Posttraumatic Stress Disorder Symptoms Research Articles

Postpartum anger among low-income women with high rates of trauma exposure.

Few studies have examined anger concerns among postpartum women despite their risk of mood dysregulation. This study examined the performance of the Dimensions of Anger Reactions-5 (DAR-5) scale, a brief screen for problematic anger, in a sample of 1,383 postpartum women in Wisconsin who received perinatal home visiting services. We aimed to analyze the discriminant validity and measurement invariance of the DAR-5, the occurrence of problematic anger symptoms and their co-occurrence with mental health concerns, and the association between elevated anger levels and exposure to potentially traumatic events in childhood and adulthood. Descriptive statistics for anger symptoms and their associations with depression, anxiety, and PTSD were calculated. Psychometric properties of the DAR-5 were assessed via confirmatory factor analyses, and associations between trauma exposure and anger were evaluated as bivariate and partial correlations. Approximately 21% of the sample exhibited problematic anger based on an established DAR-5 cutoff score (≥ 12). Anger symptoms co-occurred with posttraumatic stress disorder (PTSD), depressive, and anxiety symptoms, though the DAR-5 sufficiently distinguished anger from these correlated symptom profiles. The DAR-5 also demonstrated acceptable measurement invariance across levels of trauma exposure. Higher levels of trauma exposure in childhood and adulthood significantly increased the risk of problematic anger even after controlling for PTSD, anxiety, and depressive symptoms, partial pb range:.07-.16. The findings suggest the DAR-5 is a valid brief screen for anger in postpartum women. Increased attention should be paid to elevated anger and the co-occurrence of other mental health concerns following childbirth.

What's in a treatment name? How people with posttraumatic stress disorder (PTSD) symptoms interpret and react to PTSD treatment names.

Prior research has rarely examined how people understand or react to the names of psychological treatments. In the case of evidence-based psychotherapies for posttraumatic stress disorder (PTSD), such reactions may be relevant to the low rates of uptake of such treatments. Participants who screened positive for PTSD (n = 887) completed questions assessing their initial reactions to PTSD treatment names as well as how a different name would affect their openness to treatment. In addition, they gave brief responses to open-ended questions about the reason for their initial reactions, and content analysis was used to better understand these reasons. The results indicated that among the treatment name options, cognitive processing therapy (CPT) and present-centered therapy (PCT) were viewed most positively. Approximately 40% of the sample preferred plain language alternatives for treatment names. Content analyses focused on descriptions of the treatments-which could be accurate or inaccurate-as well as whether respondents evaluated a treatment name itself as positive or negative. Some names conveyed treatments more accurately (e.g., CPT and written exposure therapy) than others (e.g., eye movement desensitization and reprocessing and prolonged exposure [PE]). Some names were also evaluated more positively (e.g., PCT) than others (e.g., PE). The general term "trauma-focused therapy" was seen as positive and clear. Addressing the ways patients react to psychological terms and treatment names could help clarify misperceptions about evidence-based psychotherapies and promote more widespread uptake of effective treatments for PTSD.

Does cardiorespiratory fitness moderate the relationship between overweight, cardiovascular risk markers and mental health among forcibly displaced individuals living in a Greek refugee camp?

Refugees may have an increased risk of developing overweight/obesity as they often experience a nutritional transition. Because maintaining good cardiorespiratory fitness can help reduce the negative impact of excess weight on overall health, the objective of this study was to examine whether fitness moderates the relationship between weight status and cardiovascular and mental health outcomes in forcibly displaced individuals living in a Greek refugee camp. A sample of 142 forcibly displaced individuals were recruited. Cardiorespiratory fitness was assessed with the submaximal Åstrand-Rhyming bicycle ergometer test. Blood pressure, blood lipids, blood glucose, and hs-CRP were assessed as physical health outcomes, whereas post-traumatic stress disorder, depression and anxiety symptoms, pain, and quality of life were assessed as mental health outcomes. Main and interaction effects were tested via analyses of covariance (ANCOVAs). Almost 50% of the participants were overweight/obese, more than 60% presented with very poor fitness levels, and the percentage of participants with very poor fitness levels was particularly high among overweight/obese participants. Whereas overweight/obesity was associated with a less favorable body composition and cardiovascular risk profile, poor fitness was associated with a higher percentage of body fat and a lower percentage of muscle mass. Cardiorespiratory fitness did not moderate the relationship between overweight/obesity and most of the assessed health outcomes. Only limited support was found for the applicability of the fit-but-fat concept to our population of forcibly displaced individuals. Public health services should prioritize measures to prevent overweight/obesity and associated diseases in refugee camps. Moreover, efforts are needed to improve the fitness of camp residents via exercise/sport interventions.

