The role of gender and child sexual abuse history in treatment response in two treatments for posttraumatic stress disorder.

Eye Movement Desensitization and Reprocessing (EMDR) is one of the recommended, evidence-based treatments for post-traumatic stress disorder (PTSD). Although the effects of eye movements on the desensitization of traumatic memories have been extensively documented, there are less studies on the effectiveness of vibratory bilateral stimulation (VBS), even though this type of stimulation is often used in clinical practice. In the present study, we tested the effect of VBS on the emotionality and vividness of autobiographical negative memories in healthy participants. After selecting two moderate negative memories, participants had to rate one of these memories on emotionality and vividness scales and to recall it four times without any stimulation or with VBS. In the control condition (without stimulation), emotionality ratings increased after recall, whereas vividness remained unchanged. Most importantly, VBS prevented this emotional rise without affecting vividness. We also found that the more participants were distracted by the VBS, the greater was the reduction in emotionality. These findings therefore provide new encouraging empirical evidence in favour of using VBS to reduce the emotional burden of negative autobiographical memories.

Posttraumatic stress disorder (PTSD) is a chronic and disabling condition and identifying beneficial therapies is timely and important. We aimed to estimate the efficacy of 3,4-methylenedioxymethamphetamine-assisted therapy (MDMA-AT) compared with control on clinical and functional outcomes in PTSD. A PRISMA-compliant search (PROSPEROCRD42022353261) up to August 14, 2025, covered nine databases and manual searches to identify randomised controlled trials (RCTs). Methodological quality was assessed using the Cochrane Risk of Bias tool (RoB2), and the certainty of the evidence for each outcome was evaluated using the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) approach. Of 1035 records identified, 14 studies met inclusion criteria for qualitative synthesis; eight trials provided sufficient data for quantitative synthesis (k = 24). Random-effects meta-analyses indicated that MDMA-AT was associated with reductions in PTSD symptom severity (n = 298, k = 9, SMD = -1.19, 95 % CI [-1.95, -0.42]; I² = 68.8 %, τ2 = 1.02), dissociative symptoms (n = 148, k = 5, SMD = -0.37, 95 % CI [-0.70, -0.04]; I² = 0.0 %, τ2 = 0), and may improve functioning (n = 227, k = 4, SMD = -0.83, 95 % CI [-1.47, -0.19]; I² = 61.2 %, τ2 = 0.27). No clear evidence of benefit was observed for depressive symptoms. Most studies showed a high risk of bias in the measurement of the outcome, and some concerns due to deviations from the intended intervention; the overall certainty of the evidence was very low. The number of trials remains limited, with considerable heterogeneity in certain outcomes, small sample sizes, and the absence of active controls in most studies, which likely compromised blinding integrity. Current findings suggest that MDMA-AT may warrant further investigation as a potential treatment for PTSD; however, larger, higher-quality RCTs with active controls and long-term follow-up are needed to determine its efficacy.

Trauma exposure and post-traumatic stress disorder (PTSD) are a global public health concern, especially in low and middle-income countries (LMICs). University students are a unique population that has been found to have increased levels of trauma exposure and PTSD, yet limited clinical outcome and neurobiological data exist, especially in LMICs, on treatment responses to evidence-based trauma-focused treatments for PTSD among university students in LMICs. The development and integration of neuroimaging tools in psychotherapy enable more robust integration of data from clinical psychology and neuroscience. Our protocol is the first to use functional Near-infrared spectroscopy (fNIRS) to investigate the treatment response of a first-line trauma-focused cognitive behavioural therapy, namely, prolonged exposure therapy, for the treatment of PTSD. Using a pilot randomised controlled trial, university students diagnosed with PTSD will be assessed using clinical outcome measures and fNIRS to ascertain prefrontal cortical increases and decreases in persons diagnosed with PTSD. Participants will be randomised to either the experimental condition (PE) or a comparative control condition (supportive counselling). Participants will be assessed at baseline, post-intervention, and at 12 and 24-week follow-ups using the same measures and imaging.•Recruit and assess university students using standard clinical measures and fNIRS for PTSD.•Assign enrolled students to either PE (experimental condition) or supportive counselling (control condition) for a minimum of 8 sessions.•Assess students at the end of treatment and at 12 and 24-week follow-ups using the same clinical measures and fNIRS for any changes in PTSD.

