 37.2%) was characterised by moderate symptomology and moderate wellbeing. Class 2 (34.2%) was characterised by low symptomology and high wellbeing, while Class 3 (25.4%) was characterised by moderate symptomology and high wellbeing. Finally, Class 4 was the smallest (3.2%) and was characterised by high symptomology and low wellbeing. Compared to the low symptomology, high wellbeing class, all other classes were associated with less social engagement with friends, poorer family functioning, greater somatic symptoms, and a less positive model of self. A number of unique associations between the classes and predictor variables were identified. Although around two-thirds of adolescents reported moderate-to-high symptomology, most of these individuals also reported concurrent moderate-to-high levels of wellbeing, reflecting resilience. Furthermore, these findings demonstrate how a more comprehensive picture of mental health can be gained through adopting a dual-continua conceptualisation of mental health that incorporates both pathology and well-being. In this way, at-risk youth can be identified and interventions and resources targeted appropriately. [ABSTRACT FROM AUTHOR]

Introduction: Complex PTSD (CPTSD) is a relatively new condition in ICD-11. This pilot randomised controlled trial aimed to compare a four-module intervention developed to target all symptoms of ICD-11 CPTSD, namely Enhanced Skills in Affective and Interpersonal Regulation (ESTAIR) with treatment as usual (TAU). The purpose of the study was to assess feasibility, safety, acceptability, and preliminary outcomes at the end of treatment and 3-month follow-up. Methods: A total of N = 56 eligible veterans with CPTSD were randomised to either ESTAIR (n = 28) or TAU (n = 28). Linear mixed models were conducted to assess CPTSD severity, the primary outcome, as measured by the International Trauma Questionnaire (ITQ). Results: Treatment dropout in ESTAIR and TAU was low and equivalent (18% vs. 11%; χ2 (1) = 1.19, p = 0.275), and study retention was high, supporting the feasibility of the study. No serious adverse effects and very few adverse effects occurred, none of which were deemed related to the study. ESTAIR provided significantly greater reduction in CPTSD severity across time for ITQ PTSD (p < 0.001) and DSO (p < 0.001) symptoms. CPTSD pre-to-post effect sizes for ESTAIR were large (PTSD d = 1.78; DSO d = 2.00). Remission of probable CPTSD diagnosis at post-treatment was substantially greater in ESTAIR compared to TAU with only 13.6% versus 84% (p < 0.001) retaining the diagnosis. Conclusion: A trial of ESTAIR versus TAU for the treatment of ICD-11 CPTSD indicates the potential efficacy of ESTAIR as well as its feasibility, safety, and acceptability. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

The latent structure of ICD‐11 prolonged grief disorder (PGD), as measured using the International Prolonged Grief Disorder Scale (IPGDS), was assessed in a large general population sample of bereaved adults from the United Kingdom. Data were derived from Wave 5 of the COVID‐19 Psychological Research Consortium Study (C19PRC‐UK). Exploratory structural equation modeling (ESEM) was used to assess the latent structure of the IPGDS. Identified factors were explored in relation to known correlates (i.e., gender, age of the bereaved, income, bereavement timeframe, age of the deceased) and functional impairment. Three factors—Loss, Emotional Numbing, and Emotional Reactivity—emerged in the best‐fitting ESEM model, χ2(92, N = 1,763) = 273.70, p <.001, CFI =.97, TLI =.96, RMSEA =.048, SRMR =.020. All factors were significantly associated with bereavement timeframe, βs = ‐.15–‐.20, and age of the deceased, βs = ‐.22–‐.31. Lower income predicted both Loss and Emotional Numbing; younger age of the bereaved predicted both Loss and Emotional Reactivity; and female gender was a unique predictor of Loss. Functional impairment was associated only with Emotional Numbing, β =.89. The findings highlight the multidimensional structure of PGD. However, the patterns of factor/cross‐factor loadings observed in the present study indicate that a "simple" structure was not attainable. Associations between factors and covariates attest to the discriminant validity of the factors, and the association between Emotional Numbing and functional impairment may afford clinicians an opportunity to better understand and target the most disruptive features of grief. [ABSTRACT FROM AUTHOR]

Background: The psychosis continuum implies that subclinical psychotic experiences (PEs) can be differentiated from clinically relevant expressions since they are not accompanied by a 'need for care'. Methods: Using data from Wave 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC; N = 34 653), the current study examined variation in functioning, symptomology and aetiological risk across the psychosis phenotype [i.e. variation from (i) no PEs, 'No PEs' to (ii) non-distressing PEs, 'PE-Experienced Only' to (iii) distressing PEs, 'PE-Impaired' to (iv) clinically defined psychotic disorder, 'Diagnosed']. Results: A graded trend was present such that, compared to those with no PEs, the Diagnosed group had the poorest functioning, followed by the PE-Impaired then PE-Experienced Only groups. In relation to symptom expression, the PE-Impaired group were more likely than the PE-Experienced Only and the Diagnosed groups to endorse most PEs. Predictors of group membership tended to vary quantitatively rather than qualitatively. Trauma, current mental health diagnoses (anxiety and depression) and drug use variables differentiated between all levels of the continuum, with the exception of the extreme end (PE-Impaired v. Diagnosed). Only a few variables distinguished groups at the upper end of the continuum: female sex, older age, unemployment, parental mental health hospitalisation and lower likelihood of having experienced physical assault. Conclusions: The findings highlight the importance of continuum-based interpretations of the psychosis phenotype and afford valuable opportunities to consider if and how impairment, symptom expression and risk change along the continuum. [ABSTRACT FROM AUTHOR]

The present study aimed to examine the structure of the Prodromal Questionnaire-16 (PQ-16) in a non-help-seeking youth population through exploratory and confirmatory factor analysis. Previous studies have not examined the structure of this self-report measure in this age group outside a clinical setting. Participants (n = 1165) aged 11–19 years were recruited to an epidemiological study of young people in Northern Ireland, and completed the PQ-16 alongside other measures. The dataset was split randomly in two for separate factor analyses. A polychoric correlation matrix was created and exploratory factor analysis was used to identify the optimal number of factors. In addition, based on previous studies, six models were tested through confirmatory factor analysis to determine best fit. A one-factor, 3 two-factor, a three-factor and a four-factor model were all tested. The exploratory factor analysis indicated a two-factor structure of the PQ-16 in this population, which we have labelled 'general unusual experiences' and 'hallucinations'. Confirmatory analysis indicated that the two-factor model identified through the exploratory analysis was the best fit for the data. The present study suggests that the structure of the PQ-16 may vary across age groups in non-clinical settings, and adds further support to the validity of the PQ-16 is a cost-effective, easy to administer self-report measure that is suitable for use in non-help-seeking populations as a screening tool for prodromal symptoms. [ABSTRACT FROM AUTHOR]

