A programme for the prevention of post-traumatic stress disorder in midwifery (POPPY): indications of effectiveness from a feasibility study

Posttraumatic Stress Disorder Symptoms During the First Six Months After Traumatic Brain Injury

Background: Studies on mental health rates among primary school children are still limited, particularly related to psychological trauma and its relationship to other mental health challenges. Objective: The objective of this study was to 1) examine the prevalence of PTSD, depression, and anxiety symptoms in primary school children before the Covid-19 pandemic; 2) identify the relationship between PTSD, depression and anxiety symptoms; and 3) investigate potential gender differences in PTSD symptoms. Methods: This is the first cross-sectional study examining the rates of trauma exposure, posttraumatic stress disorder (PTSD), depression, and anxiety symptoms in primary school children before the covid-19 pandemic in Malaysia. Two hundred and twenty-one students participated in this study. They were recruited from four primary schools that volunteered to participate in this study. PTSD Checklist for DSM-5 (PCL-5), Child PTSD Symptoms Scale-5 (CPSS-5), The Center for Epidemiologic Studies Depression Scale version (CESD), and the Spence Children's Anxiety Scale (SCAS) were used to survey psychological symptoms. Results: Most of the students, or 54.3% of them, have experienced at least one traumatic event. Of 221 students, 39.4% reported having PTSD symptoms, 38% reported having depressive symptoms, and 19% reported having anxiety symptoms. Female students were more likely to report PTSD symptoms compared to male students. The first regression analysis model indicated that depressive symptoms were the only significant predictors of PTSD. In the second model, religion, family income, anxiety, and PTSD symptoms were significant predictors of depressive symptoms. In the third model, depressive symptoms were the sole significant predictors of anxiety. Conclusion: The study reveals that primary school children experience high levels of trauma, PTSD, depression, and anxiety, especially before the COVID-19 pandemic. During the early phases of the pandemic, these mental health issues have been largely neglected in Malaysia, with limited preventative and therapeutic interventions available. Future research should focus on documenting the prevalence of these issues in relation to the COVID-19 pandemic.

Project Liberty provided brief crisis counseling to 753,015 residents of New York City and surrounding counties after the attacks on the World Trade Center. Most regained predisaster functioning after counseling. For those who did not, Project Liberty provided enhanced services by specially trained, licensed mental health professionals. Individuals receiving crisis counseling and enhanced services responded to confidential telephone interviews about 18 and 24 months, respectively, after the attacks. Impairment was compared between groups to determine whether enhanced services recipients reported improved functioning and fewer symptoms of depression, posttraumatic stress, and complicated grief. Crisis counseling recipients (N=153) were interviewed once and enhanced services recipients (N=76) were interviewed twice about symptomatology and daily functioning. The samples did not differ in age or gender. Significantly greater proportions of enhanced services recipients reported knowing someone who died as a result of the attacks, having been involved in rescue efforts, or having lost their job because of the attacks. Compared with crisis counseling respondents, enhanced services recipients at their first interview reported significantly more symptoms of depression, grief, and traumatic stress and significantly poorer daily functioning in five life areas. At follow-up, enhanced services respondents reported significant improvement in three of five functioning domains, significantly fewer symptoms of depression and grief, and marginally less traumatic stress. Recipients of enhanced services were more impaired than people who received only crisis counseling. On the basis of reports from service recipients, meaningful improvements in functioning and symptoms may be associated with the receipt of enhanced services.

Cognitive behavioral conjoint therapy (CBCT) for posttraumatic stress disorder (PTSD) is a 15-session conjoint treatment for PTSD designed to improve PTSD symptoms and enhance intimate relationship functioning. Numerous studies of CBCT for PTSD document improvements in patient PTSD and comorbid symptoms, partner mental health, and relationship adjustment. However, little is known about its effectiveness in real-world clinical settings. Using an intention-to-treat sample of couples who participated in CBCT for PTSD in an outpatient U.S. Veterans Affairs (VA) PTSD clinic (N = 113), trajectories of session-by-session reports of veterans' PTSD symptoms and both partners' relationship happiness were examined. Across sessions, there were significant reductions in veteran-rated PTSD symptoms, d = -0.69, and significant increases in veteran- and partner-rated relationship happiness, ds = 0.36 and 0.35, respectively. Partner ratings of veterans' PTSD symptoms increased before significantly decreasing, d = -0.24. Secondary outcomes of veteran and partner relationship satisfaction, ds = 0.30 and 0.42, respectively; veteran and partner depressive symptoms, ds = -0.75 and -0.29, respectively; and partner accommodation of PTSD symptoms, d = -0.44, also significantly improved from pre- to posttreatment. The findings suggest that CBCT for PTSD was effective for decreasing PTSD and comorbid symptoms in veterans, as well as for improving relationship functioning and partners' mental health, among a sample of real-world couples seeking treatment in a VA PTSD specialty clinic.

