Trauma Response Research Articles

Cross-Sectional Analysis of Psychological Mediators Between Occupational Trauma and PTSD in Metropolitan Firefighters.

The present investigation sought to examine the interrelationships between early-life adverse experiences, dissociative symptoms, suicidal ideation, and depressive manifestations among metropolitan firefighters screened with post-traumatic stress disorder (PTSD), and to elucidate the potential mediating effects of these psychological variables on both the presence and severity of PTSD symptomatology in this high-risk occupational cohort. A cross-sectional investigation was performed to assess psychological conditions among 760 metropolitan male firefighters, employing conditional process analysis with multiple mediation modeling (PROCESS macro Model 6). The investigative protocol employed validated psychometric instruments including the PTSD Checklist (PCL-5); the Childhood Trauma Questionnaire (CTQ-33); the Dissociative Experiences Scale (DES); the Suicidal Behaviors Questionnaire (SBQ-4); and the Patient Health Questionnaire (PHQ-9). Bootstrap resampling (n = 5000) generated bias-corrected 95% confidence intervals, enabling interrogation of complex trauma response mechanisms. Conditional process analysis demonstrated that childhood trauma functions as a significant mediator (indirect effect = 0.142, 95% CI [0.086, 0.198]), with emotional abuse pathways revealing significant mediational effects (β = 0.285, p < 0.001). Stratifying participants using a PCL-5 ≥ 33 threshold (non-PTSD: n = 543, 71.5%, median PCL-5: 22; PTSD: n = 217, 28.5%, median PCL-5: 39), the investigation elucidated serial mediation mechanisms, particularly through childhood trauma to dissociative experiences (serial indirect effect = 0.168, 95% CI [0.092, 0.244]), collectively explaining nearly half of PTSD variance through complex psychological interaction pathways. Conditional process analysis revealed childhood trauma as a pivotal mediator, with emotional abuse pathways demonstrating significant mediational effects, while dissociative experiences emerged as a significant secondary mechanism, collectively explaining a substantial portion of PTSD variance through interactions between occupational trauma exposure and intrinsic psychological vulnerabilities.

Psychological, neuroendocrine and inflammatory stress responses in women after miscarriage or stillbirth: investigating early psychobiological adaptations to potential traumatic events.

Miscarriage (MC) and stillbirth (SB) can be considered as potentially traumatic events (PTE) and affect approximately 10-20% of all pregnancies. PTEs can lead to the development of post-traumatic stress disorder (PTSD). While the psychobiology of PTSD is well-understood, our knowledge on psychobiological adaptations shortly after a PTE is limited. This study aimed to shed light on early psychobiological changes associated with MC and SB. We included 25 women who had experienced a MC/SB within the previous three months and compared them with 28 healthy control women. All participants were asked to attend a study appointment, during which they participated in a socially evaluated cold-pressor test (SECPT) to induce psychosocial stress. Saliva and blood samples were collected at rest, immediately and at 20, 45 and 90min after the SECPT. We determined salivary cortisol levels and α-amylase (sAA) activity, and plasma interleukin-6 (IL-6) concentrations. We assessed symptoms of PTSD, anxiety and depression using self-report questionnaires. Women who had experienced MC or SB reported significantly more symptoms of PTSD (p < 0.001) and anxiety (p < 0.001), when compared to the control group. Despite elevated psychological distress in the MC/SB group, there were no significant differences of salivary cortisol, sAA and IL-6 levels between the two groups at rest or after SECPT induced stress. Despite the high psychological strain on women after MC/SB, the stress is not yet reflected at a biological level. These results highlight the complex relationship between early trauma, PTSD symptoms, and biological responses. Further research is needed to understand the long-term effects of trauma related to MC/SB, and the development of PTSD, as well as the underlying mechanisms contributing to the observed psychological and biological changes.

