Posttraumatic Research Articles

Investigating the impact of Cognitive Processing Therapy (CPT) on Post-Traumatic Stress Disorder (PTSD), depression, and anxiety symptoms in female victims of domestic violence.

This study aimed to investigate the effects of CPT on PTSD, depression, and anxiety symptoms in female victims of domestic violence. A two-arm randomized clinical trial was conducted in Bandar-Abbas involving 62 female victims of domestic violence referred from private gynecology and obstetrics clinics. Initial screening for domestic violence was based on the World Health Organization violence questionnaire. Participants were randomly assigned to either a control group (n=32) or an intervention group (n=28) for a study duration of six months in 2022. Twelve group CPT sessions were conducted. The domestic violence questionnaire, Beck's Depression Inventory, Beck's Anxiety Inventory, and the Impact of Event Scale-Revised were completed in three time points: pre-test, post-test, and follow-up. There was a statistically significant difference in the mean scores of depression, PTSD, and domestic violence (P less than .001) between the two groups; however, no significant difference was found in anxiety scores (P greater than .050). CPT is recommended for female victims of domestic violence to reduce symptoms of depression, PTSD, and domestic violence.

Distinct comorbidity phenotypes among post-9/11 Veterans with epilepsy are linked to diverging outcomes and mortality risks.

To investigate phenotypes of comorbidity before and after an epilepsy diagnosis in a national cohort of post-9/11 Service Members and Veterans and explore phenotypic associations with mortality. Among a longitudinal cohort of Service Members and Veterans receiving care in the Veterans Health Administration (VHA) from 2002 to 2018, annual diagnoses for 26 conditions associated with epilepsy were collected over 5 years, ranging from 2 years prior to 2 years after the year of first epilepsy diagnosis. Latent class analysis (LCA) was used to identify probabilistic comorbidity phenotypes with distinct health trajectories. Descriptive statistics were used to describe the characteristics of each phenotype. Fine and Gray cause-specific survival models were used to measure mortality outcomes for each phenotype up to 2021. Six distinct phenotypes were identified: (1) relatively healthy, (2) post-traumatic stress disorder, (3) anxiety and depression, (4) chronic disease, (5) bipolar/substance use disorder, and (6) polytrauma. Accidents were the most common cause of death overall, followed by suicide/mental health and cancer, respectively. Each phenotype exhibited unique associations with mortality and cause of death, highlighting the differential impact of comorbidity patterns on patient outcomes. By delineating clinically meaningful epilepsy comorbidity phenotypes, this study offers a framework for clinicians to tailor interventions. Moreover, these data support systems of care that facilitate treatment of epilepsy and comorbidities within an interdisciplinary health team that allows continuity of care. Targeting treatment toward patients with epilepsy who present with specific heightened risks could help mitigate adverse outcomes and enhance overall patient care.

Web-Based Intervention (SunnysideFlex) to Promote Resilience to Posttraumatic Stress Disorder Symptoms During Pregnancy: Development and Pilot Study.

Approximately 4% to 8% of pregnant individuals meet the criteria for current posttraumatic stress disorder (PTSD), a known risk factor for a multitude of adverse maternal and child health outcomes. However, PTSD is rarely detected or treated in obstetric settings. Moreover, available prenatal PTSD treatments require in-person services that are often inaccessible due to barriers to care. Thus, web-based interventions offer great potential in extending PTSD treatment to high-risk pregnant individuals by providing affordable, accessible care. However, there are currently no web-based interventions designed specifically for the treatment of PTSD symptoms during pregnancy. This study aims to develop and pilot a 6-week, web-based, cognitive behavioral therapy intervention for PTSD, SunnysideFlex, in a sample of 10 pregnant women with current probable PTSD. Consistent with established guidelines for developing and testing novel interventions, the focus of this pilot study was to evaluate the initial feasibility and acceptability of the SunnysideFlex intervention and preintervention to postintervention changes in PTSD and depression symptoms. This approach will allow for early refinement and optimization of the SunnysideFlex intervention to increase the odds of success in a larger-scale clinical trial. The SunnysideFlex intervention adapted an existing web-based platform for postpartum depression, Sunnyside for Moms, to include revised, trauma-focused content. A total of 10 pregnant women in weeks 16 to 28 of their pregnancy who reported lifetime interpersonal trauma exposure (ie, sexual or physical assault) and with current probable PTSD (scores ≥33 per the PTSD checklist for DSM-5) were enrolled in the SunnysideFlex intervention. Assessments took place at baseline and 6 weeks (postintervention). All participants were retained through the postintervention assessment period. Engagement was high; participants on average accessed 90% of their lessons, logged on to the platform at least weekly, and reported a generally positive user experience. Moreover, 80% (8/10) of participants demonstrated clinically meaningful reductions in PTSD symptoms from baseline to postintervention, and 50% (5/10) of participants no longer screened positive for probable PTSD at postintervention. Most (6/10, 60%) of the participants maintained subclinical depression symptoms from baseline to postintervention. Findings from this small pilot study indicate that SunnysideFlex may be a feasible and acceptable mechanism for delivering PTSD intervention to high-risk, trauma-exposed pregnant women who might otherwise not have opportunities for services. Larger-scale trials of the intervention are necessary to better understand the impact of SunnysideFlex on PTSD symptoms during pregnancy and the postpartum period.

