Trauma-related Symptomatology Research Articles

The Centrality of Humiliation in Complex Posttraumatic Stress Disorder

ABSTRACT Victims of traumatic events that involve repeated interpersonal aggression and low or no chance of escape frequently report intense Self-Conscious Emotions (SCEs), such as Shame, Guilt, and Humiliation. Humiliation is the reaction to a forced loss of status and is hypothesized to have unique contributions to the development and maintenance of Posttraumatic Stress Disorder (PTSD) and Complex Posttraumatic Stress Disorder (CPTSD). However, previous studies did not include humiliation or did not simultaneously probe the relative contribution of each SCE to posttraumatic symptoms. This study aimed to investigate the dynamics between specific SCEs and trauma-related symptomatology in the general population who suffered a form of complex trauma. Four hundred forty-nine people (77.11% women) exposed to domestic violence and sexual abuse answered an online survey. We investigated whether each emotion would accurately predict probable PTSD and CPTSD levels above the proposed cutoff. We estimated a network model to understand the dynamics of their interactions and whether the traumatic event type would moderate relationships between SCEs and posttraumatic stress symptoms, comparing networks of two types of complex trauma. No SCE predicted PTSD, but humiliation was a predictor of CPTSD while controlling for Shame and Guilt. Humiliation was also the most central SCE domain in the networks of both traumatic events. Our results stress the relevance of Humiliation to understanding posttraumatic stress symptoms and the necessity to consider humiliation when studying the emotional processing in complex trauma.

Psychological intervention in women victims of childhood sexual abuse: a randomized controlled clinical trial comparing EMDR psychotherapy and trauma-focused cognitive behavioral therapy.

Childhood sexual abuse persists as a painful societal reality, necessitating responses from institutions and healthcare professionals to prevent and address its severe long-term consequences in victims. This study implements an intervention comprising two psychotherapeutic approaches recommended by the WHO and international clinical guidelines for addressing short-, medium-, and long-term posttraumatic symptomatology: Trauma-Focused Cognitive Behavioral Therapy (TF-CBT) and Eye Movement Desensitization and Reprocessing (EMDR). Both approaches are adapted from group formats for implementation in small online groups via Zoom. The impact of both therapeutic approaches on trauma improvement was assessed in a sample of 19 women who were victims of childhood sexual abuse through a Randomized Clinical Trial comparing EMDR Psychotherapy and Trauma-Focused Cognitive Behavioral Therapy after a baseline period. Intra and inter comparison were made using statistics appropriate to the sample. Both therapeutic approaches significantly reduced symptomatology across various evaluated variables, suggesting their efficacy in improving the quality of life for these individuals. Following CBT-FT treatment, patients exhibited enhanced emotional regulation, reduced reexperiencing, and avoidance. The EMDR group, utilizing the G-TEP group protocol, significantly improved dissociation, along with other crucial clinical variables and the perception of quality of life. Although the limitations of this study must be taken into account due to the size of the sample and the lack of long-term follow-up, the results align with existing scientific literature, underscoring the benefits of trauma-focused psychological treatments. The online group format appears promising for enhancing the accessibility of psychological treatment for these women. Furthermore, the differential outcomes of each treatment support recent research advocating for the inclusion of both approaches for individuals with trauma-related symptomatology. The study has been approved by the Ethics Committee of the Valencian International University (VIU) (Valencia, Spain) (Ref. CEID2021_07). The results will be submitted for publication in peer-reviewed journals and disseminated to the scientific community. https://clinicaltrials.gov/ct2/show/NCT04813224, identifier NCT04813224.

Event centrality in social anxiety disorder and major depressive disorder

ABSTRACT Event centrality is defined by the extent to which a memory of an event has become central to an individual’s identity and life story. Previous research predominantly focused on the link between event centrality and trauma-related symptomatology. Nevertheless, it can be argued that the perception of (adverse) events as central to one’s self is not exclusive to Posttraumatic Stress Disorder (PTSD). Other disorders where adverse events are linked to the onset of symptoms might also be related to event centrality. This study examined the relevance of event centrality for Social Anxiety Disorder (SAD) and for Major Depressive Disorder (MDD) separately. Moreover, we examined which cognitive and emotion regulation variables (i.e., trait anxiety, rumination, worry, intrusions and avoidance, and posttraumatic cognitions) mediated these relationships. No significant correlation was found between event centrality and social anxiety. However, a significant positive correlation was found between event centrality and depression. In a combined group, this relation was mediated by all cognitive and emotion regulation variables except for worry.