Parenting in the Face of Trauma: Music Therapy to Support Parent-Child Dyads Affected by War and Displacement.

The literature highlights the profound psychological impact of war on children, families, and communities, emphasizing the prevalence of Post-Traumatic Stress Disorder (PTSD), anxiety, and other symptoms among affected individuals. Interventions, such as Child-Parent Psychotherapy (CPP) and music therapy, show promise in mitigating trauma effects, underscoring the need for holistic approaches that address familial and community dynamics alongside individual well-being. Aiming to explore the influences of dyadic music therapy sessions on parents' capacity to support their children, this study involved four families displaced from their home-kibbutz as result of a terrorist attack. All dyads participated in music therapy sessions with a focus on parent-child interactions and trauma processing (CPP informed). Embedded in a qualitative, phenomenological approach, the research utilized interpretative phenomenological analysis (IPA) and micro-analytic methods to explore meaningful moments in the music therapy sessions. Findings identified four central categories: (1) Discovering the child's grounding song: identifying resources; (2) Musical improvisation sets the grounds for parent-child mutual recognition of the child's traumatic experience; (3) Musical performance empowers child and parent; (4) A sense of agency is gained through controlling the musical environment. The significance of restoring the children's freedom of play, the parents' sense of competency, and of enhancing families' capacity to connect to their traumatic experiences through the musical environment is discussed.

Reducing PTSD in mass medical events: An immediate preventive intervention

A preventive approach to Post-Traumatic Stress Disorder (PTSD) through an Immediate Psycho-Trauma Intervention (IPTI) may significantly reduce PTSD likelihood and provide a cost-effective way to alleviate suffering. This mixed-method study 1) compared medics who received an IPTI to those who did not after a mass medical event, 2) compared the number medics diagnosed with PTSD from the IPTI group to the minimum number in similar cases reported in the literature. The results indicated that 1.09 % of the medics who underwent the IPTI (N = 275) followed by peer discussion groups and a memorial ceremony were formally diagnosed with PTSD in contrast to the 5 %-20 % reported in similar circumstances. Of these, all but three resumed work within their emergency medical teams. In the one-year qualitative follow-up interviews (N = 14), the IPTI recipients exhibited significantly fewer PTSD symptoms and negative effects than the non-IPTI group. They reported fewer negative themes and a reduced need for professional psycho-trauma assistance, with no significant differences in event recollections between groups. These findings point to the efficacy of the VIOS IPTI in mitigating PTSD risk and suggest its potential for widespread application in clinical settings as a preemptive measure in response to traumatic events.

Psychological Factors and Blood Pressure Responses to Acute Stress in Women with Takotsubo Syndrome: An Exploratory Study.

This secondary analysis aimed to: 1) describe psychological resources and distress in women with Takotsubo Syndrome (TS), and 2) explore whether such factors affect blood pressure (BP) responses to acute mental stress. Participants were 47 women consecutively enrolled in an ongoing study examining the prognostic significance of stress reactivity in TS. Psychological resources (resilience, adaptive coping) and distress (depression, anxiety, PTSD, perceived stress) were self-reported using validated questionnaires <12 weeks after TS. Using a standardized protocol, systolic BP (SBP) and diastolic BP (DBP) (mmHg) were measured every 5 minutes during baseline (10 min), mental stress (10 min), and recovery (20 min). Associations of psychological resources and distress (high vs. low composite scores), respectively, with BP during mental stress and recovery (change from baseline) were examined using one-way ANCOVAs (covariates: age, anti-hypertensive medications). Given the study's exploratory nature, results are shown as effect sizes.On average, women (Mage= 64.3 years) had high perceived stress, anxiety, and PTSD symptoms and low resilience. Women with high (vs. low) psychological distress displayed less complete SBP (d=.57) and DBP (d=.33) recovery to baseline. Women with low (vs. high) psychological resources demonstrated lower SBP responses during mental stress (d=-.26) alongside a more complete SBP recovery (d=.30). Female survivors of TS with high psychological distress exhibited impaired BP recovery following acute mental stress. While the prognostic significance of impaired BP recovery from mental stress remains to be determined in longitudinal studies, this finding could help identify TS survivors at risk for recurrence.

