Psychological Trauma: Theory, Research, Practice, and Policy

A current challenge in classification and treatment of DSM-5-TR prolonged grief disorder.
This letter discusses the current challenge in classification and treatment of DSM-5-TR prolonged grief disorder. Prolonged grief disorder (PGD) is among the new mental disorders included in the DSM-5-TR section II, a chapter about trauma and stressor-related disorders. By definition, PGD is a maladaptive response to the death of a loved one characterized by a period of at least 12 months of persistent yearning for or preoccupation with the deceased and disabling symptoms such as disbelief about the death, avoidance, emotional numbness, identity disruption, intense emotional pain, loneliness, a sense that life is meaningless, and failure to move forward. This syndrome occurs in 9.8% of bereaved survivors and may be associated with increased risk of medical conditions (e.g., cardiovascular disease, cancer, and immunological dysfunction), substance use disorders (particularly increased tobacco and alcohol use), suicidality, and diminished quality of life. Given that PGD has clinical similarities with major depressive disorder (MDD) and posttraumatic stress disorder (PTSD), recent studies have evaluated selective serotonin reuptake inhibitors (SSRIs) in the treatment of this novel DSM-5-TR diagnosis. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Visible wounds of invisible repression: A perspective on the importance of investigating the biological and psychological impact of political repression.
Objective: Exposure to psychological trauma is a well-accepted risk factor for the development of mental and somatic diseases. However, chronic stressors not fulfilling the criteria of traumatic experience can have similarly adverse health consequences. While the harmful impact of chronic stressors is generally recognized among researchers, there is a lack of acknowledgment within clinical, political, and societal entities. This becomes evident in the experiences of victims of political repression in the former German Democratic Republic (GDR), an authoritarian state in East Germany. Repression in the GDR included covert measures, such as “Zersetzung” (engl: disintegration), consisting of wiretapping, spreading rumors, or provoking failure in professional and social domains. It aimed to systematically undermine the psychosocial integrity of individuals, inducing anxiety, social isolation, and confusion. Method: This article integrates findings on repression in the GDR with existing trauma and chronic stress literature. Results: “Zersetzung” shares key features with severe psychosocial chronic stressors. Like trauma, experiencing “Zersetzung” likely dysregulated the biological stress systems, thereby predisposing victims to the health consequences they frequently experience to the present day. Conclusion: Certain severe chronic stressors, such as “Zersetzung,” do not appear to differ in their negative health consequences from Criterion A traumatic events. Identifying the biological and psychological impact of political repression techniques is essential, not only for public acknowledgment, and proper health care of victims of GDR repression, but also for those individuals suffering from similar repression methods today. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Posttraumatic stress disorder in diverse populations: Testing for assessment bias in a nationally representative sample.
Objective: A growing body of research has emerged to characterize differences in posttraumatic stress disorder (PTSD) symptom presentations in individuals from diverse racial and ethnic groups. However, less research has examined if these observed differences can be attributed to bias within PTSD assessments. Knowledge about potential bias in PTSD assessment is essential for interpreting group differences. If PTSD assessments do not perform similarly across diverse demographic groups, then observed differences may be artificial products of inaccurate measurement, new assessments could be required for individuals from different demographic groups, and we would be unable to accurately detect PTSD treatment effects in patients from diverse groups. Method: We evaluated PTSD assessment bias through tests of measurement invariance for the semistructured, clinician-administered AUDADIS-5 diagnostic assessment of participants in the National Epidemiologic Survey on Alcohol and Related Conditions-III. Participants included those who reported having experienced at least one potentially traumatic event in their lifetime (N = 23,936). Measurement invariance was assessed for participants who identified from several demographic groups (Asian, Native Hawaiian, or Pacific Islander; Hispanic; American Indian/Alaskan Native; and Black) compared to participants who identified as White (non-Hispanic). Results: Overall, PTSD assessment was largely invariant across groups, while small amounts of measurement invariance were detected that can inform future research and clinical adaptations. Conclusions: This work validates prior research that relies on a common conceptualization of PTSD, and it provides several paths for future improvement in research and clinical practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
“The war is here!” anxiety, trauma centrality, and the mediating role of daily stressors in Romanian and Ukrainian civilians.
