Emergency service personnel perform roles associated with high levels of trauma exposure and stress, and not surprisingly experience greater risk for poor mental health including posttraumatic stress disorder (PTSD), depression, anxiety, and substance use relative to the general population. Although programs exist to minimise the risk of developing mental health problems, their efficacy to date has been limited or untested. We will test the efficacy of the three programs which form PEREI: Protecting Emergency Responders with Evidence-Based Interventions. PEREI consists of modified versions of internet-delivered cognitive training in resilience (iCT-R) for early career first responders, PEREI-S for supervisors, and Be Well for Significant Others (BW-SO).: Up to 450 members in their first 5 years of service across multiple agencies will be recruited, with their adult supports (significant others, friends) invited to participate. Up to 180 supervisors in the agencies will be recruited. Participants will be randomized to their respective program or to receive the standard practice for mental health offered by the service (or usual mental health support for significant others). Assessments will be conducted pre- and post-program, and at 6- and 12-month follow-up. Primary outcome is PTSD and depression severity and probable-diagnosis. Secondary measures will index hypothesized mediators and moderators of outcome and determine whether the programs are cost-effective.: The results will provide evidence as to efficacious methods for reducing risk of mental health problems in high-risk occupations, a better understanding of how such interventions may work, and whether they are good value for money. www.anzctr.org.au (ACTRN12622001267741).

Accessible, low-cost digital programmes are emerging as a means by which to address high rates of mental health problems. However, the development and assessment of scalable training programmes for effective use of digital interventions has lagged. This is particularly important, as coach-supported digital interventions provide benefits that substantially and consistently exceed those of programmes that are entirely self-guided. This report describes the evaluation of a brief coach training programme consisting of a two-hour workshop and six 1-hour consultation sessions for delivery of webSTAIR, a 10-module transdiagnostic web-based programme for trauma-exposed populations. The training was provided to 68 mental health counsellors at Veteran Health Administration Readjustment Counselling Services, who delivered the treatment to 99 veteran clients. A total of 51% of the coaches completed the programme. Client outcomes were encouraging. Veterans enrolled in the programme demonstrated significant and clinically meaningful improvements in functioning (Cohen's  = 0.88), emotion regulation (Cohen's  = 0.97), posttraumatic stress disorder (PCL-5 Cohen's  = 0.61; ITQ Cohen's  = 0.60), and depression (Cohen's  = 0.53). The study contributes much needed information regarding evidence for the effectiveness of 'light-touch' training strategies. The data support the integration and testing of brief training programmes in the implementation and dissemination of evidence-based digital interventions. Strategies for improving training completion rates among busy providers and resource-burdened clinical services need to be considered.

As reported in this journal, Resick and colleagues (2023) investigated discrepancies between scores from two widely used PTSD measures: the Clinician-Administered PTSD Scale for DSM-5 (CAPS-5; Weathers et al., 2013) and the PTSD Checklist for DSM-5 (PCL-5; Weathers et al., 2013), a clinician-rated structured interview and a self-rated questionnaire, respectively. Using data from four clinical trials of active-duty military personnel and veterans, the authors replicated the common finding that PCL-5 scores are higher than CAPS-5 scores. They then examined item response distributions, finding that ratings on the PCL-5 were more evenly distributed across all five options whereas specific CAPS-5 scores were used relatively infrequently. Concluding that this finding indicates a problem that should be addressed, they offered suggestions for revising anchors and items to improve correspondence between the two measures. The results are informative and the nature and size of the sample are well-suited to this important research question. However, we have a number of concerns and comments about this paper. In our view, the authors mischaracterized the CAPS-5 and PCL-5 in several important ways, resulting in some erroneous conclusions about their findings and the expected nature of the relationship between the CAPS-5 and PCL-5. Given that these issues are vital to the field of traumatic stress, we felt compelled to address them and provide an alternative perspective.