From sleep to sip? Examining a daily model of sleep and trauma-related drinking among sexual violence survivors.

Alcohol misuse is common among women who have experienced sexual violence and is often attributed to the self-medication model of alcohol use to alleviate posttraumatic stress disorder (PTSD) symptoms. Despite the proximal theorized role of PTSD symptoms, less attention has been given to daily associations between PTSD symptoms, trauma-related drinking to cope (TRD) motives, and ensuing alcohol use by survivors. Moreover, despite indications that poor sleep impacts affective functioning and may exacerbate daily PTSD symptoms, the role of sleep duration and quality in drinking to cope with PTSD symptoms is not well understood. This study examined an integrated model testing whether shorter sleep duration and poorer sleep quality predict greater daily PTSD symptoms and, in turn, greater alcohol use later that day through TRD motives. Participants were 82 cisgender women (Mage = 22.8, 73.2% White, 13.4% Hispanic/Latina, 56.1% heterosexual, 30.5% bisexual) who had experienced sexual violence. Participants completed ecological momentary assessment measures and wore actigraphs for 3 weeks. Contrary to hypotheses, shorter-than-usual sleep duration did not predict greater alcohol use quantity via daily PTSD symptoms and TRD motives. However, poorer-than-usual sleep quality predicted greater PTSD symptoms that day, which in turn predicted greater same-day TRD motives. Findings underscore the importance of sleep quality in heightened PTSD symptoms but suggest survivors did not drink more to alleviate trauma-related distress. Future research should examine other drinking motives among survivors to inform proximal interventions to prevent alcohol misuse. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Maternal trauma exposure is linked to adult offspring's cognitive functioning in the context of mass violence.

This study aimed to examine whether mothers' level of trauma exposure and posttraumatic stress disorder (PTSD) symptoms are related to their offspring's cognitive functioning. Mothers exposed to the 1994 genocide perpetrated against the Tutsi (N = 181) and one of their adult offspring were recruited in Rwanda. Mothers and their offspring answered questionnaires on sociodemographic information, the level of trauma exposure, and PTSD symptoms. They also performed a backward digit span task and a similarity task to assess their working memory and abstract reasoning, respectively. Hierarchical regression models were used to analyze the data. Mothers' level of trauma exposure, but not PTSD symptoms, was significantly related to their offspring's abstract reasoning performance after controlling for offspring's age, sex, and economic status. The relationship between mothers' level of trauma exposure, PTSD symptoms, and their offspring's working memory performance was not significant. Offspring's education was significantly linked to their working memory and abstract reasoning performance. The findings demonstrate that the intergenerational transmission of trauma can impact the cognitive functioning of the next generation. These results also illustrate the profound and long-term human impact of mass violence. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

The Role of Shame in Associations with PTSD and Depression Symptoms and Hazardous Drinking Among Bisexual Women Who Experienced Sexual Violence

ABSTRACT Bisexual (i.e. those with attraction to multiple genders) women experience disparities in sexual violence and mental health outcomes, including PTSD, depression, and hazardous drinking, compared to lesbian and heterosexual women. Unique stigma due to bisexual identity (antibisexual stigma), negative reactions to sexual violence (SV) disclosure (e.g. victim blaming), and prior child sexual abuse (CSA) may all contribute to shame. We tested whether shame explained the associations of antibisexual stigma, negative reactions to SV disclosure, and CSA severity with PTSD symptoms, depression, and hazardous drinking among young bisexual women. Participants who self-identified as bisexual women, between the ages of 18–35, residing in the US were recruited via Amazon’s Mechanical Turk (MTurk) and completed online questionnaires. Women who reported SV since age 18 that they disclosed to someone were included in the current study, yielding a sample of 156 bisexual women (Mage = 25.7; 98.1% cisgender, 86.5% White). Path analysis with bias-corrected bootstrapping was conducted. There were significant direct effects of negative reactions on hazardous drinking and CSA on PTSD, and direct effects of shame on PTSD and depression symptoms. Shame explained the associations of antibisexual stigma, negative reactions, and CSA with PTSD symptoms, depression symptoms, and hazardous drinking. Shame may explain why stigmatizing experiences related to bisexual identity, sexual violence, and CSA history relate to distress among bisexual women. Shame is an important treatment target among bisexual survivors of SV.

