ABSTRACT Background: The Childhood Trauma Questionnaire (CTQ) is a widely used tool for the retrospective assessment of childhood trauma (CT). However, evidence on its long-term stability remains limited, especially in diagnostically complex populations such as individuals with borderline personality disorder (BPD). Given the disorder’s characteristic emotional instability and altered self-perception, assessing the stability of CTQ scale scores in this group is particularly important. Methods: In a longitudinal design, CTQ and the Borderline Symptom List-23 (BSL-23) scores were collected at two timepoints (T0: n = 417; T1: n = 195) from individuals with current or past BPD. The interval between assessments ranged from 4–11 years (mean 7.72 years). Results: CTQ total scores showed excellent internal consistency (McDonald’s ω = .95) and high long-term stability (intraclass correlation coefficient = .82), regardless of assessment interval. Subscale stabilities ranged from moderate to high (Sexual Abuse = .86; Physical Abuse = .81; Emotional Neglect = .77; Physical Neglect = .76; Emotional Abuse = .75). Changes in CTQ subscale scores showed small to moderate positive associations with changes in BPD symptom severity (β = .23 –.33), indicating that increases in perceived childhood trauma were accompanied by increases in symptom severity, except for Physical Neglect (β = .16, p = .078). Conclusions: The CTQ scales demonstrated strong long-term stability over up to 11 years in a heterogeneous BPD sample. Individual changes in perceived childhood trauma were associated with corresponding changes in BPD symptom severity. These results support the CTQ’s utility as a retrospective measure of childhood trauma.

ABSTRACT Background: The ongoing war in Ukraine has profoundly disrupted maternal healthcare and exposed women to acute psychosocial stressors throughout the perinatal period. This context may heighten the risk of childbirth-related posttraumatic stress disorder (CB-PTSD), particularly among displaced women. Objective: To identify and compare the proportion of women meeting full diagnostic criteria for CB-PTSD and the severity of specific symptom clusters (stressor, re-experiencing, avoidance, negative cognitions and mood, hyperarousal, distress, and dissociation) by displacement status, and to examine sociodemographic, obstetric, and war-related psychosocial factors associated with CB-PTSD. Method: Data came from an online survey of 318 Ukrainian perinatal women grouped as not displaced (ND), internally displaced (ID), or externally displaced (ED). Measures included CB-PTSD (City BiTS), assessment, care, and trust in pregnant and new mothers (ACT-PNM), and emotional stability (TIPI). Group differences in CB-PTSD diagnostic status and symptom clusters were analysed using Pearson’s chi-square tests, Welch one-way ANOVAs, Spearman correlations and Kruskal–Wallis tests. Hierarchical linear regression models assessed the contribution of sociodemographic, obstetric, and war-related psychosocial factors to CB-PTSD symptom severity. Results: Overall, 4.9% of women met full diagnostic criteria for CB-PTSD, with a tendency to higher rates across displacement groups (9.4% ID vs. 8.3% ED). Symptom differences by displacement status were only significant for the dissociation cluster, which were elevated among displaced women, while other clusters did not differ across groups. Factors significantly associated with higher CB-PTSD scores included neonatal intensive care unit admission, lack of resources, worsened perinatal care, high financial stress due to the war, greater war-related disruption in daily life, and lower emotional stability, jointly explaining 37.1% of the variance in CB-PTSD. Conclusions: Ukrainian women giving birth during wartime face pronounced psychosocial vulnerability, particularly when displaced. These findings highlight the urgent need for trauma-informed perinatal care and targeted psychosocial support tailored to conflict-affected perinatal populations. Trial registration: ClinicalTrials.gov identifier: NCT05654987.

