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Psychology › Clinical Psychology

Posttraumatic Stress Disorder Research

Works Count: 34350

Description

This cluster of papers explores the impact of trauma, particularly posttraumatic stress disorder (PTSD), on individuals' mental health and the potential for resilience and growth following extremely aversive events. It covers topics such as the neurocircuitry of fear, stress, and anxiety disorders, psychological treatments for PTSD, psychometric evaluation of PTSD symptoms, and the epidemiology of traumatic events and PTSD. The papers also delve into the concept of posttraumatic growth and the role of cognitive therapy in addressing PTSD.

Keywords

Posttraumatic Stress Disorder; Trauma; Resilience; Mental Health; Psychological Treatment; Neurocircuitry; PTSD Symptoms; Psychometric Evaluation; Cognitive Therapy; Epidemiology

Posttraumatic stress disorder: the burden to the individual and to society.

2000-01-01
RC Kessler
Little is known about the total population prevalence and societal costs of posttraumatic stress disorder (PTSD); this report reviews relevant literature on these topics.A literature search of computerized databases for … Little is known about the total population prevalence and societal costs of posttraumatic stress disorder (PTSD); this report reviews relevant literature on these topics.A literature search of computerized databases for published reports on trauma and PTSD was conducted. This literature was reviewed to find data on general population exposure to trauma, conditional risk of PTSD among those exposed to trauma both in focused samples of trauma victims and in general population samples, and the adverse consequences of PTSD.PTSD was found to be a commonly occurring disorder that often has a duration of many years and is frequently associated with exposure to multiple traumas. The impairment associated with PTSD in U.S. samples, where the majority of research on these consequences has been carried out, is comparable to, or greater than, that of other seriously impairing mental disorders. Risk of suicide attempts is particularly high among people with PTSD. Available evidence suggests that the prevalence of PTSD and the adverse emotional and psychological consequences of PTSD are much greater in the many countries around the world that are in the midst of armed conflicts involving political, racial, or ethnic violence.PTSD is a highly prevalent and impairing condition. Only a minority of people with PTSD obtain treatment. Early and aggressive outreach to treat people with PTSD could help reduce the enormous societal costs of this disorder.

Effective Treatments for PTSD

2001-11-15
Arthur M. Freeman
Article AbstractFrom our regular book review column. Effective Treatments for PTSD, edited by Drs. Foa, Keane, and Friedman, is a most timely book. It is attuned to our current emphasis … Article AbstractFrom our regular book review column. Effective Treatments for PTSD, edited by Drs. Foa, Keane, and Friedman, is a most timely book. It is attuned to our current emphasis on practice guidelines that are derived from evidence-based psychiatry. The work is sponsored by the PTSD Treatment Guidelines Task Force of the International Society for Traumatic Stress Studies. Although under 400 pages, the volume is exhaustive in several ways. It reviews nearly all of the relevant research literature and includes 14 different treatment approaches for posttraumatic stress disorder (PTSD), from psychological debriefing to creative therapies, with lengthy references for all treatments.
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The Psychological Impact of the SARS Epidemic on Hospital Employees in China: Exposure, Risk Perception, and Altruistic Acceptance of Risk

2009-05-01
Ping Wu , Yunyun Fang , Zhiqiang Guan +7 more
Objective: We examined the psychological impact of the 2003 outbreak of severe acute respiratory syndrome (SARS) on hospital employees in Beijing, China. Methods: In 2006, randomly selected employees ( n … Objective: We examined the psychological impact of the 2003 outbreak of severe acute respiratory syndrome (SARS) on hospital employees in Beijing, China. Methods: In 2006, randomly selected employees ( n = 549) of a hospital in Beijing were surveyed concerning their exposure to the 2003 SARS outbreak, and the ways in which the outbreak had affected their mental health. Results: About 10% of the respondents had experienced high levels of posttraumatic stress (PTS) symptoms since the SARS outbreak. Respondents who had been quarantined, or worked in high-risk locations such as SARS wards, or had friends or close relatives who contracted SARS, were 2 to 3 times more likely to have high PTS symptom levels, than those without these exposures. Respondents' perceptions of SARS-related risks were significantly positively associated with PTS symptom levels and partially mediated the effects of exposure. Altruistic acceptance of work-related risks was negatively related to PTS levels. Conclusions: The psychological impact of stressful events related to an infectious disease outbreak may be mediated by peoples' perceptions of those events; altruism may help to protect some health care workers against these negative impacts.
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The Impact of Event Scale: Revised

2007-07-16
Daniel S. Weiss

A prospective study of depression and posttraumatic stress symptoms after a natural disaster: The 1989 Loma Prieta earthquake.

1991-01-01
Susan Nolen–Hoeksema , Jannay Morrow
Measures of emotional health and styles of responding to negative moods were obtained for 137 students 14 days before the Loma Prieta earthquake. A follow-up was done 10 days again … Measures of emotional health and styles of responding to negative moods were obtained for 137 students 14 days before the Loma Prieta earthquake. A follow-up was done 10 days again 7 weeks after the earthquake to test predictions about which of the students would show the most enduring symptoms of depression and posttraumatic stress. Regression analysis showed that students who, before the earthquake, already had elevated levels of depression and stress symptoms and a ruminative style of responding to their symptoms had more depression and stress symptoms for both follow-ups. Students who were exposed to more dangerous or difficult circumstances because of the earthquake also had elevated symptom levels 10 days after the earthquake. Similarly, students who, during the 10 days after the earthquake, had more ruminations about the earthquake were still more likely to have high levels of depressive and stress symptoms 7 weeks after the earthquake.

A cognitive model of posttraumatic stress disorder

2000-04-01
Anke Ehlers , David M. Clark

The Posttraumatic Cognitions Inventory (PTCI): Development and validation.

1999-09-01
Edna B. Foa , Anke Ehlers , David M. Clark +2 more
This article describes the development and validation of a new measure of trauma-related thoughts and beliefs, the Posttraumatic Cognitions Inventory (PTCI), whose items were derived from clinical observations and current … This article describes the development and validation of a new measure of trauma-related thoughts and beliefs, the Posttraumatic Cognitions Inventory (PTCI), whose items were derived from clinical observations and current theories of post-trauma psychopathology. The PTCI was administered to 601 volunteers, 392 of whom had experienced a traumatic event and 170 of whom had moderate to severe posttraumatic stress disorder (PTSD). Principal-components analysis yielded 3 factors: Negative Cognitions About Self. Negative Cognitions About the World, and Self-Blame. The 3 factors showed excellent internal consistency and good test-retest reliability; correlated moderately to strongly with measures of PTSD severity, depression, and general anxiety: and discriminated well between traumatized individuals with and without PTSD. The PTCI compared favorably with other measures of trauma-related cognitions, especially in its superior ability to discriminate between traumatized individuals with and without PTSD.

Psychological Sequelae of the September 11 Terrorist Attacks in New York City

2002-03-28
Sandro Galea , Jennifer Ahern , Heidi S. Resnick +4 more
The scope of the terrorist attacks of September 11, 2001, was unprecedented in the United States. We assessed the prevalence and correlates of acute post-traumatic stress disorder (PTSD) and depression … The scope of the terrorist attacks of September 11, 2001, was unprecedented in the United States. We assessed the prevalence and correlates of acute post-traumatic stress disorder (PTSD) and depression among residents of Manhattan five to eight weeks after the attacks.
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Psychometric properties of the Impact of Event Scale—Revised

2003-10-11
Mark Creamer , Richard Bell , Salvina Failla

Positive change following trauma and adversity: A review

2004-02-01
P. Alex Linley , Stephen Joseph
Abstract Empirical studies ( n = 39) that documented positive change following trauma and adversity (e.g., posttraumatic growth, stress‐related growth, perceived benefit, thriving; collectively described as adversarial growth) were reviewed. … Abstract Empirical studies ( n = 39) that documented positive change following trauma and adversity (e.g., posttraumatic growth, stress‐related growth, perceived benefit, thriving; collectively described as adversarial growth) were reviewed. The review indicated that cognitive appraisal variables (threat, harm, and controllability), problem‐focused, acceptance and positive reinterpretation coping, optimism, religion, cognitive processing, and positive affect were consistently associated with adversarial growth. The review revealed inconsistent associations between adversarial growth, sociodemographic variables (gender, age, education, and income), and psychological distress variables (e.g., depression, anxiety, posttraumatic stress disorder). However, the evidence showed that people who reported and maintained adversarial growth over time were less distressed subsequently. Methodological limitations and recommended future directions in adversarial growth research are discussed, and the implications of adversarial growth for clinical practice are briefly considered.

Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women.

1993-01-01
Heidi S. Resnick , Dean G. Kilpatrick , Bonnie S. Dansky +2 more
Prevalence of crime and noncrime civilian traumatic events, lifetime posttraumatic stress disorder (PTSD), and PTSD in the past 6 months were assessed in a sample of U.S. adult women (N … Prevalence of crime and noncrime civilian traumatic events, lifetime posttraumatic stress disorder (PTSD), and PTSD in the past 6 months were assessed in a sample of U.S. adult women (N = 4,008). Random digit-dial telephone methods were used to identify study participants. Structured telephone interviews for assessment of specific crime or other traumatic event history and PTSD were conducted by trained female interviewers. Lifetime exposure to any type of traumatic event was 69%, whereas exposure to crimes that included sexual or aggravated assault or homicide of a close relative or friend occurred among 36%. Overall sample prevalence of PTSD was 12.3% lifetime and 4.6% within the past 6 months. The rate of PTSD was significantly higher among crime versus noncrime victims (25.8% vs. 9.4%). History of incidents that included direct threat to life or receipt of injury was a risk factor for PTSD. Findings are compared with data from other epidemiological studies. Results are discussed as they relate to PTSD etiology.

Psychometric Properties of the Life Events Checklist

2004-10-14
Matt J. Gray , Brett T. Litz , Julie L. Hsu +1 more
The Life Events Checklist (LEC), a measure of exposure to potentially traumatic events, was developed at the National Center for Posttraumatic Stress Disorder (PTSD) concurrently with the Clinician Administered PTSD … The Life Events Checklist (LEC), a measure of exposure to potentially traumatic events, was developed at the National Center for Posttraumatic Stress Disorder (PTSD) concurrently with the Clinician Administered PTSD Scale (CAPS) to facilitate the diagnosis of PTSD. Although the CAPS is recognized as the gold standard in PTSD symptom assessment, the psychometric soundness of the LEC has never been formally evaluated. The studies reported here describe the performance of the LEC in two samples: college undergraduates and combat veterans. The LEC exhibited adequate temporal stability, good convergence with an established measure of trauma history -- the Traumatic Life Events Questionnaire (TLEQ) -- and was comparable to the TLEQ in associations with variables known to be correlated with traumatic exposure in a sample of undergraduates. In a clinical sample of combat veterans, the LEC was significantly correlated, in the predicted directions, with measures of psychological distress and was strongly associated with PTSD symptoms.

Behavioral/cognitive conceptualizations of post-traumatic stress disorder

1989-01-01
Edna B. Foa , Gail Steketee , Barbara O. Rothbaum

Reliability and validity of a brief instrument for assessing post‐traumatic stress disorder

1993-10-01
Edna B. Foa , David S. Riggs , Constance V. Dancu +1 more
Abstract This study examines the psychometric properties of two versions of the PTSD Sympton Scale (PSS). The scale contains 17 items that diagnose PTSD according to DSM‐III‐R criteria and assess … Abstract This study examines the psychometric properties of two versions of the PTSD Sympton Scale (PSS). The scale contains 17 items that diagnose PTSD according to DSM‐III‐R criteria and assess the severity of PTSD symptoms. An interview and self‐report version of the PSS were administered to a sample of 118 recent rape and non‐sexual assault victims. The results indicate that both versions of the PSS have satisfactory internal consistency, high test‐retest reliability, and good concurrent validity. The interview version yielded high interrater agreement when administred separately by two interviewers and excellent convergent validity with the SCID. When used to diagnose PTSD, the self‐report version of the PSS was somewhat more conservative than the interview version.