War-related trauma and posttraumatic stress disorder in refugees, displaced, and nondisplaced people during armed conflict in Sudan: a cross-sectional study

BackgroundThe ongoing armed conflict in Sudan has caused mass displacement, affecting mental health. This study aimed to assess the prevalence of posttraumatic stress disorder (PTSD) and trauma among refugees, internally displaced, and nondisplaced people, while also examining the link between displacement type, PTSD severity, and associated factors.MethodsThis cross-sectional study used the Posttraumatic Stress Disorder Checklist for DSM-5 to assess PTSD symptoms and the General Health Questionnaire-28 to evaluate depression. Data were collected from 642 participants, targeting general social media groups for those within Sudan and specific groups for refugees outside the country. Sociodemographic and trauma event data were also gathered. Data analysis was conducted using SPSS, applying one-way ANOVA and independent t-tests to compare PTSD and depression. Binary logistic regression identified associations between sociodemographic factors and PTSD symptoms.ResultsAmong the 642 participants, 46.3% were internally displaced people (IDP), 42.1% were refugees, and 11.7% were non-displaced individuals. Clinically significant PTSD symptoms were identified in 36.6% of the participants. Refugees had a significantly greater percentage of traumatic events (M = 4.31, SD = 2.605, p < .01). Depression symptoms were found to be strongly associated with clinically significant PTSD (p < .001). Factors significantly linked to depression symptoms included female gender (p = 0.015), being single (p = 0.048), younger age (p = 0.036), dissatisfaction with living conditions (p < 0.001), and unemployment (p = 0.021). Dissatisfaction with living conditions also significantly influenced the likelihood of developing PTSD (p < .001).ConclusionThe study found that 36.6% of participants experienced PTSD, with refugees having a 1.4 times greater risk of developing PTSD compared to IDP and non-displaced individuals. Traumatic events were moderately correlated with PTSD symptoms, though non-displaced individuals had higher exposure to such events. These findings highlight the need for targeted mental health interventions, particularly for refugees and those affected by traumatic events. Further research using probability sampling is necessary to confirm these results and inform more effective mental health policies and programs for displaced populations.

The role of shame and trauma type on posttraumatic stress disorder and depression severity in a treatment-seeking veteran population.

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. 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. 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. 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).

Intrusive thoughts and memories in adolescents with major depressive disorder or post-traumatic stress disorder.

Research in adults suggests that intrusive memories and intrusive thoughts (often referred to as intrusive cognitions) are common in members of the general population and are often seen in clinical disorders. However, little is known about the experience of intrusive cognitions in adolescents, particularly in adolescents with major depressive disorder (MDD) and post-traumatic stress disorder (PTSD). The present study sought to gather fundamental data on these phenomena (i.e., frequency, characteristics and appraisals of intrusive cognitions) in adolescents with MDD and PTSD. Adolescents aged 11-18 with MDD (n = 11), PTSD (n = 13) and a non-clinical control group (n = 25) completed structured interviews concerning their intrusive memories and thoughts. Intrusive thoughts were common in all three groups but were particularly frequently experienced in the MDD group. Intrusive memories were expectedly very common in the PTSD group but also experienced by over half of the adolescents with MDD. Both clinical groups reported more negative emotions in response to their intrusive thoughts or memories and appraised these cognitions more negatively than the non-clinical group. Intrusive memories and thoughts are common experiences in adolescents with MDD and PTSD. Emotions and appraisals relating to these cognitions may be targets for psychological intervention in this age group. However, small sample sizes limit the conclusions that can be drawn. Replication is needed with larger numbers of clinical participants.