Exploring networks of complex developmental trauma symptomatology among children and adolescents involved in child welfare.

Clinical presentations of child and adolescent psychopathology can vary systematically for boys and girls. While network analysis is increasingly being applied to explore psychopathology in adults, there is a dearth of network studies considering differences in symptoms for boys and girls, particularly in developmental trauma-related symptomatology. This study involves rural children (n=375, 39.47% girls) and adolescents (n=291, 51.20% girls) involved with child protection services in Ontario, Canada. Caregivers completed the Assessment Checklist for Children or Adolescents within the first 6months of care. Psychometric network analyses were conducted using subscales for boys and girls. Differences were examined via network comparison permutation tests, moderated network models, and independent t-tests. Attachment-related interpersonal difficulties were the most central nodes in the child and adolescent networks for both boys and girls. Emotional dysregulation also had high strength centrality for adolescents. While network comparison tests found the overall network structures and global network strength to be invariant between boys and girls for children and adolescents, moderated network models and independent t-tests revealed several differences with regards to the expression of specific symptoms. Among children, girls exhibited more indiscriminate and pseudomature interpersonal behaviors, whereas boys expressed significantly more non-reciprocal interpersonal behaviors and self-injury. Adolescent girls exhibited more behavioral dysregulation and suicide discourse in the moderated network model; t-tests also indicated higher levels of emotional dysregulation, negative self-image, and other items considered clinically important complex trauma symptoms (e.g., distrust of adults, confused belonging). This study supports evidence of differences in the expression of complex trauma symptomatology for boys and girls. Additionally, girls exhibit more symptoms, in general. Consistent with the transdiagnostic conceptualization of the consequences of developmental trauma, findings demonstrate the primacy of attachment-specific difficulties and emotion dysregulation.

Universal and Trauma-Specific Care Suggestions for Pediatric Primary Care Settings

Trauma exposure and other adverse life events are common experiences among youth and present long-standing mental and physical health consequences. Given the ongoing lack of sufficient mental health services, pediatricians play a critical role in supporting trauma-exposed youth. We propose both universal precaution and trauma-specific strategies for pediatric primary care settings. Universal interventions include recommendations to make health care systems more trauma-informed, reduce trauma or re-traumatization in the medical setting, eliminate potential bias, and focus on a strengths-based approach to support diverse youth and families. Trauma-specific strategies include screening for trauma-related symptomatology and risk stratification to link youth to appropriate levels of care. Specific assessment tools, resources, and materials are provided. [ Pediatr Ann . 2023;52(11):e418–e421.]

Did Cognitive Attentional Syndrome Symptoms Predict Stress- and Trauma-Related Symptoms in the Initial Phase of the COVID-19 Pandemic? Results from a Two-Wave Study on a Sample of Polish Internet Users.

According to metacognitive theory, Cognitive Attentional Syndrome (CAS) is a transdiagnostic factor and a main mechanism of psychopathology maintenance. The main goal of this study is to examine whether CAS predicted stress- and trauma-related symptomatology in the first months of the COVID-19 pandemic and three months later. Initially, 1792 participants were recruited online via social media; the data were collected at two time points. The measures included the Cognitive Attentional Syndrome Questionnaire, the Adjustment Disorder-New Module 20, the International Trauma Questionnaire, and additional measures. Structural equation modeling was conducted in order to determine the relations between the reported stressors, CAS, and symptomatology. At both time points, CAS was a significant mediator between the stressors and symptoms of adjustment disorder. Despite the decrease in the intensity of adjustment disorder symptoms between waves, it was a significant predictor of other psychopathologies at both time points, except for traumatic stress. The findings confirm the assumption that CAS is a transdiagnostic factor of psychopathology and has a mediating role in the relationship between stressors and adjustment disorder and co-occurring symptomatology. The effect was particularly significant in the initial phase of the pandemic, which was highly stressful for many people.

Characterizing experiential elements of early-life stress to inform resilience: Buffering effects of controllability and predictability and the importance of their timing.

