Posttraumatic Research Articles

Insomnia is highly prevalent among military personnel, with many gaps in knowledge. The purpose of this study was to quantify the medical, psychiatric, and utilization burden of insomnia among active-duty military personnel. We hypothesized that insomnia is associated with worsened health and economic outcomes. This was a retrospective case-control study. Data were derived from the Military Data Repository (2016-2021). Active-duty service members (ADSMs) younger than 65 years, with 12 months of continuous enrollment before and after first insomnia diagnosis and no evidence of previous insomnia or insomnia treatment, were matched 1:1 on demographic, clinical, and military characteristics to ADSMs without insomnia. Insomnia and psychiatric and medical comorbidities were defined using International Classification of Diseases, 10th Revision diagnostic codes. The impact of newly diagnosed insomnia on psychiatric and medical outcomes within 12 months was examined using time-to-event models. The impact of newly diagnosed insomnia on 12-month health care resource utilization (HCRU) was examined using generalized linear models. A total of 40,978 ADSMs met insomnia criteria and were matched to 40,978 ADSMs without insomnia. Participants were 78.6% male and 61.8% identified as White, with most younger than 44 years (90.3%). Insomnia was associated with increased risk of almost every studied physical and psychological health outcomes; relative to those without insomnia, ADSMs with insomnia demonstrated a 6-fold increased risk of post-traumatic stress disorder (hazard ratio [HR] 6.51, 95% CI 5.95-7.12, p < 0.001), as well as elevated risk of traumatic brain injury (HR 5.32, 95% CI 4.53-6.24, p < 0.001). ADSMs with insomnia demonstrated greater all-cause HCRU across all points of service (all p's < 0.001). Among active-duty personnel, new-onset insomnia was associated with substantially increased risk of adverse medical and psychiatric burden, as well as increased utilization, over 12 months. Key limitations include our observational study design.

Post-traumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co-occur, leading to significant impairments in learning and memory. Despite the prevalence of these disorders, existing treatment strategies remain inadequate, necessitating novel approaches targeting underlying neural circuits. This study investigated whether optogenetic stimulation of medial prefrontal cortex subregions could rescue fear extinction deficits in a preclinical model of comorbid PTSD/AUD. We examined the differential roles of the infralimbic (IL) and prelimbic (PL) cortices in modulating extinction learning following combined stress and chronic alcohol exposure. Male and female Wistar rats underwent restraint stress (RS) and chronic intermittent ethanol exposure (CIE), followed by fear conditioning and extinction training. Animals received optogenetic stimulation (ChR2 or eYFP control) targeting either IL or PL cortex immediately prior to each extinction session. Extinction learning rates, days to criterion, and long-term memory retention (21-day spontaneous recovery) were assessed. Combined stress and alcohol exposure significantly impaired extinction learning compared to controls. IL-ChR2 stimulation recovered these extinction deficits in the RS + CIE group, accelerating extinction rates and reducing spontaneous recovery. Conversely, PL-ChR2 stimulation impaired extinction learning in control animals but produced no additional deficits in the already-impaired RS + CIE group, suggesting a ceiling effect. This study identifies the IL cortex as a critical regulator of fear extinction learning following stress and alcohol exposure, demonstrating that targeted circuit activation can overcome extinction deficits characteristic of comorbid PTSD and AUD. These region-specific effects provide important insights into the prefrontal mechanisms governing fear memory processes in pathological states.