Development of a codebook for the narrative analysis of in-hospital trauma interviews of patients following stroke.

Given their sudden onset and life-threatening consequences, strokes and transient ischemic attacks (TIAs) can trigger posttraumatic stress disorder (PTSD). To gain a deeper understanding of the potential influence of factors in patients' descriptions of these medical events on PTSD, we conducted a standardized trauma interview with a convenience sample of patients hospitalized for suspected stroke/TIA (N = 98) to assess the details and emotional experience of the stroke/TIA event. Three researchers reviewed the interviews and the research literature on risk and protective factors for PTSD. From this analysis, a codebook with descriptions, examples, and scoring protocols for eight Likert scale, two categorical, and four binary codes was developed. Upon demonstrating sufficient interrater reliability, the research team scored all narratives. Three superordinate themes were identified in the analysis: distress (e.g., fear, helplessness), potential protective factors (e.g., positive expectancies, concern for loved ones), and level of detail (e.g., somatic detail, emotional detail). Differences in perceptions, themes, and expectations emerged in the narratives, indicating a wide range of responses following stroke/TIA. Additionally, patient age was negatively correlated with scores for the fear, r = -.34, p <.001, and negative consequences, r = -.24, p =.018, codes and positively associated with the likelihood of having positive expectancies, OR = 1.05, 95% CI [1.00, 1.10], p =.039. These findings provide a more comprehensive understanding of how patients reflect on their experiences post-stroke/TIA and can inform future research on the contributions of trauma narrative characteristics and emotional responses to PTSD risk.

Effectiveness of Drama and music therapies as health communication interventions for reducing anxiety and posttraumatic disorders among children-victims of flood

This study examined the usefulness of drama and music therapies as communication strategies for reducing symptoms of post-traumatic stress disorder (PTSD) and generalised anxiety disorder (GAD) among school children (aged 10-16) who were victims of the 2022 floods in Nigeria. The researchers randomly assigned the children to control (n=122) drama therapy (n=120) and music therapy (n=120) groups. The result of the study revealed that after the intervention, school children in the drama and music therapies (unlike those in the control group) reported a significant reduction in their PTSD and GAD symptoms; the reduction achieved statistical significance (p=0.001, ηp2 =.48). Further results revealed a significant interactive effect of gender (p=0.001) with boys reporting a significant reduction more than girls. The results showed that drama therapy contributed more to reducing PTSD symptoms, while music therapy contributed more to reducing GAD symptoms. The difference did not achieve statistical significance (p=0.23). The researchers conclude that both drama and music therapies were associated with reduced symptoms, indicating the interventions may be beneficial therapies.

Astrocytes and Memory: Implications for the Treatment of Memory-related Disorders.

Memory refers to the imprint accumulated in the brain by life experiences and represents the basis for humans to engage in advanced psychological activities such as thinking and imagination. Previously, research activities focused on memory have always targeted neurons. However, in addition to neurons, astrocytes are also involved in the encoding, consolidation, and extinction of memory. In particular, astrocytes are known to affect the recruitment and function of neurons at the level of local synapses and brain networks. Moreover, the involvement of astrocytes in memory and memory-related disorders, especially in Alzheimer's disease (AD) and post-traumatic stress disorder (PTSD), has been investigated extensively. In this review, we describe the unique contributions of astrocytes to synaptic plasticity and neuronal networks and discuss the role of astrocytes in different types of memory processing. In addition, we also explore the roles of astrocytes in the pathogenesis of memory-related disorders, such as AD, brain aging, PTSD and addiction, thus suggesting that targeting astrocytes may represent a potential strategy to treat memory-related neurological diseases. In conclusion, this review emphasizes that thinking from the perspective of astrocytes will provide new ideas for the diagnosis and therapy of memory-related neurological disorders.

