Military Veterans, public safety personnel (police, fire fighters, paramedics, and others), and frontline healthcare workers are at elevated risk of posttraumatic stress disorder (PTSD) due to trauma exposure. Multimodal motion-assisted memory desensitization and reconsolidation (3MDR) therapy is an innovative therapy for PTSD and trauma-related mental health concerns, originally developed for military members and Veterans. The purpose of this study was to extend evidence for the effectiveness of 3MDR in Canadian military Veterans and to test it with public safety personnel and frontline healthcare workers. This study is a longitudinal mixed-methods clinical trial. We examined 48 participants with PTSD from Alberta, Canada. Twenty-two participants had treatment-resistant PTSD. Participants were active military members or Veterans (n=17), public safety personnel (n=21), and/or healthcare workers (n=21). Participants received a 10- to 14-week course of 3MDR therapy. Quantitative data were collected pretreatment, at the end of treatment, and longitudinally at 3, 6, and 12months after completion of 3MDR. Data from 48 participants were analyzed. Data collected pre- and post-3MDR therapy showed both statistically and clinically significant reductions in symptom scores for PTSD (CAPS-5 clinical interview: 46.4±2.2 to 25.1±3.4, mean±standard error; PCL-5 questionnaire: 48.5±2.2 to 32.2±3.0), depression (PHQ-9: 14.3±1.0 to 9.8±1.0), anxiety (GAD-7: 12.2±0.9 to 8.3±0.9), and difficulties with life functioning (OQ-45: 92.0±3.9 to 77.3±4.4). These improvements were maintained through to 12months follow-up. Resilience (CD-RISC-25), which was assessed pre- and post-3MDR but not at follow-up, also showed significant improvements over the course of 3MDR therapy. All results survived multiple comparison correction. These results support the growing body of literature illustrating 3MDR as an effective treatment for military-related PTSD as well as PTSD-related mental health conditions in public safety personnel and healthcare workers. These results also extend the period of post-3MDR follow-up to 12months in a sample of Canadian 3MDR participants, from 6months follow-up in earlier Canadian 3MDR studies. ISRCTN Registry 11264368; http://www.isrctn.com/ISRCTN11264368. International Registered Report Identifier (IRRID): DERR1-10.2196/20620.

Sexual minority women, transgender people, and nonbinary (SMW/TNB) people experience disproportionately high rates of traumatic stressors (e.g., child abuse, sexual violence), which are associated with adverse trauma-related mental health outcomes, such as dissociation. SMW/TNB people also experience ongoing stressors related to their minoritized sexual and/or gender identities (e.g., discrimination). Dissociation has been associated with minority stressors in studies primarily using single-time point, cross-sectional approaches. Reliance on single-time point approaches may obscure how minority stressors and trauma-related outcomes, like dissociation, covary within individuals and unfold over time. We conducted a secondary analysis of data from a 14-day daily diary study with trauma-exposed SMW/TNB participants (N = 57) to examine whether variations in daily minority stressors were associated with same-day fluctuations in dissociation. Results indicated minority stressors and dissociation significantly covaried over the 14-day study period. Multilevel models showed that participants' reports of higher-than-average daily minority stressors were associated with same-day reports of higher-than-average dissociative symptoms, B = 0.24, 95% CI [0.07, 0.41], p =.007. Participants also reported small decreases in dissociation levels over the study period, B = -0.05, 95% CI [-0.08, -0.02], p =.004. The findings highlight the importance of considering the health impacts of consistent state elevations in dissociation associated with minority stressors for SMW/TNB people. Future time-varying approaches should investigate temporal sequencing of minority stressors and dissociation, assess whether minority stressors relate to dissociation independent of trauma exposure, and explore whether trauma exposure characteristics (e.g., identity-relatedness of trauma) moderate this association.