ABSTRACT Background: Sex and gender impact trauma exposure, as well as trauma-related outcomes and treatment efficacy. Still, knowledge about the extent of these sex/gender differences, as well as the distinct mechanisms that contribute towards these differences in psychotraumatology, is limited. Objective: This article outlines how the use of Findable, Accessible, Interoperable, and Reusable (FAIR) research data can further enhance our insights into sex and gender aspects in trauma research. Method and Results: We present and discuss four ways in which FAIR trauma data can facilitate sex/gender-sensitive trauma research: (1) FAIR trauma data may overcome the current lack of sex/gender-sensitive reporting in our field by enabling secondary sex-stratified analyses; (2) FAIR trauma data may facilitate data pooling across studies and thereby increase the statistical power of sex/gender-related analyses into trauma-related outcomes and its underlying mechanisms; (3) FAIR trauma data may promote the reliability and robustness of sex/gender-related trauma research; and (4) FAIR trauma data may aid in creating an evidence base for currently understudied sex and/or gender minorities by means of data pooling across studies. Additional benefits, potential challenges, and further considerations are discussed. Conclusions: FAIR data provide an important and feasible avenue to address pressing and timely questions on sex/gender-related aspects in trauma research. Such knowledge will contribute towards refined sex/gender-sensitive interventions and advance health equity in the psychotraumatology field.

ABSTRACT Background: In experimental studies using the cue reactivity paradigm (CRP), classically conditioned substance craving is well-documented among individuals who use substances with trauma histories. However, the magnitude of this effect has not yet been quantified, nor have moderators of this relationship been identified [DeGrace, S., Romero-Sanchiz, P., Standage, C., & Stewart, S. H. (2022). A scoping review of the literature on trauma cue-induced drug craving in substance users with trauma histories or PTSD. IntechOpen. https://doi.org/10.5772/intechopen.103816]. Objective: While the mechanism driving these trauma cue-induced craving effects has been suggested to involve trauma cue-induced negative affect [Baker, T. B., Piper, M. E., McCarthy, D. E., Majeskie, M. R., & Fiore, M. C. (2004). Addiction motivation reformulated: An affective processing model of negative reinforcement. Psychological Review, 111(1), 33–51. https://doi.org/10.1037/0033-295X.111.1.33], this remains largely untested. Method: We conducted a meta-analysis to quantify the trauma cue-induced craving effect size, as well as possible moderators of these effects. Moreover, we utilized two-step meta-analytic structural equation modelling (TS-MA-SEM) to test the indirect effect of trauma (vs. neutral) cue exposure on substance craving through negative affect as the mediator. Our literature search returned n = 32 studies involving a total of k = 21 unique datasets that were included in our analyses. Results: Results supported our hypothesis that trauma cues would induce greater substance craving relative to other cue types/controls (neutral cues, substance cues, pre-cue baseline), with small to medium effect sizes (d = 0.259 – 0.526). We found a few theoretically relevant moderators (CRP method, study quality, and % of sample with PTSD) that varied by comparator condition. Additionally, results supported our proposed mediational model with negative affect indirectly explaining the relationship between trauma cue exposure and substance craving. Conclusions: Results suggest that trauma cue-elicited substance craving is a robust phenomenon that may be explained through trauma cue-induced negative affect driving increased craving.

ABSTRACT Background: Bereavement is a major life stressor, with millions of Chinese individuals experiencing grief each year. Prolonged grief disorder (PGD) and posttraumatic stress disorder (PTSD) are prevalent among bereaved people in China, yet culturally appropriate interventions are scarce. Existing Western-based protocols often showed limited cross-cultural applicability when implemented in the Chinese context, highlighting the need for evidence-based, culturally adapted interventions. Objective: This study aimed to introduce and evaluate the effectiveness of a newly developed structured Grief Modular Group Therapy (GMGT), designed under the framework of the Dual Process Model and integrating multiple therapeutic elements and culturally relevant practices. Method: A non-randomized controlled trial was conducted. Trained therapists delivered a 10-session GMGT protocol to bereaved individuals with prolonged grief symptoms (N = 69). Their outcomes were compared with those of a blank (non-intervention) control group (N = 64). Symptoms of PGD and PTSD were measured at baseline, post-treatment, and 3-month follow-up. GMGT showed high acceptability, with 79.8% of participants completing the programme. Result: Compared with the control group, the intervention group demonstrated significant reductions in PGD symptom severity to a clinically significant extent (Cohen’s d = 0.85). Improvements were maintained at follow-up (Cohen’s d = 0.86). GMGT also reduced posttraumatic stress symptoms, though with smaller effect sizes. Conclusion: These findings suggest that GMGT is a promising, culturally sensitive, structured, and scalable intervention that could be remotely delivered for bereaved individuals in China, with potential applicability in other cultural contexts facing similar resource limitations in mental health care. Further randomized controlled trials are warranted.