A National Survey of Stress Reactions after the September 11, 2001, Terrorist Attacks

2001-11-15
Mark A. Schuster , Bradley D. Stein , Lisa H. Jaycox +7 more
People who are not present at a traumatic event may experience stress reactions. We assessed the immediate mental health effects of the terrorist attacks on September 11, 2001. People who are not present at a traumatic event may experience stress reactions. We assessed the immediate mental health effects of the terrorist attacks on September 11, 2001.
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TARGET ARTICLE: "Posttraumatic Growth: Conceptual Foundations and Empirical Evidence"

2004-01-01
Richard G. Tedeschi , Lawrence G. Calhoun
Abstract This article describes the concept of posttraumatic growth, its conceptual foundations, and supporting empirical evidence. Posttraumatic growth is the experience of positive change that occurs as a result of … Abstract This article describes the concept of posttraumatic growth, its conceptual foundations, and supporting empirical evidence. Posttraumatic growth is the experience of positive change that occurs as a result of the struggle with highly challenging life crises. It is manifested in a variety of ways, including an increased appreciation for life in general, more meaningful interpersonal relationships, an increased sense of personal strength, changed priorities, and a richer existential and spiritual life. Although the term is new, the idea that great good can come from great suffering is ancient. We propose a model for understanding the process of posttraumatic growth in which individual characteristics, support and disclosure, and more centrally, significant cognitive processing involving cognitive structures threatened or nullified by the traumatic events, play an important role. It is also suggested that posttraumatic growth mutually interacts with life wisdom and the development of the life narrative, and that it is an ongoing process, not a static outcome.

Post-Traumatic Growth After a Myocardial Infarction: A Matter of Personality, Psychological Health, or Cognitive Coping?

2008-12-01
Nadia Garnefski , V. Kraaij , Maya J. Schroevers +1 more
The aim of the present study was to focus on the relative contributions of personality, psychological health and cognitive coping to post-traumatic growth in patients with recent myocardial infarction (MI). … The aim of the present study was to focus on the relative contributions of personality, psychological health and cognitive coping to post-traumatic growth in patients with recent myocardial infarction (MI). The sample consisted of 139 patients who had experienced a first-time acute MI between 3 and 12 months before data assessment. Multivariate relationships were tested by means of Structural Equation Modeling. The results showed that besides the contribution of personality and psychological health, a significant amount of variance in growth was explained by the cognitive coping strategies people used to handle their MI. As cognitive coping strategies are generally assumed to be mechanisms that are subject to potential influence and change, this provides us with important targets for intervention.
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The validation of a self-report measure of posttraumatic stress disorder: The Posttraumatic Diagnostic Scale.

1997-12-01
Edna B. Foa , Laurie Cashman , Lisa H. Jaycox +1 more
The present article reports on the development and validation of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Diagnostic Scale (PTDS), that yields both a PTSD diagnosis according … The present article reports on the development and validation of a self-report measure of posttraumatic stress disorder (PTSD), the Posttraumatic Diagnostic Scale (PTDS), that yields both a PTSD diagnosis according to Diagnostic and Statistical Manual of Mental Disorders (4th ed.; American Psychiatric Association, 1994; DSM-IV) criteria and a measure of PTSD symptom severity. Two-hundred forty-eight participants who had experienced a wide variety of traumas (e.g., accident, fire, natural disaster, assault, combat) were administered the PTSD module of the Structured Clinical Interview (SCID; Spitzer, Williams, Gibbons, & First, 1990), the PTDS, and scales measuring trauma-related psychopathology. The PTDS demonstrated high internal consistency and test-retest reliability, high diagnostic agreement with SCID, and good sensitivity and specificity. The satisfactory validity of the PTDS was further supported by its high correlations with other measures of trauma-related psychopathology. Therefore, the PTDS appears to be a useful tool for screening and assessing current PTSD in clinical and research settings.

Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults.

2000-01-01
Chris R. Brewin , Bernice Andrews , John D. Valentine
Meta-analyses were conducted on 14 separate risk factors for posttraumatic stress disorder (PTSD), and the moderating effects of various sample and study characteristics, including civilian/military status, were examined. Three categories … Meta-analyses were conducted on 14 separate risk factors for posttraumatic stress disorder (PTSD), and the moderating effects of various sample and study characteristics, including civilian/military status, were examined. Three categories of risk factor emerged: Factors such as gender, age at trauma, and race that predicted PTSD in some populations but not in others; factors such as education, previous trauma, and general childhood adversity that predicted PTSD more consistently but to a varying extent according to the populations studied and the methods used; and factors such as psychiatric history, reported childhood abuse, and family psychiatric history that had more uniform predictive effects. Individually, the effect size of all the risk factors was modest, but factors operating during or after the trauma, such as trauma severity, lack of social support, and additional life stress, had somewhat stronger effects than pretrauma factors.

Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis.

2003-01-01
Emily J. Ozer , Suzanne R. Best , Tami L. Lipsey +1 more
A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met … A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of 7 predictors: (a) prior trauma, (b) prior psychological adjustment, (c) family history of psychopathology, (d) perceived life threat during the trauma, (e) posttrauma social support, (f) peritraumatic emotional responses, and (g) peritraumatic dissociation. All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.

A dual representation theory of posttraumatic stress disorder.

1996-10-01
Chris R. Brewin , Tim Dalgleish , Stephen Joseph
A cognitive theory of posttraumatic stress disorder (PTSD) is proposed that assumes traumas experienced after early childhood give rise to 2 sorts of memory, 1 verbally accessible and 1 automatically … A cognitive theory of posttraumatic stress disorder (PTSD) is proposed that assumes traumas experienced after early childhood give rise to 2 sorts of memory, 1 verbally accessible and 1 automatically accessible through appropriate situational cues. These different types of memory are used to explain the complex phenomenology of PTSD, including the experiences of reliving the traumatic event and of emotionally processing the trauma. The theory considers 3 possible outcomes of the emotional processing of trauma, successful completion, chronic processing, and premature inhibition of processing We discuss the implications of the theory for research design, clinical practice, and resolving contradictions in the empirical data.

The primary care PTSD screen (PC–PTSD): development and operating characteristics

2004-01-01
Annabel Prins , Paige Ouimette , Rachel Kimerling +6 more
Posttraumatic stress disorder (PTSD) is a frequently unrecognized anxiety disorder in primary care settings. This study reports on the development and operating characteristics of a brief 4-item screen for PTSD … Posttraumatic stress disorder (PTSD) is a frequently unrecognized anxiety disorder in primary care settings. This study reports on the development and operating characteristics of a brief 4-item screen for PTSD in primary care (PC-PTSD). 188 VA primary care patients completed the PC-PTSD, the PTSD Symptom Checklist (PCL) and the Clinician Administered Scale for PTSD (CAPS). The prevalence of PTSD was 24.5%. Signal detection analyses showed that with this base rate, the PC-PTSD had an optimally efficient cutoff score of 3 for both male and female patients. A cutoff score of 2 is recommended when sensitivity rather than efficiency is optimized. The PC-PTSD outperformed the PCL in terms of overall quality, sensitivity, specificity, efficiency, and quality of efficiency. The PC-PTSD appears to be a psychometrically sound screen for PTSD with comparable operating characteristtics to other screens for mental disorders.

Traumatic Events and Posttraumatic Stress Disorder in an Urban Population of Young Adults

1991-03-01
Naomi Breslau
• To ascertain the prevalence of posttraumatic stress disorder (PTSD) and risk factors associated with it, we studied a random sample of 1007 young adults from a large health maintenance … • To ascertain the prevalence of posttraumatic stress disorder (PTSD) and risk factors associated with it, we studied a random sample of 1007 young adults from a large health maintenance organization in the Detroit, Mich, area. The lifetime prevalence of exposure to traumatic events was 39.1%. The rate of PTSD in those who were exposed was 23.6%, yielding a lifetime prevalence in the sample of 9.2%. Persons with PTSD were at increased risk for other psychiatric disorders; PTSD had stronger associations with anxiety and affective disorders than with substance abuse or dependence. Risk factors for exposure to<i>traumatic events</i>included low education, male sex, early conduct problems, extraversion, and family history of psychiatric disorder or substance problems. Risk factors for<i>PTSD following exposure</i>included early separation from parents, neuroticism, preexisting anxiety or depression, and family history of anxiety. Life-style differences associated with differential exposure to situations that have a high risk for traumatic events and personal predispositions to the PTSD effects of traumatic events might be responsible for a substantial part of PTSD in this population.

The development of a Clinician-Administered PTSD Scale

1995-01-01
Dudley David Blake , Frank W. Weathers , Linda Nagy +4 more
Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician-Administered PTSD Scale (CAPS-1) appears … Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician-Administered PTSD Scale (CAPS-1) appears to satisfy these standards most uniformly. The CAPS-1 is a structured interview for assessing core and associated symptoms of PTSD. It assesses the frequency and intensity of each symptom using standard prompt questions and explicit, behaviorally-anchored rating scales. The CAPS-1 yields both continuous and dichotomous scores for current and lifetime PTSD symptoms. Intended for use by experienced clinicians, it also can be administered by appropriately trained paraprofessionals. Data from a large scale psychometric study of the CAPS-1 have provided impressive evidence of its reliability and validity as a PTSD interview.

Psychometric properties of the PTSD checklist (PCL)

1996-08-01
Edward B. Blanchard , Jacqueline Jones-Alexander , Todd C. Buckley +1 more

Longitudinal Assessment of Mental Health Problems Among Active and Reserve Component Soldiers Returning From the Iraq War

2007-11-13
Charles S. Milliken , Jennifer L. Auchterlonie , Charles W. Hoge
To promote early identification of mental health problems among combat veterans, the Department of Defense initiated population-wide screening at 2 time points, immediately on return from deployment and 3 to … To promote early identification of mental health problems among combat veterans, the Department of Defense initiated population-wide screening at 2 time points, immediately on return from deployment and 3 to 6 months later. A previous article focusing only on the initial screening is likely to have underestimated the mental health burden.To measure the mental health needs among soldiers returning from Iraq and the association of screening with mental health care utilization.Population-based, longitudinal descriptive study of the initial large cohort of 88 235 US soldiers returning from Iraq who completed both a Post-Deployment Health Assessment (PDHA) and a Post-Deployment Health Re-Assessment (PDHRA) with a median of 6 months between the 2 assessments.Screening positive for posttraumatic stress disorder (PTSD), major depression, alcohol misuse, or other mental health problems; referral and use of mental health services.Soldiers reported more mental health concerns and were referred at significantly higher rates from the PDHRA than from the PDHA. Based on the combined screening, clinicians identified 20.3% of active and 42.4% of reserve component soldiers as requiring mental health treatment. Concerns about interpersonal conflict increased 4-fold. Soldiers frequently reported alcohol concerns, yet very few were referred to alcohol treatment. Most soldiers who used mental health services had not been referred, even though the majority accessed care within 30 days following the screening. Although soldiers were much more likely to report PTSD symptoms on the PDHRA than on the PDHA, 49% to 59% of those who had PTSD symptoms identified on the PDHA improved by the time they took the PDHRA. There was no direct relationship of referral or treatment with symptom improvement.Rescreening soldiers several months after their return from Iraq identified a large cohort missed on initial screening. The large clinical burden recently reported among veterans presenting to Veterans Affairs facilities seems to exist within months of returning home, highlighting the need to enhance military mental health care during this period. Increased relationship problems underscore shortcomings in services for family members. Reserve component soldiers who had returned to civilian status were referred at higher rates on the PDHRA, which could reflect their concerns about their ongoing health coverage. Lack of confidentiality may deter soldiers with alcohol problems from accessing treatment. In the context of an overburdened system of care, the effectiveness of population mental health screening was difficult to ascertain.