Background: Prolonged Grief Disorder (PGD) is a new disorder included in ICD-11 (WHO, 2018). There is a growing body of literature surrounding the prevalence and correlates of ICD-11 PGD symptoms as assessed using various measures. This study was the first to assess levels of ICD-11 PGD symptoms as measured by the International Prolonged Grief Disorder Scale (IPGDS), a self-report scale directly aligned with the ICD-11 definition of PGD, among the United Kingdom adult general population, and identify correlates. Method: Participants included 2025 adults who participated in Wave 5 of the COVID-19 Psychological Research Consortium Study (C19PRC-UK). Prevalence rates of PGD were estimated based on two commonly used algorithms defined as 'strict' and 'moderate'. Sociodemographic, loss-related, and mental health correlates (i.e., anxiety, depression, mental health treatment seeking, loneliness) of strict and moderate PGD were then examined using multinomial logistic regressions. Results: It was found that 2.4% (n = 43) of participants met probable caseness for PGD using the strict criteria while 7.9% (n = 140) met probable caseness for PGD using the moderate criteria. Multinomial logistic regression analysis results showed, as predicted, that income, time since bereavement, death of a child, religiosity, and depression were associated with both moderate and strict PGD. Correlates of moderate PGD included country of residence, urbanicity, younger age of bereaved, and loneliness. Conclusions: This study highlights that some symptoms of PGD are commonly reported in the general population, although relatively few meet the criteria for clinical significance. The routine assessment for PGD following a bereavement is discussed and the development of appropriate interventions are recommended. [ABSTRACT FROM AUTHOR]

The 11th version of the International Classification of Diseases (ICD-11) includes complex posttraumatic stress disorder (CPTSD) as a separate diagnostic entity alongside posttraumatic stress disorder (PTSD). ICD-11 CPTSD is defined by six sets of symptoms, three that are shared with PTSD (reexperiencing in the here and now, avoidance, and sense of current threat) and three (affective dysregulation, negative self-concept, and disturbances in relationships) representing pervasive "disturbances in self-organization" (DSO). There is considerable evidence supporting the construct validity of ICD-11 CPTSD, but no theoretical account of its development has thus far been presented. A theory is needed to explain several phenomena that are especially relevant to ICD-11 CPTSD such as the role played by prolonged and repeated trauma exposure, the functional independence between PTSD and DSO symptoms, and diagnostic heterogeneity following trauma exposure. The memory and identity theory of ICD-11 CPTSD states that single and multiple trauma exposure occur in a context of individual vulnerability which interact to give rise to intrusive, sensation-based traumatic memories and negative identities which, together, produce the PTSD and DSO symptoms that define ICD-11 CPTSD. The model emphasizes that the two major and related causal processes of intrusive memories and negative identities exist on a continuum from prereflective experience to full self-awareness. Theoretically derived implications for the assessment and treatment of ICD-11 CPTSD are discussed, as well as areas for future research and model testing. [ABSTRACT FROM AUTHOR]

Despite growing emphasis on the benefits of physical activity for promoting mental health, inclusion of muscle-strengthening (MS) (e.g., body-weight exercises, resistance machines) activities is limited. Notably, few studies collectively assess MS behavioural frequency, duration, and intensity. To address the gap, the current study examined associations between frequency (days), intensity (rating of perceived exertion in relation to repetitions in reserve [RPE/RIR]), and duration (minutes per typical session) of MS activities on anxiety, depression, and mental well-being. A cross-sectional study of 601 participants (Mean age = 30.92 years [SD = 12.70]; 57.7 % female) across Ireland was conducted. Participants completed a self-report questionnaire containing MS instruments previously used, or adapted from valid and reliable measures (i.e., International Physical Activity Questionnaire IPAQ, RPE/RIR), alongside, the Generalized Anxiety Disorder-7 (GAD-7), Patient Health Questionnaire-8 (PHQ-8) and the Mental Health Continuum- Short Form (MHC-SF). A multivariate regression model was tested in MPLUS, using dummy coding for MS frequency in relation to no activity (i.e., 0-days) non-adherence (i.e., 1-day), adherence (i.e., 2-days) and enhanced adherence (i.e., ≥3 days) to the MS public health guidelines, with the mental health variables representing the dependent variables. Intensity and duration were specified in the model as continuous variables; gender and age were included as statistical controls. Three or more days engaged in MS activities was associated with fewer anxiety (β = −0.12, p <.05) and depression (β = −0.14, p <.01) symptoms. Increased intensity had a negative association with anxiety (β = −0.10, p <.05) and depression (β = −0.15, p <.001). Unexpectedly, adherence to the MS guidelines (2-days) did not predict any of the mental health outcomes, whereas 1-day of MS activity was associated with fewer depression symptoms (β = −0.11). No effects were observed for mental well-being, and MS duration exerted a null effect across all mental health outcomes. Higher frequency and intensity of MS activities may protect against anxiety and depression symptoms. Doing some MS activities (at least 1-day) is likely more beneficial than none for depression. Evidence-based, MS interventions may help curb mental illness rates, and future longitudinal, intervention-based research could consider inclusion of MS frequency, intensity and duration variables to enhance efforts to identify at-risk groups and trends within physical activity and mental illness surveillance. • Few studies collectively assess the frequency, intensity and duration of muscle-strengthening physical activities (MS). • MS frequency was dummy coded in relation to no activity (0-days), non-adherence (1-day), adherence (2-days), and enhanced adherence (3-days or more) of the public health guidelines, and regressed onto mental health outcomes alongside MS duration and intensity. • Higher frequency and intensity of MS activities protected against depression and anxiety. • Findings support the rationale for co-produced, evidence-based, MS interventions to help curb mental illness rates. [ABSTRACT FROM AUTHOR]

Background: The new International Classification of Diseases came into effect in 2022 (ICD‐11; World Health Organization, 2022) and included updated descriptions and diagnostic rules for "Depressive Episode" and "Generalized Anxiety Disorder." No self‐report measures align with these disorders so this study reports the development and initial validation of the "International Depression Questionnaire" (IDQ) and "International Anxiety Questionnaire" (IAQ). Methods: Items were developed that aligned to the ICD‐11 descriptions and their performance was assessed using data from a community sample (N = 2058) that was representative of the United Kingdom adult population. Results: Item response theory models indicated that the two scales were unidimensional, and the items performed well in terms of difficulty and discrimination. Estimates of internal reliability were high. Based on ICD‐11 derived diagnostic algorithms, 7.4% met requirements for ICD‐11 Depressive Episode and 7.1% for Generalized Anxiety Disorder. Conclusions: The IDQ and the IAQ are short, easy to use, self‐report measures aligned to the new and updated ICD‐11 diagnostic descriptions. This study provides initial evidence that the scales produce scores that are reliable and valid. [ABSTRACT FROM AUTHOR]