Arthroscopic versus open fixation for medial malleolus fractures improves trauma response and bone healing

Medial malleolus fracture is traditionally performed via an open approach. However, significant drawbacks such as exfoliated soft tissue injury, infection, prolonged recovery periods have been reported. Recently, arthroscopy-assisted reduction percutaneous internal fixation (ARPF) demonstrates advantages in minimizing soft tissue damage, improving joint visualization, and enhancing postoperative recovery, however, robust comparative evidence remains sparse on the efficacy of ARPF versus open reduction and internal fixation (ORIF) in treating medial malleolus fractures. The current study provides preliminary evidence suggesting the potential utility of trauma response indexes and bone metabolism markers in clinical outcomes evaluation associated with these two surgical techniques. A retrospective study was conducted on 60 patients with medial malleolus fractures from January 2021 to November 2023, The patients were divided into the ARPF (arthroscopy-assisted reduction and percutaneous internal fixation) group (n = 28) and the ORIF (open reduction and internal fixation) group (n = 32). The differences in preoperative general data, intraoperative bleeding volume, operation time, hospital stay, bone union time, and preoperative, postoperative 1 day, postoperative 3 days inflammatory response indicators [C-reactive protein (CRP), interleukin-6 (IL-6), cortisol (Cor), norepinephrine (NE)] and preoperative, postoperative 2 weeks, 4 weeks bone metabolism markers [bone carboxyglutamicacid protein (BGP), bone alkaline phosphatase (BALP), β-collagen degradation products (β-CTX)] levels, and postoperative 6 months, 1 year Olerud–Molander Ankle Score (OMAS) were compared. No significant differences were observed in age, gender, injury side, or cause of injury between the two groups (P > 0.05). Compared to the ORIF group, the ARPF group exhibited reduced intraoperative blood loss, shorter hospital stays, and accelerated bone healing time. However, the duration of surgery was significantly longer (p < 0.05). Postoperative CRP levels on days 1 and 3 were lower in the ARPF group compared to the ORIF group. Similarly, IL-6 levels on days 1 and 3 were also lower in the ARPF group. Cor levels on days 1 and 3, as well as NE levels on days 1 and 3, were both lower in the ARPF group. At weeks 2 and 4 postoperatively, BGP and BALP levels were both higher, butβ-CTX levels were lower in the ARPF group. Additionally, the OMAS scores at 6 months and 1 year postoperatively were higher in the ARPF group. Arthroscopy-assisted reduction and percutaneous internal fixation for isolated medial malleolus fracture can minimize intraoperative bleeding, reduce trauma, expedite fracture healing, enhance ankle functional recovery, making it a valuable technique for clinical application.

Posttraumatic experience as mediator of the relationship between therapeutic empathy and working alliance: an exploratory study of therapists and trainees

ABSTRACT Empathy and the working alliance are essential in therapy, but trauma responses may affect them. This exploratory study examined post-traumatic experience, therapeutic empathy, and working alliance. A survey of Australian therapists (n = 53; 49%; 11 males, 42 females; M age = 43.03, SD = 12.64; M practice = 11.79 years, SD = 7.27) and therapy trainees (n = 55; 51%; 10 males, 45 females) was conducted. Trainees reported higher levels of unresolved trauma than therapists. In both groups, unresolved trauma was associated with lower working alliance. Emotional empathy and working alliance were impacted directly and via intrusion symptoms (TE = 2.03, p = .004; DE = 2.35, p = .001; IE = –.32, p < .05; k² = .05). Sampling limitations and cohort differences restrict generalisability.

One Year in Uvalde: Mapping Journalists’ Trauma Responses in the Aftermath of a Mass Shooting

ABSTRACT With the high prevalence of mass shootings in the United States, journalists increasingly find themselves on the frontlines as first responders. As news broke about a school shooting in Texas in May 2022, reporters immediately descended upon the small town of Uvalde to uncover the devastating violence at Robb Elementary, where 19 children and two teachers were killed. Over the ensuing months, these journalists not only chronicled stories of survival and horror but also confronted the raw grief of bereaved families, often placing themselves in the path of ongoing emotional and psychological trauma. This case study explores the physical and psychological trauma responses exhibited by journalists covering the Uvalde mass shooting, highlighting the impact of prolonged exposure to traumatic events over the course of a year.