A Multidimensional Meta-Analysis of Psychotherapy for PTSD

2005-01-27
Rebekah Bradley , Jamelle Greene , Eric Russ +2 more
OBJECTIVE: The authors present a multidimensional meta-analysis of studies published between 1980 and 2003 on psychotherapy for PTSD. METHOD: Data on variables not previously meta-analyzed such as inclusion and exclusion … OBJECTIVE: The authors present a multidimensional meta-analysis of studies published between 1980 and 2003 on psychotherapy for PTSD. METHOD: Data on variables not previously meta-analyzed such as inclusion and exclusion criteria and rates, recovery and improvement rates, and follow-up data were examined. RESULTS: Results suggest that psychotherapy for PTSD leads to a large initial improvement from baseline. More than half of patients who complete treatment with various forms of cognitive behavior therapy or eye movement desensitization and reprocessing improve. Reporting of metrics other than effect size provides a somewhat more nuanced account of outcome and generalizability. CONCLUSIONS: The majority of patients treated with psychotherapy for PTSD in randomized trials recover or improve, rendering these approaches some of the most effective psychosocial treatments devised to date. Several caveats, however, are important in applying these findings to patients treated in the community. Exclusion criteria and failure to address polysymptomatic presentations render generalizability to the population of PTSD patients indeterminate. The majority of patients posttreatment continue to have substantial residual symptoms, and follow-up data beyond very brief intervals have been largely absent. Future research intended to generalize to patients in practice should avoid exclusion criteria other than those a sensible clinician would impose in practice (e.g., schizophrenia), should avoid wait-list and other relatively inert control conditions, and should follow patients through at least 2 years.

Mental Health Problems, Use of Mental Health Services, and Attrition From Military Service After Returning From Deployment to Iraq or Afghanistan

2006-02-28
Charles W. Hoge , Jennifer L. Auchterlonie , Charles S. Milliken
ContextThe US military has conducted population-level screening for mental health problems among all service members returning from deployment to Afghanistan, Iraq, and other locations. To date, no systematic analysis of … ContextThe US military has conducted population-level screening for mental health problems among all service members returning from deployment to Afghanistan, Iraq, and other locations. To date, no systematic analysis of this program has been conducted, and studies have not assessed the impact of these deployments on mental health care utilization after deployment.ObjectivesTo determine the relationship between combat deployment and mental health care use during the first year after return and to assess the lessons learned from the postdeployment mental health screening effort, particularly the correlation between the screening results, actual use of mental health services, and attrition from military service.Design, Setting, and ParticipantsPopulation-based descriptive study of all Army soldiers and Marines who completed the routine postdeployment health assessment between May 1, 2003, and April 30, 2004, on return from deployment to Operation Enduring Freedom in Afghanistan (n = 16 318), Operation Iraqi Freedom (n = 222 620), and other locations (n = 64 967). Health care utilization and occupational outcomes were measured for 1 year after deployment or until leaving the service if this occurred sooner.Main Outcome MeasuresScreening positive for posttraumatic stress disorder, major depression, or other mental health problems; referral for a mental health reason; use of mental health care services after returning from deployment; and attrition from military service.ResultsThe prevalence of reporting a mental health problem was 19.1% among service members returning from Iraq compared with 11.3% after returning from Afghanistan and 8.5% after returning from other locations (P&lt;.001). Mental health problems reported on the postdeployment assessment were significantly associated with combat experiences, mental health care referral and utilization, and attrition from military service. Thirty-five percent of Iraq war veterans accessed mental health services in the year after returning home; 12% per year were diagnosed with a mental health problem. More than 50% of those referred for a mental health reason were documented to receive follow-up care although less than 10% of all service members who received mental health treatment were referred through the screening program.ConclusionsCombat duty in Iraq was associated with high utilization of mental health services and attrition from military service after deployment. The deployment mental health screening program provided another indicator of the mental health impact of deployment on a population level but had limited utility in predicting the level of mental health services that were needed after deployment. The high rate of using mental health services among Operation Iraqi Freedom veterans after deployment highlights challenges in ensuring that there are adequate resources to meet the mental health needs of returning veterans.

Posttraumatic Stress Disorder in the National Comorbidity Survey

1995-12-01
Ronald C. Kessler
Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated life-time prevalence, the kinds of traumas most often associated with PTSD, sociodemographic … Data were obtained on the general population epidemiology of DSM-III-R posttraumatic stress disorder (PTSD), including information on estimated life-time prevalence, the kinds of traumas most often associated with PTSD, sociodemographic correlates, the comorbidity of PTSD with other lifetime psychiatric disorders, and the duration of an index episode.Modified versions of the DSM-III-R PTSD module from the Diagnostic Interview Schedule and of the Composite International Diagnostic Interview were administered to a representative national sample of 5877 persons aged 15 to 54 years in the part II subsample of the National Comorbidity Survey.The estimated lifetime prevalence of PTSD is 7.8%. Prevalence is elevated among women and the previously married. The traumas most commonly associated with PTSD are combat exposure and witnessing among men and rape and sexual molestation among women. Posttraumatic stress disorder is strongly comorbid with other lifetime DSM-III-R disorders. Survival analysis shows that more than one third of people with an index episode of PTSD fail to recover even after many years.Posttraumatic stress disorder is more prevalent than previously believed, and is often persistent. Progress in estimating age-at-onset distributions, cohort effects, and the conditional probabilities of PTSD from different types of trauma will require future epidemiologic studies to assess PTSD for all lifetime traumas rather than for only a small number of retrospectively reported "most serious" traumas.

Moral injury and moral repair in war veterans: A preliminary model and intervention strategy

2009-07-30
Brett T. Litz , Nathan R. Stein , Eileen Delaney +4 more

Sex differences in trauma and posttraumatic stress disorder: A quantitative review of 25 years of research.

2006-01-01
David F. Tolin , Edna B. Foa
Meta-analyses of studies yielding sex-specific risk of potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD) indicated that female participants were more likely than male participants to meet criteria for … Meta-analyses of studies yielding sex-specific risk of potentially traumatic events (PTEs) and posttraumatic stress disorder (PTSD) indicated that female participants were more likely than male participants to meet criteria for PTSD, although they were less likely to experience PTEs. Female participants were more likely than male participants to experience sexual assault and child sexual abuse, but less likely to experience accidents, nonsexual assaults, witnessing death or injury, disaster or fire, and combat or war. Among victims of specific PTEs (excluding sexual assault or abuse), female participants exhibited greater PTSD. Thus, sex differences in risk of exposure to particular types of PTE can only partially account for the differential PTSD risk in male and female participants.

Nationwide Longitudinal Study of Psychological Responses to September 11

2002-09-11
Roxane Cohen Silver
OST PEOPLE ENCOUNTER stressful events that can alter the course of their lives.Clinicians often see the mental and physical health consequences of such events. 1On September 11, 2001, everyone in … OST PEOPLE ENCOUNTER stressful events that can alter the course of their lives.Clinicians often see the mental and physical health consequences of such events. 1On September 11, 2001, everyone in the United States was exposed to an incident unprecedented in scope and traumatic impact.Tens of thousands of people directly witnessed the terrorist attacks against the World Trade Center (WTC) and the Pentagon; others viewed the attacks and their aftermath via the media-most within half an hour after they occurred. 2It has been argued that this national trauma "influenced and will continue to influence the clinical presentation of patients seeking health care services" across the country 3 and that it offers "an unfortunate opportunity to find out more about what something like this does to a country as a whole." 4 Research after the Oklahoma City, Okla, bombing suggests that emotional responses to a terrorist attack can be highly variable. 57][8] Yet, information about the range and rates of distress to be expected following such a national trauma is limited.Unfortunately, potentially harmful myths about coping remain prevalent in lay and professional communities, 8 such as the ex-pectation that subjective responses to trauma are proportional to the degree of objective loss experienced.Gaining information concerning the adjustment process can aid clinicians by iden-tifying risk factors 9,10 and can inform the design of interventions for individuals coping with stressful life events. 11e conducted a longitudinal study of acute responses to the terrorist attacks
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National Estimates of Exposure to Traumatic Events and PTSD Prevalence Using<i>DSM-IV</i>and<i>DSM-5</i>Criteria

2013-10-01
Dean G. Kilpatrick , Heidi S. Resnick , Melissa E. Milanak +3 more
Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association's Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a … Prevalence of posttraumatic stress disorder (PTSD) defined according to the American Psychiatric Association's Diagnostic and Statistical Manual fifth edition (DSM-5; 2013) and fourth edition (DSM-IV; 1994) was compared in a national sample of U.S. adults (N = 2,953) recruited from an online panel. Exposure to traumatic events, PTSD symptoms, and functional impairment were assessed online using a highly structured, self-administered survey. Traumatic event exposure using DSM-5 criteria was high (89.7%), and exposure to multiple traumatic event types was the norm. PTSD caseness was determined using Same Event (i.e., all symptom criteria met to the same event type) and Composite Event (i.e., symptom criteria met to a combination of event types) definitions. Lifetime, past-12-month, and past 6-month PTSD prevalence using the Same Event definition for DSM-5 was 8.3%, 4.7%, and 3.8% respectively. All 6 DSM-5 prevalence estimates were slightly lower than their DSM-IV counterparts, although only 2 of these differences were statistically significant. DSM-5 PTSD prevalence was higher among women than among men, and prevalence increased with greater traumatic event exposure. Major reasons individuals met DSM-IV criteria, but not DSM-5 criteria were the exclusion of nonaccidental, nonviolent deaths from Criterion A, and the new requirement of at least 1 active avoidance symptom. 標題:使用DSM-Ⅳ和DSM-5準則去估算全國的創傷經歷和PTSD患病率 撮要 : 透過網上小組集合美國全國成人樣本(N=2,953), 套用美國精神學協會的精神疾病診斷和統計手冊(DSM)的DSM-5和DSM IV版本來診斷PTSD的患病率並比較。評估是在網上利用一個高度結構自我評估調查:創傷經歷,PTSD症狀,和功能障礙。創傷經歷若使用DSM-5準則會有高比率(89.7%),但標準是多重創傷經歷。利用同一事件(即所有症狀準則符合同一事件類別)和綜合事件(即症狀準則符合事件類別的混合)定義來決定PTSD病例。使用DSM-5和同一事件定義的終身、過去12個月及過去6個月PTSD患病率分別為8.3%,4.7%和3.8%。所有6個DSM-5患病率估量都比DSM-IV者為低,雖然其中只有2個的差別是統計上有效的。DSM-5 PTSD患病率是女性高於男性,而且隨着更大創傷經歷而增加。有些人符合DSM-IV但不合DSM-5診斷的主因是:撇除在準則A內非意外非暴力死亡和新加的最少一個主動迴避症狀的要求。 标题:使用DSM-Ⅳ和DSM-5准则去估算全国的创伤经历和PTSD患病率 撮要 : 透过网上小组集合美国全国成人样本(N=2,953), 套用美国精神学协会的精神疾病诊断和统计手册(DSM)的DSM-5和DSM IV版本来诊断PTSD的患病率并比较。评估是在网上利用一个高度结构自我评估调查:创伤经历,PTSD症状,和功能障碍。创伤经历若使用DSM-5准则会有高比率(89.7%),但标准是多重创伤经历。利用同一事件(即所有症状准则符合同一事件类别)和综合事件(即症状准则符合事件类别的混合)定义来决定PTSD病例。使用DSM-5和同一事件定义的终身、过去12个月及过去6个月PTSD患病率分别为8.3%,4.7%和3.8%。所有6个DSM-5患病率估量都比DSM-IV者为低,虽然其中只有2个的差别是统计上有效的。DSM-5 PTSD患病率是女性高于男性,而且随着更大创伤经历而增加。有些人符合DSM-IV但不合DSM-5诊断的主因是:撇除在准则A内非意外非暴力死亡和新加的最少一个主动回避症状的要求。
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Clinician-administered PTSD scale: A review of the first ten years of research