Objective: The present study investigated the level of anxiety among Ukrainian and Romanian civilians brought about by the war that started in Ukraine on February 24, 2022, using a model for the impact of traumatic experiences. We aimed to test the mediating effect of daily stressors on the relationships between trauma centrality and anxiety. Method: The research was conducted on a sample of 720 people (24.3% males and 75.7% females, Mage = 35.61, SD = 12.59). Participants were civilians who lived either in Ukraine or outside Ukraine but at a maximum distance of 100 km from the border when the conflict started. They filled out questionnaires that measure anxiety, trauma centrality—indicating how central an event is to an individual’s identity and life story, and daily stressors—predisposing factor for negative mental health outcomes. Results: The outcomes highlighted the direct relationship between trauma centrality and anxiety, but also the mediating effect of daily stressors on the aforementioned relationships (in the overall sample, Ukrainian sample, and Romanian sample). Our research also underlined that there are significant differences in anxiety levels between people who have children and those who do not (in the overall sample and the Ukrainian sample, but not among Romanian civilians). Conclusions: The present work contributes by enhancing knowledge about the relationships between trauma centrality, daily stressors, and anxiety within a war context, and the particularization of Carlson and Dalenberg’s model (2000) in the context of the Russo–Ukrainian war. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Parent-reported posttraumatic stress reactions in children and adolescents: Findings from the mental health of parents and children in Ukraine study.
Background: Despite the long-standing ongoing war in Ukraine, information regarding war-related negative mental health outcomes in children is limited. A nationwide sample of parents in Ukraine was surveyed to assess posttraumatic stress disorder (PTSD) symptoms in their children and to identify risk factors associated with child PTSD status. Method: A nationwide opportunistic sample of 1,238 parents reported on a single randomly chosen child within their household as part of The Mental Health of Parents and Children in Ukraine Study. Data were collected approximately 6 months after the war escalation in February 2022. The prevalence of PTSD was estimated using the parent-reported Child and Adolescent Trauma Screen (CATS). Results: Based on parental reports, 17.5% of preschoolers and 12.6% of school-age children met Diagnostic and Statistical Manual of Mental Disorders (5th ed.) criteria for PTSD. Delay in milestone development (AOR = 2.38, 95% confidence interval [CI] [1.38–4.08]), having a parent affiliated with the emergency services or army (AOR = 2.13, [1.28–3.53]), parental PTSD/complex PTSD status (AOR = 1.88, [1.22–2.89]), and mean changes in parental anxiety (AOR = 1.98, [1.44–2.72]) were among the strongest predictors of increased risk of pediatric PTSD. Conclusion: Russia’s war escalation in Ukraine resulted in an increased estimated prevalence of war-related PTSD in children of various ages. Urgent efforts to increase the capacity of national pediatric mental health services are critically needed to mitigate these challenges in an environment of limited financial and human resources. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The influence of betrayal trauma on complex posttraumatic stress disorder symptoms.
Objective: Complex posttraumatic stress disorder (complex PTSD) is characterized by symptoms of PTSD combined with disturbance in self-organization and is distressing for many people who have experienced chronic and repetitive interpersonal trauma. Studies on the precursors to complex PTSD have thus far focused on the forms of trauma perpetrated rather than who perpetrated the trauma. Traumas that are associated with complex PTSD (i.e., chronic and repetitive interpersonal traumas) are often perpetrated by someone that is close to the victim and thus involve an element of betrayal. However, there is little research on whether traumas high in betrayal are more associated with complex PTSD symptoms than traumas lower in betrayal. The aim of this study is to examine the association between traumas with varying degrees of betrayal and complex PTSD symptoms. Method: We examined this association in a sample of adults (N = 364) recruited using Amazon’s Mechanical Turk using a Bayesian approach to multiple regression. Results: Results suggest that interpersonal traumas both with and without a component of betrayal were associated with complex PTSD symptoms for both women and men. We further found that for men, noninterpersonal trauma was also associated with complex PTSD symptoms. Conclusion: Study findings highlight the role of interpersonal trauma on complex PTSD symptoms, especially for women. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Changes in the networks of complex posttraumatic stress disorder symptoms among Chinese college students with childhood trauma.
