Event centrality, identity, and trauma type may impact the symptoms of posttraumatic stress disorder (PTSD), although extant literature is still in nascent stages, particularly in low- and middle-income countries. This study examined the direct and indirect effects of event centrality, identity, and trauma type on PTSD among 276 college students in India (Mage = 19.05, SD = 0.91) analyzed using bivariate correlation and mediation analysis using a single group, cross-sectional, exploratory design. Trauma History Questionnaire, Centrality of Events Scale (CES), PTSD Checklist-Civilian-5, and Severity Indices in Personality Problems were used. Event centrality showed strong correlation (ρ = .798) while self-control showed moderate correlation (ρ = .45) with PTSD symptoms. General disasters were found to be highly correlated with event centrality (ρ = .69) and PTSD symptoms (ρ = .68), while traumatic physical and sexual experiences were moderately correlated (CES: ρ = .42 and PTSD: ρ = .50). Indirect effects were mediated by event centrality and self-control between general disasters and PTSD symptoms (CES: β = 2.85, SE = 0.36, p < .001; self-control: β = 0.61, SE = 0.20, p < .01) and traumatic physical and sexual experiences and PTSD symptoms (CES: β = 1.92, SE = 0.62, p < .005; self-control: β = 01.05, SE = 0.43, p < .05). Direct effects were found between traumatic physical and sexual experiences and PTSD symptoms (β = 4.50, SE = 0.85, p < .001). Event centrality and self-control may indirectly mediate the relationship between trauma type and PTSD symptoms. The implications for developing event centrality-focused interventions for PTSD targeting self-control are discussed. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

PTSD symptoms moderate the effects of interpretation bias modification on hostile interpretation bias and trait anger.

PTSD-related drinking to cope and changes in drinking risk levels in a nationally representative sample.

Linking childhood maltreatment to ICD-11 PTSD and CPTSD: Differential roles of insecure attachment and emotion dysregulation.

The goal of this study was to examine the cost-effectiveness of evidence-based psychotherapies for posttraumatic stress disorder (PTSD), including prolonged exposure and cognitive processing therapy, by comparing four delivery modalities: home-based telehealth (patient in home), office-based telehealth (patient in one office, provider in another), in-home in-person, and in-office in-person. Pooled data from 268 veterans enrolled in two harmonized PTSD clinical trials were used to examine costs related to personnel, travel mileage, and office space. Cost-effectiveness was calculated using an incremental cost-effectiveness ratio that included unadjusted medians of cost differences between modalities and percent change in clinical outcomes. K-sample equality of medians tests were used to ascertain statistical significance in differences across treatment modalities for the total cohort, as well as for cohorts based on greater baseline PTSD severity (baseline Clinician-Administered PTSD Scale for Diagnostic and Statistical Manual of Mental Disorders, fifth edition, score ≥39 points), for the half of participants who did not respond as well to therapy, and for those who experienced reliable change in PTSD symptoms. The median incremental cost-effectiveness ratio was -$81 across all treatment modalities, -$92 for in-office in-person, -$92 for home-based telehealth, -$131 for office-based telehealth, and -$55 for in-home in-person. Sensitivity analyses examining baseline PTSD severity and responder status are also presented. Cost-effectiveness differed across treatment modalities, but only for those who were considered treatment responders. Shared decision making can help clinicians determine the best therapy delivery approach for each patient suffering from PTSD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Seven-year data trends in mental health of refugees in transit: a repeated cross-sectional study.

Perceptions and knowledge of childbirth-related post-traumatic stress disorder among health professionals involved in intrapartum and postpartum care.