Refugee women in the United States face persistent barriers to maternal healthcare shaped by structural, sociocultural, and individual factors. Limited healthcare resources, transportation challenges, financial constraints, and complex health systems restrict timely and effective care. Sociocultural barriers such as limited cultural humility among providers, conflicts between medical and traditional practices, and miscommunication further deepen disparities. Trauma-related mental health conditions, language barriers, and fears of discrimination also hinder care at the individual level. Arizona's Refugee Women's Health Clinic exemplifies an effective, culturally grounded model for meeting refugee women's maternal health needs. Strong community networks, culturally responsive services, and targeted policy interventions serve as key facilitators to improve access. Recent policy shifts may further shape access to prenatal and postpartum care for lawfully present refugees and asylees. To close existing gaps, this commentary calls for extending Medicaid coverage beyond initial resettlement, strengthening provider cultural humility, investing in community-based infrastructure, and ensuring sustainable funding for community health workers. Advancing these strategies will promote equitable, culturally informed maternal care and improve outcomes for refugee women nationwide.

Introduction: The COVID-19 pandemic likely increased exposure to potentially traumatic events. A population of special interest is healthcare workers who cared for COVID-19 patients, as they were, especially during the peaks of the pandemic, exposed to groups of severely ill or dying patients under extreme care delivery circumstances. This review and meta-analysis estimate the pooled prevalence of mental health outcomes among healthcare workers exposed to these conditions. Methods: A systematic literature search was conducted using several databases: Embase, PubMed, PsycINFO, and PTSDPubs. Inclusion criteria focused on studies assessing work-related trauma exposure among healthcare workers during the pandemic and those reporting prevalence rates of trauma-related mental health outcomes (PTSD, anxiety, and depression). A multilevel meta-regression was used to calculate pooled prevalence rates and examine the impact of study characteristics on outcomes. Results: Eleven studies were included that assessed the mental health of healthcare workers who cared for severely ill or dying COVID-19 patients. The mean pooled prevalence of trauma-related mental health outcomes was 26.1%. There was no significant difference in pooled prevalence between outcome types (PTSD, anxiety, or depression). A significant difference was observed between the pooled prevalence from studies conducted in countries with a high Human Development Index (12.9%) compared to studies from countries with a very high Human Development Index (45.8%). Conclusion: A relatively high proportion of healthcare workers exhibit psychopathology following work-related exposure to the pandemic. This highlights the severe psychological toll of the pandemic on this professional group, who faced sustained exposure to stressful situations during the pandemic in exceedingly difficult circumstances. It is crucial to ensure early access to psychosocial support, such as organized peer support, to healthcare workers during major public health crises, especially during crises when traditional social support systems may be disrupted.

Mental health in professional emergency responders: A systematic review and best evidence synthesis of prevention programs for trauma-related mental health symptoms.

Refugee populations in Canada experience disproportionately high rates of trauma-related mental health conditions. We conducted 15 semi-structured interviews across six stakeholder groups to explore mental healthcare gaps. Findings reveal three major barriers: fragmented regulatory frameworks; unsustainable funding models; and failure to integrate end-user needs.

Trauma-Focused Cognitive Behavioral Therapy for Children and Parents.

Intimate partner violence in United States military veterans: Results from the National Health and Resilience in Veterans Study.

BackgroundThe Kurdistan region experienced a series of devastating events, such as the 1988 chemical attacks and the 2014 Yazidi genocide, which have had substantial impacts on the psychological and physical health of survivors.ObjectivesThis study evaluates the long-term mental health of individuals who were exposed to chemical gas, with a focus on the prevalence and severity of psychological symptoms and their associations with sociodemographic, clinical, and trauma-related factors.MethodsA total of 534 participants were recruited (300 women and 234 men). Data collection was completed in 7 months, from March to September 2023. All participants completed validated psychological assessments, including the PTSD Checklist for DSM-5 (PCL-5), Patient Health Questionnaire-15 (PHQ-15), and Hopkins Symptom Checklist-25 (HSCL-25). Multivariate General Linear Modeling (GLM) was performed, adjusting for trauma exposure to simultaneously assess the effects of demographic and clinical variables on multiple symptom domains.ResultsMost of the participants exhibited clinically significant symptoms, with 78.8% meeting the post-traumatic stress disorder (PTSD) threshold and 46.3% exhibiting comorbid symptoms across multiple domains. The GLM demonstrated that gender, trauma exposure, education level, and clinical factors were significantly associated with symptom severity across PTSD, somatic, and anxiety/depression symptoms (p < 0.001). The model explained up to 47% of variance in symptom outcomes. After adjusting for covariates, women showed higher symptom severity than men. Greater trauma exposure and lower education independently predicted increased symptoms.ConclusionThese findings highlight serious psychological and somatic effects among survivors and underscore the urgent need for targeted mental health interventions for those affected by chemical attacks, with particular attention to individuals with lower levels of education and socioeconomic status, while incorporating gender-sensitive approaches to address differential vulnerabilities.