2001-01-01
Frank W. Weathers , Terence M. Keane , Jonathan Davidson
The Clinician-Administered PTSD Scale (CAPS) is a structured interview for assessing posttraumatic stress disorder (PTSD) diagnostic status and symptom severity. In the 10 years since it was developed, the CAPS … The Clinician-Administered PTSD Scale (CAPS) is a structured interview for assessing posttraumatic stress disorder (PTSD) diagnostic status and symptom severity. In the 10 years since it was developed, the CAPS has become a standard criterion measure in the field of traumatic stress and has now been used in more than 200 studies. In this paper, we first trace the history of the CAPS and provide an update on recent developments. Then we review the empirical literature, summarizing and evaluating the findings regarding the psychometric properties of the CAPS. The research evidence indicates that the CAPS has excellent reliability, yielding consistent scores across items, raters, and testing occasions. There is also strong evidence of validity: The CAPS has excellent convergent and discriminant validity, diagnostic utility, and sensitivity to clinical change. Finally, we address several concerns about the CAPS and offer recommendations for optimizing the CAPS for various clinical research applications. Depression and Anxiety 13:132–156, 2001 © 2001 Wiley-Liss, Inc.

Combat Duty in Iraq and Afghanistan, Mental Health Problems, and Barriers to Care

2004-06-30
Charles W. Hoge , Carl A. Castro , Stephen Craig Messer +3 more
The current combat operations in Iraq and Afghanistan have involved U.S. military personnel in major ground combat and hazardous security duty. Studies are needed to systematically assess the mental health … The current combat operations in Iraq and Afghanistan have involved U.S. military personnel in major ground combat and hazardous security duty. Studies are needed to systematically assess the mental health of members of the armed services who have participated in these operations and to inform policy with regard to the optimal delivery of mental health care to returning veterans.We studied members of four U.S. combat infantry units (three Army units and one Marine Corps unit) using an anonymous survey that was administered to the subjects either before their deployment to Iraq (n=2530) or three to four months after their return from combat duty in Iraq or Afghanistan (n=3671). The outcomes included major depression, generalized anxiety, and post-traumatic stress disorder (PTSD), which were evaluated on the basis of standardized, self-administered screening instruments.Exposure to combat was significantly greater among those who were deployed to Iraq than among those deployed to Afghanistan. The percentage of study subjects whose responses met the screening criteria for major depression, generalized anxiety, or PTSD was significantly higher after duty in Iraq (15.6 to 17.1 percent) than after duty in Afghanistan (11.2 percent) or before deployment to Iraq (9.3 percent); the largest difference was in the rate of PTSD. Of those whose responses were positive for a mental disorder, only 23 to 40 percent sought mental health care. Those whose responses were positive for a mental disorder were twice as likely as those whose responses were negative to report concern about possible stigmatization and other barriers to seeking mental health care.This study provides an initial look at the mental health of members of the Army and the Marine Corps who were involved in combat operations in Iraq and Afghanistan. Our findings indicate that among the study groups there was a significant risk of mental health problems and that the subjects reported important barriers to receiving mental health services, particularly the perception of stigma among those most in need of such care.
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Five Essential Elements of Immediate and Mid–Term Mass Trauma Intervention: Empirical Evidence

2007-12-01
Stevan E. Hobfoll , Patricia Watson , Carl C. Bell +7 more
Given the devastation caused by disasters and mass violence, it is critical that intervention policy be based on the most updated research findings. However, to date, no evidence–based consensus has … Given the devastation caused by disasters and mass violence, it is critical that intervention policy be based on the most updated research findings. However, to date, no evidence–based consensus has been reached supporting a clear set of recommendations for intervention during the immediate and the mid–term post mass trauma phases. Because it is unlikely that there will be evidence in the near or mid–term future from clinical trials that cover the diversity of disaster and mass violence circumstances, we assembled a worldwide panel of experts on the study and treatment of those exposed to disaster and mass violence to extrapolate from related fields of research, and to gain consensus on intervention principles. We identified five empirically supported intervention principles that should be used to guide and inform intervention and prevention efforts at the early to mid–term stages. These are promoting: 1) a sense of safety, 2) calming, 3) a sense of self– and community efficacy, 4) connectedness, and 5) hope.
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Post-traumatic stress disorder following disasters: a systematic review

2007-09-06
Yuval Neria , Ayon Nandi , Sandro Galea
Background Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric … Background Disasters are traumatic events that may result in a wide range of mental and physical health consequences. Post-traumatic stress disorder (PTSD) is probably the most commonly studied post-disaster psychiatric disorder. This review aimed to systematically assess the evidence about PTSD following exposure to disasters. Method A systematic search was performed. Eligible studies for this review included reports based on the DSM criteria of PTSD symptoms. The time-frame for inclusion of reports in this review is from 1980 (when PTSD was first introduced in DSM-III) and February 2007 when the literature search for this examination was terminated. Results We identified 284 reports of PTSD following disasters published in peer-reviewed journals since 1980. We categorized them according to the following classification: (1) human-made disasters ( n =90), (2) technological disasters ( n =65), and (3) natural disasters ( n =116). Since some studies reported on findings from mixed samples (e.g. survivors of flooding and chemical contamination) we grouped these studies together ( n =13). Conclusions The body of research conducted after disasters in the past three decades suggests that the burden of PTSD among persons exposed to disasters is substantial. Post-disaster PTSD is associated with a range of correlates including sociodemographic and background factors, event exposure characteristics, social support factors and personality traits. Relatively few studies have employed longitudinal assessments enabling documentation of the course of PTSD. Methodological limitations and future directions for research in this field are discussed.
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A developmental approach to complex PTSD: Childhood and adult cumulative trauma as predictors of symptom complexity

2009-09-30
Marylène Cloître , Bradley Stolbach , Judith Lewis Herman +4 more
Exposure to multiple traumas, particularly in childhood, has been proposed to result in a complex of symptoms that includes posttraumatic stress disorder (PTSD) as well as a constrained, but variable … Exposure to multiple traumas, particularly in childhood, has been proposed to result in a complex of symptoms that includes posttraumatic stress disorder (PTSD) as well as a constrained, but variable group of symptoms that highlight self-regulatory disturbances. The relationship between accumulated exposure to different types of traumatic events and total number of different types of symptoms (symptom complexity) was assessed in an adult clinical sample (N = 582) and a child clinical sample (N = 152). Childhood cumulative trauma but not adulthood trauma predicted increasing symptom complexity in adults. Cumulative trauma predicted increasing symptom complexity in the child sample. Results suggest that Complex PTSD symptoms occur in both adult and child samples in a principled, rule-governed way and that childhood experiences significantly influenced adult symptoms.

Social cognitive theory of posttraumatic recovery: the role of perceived self-efficacy

2003-10-29
Charles C. Benight , Albert Bandura

The Posttraumatic Stress Disorder Checklist for <i>DSM‐5</i> (PCL‐5): Development and Initial Psychometric Evaluation

2015-11-25
Christy A. Blevins , Frank W. Weathers , Margaret T. Davis +2 more
Abstract The Posttraumatic Stress Disorder Checklist (PCL) is a widely used DSM ‐correspondent self‐report measure of PTSD symptoms. The PCL was recently revised to reflect DSM‐5 changes to the PTSD … Abstract The Posttraumatic Stress Disorder Checklist (PCL) is a widely used DSM ‐correspondent self‐report measure of PTSD symptoms. The PCL was recently revised to reflect DSM‐5 changes to the PTSD criteria. In this article, the authors describe the development and initial psychometric evaluation of the PCL for DSM‐5 (PCL‐5). Psychometric properties of the PCL‐5 were examined in 2 studies involving trauma‐exposed college students. In Study 1 ( N = 278), PCL‐5 scores exhibited strong internal consistency (α = .94), test‐retest reliability ( r = .82), and convergent ( r s = .74 to .85) and discriminant ( r s = .31 to .60) validity. In addition, confirmatory factor analyses indicated adequate fit with the DSM‐5 4‐factor model, χ 2 (164) = 455.83, p &lt; .001, standardized root mean square residual (SRMR) = .07, root mean squared error of approximation (RMSEA) = .08, comparative fit index (CFI) = .86, and Tucker‐Lewis index (TLI) = .84, and superior fit with recently proposed 6‐factor, χ 2 (164) = 318.37, p &lt; .001, SRMR = .05, RMSEA = .06, CFI = .92, and TLI = .90, and 7‐factor, χ 2 (164) = 291.32, p &lt; .001, SRMR = .05, RMSEA = .06, CFI = .93, and TLI = .91, models. In Study 2 ( N = 558), PCL‐5 scores demonstrated similarly strong reliability and validity. Overall, results indicate that the PCL‐5 is a psychometrically sound measure of PTSD symptoms. Implications for use of the PCL‐5 in a variety of assessment contexts are discussed.

Predictors of posttraumatic stress disorder and symptoms in adults: A meta-analysis.

2008-08-01
Emily J. Ozer , Suzanne R. Best , Tami L. Lipsey +1 more
A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met … A review of 2,647 studies of posttraumatic stress disorder (PTSD) yielded 476 potential candidates for a meta-analysis of predictors of PTSD or of its symptoms. From these, 68 studies met criteria for inclusion in a meta-analysis of 7 predictors: (a) prior trauma, (b) prior psychological adjustment, (c) family history of psychopathology, (d) perceived life threat during the trauma, (e) posttrauma social support, (f) peritraumatic emotional responses, and (g) peritraumatic dissociation. All yielded significant effect sizes, with family history, prior trauma, and prior adjustment the smallest (weighted r = .17) and peritraumatic dissociation the largest (weighted r = .35). The results suggest that peritraumatic psychological processes, not prior characteristics, are the strongest predictors of PTSD.

Assessing Psychological Trauma and PTSD

1998-07-01
Kathleen Allden
Director, Indochinese Psychiatric Clinic; Beth Israel Deaconess Medical Center; Boston, Massachusetts Director, Indochinese Psychiatric Clinic; Beth Israel Deaconess Medical Center; Boston, Massachusetts

Psychometric properties of the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders–Fifth Edition (PCL-5) in veterans.