Post-traumatic stress disorder (PTSD) and major depressive disorder (MDD) are associated with functional impairments, yet little is known about their influence on HIV pre-exposure prophylaxis (PrEP) motivation among women survivors of intimate partner violence (IPV). Understanding how PTSD and MDD symptoms influence PrEP motivation is particularly important given survivors of IPV have an increased risk for HIV acquisition. The present study assessed the association between PrEP motivation with latent profiles of PTSD and MDD symptoms among women survivors of IPV. Data were collected from a sample of 285 women from Baltimore, MD, and New Haven, CT. Latent profile analysis (LPA) was performed to identify distinct patterns of depressive and PTSD symptoms among women survivors of IPV. Binary logistic regression was performed to examine the association of profile membership on PrEP motivation. A six-profile solution was determined to best fit the data. Profiles were characterized by: Profile 1, very low depressive and very low PTSD symptoms (28.07%); Profile 2, average depressive symptoms and low (below the mean) PTSD symptoms (21.05%); Profile 3, high depressive symptoms and low (below the mean) PTSD symptoms (9.8%); Profile 4, moderate depressive symptoms and high PTSD symptoms (15.78%); Profile 5, high PTSD avoidance and average depressive symptoms (17.1%); Profile 6, high depressive and high PTSD symptoms (8%). We found that, the odds of being in Stage 3 of the PrEP Motivational Cascade (PrEParation; defined by having access to a medical provider to prescribe PrEP, be willing to take PrEP, and self-identifying as an appropriate candidate for PrEP) compared to Stage 1 of the PrEP Motivational Cascade (Precontemplation; defined by being eligible for PrEP, but not willing to take PrEP and/or not self-identifying as an appropriate candidate for PrEP) were lower for women assigned to the low depressive symptoms and low PTSD symptoms profile (Profile 1 of the LPA) compared to women in the high depressive symptoms and High PTSD symptoms profile (Profile 6 of the LPA, OR = 0.22, 95% CI = 0.06-0.76, p = 0.02). Women assigned to the low PTSD symptoms and average depressive symptoms profile (Profile 2 of the LPA) had lower odds of being in Stage 3 (PrEParation) compared to Stage 1 (Precontemplation) compared to women assigned to the high depressive symptoms and High PTSD symptoms profile (Profile 6 of the LPA, OR = 0.25, 95% CI = 0.07-0.92, p = 0.037). Women survivors of IPV with higher PTSD and MDD symptoms expressed greater motivation to engage in PrEP compared to women survivors with low PTSD and low MDD symptoms. Findings support the CDC's clinical PrEP recommendations to integrate depression screening into PrEP services, but there is a critical need to also include PTSD screening. Further, MDD and PTSD symptoms may present differential barriers to PrEP motivation among women survivors of IPV. Precision care could synchronize trauma-informed practices and mental health treatment to engage survivors in PrEP services.

Trajectories of maternal symptoms of posttraumatic stress disorder predict long-term mental health of children following the Wenchuan earthquake in China: A 10-year follow-up study