Background: High rates of posttraumatic stress disorder (PTSD) have been documented in war‐affected populations. The prevalence of Complex PTSD (CPTSD) has never been assessed in an active war zone. Here, we provide initial data on war‐related experiences, and prevalence rates of ICD‐11 PTSD and CPTSD in a large sample of adults in Ukraine during the Russian war. We also examined how war‐related stressors, PTSD, and CPTSD were associated with age, sex, and living location in Ukraine. Method: Self‐report data were gathered from a nationwide sample of 2004 adult parents of children under 18 from the general population of Ukraine approximately 6 months after Russia's invasion. Results: All participants were exposed to at least one war‐related stressor, and the mean number of exposures was 9.07 (range = 1–26). Additionally, 25.9% (95% CI = 23.9%, 27.8%) met diagnostic requirements for PTSD and 14.6% (95% CI = 12.9%, 16.0%) met requirements for CPTSD. There was evidence of a strong dose–response relationship between war‐related stressors and meeting criteria for PTSD and CPTSD. Participants who had the highest exposure to war‐related stressors were significantly more likely to meet the requirements for PTSD (OR = 4.20; 95% CI = 2.96–5.95) and CPTSD (OR = 8.12; 95% CI = 5.11–12.91) compared to the least exposed. Conclusions: Humanitarian responses to the mental health needs of the Ukrainian population will need to take account of posttraumatic stress reactions. Education in diagnosing and treating PTSD/CPTSD, especially in the situation of a significant lack of human resources and continuing displacement of the population, is necessary. [ABSTRACT FROM AUTHOR]

Background: The current study argues that population prevalence estimates for mental health disorders, or changes in mean scores over time, may not adequately reflect the heterogeneity in mental health response to the COVID-19 pandemic within the population. Methods: The COVID-19 Psychological Research Consortium (C19PRC) Study is a longitudinal, nationally representative, online survey of UK adults. The current study analysed data from its first three waves of data collection: Wave 1 (March 2020, N = 2025), Wave 2 (April 2020, N = 1406) and Wave 3 (July 2020, N = 1166). Anxiety-depression was measured using the Patient Health Questionnaire Anxiety and Depression Scale (a composite measure of the PHQ-9 and GAD-7) and COVID-19-related posttraumatic stress disorder (PTSD) with the International Trauma Questionnaire. Changes in mental health outcomes were modelled across the three waves. Latent class growth analysis was used to identify subgroups of individuals with different trajectories of change in anxiety-depression and COVID-19 PTSD. Latent class membership was regressed on baseline characteristics. Results: Overall prevalence of anxiety-depression remained stable, while COVID-19 PTSD reduced between Waves 2 and 3. Heterogeneity in mental health response was found, and hypothesised classes reflecting (i) stability, (ii) improvement and (iii) deterioration in mental health were identified. Psychological factors were most likely to differentiate the improving, deteriorating and high-stable classes from the low-stable mental health trajectories. Conclusions: A low-stable profile characterised by little-to-no psychological distress ('resilient' class) was the most common trajectory for both anxiety-depression and COVID-19 PTSD. Monitoring these trajectories is necessary moving forward, in particular for the ~30% of individuals with increasing anxiety-depression levels. [ABSTRACT FROM AUTHOR]

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. [ABSTRACT FROM AUTHOR]

Developmental Trauma Disorder (DTD) is a proposed child psychopathology diagnosis with emotion/somatic, attention/behavioral, and self/relational dysregulation symptoms extending beyond posttraumatic stress disorder (PTSD). Confirmatory factor analyses (CFAs) tested four structural models with structured interview data for trauma history, PTSD, and DTD with 507 children receiving mental health or pediatric care (N = 162, 32% diagnosed with DTD; N = 176; 35% with PTSD; N = 169, 33% with neither). A unidimensional model with a single latent variable had unacceptable fit (RMSEA = 0.094; CFI = 0.844). Compared to a model with PTSD and DTD as correlated first-order latent variables, a multidimensional model with correlated latent variables corresponding to the PTSD and DTD symptom clusters (Dc 2 =105.62, Ddf = 14, p <.001) and a hierarchical variant with correlated second order DTD and PTSD latent variables (Dc 2 =48.10, Ddf = 6, p <.001) fit the data better. The non-hierarchical multidimensional model was superior to the hierarchical variant (Dc 2 =66.05, Ddf = 8, p <.001). Stronger latent variable inter-correlations within PTSD and DTD domains than across domains, suggested that DTD and PTSD are distinguishable despite their inter-correlation. Exposure to family violence was the primary correlate of both the DTD and PTSD second-order latent variables. Results indicate that children's trauma-related symptoms involve six inter-correlated domains extend beyond PTSD's symptoms (i.e., re-experiencing, avoidance, arousal) to include DTD symptoms of emotional, cognitive-behavioral, and self-relational dysregulation. The inter-relationship of the DTD and PTSD latent variables suggest that DTD may constitute a component within a complex PTSD diagnosis paralleling the new adult CPTSD diagnosis. [ABSTRACT FROM AUTHOR]

A recent suicidal drive hypothesis posits that psychotic experiences (PEs) may serve to externalize internally generated and self-directed threat (i.e., self-injurious/suicidal behavior [SIB]) in order to optimize survival; however, it must first be demonstrated that such internal threat can both precede and inform PEs. The current study conducted the first known bidirectional analysis of SIB and PEs to test whether SIB could be considered as a plausible antecedent for PEs. Prospective data were utilized from the Environmental Risk (E-Risk) Longitudinal Twin Study, a nationally representative birth cohort of 2232 twins, that captured SIB (any self-harm or suicidal attempt) and PEs at ages 12 and 18 years. Cross-lagged panel models demonstrated that the association between SIB at age 12 and PEs at age 18 was as strong as the association between PEs at age 12 and SIB at age 18. Indeed, the best representation of the data was a model where these paths were constrained to be equal (OR = 2.48, 95% CI = 1.63–3.79). Clinical interview case notes for those who reported both SIB and PEs at age 18, revealed that PEs were explicitly characterized by SIB/threat/death-related content for 39% of cases. These findings justify further investigation of the suicidal drive hypothesis. [ABSTRACT FROM AUTHOR]

Although there has been significant work on the association between posttraumatic stress disorder (PTSD) and attachment orientation, this is less the case for complex PTSD (CPTSD). The primary aim of this paper was to assess the strength of the association between the four adult attachment styles (i.e., secure, dismissing, preoccupied, and fearful) and severity of CPTSD symptoms (i.e., symptoms of PTSD and disturbances in self-organization [DSO]). We hypothesized that attachment orientation would be more strongly associated with DSO symptoms compared to PTSD symptoms. A trauma exposed clinical sample (N = 331) completed self-report measures of traumatic life events, CPTSD symptoms, and attachment orientation. It was found that secure attachment and fearful attachment were significantly associated with DSO symptoms but not with PTSD symptoms. Dismissing attachment style was significantly associated with PTSD and DSO symptoms. Preoccupied attachment was not significantly associated with CPTSD symptoms. Treatment implications for CPTSD using an attachment framework are discussed. [ABSTRACT FROM AUTHOR]

The article discusses the mental health consequences for the Ukrainian people due to the recent military invasion and displacement caused by the ongoing conflict. Topics include the prevalence of mental health problems among internally displaced Ukrainians, the limited availability of mental health services and the importance of evidence-based interventions.