2015-12-14
Michelle J. Bovin , Brian P. Marx , Frank W. Weathers +4 more
This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, et al., 2013b) in 2 … This study examined the psychometric properties of the posttraumatic stress disorder (PTSD) Checklist for Diagnostic and Statistical Manual of Mental Disorders-Fifth Edition (PCL-5; Weathers, Litz, et al., 2013b) in 2 independent samples of veterans receiving care at a Veterans Affairs Medical Center (N = 468). A subsample of these participants (n = 140) was used to define a valid diagnostic cutoff score for the instrument using the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers, Blake, et al., 2013) as the reference standard. The PCL-5 test scores demonstrated good internal consistency (α = .96), test-retest reliability (r = .84), and convergent and discriminant validity. Consistent with previous studies (Armour et al., 2015; Liu et al., 2014), confirmatory factor analysis revealed that the data were best explained by a 6-factor anhedonia model and a 7-factor hybrid model. Signal detection analyses using the CAPS-5 revealed that PCL-5 scores of 31 to 33 were optimally efficient for diagnosing PTSD (κ(.5) = .58). Overall, the findings suggest that the PCL-5 is a psychometrically sound instrument that can be used effectively with veterans. Further, by determining a valid cutoff score using the CAPS-5, the PCL-5 can now be used to identify veterans with probable PTSD. However, findings also suggest the need for research to evaluate cluster structure of DSM-5. (PsycINFO Database Record

The Clinician-Administered PTSD Scale for DSM–5 (CAPS-5): Development and initial psychometric evaluation in military veterans.

2017-05-11
Frank W. Weathers , Michelle J. Bovin , Daniel J. Lee +5 more
The Clinician-Administered PTSD Scale (CAPS) is an extensively validated and widely used structured diagnostic interview for posttraumatic stress disorder (PTSD). The CAPS was recently revised to correspond with PTSD criteria … The Clinician-Administered PTSD Scale (CAPS) is an extensively validated and widely used structured diagnostic interview for posttraumatic stress disorder (PTSD). The CAPS was recently revised to correspond with PTSD criteria in the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5; American Psychiatric Association, 2013). This article describes the development of the CAPS for DSM-5 (CAPS-5) and presents the results of an initial psychometric evaluation of CAPS-5 scores in 2 samples of military veterans (Ns = 165 and 207). CAPS-5 diagnosis demonstrated strong interrater reliability (к = .78 to 1.00, depending on the scoring rule) and test-retest reliability (к = .83), as well as strong correspondence with a diagnosis based on the CAPS for DSM-IV (CAPS-IV; к = .84 when optimally calibrated). CAPS-5 total severity score demonstrated high internal consistency (α = .88) and interrater reliability (ICC = .91) and good test-retest reliability (ICC = .78). It also demonstrated good convergent validity with total severity score on the CAPS-IV (r = .83) and PTSD Checklist for DSM-5 (r = .66) and good discriminant validity with measures of anxiety, depression, somatization, functional impairment, psychopathy, and alcohol abuse (rs = .02 to .54). Overall, these results indicate that the CAPS-5 is a psychometrically sound measure of DSM-5 PTSD diagnosis and symptom severity. Importantly, the CAPS-5 strongly corresponds with the CAPS-IV, which suggests that backward compatibility with the CAPS-IV was maintained and that the CAPS-5 provides continuity in evidence-based assessment of PTSD in the transition from DSM-IV to DSM-5 criteria. (PsycINFO Database Record
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Prevalence and predictors of PTSS during COVID-19 outbreak in China hardest-hit areas: Gender differences matter

2020-03-16
Nianqi Liu , Fan Zhang , Cun Wei +7 more
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Managing mental health challenges faced by healthcare workers during covid-19 pandemic

2020-03-26
Neil Greenberg , Mary Docherty , Sam Gnanapragasam +1 more
Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that … Thank you for your interest in spreading the word about The BMJ.NOTE: We only request your email address so that the person you are recommending the page to knows that you wanted them to see it, and that it is not junk mail. We do not capture any email address. Username * Your Email * Send To * You are going to email the following Managing mental health challenges faced by healthcare workers during covid-19 pandemic Your Personal Message CAPTCHA This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.
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The Mental Health Consequences of COVID-19 and Physical Distancing

2020-04-10
Sandro Galea , Raina M. Merchant , Nicole Lurie
The Need for Prevention and Early InterventionSince the first case of novel coronavirus disease 2019 (COVID-19) was diagnosed in December 2019, it has swept across the world and galvanized global … The Need for Prevention and Early InterventionSince the first case of novel coronavirus disease 2019 (COVID-19) was diagnosed in December 2019, it has swept across the world and galvanized global action.This has brought unprecedented efforts to institute the practice of physical distancing (called in most cases "social distancing") in countries all over the world, resulting in changes in national behavioral patterns and shutdowns of usual day-to-day functioning.While these steps may be critical to mitigate the spread of this disease, they will undoubtedly have consequences for mental health and well-being in both the short and long term.These consequences are of sufficient importance that immediate efforts focused on prevention and direct intervention are needed to address the impact of the outbreak on individual and population level mental health.The sparse literature on the mental health consequences of epidemics relates more to the sequelae of the disease itself (eg, mothers of children with congenital Zika syndrome) than to social distancing.However, largescale disasters, whether traumatic (eg, the World Trade Center attacks or mass shootings), natural (eg, hurricanes), or environmental (eg, Deepwater Horizon oil spill), are almost always accompanied by increases in depression, posttraumatic stress disorder (PTSD), substance use disorder, a broad range of other mental and behavioral disorders, domestic violence, and child abuse. 1 For example, 5% of the population affected by Hurricane Ike in 2008 met the criteria for major depressive disorder in the month after the hurricane; 1 out of 10 adults in New York City showed signs of the disorder in the month following the 9/11 attacks. 2,3And almost 25% of New Yorkers reported increased alcohol use after the attacks. 4Communities affected by the Deepwater Horizon oil spill showed signs of clinically significant depression and anxiety. 5The SARS epidemic was also associated with increases in PTSD, stress, and psychological distress in patients and clinicians. 6For such events, the impact on mental health can occur in the immediate aftermath and then persist over long time periods.In the context of the COVID-19 pandemic, it appears likely that there will be substantial increases in anxiety and depression, substance use, loneliness, and domestic violence; and with schools closed, there is a very real possibility of an epidemic of child abuse.This concern is so significant that the UK has issued psychological first aid guidance from Mental Health UK. 7 While the literature is not clear about the science of population level prevention, it leads us to conclude that 3 steps, taken now, can help us proactively prepare for the inevitable increase in mental health conditions and associated sequelae that are the consequences of this pandemic.

The development of a clinician‐administered PTSD scale

1995-01-01
Dudley David Blake , Frank W. Weathers , Linda Nagy +4 more
Abstract Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician‐Administered PTSD Scale (CAPS‐1) … Abstract Several interviews are available for assessing PTSD. These interviews vary in merit when compared on stringent psychometric and utility standards. Of all the interviews, the Clinician‐Administered PTSD Scale (CAPS‐1) appears to satisfy these standards most uniformly. The CAPS‐1 is a structured interview for assessing core and associated symptoms of PTSD. It assesses the frequency and intensity of each symptom using standard prompt questions and explicit, behaviorally‐anchored rating scales. The CAPS‐1 yields both continuous and dichotomous scores for current and lifetime PTSD symptoms. Intended for use by experienced clinicians, it also can be administered by appropriately trained paraprofessionals. Data from a large scale psychometric study of the CAPS‐1 have provided impressive evidence of its reliability and validity as a PTSD interview.

Meta-analysis of risk factors for posttraumatic stress disorder in trauma-exposed adults.

2000-10-01
Chris R. Brewin , Bernice Andrews , John D. Valentine

Prevalence of civilian trauma and posttraumatic stress disorder in a representative national sample of women.

1993-12-01
Heidi S. Resnick , Dean G. Kilpatrick , Bonnie S. Dansky +2 more

Body Mass Index and Risk of Post-Traumatic Stress Disorder: A Cohort Study of 1.4 Million Late Adolescents

2025-06-25
Shlomi Abuhasira , Lucian Tatsa-Laur , Leah Shelef | Military Medicine
Abstract Introduction To assess whether abnormal body mass index (BMI) among Israeli Defense Force (IDF) recruits is associated with increased risk for post-traumatic stress disorder (PTSD). Materials and Methods This … Abstract Introduction To assess whether abnormal body mass index (BMI) among Israeli Defense Force (IDF) recruits is associated with increased risk for post-traumatic stress disorder (PTSD). Materials and Methods This retrospective cohort study included 1,430,118 Israeli late adolescents aged 16–20 who were physically and mentally evaluated before IDF enlistment from January 1, 1998, to December 31, 2019. Body mass index was measured before enlistment, and PTSD diagnoses were based on the DSM-5 criteria as recorded by the IDF or the Ministry of Defense for combat-related PTSD. Individuals with PTSD diagnosis before recruitment were excluded. Results Of the 1,430,118 late adolescents in this study, 839,200 (58.7%) were male, 1,329,796 (93.1%) were Jewish, and 392,418 (27.5%) served in combat roles. Post-traumatic stress disorder was diagnosed in 7,157 (0.5%) individuals. No significant association was found between BMI and PTSD risk in combat setting. However, late adolescents with prior psychiatric diagnoses exhibited an elevated PTSD risk: 40% higher in combatants (odds ratio [OR] = 1.366) and 30% higher in non-combatants (OR = 1.296). Furthermore, extreme BMI values (below 17 or above 35) in non-combat roles were associated with a lower PTSD risk. Conclusions In the largest cohort study to date on the association between BMI and PTSD because of combat, BMI did not significantly predict PTSD risk in combat-exposed soldiers, while psychiatric history emerged as a stronger predictor across all military roles. These findings suggest prioritizing mental health history over BMI in PTSD risk assessment and prevention efforts.

Psychological impact of the February 6 earthquake on displaced individuals with proximal loss residing in temporary shelters

2025-06-24
Gülşen FİLAZOĞLU ÇOKLUK , Fatih BAL , Esra Savaş | Psychology Health & Medicine
The present study examines the psychological effects of the earthquake that occurred in Turkey on 6 February 2023 on individuals residing in temporary shelters who have experienced losses in their … The present study examines the psychological effects of the earthquake that occurred in Turkey on 6 February 2023 on individuals residing in temporary shelters who have experienced losses in their immediate surroundings. The objective of the present research is to elucidate the relationships between post-traumatic stress disorder (PTSD), depression, anxiety, and the subjective impact of the traumatic event. Nine months following the disaster, a survey was conducted among 923 adults aged 25 to 60 residing in temporary shelters in Antakya. Participants completed a series of validated and reliable measurement tools, including the DSM-5 Post-Traumatic Stress Disorder Checklist (PCL-5), the Beck Anxiety Inventory (BAI), the Beck Depression Inventory (BDI), and the Impact of Events Scale (IES). The findings indicate significant and positive correlations between PTSD and all other variables, including the impact of the event, depression and anxiety. The multiple regression analysis revealed that these three variables significantly predicted PTSD symptoms and collectively explained 41% of the variance in PTSD levels. This study emphasizes the cumulative psychological impact of forced displacement and close losses on individuals and underscores the pressing need for culturally sensitive and trauma-informed mental health services in post-disaster intervention processes. The findings contribute to the understanding of trauma dynamics in post-disaster communities and guide the development of targeted mental health policies and psychosocial support programs.