Mobile Medicine in Ukraine

Global Care Force, an international health nongovernmental organization, sent teams of physicians, physician assistants, nurses, and nurse practitioners every month to Ukraine to provide primary care for war-affected communities. I had the opportunity to partner with GCF in May 2024 during its monthly mission trip to this conflict-ravaged country. I described this medical outreach initiative in a first-person narrative in order to relay to a wider audience the realities of warfare for Ukrainian patients and health care workers. Our team treated chronic diseases in northern as well as southern Ukrainian villages near the front line near Kherson. We set up mobile medical clinics in these regions and delivered medications to patients suffering from blast injuries, hyperglycemia, hypertension, and posttraumatic stress disorder.

Organisational and Ethical Challenges While Caring for Older People During the COVID-19 Pandemic in Sweden: AFocus Group Study.

During the COVID-19 pandemic, older people in Sweden's residential care facilities and home care services experienced high mortality rates. Prior to the pandemic, the care of older people in Sweden was challenged by organisational and regulatory changes, an ageing population and insufficient increases in staff numbers. These issues led to high staff turnover, increased workloads, stress, burnout and a perceived inability to provide satisfactory care. The pandemic brought about increased job strain, stress, anxiety, depression and post-traumatic stress disorder among the staff who cared for older people. The aim of this study was therefore to focus on assistant nurses and care aides' experiences of their work environments when caring for older people during the pandemic in Sweden. The data were collected through four focus groups interviews and analysed using qualitative content analysis. The results showed that the care staff had to navigate organisational and ethical challenges in poor and unsafe work environments. They lacked supportive leadership in their respective organisations, were neither valued, seen nor heard and were treated as 'plain doers'. During the pandemic, they were unable to protect or communicate easily with the older people in their care, which had harsh consequences. According to the participants, the pandemic left them, their working conditions and this part of the care system in a worse situation than before the pandemic. The pandemic thus revealed more unsustainable and unethical working conditions for the staff than before it, including the vulnerability of the older people in their care. The findings highlights the need of policies that ensure adequate training and instruction on medical issues, for managers responsible for overseeing the care of older people. There are also a need of provision of sufficient support for care staff and health care professionals during crises. The findings also underscore the need of feasible and efficient strategies do disseminate care information and address the psychosocial needs of older people.

Factors Associated with Posttraumatic Stress Disorder in Adolescents Experiencing Earthquake Trauma

Introduction: Posttraumatic Stress Disorder (PTSD) is a prevalent psychological response among those who survive earthquakes. Objective: This study investigates the relationships between sociodemographic and clinical differences and symptoms of avoidance, re-experiencing, and hyperarousal, which are key indicators of PTSD in adolescents. Method: Research data were collected through online surveys using a simple random sampling method. The sample group consisted of 178 adolescents who met the inclusion criteria. Data were collected using the Personal Information Form (PIF) and the Posttraumatic Stress Disorder Symptoms Scale-Self-Report Scale (PSS-SR) for Children. Results: Of the participants, 77% were female, with a mean age of 16.99. A total of 84.3% lived with their families. The rate of those trapped under debris during the earthquake was 97.2%. During the earthquake, 84.8% of adolescents were injured, and 25.8% lost a family member due to the earthquake. Female participants showed significantly higher total trauma, re-experiencing, and hyperarousal scores than males (p&lt;0.05). Those physically injured during the earthquake had significantly lower total trauma and avoidance scores compared to those not injured (p&lt;0.05). Participants who lost a family member during the earthquake had significantly lower total trauma, re-experiencing, and hyperarousal scores compared to those who did not lose a family member (p&lt;0.05). Conclusion: Females exhibited more PTSD symptoms compared to males. Those not injured or who did not lose a family member during the earthquake showed more PTSD symptoms than those who experienced injury or loss.

Risk Factors of Post-Traumatic Stress in Pediatric Solid Organ Transplant Recipients.