Key theoretical frameworks have proposed that examining the impact of exposure to specific dimensions of stress at specific developmental periods is likely to yield important insight into processes of risk and resilience. Utilizing a sample of N = 549 young adults who provided a detailed retrospective history of their lifetime exposure to numerous dimensions of traumatic stress and ratings of their current trauma-related symptomatology via completion of an online survey, here we test whether an individual's perception of their lifetime stress as either controllable or predictable buffered the impact of exposure on trauma-related symptomatology assessed in adulthood. Further, we tested whether this moderation effect differed when evaluated in the context of early childhood, middle childhood, adolescence, and young adulthood stress. Consistent with hypotheses, results highlight both stressor controllability and stressor predictability as buffering the impact of traumatic stress exposure on trauma-related symptomatology and suggest that the potency of this buffering effect varies across unique developmental periods. Leveraging dimensional ratings of lifetime stress exposure to probe heterogeneity in outcomes following stress - and, critically, considering interactions between dimensions of exposure and the developmental period when stress occurred - is likely to yield increased understanding of risk and resilience following traumatic stress.

Emergence of probable PTSD among U.S. veterans over the military-to-civilian transition.

Despite theorizing that posttraumatic stress disorder (PTSD) symptomatology may be exacerbated during the military-to-civilian transition, little research has delved into the trajectory of trauma-related symptomatology or the impact of diverse factors on timing of PTSD onset. To understand risk and protective factors for PTSD during the transition into civilian life, this study examined demographic, experiential, and psychosocial characteristics that may explain variation in PTSD symptoms and timing of onset. A nationwide sample representing 48,965 U.S. veterans separating from military service in fall 2016 responded to six Web-based surveys over 3 years. Assessments included PTSD symptoms, stress, warfare exposures, military sexual trauma, moral injury events, resilience, and social support. Multivariable models estimated covariates of positive PTSD screen or symptoms. Trauma exposure during military service was high at 59%. Probable PTSD was detected in 26% of the sample at baseline, with additional cases in each survey wave for an overall rate of 30%. Meeting criteria for probable PTSD covaried with current stress, female gender, and minority race/ethnicity; baseline psychological resilience and concurrent social support mitigated the risk. PTSD symptoms correlated positively with stress levels at current and previous time points. Social support was protective but only when contemporaneous with the PTSD symptoms. This study illustrates the need for ongoing social support for veterans coping with symptoms of PTSD, life stressors, and postmilitary trauma, suggesting a countervailing influence of psychological resilience and contemporaneous (but not historical) social support on symptom exacerbation. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Gender Differences in Callous Unemotional Trait Profiles in an Undergraduate Sample

ABSTRACT A wealth of research has consistently identified two distinct callous unemotional (CU) variants that differ on etiological mechanisms. While the first variant has been posited to represent a genetically predisposed difference in lower emotional arousal, the secondary variant demonstrates overlap with trauma-related symptomatology. Limited research has examined whether these CU variants differ based on child maltreatment subtypes or whether symptom profiles for CU variants differ by male-identified and female-identified participants. We aimed to replicate findings that individuals in the secondary CU group demonstrate higher PTSS. In an undergraduate sample of youth ages 18 to 24 (N = 546; 55.5% female), the present study examined whether CU variants could be identified utilizing latent profile analysis including CU trait clusters (i.e., callousness, uncaring, unemotional), anxiety, and child maltreatment subtypes. We identified unique symptom profiles by male-identified and female-identified gender. CU variant groups were differentiated based on the severity of child maltreatment experiences and anxiety symptoms. The manifestation of CU symptoms differed by variant group and by gender. Additionally, PTSS was highest in secondary CU variant groups. The findings support the conceptualization of the secondary CU variant group as a trauma-based reaction and suggest potential differences in symptom profiles by gender.

Günter Brus: a walk through totality

This study focuses on examining a specific artwork of a member of the Austrian action group of Viennese Actionism, Günter Brus through the prism of Trauma Studies. The research question of how the trauma of World War II expressed itself in the art of Günter Brus encompasses a focus on three sub-areas based on the nature and definition of trauma and following neurosis/psychosis: individual trauma (e.g., childhood trauma), societal trauma (a consequence of WWII), and the return of trauma if it has not been consistently processed. The experience of WWII left traumas in the generation of artists such as Brus (e.g., his experience of bombing at an early age) that were individual, society-wide (the complicity of the whole Austrian society in the Nazi crimes and the Shoa), and/or the traumas caused by some recurring trauma. According to a British theatrologist Patrick Duggan, trauma on the individual level is doubled upon recurrence, which is similar to the conclusion at which German researcher Gerald Schröder arrives when he writes about the Wiederholungstrauma of a society on the whole. When the level of social traumatisation reaches a borderline level, it manifests itself through various valves, including artistic ones. Günter Brus became such a materialisation of the repetition of trauma, a living reminder, literally walking through the streets of Vienna during his event Vienna Walk. The study introduces and describes the nature of such trauma in the artwork of the Austrian post-war artist through the framework of Duggan's methodology coupled with trauma-related symptomatology.