Firefighters are exposed to a disproportionately high number of traumatic incidents and, thus, display elevated rates of trauma-related mental health disorders, with the reported average PTSD prevalence being 7.3% in firefighters vs 1.3-3.5% in the general populationOftentimes, conventional treatments demonstrate limited efficacy. Ketamine-assisted therapy (KAT) has recently arisen with promising long-term results. The experiences of six firefighters who had enrolled in but not begun the Roots to Thrive (RTT) KAT program was investigated. Interviews were conducted pre-treatment, and a thorough thematic analysis was performed. Four major themes were identified: (1) feeling stuck and reaching a breaking point, (2) stigma surrounding PTSD and the use of ketamine for treatment, (3) the importance of self-advocacy in navigating access to treatment, and (4) substantial financial and logistical barriers. This study highlights the importance of system-wide changes necessary to support treatment-seeking individuals.

ABSTRACT Background: Exposure to traumatic events is common amongst children from refugee backgrounds. Given the restricted access of refugee children to formal specialist resources and disrupted parental support mechanisms in low- and middle-income countries (LMICs), teachers are increasingly expected to be the primary responders to the complex psychosocial needs of trauma-exposed refugee children. However, despite LMICs hosting over two-thirds of the world’s refugee children, our current knowledge of how teachers respond to these needs is predominantly drawn from studies conducted in well-resourced, high-income countries, which fails to capture the unique experiences of teachers in inadequately resourced schools in LMICs. Objective: We aimed to explore qualitatively the experiences of school teachers in responding to the mental health and psychosocial needs of trauma-exposed refugee students in resource-poor settings. Method: Semi-structured qualitative interviews were conducted with 30 teachers from eleven schools in socio-economically deprived communities in Iran. Data were analysed using thematic analysis. Results: Teachers expressed that establishing close relationships with refugee students works as a ‘strategy’ to identify the trauma-related mental health needs of this population. Almost all teachers strongly emphasised that achieving positive outcomes from their support efforts requires a collaborative home-school partnership, with refugee caregivers playing a fundamental role in this process. It was also described by teachers that a welcoming school climate facilitated refugee students’ sense of belonging and maximised their ability to offer support. Whereas schools were recognised as the most accessible place for disadvantaged refugee children to receive timely psychosocial support, teachers noted context-specific barriers, such as financial stress, that negatively influenced their capacity to continuously support refugee-background students. Conclusion: Our findings highlight the need to expand the evidence base to capture the unique experiences of LMIC refugees and those supporting them, and to develop contextually-culturally relevant training programmes to help teachers better respond to the unique needs of refugee students.

Previous studies showed that posttraumatic stress disorder (PTSD) and dissociation are common trauma-related mental health problems. This study examined their prevalence, long-term persistence, and association with depression among adolescents in the general population. We assessed trauma exposure, PTSD, dissociation, and depression in a sample of 1,359 secondary school students in China at two timepoints 1 year apart. Of all participants, 19.0% had either or both probable PTSD and dissociative symptoms at baseline; 52.1% of participants with probable depression presented with co-occurring trauma-related symptoms. The 1-year persistence rate for probable PTSD and dissociative symptoms was 47% and 36.1%, respectively. After controlling for demographic variables and baseline depressive symptoms, baseline PTSD symptoms significantly predicted depressive symptoms at follow-up (β = .208, p < .001). This study contributes to the limited literature on PTSD and dissociative symptoms in general samples of adolescents, providing important data regarding their prevalence, persistence, and association with depressive symptoms. The results also support the demoralization model. Trauma-related symptoms are prevalent among young people and are associated with more depressive symptoms over time. Early identification of PTSD and dissociation is important.

