Traumatic Stress Research Articles

A systematic review and meta-analysis of experimental methods for modulating intrusive memories following lab-analogue trauma exposure in non-clinical populations.

Experiencing trauma leads to intrusive memories (IMs), a hallmark symptom of post-traumatic stress disorder (PTSD), which also occurs transdiagnostically. Understanding why IMs increase or decrease is pivotal in developing interventions to support mental health. In this preregistered meta-analysis (PROSPERO: CRD42021224835), we included 134 articles (131 techniques, 606 effect sizes and 12,074 non-clinical participants) to investigate how experimental techniques alter IM frequency, intrusion-related distress and symptoms arising from lab-analogue trauma exposure. Eligible articles were identified by searching eight databases until 12 December 2023. To test potential publication biases, we employed methods including Egger's test and three-parameter selection models. We employed three-level multilevel modelling and meta-regressions to examine whether and how experimental techniques would modulate IM frequency and associated outcomes. Results showed that techniques (behavioural, pharmacological, neuromodulation) significantly reduced intrusion frequency (g = 0.16, 95% confidence interval [0.09, 0.23]). Notably, techniques aimed to reduce IMs also ameliorated intrusion-related distress and symptoms, while techniques that increased IMs exacerbated these related outcomes, thus highlighting IM's centrality in PTSD-like symptoms. Techniques tapping into mental imagery processing (for example, trauma reminder followed by playing Tetris) reduced intrusions when administered immediately after, or at a delayed time after trauma. Although our meta-analysis is limited to symptoms induced by lab-analogue trauma exposure, some lab-based results have now generalized to real-world trauma and IMs, highlighting the promising utility of lab-analogue trauma paradigms for intervention development.

Trauma, Critical Incidents, Organizational and Operational Stressors: The Relationship Between Harms and Psychological Outcomes for Police

Early psychological health studies in policing often focused on trauma and critical incidents (CIs). More recent research builds a compelling argument that significant causes of psychological harm stems from other operational and organizational factors. The current study uses survey data from a large sample of Australian police ( N = 1763), producing strength metrics derived from mediated regression analyses. The relationships between stressors (trauma and CIs, operational and organizational) and psychological health (psychological distress and burnout) were studied. For the relationship between stress and psychological distress, compared to trauma stress, the relationship with organizational stress was three times stronger and the relationship with operational stress was two and half times stronger. No direct relationship between trauma stress and burnout was found. It was fully explained by organizational and operational stress. The findings suggest police leaders must consider the direct and combined impacts of different stressors on the psychological health of their staff.

Effect of Mindfulness Intervention on Compassion Fatigue Among Nurses: A Randomized Controlled Trial Study.

Compassion fatigue is a syndrome defined by both mental and physical restlessness. Mindfulness intervention can enhance one's emotions with nonjudgmental awareness and greater consciousness of thoughts and feelings. This study aims to examine the effect of mindfulness intervention on compassion fatigue among nurses. A randomized controlled trial was conducted, recruiting 100 nurses from three hospitals and dividing participants into an intervention and a control group. Increased mindfulness awareness was found in the comparison group in the research. The intervention group's mean burnout level was significantly lower than the comparison group. Age, gender, marital status, household size, and household income were among the sociodemographic factors that significantly correlated with compassion fatigue, which was determined through burnout and secondary traumatic stress. Nurses reported significant levels of compassion fatigue; however, this was significantly decreased through mindfulness intervention.

The relationships among factors affecting compassion fatigue, compassion satisfaction, and burnout in Japanese nurses: A cross-sectional study.