Life with end-stage organ failure is accompanied by an accumulation of traumatic medical or surgical experiences. Despite recovery after solid organ transplantation (SOT), many children and adolescents develop post-traumatic stress symptoms (PTSS). PTSS remain underappreciated as a major comorbidity in SOT programs, despite their association with decreased quality of life. We conducted a retrospective, cross-sectional study of 86 pediatric SOT recipients (17 heart, 44 kidney, and 25 liver) to evaluate potential determinants of PTSS. Trauma symptoms were measured by the Child Trauma Screening Questionnaire (CTSQ). Demographic, baseline, and contemporaneous factors were tested for independent association with CTSQ scores. The median post-transplant CTSQ score was 2 (IQR 1-4), and 22% were identified as high risk (score ≥5) for PTSD. Higher CTSQ scores were independently associated with the number of ICU days within the previous 12 months, the number of medications (complexity), and involvement with foster care in the primary model (R2 [adj.] = 0.26). The addition of the Family Impact Module improved the overall model (R2 [adj.] = 0.33), wherein higher family functioning was independently associated with lower CTSQ scores. An exploratory analysis of pre-transplant patients (n = 34) found a median pre-transplant CTSQ of 2 (IQR 1-6), suggesting that PTSS are onset before transplant and persist afterward. PTSS are highly prevalent in the SOT population. Risk factors include recent adverse medical experiences and complexity, whereas family stability may be protective. Additional research is needed to improve early ascertainment and support for patients at high risk of developing PTSS throughout their transplant journey.

Sporun Fiziksel Aktivite Boyutunun Psiko-Eğitimle Desteklenmesinin Sonuçlarının İncelenmesi

Today, especially after the pandemic, the importance of physical activity, in which individuals remember its value once again, stands out even more. During this period, it has become indisputable to what extent physical activity provides benefits to the social, emotional, physical and psychological development of individuals. So much so that physical activity applications have also found a place among the contents added to the distance education activities. Dec. However, the problem of overweight and obesity, which is rapidly becoming one of the most important health problems in the world, is also effective in spreading physical activity practices Decently. Considering the benefits of regular physical activity in general, it contributes to healthy growth and development, helps to protect against unwanted habits, prevents socialization and the formation of certain long-term diseases that may be encountered during adulthood, as well as treating and supporting the treatment of disorders that may occur, ensuring that they last an active old age, in other words, it can make important contributions to improving the quality of life throughout life. In this context, psycho-education as a complementary element of physical activity is also defined as empowering education aimed at promoting individual's awareness and entrepreneurship. Psycho-education is not only to inform the individual and his family about the problematic situation or to offer them solutions, but also the process of providing education and training about the factors that cause this situation. In this way, the person understands the situation better and develops a sense of control, so that the problem can gradually decrease. The human body, which was created in order to be able to do physical activity, can encounter various problems every day due to inactivity. Besides the well-known health benefits of physical activity, it should not be overlooked that along with its cognitive effects, it may also contribute to increasing academic achievement in the sense of its positive role on mental processes at different age levels depending on these effects, and ultimately as a result of these processes. At the same time, it is known in past and recent studies that physical activity has a direct or indirect effect on many topics, from the use of individuals experiencing mental or mental problems in treatment processes, to coping with stress, anxiety, and post-traumatic stress disorder treatments, in addition to conditions such as self-confidence, self-esteem, and well-being. Key Words: Special Ability, Special Ability Students, Physical Activity

Pre-disaster income inequality and post-disaster mental health: A natural experiment from the 2011 Great East Japan Earthquake and Tsunami

BackgroundWe sought to test the hypothesis that communities with a high degree of income inequality are ill-equipped to deal with crises. Specifically, we tested whether pre-disaster higher income inequality increases the risk of worse mental health conditions in the aftermath of disaster. MethodsWe examined the association between pre-disaster community income inequality and post-disaster mental health outcomes in a prospective cohort study of older adults (≥65 years) who survived the 2011 Great East Japan Earthquake. The baseline survey of participants (completed in 2010) predated the disaster by seven months. Survivors completed three waves of post-disaster surveys in 2013, 2016, and 2019. To assess the level of income inequality, the Gini index was calculated using individual income data in 2010 aggregated to 98 communities (range 0.05–0.50: median = 0.32) and categorized into tertiles (low, middle, high). Depressive symptoms and post-traumatic stress symptoms (PTSS) were assessed in the three post-disaster surveys using validated instruments. Multilevel analysis was conducted adjusting for pre-disaster characteristics. ResultsHigher levels of community income inequality were associated with higher PTSS scores across time (2013: β = 0.14, 95%CI = −0.01, 0.29; 2016: β = 0.16, 95%CI = 0.03, 0.29; 2019: β = 0.12, 95%CI = −0.01, 0.24). The association between income inequality and mental health was partly attenuated by adding the change in social capital to the model (2013: β = 0.14, 95%CI = -0.01, 0.29; 2016: β = 0.15, 95%CI = 0.03, 0.28; 2019: β = 0.11, 95%CI = -0.01, 0.22). ConclusionOur findings suggest that pre-disaster income inequality may explain PTSS symptoms in the aftermath of a disaster, and the relation may be mediated by disaster-related change. Further study to reveal its mechanism is needed for the policy recommendation.