Police officers are exposed to potentially psychological traumatic events and are at high risk of developing post-traumatic stress injuries (PTSI). Development and wide implementation of best practices for managing PTSI are needed. The psychological first aid (PFA) framework encompasses trauma-informed knowledge to guide the development of best practices. Based on the framework and on a pilot performed among Canadian police officers, we propose a PFA program including: 1) PTSI awareness e-learning; 2) PFA training provided by local trainers; and, 3) peer-to-peer PFA intervention to mitigate PTSI in police officers. The study was designed to evaluate the feasibility and effectiveness of a large-scale PFA program implementation among Canadian police officers. A multi-phase mixed-methods participatory action research study is being performed in five phases according to the PFA implementation and the dynamic sustainability frameworks. The program 1) was adapted to environmental needs; 2) is progressively deployed; and, to be evaluated for 3) feasibility; 4) effectiveness; and, 5) sustainability. Local trainers (N = 10) were trained to then train PFA providers (N = 322 police officers) who could then administer the intervention to police officers as needed (i.e., PFA recipients). The e-learning is being co-developed and will be disseminated. Program feasibility (i.e., acceptability, demand, practicality, implementation) will be assessed through interviews with trainers (n = 10), providers (n = 30), and recipients (n = 20). The program effectiveness will be assessed by tracking changes in PTSI literacy and stigma among officers who complete the e-learning (n = 5700) using pre-post e-learning questionnaires. Pre-post training questionnaires with participating providers (n = 175) will track perceived competence to provide the intervention. Pre-post intervention questionnaires with recipients (n = 64) will track changes in putative protective factors (i.e., professional quality of life, work safety, coping, sense of efficacy, sense of hope) and symptoms of PTSI (i.e., anxiety-, depressive-, and post-traumatic stress disorder symptoms). The PFA program is designed to help officers to recognize PTSI, promote self-care strategies and help-seeking, enhance organizational support, and expand psychological support. The study could provide trauma-informed guidelines for implementation and evaluation practices in high-risk and interdependent organizations and inform future directions for policy decisions. The study was pre-registered on OSF ( https://osf.io/7khgs/?view_only=33260c704ffc46ffb75a704320283ccf ).

Transdiagnostic psychotherapies offer potential advantages to traditional, disorder-specific approaches, including coverage of comorbidity, dissemination and implementation, and patient access. Although initial investigations testing the efficacy and capability to be disseminated exist, very few studies have tested these interventions within group settings. The present study involved a randomized clinical trial of Group Transdiagnostic Behavior Therapy (G-TBT) and matching group disorder-specific therapies (G-DST) in 243 veterans with major depressive disorder (MDD) and posttraumatic stress disorder (PTSD). Clinical symptom outcomes, patient satisfaction and participation, and access in terms of days between intake and the initiation of treatment were examined. G-DSTs were Cognitive Behavioral Therapy for Depression and Cognitive Processing Therapy for PTSD. Groups were initiated as soon as at least 6 participants were assigned. As expected, clinical outcomes for MDD and PTSD symptoms were consistently reduced in G-TBT within principal diagnostic groups, as well as associated symptoms and functional impairment. These outcomes were generally consistent with outcomes in the G-DSTs. While therapy satisfaction was similar across groups, significantly faster group assignment and less attrition were observed in G-TBT compared to G-DSTs. Together, the present findings provide support for the efficacy of G-TBT and with comparable effects to well-established G-DSTs for MDD and PTSD, but with potentially improved access to care via transdiagnostic assignment compared to tradition disorder-specific assignment for group therapies.

Efficacy, all-cause discontinuation, and safety of serotonergic psychedelics and MDMA to treat mental disorders: A living systematic review with meta-analysis.

Grief is a common experience in adolescence. Evidence-based therapies are not readily accessible for grieving young people. Unguided internet-based cognitive behavior therapy for grief in adolescents has recently been investigated in a pilot randomized controlled trial. Research is required to determine acceptability as this unguided internet intervention incorporates exposure and imagery transformation techniques that are typically delivered by therapists. The aim of this study was to understand, through qualitative content analysis, adolescents’ views about the acceptability of unguided internet-based cognitive behavior therapy for grief. Nine adolescents (M age = 16.44 years, SD = 1.13, age range 14–18 years, 55.6% female, 44.4% male) engaged in a post-intervention interview, or provided written responses to the interview questions, after trial participation. Most participants reported exposure and imagery transformation as acceptable. The findings provide initial support in a small sample of adolescents of the acceptability of unguided internet cognitive behavior therapy for grief. Grief and loss are commonly experienced by youth; 90% of adolescents have experienced bereavement of a family member or friend (Ens & Bond, 2005). Grief is a broad term that covers a wide range of responses to losses including bereavement, parental divorce, relationship break-up, and death of a pet (Breen et al., 2023). Grief in adolescence is associated with an elevated risk of developing psychological disorders including anxiety, depression, post-traumatic stress disorder (PTSD), and prolonged grief disorder (Guzzo & Gobbi, 2023). Parental loss in adolescence through death or divorce is a risk factor for depression (Guzzo & Gobbi, 2023). Data showing that both death and non-death losses are associated with a range of psychological symptoms in youth indicate the need for an accessible intervention for grief.