Predictors of Persistent Post-Traumatic Stress Symptoms After 2023 Maras Earthquake: The Impact of Gender, Loss, and Coping Strategies

2025-06-24
Hasan Bakay , Beyza Isik , Şakir Gıca +1 more | Psychiatric Quarterly
The objective of this study was to ascertain the prevalence of trauma symptoms in individuals residing within the seismic region 18 months after the February 6th 2023, Maras earthquake, and … The objective of this study was to ascertain the prevalence of trauma symptoms in individuals residing within the seismic region 18 months after the February 6th 2023, Maras earthquake, and to examine the factors contributing to these symptoms. The study included 339 participants who experienced the earthquake. The participants were administered sociodemographic data form, Traumatic Stress Symptom Checklist (TSSC), Coping with Earthquake Stress Scale (CESS), and Psychological Well-Being Scale (PWBS). According to the TSSC, 20.1% of the 339 participants were determined to have probable PTSD (pPTSD). In the pPTSD group, rate of destruction in the home, rate of women, rate of loss of life in relatives, rate of property loss, and rate of receiving psychiatric support were significantly higher. The pPTSD group demonstrated significantly lower positive reappraisal, seeking social support, and PWBS scores compared to the non-PTSD group. TSSC scores were negatively correlated with sub-scores of the CESS and PWBS among all participants. Regression analyses revealed that the presence of long-term pPTSD was predicted with being female, loss of life in relatives, property loss, and the need for psychiatric support. Additionally, positive reappraisal and seeking social support coping mechanisms were shown to decrease the risk of developing pPTSD. Current research suggest that traumatic symptoms may persist long after major natural disasters. Consequently, the provision of psychological support services, the enhancement of social support networks, and the dissemination of stress management methods following disasters such as earthquakes should be sustained over an extended period in high-risk regions. It is anticipated that the findings of this study will serve as a guide for researchers, clinicians, and policy-makers, facilitating the development of effective strategies for the management of post-disaster mental health needs.

Examining treatment outcomes for military service members in an intensive treatment program for posttraumatic stress disorder

2025-06-24
Jonathan W. Murphy , Dale L. Smith , Kevin Hiner +4 more | Military Psychology
To date, few studies have evaluated treatment outcomes for military service members who complete massed treatments for posttraumatic stress disorder (PTSD). Furthermore, no studies have directly compared treatment outcomes between … To date, few studies have evaluated treatment outcomes for military service members who complete massed treatments for posttraumatic stress disorder (PTSD). Furthermore, no studies have directly compared treatment outcomes between service members and veterans in a massed treatment setting. In the present study, we evaluated treatment outcomes for military service members who completed an intensive treatment program (ITP) for PTSD and compared their outcomes to military veterans who completed the same program. Data were collected from 558 participants who identified as U. S. military service members (n = 68) or veterans (n = 490) during a two-week, cognitive processing therapy-based ITP. Results showed that service members and veterans experienced large reductions in PTSD (d = 1.26 & d = 1.35, respectively) and depression (d = .82 & d = 1.01, respectively) severity after treatment. In addition, the reductions in PTSD and depression severity for service members were equivalent to those of veterans using a Bayes factor equivalence approach. This study contributes to the limited literature on treatment outcomes for service members who complete massed treatments for PTSD. This research is particularly important as lawmakers and military leaders continue to remove barriers to treatment for service members suffering with PTSD.

Measurement of level of PTSD with the International Trauma Questionnaire (ITQ): bias and precision when using full ordinal or dichotomized items

2025-06-23
Tine Nielsen , Ask Elklit , Sabrina Brødsgaard Nielsen +3 more | European journal of psychotraumatology
ABSTRACTBackground: The introduction of the WHO ICD-11 created a need for reliable and valid measures of Post-Traumatic Stress Disorder (PTSD) and complex PTSD (CPTSD). The International Trauma Questionnaire (ITQ) has … ABSTRACTBackground: The introduction of the WHO ICD-11 created a need for reliable and valid measures of Post-Traumatic Stress Disorder (PTSD) and complex PTSD (CPTSD). The International Trauma Questionnaire (ITQ) has been applied to different samples and cultures. Previous research using the original ordinal polytomous items supported the construct validity of the ITQ across different language versions in a sample of refugees in treatment and found evidence of locally dependent items and differential item functioning (DIF) relative to gender and time since trauma in the PTSD subscale. Another strand of research on the measurement properties of the ITQ has used dichotomized items and focused on discovering the model that best described the data found no evidence of DIF.Aim: To investigate the consequences of using dichotomized ITQ PTSD items for detecting DIF, other departures from the Rasch model as well as implications for measurement precision.Methods: We used Rasch and graphical log-linear Rasch models for the analysis, as these models have previously been employed in the only psychometric study using the original polytomous ITQ PTSD items.Results: The use of dichotomized PTSD items lead to detection of less DIF than previous research with the polytomous items, and it accentuated local dependence between items and DIF relative to gender. Measurement by scores over dichotomized items increased the standard error of measurement and reduced the reliability to a level, where psychometric theory would conclude that the measure of PTSD was inapplicable. In contrast, previous research has shown measurement by the polytomous ITQ PTSD items to have precision and reliability sufficient for screening for PTSD.Conclusions: The original polytomous ITQ PTSD items are recommended for purposes of studying measurement properties of the ITQ and treatment effects.

Post-Traumatic Stress Disorder (PTSD) Resulting from Road Traffic Accidents (RTA): A Systematic Literature Review

2025-06-23
Marija Trajchevska , Christian Jones | International Journal of Environmental Research and Public Health
Road traffic accidents (RTAs) are a leading cause of physical injury worldwide, but they also frequently result in post-traumatic stress disorder (PTSD). This systematic review examines the prevalence, predictors, comorbidity, … Road traffic accidents (RTAs) are a leading cause of physical injury worldwide, but they also frequently result in post-traumatic stress disorder (PTSD). This systematic review examines the prevalence, predictors, comorbidity, and treatment of PTSD among RTA survivors. Four electronic databases (PubMed, Scopus, EBSCO, and ProQuest) were searched following PRISMA 2020 guidelines. Articles were included if reporting on the presence of post-traumatic stress disorder as a result of a road traffic accident in adults aged 18 years and older. Including peer-reviewed journal articles and awarded doctoral theses across all publication years, and written in English, Macedonian, Serbian, Bosnian, Croatian, and Bulgarian, identified 259 articles, and using Literature Evaluation and Grading of Evidence (LEGEND) assessment of evidence 96 were included in the final review, involving 50,275 participants. Due to the heterogeneity of findings, quantitative data were synthesized thematically rather than through meta-analytic techniques. Findings are reported from Random Control Trial (RCT) and non-RCT studies. PTSD prevalence following RTAs ranged widely across studies, from 20% (using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition, DSM-5 criteria) to over 45% (using International Classification of Diseases, 10th Revision, ICD-10 criteria) within six weeks post-accident (non-RCT). One-year prevalence rates ranged from 17.9% to 29.8%, with persistence of PTSD symptoms found in more than half of those initially diagnosed up to three years post-RTA (non-RCTs). Mild or severe PTSD symptoms were reported by 40% of survivors one month after the event, and comorbid depression and anxiety were also frequently observed (non-RCTs). The review found that nearly half of RTA survivors experience PTSD within six weeks, with recovery occurring over 1 to 3 years (non-RCTs). Even minor traffic accidents lead to significant psychological impacts, with 25% of survivors avoiding vehicle use for up to four months (non-RCT). Evidence-supported treatments identified include Cognitive Behavioural Therapy (CBT) (RCTs and non-RCTs), Virtual Reality (VR) treatment (RCTs and non-RCTs), and Memory Flexibility training (Mem-Flex) (pilot RCT), all of which demonstrated statistically significant reductions in PTSD symptoms across validated scales. There is evidence for policy actions including mandatory and regular psychological screening post RTAs using improved assessment tools, sharing health data to better align early and ongoing treatment with additional funding and access, and support and interventions for the family for RTA comorbidities. The findings underscore the importance of prioritizing research on the psychological impacts of RTAs, particularly in regions with high incident rates, to understand better and address the global burden of post-accident trauma.

Rapid assessment of user feedback of PTSD coach: A posttraumatic stress mental health app for veterans and civilians.

2025-06-23
Sofia I. Reyes , Shilpa Hampole , Jason E. Owen +6 more | Professional Psychology Research and Practice

The Myth of Physician Invulnerability

2025-06-23
Lily Evangeline Fahs | Medical Science Educator

Analysis of Problems Associated with Diagnostics Combat Post-Traumatic Stress Disorder in a Psychiatric Hospital

2025-06-22
Daria Riabinina , Yana Zorkina , A M Reznik +7 more | Psikhiatriya
Background : in recent years, it has become relevant to study the effects of military operations on the mental health of veterans. The aim was to identify and evaluate the … Background : in recent years, it has become relevant to study the effects of military operations on the mental health of veterans. The aim was to identify and evaluate the leading psychopathological symptoms in veterans of a special military operation (SMO), as well as to compare diagnoses upon admission and discharge from the hospital. Patients and Methods : 140 male veterans of local wars and armed conflicts who were treated at N.A. Alekseev Psychiatric Clinical Hospital No. 1 in the period from 2023 to 2024 were examined. The average age of the participants was 34.2 ± 8.3 years. During the study, a clinical and psychopathological analysis of the identified symptoms and risk factors in patients was carried out. Results: the study revealed a high prevalence of anxiety (75.7%) and depression (51.4%) among participants with a preliminary diagnosis of post-traumatic stress disorder (PTSD). An analysis of the symptoms of PTSD showed that intrusion (72.1%) is the most common. The high incidence of organic mental disorders caused by traumatic brain injury (TBI) (26.4%), PTSD (18.6%) and affective disorders (20%) was confirmed, in addition, the presence of patients with preliminary diagnoses of the schizophrenic spectrum (15.7%) was noted, which are subsequently confirmed. Conclusions : in clinical practice, the phenomenology of mental disorders due to combat stress is characterized by a variety of symptoms, many of which are not specific to PTSD and therefore are not included in the set of diagnostic criteria. The observed dominant severity of affective register disorders, behavioral disorders, asthenia and individual symptoms of organic brain damage determines the evolution of the diagnosis from the initial examination to the time of discharge with a decrease in the frequency of diagnosed PTSD. Despite the presence of leading or even typical symptoms of PTSD, attention should be paid to other complaints and psychopathological signs, since they can be predominant in the picture of the disease, have a significant impact on the patient’s quality of life and become the most important or promising target of therapy.

Growing through adversity: A meta-analytic and conceptual elucidation of the relationship between posttraumatic stress and posttraumatic growth among youth

2025-06-19
Maria Jernslett , Ryan P. Kilmer , Demetris Avraam +1 more | Clinical Psychology Review
Trauma may engender both posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among youth, but what is the nature of the relationship between these variables and what does it imply … Trauma may engender both posttraumatic stress symptoms (PTSS) and posttraumatic growth (PTG) among youth, but what is the nature of the relationship between these variables and what does it imply about youths' recovery trajectories? To explore this, PubMed, PsycINFO, Scopus, ERIC, and ProQuest Dissertations and Theses Global were searched, supplemented by reference trails, journal searches, and expert consultations, to identify quantitative studies on PTSS and PTG in youth (mean age ≤ 19 years). This resulted in 63 eligible articles. Both linear (n = 53) and curvilinear (n = 12) estimates were meta-analysed using random-effects models. Linear dependent estimates were pooled using weighted corrected averages and curvilinear dependent effects were clustered using robust variance estimation. The pooled linear estimate was r = 0.2028 [95 % CI 0.1348; 0.2689], p < .0001, based on 53 independent estimates and a total sample size of 33,774.6. The pooled curvilinear estimate was b = -0.199 (SE = 0.0573, p = .012). Moderator analyses further revealed a significant cultural influence, with Western youth (r = 0.3100 [95 % CI 0.1977; 0.4142], N = 6141) demonstrating a stronger association between PTSS and PTG compared to their Eastern counterparts (r = 0.0727 [95 % CI -0.0130; 0.1574], N = 21,778.42). The findings paint a nuanced and complex picture of posttrauma responses among youth, ultimately underscoring that, while PTSS and PTG can coexist, PTSS that are too excessive may not be conducive to PTG.