Birth expectations, birth experiences and childbirth-related post-traumatic stress symptoms in mothers and birth companions: Dyadic investigation using response surface analysis.

During the perinatal period, women and their birth companions form expectations about childbirth. We aimed to examine whether a mismatch between birth expectations and experiences predict childbirth-related post-traumatic stress symptoms (CB-PTSS) for mothers and birth companions. We also explored the influence of the mismatch between mothers' and birth companions' expectations/experiences on CB-PTSS. Dyadic longitudinal data from the Self-Hypnosis IntraPartumTrial. Participants (n = 469 mothers; n = 358 birth companions) completed questionnaires at 27 and 36 weeks of gestation and 2 and 6 weeks post-partum. We used the measures of birth expectations (36 weeks gestation), birth experiences (2 weeks post-partum) and CB-PTSS (6 weeks post-partum). Correlations revealed that birth expectations were associated with experiences for both mothers and birth companions but were not consistently associated with CB-PTSS. Birth experiences related to CB-PTSS for both mothers and birth companions. The response surface analysis results showed no support for the effect of a mismatch between expectations and experiences on CB-PTSS in mothers or birth companions. Similarly, a mismatch between mothers' and birth companions' expectations or experiences was unrelated to CB-PTSS. Following previous literature, birth expectations were associated with experiences, and experiences were associated with CB-PTSS. By testing the effect of the match between birth experiences and expectations using an advanced statistical method, we found that experiences play a more substantial role than the match between experiences and expectations in CB-PTSS. The impact of birth experiences on CB-PTSS highlights the importance of respectful and supportive maternity care.

The Role of Animal Assisted Therapy in the Rehabilitation of Mental Health Disorders: A Systematic Literature Review

Mental health disorders like depression, anxiety, post-traumatic stress disorder (PTSD), and schizophrenia significantly reduce the daily functioning and quality of life of individuals. Traditional treatments often fall short, thus opening interest in complementary therapies like animal assisted therapy (AAT) which encourages the human-animal bond and gives emotional and psychological support. This review evaluated the efficacy of AAT in treating mental health disorders, and understanding its mechanisms and benefits. A comprehensive literature review was conducted (using databases such as PubMed, Google Scholar, and ResearchGate) focused on peer-reviewed articles, systematic reviews and meta-analyses published in the last 2 decades. Studies indicated that AAT improved mental health outcomes for people with depression, anxiety, PTSD, and schizophrenia. Interaction with therapy animals reduced cortisol levels, increased oxytocin, lowered blood pressure, and increased social engagement and emotional regulation. Benefits included reduced symptoms of depression, anxiety, PTSD, and improved social functioning and quality of life. AAT offered a complementary treatment for mental health disorders, providing emotional comfort, improving mood, and serving as a nonpharmacological option for individuals. However, challenges such as individual preferences, allergies, ethical concerns for therapy animals, and logistical issues must be addressed. Future research should focus on the long-term effects and mechanisms involved to optimize the application of AAT in the clinical setting, and alternatives like robotic companion pets could also be explored.

The impact of posttraumatic stress disorder and head injury on reactive and appetitive aggression in adult Syrian refugees in Lebanon.