Objective: To advance understanding of the development of complex posttraumatic stress disorder (CPTSD) symptoms longitudinally and facilitate future treatments, the present study investigated changes in the network of CPTSD symptoms among Chinese college students with childhood trauma. Method: A longitudinal study was conducted with college students, following them three times at 3-month intervals. CPTSD symptoms were measured using the International Trauma Questionnaire, and childhood trauma was assessed by the revised Adverse Childhood Experiences Scale. The final sample consisted of 294 participants with childhood trauma at baseline measurement (28.9% were males, Mage = 20.76 years). Comparisons of cross-sectional networks and cross-lagged panel network (CLPN) analysis were performed to characterize the features and changes of interactions among CPTSD symptoms. Results: Sense of failure and isolation were the core symptoms in the cross-sectional networks of CPTSD symptoms. The comparison of cross-sectional networks indicated that the global network strength was stable, and no node’s strength centrality and only one edge weight changed significantly from Time 1 (T1) to Time 3 (T3). The findings of the CLPN model reveal that worthlessness, difficulties with intimacy, and flashbacks have the highest out-expected influence. In the T1–T3 network, the strongest edge was from worthlessness to sense of failure. Conclusions: Cross-sectional network analyses and comparisons revealed the characteristics of CPTSD networks at multiple time points, while the CLPN analysis identified the longitudinal dynamics of CPTSD symptoms. These provide insights for designing more targeted intervention plans for college students with childhood trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Trauma symptom patterns in a large sample of military personnel outpatients: Differential relations to trauma exposure, depression, and anxiety symptoms.
Objective: Posttraumatic stress disorder (PTSD) results from experiencing or witnessing a traumatic event and is the most common clinical syndrome seen in military personnel. However, each patient experiences the impact of trauma differently exhibiting individual patterns of trauma symptoms. The current study endeavors to investigate individual patterns of trauma symptoms in military personnel and specifically analyze potential linkage and/or relation between blast exposure, anxiety, and depression. Method: We employed a person-centered approach of latent class analysis (LCA) to stratify 594 military personnel outpatients based on their response patterns in the Trauma Symptom Inventory (TSI). Then, we related the resulting clusters to the number of blasts to which they were exposed, as well as to depression (Zung Self-Rating Depression Scale) and anxiety symptom severity (Beck Anxiety Inventory) using one-way analyses of variance with Bonferroni pairwise comparisons. Results: We found three distinct clusters of traumatic symptoms: (a) Atypical response with low overall symptom burden, (b) increased response level and arousal, and (c) severe trauma symptom burden with tension-reduction behaviors. Individuals in Cluster 2 were exposed to significantly more blasts than in Cluster 1. Moreover, individuals in Cluster 3 reported the highest depression and anxiety symptom severities, followed by Cluster 2, followed by Cluster 1. Conclusions: These results suggest heterogeneity among military personnel suffering from trauma and reveal their distinct relations to clinical comorbidities—emphasizing the role of person-centered, tailored approaches in clinical practice. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The role of shame and trauma type on posttraumatic stress disorder and depression severity in a treatment-seeking veteran population.
