Traumatic Stress Research Articles

Racial Stress and Black Women’s Health in the United States: A Culturally Responsive Prevention and Health Promotion Intervention

Black babies and their mothers are dying at disproportionately high rates. Also, Black women are experiencing higher rates of racial discrimination than other racial-ethnic groups are facing in the United States. An intervention promoting the health of Black women and their unborn babies requires addressing the disproportionate level of racial stress that Black women experience. In this article, the creation of such a program is discussed. To consider individual, community, and systemic factors, three theoretical models were utilized: (a) Race-based traumatic stress injury, (b) stress-health model, and (c) racial identity model. This intervention was co-developed with community stakeholders by using community-based participatory research principles. This process resulted in the development of the Afya Black Women Wellness program, a multidimensional and strength-based intervention grounded in the experiences of Black women. Afya focuses on promoting holistic health through psychoeducation, skills building, and social support. The program is constructed to be implemented twice-a-week for 12 weeks. This will allow pregnant Black women to receive the maximum benefit from the program, improving the quality of life for themselves and their unborn children. Ameliorating health disparities in Black maternal health requires addressing the disproportionate amount of racial stress that Black women experience. Afya is a model intervention that provides practical strategies for addressing racial health inequities in Black maternal health. It does so by promoting the health of Black women at the individual and community levels.

Fifty Years of Psychiatric Classification and Epidemiology Interactions: What is a Mental Disorder?

Psychiatric clinical diagnostic formulation has evolved over time. The changes alter our understanding and our ability to provide a public health perspective on the epidemiology of mental disorders in large populations. Epidemiology is an important perspective and set of tools to assess prevalence, treated prevalence, untreated prevalence, individual risks for mental disorders, and possible links to the etiology of disorders by following the trails of environmental exposures, biological measures, interpersonal dynamics, and genetic risk factors. As communities develop health-care services to treat individuals with mental disorders, knowledge about their prevalence and treatment requirements is also important. Since severe mental disorders may require institutional care, the diagnostic criteria used may either protect an individual’s liability for dangerous behavior (i.e. the insanity defense) or be used to control political and social dissidents. The criteria may also be used to determine evidence-based treatment options and eligibility for disability benefits. In this paper, using my vantage points as a physician scientist and public health officer, with leadership positions in national federal and professional mental health organizations, I address the developments in these areas over the past 50 years that have influenced institutional positions in the U.S. National Institute of Mental Health, the World Health Organization, the American Psychiatric Association, and the Center for the Study of Traumatic Stress. These perspectives may aid the next generation of investigators to advance the epidemiological and mental disorder classification scientific fields.

Relationships Among Secondary Traumatic Stress, Mindfulness, Compassion Satisfaction, and Compassion Fatigue in Psychiatric Nurses.

To examine relationships among secondary traumatic stress, mindfulness, compassion satisfaction, and compassion fatigue in psychiatric nurses. Participants comprised 142 nurses working in two psychiatric hospitals in the same province of Turkey. Data were collected using a personal information form, the Secondary Traumatic Stress Scale, Mindful Attention Awareness Scale, and Compassion Fatigue and Compassion Satisfaction subscales of the Professional Quality of Life Scale. A significant and negative correlation was found between secondary traumatic stress, mindfulness, and compassion satisfaction, and between mindfulness and compassion fatigue. A significant and positive correlation was found between secondary traumatic stress and compassion fatigue, as well as between mindfulness and compassion satisfaction (p < 0.05). Findings demonstrate that mindfulness may be a protective factor in preventing secondary traumatic stress and compassion fatigue in psychiatric nurses. It is recommended that in-service training be organized periodically to increase levels of conscious awareness among psychiatric nurses. [Journal of Psychosocial Nursing and Mental Health Services, xx(xx), xx-xx.].