ABSTRACT Introduction Change for people who are diagnosed with PTSD often poses a great challenge for the client themselves as well as for the therapist. This study aims to investigate change in music therapy through self-report questionnaires and interview data with a patient named Anna (pseudonym). Anna experiences severe dissociation episodes and is diagnosed with borderline personality disorder and post-traumatic stress disorder. Methods A mixed-method approach is utilised to investigate change from self-report questionnaires throughout treatment and interviews at treatment termination. Results The self-report questionnaire data indicate positive change in symptoms, maladaptive schemas, and the working alliance. The interview responses illustrate the dynamics of the music therapy sessions, as well as Anna’s experiences of challenging and helpful elements within and outside of the therapeutic context. Discussion The analysis documents change from both the qualitative and quantitative perspective. This change is discussed from different theoretical perspectives: Growth, working alliance, common factors and implicit relational knowing. This study illustrates how change and the emergence of a more resourceful person unfold in music therapy. Finally, critical reflections on design shed light on limitations of the study. The case example illustrates a process of change and underlines the importance of developing and maintaining a strong alliance as a stabilising factor in music therapy to balance challenges in a chaotic world.

A significant percentage of individuals diagnosed as having posttraumatic stress disorder (PTSD) show remission within the first year after traumatic exposure, with more gradual improvement over the next several years. However, a subgroup of individuals with PTSD have an unremitting course of illness that may persist for years or decades despite treatment efforts. The authors tested the hypothesis that reduced hippocampal volume is associated with chronic, unremitting PTSD rather than with PTSD that has remitted over time. The study included 44 Vietnam War veterans whose traumatic exposure had occurred more than three decades before study participation. The authors studied the association between hippocampal volume and three PTSD diagnostic categories: veterans with unremitting PTSD (N=26), veterans with sustained remission from earlier PTSD (N=8), and veterans who never developed PTSD (N=10). Compared with trauma-exposed veterans who never developed PTSD, those with unremitting PTSD, but not those who had recovered, showed reduced hippocampal volume. The results were anatomically lateralized to the right hippocampus, consistent with previous neuroimaging studies of male combat veterans. These results support an emerging literature suggesting that reduced hippocampal volume observed among individuals with PTSD may be related to failure to recover from rather than to the development of PTSD after trauma exposure. These findings may define a subpopulation of combat veterans who are at increased risk for long-term failure to recover from PTSD because of their smaller right hippocampi.

This research represents the first in the Republic of Kazakhstan focusing on Afghan war veterans identified as being at risk for Post-Traumatic Stress Disorder (PTSD). A comprehensive investigation was undertaken regarding the comorbidity of PTSD symptoms, somatic diseases (cardiovascular and others), and mental disorders. The study’s sample comprised 293 Afghan war veterans, while the control group consisted of 149 males without combat experience. The research methodology incorporated data extracted from medical records, a demographic questionnaire, the Mississippi PTSD Scale (military and civilian versions), the Spielberger–Khanin Anxiety Inventory, the Beck Depression Inventory (BDI), and the SCL-90-R questionnaire. Subclinical symptoms indicative of chronic PTSD were identified in 25.2% of veterans, as assessed by the Mississippi PTSD Scale. According to the Spielberger–Khanin questionnaire, veterans with subclinical PTSD exhibited a moderate level of situational (44.96 ± 6.39 points) and personal anxiety (44.14 ± 5.49 points), which were significantly higher than those observed in the control group (29.87 ± 6.50, p2 &lt; 0.001, 36.13 ± 6.82, p2 = 0.003). Furthermore, based on the BDI, these veterans demonstrated an elevated level of depression (13.32 ± 1.36) in comparison to veterans without PTSD (8.61 ± 0.65, p &lt; 0.001) and the control group (4.06 ± 0.75, p &lt; 0.0001). The findings indicate that veterans exhibiting a high level of PTSD are characterized by a more pronounced manifestation of psychopathological indicators, as assessed by the SCL-90-R questionnaire. Compared to the control group, veterans exhibiting PTSD symptoms were found to have a comorbidity with somatic diseases: stage 3 hypertension in 45.2% vs. 21.3% (p2 &lt; 0.001), coronary heart disease in 45.5% vs. 13.4% (p2 &lt; 0.001), and type 2 diabetes mellitus in 20.3% vs. 6.1% (p2 = 0.001). Consequently, Afghan war veterans should be regarded as a high-risk group for cardiovascular diseases (including hypertension and coronary heart disease), cerebrovascular diseases, and mental health disorders. Accordingly, a comprehensive approach is necessary to identify PTSD symptoms alongside concomitant anxiety–depressive disorders and somatic diseases in individuals who have experienced traumatic events.