The psychological morbidity experienced by physicians, advanced practice practitioners (APPs), and nurses from working during the COVID-19 pandemic includes burnout, depression, and posttraumatic stress disorder (PTSD). To investigate whether psilocybin therapy could improve symptoms of depression, burnout, and PTSD in US clinicians who developed these symptoms from frontline clinical work during the pandemic. This double-blind randomized clinical trial enrolled participants from February to December 2022. Participants included physicians, APPs, and nurses who provided frontline care for more than 1 month during the pandemic and had no prepandemic mental health diagnoses but had moderate or severe symptoms of depression at enrollment. Participants were randomly assigned to either the psilocybin or niacin arm. Data analysis was conducted between December 2023 and May 2024 and was based on the intention-to-treat principle. One intervention episode consisted of 2 preparation visits, 1 medication session, and 3 integration visits. At the medication session, participants received psilocybin, 25 mg, or niacin, 100 mg, orally. The primary outcome was a change from baseline (preparation 1 session) to day 28 (after medication administration) in symptoms of depression as measured by the clinician-administered Montgomery-Asberg Depression Rating Scale (MADRS) used by blinded raters. The secondary outcomes were a change in symptoms of burnout (measured with the Stanford Professional Fulfillment Index [SPFI]) and symptoms of PTSD (measured with the Posttraumatic Stress Disorder Checklist for Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition [PCL-5]). A total of 30 clinicians (15 females [50%]; mean [range] age, 38 [29-60] years) participated, of whom 15 were randomly assigned to receive psilocybin and 15 to receive niacin. The mean change in symptoms of depression (MADRS scores) from preparation 1 session to day 28 was -21.33 (7.84) in the psilocybin arm compared with -9.33 (7.32) in the niacin arm, with a mean difference between arms of -12.00 (95% CI, -17.67 to -6.33; P < .001), a decrease in MADRS scores indicating improvement. The mean change in SPFI scores from preparation 1 session to day 28 showed a numerically larger improvement in symptoms of burnout in the psilocybin compared with the niacin arm (-6.40 [5.00] vs -2.33 [5.97]; P = .05) but was not statistically significant. Since the SPFI score change did not reach statistical significance, the PCL-5 score change was evaluated descriptively. The mean change in PCL-5 scores showed a numerically larger decrease in symptoms of PTSD from preparation 1 session to day 28 in the psilocybin vs the niacin arm (-16.67 [15.04] vs -6.73 [10.69]), but this difference was not statistically tested. This randomized clinical trial found that psilocybin therapy resulted in a significant, sustained reduction in symptoms of depression experienced by clinicians after frontline work during the COVID-19 pandemic. The findings establish psilocybin therapy as a new paradigm of treatment for this postpandemic condition. ClinicalTrials.gov Identifier: NCT05163496.

Meta-analysis of post-traumatic stress disorder and COVID-19 in patients discharged

BackgroundDisaster experiences have been associated with higher prevalence rates of (mental) health problems. The objective of this study was to examine the independent relation between a series of single disaster experiences versus the independent predictive value of a accumulation of disaster experiences, i.e. a sum score of experiences and symptoms of distress and post-traumatic stress disorder (PTSD).MethodsSurvivors of a fireworks disaster participated in a longitudinal study and completed a questionnaire three weeks (wave 1), eighteen months (wave 2) and four years post-disaster (wave 3). Ten years post-disaster (wave 4) the respondents consisted of native Dutch survivors only. Main outcome measures were general distress and symptoms of PTSD.ResultsDegree of disaster exposure (sum score) and some disaster-related experiences (such as house destroyed, injured, confusion) were related to distress at waves 2 and 3. This relation was mediated by distress at an earlier point in time. None of the individual disaster-related experiences was independently related to symptoms of distress. The association between the degree of disaster exposure and symptoms of PTSD at waves 2 and 3 was still statistically significant after controlling for symptoms of distress and PTSD at earlier point in time. The variable ‘house destroyed’ was the only factor that was independently related to symptoms of PTSD at wave 2. Ten years after the disaster, disaster exposure was mediated by symptoms of PTSD at waves 2 and 3. Disaster exposure was not independently related to symptoms of PTSD ten years post-disaster.ConclusionsUntil 4 years after the disaster, degree of exposure (a sum score) was a risk factor for PTSD symptoms while none of the individual disaster experiences could be identified as an independent risk factor. Ten years post-disaster, disaster exposure was no longer an independent risk factor for symptoms of PTSD. Since symptoms of PTSD and distress at earlier waves perpetuate the symptoms at later waves, health care workers should aim their resources at those who still have symptoms after one and a half year post-disaster, to prevent health problems at medium and long-term.