Associations between neighborhood factors and insomnia and their spatial clustering in Philadelphia, Pennsylvania

BackgroundNeighborhood-level adverse social determinants may be a risk factor for sleep health disparities. We examined the associations between neighborhood factors and insomnia and explored their spatial clustering in the city of Philadelphia, Pennsylvania. MethodsWe conducted a cross-sectional analysis of data from Philadelphia residents who participated in online screening for insomnia-related research. Participants self-reported sex, age, body mass index, anxiety, post-traumatic stress disorder, depression, and insomnia symptoms. The sample was stratified as “No Insomnia” (≤7) and “Insomnia” (>7) based on the Insomnia Severity Index (range: 0-28). Neighborhood and participant data were merged using geospatial techniques. Multiple regression models and geospatial analysis were used to identify neighborhood variables that are associated with insomnia and their spatial distribution. ResultsThe sample (N = 350) was predominantly female (53%), middle-aged (40.8 ± 13.8), overweight (body mass index=26.1 ± 5.54), and 53.7% had insomnia. The insomnia group had significantly higher depression scores (14.6 ± 5.5), a large percentage had anxiety (64.4%) and post-traumatic stress disorder symptoms (31.9%), and largely resided in high crime (p < .001) and highly deprived neighborhoods (p = .034). Within the insomnia group, a 1-point increase in the number of spiritual centers in the neighborhood was associated with lower insomnia symptoms (b=−1.02, p = .002), while a 1-point increase in depression scores (b=0.44, p < .001) and residence in a highly deprived neighborhood (b=1.49, p = .021) was associated with greater insomnia. ConclusionDisparities exist in the neighborhood determinants of insomnia and their spatial distribution in Philadelphia. Interventions targeting the spatial distribution of adverse social determinants may improve insomnia disparities.

Associations Between Cultural Values, Acculturation, Intimate Partner Violence, and Posttraumatic Stress Disorder Symptoms in Mexican American Women

Associations Between Cultural Values, Acculturation, Intimate Partner Violence, and Posttraumatic Stress Disorder Symptoms in Mexican American Women

Emotion Regulation Within Context: Understanding Buffering Effects on Chronic Pain and PTSD Among Black Women Who've Experienced Sexual Assault and Racism.

Previous research has found that both racism and sexual assault are related to posttraumatic stress disorder (PTSD) symptoms and chronic pain. Black women have unique relationships to these stressors situated within contexts of oppression, and little is known about factors that may exacerbate these associations among Black women. Among Black women experiencing both racism and sexual assault (n = 148), emotion clarity moderated the relation between PTSD and chronic pain, β = .0126, SE = 0.0059, p < .05. Our findings support the importance of considering the place that psychological constructs like emotion regulation and traumatic stressors hold in contexts of oppression.

Relationship between trauma, post-traumatic stress and post-traumatic growth for police officials: A path analysis

Background &amp; Objective: Police officials tend to face a high frequency of potentially traumatic incidents due to nature of their job. A dichotomous distinction among these traumatic incidents is witnessing of threat or harm to others and the experiencing of threat or harm directly to oneself. Previous research suggests that different types of traumas (direct and indirect) exposure can produce different levels of negative responses including posttraumatic stress disorder (PTSD) symptoms and positive outcomes such as posttraumatic growth (PTG) in police officials and other law enforcement agencies officials. Our objective was to study post-traumatic stress and post traumatic growth among police officials. Methods: In this cross-sectional study conducted from January 2019 to December 2022. The sample consisted of 400 police officials (having direct and indirect exposure of war trauma) who participated in war on terror in FATA Pakistan. Non probability purposive sampling technique was used for sample selection. Relationship among trauma, PTS (Post traumatic stress) and PTG (Post traumatic growth) was assessed. Results: Findings from the present study indicated that stress played vital role in paving pathway from trauma to growth (β =0.08). Study results also confirmed that moderate level of stress is linked with positive changes like posttraumatic growth. R-square change in linear relationship among stress and posttraumatic growth was 0.59 but in curvilinear relationship among stress and posttraumatic growth R-square change was 0.77 which is higher than linear relationship which confirmed the curvilinear relationship between stress and growth and these findings proved that moderate level of stress after war trauma exposure produced higher levels of post traumatic growth. Conditional indirect effect of exposure to trauma on growth is highly significant (***p &lt; .001) so the role of stress as mediator has been confirmed. Conclusion: The study provided initial evidence that after trauma exposure levels of posttraumatic stress which is experienced play a significant role in the promotion of PTG. Moreover, the results from the present study also revealed the possibility of positive changes in behaviors facilitated by moderate exposure of trauma and stress. doi: https://doi.org/10.12669/pjms.40.10.8897 How to cite this: Azeem A, Kiran N. Relationship between trauma, post-traumatic stress and post-traumatic growth for police officials: A path analysis. Pak J Med Sci. 2024;40(10):2223-2227. doi: https://doi.org/10.12669/pjms.40.10.8897 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Transcranial electrical stimulation in post-traumatic stress disorder and brain injury: possibilities of tuning neuronal networks