Trauma disclosure and willingness to involve close others in therapy across two exposure-based treatments for PTSD.

Document trauma-sensitive yoga (TSY) acceptability, appropriateness, interest, motivators, barriers, and preferences in U.S. adults with posttraumatic stress disorder symptoms and conduct gender comparisons as a preimplementation study for TSY program planning and to advance research-to-practice integration. Quota sampling was used to recruit men (n = 63) and women (n = 65) via a crowdsourcing platform for an online mixed-method survey. Descriptives and independent samples t tests, chi-square tests, and effect sizes were calculated. TSY was rated as acceptable and appropriate for trauma care. Most participants had never heard of TSY (90.62%) and indicated interest in it (96.09%). Top barriers were cost, time, and lack of awareness of programs. Top motivators were mental health support and curiosity. Program preferences were for virtual asynchronous groups open for any trauma survivors. Participants reported wanting programs with education about yoga and trauma and check-ins with the facilitator. Average preferences were for 7-week programs with 3, 45-min sessions a week with optional home practice. Women reported significantly more interest and weeks compared to men. Preference differences emerged for making up missed sessions and recording homework. U.S. adults with posttraumatic stress disorder symptoms and limited TSY experience rated TSY as acceptable and appropriate for trauma care. Most participants were interested in TSY programs and TSY integrated with psychotherapy, yet awareness of programs was a barrier. TSY facilitators and mental health providers can collaborate to increase awareness of TSY as an empirically supported adjunctive posttraumatic stress disorder intervention and design programs based on preferences. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

BackgroundWhile psychotherapeutic interventions for Post Traumatic Stress Disorder (PTSD) are effective, transfer to everyday life is challenged by a shift from treatment setting to the patients’ living environment. Adding digital components to the treatment (Blended Care, BC) may support autonomous completion of therapeutic tasks and facilitate transfer but has not been studied in residential treatment settings.ObjectiveThe present study explores the implementation, usability, and preliminary effectiveness of a BC approach for PTSD treatment in a non-acute residential hospital setting. Clinician and patient perspectives are considered.Methods36 patients participated in a two-group quasi-experimental design (intervention vs. control) with three measurements (admission, discharge, three-month follow-up). Face-to-face trauma-focused CBT was offered in both groups, complemented by a BC software in the intervention group. Also, 16 clinicians participated in the study. We collected qualitative data from semi-structured interviews, software usage-data, and psychometric questionnaire data from patients and clinicians.ResultsPatients reported high satisfaction with software usability; clinicians had varying opinions. Uptake was inconsistent on both sides. Capacity issues and an inaccurate definition of the intended use hampered implementation. Still, intensified collaboration and sustained engagement with treatment contents were identified as benefits of BC. Quantitative measures of symptom severity showed no significant between-group differences in exploratory analyses and no relation to software usage intensity.ConclusionsThis study confirms potentials and obstacles of BC to facilitate the therapeutic process in the residential treatment of PTSD. It also emphasizes the importance of a concise concept for the coordination of digital and face-to-face components to ensure sufficient uptake and raise clinical effectiveness.Trial registrationdrks.de, DRKS00031741, Registration date: 21 April 2023, https://drks.de/search/de/trial/DRKS00031741/details.Supplementary InformationThe online version contains supplementary material available at 10.1186/s40359-026-04738-5.

Posttraumatic stress disorder (PTSD) significantly impacts active duty service members, posing challenges to both individual well-being and military readiness. This study examined the long-term outcomes of a residential PTSD treatment program, focusing on the association between symptom change and military separation. Participants were 282 active duty service members diagnosed with PTSD. PTSD symptom severity was assessed weekly using the PTSD Checklist-Military version (PCL-M). Military separation data were collected from administrative records. A multivariate joint model analyzed the association between PTSD symptoms and time to separation, whereas a Cox regression analysis explored differences across treatment response subgroups. On average, participants reported a significant 0.83-point weekly decrease in PTSD symptom severity, B= -1.49,p<.001. The linear slope of PCL-M scores significantly predicted separation, with each 1-point weekly decrease in symptoms associated with a 2.4% lower risk of separation. Critically, service members classified as "improved" demonstrated a significantly lower risk of separation compared with those characterized as "worsened," hazard ratio=1.51, 95% CI [1.01, 2.26],p=.044. The findings highlight that PTSD symptom improvement during residential treatment is a significant predictor of military retention. This underscores the importance of effective PTSD treatment not only for improving psychological well-being but also for contributing to force readiness.