Paranoia and belief in conspiracy theories both involve suspiciousness about the intentions of others but have rarely been studied together. In three studies, one with a mainly student sample (N = 496) and two with more representative UK population samples (N = 1,519, N = 638) we compared single and two-factor models of paranoia and conspiracy theories as well as associations between both belief systems and other psychological constructs. A model with two correlated factors was the best fit in all studies. Both belief systems were associated with poor locus of control (belief in powerful others and chance) and loneliness. Paranoid beliefs were specifically associated with negative self-esteem and, in two studies, insecure attachment; conspiracy theories were associated with positive self-esteem in the two larger studies and narcissistic personality traits in the final study. Conspiracist thinking but not paranoia was associated with poor performance on the Cognitive Reflection Task (poor analytical thinking). The findings suggest that paranoia and belief in conspiracy theories are distinct but correlated belief systems with both common and specific psychological components. [ABSTRACT FROM AUTHOR]

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 FROM AUTHOR]

Background: The new International Classification of Diseases was published in 2018 (ICD‐11; World Health Organization, 2018) and now includes 'Mixed depressive and anxiety disorder' (6A73: MDAD) designated as a mood disorder. This disorder is defined by symptoms of both anxiety and depression occurring more days than not, for a period of two weeks, and neither set of symptoms considered separately reaches a diagnostic threshold for either disorder. However, to date no study has examined the validity of these guidelines in a general population sample. Methods: Using Goldberg et al.'s (2017) guidelines regarding measurement of depression and anxiety, this study used factor mixture modelling (FMM) to examine the validity of the ICD‐11 criteria of MDAD. Symptom endorsement rates are provided as well as demographic predictors and somatization outcomes. Results: Fit indices suggested the two‐factor four‐class solution was the best balance between model complexity and model fit. The results did not support a class that is subsyndromal to both anxiety and depression. On the contrary, we suggest that there exists a 'Comorbid' class that represents endorsement of both anxiety and depression symptoms at a higher level when compared to both 'anxiety' and 'depression' groups. Demographic predictors, as well as somatization and functional impairment outcomes, provided support for this FMM solution. Conclusions: The 'Comorbid' group was the largest symptomatic group and had the highest levels of both anxiety and depression symptoms. Importantly, this group was larger than either the 'anxiety' or 'depression' group and was associated with high levels of functional impairment and somatization. [ABSTRACT FROM AUTHOR]

Clinician-administered interviews are widely considered the 'gold standard' method of assessing psychological distress. We challenge this assumption by noting that there is no empirical evidence demonstrating that psychological distress scores derived from clinician-administered interviews more accurately reflect true psychological distress scores than those derived from self-report questionnaires. Furthermore, we argue that the clinician-administered interview method is not well-suited to measuring subjective experiences of psychological distress and is likely to generate higher levels of measurement error compared to self-reports due to there being two sources of measurement error: the interviewee and the interviewer. Contrary to popular opinion, we argue that the self-report method is superior to the clinician-administered interview method for assessing subjective psychological distress. [ABSTRACT FROM AUTHOR]

The mental health consequences of the war in Ukraine will be enormous. Mental health professionals who are providing care for people in Ukraine, or those resettled elsewhere, may require access to standardized and validated assessment tools. We have developed a repository of mental health measures that are available in Ukrainian, Russian and English and can be accessed at www.traumameasuresglobal.com/ukraine. [ABSTRACT FROM AUTHOR]

The mental health consequences of the war in Ukraine will be enormous. Mental health professionals who are providing care for people in Ukraine, or those resettled elsewhere, may require access to standardized and validated assessment tools. We have developed a repository of mental health measures that are available in Ukrainian, Russian, and English and can be accessed at http://www.traumameasuresglobal.com/ukraine. [ABSTRACT FROM AUTHOR]

Risk factors for psychological distress among help-seeking youth are poorly understood. Addressing this gap is important for informing mental health service provision. This study aimed to identify risk factors among youth attending Jigsaw, a youth mental health service in Ireland. Routine data were collected from N = 9,673 youth who engaged with Jigsaw (Mean age = 16.9 years, SD = 3.14), including presenting issues, levels of psychological distress, age, and gender. Confirmatory Factor Analysis identified thirteen factors of clustering issues. Several factors, including Self-criticism and Negative Thoughts, were strongly associated with items clustering as psychological distress, however these factors were poorly predictive of distress as measured by the CORE (YP-CORE: R2 = 14.7%, CORE-10: R2 = 6.9%). The findings provide insight into associations between young people's identified presenting issues and self-identified distress. Implications include applying appropriate therapeutic modalities to focus on risk factors and informing routine outcome measurement in integrated youth mental health services. [ABSTRACT FROM AUTHOR]

The ongoing war in Ukraine is expected to negatively impact the mental health of the country's population. This study aims to provide a preliminary estimate of the degree of change in the mental health problems of Ukrainian children following Russia's invasion in February 2022, and to identify the sociodemographic and war-related risk factors associated with these changes. A nationwide, opportunistic sample of 1238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected between July 15th and September 5th, 2022. Participants completed modified versions of the Pediatric Symptom Checklist (PSC-17) which was adapted to capture change in the frequency of symptoms since the beginning of the war. Parents reported increases across all 17 indicators of internalizing, externalizing, and attention problems of the PSC-17. Increased problems were most pronounced within the internalizing domain, with 35% of parents reporting that their child worried more since the beginning of the war. A number of individual, parental, and war-related factors were associated with increases across the three domains. Exposure to war trauma, pre-existing mental health problems, and child age were among the strongest predictors of change. This survey provides preliminary evidence that the Russian war on Ukraine has led to an increase in common mental health problems among children in the general population. Further research is required to determine the extent and sequela of this increase, and to develop intervention strategies for those most in need. [ABSTRACT FROM AUTHOR]

Background: Although high rates of bereavement are evident in war‐affected populations, no study has investigated the prevalence and correlates of probable ICD‐11 prolonged grief disorder (PGD) under these circumstances. Methods: Participants were 2050 adults who participated in a nationwide survey exploring the effects of the Ukraine‐Russia war on the daily lives and mental health of Ukrainian people. Results: Of the total sample, 87.7% (n = 1797) of people indicated a lifetime bereavement. In the full sample, 11.4% met the diagnostic requirements for probable ICD‐11 PGD, and amongst those with a lifetime bereavement, the conditional rate of probable ICD‐11 PGD was 13.0%. Significant risk factors of ICD‐11 PGD included the recent loss of a loved one (6 months to a year ago), being most affected by a partner or spouse's death, loved one dying in the war, no recent contact with the deceased prior to their death, and meeting depression and anxiety diagnostic requirements. Conclusion: The study reveals that a significant percentage of Ukrainian bereaved individuals have probable ICD‐11 PGD, and identifying risk factors, particularly war‐related losses, will aid in the development of intervention and prevention programs for bereaved adults. [ABSTRACT FROM AUTHOR]