ICU patients exhibit a high incidence of post-traumatic stress disorder (PTSD). During treatment, procedural pain (e.g., suctioning, ventilator asynchrony) and communication barriers can trigger significant stress responses, exacerbating feelings of fear and helplessness, ultimately contributing to PTSD post-extubation. Current research predominantly relies on cross-sectional studies, failing to capture the dynamic progression of PTSD. As recovery evolves, patients' psychological and physical states continuously change, necessitating adaptive intervention strategies. There is an urgent need for longitudinal studies to elucidate PTSD development trajectories, clinical characteristics, and risk factors. However, research on the psychological recovery pathways of post-ICU patients remains scarce. This study aimed to identify the heterogeneous developmental trajectories of PTSD in ICU patients receiving mechanical ventilation within 6 months post-extubation and to analyze relevant factors across trajectory subgroups. From July 2023 to June 2024, a consecutive sampling method was employed to select mechanically ventilated patients admitted to the ICU of a tertiary hospital in Zunyi, China. At 7 days post-extubation (T0), baseline assessments were conducted using the following instruments: a general information questionnaire, the Impact of Event Scale-Revised (IES-R), the Hospital Anxiety and Depression Scale (HADS), the Simplified Coping Style Questionnaire (SCSQ), the short-form Chinese version of the Eysenck Personality Questionnaire-Revised (EPQ-RSC), and the Perceived Social Support Scale (PSSS). Follow-up assessments were performed at 1 month (T1), 3 months (T2), and 6 months (T3) post-extubation using the IES-R. Data were analyzed using Mplus 8.3 and SPSS 29.0. Prospective longitudinal study. Among 204 completed cases (89.1% retention), four trajectories emerged: high-risk deterioration (6.9%), high-risk improvement (27.2%), medium-risk maintenance (14.3%), and low-risk improvement (51.6%). Lower education, prolonged hospitalization, delayed ICU discharge post-extubation, and baseline anxiety independently predicted adverse trajectories (P < 0.05). PTSD trajectories in mechanically ventilated ICU patients exhibit significant heterogeneity. Clinicians should prioritize screening high-risk subgroups (e.g., less-educated patients, extended hospitalization) for early PTSD intervention to enhance recovery outcomes. Targeted PTSD monitoring and psychological support are recommended for at-risk populations to mitigate long-term mental health burdens.

Posttraumatic stress disorder (PTSD) is prevalent among veterans and evidence-based treatments for PTSD are widely available in the Veterans Health Administration. However, rates of treatment seeking for PTSD remain low, due in part to knowledge gaps, perceived treatment readiness, shame/stigma, pride in self-reliance, and trauma-related avoidance (Zinzow et al., 2012). AboutFace is an online peer-based intervention that was developed to overcome many of these barriers to service seeking. The current clinical trial compared the efficacy of AboutFace to a psychoeducational brochure that addressed stigma and PTSD treatment engagement among veterans recommended for PTSD treatment. A total of N = 330 veterans who had presented for an intake at a PTSD specialty clinic were randomized to either AboutFace (n = 165) or a psychoeducational brochure condition (n = 165) and assessed across primary outcomes of treatment engagement and secondary measures of stigma/attitudes about treatment seeking and PTSD, depression, and quality of life at baseline and at 1, 3, and 6 months. In the intention-to-treat sample, there were no statistically significant group differences in outcomes. However, due to a large percentage of noncompliance in the AboutFace group, we considered "as treated" analysis to further quantify the effects of exposure to the intervention. These analyses revealed that participants who accessed AboutFace for at least 15 min were significantly more likely to initiate treatment, initiated treatment sooner, and completed more therapy sessions than those who did not. Study data support the potential benefit of AboutFace as a brief intervention for increasing PTSD treatment initiation. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