A Novel Diathesis-Stress Model of Comorbid Early Onset Psychiatric Disorders.

Psychiatric comorbidity is the norm. Identifying transdiagnostic risk factors will inform our understanding of developmental pathways and early intervention targets. We recently reported that many psychiatric outcomes are predicted by a three-factor model composed of adolescent externalizing (EXT) behaviors, early life adversity, and dopamine autoreceptor availability. Here, we investigated whether this model could be reproduced in a large population-based sample using functional magnetic resonance imaging (fMRI) instead of positron emission tomography. Data were collected by the IMAGEN consortium beginning in 2010 when cohort members were 14 years old, with follow-up testing at ages 16 and 19. These longitudinal data were used to predict psychiatric disorders by 19 years of age. Participants were recruited from secondary schools across Europe. Adolescents (n = 1338) with fMRI, behavioural, diagnostic, and early life trauma data. Binary regression models tested whether a combination of EXT behaviors, childhood trauma, and mesocorticolimbic reward anticipation responses at age 14 or 19 predicted the presence of a disorder by age 19. A total of 1338 participants had the required data (52.4% female). In all models, EXT and adversity scores were significant predictors (p < 0.001). Reward anticipation responses in the ventral striatum, caudate, putamen, and anterior cingulate cortex (ACC) at age 14 (p ≤ 0.05) and in the ventral striatum at age 19 (p ≤ 0.029) were predictors in their respective models. The three-factor models overall were highly significant (p < 1.0 × 10-21), yielding greater predictive strength than each factor alone. They had an accuracy of nearly 75%, accounting for ≥ 11% (Nagelkerke R2) of the variance in psychiatric disorders. The relationship between trauma and diagnoses was partially mediated by higher EXT (indirect path B = 0.0535, 95% CI = 0.0301-0.0835), and moderated by fMRI responses in the ACC (p = 0.0038) and putamen (p = 0.0135) at age 14. The results extend our previous findings, increasing confidence in a novel diathesis-stress model of commonly comorbid early onset psychiatric disorders. The results have implications for diagnostic classification schemes and pleiotropic views of psychiatric disorder etiology.

An Exploration of the Personal Experiences of Forensic Scene Investigators’ Daily Work: An Interpretative Phenomenological Analysis

Abstract Police officers are significantly more likely than other emergency workers to experience mental health issues (MIND (2015) Blue Light Scoping Survey. https://www.mind.org.uk/media-a/4857/scoping-survey.pdf) and significantly more likely than the general population to develop post-traumatic stress disorder (Bell and Eski, Policing 10:95–101, 2015). More specifically, forensic scene investigators (FSIs; also known as crime scene investigators) are a sub-group of police officers who are exposed to distressing material as part of gathering forensic evidence from crime scenes. Recent studies have suggested that FSIs are at risk of high levels of stress and trauma responses (Clark RD, Distelrath C, Vaquera GS, Winterich D, DeZolt E (2015) Critical-incident trauma and crime scene investigation: a review of police organizational challenges and interventions. J Forens Identification 65(6):929–951. https://collected.jcu.edu/cgi/viewcontent.cgi?article=1033&amp;context=soc-facpub) and (Mrevlje, Rorschachiana 39:1–19, 2018). Despite this, research into the personal experiences of FSIs is sparse. The present study therefore specifically explored the lived experiences of FSIs and their daily work using Interpretative Phenomenological Analysis (IPA). Seven FSIs from a specialist unit within a UK police force took part in semi-structured interviews. Two superordinate themes were identified: (i) The psychological impact of being an FSI is high and requires personal sacrifice and (ii) The organisation does not care about reducing our stress—it increases it. All participants talked about the psychological impact of working as an FSI and the need to emotionally detach to be able to function/work in the role. Findings are discussed in relation to theoretical and practical implications, as well as directions for future research.

A pilot investigation on inflammatory markers and theta burst stimulation protocol interaction along a three-month recovery course following an isolated upper limb fracture.

