Trauma Survivors Research Articles

Trauma as Cultural Capital: A Critical Feminist Theory of Trauma Discourse

Abstract This essay theorizes a problem for feminism posed by a particular form of trauma discourse. Feminists have played an important role in developing cultural and clinical conceptions of trauma, but one result of the destigmatization of trauma has been that trauma discourse is sometimes used as a form of cultural capital to reinforce existing hierarchies. In a novel application of Pierre Bourdieu's theory of distinction, we show how, when instrumentalized as cultural capital, trauma discourse can be used to reinforce patriarchy and other systems of oppression. We trace a critical feminist history of the struggle to understand and treat trauma. Using examples from contemporary US popular culture, we illustrate the appropriation of trauma discourse to entrench existing structures of gender, class, and racial oppression. First, the misuse of trauma discourse as cultural capital can encourage the instrumental use of trauma claims for cultural power, ultimately reinforcing patriarchy. Second, it might erode the legitimacy of trauma, a conceptual tool pioneered by feminists and still essential to their political claims. This discussion has important implications for not only mental health practitioners and trauma survivors but also feminist theorists, trauma studies scholars, and those interested in deconstructing structural injustice and relations of inequality.

Childhood Maltreatment and Amygdala-Mediated Anxiety and Posttraumatic Stress Following Adult Trauma

BackgroundChildhood abuse (physical, emotional, and sexual) is associated with aberrant connectivity of the amygdala, a key threat-processing region. Heightened amygdala activity also predicts adult anxiety and posttraumatic stress disorder (PTSD) symptoms, as do experiences of childhood abuse. The current study explored whether amygdala resting-state functional connectivity may explain the relationship between childhood abuse and anxiety and PTSD symptoms following trauma exposure in adults. MethodsTwo weeks posttrauma, adult trauma survivors (n = 152, mean age [SD] = 32.61 [10.35] years; women = 57.2%) completed the Childhood Trauma Questionnaire and underwent resting-state functional magnetic resonance imaging. PTSD and anxiety symptoms were assessed 6 months posttrauma. Seed-to-voxel analyses evaluated the association between childhood abuse and amygdala resting-state functional connectivity. A mediation model evaluated the potential mediating role of amygdala connectivity in the relationship between childhood abuse and posttrauma anxiety and PTSD. ResultsChildhood abuse was associated with increased amygdala connectivity with the precuneus while covarying for age, gender, childhood neglect, and baseline PTSD symptoms. Amygdala-precuneus resting-state functional connectivity was a significant mediator of the effect of childhood abuse on anxiety symptoms 6 months posttrauma (B = 0.065; 95% CI, 0.013–0.130; SE = 0.030), but not PTSD. A secondary mediation analysis investigating depression as an outcome was not significant. ConclusionsAmygdala-precuneus connectivity may be an underlying neural mechanism by which childhood abuse increases risk for anxiety following adult trauma. Specifically, this heightened connectivity may reflect attentional vigilance for threat or a tendency toward negative self-referential thoughts. Findings suggest that childhood abuse may contribute to longstanding upregulation of attentional vigilance circuits, which makes one vulnerable to anxiety-related symptoms in adulthood.

The Value of Student Voice and Choice: A Guide for Trauma-Informed Participatory Action Research in the University Setting

Many college and university students live with the effects of trauma, and more research is needed around trauma-informed practices in higher education. It is important that this research represents the needs and interests of students and that it be conducted in a way that is appropriate and safe for trauma survivors. We describe the process of forming a vertically integrated, interdisciplinary Participatory Action Research (PAR) team of students and faculty dedicated to creating a trauma-informed learning environment on a university campus and argue that PAR and Trauma-Informed Care (TIC) practices provide important and complementary frameworks for inclusive, just, and community-responsive research. We describe how this research team embodied core PAR values of collaboration, incorporation of local knowledge, eclecticism and diversity, case orientation, emergent process, and linking scientific understanding to social action, along with the TIC commitments of trauma awareness, safety, choice and empowerment, and strengths-based orientation. We describe lessons learned by the team and provide recommendations for researchers who seek to incorporate both PAR and TIC principles into their work on trauma and education. Central lessons learned from this process highlighted the importance of 1) establishing and maintaining psychological safety, 2) speaking openly about trauma, and 3) privileging responsiveness to the difficulty of working with trauma while living through ongoing global stressors. Specific recommendations include 1) lead with values, 2) acknowledge and attend to context, 3) recognize that defining trauma is controversial, 4) model courageous conversations, 5) emphasize responsiveness and care, and 6) teach strategies for managing painful emotions.