The effectiveness of cognitive processing therapy for posttraumatic stress disorder in Azerbaijan

2025-06-19
Jamila Ismayilova , Josef I. Ruzek , Gunel Muradova +5 more | Journal of Traumatic Stress
Abstract Posttraumatic stress disorder (PTSD) poses a significant mental health challenge in postconflict Azerbaijan. This study explored the effectiveness of cognitive processing therapy (CPT) in this context, addressing a critical … Abstract Posttraumatic stress disorder (PTSD) poses a significant mental health challenge in postconflict Azerbaijan. This study explored the effectiveness of cognitive processing therapy (CPT) in this context, addressing a critical gap in psychotherapeutic interventions for PTSD. The study employed an intent‐to‐treat (ITT) analysis to assess the impact of CPT on PTSD and depressive symptoms, evaluate sustainability over 3 months, and examine changes in psychosocial functioning and well‐being. A single‐arm, open‐label pilot dissemination project was conducted from October 2022 to April 2023. Participants ( N = 103) underwent CPT led by local clinicians trained by U.S. experts. Measures included the PTSD Checklist for DSM‐5 (PCL‐5), Patient Health Questionnaire–9 (PHQ‐9), World Health Organization Well‐Being Index (WHO‐5), and Brief Inventory of Psychosocial Functioning (B‐IPF). Post‐CPT, significant reductions were observed in PTSD symptoms, Δ M baseline–posttreatment = −35.9, p &lt; .001, d = 3.56, and depressive symptom, Δ M baseline–posttreatment = −12.9, p &lt; .001, d = 2.91. Sustained improvements in PTSD symptoms were noted at the 3‐month follow‐up assessment. Psychosocial functioning notably improved posttreatment Δ M baseline–posttreatment = −5.6, p &lt; .001, d = 0.75, and well‐being showed a significant increase, Δ M baseline–posttreatment = 7.1, p &lt; .001, d = 1.52. This pilot trial highlights CPT's effectiveness in alleviating PTSD and depressive symptoms, improving psychosocial functioning, and enhancing well‐being. Despite limitations, the findings suggest that CPT is a promising psychotherapeutic intervention for PTSD in Azerbaijan, warranting further research with larger samples and extended follow‐up periods.

Cross-sectional exercise-related differences in PTSD symptoms, psychological distress, physical pain, and sleep quality in trauma-exposed adults

2025-06-19
Nicholas J. SantaBarbara , Erica R. Checko , Michelle M. Pebole +1 more | Frontiers in Psychology
Purpose Psychological trauma can lead to PTSD which is associated with numerous negative health outcomes. Exercise has beneficial effects on PTSD; however, the amount of exercise associated with these benefits … Purpose Psychological trauma can lead to PTSD which is associated with numerous negative health outcomes. Exercise has beneficial effects on PTSD; however, the amount of exercise associated with these benefits remains unknown. To examine self-reported exercise-related differences in PTSD symptom severity, psychological distress, pain, and sleep quality in a national sample of trauma-exposed adults. Methods Participants completed online assessments of exercise participation, PTSD symptom severity, psychological distress, pain, and sleep quality. Exercise level was defined as Active (≥24 on the Godin-Leisure Time Exercise Questionnaire [GLTEQ]), Insufficiently Active (1–23 on the GLTEQ), or Inactive (no reported exercise). MANCOVA was used to determine the relationship between exercise level (i.e., independent variable) and all outcomes (PTSD, distress, pain, sleep) with post hoc means comparison adjusted for age. Results Participants’ ( n = 500) mean age was 34.9 ± 13.0, and 68% were female. The overall model for exercise was significant, such that Active participants reported less PTSD symptom severity, psychological distress, and pain, and better sleep quality than Inactive participants. Conclusion Meeting the recommended amount of weekly physical activity with moderate-to-vigorous exercise is associated with better physical and mental health among trauma survivors. Longitudinal research is needed to confirm these cross-sectional findings.

PTSD Symptoms change in response to a brief intensive trauma-focused treatment programme in non-veterans and veterans with war-related PTSD

2025-06-19
Kirsten M. Reij , Ad de Jongh , Ernst Paul Swens +1 more | European journal of psychotraumatology
Background: Evidence suggests that veterans with post-traumatic stress disorder (PTSD) are less likely to benefit from trauma-focused treatment than are patients with PTSD who have not been exposed to war-related … Background: Evidence suggests that veterans with post-traumatic stress disorder (PTSD) are less likely to benefit from trauma-focused treatment than are patients with PTSD who have not been exposed to war-related trauma. However, new developments in PTSD treatment that combine several evidence-based trauma-focused therapies within a short time frame may help veterans achieve outcomes similar to those of non-veterans.Objective: In this retrospective cohort study, we examined changes in PTSD symptoms and diagnostic status after treatment between veterans and non-veterans. The treatment consisted of a four- or eight-day intensive trauma-focused treatment programme that integrated prolonged exposure, EMDR therapy, psycho-education, and physical activities.Methods: The sample consisted of 43 veterans and 43 non-veterans, matched based on age, sex, starting date, and duration of treatment. Participants were assessed pre- and post-treatment using the Clinician-Administered PTSD Scale-5 (CAPS-5). The differences in CAPS-5 scores over time and between groups were modelled using Bayesian repeated-measures ANOVA. We performed Bayesian model averaging to quantify the differences in PTSD symptom changes between groups, based on treatment response, using the exclusion Bayes factor (BFEXCL).Results: PTSD symptoms in both veterans and non-veterans decreased between pre- and post-treatment (Cohen's d = 2.17 and 1.54, respectively). Furthermore, we found moderate evidence of no differences in CAPS-5 scores between the groups (BFEXCL = 4.8) or between the groups over time (BFEXCL = 4.9). Although a greater proportion of veterans showed improvement according to the reliable change index than non-veterans (83.7% and 74.4%, respectively), there was no difference between the groups in terms of loss of diagnostic status after treatment (74.4% for veterans and 76.7% for non-veterans).Conclusion: This study provides evidence that veterans with war-related PTSD can benefit from brief intensive, trauma-focused treatment and does not support the notion that veterans need a different treatment approach in such settings.

Severe PTSD or just PTSD?

2025-06-19
Valentin Raymond , Antoine Yrondi , Philippe Birmes | European journal of psychotraumatology
Although the widespread of trauma exposure, post-traumatic stress disorder (PTSD) remains a prevalent and disabling mental disorder. Yet, access to appropriate care, particularly for individuals with more severe forms, remains … Although the widespread of trauma exposure, post-traumatic stress disorder (PTSD) remains a prevalent and disabling mental disorder. Yet, access to appropriate care, particularly for individuals with more severe forms, remains limited. The expression 'severe PTSD' is widely used in clinical practice, yet no shared or psychometrically grounded definition has been established. Unlike other psychiatric disorders such as depression, validated instruments are still lacking to reliably determine the degree of severity of PTSD. Furthermore, relying solely on symptom scores may obscure key differences in functional impairment, or clinical relevance, as emphasized by the Project Harmony initiative. This lack of clarity may hinder the development of targeted therapeutic interventions. In this letter, we call for a shift toward a dimensional and integrative approach to assess PTSD severity. Instruments such as the Clinical Global Impression (CGI) scale could provide more ecologically valid and meaningful ways to capture the full spectrum of severity. Clarifying how severity is conceptualized may also support stepped-care approach by better identifying those who would benefit more from intensive trauma-focused interventions. Thus, reassessing how we define and measure PTSD severity requires moving away from counting symptoms toward a more nuanced, personalized understanding of the disorder.

Differentiating Among Stress, Acute Stress Disorder, Acute Crisis Episodes, Trauma, and PTSD

2025-06-19
Kenneth R. Yeager , Albert R. Roberts , Christina A. Daron | Oxford University Press eBooks
Abstract This chapter seeks to distinguish the distinct components of stress, acute stress disorder, acute crisis episodes, trauma, and post-traumatic stress disorder (PTSD). This chapter begins by defining stress, acute … Abstract This chapter seeks to distinguish the distinct components of stress, acute stress disorder, acute crisis episodes, trauma, and post-traumatic stress disorder (PTSD). This chapter begins by defining stress, acute stress disorder, acute crisis episodes, and PTSD, including a brief history and outline of prevalence of each. It next introduces a clinical framework to assist practitioners to understand each component within clinical practice. This is also diagramed within a case-specific classification paradigm. Each case is presented in conjunction with Roberts’s seven-stage crisis intervention model and the ACT model. This process aids readers in understanding presentation of each area of stress, acute stress disorder, acute crisis episodes, and PTSD and provides examples of potential clinical interventions for each aspect presented.

Crisis Intervention Teams

2025-06-19
David P. Kasick | Oxford University Press eBooks
Abstract This chapter explores crisis intervention with law enforcement, examining the impact of a career of law enforcement on the emotional well-being of those who have sworn to serve and … Abstract This chapter explores crisis intervention with law enforcement, examining the impact of a career of law enforcement on the emotional well-being of those who have sworn to serve and protect. This is especially important, given recent high-profile situations in which law enforcement has responded to extremely difficult situations with varied outcomes. It outlines a survey conducted with over 1,000 law enforcement officers and the impact of their daily work on their mental/emotional well-being. Next it provides a case example of a law enforcement response to a non-officer-involved situation (e.g., motor vehicle fatality) and the impact on the responding officer. There is a full review of the application of Roberts’s seven-stage model with law enforcement and discussion of the impact of trauma and trauma-informed care.

Introduction to the special section on the long‐term health impact of trauma, posttraumatic stress disorder, comorbid conditions, and aging

2025-06-18
Brian N. Smith , Anica Pless Kaiser | Journal of Traumatic Stress
Abstract This article introduces a special section of the Journal of Traumatic Stress devoted to new research investigating and addressing the associations among trauma exposure, posttraumatic stress disorder (PTSD), comorbid … Abstract This article introduces a special section of the Journal of Traumatic Stress devoted to new research investigating and addressing the associations among trauma exposure, posttraumatic stress disorder (PTSD), comorbid conditions, and aging. As the global population is rapidly aging, it is critical to advance understanding of the long‐term health implications of trauma, PTSD, and comorbid conditions, including impacts on health, functioning, and well‐being across the life course. In addition to understanding these trauma‐related risks in varying populations, it is important to evaluate potential sources of resilience as well as to consider implications for health care services, including trauma‐informed care, in the context of aging. This opening article introduces themes reflected in this collection of new scientific manuscripts examining a range of relevant questions and populations, which collectively contribute to this important and growing area of research in the traumatic stress field.

Maladaptive beliefs, dissociation, and suicidal ideation in people with PTSD: Results from a national survey in Japan

2025-06-17
Hong Wang Fung , Chak Hei Ocean Huang , Po‐Han Chou +4 more | Journal of Psychiatric Research

Do betrayal-based moral injury and drinking to cope explain the association between military sexual trauma and alcohol consumption?

2025-06-17
Michelle L. Kelley , Megan Strowger , Jeffrey M. Gabelmann | Military Psychology
The present study examined two sequential mediation models in which betrayal-based moral injury and drinking to cope were hypothesized to explain the associations between sexual assault/sexual harassment and alcohol consumption. … The present study examined two sequential mediation models in which betrayal-based moral injury and drinking to cope were hypothesized to explain the associations between sexual assault/sexual harassment and alcohol consumption. Participants were a community sample of 93 current or former U.S. military women (30.4 years; SD = 8.01) who completed an online, anonymous survey. In both models, sexual assault and sexual harassment and alcohol consumption were explained by betrayal-based moral injury and drinking to cope. It may be important to assess for and therapeutically address betrayal-based moral injury as it may be a mechanism that drives alcohol consumption.