This study investigates the effects of theta burst stimulation (TBS) on inflammatory markers in patients with isolated upper limb fractures (IULF). Participants underwent a 10-day TBS intervention following a randomized matched pair design. Blood samples collected at three time points were analyzed for inflammatory biomarkers, mainly including interleukin-1 receptor antagonist (IL-1Ra), IL-1β, and IL-6. Results revealed a significant interaction between TBS and time for IL-1Ra, indicating a more pronounced decrease in IL-1Ra expression over time in the active TBS group. However, IL-6 levels decreased over time regardless of TBS intervention, suggesting a natural decline in response to injury. No significant interaction was found for IL-1β. While IL-1Ra levels were associated with higher functional disability prior to treatment initiation, active TBS intervention led to a decrease of IL-1Ra levels at both follow-up time points. These changes were not associated with alterations in pain or disability, suggesting that TBS may primarily influence recovery processes independent of pain modulation. Notably, IL-1β levels were negatively correlated with disability in the active TBS group at the 3-month follow-up. This study sheds light on the potential of TBS to modulate inflammatory responses in orthopedic trauma, emphasizing the need for further research to elucidate its therapeutic implications. Clinical Significance: TBS may offer a promising adjunctive therapy for promoting functional recovery in patients with upper limb fractures.

Age-dependent glial heterogeneity and traumatic injury responses in a vertebrate brain structure.

The progression of traumatic brain injury (TBI) pathology is significantly influenced by age and involves a complex interplay of glial cells. However, the influence of age on the glial dynamics and their TBI responses remains mostly unexplored. Here, we obtain a comprehensive single-cell transcriptome atlas of three major glial types under the physiological and TBI conditions across four post-embryonic life stages in the zebrafish midbrain optic tectum. We identify a library of glial subtypes and states with specific age-dependent patterns that respond distinctly to TBI. Combining the glial interactome analysis and CRISPR-Cas9-mediated gene disruption, we reveal the essential roles of dla-notch3 and cxcl12a-cxcr4b interactions in the early-larval-stage-specific unresponsiveness of radial astrocytes to TBI and the TBI-induced age-independent recruitment of microglia to injury sites, respectively. Overall, our findings provide the molecular and cellular framework of TBI-induced age-related glial dynamics in vertebrate brains.

The School Counselor’s Corner: The Role of Social Emotional Learning in Supporting Students Facing Trauma

Trauma-informed practices (TIP) and social-emotional learning (SEL) are essential frameworks for supporting students affected by trauma, ensuring that schools foster safe, nurturing, and equitable learning environments. Research indicates that approximately 25% of children in the U.S. experience at least one traumatic event by age 16, significantly impacting their emotional well-being and academic performance. This paper explores the intersection of TIP and SEL, emphasizing their role in helping educators recognize trauma responses, build trusting relationships, and cultivate resilience in students. SEL equips students with the skills to regulate emotions, develop empathy, and build strong relationships, while also empowering educators with strategies to create inclusive, supportive classrooms. Furthermore, SEL promotes systemic equity by fostering collaboration among educators, families, and communities. By integrating TIP and SEL, schools can become spaces of healing and growth, ensuring that all students—regardless of their experiences—have the opportunity to thrive academically, socially, and emotionally.

Witch Talk: Redirected Trauma Responses to State Violence in the Dominican Republic

Witch Talk: Redirected Trauma Responses to State Violence in the Dominican Republic

The Psychological Toll on Healthcare Workers Following Türkiye's Earthquake Disasters

Objective: The Kahramanmaraş-centered earthquakes in Türkiye profoundly impacted local healthcare workers' mental health. This study examines the relationships between sociodemographic and clinical variables, perceived social support, and psychological resilience in Post-Traumatic Stress Disorder (PTSD) development. Materials and Methods: A cross-sectional survey was conducted among 104 healthcare workers from ten affected provinces: Adana, Adıyaman, Diyarbakır, Gaziantep, Hatay, Kahramanmaraş, Kilis, Malatya, Osmaniye, and Şanlıurfa. Participants completed the PTSD Checklist for DSM-5 (PCL-5), Beck Anxiety Inventory (BAI), Beck Depression Inventory (BDI), Multidimensional Scale of Perceived Social Support (MSPSS), and Connor-Davidson Resilience Scale (CD-RISC). Results: The results revealed that 17.3% of participants exhibited severe trauma responses, while 82.7% had low trauma responses. Higher PTSD rates were associated with individuals living in moderately to severely damaged homes (%13.5, p=0.009) and assistant doctors whose education was interrupted by the disaster (%5.87, p= 0.019). Furthermore, PTSD diagnosis was positively correlated with anxiety (33±9, p