There are high rates of co-occurring post-traumatic stress disorder (PTSD) among patients in treatment for substance use disorder (SUD). PTSD and SUD should be treated simultaneously, which is rarely the case. The reluctance to offer trauma-focused treatment is partially due to fear of increased risk of dropout. PTSD is related to emotion dysregulation and elevated psychological burden, higher dropout rates and increased risk of relapse. In this project, we plan to assess if it is relevant, feasible, acceptable and safe to add a combination of narrative exposure therapy (NET) and dialectical behaviour therapy for substance use disorder skills training (DBT-SUD Skills) to standard inpatient SUD treatment. We will recruit patients from a long-term inpatient SUD treatment centre on the west coast of Norway (N approx. = 90). We will assess relevance based on the prevalence of PTSD/Subthreshold-PTSD and traumatic experiences, suicidal behaviour, self-harm, and the severity of difficulties in emotion regulation. We will assess acceptability with treatment participation among patients and the subjective experience of the treatment. We will measure safety with the rate of dropout and destructive behaviour in the treatment period. It is important to develop and evaluate treatment options for this vulnerable patient population, often excluded from clinical research. Strengths include a naturalistic setting and historical data for comparison. Limitations are the absence of a control group and inability to isolate component effects. The results can be used to develop a treatment protocol for combining NET and DBT-skills training to in patient SUD treatment for further development and testing in a multicentre Protocol following SPIRIT 2025 guidelines. This trial was retrospectively registered at ClinicalTrials.gov on 3 April 2024 (#203,428).

The processing of positive memories technique (PPMT) is a promising new treatment for posttraumatic stress disorder (PTSD) involving the detailed narration and processing of specific positive autobiographical memories. This study used an interrupted time series design with daily diary reports to assess changes in daily-level affect, cognitions, and PTSD symptoms pre- to post-PPMT. A convenience sample of trauma-exposed U.S.-based adults (n=70) recruited through social media and flyers received the 4-week PPMT intervention and completed 21 daily surveys pre- and post-PPMT (42 total surveys) assessing daily positive event pleasantness, negative event unpleasantness, PTSD symptoms, posttraumatic cognition levels, and positive and negative affect levels. Mixed-effects models found post-PPMT reductions in daily negative event unpleasantness ratings, β=-.25, p<.001; PTSD symptoms, β=-.24, p<.001; posttraumatic cognition levels, β=-.32, p<.001; and negative affect levels, β=-.32, p<.001, alongside increases in daily positive affect levels, β=.12, p=.021, compared with the preintervention phase. The association between daily negative event unpleasantness and daily negative affect levels (negative affect reactivity) was weaker postintervention compared with preintervention. There was no significant change post-PPMT in positive event pleasantness ratings, β = -.03, p=.619, or the association between daily positive event pleasantness and daily positive affect levels (positive affect reactivity), β=.00, p=.931. These findings provide support for the beneficial therapeutic effects of PPMT at the daily level for trauma-exposed populations. Further studies should test these patterns with clinical samples.

Psychiatric treatment research has too frequently neglected anger. "Anger management" is widely used to tamp anger down. Yet understanding and expressing anger often have clinical and interpersonal value. Few data address anger in the context of treating patients with posttraumatic stress disorder (PTSD). The authors hypothesized the clinical utility of anger expression rather than suppression, particularly using interpersonal psychotherapy (IPT), which focuses on interpersonal handling of emotions. IPT effects on anger have barely been researched. Secondary data analyses examined anger items from a randomized, 14-week trial of prolonged exposure (PE), IPT, and relaxation therapy (RT) for 110 unmedicated patients with PTSD (ClinicalTrials.gov: NCT00739765). Anger-related variables from the Clinician-Administered PTSD Scale (CAPS), Beck Depression Inventory-II (BDI-II), and Inventory of Interpersonal Problems (IIP) were analyzed with limited mixed-effects models. Anger decreased across treatments, with greater reductions in IPT compared with RT on CAPS anger when analyses controlled for overall PTSD improvement (p=0.035). The PE group × time interaction approached significance, suggesting less CAPS anger reduction over time for PE than for IPT. RT (vs. IPT) patients reported higher end-point BDI-II irritability (p=0.046) and less IIP reduction in anger-related interpersonal difficulties (p=0.017). Men had consistently higher CAPS anger scores than women (p=0.042). In this secondary data exploratory study lacking a primary anger scale, anger levels on several instruments improved across PTSD treatments with improvement in PTSD. The effect was greatest for IPT, which focuses on negative affect and its useful expression, and least for RT, which uses typical anger management techniques.