Background: Although ICD-11 adjustment (AjD), posttraumatic stress (PTSD) and complex posttraumatic stress (CPTSD) are commonly diagnosed disorders following exposure to stressful or traumatic life events, their dimensional structure and co-occurrence has never been tested in a single study. The present study explored the latent structure of AjD, PTSD, and CPTSD symptoms and their relationship to stressful and traumatic life events to determine the degree of distinctiveness between these constructs. Methods: Participants were clinical patients (N = 331) who completed self-report measures of stressful and traumatic life events, AjD (The Adjustment Disorder – New Module 8 (ADNM-8)) and PTSD / CPTSD (The International Trauma Questionnaire – ITQ). Results: Using confirmatory factor analysis, a second-order model comprised of correlated latent variables of AjD, PTSD, and CPTSD provided the best fit of the data. It was also found that stressors and traumatic life events were positively associated with all of these conditions although childhood trauma was only associated with CPTSD. Conclusions: The current findings support the ICD-11 model of related-but-distinct stress-related disorders. We discuss the existence of a stress-response continuum and how the current findings impact the development of clinical interventions that may be shared across, or unique to, each stress-related disorder. [ABSTRACT FROM AUTHOR]

This study aimed to estimate the association between anxiety associated with COVID-19 and somatic symptoms, using data from a large, representative sample (N = 2,025) of the UK adult population. Results showed that moderate to high levels of anxiety associated with COVID-19 were significantly associated with general somatic symptoms and in particular with gastrointestinal and fatigue symptoms. This pattern of associations remained significant after controlling for generalized anxiety disorder (GAD), pre-existing health problems, age, gender, and income. This is the first evidence that anxiety associated with COVID-19 makes a unique contribution to somatization, above and beyond the effect of GAD. [ABSTRACT FROM AUTHOR]

The prevalence of posttraumatic stress disorder (PTSD) as it relates to individuals' experiences of the COVID-19 pandemic has yet to be determined. This study was conducted to determine rates of COVID-19-related PTSD in the Irish general population, the level of comorbidity with depression and anxiety, and the sociodemographic risk factors associated with COVID-19-related PTSD. A nationally representative sample of adults from the general population of the Republic of Ireland (N = 1,041) completed self-report measures of all study variables. The rate of COVID-19-related PTSD was 17.7% (n = 184), 95% CI [15.35%, 19.99%], and there was a high level of comorbidity with generalized anxiety (49.5%) and depression (53.8%). Meeting the diagnostic requirement for COVID-19-related PTSD was associated with younger age, male sex, living in a city, living with children, moderate and high perceived risk of COVID-19 infection, and screening positive for anxiety or depression. Posttraumatic stress symptoms related to the COVID-19 pandemic are common in the general population. Our results show that health professionals responsible for responding to the COVID-19 pandemic should expect to routinely encounter symptoms and concerns related to posttraumatic stress. [ABSTRACT FROM AUTHOR]

Background: Beta Thalassaemia Major (βTM) is a chronic genetic illness whereby the challenges faced by patients exposes them to increased risk of psychosocial issues. Despite this, a disease-specific tool to measure the impact of this illness on adult patients has yet to be developed.Methods: In collaboration with βTM adult patients, this study aimed to develop a comprehensive, disease-specific, easy to use psychometrically sound tool to measure the impact of chelation and transfusion dependent βTM in a cross-cultural patient group in England.The Thalassaemia Life Index (ThALI) was developed in two stages - item generation and pre-testing and item reduction - in collaboration with service users. Recruited adult patients shaped the design of the instrument including its statements and subscales. Standard item reduction techniques were used to develop the instrument.Results: The final version of the ThALI encompasses 35 statements and five sub-scales - general physical health, coping, body image, appearance and confidence, social relationships and autonomy. This endorses the multidimensionality of quality of life (QoL). The factor structure of the ThALI is highly stable and its internal consistency is high (alpha = 0.87 for the overall scale; 0.83-0.94 for its subscales). The ThALI has sound scaling assumptions, acceptability and score variability. Content validity was confirmed by experts and service user interviewees. The loadings for the items retained were adequate and the item discriminant validity sound.Conclusions: The ThALI covers the impact of βTM in adult patients. Preliminary testing shows its multidimensionality to be reliable and valid. The national authentication of the tool with patients treated in Centres of Excellence will aim to provide further evidence regarding the ThALI's psychometric properties. Once authenticated, the ThALI may be utilised in research and in clinical settings to assess the effects of new therapies and/or interventions from the patients' perspective to inform practice and/or to identify areas of concern. [ABSTRACT FROM AUTHOR]

Objectives: Research largely supports the clinical effectiveness of low‐intensity cognitive behavioural therapy (LICBT) for mild‐to‐moderate anxiety and depression, delivered by psychological well‐being practitioners (PWPs). Knowledge regarding the predictors of treatment response, however, is relatively limited. The primary aim of this study was to model the heterogeneity in longitudinal changes in anxiety and depression throughout LICBT provided by PWPs in Northern Ireland (NI), and to explore associations between pre‐treatment variables and differences in treatment response. Methods: Growth mixture modelling (GMM) techniques were employed to examine changes in psychological status in clients (N = 253) over the first six sessions of treatment, to identify divergent early response trajectories. A series of pre‐treatment variables were used to predict class membership using chi‐square tests and binary logistic regression models. Results: There was one class representing improvement and one representing no improvement for both anxiety and depression. Class membership was predictive of treatment outcome. Pre‐treatment variables associated with less improvement included unemployment, risk of suicide, neglect of self or others, using medication, receiving previous or concurrent treatments, a longer duration of difficulties, and comorbidities. Conclusions: Findings indicate most of the sample populated an 'improvers' class for both depression and anxiety. Pre‐treatment variables identified as predictive of poor treatment response may need to be considered by practitioners in potential triage referral decision policies, supporting cost‐effective and efficient services. Further research around predictors of clinical outcome is recommended. Practitioner points: Most of the sample belonged to an 'improvers' class.Several pre‐treatment variables predicted poor treatment response (unemployment, suicide risk, neglect, medication, previous or concurrent treatments, longer duration of difficulties, and comorbidities).Few studies have utilized GMM to determine predictors of outcome following LICBTRegarding pre‐treatment variables, the possibility of self‐report bias cannot be excluded.The time period was relatively short, although represented the optimum number of sessions recommended for LICBT.The lack of a control group and random allocation were the main limitations. [ABSTRACT FROM AUTHOR]