Transcranial direct current stimulation (tDCS) in the treatment of post-traumatic stress disorder (PTSD) is used to strengthen the inhibitory control of amygdala activity. However, there are still limited meta-analytic studies examining different tDCS protocols on core PTSD symptoms and the relationship between stimulation parameters and effect size. The objective is to investigate the effectiveness of such an intervention, which is a complex combination of a psychotherapy program with tDCS in the treatment of patients with PTSD and mild traumatic brain injury (mTBI) by assessing their level of functioning. 329 veterans (PTSD (n=109), mTBI (n=112), PTSD + mTBI (n=108) were examined using WHODAS 2.0. Standardized treatment was provided as well as psy­chotherapeutic intervention - a combination of psychoeducation with motivational interviewing and acceptance and commitment therapy for PTSD and tDCS. Clinical targets of therapy in the PTSD group were symptoms of intrusion, avoidance, hyperactivation and protocol of tDCS was dorsolateral prefrontal cortex arousing stimulation. In PTSD + TBI group clinical targets were neurocognitive symptoms, intrusion symptoms, avoidance, hyperactivation and tDCT protocol was motor cortex-supraorbital area inhibitory stimulation. The targest for TBI group was neurocognitive symptoms and tDCS protocol was occipital region exciting stimulation. The long-term effectiveness and the impact on neuroplasticity processes allow considering transcranial direct current stimulation as a promising method of neurorehabilitation of patients with a combination of posttraumatic stress disorder and mild traumatic brain injury.

Self-compassion as a protective factor against post-traumatic stress symptoms induced by adverse childhood experiences: A cross-sectional study among Japan air self-defense force new recruits

Adverse childhood experiences (ACEs) may result in long-term mental health complications, including post-traumatic stress disorder (PTSD). ACEs are known to be more frequent among military personnel, despite their need to maintain their mental health to accomplish their missions. Self-compassion, or treating oneself with kindness and understanding, can mitigate the psychological effects of adversity but is also affected by adversity. This cross-sectional study aimed to identify the complex relationships between ACEs, self-compassion, and PTSD symptoms among 752 new recruits of the Japan Air Self-Defense Force, of whom 537 with ACEs completed the PTSD Checklist for DSM-5. Hierarchical multiple regression analysis was used to examine the independent effect of self-compassion, measured using the Self-Compassion Scale, on PTSD symptoms. Mediation effect analysis with self-compassion as a mediator was conducted on the relationship between ACEs and PTSD symptoms. We confirmed high levels of ACEs among our participants compared to a healthy population of a previous study, and approximately 6% presented PTSD symptoms above a threshold. Self-compassion was significantly negatively associated with PTSD symptoms (β = −.22, 95% confidence interval [CI], −.34 to −.11). Mediation effect analysis revealed that self-compassion partially mediated the relationship between ACEs and PTSD symptoms, explaining 6.9% of this effect, and ACEs were negatively associated with self-compassion (β = −.13, 95% CI, −.22 to −.04). These findings suggested that self-compassion is a protective factor against PTSD symptoms, whereas ACEs can decrease self-compassion. Further research should explore educational interventions to enhance self-compassion among individuals with ACEs to mitigate PTSD symptoms.