Objective: Research on how different types of trauma affect depression and posttraumatic stress disorder (PTSD) symptoms in veterans has yielded inconsistent results. Shame, a painful and negative self-evaluative emotion observed in PTSD and across interpersonal traumas, may help explain past findings. The present study explored (a) how trauma types (childhood abuse, combat exposure, and military sexual trauma [MST]) may be associated with depression and PTSD severity and (b) how shame may be associated with trauma type, PTSD symptoms, and depression symptoms in a treatment-seeking veteran sample. Method: Veterans (N = 372) completed self-report questionnaires assessing trauma exposure, PTSD symptoms, depression symptoms, and shame upon admission to treatment programs across two Veterans Affairs Medical Centers. Results: We found that veterans with combat exposure or MST had greater depression and PTSD symptoms than those without these trauma experiences. Among veterans without a history of combat exposure and MST, a history of childhood abuse was associated with depression symptoms. Among veterans who did not experience combat but did experience MST, a history of childhood abuse was not associated with depression symptoms. We found that characterological shame (i.e., shame about oneself) partially mediated MST status and PTSD symptoms and fully mediated MST status and depression symptoms. Conclusions: These results suggest that different trauma exposures can have complex effects on clinical presentations and that shame may be a mechanism of PTSD and depression severity in veterans with MST. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Principles for secondary traumatic stress-responsive practice: An expert consensus approach.
Objective: Though research on secondary traumatic stress (STS) has greatly increased in the past decade, to date the field lacks a coherent set of guiding principles for practice that behavioral health providers and organizations can use to mitigate the occurrence and impact of STS. As such it is important to identify effective strategies, grounded in research and professional experience, to reduce the occurrence and impact of STS among behavioral health professionals and organizations. Method: We conducted a four-stage modified Delphi survey. Thirty-one international STS experts were invited to participate, with a minimum of 19 responding in each round. Thematic analysis was conducted on qualitative data, which was incorporated into revisions of the principles. Results: Consensus was achieved on 14 principles, seven targeted at individual professionals, and seven targeted at organizations. Conclusions: This is the first effort to delineate principles for practice intended to reduce the occurrence and impact of STS in individual and organizational practice in behavioral health services. The principles are intended to inform best practices for individuals and organizations providing services to persons and communities who have experienced trauma and thereby improve the quality and effectiveness of services to traumatized populations. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Predictors of compassion fatigue and compassion satisfaction among Australian teachers.
Objective: Research on factors that predict compassion satisfaction and compassion fatigue of teachers is limited. This study aimed to evaluate predictors of compassion fatigue (as defined by burnout and secondary traumatic stress) and compassion satisfaction of Australian teachers. Method: Three hundred and two teachers completed an online survey. It was hypothesized that teachers with prior experience with trauma-exposed students, a history of mental illness, and personal trauma history would show higher compassion fatigue. Older teachers, teachers previously exposed to trauma training, and teachers with higher perceived knowledge and confidence to manage student trauma were expected to show higher compassion satisfaction. Results: Teachers with exposure to student trauma, a personal history of trauma, and a history of mental illness experienced higher compassion fatigue, while older teachers and those with higher perceived knowledge and confidence to deal with student trauma experienced higher compassion satisfaction. Conclusions: Results indicate that professional development programs should include trauma-informed knowledge and skills for teachers to enhance their well-being when responding to trauma-exposed students. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Examining the psychometric properties of the expressions of moral injury scale in a sample of first responders.
Objective: There is emerging evidence that first responders, like military personnel, are at risk for exposure to potentially morally injurious events. However, studies examining expressions of moral injury in first responders are nascent, in large part due to the limited number of measures validated for use in this population. To address this gap, the present study sought to investigate the psychometric properties of the Expressions of Moral Injury Scale—Military Version (EMIS-M) in a sample of first responders. Method: The psychometric properties of the EMIS-M were investigated in a sample of 228 first responders to determine reliability, convergent validity, discriminative validity, and divergent validity. In addition, confirmatory factor analysis was conducted to test the bifactor model identified in a veteran sample (Currier et al., 2018). Results: Results yielded an excellent fit for the bifactor model with correlated self-directed and other-directed subscales identified in the EMIS-M development study. In addition, the measure evidenced strong reliability, convergent validity, discriminative validity, and divergent validity. Conclusions: The findings of the present study suggest that the Expressions of Moral Injury Scale—First Responder Version is a psychometrically sound measure capable of assessing self- and other-directed expressions of moral injury in first responders. The significance of these findings to our understanding of moral injury in first responders and their implications for future research are discussed. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Cultural Trauma Scale: Psychometric evaluation of Black men’s beliefs, emotions, and coping.