Debate exists in the trauma literature regarding the role of dissociation in traumatic stress disorders. With the release of the new ICD-11 diagnostic guideline for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD), this issue warrants further attention. In the current study, we provide a preliminary assessment of the associations between ICD-11 CPTSD and dissociative experiences. This study is based on a sample (N = 106) of highly traumatized clinical patients from the United Kingdom who completed measures of traumatic stress and dissociative experiences. The majority of participants met the diagnostic criteria for CPTSD (69.1%, n = 67), with few patients qualifying for a diagnosis of PTSD (9.3%, n = 9). Those with CPTSD had significantly higher levels of dissociative experiences compared to those with PTSD (Cohen's d = 1.04) and those with no diagnosis (Cohen's d = 1.44). Three CPTSD symptom clusters were multivariately associated with dissociation: Affective Dysregulation (β =.33), Re-experiencing in the here and now (β =.24), and Disturbed Relationships (β =.22). These findings indicate that dissociative experiences are particularly relevant for clinical patients with CPTSD. Future longitudinal work will be needed to determine if dissociation is a risk factor for, or outcome of, CPTSD. [ABSTRACT FROM AUTHOR]

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. 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. 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. 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. 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. [ABSTRACT FROM AUTHOR]

Background: Death by suicide is often preceded by attempted suicide, suicidal ideation and non-suicidal self-injury. These extreme thoughts and behaviours have been considered in terms of a continuum of suicidality. Little known research, however, has considered a suicide continuum that extends beyond these extreme thoughts and behaviours and incorporates a much wider array of phenomena that may vary in severity and may constitute a broader negative self-evaluation (NSE) continuum. Method: Harvesting key indicators of NSE from a British epidemiological survey (N = 8580), the current study used exploratory factor analysis, confirmatory factor analysis and factor mixture modelling to (i) identify the dimensional structure of NSE in the general population and (ii) profile the distribution of the resultant NSE dimensions. Multinomial logistic regression was then used to differentiate between classes using an array of risk variables, psychopathology outcome variables and a suicide attempt indicator. Results: A 4-factor model that reflected graded levels of NSE was identified; (F1) Low self-worth & subordination (F2) depression, (F3) suicidal thoughts, (F4) self-harm (SH). Seven classes suggested a clear pattern of NSE severity. Classes characterised by higher levels across the dimensions exhibited greater risk and poorer outcomes. The greatest risk for suicide attempt was associated with a class characterised by engagement in SH behaviour. Conclusions: Low self-worth, subordination and depression, while representative of distinct groups in the population are also highly prevalent in those who entertain suicidal thoughts and engage in SH behaviour. The findings promote further investigation into the genesis and evolution of suicidality and internal threat. [ABSTRACT FROM AUTHOR]

Purpose: Loneliness is a recognised public-health concern that is traditionally regarded as a unidimensional construct. Theories of loneliness predict the existence of subtypes of loneliness. In this study, latent class analysis (LCA) was used to test for the presence of loneliness subtypes and to examine their association with multiple mental health variables.Methods: A nationally representative sample of US adults (N = 1839) completed the De Jong Gierveld Loneliness Scale, along with self-report measures of childhood and adulthood trauma, psychological wellbeing, major depression, and generalized anxiety.Results: When treated as a unidimensional construct, 17.1% of US adults aged 18-70 were classified as lonely. However, the LCA results identified four loneliness classes which varied quantitatively and qualitatively: 'low' (52.8%), 'social' (8.2%), 'emotional' (26.6%), and 'social and emotional' (12.4%) loneliness. The 'social and emotional' class were characterised by the highest levels of psychological distress, followed by the 'emotional' class. The 'social' loneliness class had similar mental health scores as the 'low' loneliness class. Childhood and adulthood trauma were independently related to the most distressed loneliness classes.Conclusions: Current findings provide support for the presence of subtypes of loneliness and show that they have unique associations with mental health status. Recognition of these subtypes of loneliness revealed that the number of US adults aged 18-70 experiencing loneliness was twice as high as what was estimated when loneliness was conceptualized as a unidimensional construct. The perceived quality, not the quantity, of interpersonal connections was associated with poor mental health. [ABSTRACT FROM AUTHOR]

Abstract Background Methodological issues have been identified when quantifying exposure to adversity and abuse. To address a single type may obscure covarying effects. To sum multiple exposures gives equal weight to each. Latent class analysis (LCA) addresses this by identifying homogenous subpopulations. Most studies using LCA have pooled gender data in spite of evidence that the nature and frequency of exposure differs by gender. Males report more interpersonal abuse, females report more of other exposures, particularly sexual. Objective This study aimed to identify if stratifying data by gender resulted in different profiles of adversity/abuse Participants and setting: The National Epidemiologic Survey on Alcohol and Related Conditions (NESARC) wave II, a large community-based survey, nationally representative of the US population. Method This study used 14 indicators of childhood adversity as the basis for LCA. Results The number and nature of classes differed by gender. The best solution for females was 4-class: a low risk class; a class at higher risk of sexual abuse; a class at higher risk of physical abuse; a class at higher risk of combined physical and sexual abuse. The best solution for males had only 3-classes; a low risk class, a class at higher risk of sexual abuse; a class at higher risk of physical abuse. The combined dataset resulted in a solution similar to the female solution. Conclusion The importance of developing models for males and females separately was evidenced by the male and female classes being differentially associated with mental health variables. [ABSTRACT FROM AUTHOR]

Background: The World Health Organization(WHO) International Classification of Diseases, 11th version (ICD-11), has proposed a new trauma-related diagnosis of complex posttraumatic stress disorder (CPTSD), separate and distinct from posttraumatic stress disorder (PTSD). However, to date, no study has examined CPTSD over time. Objectives: This prospective study aimed to examine predictors and outcomes of latent classes of PTSD and CPTSD following war captivity. Method: A sample of 183 Israeli former prisoners of the 1973 Yom Kippur War (ex-POWs) participated in a 24-year longitudinal study with three waves of measurements (T1: 1991, T2: 2008, and T3: 2015). Participants completed validated self-report measures, and their cognitive performance was assessed using the Montreal Cognitive Assessment (MoCA). Results: A Latent Class Analysis (LCA) identified three main classes at T2: (1) a small class with low probability to meet PTSD and CPTSD clusters criteria (15.26%); (2) a class high only in PTSD symptoms (42.37%) and (3) a class high only in CPTSD symptoms (42.37%). Importantly, higher levels of psychological suffering in captivity at T1 were associated with higher odds of being in the CPTSD class at T2. In addition, CPTSD at T2 was more strongly associated with low self-rated health, functional impairment, and cognitive performance at T3, compared to the PTSD only class. Conclusions: Adulthood prolonged trauma of severe interpersonal intensity such as war captivity is related to CPTSD, years after the end of the war. Exposure to psychological suffering in captivity is a risk factor for future endorsement of CPTSD symptoms. CPTSD among ex-POWs is a marker for future dire mental health and functional consequences. [ABSTRACT FROM AUTHOR]