This study aimed to investigate the relationships among factors affecting compassion fatigue/secondary traumatic stress, burnout, and compassion satisfaction in Japanese nurses, focusing on self-compassion, fears of compassion, and attachment styles. This cross-sectional observational study enrolled 400 clinical nurses (aged ≥20 years) in Japan, registered with an online survey company, from June 6 to June 26, 2021. The subjects completed a web-based questionnaire that assessed compassion fatigue/secondary traumatic stress, burnout, compassion satisfaction, self-compassion, fears of compassion for self, anxiety, and avoidance. Additionally, descriptive statistics, correlation analysis, multiple regression analysis and path analysis were performed to examine the relationships among the influencing factors. Compassion fatigue/secondary traumatic stress was influenced by anxiety and fears of compassion for self (R2 = .31). Burnout was affected by compassion fatigue/secondary traumatic stress, compassion satisfaction, self-compassion, anxiety, and avoidance (R2 = .63). Compassion satisfaction was impacted by self-compassion, anxiety, and fears of compassion for self (R2 = .31). Additionally, self-compassion (R2 = .28) and fears of compassion for self (R2 = .55) were influenced by anxiety and avoidance. Compassion fatigue/secondary traumatic stress leads to burnout, whereas compassion satisfaction moderates burnout. Furthermore, there were associations among the factors leading to compassion fatigue/secondary traumatic stress and burnout and compassion satisfaction. Therefore, an approach that enhances self-compassion and promotes the development of a stable attachment style could mitigate compassion fatigue/secondary traumatic stress and fears of compassion for self while moderately maintaining and improving compassion satisfaction.

Experiences of compassion fatigue among Generation Z nurses in the emergency department: a qualitative study in Shanghai, China

BackgroundDue to the unique working environment and nature of work in emergency departments, nurses are prone to experiencing compassion fatigue (CF), leading to job burnout and attrition. As more Generation Z (Gen Z) nurses enter the emergency department with distinct personality traits compared to previous generations, studying their experiences with CF will inform future management strategies.MethodsThe qualitative phenomenological research method was utilised to investigate CF among Gen Z emergency nurses at a hospital in Shanghai, China. Data were collected through face-to-face semi-structured interviews and analyzed using Colaizzi’s seven-step phenomenological analysis method. Study participants were purposively selected.ResultsThree main themes and nine sub-themes emerged from the study: secondary traumatic stress, including physiological symptoms, psychological symptoms, and behavioral changes; cumulative effects, including impaired empathy, interference with family life, and post-traumatic growth (PTG); coping strategies, including cognitive reconstruction, seeking support, and facilitating action.ConclusionsThe aim of this study is to investigate the experience of CF among Gen Z emergency nurses, providing managers with a reference for future management strategies. The significance of multi-dimensional support for Gen Z emergency nurses is underscored by our findings. Additionally, interventions that enhance resilience and competency can facilitate their psychological transformation after experiencing CF and promote accelerated personal growth.

The association between posttraumatic stress disorder symptom severity and distress tolerance in traumatic stress treatment.

Distress tolerance, or the perceived ability to tolerate negative emotional states, is often associated with posttraumatic stress disorder (PTSD) such that higher distress tolerance is generally associated with less severe PTSD symptom levels. As distress tolerance is often considered a risk and maintenance factor in distress disorders, examining the association between changes in distress tolerance and changes in PTSD symptoms may have clinical relevance. The present study examined the associations between PTSD symptom severity and distress tolerance across three assessment points over 12 weeks among 212 patients receiving outpatient psychotherapy services. Using random-intercept cross-lagged panel modeling (RI-CLPM), concurrent and prospective associations between PTSD and distress tolerance were examined. PTSD symptoms at Time 1 and Time 2 significantly predicted distress tolerance at Time 2, β = -.296, and Time 3, β = -.395, respectively. Distress tolerance did not predict subsequent PTSD symptom severity. Exploratory analyses examined distress tolerance and four PTSD symptom clusters over time. Patterns of results differed across clusters, though it was consistent that only PTSD symptom clusters predicted subsequent distress tolerance and not vice versa. The results support the interrelationship of changes in psychopathology and emotional distress tolerance and indicate that distress tolerance may be an important factor in symptom remission during PTSD treatment.

Introduction to the Special Issue on the 39th Annual Meeting of the International Society for Traumatic Stress Studies: Scalable strategies to address the impact of trauma worldwide.

This editorial summary provides an overview of the 39th annual meeting of the International Society for Traumatic Stress Studies (ISTSS) held from November 1-4, 2023. The meeting, themed "Scalable Strategies to Address the Impact of Trauma Worldwide: Innovations and Implementation," encouraged presenters to focus on the scalability of traumatic stress research and practice. The articles presented at the meeting, which form this issue, cover a broad spectrum of topics, from basic biological mechanisms to innovative digital engagement to population-wide treatments. These articles emphasize eliminating biases in research design and psychiatric practice, promoting health equity, and addressing the unique challenges of traumatic stress. This summary underscores the importance of scalability in developing flexible, dynamic, and inclusive mental health care interventions.