Professionals in emergency-focused environments are taught to prioritize emergencies over their own emotions and trained to suppress their own emotional reactions. High-risk professionals in a vertical social structure, such as police officers, military personnel, career firefighters, and perioperative nurses, also tend to develop an us-versus-them mentality with emotional distance from patients or civilians. This study explores emotional reactions of police officers, military personnel, firefighters, paramedics, and specialized nurses (emergency room nurses, operating room nurses, and intensive care nurses) to past and present potentially traumatic events. We aim to understand how a social environment that reinforces suppression of emotional reactions and fosters emotional distance from patients and civilians influences their emotional responses. We analyzed fieldnotes from ethnographical research, encompassing 332 h of observations and 71 in-depth interviews with professionals from eight occupational groups. We identified meaning units that were interpreted through the lens of literature on etiology and treatment of trauma-related mental health problems. High-risk professionals in a vertical social structure experience unexpected moments of identification with victims or patients, which leads to personal distress and has lasting emotional impact. For those in horizontal social structures, such as paramedics and specialized nurses, we did not observe these sudden, intense emotional reactions. Instead, they seem to experience increased emotionality and exhaustion over the course of their careers. While emotional distancing may be functional during emergencies, it likely increases the risk of traumatization. This risk is amplified when ingrained during early socialization. Graphical abstract designed by Uros Pajic. • Police, military, firefighters, and surgery-teams have a vertical social structure. • One characteristic of a vertical social structure is an us-versus-them mentality. • Us-versus-them mentality reinforces emotional detachment from patients/civilians. • Moments of identification dissolve this distinction and lead to personal distress. • Early socialization shapes emotional responses and increases trauma vulnerability.

BackgroundGiven the high prevalence of trauma-related mental health problems in a growing population of refugees, identifying robust predictors of treatment outcome can optimize treatment strategies and resource allocation. The current study aimed to examine the robustness of predictors from seven previous predictor studies at the Competence Centre for Transcultural Psychiatry (CTP).MethodsWe studied if predictors from previous studies could be replicated in a sample of 219 refugees with PTSD who participated in a new distinct study conducted at CTP. We included all variables previously found to be significantly related to treatment response, as measured via the Harvard Trauma Questionnaire (HTQ) and the Hamilton Depression Scale (HAM-D). We categorised the variables as sociodemographic factors, CTP predictor index items, and baseline assessment scores. We performed regression analyses with one exposure variable at a time, controlling for baseline assessment scores corresponding to the dependent variable. We also conducted multiple linear regression analyses to examine the variance explained in total by the identified significant predictor variables.ResultsThe study successfully replicated several predictors of treatment response for PTSD and depression, including a high understanding of therapy concepts, acceptability of psychological treatment, ability to reflect, motivation for active participation and cognitive resources, as well as low baseline pain levels. The findings replicated a U-shaped relationship between age and treatment response for depression, indicating better outcomes for younger participants and those over 60. Multiple regression analyses explained 28% and 39% of the variance in the PTSD (HTQ) and depression (HAM-D) treatment responses, respectively.ConclusionsThis study contributes to the understanding of treatment response predictors in trauma-affected refugees by replicating findings from previous research in a new sample. It highlights the importance of modifiable factors, such as psychotherapy readiness, and underscores the necessity for tailored interventions to enhance treatment efficacy. As the global refugee crisis grows, the insights from this research can inform mental health strategies, ultimately improving care for this vulnerable population. Future research should continue to investigate modifiable predictors to further enhance treatment outcomes.Trial registrationClinicalTrials.gov NCT02761161

Introduction Research on mental health care with trans and gender-diverse (TGD) people presents unique challenges as it brings together two historically complex contexts for TGD communities. While ethical standards and recommendations for research do exist (e.g. Bauer et al., 2019; Puckett et al., 2023, Veale et al., 2022), it is only recently that there has been a turn toward community-engaged research, with communities calling for research led by TGD people and focused on community goals and needs. Method This article presents findings from a qualitative, community-based project on TGD young people’s priorities for future research related to improving trauma-related mental health care. Thirty-four participants engaged across two data collection activities: in-person workshops; and online, semi-structured interviews. Eligibility criteria included: identifying as trans or gender-diverse; being aged 19–30 and having experience accessing, attending, or needing trauma-related mental health supports in British Columbia. Participants shared their experiences with trauma-related mental health care and their priorities for improving mental health care more broadly for TGD communities. Results Research priorities included: Practitioner Education and Training; Indigenous Perspectives; Addressing Racism and Cultural Differences; Impact of Geography; Co-Occurring Needs; Understanding Trauma; Disability, Autism, and Neurodivergence; Pathways to Care; and Approaches to Therapy. Participants emphasized that research should be led by TGD communities who are impacted by the research and needs to be based on community priorities. Discussion These findings provide novel insight from young TGD people into community priorities that can guide future research on mental health care. Findings suggest that future researchers be strategic in building projects that shift the focus from research on TGD people to research that focuses on mental health practitioners, practice approaches, and frameworks that acknowledge the multifaceted lived experiences of TGD people. Future research should pushback against deficit-focused narratives and an over-focus on harm experienced by TGD people.