NMDA receptor subtype differential affinity as a key enabler for precision neuropsychiatry.

Predictors of momentary emotion differentiation among veterans in residential treatment for posttraumatic stress disorder: An ecological momentary assessment study.

Post Traumatic Stress Disorder (PTSD) is not uncommon following major trauma. Despite increasing awareness of the psychological sequelae of trauma, there is often inadequate mental health follow-up for trauma patients. This can lead to significant rates of under-diagnosis and under-treatment. To examine rates of under-diagnosis and under-treatment of probable PTSD amongst major trauma patients admitted to Christchurch Hospital, New Zealand. A prospective questionnaire-based cohort study including patients 16 years and older who presented to Christchurch Hospital with major trauma (Injury Severity Score >/=12) between May 2016 and September 2018. Patients with severe brain injury were excluded. Patients who consented completed the Posttraumatic Stress Disorder Checklist for DSM-V (PCL-5), plus answered questions on any assessment, treatment or diagnosis of PTSD, depression or anxiety before and/or after injury. Demographic, injury-specific and hospital care data were collated from the New Zealand Major Trauma Registry. There were 836 patients who met the eligibility criteria and were invited to participate in the study, with a 24% response rate (203 patients). Thirty-seven (18%) scored at or above the PTSD threshold, however only 8 (22%) reported having received a formal diagnosis of PTSD. All 8 patients who had received a formal diagnosis of PTSD were receiving some form of mental health treatment (either medication, 'talk therapy' or both). By comparison, within the group of 29 patients who had not received a diagnosis of PTSD but met criteria, only 11 (38%) were receiving any form of mental health treatment. Many people who develop PTSD following trauma fail to receive appropriate assessment, diagnosis or treatment. Further work is needed to ensure adequate systems are in place to allow identification and treatment of patients who develop PTSD following a major trauma.

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

The role of IDO1-mediated Tryptophan/Kynurenine metabolism and its association with estrogen level in PTSD within SPS mouse model.

Based on its in vitro profile and preliminary evidence, 4-bromo-2,5-dimethoxyphenethylamine (2C-B) may have psychoactive properties that are similar to 3,4-methylenedioxymethamphetamine (MDMA) and psilocybin, which are investigated for the treatment of posttraumatic stress disorder and depressive disorders. We compared acute effects of 2C-B (10, 20, and 30 mg), 125 mg MDMA, and 25 mg psilocybin in 24 healthy participants (12 women, 12 men) using a double-blind, randomized, placebo-controlled, crossover design. Outcome measures included acute subjective effects, autonomic effects, adverse effects, effects on emotional and cognitive empathy, plasma oxytocin and neurophysin I concentrations, and pharmacokinetics up to 9 h. 2C-B produced dose-dependent subjective effects, with the 30 mg dose exerting comparable "any drug effects" to MDMA but lower "any drug effects" than psilocybin. Only psilocybin induced "bad drug effects" and "anxiety" compared with placebo. The 30 mg dose of 2C-B induced psychedelic-type alterations of state of consciousness and increased emotional empathy similarly to MDMA. The average subjective effect duration of 30 mg 2C-B was 4.9 h and similar to MDMA (4.8 h) and shorter than psilocybin (6.1 h). MDMA produced the highest cardiovascular stimulation, followed by psilocybin and 2C-B. Only MDMA increased plasma oxytocin and neurophysin I concentrations. 2C-B exhibited dose-proportional pharmacokinetics, with a plasma elimination half-life of ~1.3 h. The 30 mg dose of 2C-B induced entactogenic and psychedelic effects similarly to MDMA and psilocybin, respectively. MDMA is more cardiostimulant than psilocybin and 2C-B. At the tested dose-level, psilocybin is more distressing than MDMA and 2C-B. These results may assist with dose-finding for future 2C-B research and provide a direct comparison with standard doses of the prototypical compounds MDMA and psilocybin. Trial registration: ClinicalTrials.gov identifier: NCT05523401.