Vicarious heterosexism-based stress induces alcohol, nicotine, and cannabis craving and negative affect among sexual minority young adults: An experimental study

PurposeSexual minority young adults are at increased risk for hazardous drinking and alcohol use disorder compared to heterosexual adults. Heterosexism-based stressors contribute and often explain inequities in alcohol outcomes. However, the extant research primarily relies on correlational designs, and often neglects the importance of alcohol craving, despite its foundational role in addiction. Leveraging a novel experimental mood induction paradigm, this study examined the effects of exposure to vicarious heterosexism-based stress on alcohol craving and negative affect among sexual minority young adults who drink heavily. We also examined its effects on cannabis and nicotine craving among participants who used cannabis and nicotine, respectively. Lastly, we examined moderating factors that could influence the impact of exposure to heterosexism-based stress on alcohol craving. MethodsParticipants were 101 heavy drinking sexual minority young adults, ages 20–35 (M = 26.46 years old; SD = 3.49), recruited from the community (51.5% female sex assigned at birth; 76.3% cisgender; 51.5% plurisexual; and 42.6% racial and ethnic minorities). They completed three mood induction trials counterbalanced over three visits on different days: heterosexism stress, general stress, and neutral. Structured interviews assessed criteria for DSM-5 alcohol use disorder (AUD) and substance use, and self-report measures assessed lifetime traumatic stressors. ResultsMost participants met criteria for past-year AUD (74.7%). Exposure to heterosexism stress produced more negative affect and substance craving than the neutral mood induction, even while controlling for demographic variables and lifetime exposure to traumatic and heterosexism stressors. Exposure to heterosexism-based stress had large effects on alcohol craving among participants who had greater drinking to cope motives and heterosexism-specific rejection sensitivity, whereas the effects were small for those who had lower drinking to cope motives and heterosexism-specific rejection sensitivity. Demographic, lifetime stress, prior alcohol use, and AUD symptom severity variables were not significant moderators. Greater substance craving induced by heterosexism-based stress in the laboratory was associated with greater recent and current substance use. ConclusionsThis study findings show that vicarious exposure to heterosexism elicits negative mood and alcohol, cannabis, and nicotine craving among sexual minority young adults who engaged in heavy drinking. The effects for alcohol craving were largest among those who endorse high levels of drinking to cope motives and heterosexism-based rejection sensitivity. These findings have implications for oppression-based stress and motivational models of addiction.

The Protective Effects of Hope Training on the Human Service Workforce Burnout and Secondary Traumatic Stress

ABSTRACT Workplace stress and burnout are a concern among human service leaders. Organizations need evidence-driven enhancements and actionable strategies that impact employee wellbeing. This study evaluates employee-focused training that draws from theory and research on hope in a large, multi-agency human service organization. The training used both in-person and asynchronous learning. A nonrandomized comparison group design with retrospective posttest assessment was used to investigate the potential impact of participation in hope training on workforce burnout and secondary trauma. Findings demonstrate statistically significant differences between those who completed training and those in the control group with no training.

Evaluating the Early Implementation of a Resilience Intervention Addressing Secondary Traumatic Stress in Child Welfare Workers

ABSTRACT This mixed-methods study evaluated early implementation outcomes of Resilience Alliance (RA), an intervention delivered to child welfare professionals. RA included 12 sessions that were held for 60–90 minutes. Sessions focused on teaching participants skills to cope with secondary traumatic stress and increase resilience such as emotion regulation, cognitive reframing, and mindfulness. Findings indicated high adoption and moderate feasibility. Most participants (83.6%) completed RA. Findings from semi-structured focus groups identified three themes that highlighted supports and barriers that occurred individually, organizationally, and systemically and influenced the adoption and feasibility of the intervention. Additionally, results demonstrated that participants’ experiences differed by job role.

Addressing disaster fatigue: A SAFE framework for enhancing disaster resilience in social work

An increase in exposure to successive disaster events is causing widespread adverse impacts on social workers worldwide, resulting in escalated levels of stress and exhaustion. This article examines the concept of disaster fatigue and its impact on social workers engaging in disaster practice. A SAFE framework for addressing disaster fatigue is outlined involving: (S) sustaining self-care; (A) adopting a trauma-informed approach; (F) fostering professional capability; and (E) enhancing disaster preparedness. Implications for social work involve the need to move beyond individualised notions of burnout, compassion fatigue and secondary traumatic stress towards a collective and multidimensional approach to enhancing disaster resilience.