Background: Refugees and internally displaced persons (IDPs) in Africa are frequently exposed to armed conflict, violence, and displacement-related trauma, placing them at heightened risk of mental health disorders. This systematic review and meta-analysis aimed to estimate the prevalence of trauma-related mental health outcomes among refugees and IDPs in African conflict and crisis settings. Methods: We conducted a systematic search of PubMed, PsycINFO, Scopus, African Journals Online (AJOL), and the UNHCR digital library, including grey literature, for studies published between January 2000 and July 2025. Eligible studies reported prevalence rates of PTSD, depression, anxiety, or psychological distress using validated instruments among African refugee or IDP populations. Study quality was assessed using the Joanna Briggs Institute (JBI) checklist. A random-effects meta-analysis was performed to calculate pooled prevalence estimates. Heterogeneity was assessed using the I² statistic, and publication bias was evaluated through funnel plot analysis. Results: Out of 3,365 identified records, 40 studies met inclusion criteria for qualitative synthesis, and 35 were included in the meta-analysis. The pooled prevalence estimates were 37.8% (95% CI: 32.5–43.2%) for PTSD, 32.1% (95% CI: 27.0–37.8%) for depression, and 30.4% (95% CI: 25.3–36.1%) for anxiety. Subgroup analysis indicated higher prevalence among IDPs compared to refugees and among studies conducted in East and Central Africa. Significant heterogeneity was observed across studies (I² &gt; 90%). Conclusions: The findings reveal alarmingly high levels of trauma-related mental health conditions among refugees and IDPs in Africa, with considerable regional and population-based variations. These results underscore the urgent need for culturally adapted, trauma-informed mental health interventions in conflict-affected African settings. Keywords: Refugees, Internally Displaced Persons, PTSD, Depression, Anxiety, Mental Health, Africa, Conflict, Crisis, Meta-analysis, Systematic Review

Although the health effects of trauma have been increasingly recognized, much less is known about the intergenerational effects of trauma and its outcomes. This study examined trauma and trauma-related mental health problems among socio-economically disadvantaged parents. We recruited parents in disadvantaged housing and living conditions from a community development center in Hong Kong (response rate = 74.09%). Participants completed standardized self-report measures. In this sample of 203 parents, 40.39% and 43.84%, respectively, reported at least one childhood and adulthood traumatic event; 6.90% suffered from probable ICD-11 PTSD/Complex PTSD and/or somatoform dissociation. Parents' disturbances in self-organization (DSO) symptoms were associated with problematic parenting styles. Parents' childhood trauma and DSO symptoms were also associated with children's behavioral problems. Although trauma is not particularly prevalent in this sample, trauma and trauma-related symptoms are strongly linked to problematic parenting styles (such as over-reacting) and children's behavioral issues. More attention to the intergenerational effects of trauma is necessary from a public mental health perspective.

Large online mental health communities exist for both posttraumatic stress disorder (PTSD) and complex posttraumatic stress disorder (CPTSD) on Reddit. These communities have not been sufficiently understood through prior work. Posts (N = 86,267) from r/ptsd and r/CPTSD subreddits from December 2020 to December 2022 were collected, processed, and assessed. A modified reflexive thematic analysis was used to generate themes and codes from corpus data and Bidirectional Encoder Representation from Transformers topic models. Representative posts (N = 397) were coded. Chi-square analyses were used to compare the frequency of themes and codes across r/ptsd and r/CPTSD. Most sampled posts in r/ptsd and r/CPTSD were focused on posting for oneself. Venting was significantly more common in r/CPTSD (p < .01), whereas seeking advice was more frequent in r/ptsd (p < .01). Traumatic experiences, mental health symptoms, treatment, diagnosis, and relationships were discussed frequently in both communities. Discussions of noninterpersonal trauma, anxiety symptoms, sleep-related symptoms, flashback/reexperiencing symptoms, somatic symptoms, diagnosis, and medication use were significantly more prevalent in r/ptsd compared to r/CPTSD (p < .01). Discussions of depression/mood symptoms, resources/coping tools, and interpersonal conflict were significantly more common in r/CPTSD (p < .01). Findings suggest that trauma-related online mental health communities may allow users to fulfill different objectives (i.e., seeking support, venting, or asking for advice) related to a wide range of discussion themes. Findings may be used to help inform the design and delivery of informal and formal interventions directed at these communities. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