The co-occurrenceof mild traumatic brain injury (mTBI) and posttraumatic stress disorder (PTSD) is associated with greater impairment relative to the presence of either condition alone. This study evaluated the effectiveness of cognitively augmented behavioral activation (CABA) therapy, compared to treatment as usual (TAU), at reducing mTBI and PTSD symptoms in 71 military veterans randomized to treatment at two urban U.S. Department of Veterans Affairs medical centers. Primary outcomes were PTSD symptom severity, measured by structured clinical interview (Clinician-Administered PTSD Scale for DSM-5; CAPS-5) and self-report questionnaire (PTSD Checklist for DSM-5; PCL-5), and objective cognitive function (neuropsychological test battery). Intent-to-treat analyses using linear mixed-effects regression models (LMM) indicated that CABA significantly outperformed TAU in reducing PTSD symptom severity, CAPS-5: d = 0.11, p =.027, PCL-5: d = 0.11, p =.030 (small effects), and improving performance on neuropsychological tests of verbal learning, d = 0.07 (small effect) and delayed recall, d = 0.26 (small-to-medium effect). Changes in PTSD symptoms were explored via within-group LMM, which revealed significant within-CABA reductions, CAPS-5: d = 0.87, p <.001, PCL-5: d = 0.40, p =.006 (medium-to-large effects), but no significant symptom change within the TAU group, CAPS-5: d = 0.07, p =.195, PCL-5: d = 0.00, p =.978 (small effects). There was no significant difference between groups on treatment satisfaction ratings. This randomized controlled trial provides preliminary evidence that CABA may be a promising intervention for comorbid mTBI and PTSD.

Humanitarian emergencies expose millions of young people to adversity each year, with particularly severe consequences in low-and middle-income countries (LMICs) where mental health resources are scarce. In these contexts, community-based interventions (CBIs) can fill treatment gaps by leveraging local strengths to address mental health symptoms and sustainably foster resilience. Although these interventions demonstrate therapeutic potential, evidence regarding their effectiveness in reducing youth Post-Traumatic Stress Disorder (PTSD) symptoms remains mixed, particularly in LMICs affected by humanitarian emergencies. To examine the efficacy of CBIs for this population, a systematic review of five databases (Cochrane, Embase, PsycINFO, PubMed, and Scopus) was completed. Of the 1,687 records screened, 22 records met the inclusion criteria, 21 of which were included in analyses. Findings suggest a statistically significant, moderate effect of CBIs in reducing symptoms of PTSD in children and adolescents (g = -0.5). Further, exploratory moderator analyses suggests that incorporating individual sessions and culturally adapting interventions may enhance treatment outcomes. However, substantial heterogeneity across studies indicate that study effects vary widely. The findings from this review suggest that community-driven approaches are viable treatment options for traumatized youth in low-resource settings, offering valuable insights into the effectiveness of CBIs in high-risk contexts.

Because extinction forms the empirical foundation of exposure therapy, strategies to enhance extinction could lead to more effective interventions for posttraumatic stress disorder (PTSD). Here, we used functional MRI to compare immediate and long-term efficacy of enhanced versus standard extinction in 54 adults with (n = 32) and without (n = 22) PTSD. In both control and PTSD groups, counterconditioning-an enhanced form of extinction that replaces threat with positive outcomes-was more effective than standard extinction. It reduced threat-related neural activity and promoted reinstatement of safety (extinction) patterns in the ventromedial prefrontal cortex (a region involved in learning and retrieving safety associations). However, the PTSD group continued to reinstate both threat- and safety-related neural patterns in the dorsal anterior cingulate cortex (a region involved in learning and retrieving threat associations). These findings represent novel evidence that enhanced extinction outperforms standard extinction in promoting more rapid and persistent neural representations of safety in PTSD.