Prevalence of posttraumatic stress disorder in orthopedic trauma patients and a call to implement the Injured Trauma Survivor Screen as a prospective screening protocol in the United States.

Posttraumatic stress disorder (PTSD) is prevalent and is associated with protracted recovery and worse outcomes after injury. This study compared PTSD prevalence using the PTSD checklist for DSM-5 (PCL-5) with the prevalence of PTSD risk using the Injured Trauma Survivor Screen (ITSS). Adult trauma patients at a level I trauma center were screened with the PCL-5 (sample 1) at follow-up visits or using the ITSS as inpatients (sample 2). Sample 1 (n=285) had significantly fewer patients with gunshot wounds than sample 2 (n=45) (8.1% vs. 22.2%, P=0.003), nonsignificantly fewer patients with a fall from a height (17.2% vs. 28.9%, P=0.06), and similar numbers of patients with motor vehicle collision (40.7% vs. 37.8%, P=0.07). Screening was performed at a mean of 154 days following injury for sample 1 versus 7.1 days in sample 2. The mean age of the patients in sample 1 was 45.4 years, and the mean age of those in sample 2 was 46.1 years. The two samples had similar proportions of female patients (38.2% vs. 40.0%, P=0.80). The positive screening rate was 18.9% in sample 1 and 40.0% in sample 2 (P=0.001). For specific mechanisms, the positive rates were as follows: motor vehicle collisions, 17.2% in sample 1 and 17.6% in sample 2 (P>0.999); fall from height, 12.2% in sample 1 and 30.8% in sample 2 (P=0.20); and gunshot wounds, 39.1% in sample 1 and 80.0% in sample 2 (P=0.06). The ITSS was obtained earlier than PCL-5 and may identify PTSD in more orthopedic trauma patients. Differences in the frequency of PTSD may also be related to the screening tool itself, or underlying patient risk factors, such as mechanism of injury, or mental or social health.

Trauma, Emotional Regulation, and Coping Styles in Individuals with and without Probable Dissociative Disorders in Hong Kong

ABSTRACT Previous studies showed that dissociation and dissociative disorders (DDs) are prevalent and are associated with considerable individual and social consequences. There are ongoing debates regarding whether dissociation is a response to betrayal trauma across cultures and whether dissociation can be explained by maladaptive coping. Additionally, little is known about the clinical features of individuals with DDs in the Chinese context. This study aimed to investigate the relationship between trauma, emotional regulation, coping, and dissociation. We analyzed baseline data from a randomized controlled trial (N = 101). Participants with dissociative symptoms in Hong Kong completed self-report assessments. Structured interviews were also conducted subsequently. Participants with probable DDs reported more traumatic events (p = .009 to .017) and exhibited significantly higher levels of dysfunctional coping (p < .001) compared to those who reported dissociative symptoms but did not have a DD. Dissociative symptoms were more strongly associated with betrayal trauma than with non-betrayal trauma. Among different emotion regulation and coping strategies, dysfunctional coping was the only significant factor associated with dissociative symptoms (β = .309, p = .003). Dysfunctional coping was a statistically significant mediator that may explain the relationship between betrayal trauma and dissociative symptoms. Although other mediation paths are also possible and further longitudinal studies are required, our findings highlight the strong link between dysfunctional coping and dissociative symptoms and suggest that coping skills training should be incorporated into interventions for betrayal trauma survivors with dissociative symptoms. Additionally, this study provides evidence for the cross-cultural validity of the betrayal trauma theory. Further studies, however, are required.