Psychological impact of the COVID-19 pandemic on Taiwanese youth: soldiers and college students

Researchers have identified university students and military personnel as highly susceptible to the stress and emotional challenges imposed by the Coronavirus disease 2019 (COVID-19) pandemic. The objective of this study was to compare the psychological impact of COVID-19 on soldiers and students based on risk factors identified in self reports. We recruited 258 students (male: female = 58: 204, average age = 19.73 ± 1.52 years) and 194 active soldiers (male: female = 172: 22, average age = 24.88 ± 4.11 years) from northern Taiwan. Analysis was performed on demographic data, history of COVID-19 infection, vaccinations, and the subjective psychological impact of the pandemic, as well as their current (within one month) anxiety levels, depression level, and symptoms of post-traumatic stress disorder (PTSD). Descriptive statistics and linear regression analysis models were used to compare soldier vs. student status and male vs. female. Overall, roughly 54% of the subjects had been infected by COVID-19 at least once, and the psychological impact of the pandemic was more pronounced in the infected group. The students reported more pronounced symptoms of PTSD (elevated anxiety and depression levels) than did the soldiers. All regression models other than those associated with age and sex revealed that the link between COVID-19 infection and the symptoms of PTSD was more salient among soldiers and males than among students and females. It appears that the psychological impact of COVID-19 is underreported by soldiers. These findings indirectly support previous research indicating that soldiers are less likely than students to disclose emotions related to trauma, indicating the need for psychological support for military personnel.

Towards accurate screening and prevention for PTSD (2-ASAP): protocol of a longitudinal prospective cohort study

BackgroundEffective preventive interventions for PTSD rely on early identification of individuals at risk for developing PTSD. To establish early post-trauma who are at risk, there is a need for accurate prognostic risk screening instruments for PTSD that can be widely implemented in recently trauma-exposed adults. Achieving such accuracy and generalizability requires external validation of machine learning classification models. The current 2-ASAP cohort study will perform external validation on both full and minimal feature sets of supervised machine learning classification models assessing individual risk to follow an adverse PTSD symptom trajectory over the course of 1 year. We will derive these models from the TraumaTIPS cohort, separately for men and women.MethodThe 2-ASAP longitudinal cohort will include N = 863 adults (N = 436 females, N = 427 males) who were recently exposed to acute civilian trauma. We will include civilian victims of accidents, crime and calamities at Victim Support Netherlands; and who were presented for medical evaluation of (suspected) traumatic injuries by emergency transportation to the emergency department. The baseline assessment within 2 months post-trauma will include self-report questionnaires on demographic, medical and traumatic event characteristics; potential risk and protective factors for PTSD; PTSD symptom severity and other adverse outcomes; and current best-practice PTSD screening instruments. Participants will be followed at 3, 6, 9, and 12 months post-trauma, assessing PTSD symptom severity and other adverse outcomes via self-report questionnaires.DiscussionThe ultimate goal of our study is to improve accurate screening and prevention for PTSD in recently trauma-exposed civilians. To enable future large-scale implementation, we will use self-report data to inform the prognostic models; and we will derive a minimal feature set of the classification models. This can be transformed into a short online screening instrument that is user-friendly for recently trauma-exposed adults to fill in. The eventual short online screening instrument will classify early post-trauma which adults are at risk for developing PTSD. Those at risk can be targeted and may subsequently benefit from preventive interventions, aiming to reduce PTSD and relatedly improve psychological, functional and economic outcomes.

Social support and (complex) posttraumatic stress symptom severity: does gender matter?

ABSTRACT Background: Perceived social support is an established predictor of post-traumatic stress disorder (PTSD) after exposure to a traumatic event. Gender is an important factor that could differentiate responses to social support, yet this has been little explored. Symptoms of complex PTSD are also common following trauma but have been under-researched in this context. Large scale studies with culturally diverse samples are particularly lacking. Objectives: In a multi-country sample, we examined: (a) gender differences in perceived social support and both posttraumatic stress symptom severity (PTSS) and complex posttraumatic stress symptom severity (CPTSS); (b) associations between social support and PTSS/CPTSS; and (c) the potential moderating role of gender in the relationship between perceived social support and trauma-related distress. Method: A total of 2483 adults (Mage = 30yrs, 69.9% females) from 39 countries, who had been exposed to mixed trauma types, completed the Multidimensional Scale of Perceived Social Support and the International Trauma Questionnaire (which captures PTSS/CPTSS). Regression analyses examined associations between gender, perceived social support, and PTSS/CPTSS; and tested for gender by social support interactions in predicting PTSS/CPTSS scores. Models were adjusted for age and socioeconomic status. Results: In our cross-country sample, females had greater PTSS/CPTSS than males (B = .23 [95% CI 0.16, 0.30], p < .001; B = .20 [0.12, 0.27], p < .001; respectively), but there was no evidence of gender differences in perceived social support (B = .05 [−0.05, 0.16], p = .33). For both genders, low perceived social support was associated with higher PTSS/CPTSS (females: B = −.16 [−0.20, −0.12], p < .001; B = −.27 [−0.30, −0.24], p < .001; respectively; males: B = −.22 [−0.29, −0.15], p < .001; B = −.31 [−0.36, −0.26], p < .001; respectively), and for PTSS only we found weak evidence that this association was stronger for males vs. females (B = .07 [0.04, 0.14, p = .04). Conclusion: Individuals who feel more socially supported have lower trauma-related distress, and this association is similar in males and females. PTSD/CPTSD interventions may benefit from augmenting perceived social support, regardless of gender.