Lipid metabolic disorders and their impact on cartilage endplate and nucleus pulposus function in intervertebral disk degeneration.

Lipid metabolism encompasses the processes of digestion, absorption, synthesis, and degradation of fats within biological systems, playing a crucial role in sustaining normal physiological functions. Disorders of lipid metabolism, characterized by abnormal blood lipid levels and dysregulated fatty acid metabolism, have emerged as significant contributors to intervertebral disk degeneration (IDD). The pathogenesis of IDD is multifaceted, encompassing genetic predispositions, nutritional and metabolic factors, mechanical stressors, trauma, and inflammatory responses, which collectively facilitate the progression of IDD. Although the precise mechanisms underlying IDD remain incompletely elucidated, there is substantial consensus regarding the close association between lipid metabolism disorders and its development. Intervertebral disks are essential for maintaining spinal alignment. Their primary functions encompass shock absorption, preservation of physiological curvature, facilitation of movement, and provision of stability. The elasticity and thickness of these disks effectively absorb daily impacts, safeguard the spine, uphold its natural curvature and flexibility, while also creating space for nerve roots to prevent compression and ensure normal transmission of nerve signals. Research indicates that such metabolic disturbances may compromise the functionality of cartilaginous endplates (CEP) and nucleus pulposus (NP), thereby facilitating IDD's onset and progression. The CEP is integral to internal material exchange and shock absorption while mitigating NP herniation under mechanical load conditions. As the central component of intervertebral disks, NP is essential for maintaining disk height and providing shock-absorbing capabilities; thus, damage to these critical structures accelerates IDD progression. Furthermore, lipid metabolism disorders contribute to IDD through mechanisms including activation of endoplasmic reticulum stress pathways, enhancement of oxidative stress levels, induction of cellular pyroptosis alongside inhibition of autophagy processes-coupled with the promotion of inflammation-induced fibrosis and fibroblast proliferation leading to calcification within intervertebral disks. This review delineates the intricate interplay between lipid metabolism disorders and IDD; it is anticipated that advancing our understanding of this pathogenesis will pave the way for more effective preventive measures and therapeutic strategies against IDD in future research.

Self-Concealment as a Trauma Response: Examining the Mediating Role of Shame and Dissociation in the Link Between PTSD Symptoms and Self-Concealment Among Women Who Were Sex-Trafficked

ABSTRACT Self-concealment is a coping response to trauma through which survivors withhold information with personal, emotional, or social consequences. In this study, we examined shame and dissociation as mediators of the relationship between PTSD symptoms and self-concealment among women who were sex-trafficked. Survivors (N = 75) completed self-reported questionnaires, and statistical analysis revealed the relation between PTSD symptoms and self-concealment was mediated by shame and dissociation (19.4% and 52.3% of total effects mediated, respectively). Examining shame and dissociation as mechanisms of self-concealment provides a deeper understanding of why sex trafficking may be underdetected and how to aid survivors in discussing their experiences.

The lived experiences of childhood trauma in war: has post-traumatic growth occurred?