All wounds speak – performing trauma/witnessing grief

While ‘trauma' has become a buzzword encompassing any distressing event, its definition as an unassimilated psychological wound, unresolved and recurrent, also means that it cannot ever be completely known. Trauma therapy seeks to reintegrate experiences, breaking the cycle of perpetual suffering through fragmentary recollection. Drama and performance art offer a platform for this reintegration, potentially facilitating healing. However, the fine line between therapeutic confrontation and re-traumatization necessitates careful navigation, avoiding triggering negative emotions. Crucially, not all traumatic events lead to PTSD; resilience and communal support can mitigate the effects of distressing experiences, as seen in instances of shared acceptance and forgiveness. Theatre's role in addressing trauma lies in its ability to bear witness, creating spaces for communal acknowledgment and shared grieving. While contemporary performances often revel in discomfort, embracing unresolved narratives, they prompt reflection on the limitations of representation. Art's transformative potential lies not in explicit curative intent but in its expression of unresolved complexities of human experience. Through patience, acceptance, and a refusal to impose meaning, creative arts can serve as a site for healing, fostering empathy and connection amidst the fragmentary experience of what Freud called ‘traumatic neurosis,’ what has since come to be called Post Traumatic Stress Disorder.

The effectiveness of brief workplace compassion-focussed training in improving wellbeing of stressed school employees

Australian teachers and school employees report high levels of stress-related mental health problems. Previous theory and research show that workplace training in strategies to manage stress can improve organisational productivity as well as employee wellbeing. Theory suggests that self-compassion strategies may produce better outcomes, than standard cognitive behavioural training interventions, due to activation of self-soothing. This pilot randomised controlled trial evaluated whether inclusion of a brief compassion-focussed therapy (CFT) training workshop was more effective in reducing stress-related mental health problems of school employees, than the standard professional development (PD) workshop that incorporated cognitive behavioural therapy and mindfulness strategies. School employees (103) were recruited and randomly allocated to either the standard PD alone or to also participate in a brief CFT workshop. There were very large reductions in burnout and clinically significant improvements in mental health problems under both conditions. The results provide preliminary evidence that CFT-enhanced training improves secondary traumatic stress and compassion satisfaction; further research needs to be conducted with a larger sample. These results may also be relevant to other occupations with a high emotional load. JEL Classification: I310

Mitigating the impact of secondary traumatic stress and compassion fatigue among forensic interviewing professionals: utilization of the four quadrants of self-preservation to promote post-traumatic growth

Forensic interviewing professionals, who regularly engage with children and youth reporting traumatic experiences, are particularly susceptible to secondary traumatic stress (STS) and compassion fatigue (CF). This conceptual article delves into the occupational hazards associated with forensic interviewing, emphasizing the inevitability of STS and CF due to frequent exposure to harrowing accounts of abuse. The article underscores the importance of recognizing these phenomena and differentiating them from burnout—a critical distinction that guides appropriate interventions. Utilizing the "Four Quadrants of Self-Preservation," a trauma- informed framework, the article offers practical strategies for forensic interviewers to mitigate the impacts of STS and CF. This approach promotes resilience through intentional self-care practices across four stages of secondary trauma exposure: before, during, immediately after, and ongoing post-exposure to traumatic material. The article advocates for organizational support in implementing these strategies, emphasizing the ethical imperative to safeguard the well-being of forensic interviewers. The findings suggest that addressing STS and CF not only enhances the personal resilience of professionals but also improves client outcomes, by reducing the likelihood of turnover and professional errors. This article contributes to the growing body of literature calling for trauma-informed practices in forensic settings, highlighting the need for continued research and organizational commitment to support these professionals.

The psychometric properties of the Swahili version of the Primary Care Post Traumatic Stress Disorder screen for DSM-5 among adults in Kenya.

The psychometric properties of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) are undocumented in Kenya and sub-Saharan Africa (SSA) at large. This study aimed to evaluate the psychometric properties of the Swahili version of the tool, S-PC-PTSD-5, in a community sample of adults 18 years and older drawn from Nairobi, Mombasa and Kwale counties in Kenya. Analysis of cross-sectional data from 1431 adults from the community was conducted, examining the reliability, factorial structure, measurement invariance, and convergent and divergent validity of the interviewer-administered S-PC-PTSD-5. Out of 1431 adults who completed the S-PC-PTSD-5, 666 (46.5%) reported experiencing at least one traumatic event. Internal consistency of the S-PC-PTSD-5 was good overall, with alpha and omega values above 0.7. Confirmatory factor analysis (CFA) results indicated a one-factor structure of the S-PC-PTSD-5 for the overall sample. Multigroup CFA also demonstrated factorial invariance for sex for the one-factor structure of S-PC-PTSD-5. Scores for S-PC-PTSD-5 significantly correlated (positively) with those of generalized anxiety disorder (GAD7) and depressive symptoms (PHQ9), indicating convergent validity. S-PC-PTSD-5 scores also significantly correlated (negatively) with the WHO-5 wellbeing index, supporting divergent validity. The S-PC-PTSD-5 is a reliable and valid unidimensional measure. It appears to be a valuable screening measure for probable PTSD in both urban and rural community settings in Kenya. Nonetheless, to confidently identify those who may need treatment/additional support, further research on the reliability and validity of S-PC-PTSD-5 is required, especially its diagnostic accuracy at different cutoff scores.