Cardiovascular risk as a moderator of associations among anxiety sensitivity, distress tolerance, PTSD and depression symptoms among trauma-exposed firefighters

HighlightsWhat are the main findings?Critical care nurses experience high levels of post-traumatic stress disorder (PTSD) symptoms and moderate compassion fatigue, with psychological well-being compromised in a substantial proportion of participants.PTSD symptoms and compassion fatigue are strongly associated with poorer well-being, whereas demographic factors have limited influence compared with work-related stressors.What are the implications of the main findings?The findings highlight the need for system-level rather than demographic-based interventions, as mental health risks are primarily driven by workplace exposure and organizational pressures.Integrating routine psychological screening, trauma-informed support, and improved staffing and workload management may help protect nurses’ well-being.Background: Critical care nurses are frequently exposed to traumatic clinical events and occupational stress, increasing the risk of post-traumatic stress disorder (PTSD), compassion fatigue, and compromised psychological well-being. However, the interrelationships among these variables in Saudi Arabia remain unclear. This study investigated the associations between PTSD symptoms, compassion fatigue, and psychological well-being among critical care nurses. Methods: A descriptive cross-sectional study was conducted between October and December 2025 with 210 critical care nurses from the Eastern and Riyadh regions of Saudi Arabia. Data were collected using the PTSD Checklist for DSM-5 (PCL-5), the Professional Quality of Life Scale, and the WHO-5 Well-Being Index. Data analysis included descriptive statistics, t-tests, one-way analysis of variance, Pearson’s correlation coefficients, and multiple linear regression. Results: The mean PCL-5 score was 27.44, with 38.1% of participants meeting the cutoff for probable PTSD. Compassion fatigue was moderate. The mean WHO-5 score was 54.60, indicating moderate well-being, though a substantial proportion reported poor well-being. Psychological well-being was negatively correlated with both PTSD symptoms and compassion fatigue, while PTSD symptoms were strongly positively correlated with compassion fatigue. Both PTSD and compassion fatigue independently predicted lower well-being, explaining 21% of the variance. Sociodemographic variables were not significant predictors after adjustment. Conclusions: Critical care nurses experience moderate PTSD symptoms and compassion fatigue, adversely affecting psychological well-being. These findings underscore the interconnected nature of trauma-related distress and professional quality of life, highlighting the need for routine psychological screening, trauma-informed support, and resilience-focused interventions.

BackgroundChildhood maltreatment and HIV are both associated with a greater risk for adverse mental health, including posttraumatic stress disorder (PTSD), depression, and increased systemic inflammation. However, it remains unknown whether childhood maltreatment and HIV interact to exacerbate PTSD, depression, and inflammation in a manner that may further increase the risk of adverse health outcomes in people living with HIV. This study investigated the interaction between childhood maltreatment and HIV status on PTSD and depression symptom severity, and on peripheral concentrations of lipopolysaccharide (LPS) and high sensitivity C-reactive protein (hsCRP) in women. We hypothesized that women living with HIV (WLWH) who report high levels of childhood maltreatment exposure would show the greatest PTSD and depressive symptoms, as well as the highest concentrations of LPS and hsCRP.MethodsWe conducted a cross-sectional study of 116 women (73 WLWH and 43 women without HIV). Participants completed interviews to measure trauma exposure, including childhood maltreatment, and PTSD and depression symptoms. They also provided blood samples that were analyzed for LPS and hsCRP concentrations.ResultsBoth women living with and without HIV reported high rates of trauma exposure and showed no statistically significant differences in overall rates of childhood maltreatment. Moderate to severe childhood maltreatment was associated with higher PTSD symptom severity (p =.005), greater depression severity (p =.005), and elevated plasma LPS concentrations (p =.045), regardless of HIV status. There were no effects of childhood maltreatment on hsCRP concentrations. There were no detectable significant effects of HIV status, or interactions between HIV status and childhood maltreatment, on PTSD and depression symptoms, or LPS and hsCRP concentrations (all p’s > 0.05).ConclusionsOur findings highlight the impact of childhood maltreatment on depression and PTSD symptoms and LPS concentrations in women. These results underscore the importance of trauma-informed health care in addressing childhood maltreatment to potentially improve both mental and physical health outcomes of adult women.

PTSD and Combat-Related Injuries: Functional Neuroanatomy

Prevalence and factors associated with post-traumatic stress disorder among internally displaced populations due to gang violence in Haiti.

The impact of intimate partner violence on psychological well-being: Predictors of posttraumatic stress disorder and the mediating role of insecure attachment styles