An evaluation of survive and thrive: a 10-week group psychoeducational course for adult interpersonal trauma survivors in Scotland

ABSTRACT Emerging evidence supports a phased approach to trauma treatment, including manualised group-based interventions, to facilitate symptom reduction resulting from complex trauma sequelae. This study investigates the efficacy of Survive and Thrive, a 10-week group psychoeducational course for adult survivors of interpersonal trauma. Between August 2019 and February 2022, participants were enrolled on the course. The Clinical Outcomes in Routine Evaluation—Outcome Measure (CORE-OM) and Difficulties in Emotion Regulation Scale—Short Form (DERS-SF) were administered pre-intervention and immediately post-intervention. In addition, thematic analysis was applied to qualitative feedback. Results revealed significant reductions in CORE-OM and DERS-SF scores post-intervention, with minimal variability in scores attributed to group delivery (either face-to-face or online). The thematic analysis demonstrated that normalising trauma symptoms and providing coping skills positively impacted participants’ experiences. At the same time, the breadth and nature of the content were observed to be an occasional barrier to engagement. In summary, this study proposes that group-based psychoeducational interventions are generally effective for those with mild-to-moderate symptoms of complex trauma. However, further evidence is needed to offer more nuanced recommendations for identifying individuals who may benefit the most from these interventions.

Finding Her Voice Through Scriptotherapy: Marina Nemat’s Journey of Reclaiming Subjectivity after Trauma

Scriptotherapy, a form of writing therapy proposed by Suzette Henke, is gaining recognition in literary research but remains underrepresented in studies of Iranian diasporic literature, which often focus on identity crisis and Orientalist discourse. This paper explores the application of scriptotherapy in Marina Nemat’s memoirs, Prisoner of Tehran (2007) and After Tehran (2010), revealing the significant role of therapeutic writing in reclaiming subjectivity fragmented by trauma. As a teenager advocating for legislative reformation in 1980s Iran, Nemat faced legal consequences and two years of imprisonment, leaving enduring psychological wounds. Years after her release, disturbing memories and enduring silence compelled Nemat to utilize writing for catharsis. Through writing, Nemat confronts and transcends her haunting past, embarking on a transformative journey of healing and reclaiming her voice within an intersubjective realm. This paper emphasizes the importance of an audience as witnesses to trauma and discusses obstacles faced by women who bear witness, particularly when their testimonies involve institutional abuse and patriarchal constraints. This analysis demonstrates scriptotherapy’s transformative potential, empowering trauma survivors like Nemat to heal from the wounds of their traumatic pasts, ultimately enabling them to regain a profound sense of subjectivity, despite doubts about the authenticity of their narratives.

'My child could have died': counterfactual thoughts and psychological distress in parents of trauma survivors.

Background: After exposure to a potentially traumatic event, survivors may experience thoughts about 'what could have happened', referred to as counterfactual thoughts (CFTs). CFTs have been found to have a negative impact on survivors' mental health. This is the first study to investigate whether parents of trauma survivors experience CFTs and the association with psychological distress in this group.Objective: The main aim of the present study is to investigate CFTs in parents of trauma survivors and the relationship between the frequency and vividness of CFTs and psychological distress.Method: The participants (N = 310, 191 females) were parents of the youths targeted in the terror attack on Utøya island, Norway, in 2011. Frequency and vividness of CFTs, posttraumatic stress reactions (PTSR), and symptoms of anxiety and depression were measured 8.5-9 years post-terror.Results: The majority of the parents (74%) reported having experienced CFTs at some time point since the attack. For almost one-third of the parents, CFTs were still present more than eight years after the attack. Higher frequency and vividness of CFTs were uniquely associated with higher levels of PTSR, anxiety, and depression.Conclusion: The present findings suggest that frequent and vivid CFTs may contribute to mental health problems in parents of trauma survivors and should be addressed in therapy.

Digital Trauma Healing Adherence Intervention Using Expert System Method and Social Media Participation with Trauma Scale Level-Based Analysis and Hobby Analysis to Improve Self-Efficacy

Purpose: The purpose of this study was to help survivors have access to self-care and control over the digital intervention process by utilizing mobile system technology to increase their self-efficacy scores. Methods: Using the validated IES-R questionnaire scoring system, the level of trauma was determined initially. Later, the knowledge base for the expert system was built using hobby analysis and social media approaches combined with expert analysis. Next, efficacy scores were calculated using the General Self-Efficacy Scale (GSES) technique, which compares the survivor's self-efficacy rating before and after treatment. Results and Conclusion: 40 respondents who experienced the trauma of the Mount Sinabung eruption in North Sumatra Province and the earthquake in Maluku Province, Indonesia, participated in the application testing. At the 5% significance level, the findings were significant. This shows how effective "DITRAHEAL" is in helping survivors of disaster trauma in the Maluku and Tanah Karo regions. Research implications: It is possible to explore the possibility of establishing screening techniques that work effectively with technology so that digital medicine can reach a wider audience. Originality/value: This research provides a digital trauma healing intervention called the "DITRAHEAL" system. The expert system is used to determine the best treatment according to the Research and Development method being developed.