ABSTRACT Background: Children and adolescents in out-of-home care are particularly vulnerable to potentially traumatising events (PTEs) and trauma-related mental health disorders. In Germany, there is limited evidence on trauma exposure and posttraumatic stress symptoms (PTSS) among youth in child welfare facilities. Better understanding their psychopathology could support the development of tailored trauma-focused interventions. Objective: This study investigates PTEs and PTSS (DSM-5 criteria) in adolescents living in residential care. It also examines risk factors for PTSS and compares self-reports with proxy-reports from institutional staff. Method: A total of N = 126 adolescents (mean age = 14.98 years, SD = 1.62, range = 11–19) from 17 residential care facilities in southern Germany and their institutional caregivers completed questionnaires assessing demographics, PTEs, and PTSS. Results: Participants reported an average of M = 4.51 PTEs (SD = 3.08, range = 0–12). High rates of online victimisation were found, with 19.8% reporting cyberbullying and 22.2% reporting being coerced online into sexual acts – the latter showing a strong correlation with PTSS (r = 0.33). Adolescents scored an average of M = 21.24 (SD = 11.01, range = 2–50) on the CATS–2, with scores above the clinical cut–off (≥21) indicating high symptom burden. Significant predictors of PTSS included the number of PTEs (β = .55, p < .001), female gender (β = .27, p < .01), and interpersonal trauma (β = .55, p < .001). Correlations between self– and staff–reports were low (r = .06–.19), with staff reporting fewer symptoms. Conclusion: The findings underline the high vulnerability of youth in care to trauma and stress-related symptoms and support the need for trauma-sensitive care. The prominence of online victimisation highlights the need for routine clinical screening. Low agreement between self- and caregiver reports reinforces the importance of directly assessing adolescents' experiences.

BackgroundPosttraumatic stress disorder (PTSD) is often underdiagnosed based on medical records. This study aimed to estimate the prevalence and health care utilization of individuals with PTSD and other trauma-related disorders in a large, integrated health care system.MethodsAdults (between the ages of 18 and 65) with Kaiser Permanente Northern California membership and ≥ 1 outpatient visit in 2022 were eligible. Unspecified/other specified trauma and stressor-related disorder, acute stress disorder, and PTSD were based on diagnosis codes from the International Classification of Diseases, 10th Revision, Clinical Modification. The Primary Care PTSD (PC-PTSD) Scale was used as a screening tool. Prevalence was assessed overall and among the subset of patients seen in primary care, psychiatry, and addiction medicine. To contextualize health care utilization, the authors compared patients with trauma-related disorders to those with major depressive disorder.ResultsOf the 2,128,670 eligible adults, the overall prevalence of trauma-related diagnoses and positive screening on PC-PTSD was 4.9% (103,947); 1.3% (n = 27,670) had PTSD, 1.9% (n = 41,205) had unspecified/other specified trauma and stressor-related disorder, 0.1% (n = 1818) had acute stress disorder, and 1.6% (n = 33,254) screened positive on PC-PTSD without a trauma-related International Classification of Diseases code. Prevalence of trauma-related diagnoses by department was 18.3% (n = 47,516) in psychiatry, 16.5% (n = 3816) in addiction medicine, and 3.4% (n = 67,469) in primary care. There were no clinically meaningful differences in health care utilization between those with trauma-related diagnoses compared with major depressive disorder.ConclusionBroadly defining trauma-related disorders and substantial symptoms may provide a more accurate representation of the actual prevalence of PTSD in a health care system. These data may help health care leaders plan treatment options for this diverse group of individuals.