Equity, Diversity, Inclusion, and Other Trigger Words

Equity, Diversity, Inclusion, and Other Trigger Words

STRING-ing together protein complexes: corpus and methods for extracting physical protein interactions from the biomedical literature.

Understanding biological processes relies heavily on curated knowledge of physical interactions between proteins. Yet, a notable gap remains between the information stored in databases of curated knowledge and the plethora of interactions documented in the scientific literature. To bridge this gap, we introduce ComplexTome, a manually annotated corpus designed to facilitate the development of text-mining methods for the extraction of complex formation relationships among biomedical entities targeting the downstream semantics of the physical interaction subnetwork of the STRING database. This corpus comprises 1287 documents with ∼3500 relationships. We train a novel relation extraction model on this corpus and find that it can highly reliably identify physical protein interactions (F1-score = 82.8%). We additionally enhance the model's capabilities through unsupervised trigger word detection and apply it to extract relations and trigger words for these relations from all open publications in the domain literature. This information has been fully integrated into the latest version of the STRING database. We provide the corpus, code, and all results produced by the large-scale runs of our systems biomedical on literature via Zenodo https://doi.org/10.5281/zenodo.8139716, Github https://github.com/farmeh/ComplexTome_extraction, and the latest version of STRING database https://string-db.org/.

Repetitive subconcussion results in disrupted neural activity independent of concussion history

Abstract Concussion is a public health crisis that results in a complex cascade of neurochemical changes that can have life-changing consequences. Subconcussions are generally considered less serious, but we now realize repetitive subconcussions can lead to serious neurological deficits. Subconcussions are common in contact sports and the military where certain personnel are exposed to repetitive occupational blast overpressure. Post-mortem studies show subconcussion is a better predictor than concussion for chronic traumatic encephalopathy—a progressive and fatal neurodegenerative tauopathy, only diagnosable post-mortem—thus, an in vivo biomarker would be transformative. Magnetoencephalography captures the dynamics of neuronal electrochemical action, and functional MRI shows that functional connectivity is associated with tauopathy patterns. Therefore, both imaging modalities could provide surrogate markers of tauopathy. In this cross-sectional study, we examined the effects of repetitive subconcussion on neuronal activity and functional connectivity using magnetoencephalography and functional MRI, and on neurological symptoms and mental health in a military sample. For magnetoencephalography and outcome analyses, 81 participants were split into ‘high’ and ‘low’ blast exposure groups using the generalized blast exposure value: n = 41 high blast (26.4–65.7 years; 4 females) and n = 40 low blast (28.0–63.3 years; 8 females). For functional MRI, two high blast male participants without data were excluded: n = 39 (29.6–65.7 years). Magnetoencephalography revealed disrupted neuronal activity in participants with a greater history of repetitive subconcussions, including neural slowing (higher delta activity) in right fronto-temporal lobes and subcortical regions (hippocampus, amygdala, caudate, pallidum and thalamus), and functional dysconnectivity in the posterior default mode network (lower connectivity at low and high gamma). These abnormalities were independent of concussion or traumatic stress history, and magnetoencephalography showed functional dysconnectivity not detected in functional MRI. Besides magnetoencephalography changes, those with higher blast exposure had poorer somatic and cognitive outcomes, with no blast-related differences in mental health or associations between neurological symptoms and neuronal activity. This study suggests that repetitive subconcussions have deleterious effects on brain function and that magnetoencephalography provides an avenue for both treatment targets by identifying affected brain regions and in prevention by identifying those at risk of cumulative subconcussive neurotrauma.