Racism and gender-based prejudice produce a synergistic and toxic effect that necessitates analysis. There is a need to conduct more research with Black men as their experiences with race-based trauma may differ, given their concurrent disproportionate exposure to other forms of violence. Objective: The study’s purpose was to develop items for and evaluate the factor structure and internal consistency of the Cultural Trauma Scale (CuTS) in an exclusive sample of Black men. Method: Using the Yale Center for Clinical Investigation, Community Alliance for Research Engagement principles, the study was conducted in a context of community-engaged research. Data were collected from individual interviews and focus groups, subject matter experts, and a sample of 150 adult Black men. Principal axis factoring (PAF) was used to determine the factor structure of the scale items. Results: Via PAF the final factor structure included five constructs addressing: American and its justice system: cognitive–emotional responses (Cronbach’s α = .88), cognitive–behavioral coping (Cronbach’s α = .77), willingness to seek cultural trauma treatment (Cronbach’s α = .88), tripartite police fear (Cronbach’s α = .81), and resilience (Cronbach’s α = .61). Conclusions: The CuTS represents psychometric advancement in the measurement of Black male social justice and healing from cultural trauma. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Validation of the four-item very brief University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index screening tool for children and adolescents.
Objective: Experiencing traumatic events places children and adolescents at risk for developing posttraumatic stress disorder (PTSD), often leading to adverse mental health consequences. Although well-validated measures of PTSD are available, very brief screening tools are needed to assess PTSD when resources are limited. This study was conducted to develop and validate the four-item University of California at Los Angeles (UCLA) PTSD Reaction Index for DSM-5–Very Brief Form (RI-5-VBF) to be used in settings requiring rapid and efficient screening. Method: Item response theory (IRT) models were used to derive RI-5-VBF scores from the UCLA PTSD Reaction Index for DSM-5 and assess its internal consistency using a sample of 1,785 youth (Mage = 12.32 years, SD = 2.78) seeking support at an academic medical center clinic or bereavement center. Receiver operating characteristic (ROC) analyses and diagnostic efficiency statistics were used to assess discriminant groups validity and screening utility of the RI-5-VBF scores. Differential item functioning (DIF) analyses were used to examine possible bias across age, gender, race, ethnicity, and clinical setting versus bereavement center setting. Results: IRT models identified four items with the highest discrimination within each PTSD subscale. The RI-5-VBF scores exhibited acceptable internal consistency (α = .74). ROC analyses indicated that an RI-5-VBF score of 9 maximized sensitivity and specificity. DIF analyses did not find evidence of bias across age, gender, race, ethnicity, or clinical versus bereavement center settings. Conclusion: These findings provide support for the reliability and validity of the RI-5-VBF. Findings highlight the utility of the RI-5-VBF as a brief screening measure for PTSD in children and adolescents. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Psychometric evaluation of the Dutch International Trauma Questionnaire for the 11th revision of the International Classification of Diseases posttraumatic stress disorder and complex posttraumatic stress disorder.