Can Baseline Patient Clinical and Demographic Characteristics Predict Response to Early Posttraumatic Stress Disorder Interventions After Physical Injury?

Objective A growing evidence base supports stepped care interventions for the early treatment of posttraumatic stress disorder (PTSD) after physical injury. Few investigations have examined the characteristics of patients who do and do not respond to these interventions. Method This investigation was a secondary analysis that used previously collected data from three randomized clinical trials of stepped care interventions (patient N = 498). The study hypothesized that a subgroup of patients would manifest persistent PTSD symptoms regardless of randomization to intervention or control conditions, and that characteristics present at the time of baseline injury hospitalization could distinguish patients who would develop persistent symptoms from potential treatment responders. Regression analyses identified baseline patient clinical and demographic characteristics that were associated with persistent PTSD symptoms over the 6-months post-injury. Additional analyses identified treatment attributes of intervention patients who were and were not likely to demonstrate persistent symptoms. Results A substantial subgroup of patients (n = 222, 44.6%) demonstrated persistent PTSD symptoms over time. Greater numbers of pre-injury trauma, pre-injury PTSD symptoms, elevated early post-injury PTSD symptoms, unemployment, and non-White race identified patients with persistent symptoms. Patients with ≥3 of these baseline risk characteristics demonstrated diminished treatment responses when compared to patients with <3 characteristics. Intervention patients with ≥3 risk characteristics were less likely to engage in treatment and required greater amounts of interventionist time. Conclusions Injured trauma survivors have readily identifiable characteristics at the time of hospitalization that can distinguish responders to PTSD stepped care interventions versus patients who may be treatment refractory.

A comparison of the psychometric properties of a person-administered vs. automated screening tool for posttraumatic stress disorder (PTSD) in traumatically injured patients

BackgroundThe American College of Surgeons Committee on Trauma (ACS-CoT) mandated that trauma centers have mental health screening and referral protocols in place by 2023. This study compares the Injured Trauma Survivor Screen (ITSS) and the Automated Electronic Medical Record (EMR) Screen to assess their performance in predicting risk for posttraumatic stress disorder (PTSD) within the same sample of trauma patients to inform trauma centers’ decision when selecting a tool to best fit their current clinical practice. MethodsThis was a secondary analysis of three prospective cohort studies of traumatically injured patients (N = 255). The ITSS and Automated EMR Screen were compared using receiver operating characteristic curves to predict risk of subsequent PTSD development. PTSD diagnosis at 6-month follow-up was assessed using the Clinician Administered PTSD Scale for DSM-5. ResultsJust over half the sample screened positive on the ITSS (57.7%), while 67.8% screened positive on the Automated EMR Screen. The area under the curve (AUC) for the two screens was not significantly different (ITSS AUC = 0.745 versus Automated EMR Screen AUC = 0.694, p = 0.21), similar performance in PTSD risk predication within the same general trauma population. The ITSS and Automated EMR Screen had similar sensitivities (86.5%, 89.2%), and specificities (52.5%, 40.9%) respectively at their recommended cut-off points. ConclusionBoth screens are psychometrically comparable. Therefore, trauma centers considering screening tools for PTSD risk to comply with the ACS-CoT 2023 mandate should consider their local resources and patient population. Regardless of screen selection, screening must be accompanied by a referral process to address the identified risk.

The Narrative of Trauma in Art spiegelman’s Maus

This article explores how Art Spiegelman’s Maus (1986-1991) challenges the humanist concept of the unified self, proposing instead that the post-war self is fragmented and split. This fragmentation is particularly examined through the lens of Holocaust survivors in Maus, showcasing how extreme experiences during and after the Second World War cause the self to fracture and even disintegrate. The article argues that storytelling and narration serve as a crucial tool for the trauma survivors to navigate and reconcile the fractured aspects of their self. Through storytelling, the protagonist finds a means of survival, by finding a language to articulate his otherwise inexpressible and ineffable experiences and memories. It highlights the fragmentation of the human psyche as a direct consequence of Holocaust trauma and similar traumatic experiences, examining how narrative acts as a medium for the protagonist to deal with his traumas. The novel offers insights into the complexities of the new post-war self, the enduring scars of trauma and the potential of narrative in coping with trauma, providing a deeper understanding of the fragmented self in the context of Holocaust trauma.