Suicidal ideation/behaviour (SIB) and psychosis are highly associated phenomena. We propose that psychosis, for some, may be consequential to SIB. More specifically we hypothesise that psychosis may serve to externalise internally generated and self-directed threat among those experiencing SIB. Using prospective data from a Danish population cohort, we first sought to test the temporal occurrence of suicidal behaviour and psychotic disorder. Next, using cross-sectional epidemiological survey data (UK), we sought to demonstrate that psychotic experiences (PEs) were more commonly reported by those who experienced SIB and that the strength of the association varied according to (i) SIB recency and (ii) severity. Chi-square comparison tests on the Danish data revealed that suicidal behaviour was statistically more likely to precede (41.4%) rather than follow psychotic disorder (20.7%). Regression analyses of the UK data indicated that individuals who thought about suicide in their lifetime were up to eight times more likely to experience specific PEs while those who thought about and attempted suicide in their lifetime and in the year of assessment were up to 48 times more likely to experience PEs, compared to SIB free members of the population. The findings provide preliminary support for a novel suicidal drive hypothesis for psychosis. [ABSTRACT FROM AUTHOR]

The network approach suggests that psychopathology arises from complex associations between symptoms and may offer insight into the mechanisms that underpin psychiatric comorbidities. The transition from childhood to adolescence is a key period in the development of psychopathology, yet has rarely been considered from a network perspective. As such, the present study examined the network structure of internalizing and externalizing psychopathology from middle childhood through adolescence using data from the Avon Longitudinal Study of Parents and Children (ALSPAC; n = 4405). Eight DSM-IV disorders were assessed using maternal reports when children were aged 7.5, 10.5 and 14 years. Weighted, undirected networks were estimated and the relative importance of each node was assessed using three common measures of node centrality; strength, betweenness, and closeness. A consistent network structure emerged at all three time points; nodes clustered together in two regions of space broadly reflecting the internalizing and externalizing spectra. Permutation tests supported structural invariance across this developmental period. These spectra were bridged by numerous disorder-level interactions, the most consistent of which was between depression and oppositional defiant disorder (ODD). Furthermore, inspection of the centrality indices indicated that generalised anxiety disorder and ODD were the most central disorders in the networks. These findings demonstrate that symptom/disorder-level interplay and reciprocal influence are plausible mechanisms for the association between internalizing and externalizing psychopathology in childhood/adolescence. [ABSTRACT FROM AUTHOR]

In a recently published study in this journal that used a population-based sample in the Republic of Ireland (Karatzias et al., 2020), we concluded that 17.7% of the sample met the diagnostic requirements for COVID-19-related posttraumatic stress disorder (PTSD). Subsequently, Van Overmeire (2020) has raised concerns about the validity of our findings, arguing that simply experiencing the COVID-19 pandemic is not sufficient to meet the trauma exposure criterion for a PTSD diagnosis and, consequently, our estimated PTSD prevalence figure was inflated. In this response, we provide (a) an explanation for why the COVID-19 pandemic can be reasonably considered to be a traumatic event, (b) evidence that PTSD in response to the COVID-19 pandemic is a meaningful construct, and (c) an argument for why our estimated prevalence rate is not unreasonably high. [ABSTRACT FROM AUTHOR]

• A team of scientists, patients, and clinicians formed the Aarhus PGD scale (A-PGDs). • Findings show A-PGDs to be a valid and reliable measure that can be used to operationalize both ICD-11 and DSM-5-TR PGD. • Two PGD factors, separation distress and emotional distress, were found using ESEM. • Only emotional distress (associated symptoms) was related to functional impairment. • A 3rd factor, antagonistic feelings (anger, bitterness) was found in DSM-5-TR alone. [ABSTRACT FROM AUTHOR]

Furthermore, nearly three-quarters of people with mental health problems were not receiving any mental health or psychosocial support.5 It is highly probable, therefore, that many Ukrainians, living inside and outside of Ukraine, will be experiencing mental health problems as a direct result of this war. On 24th February 2022, Russian troops invaded Ukraine and launched an unprovoked and illegal war, which independent experts have concluded represents an intended genocide.1 The people of Ukraine will surely have experienced horror at the real and immediate threat to their lives, the lives of their loved ones, and to the existence of their nation. [Extracted from the article]

Objective: We set out to investigate the association between negative trauma‐related cognitions, emotional regulation strategies, and attachment style and complex post‐traumatic stress disorder (CPTSD). As the evidence regarding the treatment of CPTSD is emerging, investigating psychological factors that are associated with CPTSD can inform the adaptation or the development of effective interventions for CPTSD. Method: A cross‐sectional design was employed. Measures of CPTSD, negative trauma‐related cognitions, emotion regulation strategies, and attachment style were completed by a British clinical sample of trauma‐exposed patients (N = 171). Logistic regression analysis was used to assess the predictive utility of these psychological factors on diagnosis of CPTSD as compared to PTSD. Results: It was found that the most important factor in the diagnosis of CPTSD was negative trauma‐related cognitions about the self, followed by attachment anxiety, and expressive suppression. Conclusions: Targeting negative thoughts and attachment representations while promoting skills acquisition in emotional regulation hold promise in the treatment of CPTSD. Further research is required on the development of appropriate models to treat CPTSD that tackle skills deficit in these areas. Practitioner points: Results suggest that cognitive‐behavioural interventions might be useful for the treatment of CPTSD. Targeting negative thoughts and attachment representations while promoting skills acquisition in emotional regulation hold promise in the treatment of CPTSD. [ABSTRACT FROM AUTHOR]

The American Psychiatric Association and the World Health Organization provide distinct trauma-based diagnoses in the fifth edition of the Diagnostic and Statistical Manual (DSM-5), and the forthcoming 11th version of the International Classification of Diseases (ICD-11), respectively. The DSM-5 conceptualizes posttraumatic stress disorder (PTSD) as a single, broad diagnosis, whereas the ICD-11 proposes two "sibling" disorders: PTSD and complex PTSD (CPTSD). The objectives of the current study were to: (a) compare prevalence rates of PTSD/CPTSD based on each diagnostic system; (b) identify clinical and behavioral variables that distinguish ICD-11 CPTSD and PTSD diagnoses; and (c) examine the diagnostic associations for ICD-11 CPTSD and DSM-5 PTSD. Participants in a predominately female clinical sample (N = 106) completed self-report scales to measure ICD-11 PTSD and CPTSD, DSM-5 PTSD, and depression, anxiety, borderline personality disorder, dissociation, destructive behaviors, and suicidal ideation and self-harm. Significantly more people were diagnosed with PTSD according to the DSM-5 criteria (90.4%) compared to those diagnosed with PTSD and CPTSD according to the ICD-11 guidelines (79.8%). An ICD-11 CPTSD diagnosis was distinguished from an ICD-11 PTSD diagnosis by higher levels of dissociation (d = 1.01), depression (d = 0.63), and borderline personality disorder (d = 0.55). Diagnostic associations with depression, anxiety, and suicidal ideation and self-harm were higher for ICD-11 CPTSD compared to DSM-5 PTSD (by 10.7%, 4.0%, and 7.0%, respectively). These results have implications for differential diagnosis and for the development of targeted treatments for CPTSD. [ABSTRACT FROM AUTHOR]