ABSTRACT Background: Siblings bereaved by homicide or accidents are often referred to as the forgotten bereaved because they face difficulties in accessing adequate support. Globally, research focusing directly on siblings’ perspectives remains scarce, and studies specifically addressing siblings’ resilience are almost absent in Japan. A deeper understanding of siblings’ experiences is required to develop support systems that acknowledge their emotions and strengthen their resilience. Objective: This study aimed to clarify the psychological transformation processes of bereaved siblings in Japan, focusing on interactions between individual and environmental factors of resilience. Method: Semi-structured interviews were conducted with 10 siblings who had lost their brother or sister to homicide or accidents. The data were analysed using a modified grounded theory approach that emphasizes context and social interaction in qualitative research. Results: The analysis generated six categories. The siblings experienced the process of grieving and adapting simultaneously during their adjustment. They engaged in practical coping strategies while struggling with the latent conflicts in their families and social relationships. Importantly, positive interactions from others, such as friends of the deceased greeting them at the family altar or spending time together as before, helped the siblings to construct continuing bonds and supported their resilience. Conclusion: These findings highlight distinctive features of grief and adaptation among Japanese siblings. By highlighting siblings’ perspectives, this study underscores the importance of culturally sensitive community-based support that validates hidden grief and promotes resilience.

ABSTRACT Background: Afghan adolescents have been exposed to decades of war, displacement, and limited access to mental health care. Memory Training for Recovery–Adolescent Plus (METRA+) was developed to address posttraumatic stress (PTSD), depression, and social functioning through a brief, culturally adapted, and scalable approach. This pilot study evaluated the feasibility and preliminary efficacy of METRA + among Afghan refugee adolescents in Pakistan. Methods: A single-arm mixed-methods design was used, with 41 Afghan adolescents (27 girls, 14 boys; mean age = 15.4 years) completing a 13-session METRA + programme integrating compassionate communication, memory specificity, and written exposure. Quantitative measures assessed PTSD symptoms, depression symptoms, anxiety, and social functioning, administered at baseline, after each module, and at two-month follow-up. Data were analyzed using repeated-measures analysis of variance (ANOVA). Post-intervention focus groups explored participants’ experiences and emotional changes, with thematic analysis conducted using MAXQDA 2024, following Braun and Clarke’s (2006) framework. Results: Significant reductions were observed in symptoms of PTSD, p < .001, partial η² = .34, depression, p = .001, partial η² = .16, and anxiety, p = .004, partial η² = .13, with significant reductions in anxiety observed at follow-up but not immediately post-intervention, and all reductions maintained at follow-up. Improvements in social and communication skills were non-significant, but qualitative analyses indicated that METRA + enhanced emotion regulation, self-efficacy, empathy, academic motivation, and the normalization of traumatic memories. Participants and facilitators reported high satisfaction and strong cultural relevance of the programme. Conclusions: METRA + appears feasible, acceptable, and has potential efficacy for improving mental health and psychosocial outcomes among Afghan refugee adolescents. Findings highlight the promise of memory-focused and compassion-based interventions for youth in humanitarian and low-resource settings. Larger randomized controlled trials are warranted. Trial registration: Australian New Zealand Clinical Trials Registry identifier: ACTRN12624001453572..

ABSTRACT Background: From a victim support perspective, researching public perceptions of sexual violence is critically important, since these perceptions can influence judicial decisions and media coverage. However, a few studies have examined the public awareness of the gender bias in the perpetrator-victim relationships. Objective: We conducted a survey to investigate whether the general public in Japan perceives sexual violence differently depending on the genders of the perpetrators and victims. Methods: We surveyed 137 members of the Japanese general public aged ≥18 years (48 men, 89 women, aged 19–73 years). Participants completed a cross-sectional online survey describing four short case vignettes with four different gender patterns regarding the perpetrator and victim of sexual violence. Participants were asked to rate the psychological impact on the victim in each vignette and to indicate whether the victim would be considered having experienced psychological trauma, and whether the victim could have escaped without being victimized. Results: Participants’ responses showed that they regarded the ‘man perpetrator-woman victim’ situation as having the greatest psychological impact. When the perpetrators were women, the participants described lower psychological impacts. Conclusions: These results revealed that the general public perceives sexual violence differently depending on the genders of the perpetrator and victim, especially when the perpetrator is a woman.