ABSTRACT Background: This study seeks to explore the Post-Traumatic Growth (PTG) condition, a transformative psychological process that promotes improved cognitive functioning and resilience in individuals who suffered childhood trauma, including those affected by the Iran-Iraq war. PTG denotes positive psychological changes, such as enhanced reasoning abilities and emotional strength (Tedeschi, R. G., & Calhoun, L. G. (2004). Posttraumatic growth: Conceptual foundations and empirical evidence. Psychological Inquiry, 15(1), 1–18)). Method: This study views trauma responses as complex and multidimensional, including not only negative outcomes but also coping strategies and psychological growth. Data was collected through semi-structured interviews with 11 participants who witnessed the Iran-Iraq war during childhood. Participants were from a broad spectrum of ethnic backgrounds, reflecting the multiethnic diversity of the war-affected areas. This is significant as their cultural background could affect how they process and heal from trauma due to the multiplicity of values, beliefs, and behaviours. Also, participants' socio-economic backgrounds ranged from low to middle-income, allowing for an investigation of how trauma and growth are impacted by financial resources and constraints. Data were analyzed using Moustakas's phenomenological analysis approach. Results: The findings revealed eight primary and twelve secondary themes ranging from psychological effects and long-term coping mechanisms and wartime recollections. The analysis also revealed distinct patterns of trauma symptoms and growth in adults approaching middle age. The available evidence points to the fact that, although the war-afflicted participants had to contantly live with the lingering effects of trauma across different stages of their lives, they continued to flourish and remain resilient with efficient stress management. Conclusions: The study emphasizes that, in theoretical terms, unexpected developmental steps are crucial, suggesting that childhood trauma, while commonly associated with negative outcomes, can also lead to growth and resilience in certain circumstances.

Curcumin-Functionalized Electrospun Nanofibrous Membranes with Antimicrobial Activity for Wound Healing.

Chronic or improperly healed wounds, either as a result of extended trauma or prolonged inflammatory response, affect a significant percentage of the world population. Hence, there is a growing interest in the development of biomimetic scaffolds that expedite wound closure at the early stages. Curcumin (Cur) is a plant-derived polyphenol with antimicrobial activity, and it accelerates the wound contraction rate. Recently, electrospraying has emerged for the precise deposition of bioactive molecules into scaffolds to improve therapeutic outcomes. In this study, we produced membranes for wound healing and endowed them with antibacterial properties to promote the healing of impaired wounds. Unlike previous studies that incorporated curcumin directly into electrospun fibers, we employed electrospraying to coat curcumin onto PVA/KC membranes. This approach improves the curcumin bioavailability and release kinetics, ensuring sustained therapeutic action. Toward this end, we fabricated four types of membranes, poly(vinyl alcohol) PVA and PVA/kappa carrageenan (KC), using electrospinning, and PVA/KC/Cur5 and PVA/KC/Cur20, in which the PVA/KC membranes were coated with two different concentrations of Cur by electrospraying. All membranes showed low cytotoxicity, good cell adhesion, the capability of enabling cells to produce collagen, and an adequate degradation rate for wound-healing applications. Antibacterial evaluation showed that both Cur-loaded membranes increased the antibacterial efficacy against both Escherichia coli and Staphylococcus aureus compared with PVA and PVA/KC membranes. These findings highlight the potential of electrosprayed curcumin as an effective strategy for bioactive wound dressings.

Medically Unexplained Behaviors and Symptoms in Consultation-Liaison Psychiatry: Biopsychosocial and Psychodynamic Considerations.

Medically Unexplained Behaviors and Symptoms in Consultation-Liaison Psychiatry: Biopsychosocial and Psychodynamic Considerations.

A Paradigm for Optimal Management: Traumatic Neck Injuries at a Tertiary Care Centre in South India.