• Despite the high prevalence of mental disorders, refugees underutilize mental health services. • Cultural adaptation of interventions is suggested as a way to narrow this treatment gap. • The Raha Arabic program was efficient in reducing symptoms of depression, anxiety, insomnia, and PTSD. • The Raha Arabic program was also efficient in improving resilience and well-being. • Treatment effects were sustained at the 6-month follow-up. Despite an elevated risk for developing mental health problems, evidence-based treatment options for this population remain scarce. The current study aimed to examine the efficacy of a culturally adapted internet-based cognitive behavioral therapy (iCBT) program for youth and young adults with mild to moderate mental health problems. Raha is a culturally adapted, guided, and tailored iCBT program for mild to moderate mental health problems. One hundred twenty-five Arabic-speaking refugee youth and young adults aged 15–29 years were randomly allocated to either a 10-week CA-iCBT condition or a wait-list control condition. The Hopkins Symptom Checklist (HSCL-25) served as the primary outcome measure and was assessed at pre-treatment, 4-week follow-up, post-treatment, and at 6-months post-treatment. Treatment effects were evaluated using a latent growth model. In the intention-to-treat analysis, anxiety and depressive symptoms on the HSCL-25 were significantly reduced in the treatment group compared with the wait-list control group, with a between-group effect size at post-treatment of Cohen’s d = 1.43 [0.97,1.89]. Treatment effects were sustained at the 6-month follow-up. Significant moderate-to-large effects were also observed across most secondary outcome measures. The findings of this study indicate that CA-iCBT is effective in reducing symptoms of common mental health problems in a population that generally underutilizes traditional mental health services.

This study aimed to examine the determinants of mental health among adult earthquake survivors by testing conceptual models of post-traumatic stress disorder (PTSD) and complex post-traumatic stress disorder (CPTSD). Specifically, the study investigated how trauma memories, post-traumatic cognitions, trauma identity and safety-seeking behaviours interact to influence mental health outcomes. A cross-sectional design was employed with a sample of 285 adults (65.3% female) who experienced the 2023 Kahramanmaraş earthquakes in Türkiye. Participants completed self-report measures assessing trauma memories, post-traumatic cognitions, safety-seeking behaviours, trauma identity, PTSD and CPTSD symptoms, and overall mental health. Two structural equation models-one for PTSD and one for CPTSD-were tested to evaluate the pathways linking trauma-related variables to mental health. Structural equation modelling indicated that trauma memories significantly and positively predicted post-traumatic cognitions, which in turn predicted both trauma identity and safety-seeking behaviours. These mediators were positively associated with PTSD and CPTSD symptoms, which negatively predicted mental health. In the PTSD model, trauma identity had a stronger effect, whereas in the CPTSD model, safety-seeking behaviours were more influential. Both models demonstrated good fit indices, confirming the hypothesized pathways. The findings underscore the pivotal role of trauma memories and post-traumatic cognitions in shaping trauma-related behavioural and identity processes that contribute to PTSD and CPTSD symptoms. Targeting these mechanisms in clinical interventions may enhance mental health outcomes in individuals exposed to large-scale natural disasters.

Post-traumatic stress disorder symptoms in children after PICU discharge: exploring contributing factors and the need for targeted interventions.

Humanitarian emergencies expose millions of young people to adversity each year, with particularly severe consequences in low-and middle-income countries (LMICs) where mental health resources are scarce. In these contexts, community-based interventions (CBIs) can fill treatment gaps by leveraging local strengths to address mental health symptoms and sustainably foster resilience. Although these interventions demonstrate therapeutic potential, evidence regarding their effectiveness in reducing youth Post-Traumatic Stress Disorder (PTSD) symptoms remains mixed, particularly in LMICs affected by humanitarian emergencies. To examine the efficacy of CBIs for this population, a systematic review of five databases (Cochrane, Embase, PsycINFO, PubMed, and Scopus) was completed. Of the 1,687 records screened, 22 records met the inclusion criteria, 21 of which were included in analyses. Findings suggest a statistically significant, moderate effect of CBIs in reducing symptoms of PTSD in children and adolescents (g = -0.5). Further, exploratory moderator analyses suggests that incorporating individual sessions and culturally adapting interventions may enhance treatment outcomes. However, substantial heterogeneity across studies indicate that study effects vary widely. The findings from this review suggest that community-driven approaches are viable treatment options for traumatized youth in low-resource settings, offering valuable insights into the effectiveness of CBIs in high-risk contexts.