Background: The International Trauma Questionnaire (ITQ) is a recent self-report measure to assess the severity and probable posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD) as defined by the 11th revision of the International Classification of Diseases. Few studies have examined the psychometric properties of full and short ITQ versions in depth. Therefore, we aimed to evaluate the psychometric properties of the Dutch-translated 28-item ITQ and the 12-item version. Method: Data were used from existing clinical studies and routine clinical assessments for the 28-item (n = 956) and 12-item (N = 4,944) ITQ versions in trauma-exposed treatment-seeking individuals in the Netherlands. Internal consistency and factor validity were assessed, and rates of probable PTSD and CPTSD were estimated. In addition, convergent and discriminant validity were examined by correlations with similar and dissimilar measures. Results: Both versions of the ITQ showed good internal consistency and convergent validity. Confirmatory factor analysis showed that both a first-order correlated six-factor model and a two-factor second-order model were a good representation of the latent structure for the ITQ-12. The ITQ-12 resulted in higher CPTSD rates compared to the ITQ-28 (47% vs. 36.3%), while a similar number of patients met the criteria for either PTSD or CPTSD (70.6% vs. 76.4%). Conclusion: Internal consistency and convergent validity for the ITQ-12 and ITQ-28 were supported. The factorial validity was good for the ITQ-12 and acceptable for the ITQ-28. The discrepancy in CPTSD rates between the ITQ-12 and ITQ-28 calls for further testing of scoring methods against diagnostic clinical interviews for CPTSD. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Working memory performance is related to childhood trauma but not psychotic-like experiences in a nonpsychiatric sample.
Objective: This project seeks to clarify the impact of childhood trauma and psychotic-like experiences (PLEs) on working memory (WM) and explore gender differences in these relationships. The effect of childhood trauma on WM performance has yet to be explored in individuals with PLEs, despite consistent associations between trauma, psychosis spectrum symptoms, and WM performance. Method: In 466 undergraduates, positive PLEs (Prodromal Questionnaire) and trauma (Childhood Trauma Questionnaire) were examined to determine contributions to WM performance on a spatial n-back task. We conducted hierarchical linear regressions on the total sample and stratified by gender to examine the effects of childhood trauma, positive PLEs, and their interaction on WM performance. Supplemental analyses explored attenuated negative and disorganized symptoms. Results: Controlling for age, there were no significant main effects of positive PLEs, childhood trauma, their interaction, or three-way interaction including gender in predicting WM. After stratifying by gender, childhood trauma was significantly associated with poorer WM in females only. Post hoc analyses revealed that in the full sample, physical neglect predicted WM performance and was a trend for females, while sexual abuse trended toward predicting WM in males. Supplemental analyses of attenuated negative and disorganized symptoms revealed childhood trauma significantly predicted WM in the full sample and females only for negative symptoms. Conclusions: Females who have experienced childhood trauma may be at greater risk for WM problems, irrespective of co-occurring PLEs, suggesting that cognitive difficulties may be partially attributable to history of trauma. These findings have potential implications for intervention strategies in trauma-exposed individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Assessing the existence of trauma-related diagnostic overshadowing in adult populations.
Objective: Previous research with youth has shown that clinicians tend to diagnose and treat posttraumatic stress disorder (PTSD) in trauma-exposed clients, even when clinical presentations indicate that PTSD is not the primary diagnosis. The current study sought to examine this trauma-related diagnostic overshadowing bias in adult cases across different types of trauma exposure. Method: Mental health professionals (N = 232) reviewed two vignettes describing an adult seeking treatment for either obsessive-compulsive disorder (OCD) symptoms or substance use disorder (SUD) symptoms (target disorders). Each participant was randomly assigned to one vignette in which one client endorsed exposure to trauma (i.e., sexual trauma or physical trauma) and one vignette in which the client reported no trauma exposure. Following each vignette, participants responded to questions related to the diagnosis and treatment of the client. Results: In both cases, participants were significantly less likely to choose the target diagnosis and treatment and more likely to choose a PTSD diagnosis and trauma treatment when trauma exposure was present in the vignettes. Evidence for the bias was strongest for vignettes that contained sexual trauma compared to vignettes that contained physical trauma. Evidence for the bias was also more consistent in the OCD case compared to the SUD case. Conclusions: Results indicate evidence for the existence of trauma-related diagnostic overshadowing in adult populations, though the strength of this bias may be dependent on aspects of the trauma and overall clinical presentation. More work is needed to understand factors that may impact the presence of this bias. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Cumulative trauma, posttraumatic stress, and obstetric and perinatal outcomes.