Rapid and sustained reduction of treatment-resistant PTSD symptoms after intravenous ketamine in a real-world, psychedelic paradigm.

Traditional treatments for post-traumatic stress disorder (PTSD) often show limited success with high dropout. Ketamine, an N-methyl-D-aspartate antagonist known for rapid antidepressant effects, has decreased PTSD symptoms in some studies but not in others. Administering ketamine in ways that parallel psychedelic-assisted treatments-including preparatory, integration, sensory immersion, and psychotherapy sessions-could decrease PTSD symptoms meaningfully. A retrospective sample of 117 screened outpatients with elevated PTSD Checklist for DSM-5 (PCL-5) scores received intravenous ketamine in supportive environments. The protocol included preparation, intention-setting, and integration sessions accompanying at least six administrations. Administration sessions included eye shades and evocative music paralleling typical psychedelic therapy trials. Mean PCL scores decreased from 52.54 (SD = 12.01) to 28.78 (SD = 16.61), d = 1.64. Patients tolerated treatment well, with no serious adverse events. Covariates, including age, gender, days between PCL assessments, number of psychiatric medications, and suicidal ideation were not significant moderators; concomitant psychotherapy did reach significance, d = 0.51. Of the 117 patients' final PCL scores, 88 (75.21%) measures suggested clinically meaningful improvement and 72 (61.54%) suggested remission of PTSD symptoms. Intravenous ketamine in supportive environments, with hallmarks of psychedelic therapy, preceded large reductions in PTSD symptoms. These results highlight ketamine's potential when delivered in this manner, suggesting environmental factors might account for some variation seen in previous work. Given the molecule's cost, minimal interaction with other psychiatric medications, and legal status, intravenous ketamine in a psychedelic paradigm may be a promising option for PTSD unresponsive to other treatments.

Intrinsic functional connectivity of right dorsolateral prefrontal cortex and hippocampus subregions relates to emotional and sensory-perceptual properties of intrusive trauma memories.

Trauma-related intrusive memories (TR-IMs), unwanted and vivid, are core symptoms of posttraumatic stress disorder (PTSD). Prior research links voluntary TR-IM suppression to inhibitory control of the right dorsolateral prefrontal cortex (dlPFC) over the hippocampus (HPC). However, the potential relevance of tonic resting-state inhibition has not been examined, nor has the functional differentiation of the anterior and posterior hippocampus (aHPC/HPC). This study examined relationships of TR-IM frequency and properties with resting-state negative coupling between the right dlPFC and right aHPC/pHPC in trauma-exposed individuals with PTSD symptoms. Participants (N=109; 88 female) completed two weeks of ecological momentary assessments capturing TR-IM frequency and properties (intrusiveness, emotional intensity, vividness, visual properties, and reliving). Using 3T resting-state magnetic resonance imaging, participant-specific 4-mm spheres were placed at the right dlPFC voxel most anticorrelated with the right aHPC and pHPC. Quasi-Poisson and linear mixed-effects models assessed relationships of TR-IM frequency and properties with right dlPFC-right aHPC and pHPC anticorrelation. TR-IM emotional intensity was positively associated with right dlPFC-aHPC connectivity, while vividness and visual properties were linked to right dlPFC-pHPC connectivity. No significant associations were found between TR-IM frequency, intrusiveness, or reliving, and anticorrelation with either HPC subregion. This study provides novel insights into the neural correlates of TR-IMs, highlighting the relevance of intrinsic negative coupling between the right dlPFC and aHPC/pHPC to their emotional impact and perceptual properties. Further research on inhibitory mechanisms in this circuit could improve understanding of component processes of intrusive reexperiencing, a severe and treatment-refractory PTSD symptom.