From the bottom to the sublime spirituality in the recovery process from PTSD

ABSTRACT For those who have suffered from trauma and are struggling with PTSD, finding healing through spiritual means can be a meaningful experience for trauma survivors, caregivers, and their loved ones. While much of the current research on PTSD recovery focuses on psychological, physiological, social, and cognitive factors, the spiritual dimension is often overlooked despite its increasing recognition in recent years. This study explores the experiences of individuals who attribute their recovery from PTSD to spirituality, with participants from diverse backgrounds of religion, culture, nationality, and level of faith who have experienced various traumas and recovery methods. The study identifies four stages of recovery: disappointment and disconnection, rock bottom, a leap into spirituality, and mutual forgiveness leading to reconnection. The role of powerlessness in the recovery process is also examined, and a model for a spiritually-based approach to recovery containing the four phases and three turning points is proposed.

Children of trauma survivors: Influences of parental posttraumatic stress and child-perceived parenting

BackgroundResearch has established a negative association between parental posttraumatic stress symptoms (PTSS), including subthreshold symptoms, and child physical and behavioral health outcomes. Such intergenerational transmission of risk has multiple possible mechanisms, including lack of positive parenting, increased negative parenting, shared environmental and contextual risks, and potential biological components such as shared genetics or even transmission of epigenetic risk. MethodThis study examined 93 parent-child dyads (n = 171 participants total) from a mixed Urban-Suburban US metropolitan area to investigate the relations between parental PTSS and child-perceived parenting and child PTSS. We sought to examine interactions between parental PTSS and parenting on child PTSS. ResultsWe found an association between parent and child PTSS, consistent with prior literature showing increased risk for children of trauma survivors. Interestingly, we found effects of positive parenting on diminished child PTSS symptoms only in parents without PTSS, whereas the effect of positive parenting on buffering child symptoms was absent in parents with PTSS.Limitations.The present findings are tempered by the use of self-report data to assess parent and child PTSS, which is not as reliable as clinician assessment of symptoms. Further, the use of survey data limits what is known about the extent of trauma exposure in parents and children, and different measures were used to assess PTSS in parents and kids, which limits comparability of these reported symptoms. DiscussionLimitations notwithstanding, findings suggest joint attention paid to parenting practices and to a parent's recovery, even from subthreshold symptoms of PTSS, as two different but important ways to support trauma survivor parents in their efforts to most optimally parent and protect their children from intergenerational risk.

Health-related quality of life in the year following road trauma: Longitudinal analysis using piecewise latent curve modeling

BackgroundRoad trauma (RT) survivors have reduced health-related quality of life (HRQoL). We identified phases and predictors of HRQoL change following RT injury. MethodsIn a prospective cohort study of 1480 Canadian RT survivors aged 16 to 103 years (July 2018 – March 2020), physical component (PCS) and mental component (MCS) summary scores from the SF-12v2 were measured pre-injury and 2, 4, 6, and 12 months post-injury and their trajectories were analyzed with piecewise latent growth curve modeling. Potential predictors of HRQoL changes included sociodemographic, psychological, medical, and trauma-related factors. ResultsPCS and MCS scores worsened from pre-injury to 2-months (phase 1) and then improved (phase 2), but never regained baseline values. Older age, somatic symptoms and pain catastrophizing were associated with lower preinjury PCS and MCS scores. Psychological distress was associated with lower preinjury MCS scores and higher preinjury PCS scores. Phase 1 PCS scores decreased most in females, participants with fewer pre-injury somatic symptoms and those without expectations for fast recovery. Phase 1 MCS decreases were associated with younger age, female sex, living alone, lower psychological distress, lack of expectation for fast recovery and higher injury pain. In phase 2, MCS improved most in participants not using recreational drugs; PCS improved most in participants with higher education and longer recovery expectations. LimitationsThere may be recall bias with reporting pre-injury HRQoL. Selection bias is possible. ConclusionsMany factors influence HRQoL following RT. These findings may inform measures to minimize HRQoL reduction following RT and speed up subsequent recovery.