Objective: Traumatic stress is associated with increased risk for physical health conditions, emotional disorders, and reproductive challenges. Significant rates of posttraumatic stress disorder are reported during pregnancy and after childbirth (Yildiz et al., 2017). However, a dearth of research has explored how traumatic stress impacts obstetric and perinatal outcomes. The aim of this study was to examine whether cumulative trauma and posttraumatic stress symptoms (PTSS) were positively associated with adverse obstetric and perinatal outcomes (i.e., pregnancy complications, nonviable pregnancies, preterm birth, and low birth weight). Abortion was also explored in relation to trauma exposure. Method: Two hundred and twenty-six trauma-exposed women (Mage = 40.54, SD = 13.03) who had been pregnant at least once were recruited from Amazon’s Mechanical Turk (MTurk; 63.3%) or midwestern university (36.7%) to participate in the study. Results: Higher levels of PTSS were related to a greater number of nonviable pregnancies and abortions (βs = .18–.20) as well as delivering a low birth weight baby (OR = 1.03). Yet, these same associations were not found with cumulative trauma exposure. Conversely, greater cumulative trauma was linked with delivering a baby prematurely (OR = 1.16). Pregnancy complications were unrelated to both PTSS and cumulative trauma. Conclusions: Cumulative trauma exposure and PTSS may have adverse effects on obstetric and perinatal outcomes and pregnant women with PTSS may be especially vulnerable. Further research is needed to replicate these findings and examine the temporal relationship between duration of PTSS and obstetric and perinatal outcomes. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Revisiting the hidden wound: Impact of the COVID-19 pandemic on domestic violence and divorce in Taiwan (2020–2021).
Background: Data from some countries showed a worrisome increase in domestic violence but a paradoxical decrease in divorce during the early months of the COVID-19 pandemic. We investigated the impact of the pandemic on domestic violence and divorce in Taiwan in 2020–2021. Method: Data for reported domestic violence and divorce by month and county/city (2017–2021) were from Taiwan government’s registries. We used random-effects negative binomial regression to estimate the rate ratios (RRs) and their 95% confidence intervals (CIs) between the observed numbers of domestic violence cases and divorces in 2020–2021 and the expected numbers based on prepandemic trends (2017–2019). We calculated RRs for the two outbreak periods (First: January–May 2020; Second: May–July 2021) and the two postoutbreak periods (First: June 2020–April 2021; Second: August–December 2021) and each month in 2020–2021. Results: The number of overall domestic violence cases was greater than expected during the first COVID-19 outbreak—a 3% increase (95% CI [0.3%–6%])—and the two postoutbreak periods—a 9% increase ([6%–12%]) and a 12% increase ([8%–16%]), respectively. Intimate partner violence was the main contributor to the increases. The number of divorces was lower than expected throughout the pandemic (a 5%–24% decrease). Conclusion: Reported domestic violence cases were higher than expected during the pandemic, particularly during the postoutbreak periods when the outbreak control measures were relaxed and people’s movement resumed. Tailored prevention and intervention measures may be needed to address the increased vulnerability to domestic violence and restricted access to support during the outbreaks. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
The dual role of time perception in trauma-exposed individuals: A conceptual review.
Objective: This comprehensive review seeks to integrate knowledge on the dual role of time as a reactive and a constructive measure with literature on the distinctive encoding of traumatic memories. First, we discuss the dual role of time. Later, we show how encoding traumatic events may lead to chronic alteration in time perception. Finally, we review the potential of temporal metacognitive awareness as a therapeutic avenue to rectify chronic time dilation following trauma, ultimately mitigating posttraumatic symptoms. Method: A systematic search of electronic databases was conducted using four main terms: time perception, temporal encoding of traumatic memories, temporal metacognitive awareness, and temporal learning tasks as clinical interventions. Results: The review proposes that the interplay between the dual roles of time—reactive and constructive—alongside the elemental encoding of traumatic events can give rise to a self-perpetuating cycle. Within this cycle, overgeneralized fear could lead to neutral stimuli triggering and fortifying time dilation, thus contributing to the maintenance of posttraumatic stress disorder (PTSD) symptoms. Furthermore, we propose that cultivating temporal metacognitive awareness could potentially yield a positive impact on time dilation by embracing a more adaptable learning approach—one that places less emphasis on external signals and does not necessitate direct engagement with traumatic content. Strengthened temporal awareness might serve to mitigate chronic time dilation, potentially leading to a reduction in PTSD symptoms. Conclusion: The review emphasizes the need for further research to examine whether enhancing temporal metacognitive awareness for time duration may offer an innovative and effective avenue for alleviating PTSD symptoms in trauma-exposed individuals. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Testing the nightmare cognitive arousal processing model.