This study aims to systematically evaluate the findings of quantitative research examining the relationship between spirituality and depression, anxiety, and post-traumatic stress disorder (PTSD). The systematic review was conducted in accordance with the PRISMA guidelines, and the study protocol was pre-registered in the PROSPERO database. A comprehensive literature search conducted in PubMed, Web of Science Core Collection, Scopus, and PsycINFO databases resulted in a total of 17 studies meeting the predefined inclusion and exclusion criteria being included in the review. The findings were evaluated using a narrative synthesis approach. The vast majority of the studies reviewed showed that spirituality and spiritual well-being are inversely related to symptoms of depression and anxiety. In clinical and community-based samples, lower depressive and anxious symptoms were reported in individuals with higher levels of spiritual well-being. Findings in the context of post-traumatic stress disorder (PTSD) revealed that spirituality is not a unidirectional protective factor. Positive spiritual coping and spiritual functioning were associated with lower PTSD symptoms, whereas spiritual conflict and unmet spiritual needs were associated with higher levels of psychological distress. In conclusion, this systematic review demonstrates that spirituality exhibits meaningful relationships with mental health, but that its effects must be considered in a manner sensitive to contextual and individual differences.

BackgroundRecent data highlight problematic rates of mental health symptoms (MHS) among adolescents and young adults following the COVID-19 pandemic, with implications for early identification and clinical service provision. This study estimated the prevalence of MHS and its sociodemographic correlates among Canadian youths.MethodsWe conducted a cross-sectional analysis of 896 iundividuals aged 18-24years using data from Statistics Canada's Survey on COVID-19 and Mental Health. Symptoms of anxiety, psychological distress, depression, and post-traumatic stress disorder (PTSD) were assessed using validated self-report instruments. Analyses included descriptive statistics, Pearson's chi-square tests, two-way analysis of covariance (ANCOVA), and multivariate linear regression.ResultsParticipants' mean (SD) age was 21.2 (2.0) years; 53% identified as women, and 81% lived in urban areas. Prevalence was highest for psychological distress (57.0%), followed by depression (31.6%), anxiety (23.7%), and PTSD symptoms (12.6%). Women reported higher anxiety and distress than men (p < 0.05). In multivariable analyses, female gender, non-essential worker status, poorer self-rated mental health, weaker community belonging, lower household income, lower life satisfaction, and pre-existing mental health disorder were associated with greater symptom severity (p < 0.05).ConclusionThe rising prevalence of mental health symptoms reflects gendered, socioeconomic, and psychosocial vulnerabilities, requiring trauma-informed clinical screening and equity-focused public health interventions for Canadian youth.

Abstract Objective The ongoing conflict in Ukraine has created a severe humanitarian crisis, disproportionately affecting vulnerable populations such as children with chronic conditions. We set out to determine information about mental health in children with epilepsy in Ukraine affected by the conflict. Methods Mental health outcomes in 213 Ukrainian children with epilepsy during the conflict were screened using standardized instruments for post‐traumatic stress disorder (PTSD; Harvard Trauma Questionnaire), anxiety (7 item Generalized Anxiety Disorder module, GAD‐7), depression (Patient Health Questionnaire‐9, PHQ‐9), and epilepsy severity (Global Assessment of Severity of Epilepsy scale, GASE). Data were collected between February and June 2023 through self‐ or proxy‐completed surveys. Results Participants (14.6%) screened positive for PTSD symptoms, with girls significantly more affected than boys. A high proportion screened positive for symptoms of anxiety and depression, with 22% in the range for severe anxiety and 55% in the moderate‐to‐severe depression range. Epilepsy severity strongly correlated with mental health burden. Access to care was severely disrupted: 76% reported difficulty obtaining antiseizure medications, and 51% struggled to access medical services, contributing to increased seizure frequency in 56% of cases. Regression analyses identified epilepsy severity and barriers to medical care as key predictors of adverse mental health outcomes. Significance These findings underscore the compounded impact of war and chronic illness on children's psychological well‐being and highlight the urgent need for trauma‐informed, multilevel interventions, and improved access to health care for this vulnerable population.