ABSTRACT Background: North Korean defectors (NKDs), a predominantly trauma-exposed population, are at high risk for somatic symptoms. Unrecognized and untreated somatic symptoms can profoundly affect health and psychosocial functioning. Therefore, it is crucial to understand and address somatic symptoms in the NKD population. Objective: This study aimed to assess the prevalence of somatic symptoms and to identify and quantify their correlates among trauma-exposed NKDs. Method: Cross-sectional survey data of 438 trauma-exposed NKDs in South Korea were analyzed. Participants completed a survey assessing somatic symptoms, sociodemographic, trauma-related (repatriation experience, trauma exposure, probable post-traumatic stress disorder [PTSD] and disturbances in self-organization [DSO]), health-related (physical activity), and social (loneliness and perceived discrimination) characteristics. Results: Overall, 42 of the 438 NKDs reported moderate-to-severe somatic symptoms. Multiple linear regression and relative importance analyses revealed that higher levels of loneliness (β = 0.27, p < .001; 25.2% relative variance explained [RVE]) was the strongest correlates of somatic symptoms, followed by older age (β = 0.24, p < .001; 17.2% RVE), probable PTSD (β = 0.14, p = .001; 14.6%), greater perceived discrimination (β = 0.15, p = .001; 14.5%), and probable DSO (β = 0.10, p = .026; 13.0% RVE). Conclusions: This study provides evidence of the high severity of somatic symptoms among NKDs. Further research is needed to develop and test culturally appropriate interventions to address loneliness and perceived discrimination of NKDs, especially those with comorbid PTSD and DSO symptoms, to help mitigate somatic symptoms.

ABSTRACT Background: Despite ongoing debate on the necessity of using the Continuous Traumatic Stress Response (CTSR) concept in contexts of repetitive threat – where the traditional post-traumatic stress disorder (PTSD) paradigm is insufficient [Goral, A., Feder-Bubis, P., Lahad, M., & Aharonson-Daniel, L. (2022). ‘In the middle, between anxiety victims and PTSD, there are people that have some kind of a disorder that has no name yet’ Insights about the traumatic stress consequences of exposure to ongoing threat. Trauma Care, 2(2), 185–196. https://doi.org/10.3390/traumacare2020015], validated measurement tools remain scarce. Moreover, because previous operationalizations focused primarily on civilian populations, adapting CTSR measures to military contexts is essential given their sensitivity to contextual factors. Objective: The present study aimed to adapt the CTSR scale [Goral, A., Feder-Bubis, P., Lahad, M., Galea, S., O'Rourke, N., & Aharonson-Daniel, L. (2021). Development and validation of the Continuous Traumatic Stress Response scale (CTSR) among adults exposed to ongoing security threats. PLoS One, 16(5), e0251724. https://doi.org/10.1371/journal.pone.0251724] for Ukrainian military personnel by examining their specific psychoemotional responses to continuous traumatic stress (CTS). Methods: A total of 1,902 military personnel completed 25 CTSR items, the Patient Health Questionnaire-9, the International Trauma Questionnaire, and a sociodemographic survey. Exploratory and confirmatory factor analyses were used to identify context-specific psychological responses to CTS, followed by assessments of homogeneity and discriminant validity. Results: Cross-validation procedure resulted in a three-factor structure encompassing psychoemotional responses of exhaustion, helplessness – depression, and psychosocial disruption. This structure was confirmed by CFA and supported by Cronbach’s α values ranging from 0.74 to 0.87. Correlation between PTSD and CTSR remained below the 0.7 threshold, indicating good construct discrimination. Notably, higher CTSR scores were observed among younger personnel with shorter service length and among administrative staff compared to combat and combat-support personnel. Conclusions: The adapted CTSR scale revealed a focused clinical profile of CTSR in a military context. While PTSD-related events increased CTSR levels, discriminant validity analysis confirmed the two constructs as clearly distinct. Further analyses indicated that CTSR may be more applicable to military personnel operating in settings of mild-to-moderate ongoing stress rather than in high-exposure combat situations. Content analysis further revealed overlap between CTSR and depressive or burnout-like manifestations. The findings suggest that the CTSR framework may offer a more comprehensive conceptualization of psychological responses to recurrent, yet not high-exposure, threat.