Preventing Stress and Anxiety in Children and Adults during Martial Law: Prospects for Ukraine and Worldwide

2025-06-17
Olesia Prokofieva , Tetiana Marchak , Olha Podzhynska +3 more | Revista Romaneasca pentru Educatie Multidimensionala
The article examines the psychological impact of war on emotional well-being. It focuses on rehabilitation methods for children and adults who have experienced psychological trauma during wartime. Given Russia’s war … The article examines the psychological impact of war on emotional well-being. It focuses on rehabilitation methods for children and adults who have experienced psychological trauma during wartime. Given Russia’s war against Ukraine, addressing stress and anxiety management has become a critical concern for Ukrainians. This article aims to accomplish four main objectives. First, it defines key psychological constructs (stress, fear, and anxiety) in the context of war and displacement. Second, it analyzes existing literature on the psychological impact of war on children and adults. Third, it identifies primary factors contributing to stress resilience as a foundation for mental health. Finally, it proposes rehabilitation methods to mitigate the psychological effects of war. The research is grounded in a comprehensive analysis of scientific literature and a systematic methodological approach. The findings emphasize that psychological resilience is fundamental to maintaining mental well-being. In particular, children affected by psychological trauma require timely diagnosis and professional psychological support to reduce the long-term consequences of distress. The article examines various therapeutic interventions, including music therapy, art therapy, martial arts, and eye movement desensitization and reprocessing (EMDR) therapy, as potential methods for psychological rehabilitation. The results confirm the profound negative impact of war on emotional health. Children, in particular, are often affected, frequently experiencing heightened fear, anxiety, depression, and difficulty concentrating on their studies. A key contribution of this article is the identification of distance learning as an additional factor exacerbating anxiety levels in children. This finding underscores the urgent need for comprehensive psychological support. It also highlights the importance of tailored educational strategies to address the emotional challenges faced by learners in conflict-affected regions.

Work-Related Psychological Trauma Research: A Multidisciplinary Review and Integrated Trauma Response and Adaptation Model

2025-06-17
Madelynn Stackhouse | Academy of Management Annals

Impact of Clinical Psychology in Emergencies and Disasters in Ecuador and other Global Crises

2025-06-14
José Roberto Lema Balla , Farid Eduardo Cedeño Morales , María Noemí Alchundia Mendoza | Salud Ciencia y Tecnología
In a world where emergencies and disasters are becoming more frequent due to climate change, social conflicts, and global pandemics, clinical psychology has proven to be an essential tool for … In a world where emergencies and disasters are becoming more frequent due to climate change, social conflicts, and global pandemics, clinical psychology has proven to be an essential tool for mitigating the emotional and mental impact of these crises. The objective of this study is to identify the challenges and opportunities of clinical psychology professionals in the context of emergencies and disasters in Ecuador, proposing recommendations to optimize their work based on the comparison of various telepsychology methodologies. This study uses a combination of literature review and qualitative case analysis. Documents from organizations such as the World Health Organization (WHO) and interviews with mental health professionals in Ecuador were reviewed. In addition, strategies used in international disasters such as the tsunami in Japan (2011) and Hurricane Katrina (2005) were analyzed. Among the most common psychological effects derived from disasters are Post-Traumatic Stress Disorder (PTSD), anxiety and depression, affecting both direct victims and response teams. Clinical psychology plays a fundamental role in emotional recovery during crisis contexts. In Ecuador, significant progress has been made in this area; however, it is imperative to strengthen psychological services, especially in vulnerable and rural areas.

Trajectories of posttraumatic stress in military peacekeepers: A longitudinal analysis over 23 years.

2025-06-12
Christer Lunde Gjerstad , Hans Jakob Bøe , Andreas Espetvedt Nordstrand +2 more | Psychological Trauma Theory Research Practice and Policy
This study investigated trajectories of posttraumatic stress in Norwegian peacekeepers over a 23-year period, focusing on the prevalence and characteristics of late-onset posttraumatic stress disorder (PTSD), where symptoms develop or … This study investigated trajectories of posttraumatic stress in Norwegian peacekeepers over a 23-year period, focusing on the prevalence and characteristics of late-onset posttraumatic stress disorder (PTSD), where symptoms develop or intensify long after deployment. We analyzed PTSD symptoms in 463 Norwegian peacekeepers who had deployed to Lebanon as part of the UN peacekeeping mission, UN Interim Force in Lebanon. PTSD symptoms were assessed using the Posttraumatic Symptom Scale-10 at two time points: a median of 7 years (T1) and 29 years (T2) postdeployment. Late-onset PTSD was defined as cases in which peacekeepers did not meet criteria for PTSD at T1 but met the criteria by T2. We used logistic regression to identify predictors of late-onset PTSD, including deployment and postdeployment factors. Estimated PTSD prevalence increased from 2.8% at T1 to 8.9% at T2, with 8.0% (95% confidence interval [5.5, 10.5]) showing a late-onset trajectory. At T1, those on a late-onset path reported more symptoms than their resilient counterparts. By T2, late-onset cases constituted 90.2% of all PTSD cases. Key predictors of late-onset PTSD included causal attribution of mental health issues to service, OR = 3.03, p < .001; number of deployments, OR = 1.56, p = .039; and postdeployment stressors, OR = 1.30, p = .049. We found a significant rise in estimated PTSD prevalence among military peacekeepers over two decades, with causal attribution emerging as the strongest predictor of a late-onset trajectory. Interventions aimed at addressing these attributions could be important in mitigating long-term PTSD symptoms. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Duty and distress — military personnel seeking mental health services

2025-06-10
Rebecca Cooney | Nature Mental Health

Supplemental Material for Trajectories of Posttraumatic Stress in Military Peacekeepers: A Longitudinal Analysis Over 23 Years

2025-06-05

Supplemental Material for Experiences and Regulation of Posttraumatic Shame Among Women With Interpersonal Trauma Histories: An Ecological Momentary Assessment Study

2025-06-05

Commentary on "A Post-Pandemic Wellness Experiences Scale: Demographic Variation and Influences on Depression"

2025-06-05
Jayashabari Shankar | JOURNAL OF MENTAL HEALTH AND CLINICAL PSYCHOLOGY
This commentary critically engages with Tawa et al.’s development and validation of the Post-Pandemic Wellness (PPW) scale, a psychometrically grounded instrument designed to measure wellness across four dimensions: positive reframing, … This commentary critically engages with Tawa et al.’s development and validation of the Post-Pandemic Wellness (PPW) scale, a psychometrically grounded instrument designed to measure wellness across four dimensions: positive reframing, economic stress, social stress, and existential impact. The authors’ multi-time point validation (2021 and 2024) adds rigor and temporal relevance to their findings, revealing both consistencies and evolutions in post-pandemic mental health trajectories across demographic groups. While the PPW subscales show high internal consistency and statistical integrity over time, notable differences emerge in the mediation pathways previously linking race and depression, particularly among Asian American participants. The disappearance of these effects in the 2024 data invites further inquiry into how sociopolitical shifts modulate psychological stress. This commentary explores how existential stress may not only predict distress but also correlate with resilience, drawing on existing literature on post-traumatic growth. Limitations in the study’s design—including under examined intersections of age, race, and gender, and its reliance on self-reported online data—suggest directions for future research. Expanding the scale to distinguish between negative and adaptive existential responses and incorporating mixed-methods approaches—such as in-depth interviews or focus groups stratified by racial-gender identity—would enhance its applicability. Finally, while the scale offers significant diagnostic promise, its generalizability to clinical populations or minoritized subgroups with limited digital access may be constrained.

MECHANISMS OF DEVELOPMENT OF STRESS-RELATED MENTAL DISORDERS IN COMBAT-INJURED MILITARY PERSONNEL: THE ROLE OF COMORBID PATHOLOGY AND SYNDROMAL ORGANIZATION

2025-06-03
Hanna Kozhyna , Viktoriia SUKHARIEVA , Oleksandr Oleksandrovych Potapov | Ukrains kyi Visnyk Psykhonevrolohii
Disorders specifically related to stress (DSRS) are a significant problem for the mental health of military personnel who have experienced combat trauma. The heterogeneity of clinical manifestations of DSRS indicates … Disorders specifically related to stress (DSRS) are a significant problem for the mental health of military personnel who have experienced combat trauma. The heterogeneity of clinical manifestations of DSRS indicates a multifactorial nature of their pathogenesis. Understanding the role of concomitant somatic pathology (comorbidity) and the specificity of psychopathological syndrome formation is critically important for improving diagnosis and developing effective, differentiated therapeutic strategies. Aim of the study — to develop and empirically substantiate a multifactorial model of DSRS formation in military personnel with combat trauma, integrating the influence of the type of injury/ comorbidity received and the specificity of the syndromal structure. The study was conducted on a sample of 242 male military personnel with combat trauma, divided into three groups by the profile of the treatment department. Clinical-psychopathological, psychodiagnostic methods, assessment of combat experience intensity, and statistical analysis (ANOVA, correlation, factor) were used. Significant differences were found in the intensity of combat experience between the groups (p&lt;0.05) and a reliable influence of the type of trauma/comorbidity on symptom severity (sleep, mood, etc.). Symptoms are clustered into stable syndromes. The type of trauma/comorbidity significantly influenced the frequency of final diagnoses (anxiety-depressive syndrome was reliably more often detected in patients of group III (26,1 %, p&lt;0.01), and post-concussion syndrome — in patients of group II (32.7%, p&lt;0.01)), which confirmed the influence of the type of trauma/comorbidity on the final diagnostic outcome. A multifactorial model of DSRS formation that explains these regularities was developed. The developed model is empirically substantiated and emphasizes the central role of the type of concomitant somatic pathology in the formation of specific syndromes and final diagnostic categories of DSRS in military personnel with combat trauma, justifying the necessity of differentiated approaches in clinical practice.

PSYCHOPATHOLOGICAL PHENOMENOLOGY AND CLINICAL MANAGEMENT OF PATIENTS WITH DEPRESSIVE EPISODE UNDER CONDITIONS OF FULL-SCALE INVASION

2025-06-02
Iryna TIEROSHYNA , Kateryna ZELENSKA , Inna Chernenko +1 more | Ukrains kyi Visnyk Psykhonevrolohii
In the course of work aimed at studying clinical-psychological and pathopsychological features of depressive episode, a comprehensive examination of 123 patients under prolonged influence of war stress was conducted (group … In the course of work aimed at studying clinical-psychological and pathopsychological features of depressive episode, a comprehensive examination of 123 patients under prolonged influence of war stress was conducted (group І — 57 military servicemen, group ІІ — 66 internally displaced persons). It was established that the clinical structure of depressive disorders in examined patients was represented by: anxiety-depressive (33.7 % of group І subjects and 33.9 % of group ІІ), apathetic-adynamic (22.6 % and 19.9 % respectively), melancholic (27.7 % of group І and 28.1 % of group ІІ subjects), and dysphoric (36.0 % and 8.1 % respectively) variants of psychopathological symptomatology. A differentiated approach to clinical management was developed, including personalized pharmacotherapy using SSRIs and SNRIs, adapted psychotherapeutic interventions and self-help methods taking into account the specificity of traumatic impact in each group for the formation of long-term resilience.

Female Veterans with Military Sexual Trauma History and Posttraumatic Stress Disorder Display Impaired Fear Extinction Learning

2025-06-01
Seth D. Norrholm , Jenna L. Laymon , Michelle Szewczuk +7 more | Behaviour Research and Therapy