Trauma Prevalence and Its Association With Health-Related Quality of Life in Pregnant Persons with Opioid Use Disorder.

Trauma screening is recommended for pregnant persons with opioid use disorder (OUD), but there is limited literature on screening results from buprenorphine treatment. This study's objectives were to 1) describe the types, and severity, of traumatic events reported and 2) evaluate the associations between trauma and health-related quality of life (HRQoL). Baseline data from an ongoing trial were analyzed. Participants were 155 pregnant persons with OUD receiving, or enrolling in, buprenorphine treatment at one of 13 sites. The experience, and relative severity, of 14 high magnitude stressors were assessed with the trauma history screen. The Patient-Reported Outcomes Measurement Information System-29+2 was used to assess 8 HRQoL domains. Traumatic stressors were reported by 91% of the sample (n = 155), with 54.8% reporting a lifetime persisting posttraumatic distress (PPD) event and 29.7% reporting a childhood PPD event. The most prevalent lifetime PPD event was sudden death of a close family/friend (25.8%); physical abuse was the most prevalent childhood PPD event (10.3%). Participants with lifetime PPD, relative to no PPD, reported significantly greater pain interference (P = 0.02). Participants with childhood PPD, relative to no PPD, had significantly worse HRQoL overall (P = 0.01), and worse pain intensity (P = 0.002), anxiety (P = 0.003), depression (P = 0.007), fatigue (P = 0.002), and pain interference (P < 0.001). A majority of pregnant persons enrolled/enrolling in buprenorphine treatment reported persisting posttraumatic distress with sudden death of close family/friend being the most prevalent originating event; clinicians should consider the impact that the opioid-overdose epidemic may be having in increasing trauma exposure in patients with OUD.

Anxiety, post-traumatic symptoms, media-induced secondary trauma, post-traumatic growth, and resilience among mental health workers during the Israel-Hamas war.

The ongoing Israel-Hamas war is posing additional challenges for mental health workers in an already stressful workplace. This study centres on the psychological effects of the shared traumatic reality on mental health workers, arising from the Israel-Hamas war. One month after exposure to the terrorist attack of 7 October 2023 and the outbreak of war following this event, 147 mental health workers completed questionnaires regarding a variety of variables such as demographics, anxiety symptoms, acute stress symptoms, media-induced secondary trauma, personal resilience, National resilience (NR), and post-traumatic growth (PTG). The study found that mental health workers with previous trauma displayed higher anxiety symptoms, acute stress symptoms, and media-induced secondary trauma. Additionally, acute stress and anxiety were positively correlated with media-induced secondary trauma. Religiosity, personal resilience, and NR were found associated with lower anxiety and acute stress symptoms. Religiosity was also positively correlated with personal resilience, NR, and PTG. The PTG of mental health workers working with trauma survivors and evacuees was higher compared to that of other mental health workers. Both adverse and adaptive reactions were evident among mental health workers. While traumatic stress is expected, individual, professional, and NR factors may mitigate its effects. Providing training, social support, regulated media exposure, stress management, and meaning-focused coping strategies can help safeguard workers' well-being.

Assessing the interplay: teacher efficacy, compassion fatigue, and educator well-being in Australia

AbstractIn Australia, there is a growing concern about the well-being of teachers with many expressing their intention to leave the profession or indeed have already left. Various reasons have been suggested for this trend, with burnout being identified as one of the factors. This study investigates burnout in Australian teachers as one of the constructs which make up compassion fatigue (CF), a reduced ability to empathise with others. Moreover, it explores secondary traumatic stress (STS), which also contributes to CF and occurs when a person learns about the traumatic experiences of someone under their care. Both constructs may severely impact the ability of teachers to form close relationships with their students. As part of the present study, 1939 Australian teachers were surveyed about their quality of life, well-being, classroom efficacy, and trauma awareness. Findings demonstrate that teachers with higher levels of well-being and with higher perceived classroom efficacy are less prone to burnout, reducing the risk of emotional exhaustion and disengagement often associated with this phenomenon. Conversely, connections were found between lower well-being of teachers and educators' awareness of trauma and their susceptibility to STS. Recommendations are made for further research exploring the barriers and enablers of compassion fatigue as well as positive teacher well-being, in order to develop targeted initiatives to better prepare and protect teachers to work with a cohort of students who are increasingly demonstrating symptoms of trauma and poor well-being.