The research on posttraumatic stress disorder and psychosis has now shown that these experiences can be bidirectional and actually potentiate each other. This scientific knowledge provides the field invaluable insight about points of prevention for either condition so that the risk for onset of the other mental health challenge does not occur, as well as diverse information for when the experiences are fully comorbid. In this article, a conceptual model is provided outlining practical conceptual and clinical applications. By using an innovative conceptual model, this article provides more insight about understanding and using the literature we know to inform prevention of co-occurrence and a diverse approach when both disorders are present in comorbidity, actually potentiating each other, and how to then address the situation holistically, rather than in silos. Using the innovative conceptual model, this article is able to help systems and providers move toward more effective treatment of the bidirectionality of posttraumatic stress disorder and psychosis holistically and equally rather than treating either of the conditions solely, in silos, or treating one condition over the other, as this is a risk that is reductionistic and negates the true capabilities of our clinical interventions. Practical clinical applications are provided as part of this conceptual piece. This conceptual model is innovative as common practice in many settings is to still prioritize one diagnosis, and this failure in treatment falls short of adequately targeting every element that makes up the complexity of experience for individuals who experience comorbid posttraumatic stress disorder and psychosis. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Traumatic brain injury (TBI) is associated with a variety of adverse health outcomes that display complex behavior over time. The objective of this study was to investigate both the early and late health impacts of TBI within a single framework. This study evaluated TBI associations among a cohort of post-9/11 Veterans with TBI documented between 2008 and 2017 in Veteran Health Administration (VHA) records. The cohort included 108,408 post-9/11 Veterans with any history of TBI documentation between 2008-2017 who were demographically matched with 108,408 TBI negative controls. Interrupted time series (ITS) models were used to fit the prevalence of comorbidities over time (±6 years from index date, i.e., date of first TBI). Three ITS measures were modeled for each comorbidity: 1) The incidence rate (IR) in the month of TBI index date, 2) The incidence rate ratio (IRR) between TBI and control groups in the month of index date, and 3) Long-term changes in year-over-year diagnosis rates, i.e., the annual incidence rate difference (IRD) before vs. after index date. Overall, TBI was associated with conditions related to somatic, cognitive, and psychological outcomes including headache, cognitive dysfunction, and PTSD. Neurological events were found to be elevated within the month of TBI documentation. Conditions with the largest IR were post-traumatic stress disorder (PTSD) (+29%, p < 0.001), headache (+22%, p < 0.001), and adjustment disorder (+22%, p < 0.001). Conditions with the highest IRR across TBI and control groups were cognitive dysfunction (474, p < 0.001), vestibular dysfunction (137, p < 0.001), and stroke (72, p < 0.001). Long term, the conditions with the highest IRD were substance use disorders (p < 0.001) and mental health conditions (p < 0.001). This work demonstrates how ITS modeling can help bridge traditional divides between early and late paradigms of TBI investigation to help inform research and care for Veterans living with TBI.