Traumatic neck injuries represent a critical emergency in surgical practice due to the high concentration of vital structures within the cervical region. These injuries can be classified into blunt and penetrating types, each presenting unique challenges in diagnosis and management. While advances in trauma care have improved patient outcomes, the mortality and morbidity associated with neck injuries remain significant, especially in resource-limited settings. A retrospective cohort study was conducted at Government Medical College, Thrissur, analyzing the patterns, management, and outcomes of traumatic neck injuries from January 2022 to December 2024. The study included patients aged 13-79 years, with data collected from medical records, trauma registers, and operative reports. Patient demographics, injury type, anatomical location, management strategies, and clinical outcomes were assessed. A total of 72 traumatic neck injuries were reviewed, with the majority being young males (n=57, 79%). Blunt trauma (n=45, 62%) was more common than penetrating trauma (n=27, 38%), with road traffic accidents (n=32, 44%) and falls (n=20, 28%) being the leading causes of blunt injuries, while stabbing injuries accounted for most penetrating trauma (n=20, 73%). Emergency neck exploration was required in 17 cases (24%), and the overall mortality rate was seven cases (10%), primarily due to exsanguination (n=5, 67%) and vascular damage (n=2, 33%). The highest mortality was observed in penetrating Zone II injuries (n=5 deaths, 13%), often involving major vascular damage. Complications occurred in 13 survivors (18%), including wound infections (n=6, 8%), pneumonia (n=4, 5%), and neurological deficits (n=4, 5%). Night-time injuries were reported in 43 cases (60%), with a peak incidence during festive seasons and weekends, showing a significant association with alcohol consumption. The findings align with global trends, where penetrating injuries, especially in Zone II, carry a significantly higher risk of mortality. The study underscores the importance of early airway management, rapid surgical intervention, and the role of imaging-based triage for blunt trauma cases. The association of neck trauma with alcohol consumption, especially during nighttime hours, highlights the need for targeted public health measures and enhanced trauma response. This study provides valuable insights into the epidemiology, management strategies, and outcomes of traumatic neck injuries in a South Indian tertiary care center. The findings emphasize the critical role of early intervention, particularly in penetrating injuries involving vascular structures, and suggest that public health interventions and improved trauma care systems could optimize outcomes in this high-risk population.

The role of prenatal stress and maternal trauma responses in predicting children’s mental health during war

ABSTRACT Background: The negative effects of prenatal stress on children’s development and the buffering effects of maternal behaviour are well documented. However, specific maternal responses to trauma, particularly among families experiencing cumulative stressors during pregnancy and early childhood, remain less understood. Objective: This study investigated the interplay between prenatal stress in the context of the coronavirus disease 2019 (COVID-19) pandemic and consequent maternal trauma responses and children’s difficulties in the context of war-related trauma. Methods: We recruited 318 pregnant women in Israel during the first wave of the COVID-19 pandemic (Time 1). Prenatal depression, anxiety, and COVID-related stress symptoms were assessed. When children were approximately 3.5 years old (SD = 0.02), the mothers were asked to report on parental responses related to the ongoing war and their child’s emotional and behavioural difficulties (Time 2). Structural equation modelling was used to examine how maternal trauma responses mediate the association between prenatal stress-related mental health symptoms and children’s difficulties during war. Results: Maternal prenatal depressive, anxious, and COVID-19-related stress symptoms predicted maladaptive maternal trauma responses during the war, which in turn were associated with increased emotional and behavioural problems in their children. Among the specific maternal trauma-related responses examined, cognitive avoidance and overprotectiveness were the only behavioural responses during the war significantly associated with children’s difficulties. Conclusions: Our study highlights the impact of pandemic-related prenatal stress on maternal responses and children's difficulties during war, emphasizing the importance of identifying at-risk families as well as developing targeted interventions that mitigate negative parenting responses, particularly avoidance and overprotection.

From Suez to Suez: an autoethnographic study of transgenerational trauma

Purpose The term transgenerational trauma describes a process whereby trauma responses may be transmitted through a number of generations. This paper aims to increase understanding of the mechanisms behind transgenerational trauma by tracing the transmission of the effects of the author’s grandfather’s post-traumatic stress disorder, arising from his involvement in some of the worst actions of WWI, through his mother to himself. Design/methodology/approach The approach uses the autoethnographic paradigm to elucidate some of the mechanisms involved in the transmission of trauma responses from one generation to the next. Findings The paper demonstrates how upsetting childhood experiences of the author had their origin in his mother’s wartime experience a decade earlier, which themselves were influenced by his grandfather’s wartime experience 30 years before that. Originality/value The originality of the research rests on the fact that it is a study of three generations of one particular family. However, its value lies in the applicability of its results in a wider context.