Poor sleep and decreased cortical thickness in veterans with mild traumatic brain injury and post-traumatic stress disorder

BackgroundPoor sleep quality has been associated with changes in brain volume among veterans, particularly those who have experienced mild traumatic brain injury (mTBI) and post-traumatic stress disorder (PTSD). This study sought to investigate (1) whether poor sleep quality is associated with decreased cortical thickness in Iraq and Afghanistan war veterans, and (2) whether these associations differ topographically depending on the presence or absence of mTBI and PTSD.MethodsA sample of 440 post-9/11 era U.S. veterans enrolled in the Translational Research Center for Traumatic Brain Injury and Stress Disorders study at VA Boston, MA from 2010 to 2022 was included in the study. We examined the relationship between sleep quality, as measured by the Pittsburgh Sleep Quality Index (PSQI), and cortical thickness in veterans with mTBI (n = 57), PTSD (n = 110), comorbid mTBI and PTSD (n = 129), and neither PTSD nor mTBI (n = 144). To determine the topographical relationship between subjective sleep quality and cortical thickness in each diagnostic group, we employed a General Linear Model (GLM) at each vertex on the cortical mantle. The extent of topographical overlap between the resulting statistical maps was assessed using Dice coefficients.ResultsThere were no significant associations between PSQI and cortical thickness in the group without PTSD or mTBI (n = 144) or in the PTSD-only group (n = 110). In the mTBI-only group (n = 57), lower sleep quality was significantly associated with reduced thickness bilaterally in frontal, cingulate, and precuneus regions, as well as in the right parietal and temporal regions (β = −0.0137, P < 0.0005). In the comorbid mTBI and PTSD group (n = 129), significant associations were observed bilaterally in frontal, precentral, and precuneus regions, in the left cingulate and the right parietal regions (β = −0.0094, P < 0.0005). Interaction analysis revealed that there was a stronger relationship between poor sleep quality and decreased cortical thickness in individuals with mTBI (n = 186) compared to those without mTBI (n = 254) specifically in the frontal and cingulate regions (β = −0.0077, P < 0.0005).ConclusionsThis study demonstrates a significant relationship between poor sleep quality and lower cortical thickness primarily within frontal regions among individuals with both isolated mTBI or comorbid diagnoses of mTBI and PTSD. Thus, if directionality is established in longitudinal and interventional studies, it may be crucial to consider addressing sleep in the treatment of veterans who have sustained mTBI.

Arkansas crisis stabilization unit guests: Baseline characteristics from a longitudinal cohort study.

Crisis Stabilization Units (CSUs) are short-term residential facilities that provide care to people experiencing mental health crises, seeking to reduce reliance on local emergency departments and avoid unnecessary jail detention. Despite these intentions, there is little foundational literature to support research on CSU efficacy and a dearth of research on the sociodemographic characteristics and specific needs of CSU patients. Here, we recruited and surveyed 208 participants admitted to one of two focal Arkansas CSUs on their sociodemographic characteristics, justice-involvement, mental health, substance use, and health care utilization. Results revealed that participants were mostly unemployed (68.16%), low-income (72.34%), and experiencing insecure housing (33.33%). They reported extensive justice-involvement (85.57%), high rates of clinically significant mental illness symptom severity (77.00% for anxious symptoms; 78.33% for depressive symptoms; 79.40% for traumatic stress symptoms), and recent substance use (73.34%). Recent engagement with other medical services was common, though more participants reported visiting an emergency department (42.23%) than did receiving outpatient medical care (26.73%). While research on CSU patient outcomes is needed, our results indicate that CSUs have the potential to be an essential part of the health care continuum by serving a population with multiple, intersecting needs and addressing a deficit in community-based crisis care. Continued investigation of community-based crisis intervention services is critical to bridging the gap between vital behavioral health resources and the populations in need of them. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Secondary Traumatic Stress in Nursing Students: An Integrative Review.