Objective: Posttrauma nightmares are recurring nightmares that begin after a traumatic experience. Research has only recently begun to identify variables that predict posttrauma nightmare occurrences. Research has identified presleep arousal-cognitive (PSA-C) and presleep arousal physiological (PSA-PHYS), sleep onset latency (SOL), and sleep-disordered breathing (SDB) as potential predictors of posttrauma nightmares. However, previous research includes methodological limitations, such as a lack of physiological measures and a homogeneous sample. To replicate previous findings and increase generalizability, the current study investigated predictors of nightmare occurrences in a sample of male inpatient veterans with mixed-trauma history. Method: Participants (n = 15) completed an initial assessment battery and seven consecutive days of pre and postsleep diaries, including measures of posttrauma nightmare triggers and posttrauma nightmare occurrences. Portable objective measurements of sleep and presleep states were used to examine sleep quality and physical arousal. Results: Analyses revealed that PSA-C and SOL both predicted posttrauma nightmare occurrences and that PSA-PHYS was significantly higher on nights when nightmares occurred. Conclusion: Results replicate earlier research which posits that PSA and SOL play a role in triggering the occurrence of posttrauma nightmares. It should be noted that the sample was relatively small, warranting cautious interpretation of results. However, when taken together with the findings of the replicated study, results could suggest the plausibility of therapies targeting presleep cognitions, SOL, and presleep arousal in the treatment of posttrauma nightmares. (PsycInfo Database Record (c) 2024 APA, all rights reserved)
Exploring false negatives in self-reported trauma exposure status.
Introduction: Trauma exposure is often assessed using checklists such as the Life Events Checklist for DSM-5 (LEC-5; Weathers et al., 2013b). When participants endorse multiple events, respondents are asked to identify a single, worst event (i.e., index event). Recent work indicates that the “worst event” method leads to a concerning number of false negatives. The purpose of the current study was to replicate previous findings of false negatives and extend them by examining characteristics associated with false negatives, such as trauma type, means of exposure, recency of trauma, and posttraumatic stress disorder (PTSD) symptom severity. Method: Adults (n = 476) provided data on trauma history assessed using a revised version of the LEC-5 that asked participants to provide follow-up information for each traumatic event endorsed. Participants also provided demographic data and completed the PTSD Checklist for DSM-5. Results: Two hundred thirty-four participants (49.16%) reported a worst event that met the DSM-5 definition of Criterion A trauma (“primary Criterion A” group). However, of the 242 participants who did not, 138 participants (57.02%, or 28.99% of the total sample) reported a secondary event that did meet Criterion A (“secondary Criterion A” group). The secondary Criterion A group most commonly reported serious life-threatening illnesses/injuries and “other” stressful life experiences as their index trauma that did not fulfill Criterion A. Participants in the primary and secondary Criterion A groups reported similar levels of PTSD symptoms. No differences were observed in means of exposure and recency of index trauma between the Criterion A groups. Discussion: Findings raise questions regarding the efficiency and accuracy of the worst event method to determine trauma exposure status via self-report. Researchers should consider alternative methods for assessing trauma exposure rather than relying on the worst event scoring method. (PsycInfo Database Record (c) 2024 APA, all rights reserved)

Psychological Trauma: Theory, Research, Practice, and Policy - Vol 16, Iss 8