Mental Health Symptom Profiles of Adolescents in Foster Care.

The article describes an investigation of the nature, patterns and complexity of carer-reported mental health symptoms for a population sample (N = 230) of adolescents (age 12-17) placed in long-term foster and kinship care following chronic and severe maltreatment. Two cluster analyses of Child Behaviour Checklist DSM-oriented (CBCL-DSM) and Assessment Checklist for Adolescents sub-scale scores of clinical cases were performed. The first yielded 8 profiles of attachment- and trauma-related symptoms as measured across eight ACA scales (N = 113 cases). The second yielded 11 profiles of a broader range of symptoms, as measured across five CBCL-DSM and five ACA sub-scales (N = 141 cases). The symptom profiles derived from both cluster analyses are differentiated more by symptom severity and complexity, than by symptom specificity - suggesting that trauma- and attachment-related symptomatology does not conform to a taxonomy of discrete disorders. Five of the 11 CBCL-DSM/ACA profiles describe severe and complex symptomatology that does not correspond to discrete DSM-5 or ICD-11 diagnoses. Accurate measurement and formulation of clinical phenomena is an essential component of evidence-based psychological and psychiatric practice. Clinicians who carry out mental health assessments of children and adolescents in care should be aware of the limits of the diagnostic classification systems for formulating complex attachment- and trauma-related symptomatology.

Stress is associated with larger perivascular spaces in depression: A 7-tesla MRI study

IntroductionEmerging evidence in depressive phenotypes suggests that the breakdown of the blood brain barrier (BBB) andhigh levels of inflammatory cytokines in states of persistent stress or traumatic experiences may contribute to its pathophysiology. Ultra-high field MRI may aid in the radiological detection of maladaptations of the glymphatic system related to BBB integrity that may not be visualized at lower field strengths.ObjectivesWe aimed to investigate the link between glymphatic neuroanatomy in the form of perivascular spaces (PVS) and trauma experience in patients with major depressive disorder.MethodsWe examined PVS’s in patients with major depressive disorder and in healthy controls using 7-Tesla MRI and a semi-automated segmentation algorithm.ResultsAfter controlling for age and gender, we found that the number of traumatic life events experienced was positively correlated with total PVS volume in MDD patients (r= 0.50, p= 0.028) and the overall population (r= 0.34, p= 0.024). Furthermore, the number of traumatic events eliciting fear, helplessness, or horror was positively correlated with total PVS volume in MDD patients (r= 0.50, p= 0.030) and the overall population (r= 0.32, p= 0.023). As expected, age correlated positively with PVS count (r= 0.37, p= 0.013), PVS total volume (r= 0.53, p< 0.001), and PVS density (r= 0.68, p< 0.001 in all participants.ConclusionsThese results suggest a relationship between glymphatic dysfunction potentially related to BBB integrity and psychological trauma in patients with depression, and suggest that glymphatic impairment may play a role in trauma-related symptomatology.

Profiles in COVID-19: peritraumatic stress symptoms and their relation with death anxiety, anxiety sensitivity, and emotion dysregulation

ABSTRACT Background: The COVID-19 pandemic might be experienced as an ongoing traumatic event and could result in peritraumatic stress symptoms. Evidence implies that individuals’ levels of death anxiety, anxiety sensitivity, and difficulties in emotion regulation may contribute to their peritraumatic stress symptomatology in the aftermath of trauma exposure. Objective: The current study aimed to explore these hypotheses in the context of the COVID-19 pandemic. Method: An online survey was conducted among a convenience sample of 846 Israeli adults from April 2 to 19 April 2020. COVID-19-related stressors, death anxiety, anxiety sensitivity, difficulties in emotion regulation, and peritraumatic stress symptoms were assessed via self-report questionnaires. Results: Analyses indicated significant relations between death anxiety, anxiety sensitivity, and emotion regulation difficulties, on the one hand, and peritraumatic stress symptoms, on the other. Three distinct profiles were identified. Furthermore, profile type – namely having low, medium, and high levels of death anxiety, anxiety sensitivity, and emotion dysregulation – had a significant effect in explaining peritraumatic stress symptoms. Conclusions: Results suggest that during the pandemic, levels of death anxiety, anxiety sensitivity, and emotion dysregulation may explain heterogeneity in individuals’ trauma-related symptomatology.