Overcoming Rape: A Mixed-Methods Approach to Understanding Psychological and Physical Health Functioning of Male Survivors.

When examining sexual assault, men are often hidden from the literature. The current study employed a mixed-methods, convergent parallel design to examine the experiences of 22 male survivors of sexual assault (mean age = 44.19, SD = 13.28, range 18-65; 91% European American; 50% heterosexual). Survivors were administered an online survey using quantitative and qualitative questions to assess rape myths, gender roles, self-esteem, self-efficacy, resiliency, coping, overall mental and physical health, and diagnostic criteria for alcohol abuse, post traumatic stress disorder (PTSD), and sexual dysfunction. Three key themes emerged from the integration of quantitative and qualitative data: (a) Help is Elusive, (b) Internal Struggles and External Strengths, and (c) Living with Clinical Diagnoses. This study adds to an important area of the literature that increases understanding of men's experiences with sexual violence and honors the voices of these survivors.

Prazosin Treatment of Sleep Problems in Youth with PTSD

Post traumatic stress disorder (PTSD) is a condition characterized by reexperiencing symptoms, persistent avoidance, negative alterations in cognition and mood, and changes in arousal and reactivity in response to a traumatic event (American Psychiatric Association, 2013). The pathophysiology of PTSD is not fully understood but likely related to dysregulation of fear‐processing. Currently, the gold standard of treatment is trauma‐focused cognitive behavioral therapy (TF‐CBT). SSRIs are the only FDA‐approved pharmacologic treatments for PTSD in adults and there are no FDA approved medications to treat pediatric PTSD. Unlike studies in adults, double‐blinded randomized control trials (RCTs) did not show any efficacy for SSRIs in pediatric patients diagnosed with PTSD (Hudson et al., 2021). While estimates of pediatric PTSD prevalence varies, the prevalence of PTSD at age 18 is 7.8% (Rolling et al., 2023). Sleep disturbances such as insomnia, night‐time awakenings, and nightmares often persist despite treatment with TF‐CBT or SSRIs. Left untreated, sleep disturbances are predictive of PTSD persistence and comorbid psychiatric complications (Rolling et al., 2023). There is evidence supporting the use of the medication prazosin in alleviating pediatric PTSD sleep disturbances including nightmares and insomnia. Anywhere from 20–80% of children with PTSD report nightmares compared to a prevalence of 10–20% in the general pediatric population (Kovachy et al., 2013). There is a growing need for pharmacologic therapy given the paucity of providers trained in TF‐CBT and a need for symptomatic management. In this review, we will examine sleep disturbances in pediatric PTSD patients and discuss the feasibility of prazosin as an adjunct treatment option.

What I was thinking/what I would do differently: Clinical research.

At the 2023 International Society for Traumatic Stress Studies annual meeting, a panel of three distinguished investigators and clinicians convened to reflect on their careers, their contributions to the field of traumatic stress disorders, and the lessons learned over the years. Dr. Terence M. Keane has guided the development and deployment of evidence-based care, shaping evaluation guidelines and best treatment practices for traumatic stress pathology. Dr. Sheila Rauch, a pioneer in the development of prolonged exposure therapy, has significantly contributed to the treatment of posttraumatic stress disorder (PTSD) and other traumatic stress disorders. Dr. Richard Bryant has developed targeted psychological treatments for traumatic stress and prolonged grief, adapting to the diverse needs, mechanisms, and cultural contexts of patients. These individuals' collective experiences span from the establishment of the PTSD diagnosis to the current proliferation of scientific knowledge on its epidemiology, assessment, and treatment. Their unique yet overlapping contributions have provided invaluable guidelines for the next generation of clinicians and investigators. This panel discussion offers a retrospective look at their careers and a forward-looking perspective on the future of traumatic stress treatment.

"The light after the storm": Psychosocial correlates of adversarial growth among nurses in Hong Kong amid the fifth wave of the COVID-19 pandemic.