Public safety personnel (PSP) are likely to encounter multiple traumatic events and are thus more likely to develop posttraumatic stress disorder than the general population. It is important, then, to identify modifiable factors that increase the risk for posttraumatic stress disorder so that preventative treatments may be developed. Anxiety sensitivity (AS; the fear of physiological arousal sensations) has been identified as one such potential modifiable risk factor. However, research on the longitudinal, reciprocal association between AS and posttraumatic stress symptoms (PTSS) in those experiencing multiple traumas is limited. The aim of the present study was to investigate the association between AS and PTSS in PSP over the course of 1 year. PSP (N = 272) recruited via social media completed self-report measures of PTSS, trauma exposure, and AS at baseline, 6 months, and 1 year. Cross-lagged panel analysis did not reveal cross-lagged associations between AS and PTSS. Instead, only Wave 2 trauma exposure negatively predicted Wave 3 PTSS. Findings may be due to strong autoregressive associations (e.g., baseline PTSS predicting future PTSS) or may indicate that the association between AS and PTSS is more difficult to disentangle in populations that have already experienced multiple traumatic events. Future research should investigate this association among PSP who have yet to be exposed to potentially traumatic events to further elucidate whether AS is a risk factor worth intervention (or not) in this population. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Abstract Objective This study sought to evaluate the efficacy of Mindfulness-based Stress Reduction (MBSR) on symptoms of posttraumatic stress, depression, anxiety, and perceived stress and quality of life in unstably-housed women undergoing substance use disorder (SUD) treatment. Despite the potential for MBSR to be a helpful adjunct to ongoing care, prior research on the benefit of MBSR in this population is limited. Method Participants were 156 unstably-housed women residing in a state-funded residential SUD treatment program. Using a community-engaged approach, we conducted an open-label, cluster-based clinical trial. Clusters of participants were assigned to 8-week, 9-session MBSR or Health Promotion Attention Control (HP Control) interventions. Participants were evaluated at Time 1 (T1, baseline), Time 2 (T2, immediately post-intervention), and Time 3 (T3, 6-months post-baseline). Mixed-effects modeling examined group-by-time effects on primary (posttraumatic stress) and secondary (depression, anxiety, quality of life, perceived stress) outcomes. The trial was registered on ClincialTrials.gov. Results Posttraumatic stress symptoms improved from T1 to T2 and T3 ( p -values &lt; 0.001); however, MBSR and HP groups did not differ significantly ( p -values &gt; 0.05). Depression also improved over time, with significant between-group differences. Participants reported lower depression at T2 and T3 ( p -values &lt; 0.05); MBSR participants reported significantly greater improvements at T2 ( contrast = -3.57, p = 0.008, 95% CI, -6.23, -0.91) and T3 ( contrast = -5.65, p &lt; 0.001, 95% CI, -8.68, -2.63) compared to HP participants. Anxiety similarly improved over time: MBSR compared to HP participants reported lower anxiety at T3 ( contrast = -3.74, p = 0.007, 95% CI, -6.44, -1.04). Quality of life and perceived stress improved from T1 to T2 and T3; between-group differences were significant ( p -values &lt; 0.05). Small to medium effect sizes were consistently indicated. Conclusions MBSR-based interventions may help ameliorate comorbidities and improve quality of life in unstably-housed women recovering from trauma and SUD. Preregistration Study design and proposed analyses were preregistered on ClinicalTrials.gov (NCT04605198).

Purpose Barriers to accessing healthcare exist for refugees, suggesting the need for culturally appropriate interventions such as peer-delivered treatment. There is limited research regarding the effectiveness of peer-led interventions, thus this systematic review aims to investigate whether peer-to-peer psychological interventions improve trauma-related outcomes, common mental health problems, and functioning and wellbeing for refugees in resettled countries. This review therefore will allow for a greater understanding of the efficacy of peer-led interventions through systematically reviewing the available quantitative findings. Design/methodology/approach A PRISMA protocol was followed to conduct a systematic review. Four databases were searched (PsychINFO, Medline, CINAHL, Web of Science) for peer-reviewed research studies published in English from 2012–2022. Studies were included if they had a focus on peer-to-peer interventions targeting refugee mental health in resettled countries. Findings Of an initial 732 studies retrieved, 10 met the inclusion criteria for this review. Results indicated that peer-to-peer interventions improved posttraumatic growth, posttraumatic stress disorder, depression, anxiety, and psychological distress. Equally, some results were suggestive of improving functioning and wellbeing. Originality/value This review showed the evidence has generally supported the use of peer-delivered interventions for refugees in resettled countries. Thus, the results of this review indicate that peer-to-peer interventions could be offered within clinical practice to support and improve mental health, functioning and wellbeing.