Refugees are highly vulnerable to mental health disorders and head injuries. The primary aim of this study is to examine the impact of posttraumatic stress disorder (PTSD) and head injury on reactive and appetitive aggression in adult Syrian refugees in Lebanon. A cross-sectional study was conducted targeting adult Arab United Nations High Commissioner for Refugees-registered Syrian refugees residing in Beirut and southern regions of Lebanon. Eligible refugees completed a battery of questionnaires including the PTSD Checklist for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, the Trauma Events and Head Injury sections of the Harvard Trauma Questionnaire, the Buss-Perry Aggression Questionnaire, and the Appetitive Aggression Scale. A total of 191 Syrian refugees participated in the study: 62.83% were females, and the mean age was 31.01 years (SD = 10.98). The severity of PTSD (adjusted B = 0.18, 95% CI [0.05, 0.31], p = .006), having experienced at least one head injury trauma event (adjusted B = 10.20, 95% CI [1.61, 18.79], p = .020), and the severity of somatic symptoms (adjusted B = 0.71, 95% CI [0.23, 1.20], p = .004) were significant risk factors of reactive aggression. As for appetitive aggression, males (females adjusted OR [aOR] = 0.06, 95% CI [0.02, 0.18], p < .001), younger individuals (aOR = 0.95, 95% CI [0.91, 0.99], p = .024), and higher severity of somatic symptoms (aOR = 1.20, 95% CI [1.09, 1.32], p < .001) were significant risk factors. PTSD and head injury are independent risk factors for reactive aggression but not appetitive aggression in Syrian refugees in Lebanon, while the severity of somatic symptoms is an independent risk factor for both reactive and appetitive aggression. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Evaluating the mobile Mantram Repetition Program for veterans with PTSD: A multimethod randomized feasibility trial of self-directed versus text support delivery.

While mobile delivery can help increase access to evidence-based treatment for veterans with posttraumatic stress disorder (PTSD), feasibility and acceptability are of concern with the potential for high attrition rates and limited participation. The Mantram Repetition Program (MRP), a meditation-focused approach with documented efficacy for reducing symptoms of PTSD and insomnia, was adapted as a brief, mobile-delivered MRP (mMRP) training. This study assessed implementation indicators of mMRP and compared self-directed users of mMRP versus users who received additional text message support. Thirty-six veterans with clinically significant PTSD symptoms (Mage = 50.50 years; 83.3% male; 72.2% White; 88.9% heterosexual) completed four weekly training video modules. Participants completed questions related to program satisfaction, mantram repetition use, clinical measures, and a 30-min individual interview. Participants reported using their mantram between 4 and 5 days per week. Participants indicated that mMRP was generally acceptable, appropriate, and feasible across quantitative and qualitative data. On clinical measures, change from pre- to postintervention was significant for the brief symptom screen, PTSD symptoms, and Personal Health Inventory but not for depression or insomnia symptoms. No significant differences were found between the self-directed and supported conditions; however, data suggest that participants primarily engaged with the support for administrative needs. Qualitative data highlighted suggestions for mMRP improvement, including alternative methods for receiving support and more content on how to use the skills taught. Findings suggest that mMRP can be delivered in a brief format, with veterans learning and using mantram repetition. Developing additional ways of individualizing the mMRP and further testing are warranted. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Identifying transdiagnostic and multidimensional prognostic indicators among veterans with PTSD symptoms in brief integrated care settings.

Brief integrated care settings hold promise for accessible and effective trauma-informed interventions. However, clinicians often have difficulty efficiently forecasting who is most appropriate for interventions in such settings and how to target individualized care. Multidimensional and transdiagnostic evaluations may provide valuable information to improve stepped-care and treatment practices for veterans. A middle-out approach was used to concurrently evaluate self-reported posttraumatic stress disorder (PTSD) symptoms, depressive symptoms, and physical health problems using cross-sectional (latent profile analysis) and longitudinal (latent growth mixture modeling) analyses that identified unique symptom profiles, trajectories of traumatic stress reactions, and correlates of these health outcomes. Data from 234 veterans who participated in a randomized controlled trial of primary care PTSD intervention were analyzed at 0, 8, 16, and 24 weeks. Latent profile analysis identified two homogenous baseline profiles: global symptoms (33.8%); low dysphoria-lower negative cognitions, mood, and depressive symptoms (66.2%). Low dysphoria participants reported more social relationships (OR = 1.32) and fewer environmental (OR = 0.89) and financial (OR = 0.23-0.35) stressors. Latent growth mixture modeling identified three trajectories: (a) reducing symptoms ("responders"; 21.3%) and chronic symptoms of (b) moderate (59.6%) and (c) high (19.1%) severity. Low dysphoria participants were 4.35 times more likely to be responders over time compared to participants with moderate severity symptoms. Findings indicated that veterans with moderate PTSD symptoms and physical health problems but low dysphoria may respond best to trauma-informed intervention in brief integrated care settings, while others may require further individualized stepped care. Findings demonstrate unique traumatic stress reactions that support individualized stepped care and may offer greater treatment utilization, retention, and efficacy. (PsycInfo Database Record (c) 2024 APA, all rights reserved).