BACKGROUND Survivors of acute respiratory distress syndrome (ARDS) frequently suffer from long-term physical and psychological sequelae, including impaired lung function and posttraumatic stress disorder (PTSD), highlighting the need for comprehensive rehabilitation strategies. AIM To evaluate the impact of staged pulmonary rehabilitation nursing combined with cognitive psychological intervention (SPRNCPI) on PTSD in patients with ARDS. METHODS A retrospective analysis was conducted on the data of 230 patients with ARDS admitted from April 2020 to April 2024. The patients were divided into two groups: A routine care (RC) group (n = 125) and a SPRNCPI group (n = 105). The SPRNCPI group received mechanical ventilation support, RC, and additional staged pulmonary rehabilitation nursing combines with cognitive psychological interventions including psychological support, emotional management training, and regular follow-ups. Baseline demographic information, respiratory function parameters, oxygenation index, serum cortisol levels, PTSD symptoms, emotional status, and quality of life were assessed. RESULTS After nursing, forced expiratory volume in one second (P &lt; 0.001), forced vital capacity (P = 0.009), and PaO2/FiO2 (P = 0.005) were significantly higher in the SPRNCPI group than in the RC group. Serum cortisol levels (P = 0.002), Impact of Event Scale-Revised overall score (P &lt; 0.001), Self-Rating Anxiety Scale (P = 0.002), and Self-Rating Depression Scale (P &lt; 0.001) scores were significantly lower in the SPRNCPI group. Physiological field scores (P = 0.033), psychological field scores (P = 0.015), social field scores (P = 0.043), and environmental field scores (P = 0.010) were significantly higher in the SPRNCPI group. CONCLUSION SPRNCPI significantly improves respiratory function, reduced PTSD symptoms, lowered anxiety and depression levels, and enhanced overall quality of life in patients with ARDS. This integrated approach offers a promising strategy for enhancing patient outcomes in critical care settings.

This article is devoted to the symptom of gendered trauma and its lasting psychological effect on Holly Gibney, the central female protagonist in the novella collection of Stephen King, If It Bleeds . With a trauma-based approach to a literary analysis combining gender studies and psychological interpretation, this question will take into consideration the long-term effects of gendered violence on Holly Gibney. The exhibition of violence does not simply cease at the physical but goes on to investigate psychological trauma, emotional vulnerability and embodied experience. This article talks about the ways in which the novella describes common post-traumatic stress disorder (PTSD) symptoms and other psychological reactions like anxiety and dissociation. The study brings out the processes involved in psychological resiliency, adaptive coping, and recovery by using the character of Holly, who is able to be strong despite hardship challenges. Overall, the research contributes to the current knowledge on gender violence and trauma in modern literature, especially in the horror sub-genre, where the inner world of psychological suffering and survival can be observed. Through an interdisciplinary approach to gender, trauma theory, and literary analysis, the article reveals the intricate nature of female subjectivity and psychological resilience in a world that is constructed by fear, violence, and unequal power relations.

Objective In the current study, we review and meta-analyze the existing clinical trials of emotion-focused therapy (EFT) for treating a wide variety of distress-based forms of psychopathology, including depression, generalized anxiety, posttraumatic stress disorder (PTSD), and borderline personality symptomology. Method We conducted a systematic review and meta-analysis of existing published clinical trials through April 2025 of EFT for distress-based dysfunction. Results We located 13 existing articles (n = 348 participants receiving EFT; 201 receiving control) that met inclusion criteria. Most studies examined EFT for depression, while a significant number measured anxiety as an outcome, and two examined PTSD symptoms. EFT significantly outperformed inactive controls (g = 1.39, 95% CI = [1.06, 1.72]) but not other psychotherapies (g = .28, 95% CI = [−.19, .76]). Limitations of the existing research include evidence of publication bias and a strong focus on women and White/Iranian populations. Additionally, the quality of existing research is largely poor with varying methodological problems, including small sample sizes, inadequate randomization, and failure to account for dropouts. Conclusion EFT appears to be modestly effective for the examined concerns. Future researchers should prioritize examining EFT with more methodologically rigorous designs in more culturally and gender diverse populations.

Background The COVID-19 pandemic profoundly disrupted education in South Africa, yet quantitative investigations into its mental health impact among learners in late adolescence remain scarce. This study examined associations between COVID-19-related cognitive appraisals and psychological outcomes among late-adolescent learners (aged 18-19 years), a group navigating the transition to adulthood amid substantial educational and social uncertainty. Method A convenience sample of 239 late-adolescent learners (mean age = 18.13 years; 72% female) from seven public schools in informal and semi-urban communities in the Western Cape completed an online survey between March and August 2022. Standardised measures assessed symptoms of depression, anxiety, posttraumatic stress disorder (PTSD), alcohol use, fear of COVID-19, perceived vulnerability to disease, and COVID-19-related worry. Results High levels of psychological distress were observed within the sample: 59% reported clinically significant depressive symptoms, 39% severe anxiety, 35% clinically significant PTSD symptoms, and 13% alcohol use suggestive of dependence. Hierarchical regression analyses indicated that fear of COVID-19 was a significant predictor of all four mental health outcomes (p < 0.001). Perceived vulnerability to disease independently predicted PTSD symptoms (p < 0.001) and alcohol use (p < 0.01). Conclusion: These findings highlight the importance of school-based mental health interventions that target learners’ cognitive appraisals of threat and vulnerability during periods of educational disruption, with implications for strengthening preparedness for future public health emergencies.