Healthcare professionals are highly susceptible to adverse psychological outcomes amid the COVID-19 pandemic due to their job duties. As the largest part of the healthcare workforce, growing attention has been paid to nurses' adjustments to the pandemic. Despite the distress, recent studies found that nurses could still experience positive changes (i.e., adversarial growth, AG) during the pandemic. Research on the general populations has indicated that individuals' stress responses, coping resources, and coping strategies are associated with their AG during the pandemic. This study examined how sociodemographic characteristics, secondary traumatic and posttraumatic stress, coping resources, and coping strategies were associated with AG among nurses in Hong Kong amid the fifth wave (i.e., the most disastrous wave) of the COVID-19 pandemic. Recruited through local nursing associations between May 24 and June 13, 2022, 209 nurses in Hong Kong completed an online questionnaire measuring the abovementioned variables. Hierarchical regression results found that those affiliating with a religion, having participated in mental health-related workshops, higher levels of secondary traumatic stress (STS), social support, job satisfaction, plus more frequent emotional processing were associated with higher AG (βs ranging from 0.15 to 0.31, ps < .01). Nurses did report AG during the fifth wave of the COVID-19 pandemic in Hong Kong. To promote AG among those nurses, future interventions should enhance nurses' understanding about the potential impact of STS on their well-being, solicit their interpersonal and work-related coping resources, plus facilitate their use of effective coping strategies. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Hardiness predicts mental health recovery during the COVID-19 pandemic.

The COVID-19 pandemic has elicited wide-scale general psychological distress; however, longitudinal investigations are required to identify the critical resources that support individuals' adaptation to this type of unique situation over time. Hardiness, a cognitive trait that facilitates adaptation in the context of adversity and possible posttraumatic growth, may be particularly influential on mental health recovery during health disasters when other resources are not available or effective. We tested the hypothesis that greater psychological hardiness prior to the pandemic would predict lower traumatic stress symptoms (TSSs) and loneliness early into the pandemic and decreases in TSSs and loneliness between early 2020 and late 2021. Predominantly ethnic minority (77% Latina/o/x or Asian American) female young adults (N = 80; Mage = 25 years; 88% female) attending a minority-serving public university completed a measure of hardiness in January 2020 as well as measures of pandemic-related TSSs and loneliness in April 2020, October 2020, and December 2021. Latent growth curve analyses indicated that hardiness was associated with lower initial loneliness as well as decreases in TSSs and loneliness over time. Consistent with previous research on adaptation to other potentially traumatic stressors, the current findings suggest that psychological hardiness may play a critical protective role during a global health disaster, both in terms of initial distress and changes in distress over time. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Secondary traumatic stress, vicarious posttraumatic growth, and rumination among healthcare professionals: Examining conditional indirect effect of secondary exposure to trauma.

Secondary traumatic stress, vicarious posttraumatic growth, and rumination among healthcare professionals: Examining conditional indirect effect of secondary exposure to trauma.

THE PSYCHOLOGICAL IMPACT OF SURVIVORS OF THE EARTHQUAKE, TSUNAMI, AND LIQUEFACTION: A QUALITATIVE STUDY

Introduction: Natural disasters in the form of earthquakes, tsunamis, and liquefactions in Central Sulawesi in 2018 had several impacts on disaster survivors' psychology. These psychological problems have developed as an effect from serious injuries or loss of family members of the survivors. Psychological disorders, such as anxiety, depression, to Post traumatic stress disorder, can affect long-term quality of life. This study aims to explore the psychological impacts experienced by survivors of the earthquake, tsunami, and liquefaction in Central Sulawesi. Method: A qualitative study with a phenomenological approach. In-depth interviews were conducted using semi-structured guideline, observation and voice recording of 18 survivors of the earthquake, tsunami, and liquefaction disasters. The determination of the sample is using a purposive sampling technique based on inclusion criteria. The results of the interviews were transcribed, member checking, and analyzed using the Van Mannen method. Results: This study produced four themes and fifteen sub-themes. The research themes consist of the grieving phase, post-traumatic stress disorder, social support and health services support. Conclusions: Further screening of disaster survivors who experienced psychological disorders is needed, not only as a preventive measure but also as a psychological support to improve their quality of life.