Sensory balance is the individual's ability to regulate internal and external sensory stimuli to remain in a functional and balanced state. This study aims to explore in depth the experiences of psychiatric nurses caring for trauma victims in building sensory balance and well-being. Psychiatric nurses caring for trauma victims may be constantly exposed to intense sensory stimuli such as yelling and agitation. It is known that post-traumatic stress disorder and burnout are seen in nurses caring for these individuals; however, it is noteworthy that studies on how this process is reflected sensoryly in individuals are limited. Snowball sampling method was used in this qualitative phenomenological study. In-depth interviews were conducted with 14 volunteer psychiatric nurses caring for trauma victims. Data were collected using a semi-structured interview form and analyzed using Colaizzi's method. COREQ guidelines were adhered to throughout the research process. Four categories and a total of eight themes were obtained from the in-depth interviews. "Traces of Traumatic Contact, Emotional Armor and Inner Distance, Transformation through Exhaustion, Institutional Silence and Seeking Solidarity". This study shows that psychiatric nurses caring for trauma victims are both professionally and individually traumatized and face the risk of losing their identity. It has also been found that nurses withdraw both sensorially and emotionally and experience burnout. But in some cases this process transforms into the development of awareness and maturity. It was also found that despite adverse working conditions, contact with nature, silence and collegial solidarity played a protective role in rebuilding well-being. This study addresses in depth the sensory, emotional and identity impacts experienced by psychiatric nurses caring for trauma victims and draws attention to the effects of these conditions on the process of well-being construction. The results of the study provide important points for the development of education, self-care and institutional support mechanisms to support nurses' well-being.

Dissociation is a widespread phenomenon with significant mental health implications. The 20-item Dissociative Symptoms Scale (Carlson et al., 2018) was developed to measure moderately severe levels of dissociation across a broad range of clinical populations. The factor structure of the Dissociative Symptoms Scale comprises four domains: Depersonalization/Derealization, Gaps in Awareness and Memory, Cognitive-Behavioral Reexperiencing, and Sensory Misperceptions. In this article, we present a German version of the Dissociative Symptoms Scale (G-DSS) and examine the psychometric properties of scores on the G-DSS. Across two studies (Ntotal = 257) involving clinical samples primarily composed of individuals with depressive disorders, borderline personality disorder, and posttraumatic stress disorder, we demonstrate that G-DSS scores mostly align with the expected four-factor structure. In addition, G-DSS scores demonstrated adequate internal consistency (ω ≥ .76 for subscales), strong convergent validity with large correlations to scores on other dissociation measures, good discriminant validity with small or nonsignificant correlations to scores on personality facets, and good concurrent validity with positive correlations to scores on psychopathology indicators. We conclude that scores on the G-DSS are reliable and valid for assessing dissociative symptoms in clinical populations similar to the samples studied, which can enhance our understanding of dissociation's structure and clinical implications. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

Effect of Social Support on Suicide Risk among Posttraumatic Stress Disorder, Depressive, and Comorbid Symptom Groups in Elderly Living Alone in Korea

Psychiatric comorbidities with alcohol use disorder increase the risk of alcohol abuse and relapse. However, updated epidemiologic trends of comorbid psychiatric disorders in patients with alcohol-associated liver disease (ALD) remain limited. We aim to investigate the trends of prevalence of psychiatric comorbidities among those with ALD. This population-level cohort study used TriNetX data from over 113 million U.S. patients to assess trends in nine psychiatric disorders from 2015 to 2023 among individuals with ALD, stratified by cirrhosis status and age. In addition, we also compared the trends between patients with ALD and non-ALD chronic liver disease (CLD). Joinpoint regression analyses evaluated temporal trends using annual percentage changes (APC) and average annual percentage changes (AAPC) to identify significant inflection points over the study period. We observed significant increases in the prevalence of major depressive disorder (MDD), anxiety, and post-traumatic stress disorder, while schizophrenia and psychotic disorders declined in both ALD with and without cirrhosis groups. In individuals with ALD cirrhosis, schizophrenia and psychotic disorders declined at a greater rate than those without cirrhosis. Stratifying by age, we found older individuals with ALD have a rising trend in seven out of nine psychiatric comorbidities and had a greater increase compared to younger individuals, particularly in MDD, anxiety, and bipolar disorder. Patients with ALD without cirrhosis have the highest psychiatric comorbidity rates. However, trends of prevalence are rising significantly among those with ALD cirrhosis and older adults, highlighting the urgent need for targeted mental health interventions in this vulnerable population.