Twelve-month recovery following road trauma: Results from an inception cohort in Vancouver, Canada

BackgroundInjury-related disability following road trauma is a major public health concern. Unfortunately, outcome following road trauma and risk factors for poor recovery are inadequately studied, especially for road trauma survivors with minor injuries that do not require hospitalization. ObjectivesThis manuscript reports 12-month recovery outcomes for a large cohort of road trauma survivors. MethodsThis was a prospective, observational inception cohort study of 1,480 road trauma survivors recruited between July 2018 and March 2020 from 3 trauma centres in British Columbia, Canada. Participants were aged ≥16 years and arrived in a participating emergency department within 24 h of a motor vehicle collision. Data on baseline health and injury severity were collected from structured interviews and medical records. Outcome measures, including the SF-12, were collected during follow-up interviews at 2, 4, 6 and 12 months. Predictors of recovery outcomes were identified using Cox proportional hazards models and summarized using hazard ratios. ResultsOnly 42 % of participants self-reported full recovery and only 66 % reported a return to usual daily activities. Females, older individuals, pedestrians, and those who required hospital admission had a poorer recovery than other groups. Similar patterns were observed for the SF-12 physical component. For the SF-12 mental component, no significant differences were observed between participants admitted to hospital and those discharged home from the ED. Return to work was reported by 77 % of participants who had a paying job at baseline, with no significant differences between sex and age groups. ConclusionsIn a large cohort of road trauma survivors, under half self-reported full recovery one year after the injury. Poor mental health recovery was observed in both participants admitted to hospital and those discharged home from the ED. This finding may indicate a need for early intervention and continued mental health monitoring for all injured individuals, including for those with less serious injuries.

Improving access to evidence-based interventions for trauma-exposed adults in low- and middle-income countries.

In low- and middle-income countries (LMICs), the mental health consequences of trauma exposure pose a substantial personal, societal, and economic burden. Yet, the significant need for evidence-based mental health treatment remains largely unmet. To unlock the potential for mental health care for trauma survivors in lower-resource contexts, it is critical to map treatment barriers and identify strategies to improve access to evidence-based, culturally appropriate, and scalable interventions. This review, based on an International Society for Traumatic Stress (ISTSS) briefing paper, describes the treatment gap facing adults with traumatic stress in LMICs and identifies the barriers that contribute to this gap. We then highlight strategies for enhancing access to effective treatments for these populations, including task-sharing, the use of culturally adapted and multiproblem interventions, and digital tools to scale access to appropriate care. Finally, we offer recommendations for policymakers, researchers, and service providers to guide an agenda for action to close the treatment gap for trauma survivors in LMICs.

Trauma-Informed Evangelism: Cultivating Communities of Wounded Healers

Trauma-Informed Evangelism: Cultivating Communities of Wounded Healers

Trauma-Informed Evangelism: Cultivating Communities of Wounded Healers

Trauma-Informed Evangelism: Cultivating Communities of Wounded Healers

Disclosure of traumatic details and obsessive-compulsive contamination symptoms in sexual assault survivors.

Contamination concerns are common following sexual victimization and are associated with increased attentional bias and difficulty disengaging from contamination cues. While most survivors of sexual trauma disclose their experience to others, it is unclear whether disclosure increases feelings of contamination or whether, consistent with the fever model of disclosure, existing contamination-related distress increases the amount of content shared during disclosure, indicative of attentional bias toward contamination-inducing aspects of the trauma memory. Accordingly, the current study examined the directionality and relationships between contamination symptoms and content shared during sexual assault disclosure in 106 sexual assault survivors (76.4% women). Forced decision regression with subsequent independence test (RESIT) was used to identify directionality of relationships, and multivariate and linear regressions examined these proposed effects in the presence of assault and demographic characteristics. More severe contamination symptoms predicted greater sharing of details during sexual assault disclosure yet had no impact on sharing of emotions, cognitions, and beliefs during disclosures. Although RESIT suggested that contrary to other content domains, disclosure of social experiences may directionally predict contamination symptoms, this relationship did not retain statistical significance in a linear regression model. Findings support the fever model of disclosure and attentional bias theories regarding contamination-related stimuli, and suggest that survivors experiencing postassault contamination symptoms may be more likely fixate on the contamination-invoking details of the trauma memory when disclosing. Such fixation has the potential to interfere with typical treatment-related processes (e.g., habituation) and should be thoughtfully addressed to maximize treatment gains. (PsycInfo Database Record (c) 2024 APA, all rights reserved).