Examination of the associations between young children’s trauma exposure, trauma-symptomatology, and executive function

The present study used a bioecological framework to examine associations between trauma exposure, trauma-related symptomatology, and executive function (EF) in an urban sample of 88 predominantly ethnic-minority, low-income preschoolers (age 2–5) exposed to interpersonal trauma. Contrary to hypotheses based on past literature documenting associations between trauma exposure and EF deficits in childhood, in regressions adjusting for child gender, family income, and caregiver education, neither trauma exposure or trauma-related symptoms (post-traumatic stress symptoms, internalizing behaviors, or externalizing behaviors) were significantly associated with children’s EF performance. Associations between child trauma exposure, symptomatology, and executive function were not moderated by parental PTSD symptomatology; and EF was not differentially predicted by type of trauma. Results suggest that, within an ethnically-diverse sample of preschool-aged children exposed to multiple traumas, associations between trauma exposure, symptomatology, and EF may be particularly nuanced. Keywords: child trauma, posttraumatic stress, executive function, preschool-age children, child mental health.

Self-recognition of trauma-related psychopathology and help-seeking among resettled Iraqi refugees in Australia.

The current study sought to examine resettled Iraqi refugees' recognition of trauma-related psychopathology and the association between recognition and help-seeking. Participants were 66 men and women aged 18 to 70 years with clinically significant symptoms of posttraumatic stress disorder (PTSD) recruited from a larger, community-based sample in Western Sydney, Australia. Participants were presented with a vignette of a fictional character who had been exposed to trauma prior to leaving Iraq and who was suffering from symptoms of PTSD. Participants were then asked if they believed that they might currently have a problem such as the one described in the vignette. Approximately half (50.8%) of participants believed that they might currently have a problem such as the one described in the vignette and one third (33.3%) of participants had ever sought help for such a problem. Participants who believed that they might currently have a problem like the one described were 13 times more likely to have sought help for such a problem, controlling for demographic characteristics, trauma-related symptomatology, and levels of general psychological distress. Poor self-recognition level of trauma-related psychopathology among resettled Iraqi refugees may be a barrier to help-seeking and may therefore be an important target for health promotion and early intervention initiatives.

The role of age and mode of delivery in the STEPS intervention: a longitudinal pilot-study in treatment of posttraumatic stress symptoms in Danish survivors of sexual assault

ABSTRACT Background: The STEPS programme has been succesfully implemented as a group-based treatment of trauma symptoms after rape for adolescents. The STEPS intervention was translated from Dutch to Danish and offered to adults in addition to adolescents as well as an individual intervention in addition to a group-based intervention at a Danish Centre for Rape Victims through 2011 to 2014. The programme was translated from Dutch to Danish and expanded to adults in addition to adolescents as well as to an individual intervention in addition to a group-based intervention at a Danish Centre for Rape Victims through 2011 to 2014. Objective: The present study observes development in trauma symptoms and ICD-11 diagnostic status during an adapted version of the intervention programme ‘STEPS’ for survivors of sexual assault. Methods: A prospective uncontrolled study was conducted, monitoring symptoms of posttraumatic stress and other trauma-related symptomatology before treatment, after treatment and at 6 and 12 months' follow up for 103 referrals receiving individual or group-based STEPS. Tentative diagnoses of posttraumatic stress disorder (PTSD) and complex PTSD were assigned to participants according to the ICD-11 to observe the development in diagnostic status across time, and multilevel modelling was used to assess the development of symptom severity and to assess the moderating effect of age-group and mode of delivery. Results: A loglinear function representing large and statistically significant decline in symptomatology over time provided the best fit for all measures of trauma-related symptomatology. The decline was not moderated by age-group or mode of intervention. Dropout rates were independent of mode of intervention and age. Conclusion: The adaption of the STEPS programme to adults and as an individual intervention is feasible and maintains effect sizes comparable to those observed in the original intervention. Further research using randomized controlled trials is needed to ascribe the observed effect to the STEPS programme.

Bad Blood or My Blood: A Qualitative Study into the Dimensions of Interventions for Mothers with Children Born of Sexual Violence.