Uniformed service personnel are routinely exposed to occupational trauma in their roles which contribute to elevated rates of mental health conditions. A wide range of mental health and wellbeing interventions may help uniformed service personnel manage their psychological responses to challenging incidents at work. Previous reviews of those interventions have focused on single groups of professionals or intervention types, limiting cross-sector insights. This review uses a mixed methods approach to synthesise evidence associated with mental health and wellbeing interventions across uniformed services. The protocol was registered with PROSPERO (CRD42024605877). A mixed methods systematic review was conducted using the Joanna Briggs Institute (JBI) convergent segregated approach. Searches were conducted in Medline, CINAHL, Web of Science and PsycINFO (Dec 2024). Screening and quality appraisal (Mixed Methods Appraisal Tool) were performed independently by two reviewers. Due to heterogeneity, findings were narratively synthesised. Quantitative and qualitative results were integrated following the JBI approach. Eighty-six primary studies from 22 countries were included, covering a range of professions and intervention types. Synthesis of quantitative data from 82 studies showed that mindfulness-based training, resilience coaching, cognitive behavioural therapies and supported lifestyle activities demonstrated reduced symptoms of PTSD, anxiety and depression. However, interventions such as Critical Incident Stress Debriefing (CISD) and peer support yielded mixed results. Qualitative data from 9 studies were grouped into 5 categories: enhanced emotional insight, improved interpersonal relationships, perceived effectiveness, barriers to engagement and delivery challenges. Participants valued interventions that fostered self-awareness and support but cited stigma, guilt and logistical constraints as significant barriers. Integration of quantitative and qualitative findings revealed alignment in outcomes for several interventions, while highlighting evidence gaps, such as the lack of qualitative data for many interventions and limited exploration of cultural and organisational barriers. Mental health interventions for uniformed service personnel show promise but are influenced by delivery format, occupational culture and contextual factors. This review underscores the need for delivering interventions informed by ecological models, standardised outcome sets and deeper qualitative exploration into stigma and engagement barriers.

Sleep and circadian problems are highly prevalent in ex-military personnel and first responders and often impact comorbid mental health disorders. This study tested the feasibility and efficacy of a transdiagnostic intervention-transdiagnostic intervention for sleep and circadian dysfunction (TranS-C)-in improving sleep problems and comorbid mental health symptoms in ex-military personnel and first responders with sleep and circadian disorder(s). A parallel-group, assessor-blinded, pilot randomized controlled trial design was employed. Forty first responders and ex-military personnel meeting the criteria for sleep disorder were randomized to receive immediate TranS-C or delayed TranS-C (n = 20 per condition) via telehealth. An assessment battery at pretreatment, posttreatment, and 3 months posttreatment was completed. The primary outcome was severity of sleep problems. Secondary outcomes included severity of posttraumatic stress disorder, depression, and anxiety symptoms. TranS-C treatment was associated with large pre- to posttreatment improvements in sleep problems (d = -0.97, p < .001) and depressive symptoms (d = -0.83, p < .001), as well as medium-to-large improvements in anxiety (d = -0.59, p < .001) and posttraumatic stress disorder (d = -0.69, p < .001) symptoms, with improvements maintained over time. The immediate TranS-C group had significantly greater sleep improvement after 12 weeks than the delayed TranS-C group, which, at this time, had not received treatment. After receiving treatment, symptoms in the delayed TranS-C group improved to similar posttreatment and follow-up levels as the immediate TranS-C group. In ex-military personnel and first responder populations, TranS-C is an effective treatment that simultaneously addresses sleep and circadian disorders and comorbid mental health symptoms. (PsycInfo Database Record (c) 2026 APA, all rights reserved).