Nurses have frequent interactions with traumatized individuals and may develop secondary traumatic stress (STS). Similarly, nursing students are at risk for STS development while completing clinical training. To critique and synthesize available research on the prevalence, severity, and experience of STS and its associated factors in prelicensure nursing students. The Whittemore and Knafl integrative review methodology was used to perform structured searches of 6 electronic databases. Twenty-five studies met the inclusion criteria. Findings revealed a range of STS symptom severity levels and associated factors; however, measurement is hampered by researchers' use of other concepts, like compassion fatigue. Conceptual clarity is needed to improve STS measurement in nursing students; however, students experience STS and are at risk of developing its negative consequences. Educators should implement trauma-informed educational practices targeted at reducing factors associated with STS.

Triggering of endoplasmic reticulum stress via ATF4-SPHK1 signaling promotes glioblastoma invasion and chemoresistance

Despite advances in therapies, glioblastoma (GBM) recurrence is almost inevitable due to the aggressive growth behavior of GBM cells and drug resistance. Temozolomide (TMZ) is the preferred drug for GBM chemotherapy, however, development of TMZ resistance is over 50% cases in GBM patients. To investigate the mechanism of TMZ resistance and invasive characteristics of GBM, analysis of combined RNA-seq and ChIP-seq was performed in GBM cells in response to TMZ treatment. We found that the PERK/eIF2α/ATF4 signaling was significantly upregulated in the GBM cells with TMZ treatment, while blockage of ATF4 effectively inhibited cell migration and invasion. SPHK1 expression was transcriptionally upregulated by ATF4 in GBM cells in response to TMZ treatment. Blockage of ATF4-SPHK1 signaling attenuated the cellular and molecular events in terms of invasive characteristics and TMZ resistance. In conclusion, GBM cells acquired chemoresistance in response to TMZ treatment via constant ER stress. ATF4 transcriptionally upregulated SPHK1 expression to promote GBM cell aggression and TMZ resistance. The ATF4-SPHK1 signaling in the regulation of the transcription factors of EMT-related genes could be the underlying mechanism contributing to the invasion ability of GBM cells and TMZ resistance. ATF4-SPHK1-targeted therapy could be a potential strategy against TMZ resistance in GBM patients.

Effects of Secondary Traumatic Stress &amp; Resilience on the Indicators of Compassion Fatigue Among OTPs

Abstract Date Presented 03/21/24 Compassion fatigue is debilitating, yet OTs’ studies are limited. This study delved into the relationship between resilience, secondary traumatic stress, and compassion fatigue. Findings may lead to better prevention and treatment. Primary Author and Speaker: Gayla Aguilar Contributing Authors: Anthony Napoli

Acceptance and Commitment Therapy and Therapeutic Relationships to Mitigate Post Traumatic Stress Disorder in Surgical Patients: A Systematic Review

Background: Although trauma significantly affects surgical patients, limited research exists on effective therapeutic strategies, particularly the use of acceptance and commitment therapy (ACT) and therapeutic relationships in mitigating Post-traumatic stress disorder (PTSD) symptoms. This study aims to evaluate the potential benefits of ACT and therapeutic relationships for managing PTSD in surgical patients. Methods: A systematic literature review was conducted using the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Databases such as PubMed, ScienceDirect, EBSCO, Springer, Google, and Google Scholar were searched for articles published between 2000 and 2022 in English and Bahasa. The search focused on keywords related to ACT, therapeutic relationships, and PTSD in surgical patients. The study selection process resulted in the identification of seven relevant articles that met the inclusion criteria. Results: The literature review identified PTSD as a significant issue for postoperative patients, adversely affecting various health outcomes, including rehospitalization rates, daily functioning, and overall recovery. ACT, a mindfulness-based therapeutic approach, emerged as a promising intervention for reducing PTSD symptoms by fostering acceptance of thoughts and feelings and enhancing patients' psychological flexibility. In addition, fostering therapeutic relationships between healthcare providers and patients showed potential for improving clinical outcomes. Although studies on the combined use of ACT and therapeutic relationships remain limited, initial evidence suggests that integrating these approaches may accelerate recovery and improve psychological outcomes for postoperative patients. Conclusion: This review underscores the potential of combining ACT and therapeutic relationships to mitigate PTSD symptoms in postoperative patients. Integrating these approaches into perioperative care could enhance psychological outcomes, foster patient engagement, and expedite recovery.