Research has shown that there is a negative relation between the experience of sexual violence of mothers and the well-being of their children. When a child is born out of sexual violence, the origin of the child is connected to the traumatic experience. Despite the difficult maternal task of navigating this relationship, research on interventions for mothers with a child born of sexual violence is absent. The current qualitative study was designed to gather expert knowledge of twelve clinicians on the dimensions of interventions for these mothers and their children as a first step in the development of good clinical practice for interventions. Using thematic analysis, the interviews were transcribed, coded and analyzed. Three building blocks for interventions for mothers and their children born of sexual violence were identified: building a secure attachment, reduction of trauma-related symptomatology, and addressing stigmatization. Clinicians describe many factors that need to be taken into account in treatment but emphasize the importance of the therapeutic relationship to be efficacious. The foundation of a strong therapeutic relationship together with the building blocks are the elements for good clinical practice on interventions for mothers with a child born of sexual violence.

The mediating effect of trauma and stressor related symptoms and ruminations on the relationship between autistic traits and mood spectrum

An increasing number of studies highlighted significant correlations between autistic traits (AT) and mood spectrum symptoms. Moreover, recent data showed that individuals with high AT are likely to develop trauma and stressor-related disorders. This study aims to investigate the relationship between AT and mood symptoms among university students, focusing in particular on how AT interact with ruminations and trauma-related symptomatology in predicting mood symptoms. 178 students from three Italian Universities of excellence were assessed with The Structured Clinical Interview for DSM-5 (SCID-5), the Adult Autism Subthreshold Spectrum (AdAS Spectrum), the Ruminative Response Scale (RRS), the Trauma and Loss Spectrum (TALS) and the Moods Spectrum (MOODS). Considering the AdAS Spectrum total scores, 133 subjects (74.7%) were categorized as “low scorers” and 45 subjects (25.3%) as “high scorers”. Students in the high scorer group showed significantly higher scores on RRS, TALS-SR and MOOD-SR total scores. Total and direct effects of AdAS Spectrum total score on MOODS-SR total score were both statistically significant. AdAS Spectrum total score also showed a significant indirect effect on MOODS-SR total score through TALS and RRS total scores. Results showed a significant relationship between AT and mood spectrum, which is partially mediated by ruminations and trauma/stressor-related symptomatology.

Trauma and resilient functioning among Syrian refugee children.

Following the civil war in Syria, there has been a growing interest in the impact of war, violent conflict, and refuge on the development and mental health of refugee children in general and Syrian refugee children in particular. The objective of this paper is threefold: (a) to critically review the existing literature on the psychological functioning of Syrian refugee children, with a particular focus on those residing in the urban areas or camps in Turkey; (b) to identify the main theoretical and methodological problems of this emerging literature; and (c) to suggest guidelines for how to improve research and practice in this field. The reviewed literature predominantly focuses on psychological trauma, trauma-related symptomatology or other maladaptive functioning in children, and psychosocial interventions conducted toward alleviating these issues. This paper will summarize the research findings in the above-mentioned topics to discern what can be known from the existing literature on Syrian refugee children.

Self-compassion buffers the link between self-criticism and depression in trauma-exposed firefighters.

Firefighters are frequently exposed to highly stressful, potentially traumatic events (PTEs). More than 50%, however, show no significant elevation in trauma-related symptomatology (e.g., depression). In the past, self-compassion has been discussed to promote psychological and behavioral flexibility that is vital to a successful adaptation to PTEs. The goal of this study was to understand whether and how self-compassion may alleviate personal suffering in the face of PTEs. We hypothesized that individuals who encounter their profession-related affective experiences with greater self-compassion, show lower levels of depressive symptoms because self-compassion buffers processes that perpetuate negative affectivity in response to PTEs (i.e., self-critical tendencies). Male firefighters (N = 123) completed self-report questionnaires about the severity of current depressive symptoms; prior traumatic, duty-related events; and the self-compassion scale that assesses two distinct factors: self-criticism and self-compassion. A stepwise regression model was employed to examine differential and interactive contributions of self-criticism and self-compassion to symptoms of depression across the cumulative range of exposure to PTEs. Our results indicate that the positive association between self-criticism and depression is buffered by enhanced levels of self-compassion. This moderation, however, only emerged for firefighters with substantial amounts of PTEs experience in the past. The present work provides insight into protective effects of self-compassion in the face of cumulative PTEs. It suggests that, particularly for severely trauma-exposed firefighters, self-compassion may confer resilience, that is, act as a protective factor from the development of depressive symptoms. Findings are discussed in light of counseling implications. (PsycINFO Database Record