The Evolution Process between the Earthquake Swarm Beneath the Noto Peninsula, Central Japan and the 2024 M 7.6 Noto Hanto Earthquake Sequence

Several physical mechanisms of earthquake nucleation, such as pre-slip, cascade triggering, aseismic slip, and fluid-driven models, have been proposed. However, it is still not clear which model plays the most important role in driving foreshocks and mainshock nucleation for given cases. In this study, we focus on the relationship between an intensive earthquake swarm that started beneath the Noto Peninsula in Central Japan since November 2020 and the nucleation of the 2024 M7.6 Noto Hanto earthquake. We relocate earthquakes listed in the standard Japan Meteorological Agency (JMA) catalog since 2018 with the double-different relocation method. Relocated seismicity revealed that the 2024 M7.6 mainshock likely ruptured a thrust fault above a parallel fault where the M6.5 Suzu earthquake occurred in May 2023. We find possible along-strike and along-dip expansion of seismicity in the first few months at the beginning of the swarm sequence, while no obvious migration pattern in the last few days before the M7.6 mainshock was observed. Several smaller events occurred in between the M5.5 and M4.6 foreshocks that occurred about 4 and 2 minutes before the M7.6 mainshock. The Coulomb stress changes from the M5.5 foreshock were negative at the hypocenter of the M7.6 mainshock, which is inconsistent with a simple cascade triggering model. Moreover, an M5.9 foreshock was identified in the JMA catalog 14 s before the mainshock. Results from back-projection of high-frequency teleseismic P waves show a prolonged initial rupture process near the mainshock hypocenter lasting for ∼25 seconds, before propagating bi-laterally outward. Our results suggest a complex evolution process linking the earthquake swarm to nucleation of the M7.6 mainshock at a region of complex structures associated with the bend of a mapped large-scale reverse fault. A combination of fluid migration, aseismic slip and elastic stress triggering likely work in concert to drive both the prolonged earthquake swarm and the nucleation of the M7.6 mainshock.

The epigenetic changes are affected by sex and valproic acid treatment in a rat model of post-traumatic stress disorder

Post-traumatic stress disorder (PTSD) presents distinct sex-specific differences in both symptom expression and treatment outcomes, with the underlying biological mechanisms still remain unclear. Epigenetic modifications, particularly histone acetylation, have been increasingly recognized as critical factors in the pathophysiology of PTSD. Valproic acid (VPA), a potent histone deacetylase (HDAC) inhibitor, has shown promise in modulating epigenetic responses and improving therapeutic outcomes is PTSD, though its effect may differ between sexes.This study aimed to explore the sex-specific epigenetic changes in response to trauma and the impact of VPA treatment in a rat model of PTSD induced by predator scent stress. Sprague-Dawley rats of both sexes were randomly assigned to stressed and non-stressed groups and treated with either VPA (100 mg/kg) or vehicle. Anxiety levels were assessed using the elevated plus maze, followed by analysis of histone H3 and H4 acetylation, HDAC activity, and c-fos expression in the hippocampus.Our findings revealed that traumatic stress led to increased freezing time and anxiety levels, with more pronounced effects observed in females. Additionally, we have identified sex-specific differences in hippocampal epigenetic modifications; stressed females exhibited higher H3 acetylation, and VPA-treated stressed males showed increased H4 acetylation.These results highlight the importance of considering sex differences in the epigenetic mechanism underlying PTSD and suggest that personalized therapeutic approaches may be necessary to address these complexities.

Health Behaviours after Returning to Work in Patients Who Experienced Hand Finger Amputation as a Result of Work Accidents

Background: Many organizations face health behavior related issues such as anxiety, depression, traumatic stress disorder in their employee performance, particularly in those who had experienced hand-finger amputation as a result of work accidents. Such issues reduce their overall productivity when they return to work. Aim: The objective of this research was to measure the impact of rehabilitation program participation, psychological support, workplace accommodations and self-efficacy in daily tasks on the health behaviour of patients who experienced hand finger amputation as a result of work accidents. Method: The study used cross-sectional data, collected from 210 respondents across organizations in Adana, Turkey. The empirical results were checked using Statistical Package for Social Science (SPSS) version 21. Results: The findings of this study confirmed that rehabilitation participation program, psychological support, and self-efficacy in daily tasks had a significant and direct impact on the health behaviour of patients who experienced hand-finger amputation as a result of work accidents. However, the study also reported there was no significant and direct impact of workplace accommodations on the health behaviour of patients who experienced hand-finger amputation as a result of work accidents. Conclusion: The findings of this research would contribute to the body of literature in the form of new rationale development and would provide practical solutions to improve employees' health behaviour.