This data linkage study aims to examine associations between subgroups of child maltreatment and a range of demographic (e.g., gender) familial (e.g., parental unemployment) and health outcomes. Structured interviews were conducted on 2,980 participants. Data were then linked with information drawn from Danish registries. Multinomial logistic regression analyses indicated out-of-home-care was a shared risk for all forms of maltreatment relative to nonmaltreated controls. Sexual and co-occurring abuse groups had strong associations with psychiatric outcomes at age 21. Findings emphasize how a child’s early environment can impact health, highlighting the need for targeted interventions encompassing a range of risk factors at an early age. [ABSTRACT FROM AUTHOR]

Background: Heterotypic psychopathological continuity (i.e. one disorder predicting another at a later time point) contradicts the conventional view that psychiatric disorders are discrete, static entities. Studying this phenomenon may help to tease out the complex mechanisms that underpin psychiatric comorbidity. To date, no studies have explicitly compared heterotypic effects within and across higher order dimensions of psychopathology.Methods: Patterns of homotypic and heterotypic psychopathological continuity were examined using cohort data from the Avon Longitudinal Study of Parents and Children (ALSPAC, N = 4815). Eight common psychiatric disorders were assessed at age 7.5 and again at age 14 years using the maternal report version of the Development and Well-Being Assessment (DAWBA). Cross-lagged models were used to compare patterns of homotypic and heterotypic continuity within and across three higher order dimensions of psychopathology; internalizing-fear, internalizing-distress, and externalizing.Results: Homotypic continuity was universal. Considerable heterotypic continuity was observed even after controlling for homotypic continuity and the presence of all disorders at baseline. Heterotypic continuity was more common within higher order dimensions, but a number of significant cross-dimension effects were observed, with ADHD acting as a strong predictor of subsequent internalizing disorders.Conclusions: Heterotypic continuity may reflect elements of shared aetiology, or local-level interactions between disorders. [ABSTRACT FROM AUTHOR]

Trauma informed care has become an evidenced based approach for inpatient and residential services for people in the general population who are likely to have been impacted by trauma. Given the increased vulnerability to psychological trauma for adults with an intellectual disability, it should follow that residential services for adults with an intellectual disability would also benefit from a trauma informed care approach. Two focus groups and individual interviews with seven adults with an intellectual disability and six workshops with seven service providers were conducted to co‐produce a trauma informed care framework for residential services that was evidence‐based and guided by established models (MRC, Developing and evaluating complex interventions, London: MRC & NIHR, 2019; Wight et al., Journal of Epidemiology and Community Health, 70, 520–525, 2016). The framework was developed into four chapters: 'Setting the context'; 'Organisational change'; 'Workforce development'; and 'Trauma focussed services'. A logic model outlining the mechanisms of change was refined over the course of the co‐production workshops. This is the first study to develop and co‐produce a trauma informed care framework for residential and supported living accommodation for adults with an intellectual disability. The framework has implications for local policy and practice in its current cultural context. Future development is required to operationalise and test the framework and to explore its adaptability to international contexts. [ABSTRACT FROM AUTHOR]

There have been many factor analytic studies aimed at testing alternative latent structures of DSM-IV and DSM-5 posttraumatic stress disorder (PTSD) symptoms. The primary rationale for such studies is that determining the ‘best’ factor analytic model will result in better diagnoses if that structure is the basis for diagnostic decisions. However, there appears to be a disconnect between the factor analytic modelling and the diagnostic implications. In this study, we derived prevalence rates based on commonly reported models of PTSD, based on data from two clinical samples ( N = 434), and also assessed if the different models generated consistent risk estimates in relation to the effects of childhood maltreatment. We found that the different models produced different prevalence rates, ranging from 64.5% to 83.9%. Furthermore, we found that the relationship between childhood maltreatment and ‘diagnosis’ varied considerably depending upon which latent symptom profile was adopted. It is argued that, given the maturity of this area of research, factor analytic studies of PTSD should now include information on the diagnostic implications of their findings. [ABSTRACT FROM AUTHOR]

Background: The WHO International Classification of Diseases, 11th version (ICD-11), has proposed two related diagnoses following exposure to traumatic events; Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). We set out to explore whether the newly developed ICD-11 Trauma Questionnaire (ICD-TQ) can distinguish between classes of individuals according to the PTSD and CPTSD symptom profiles as per ICD-11 proposals based on latent class analysis. We also hypothesized that the CPTSD class would report more frequent and a greater number of different types of childhood trauma as well as higher levels of functional impairment. Methods Participants in this study were a sample of individuals who were referred for psychological therapy to a National Health Service (NHS) trauma centre in Scotland (N=193). Participants completed the ICD-TQ as well as measures of life events and functioning.Results: Overall, results indicate that using the newly developed ICD-TQ, two subgroups of treatment-seeking individuals could be empirically distinguished based on different patterns of symptom endorsement; a small group high in PTSD symptoms only and a larger group high in CPTSD symptoms. In addition, CPTSD was more strongly associated with more frequent and a greater accumulation of different types of childhood traumatic experiences and poorer functional impairment.Limitations: Sample predominantly consisted of people who had experienced childhood psychological trauma or been multiply traumatised in childhood and adulthood.Conclusions: CPTSD is highly prevalent in treatment seeking populations who have been multiply traumatised in childhood and adulthood and appropriate interventions should now be developed to aid recovery from this debilitating condition. [ABSTRACT FROM AUTHOR]

Among the conditions following exposure to traumatic life events proposed by ICD-11 are Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). The primary aim of this study was to provide an assessment of the reliability and validity of a newly developed self-report measure of ICD-11 PTSD and CPTSD: the ICD-11 Trauma Questionnaire (ICD-TQ). Participants in this study were a sample of individuals who were referred for psychological therapy to a National Health Service (NHS) trauma centre in Scotland ( N = 193). Participants completed the ICD-TQ and measures of traumatic life events, DSM-5 PTSD, emotion dysregulation, self–esteem, and interpersonal difficulties. Confirmatory factor analysis results supported the factorial validity of the ICD-TQ with results in line with ICD-11 proposals. The ICD-TQ demonstrated satisfactory internal reliability, and correlation results indicated that the scale exhibited convergent and discriminant validity. Current results provide initial support for the psychometric properties of this initial version of the ICD-TQ. Future theoretical and empirical work will be required to generate a final version of the ICD-TQ that will match the diagnostic structure of PTSD and CPTSD when ICD-11 is published. [ABSTRACT FROM AUTHOR]