Focusing on positive memories as a complement to trauma-focused interventions for intimate partner violence against women (IPVAW) could contribute to enhancing the recovery from trauma with the development of a more integrated and emotionally modulated autobiographical narrative. To test the effectiveness of a trauma-focused cognitive behavioural therapy (CBT) tailored for IPVAW that incorporates the evocation of positive memories. Female survivors of IPVAW entered a randomized controlled trial comparing trauma-focused CBT for IPVAW (CBT;  = 35) to a version that incorporates the evocation of positive memories (CBT-M+;  = 44) and to a waitlist (WL;  = 12) control group. Pre and post measures were obtained for: posttraumatic stress, meaning of trauma, affect, emotional regulation, associated symptoms, self-concept and overall functioning. A total of 43.04% of women who entered treatment dropped out, without significant treatment differences. Pre-post changes were not significant for the WL; both treatments resulted in significant improvements, with good effect sizes, for posttraumatic stress ( = 0.78 and  = 1.00 for CBT and CBT-M+, respectively), meaning of trauma, affect, associated symptoms, self-concept and overall functioning, but not in emotional regulation. There were no significant differences between CBT and CBT-M+ in the direct comparisons; however, the effect sizes showed better effects of CBT for centrality of the IPVAW, whereas they favoured CBT-M+ for PTSD, depression, self-esteem and impairment measures. No clinically significant change was reached for the WL, while both treatments significantly reduced the percentage of women with PTSD and self-esteem problems; additionally, the percentage of women with depression and impairment problems in the CBT-M+ group was significantly decreased. Although there were few differences between both treatments, CBT-M+ seemed to have a greater effect, pointing to the potential of the inclusion of the evocation of positive memories that should be further researched.

Chinese bereaved parents over the age of 49 who have lost their only child are known as shidu parents. This study aimed to explore their symptoms of prolonged grief disorder (PGD) and post-traumatic growth (PTG). Shidu parents who experienced the loss of their only child at least six months prior and had no biological or adopted children at the time of the study were recruited. Eleven shidu parents participated in individual interviews conducted in Mandarin via WeChat video or voice calls. The interview guide was developed by the first researcher and refined through discussions with doctoral students and a professor specializing in bereavement. Reflexive thematic analysis was used to analyse the data from the semi-structured interviews. The interviewees (3 men and 8 women) were aged between 53 and 72 years, and the time since their child's loss ranged from 2.25 to 24 years. Four themes of PGD symptoms were identified: Separation distress, Cognitive, emotional, and behavioural symptoms, Somatic responses and Changes in grief responses. Subtheme of 'feelings of inferiority or shame' and 'somatic responses' were prominent among this group, potentially representing culturally relevant grief reactions. They also experienced genuine PTG that helped them adapt to life without the child: changes in self-perception, changes in interpersonal relationships, and a changed philosophy of life. The subtheme of 'living for self' emerged as a potentially unique PTG among shidu parents. Shidu parents share some important similarities with bereaved individuals across cultures, but also exhibit some unique characteristics. Considering their persistent intense grief, regular screening for grief severity, physical issues, and suicidal ideation is essential. Culturally sensitive interventions that acknowledge and validate their sense of inferiority or shame may be beneficial. Additionally, fostering PTG may support shidu parents in coping with their loss and adapting to life.

Women with borderline personality disorder (BPD) show increased basal levels of testosterone. We investigated whether salivary testosterone levels in women with BPD were indicative of specific symptoms associated with BPD. Based on the assumed link between testosterone and interpersonal dominance, we hypothesized a positive association between testosterone and externalising, i.e. aggressive or impulsive behaviour, potentially contributing to higher burden of interpersonal reactivity and conflict. Saliva was collected from 98 women with BPD (average age in years: 28, range 18-46) between 1 and 2 pm. Self-rating scales were administered to assess severity of BPD (Borderline Symptom Checklist, BSL-23) and depressive symptoms (Beck's Depression Inventory, BDI-II). Regression analyses targeted associations between individual testosterone levels and BSL-23 and BDI-II total and by-item scores. Higher testosterone levels were associated with higher overall disease burden indicated by BSL-23 and BDI-II total scores. When analysed by item, higher testosterone levels were significantly associated with increased feelings of self-dislike, senselessness and pessimism, and the feeling of being a failure. Our findings show that in women with BPD testosterone levels are positively associated with increased borderline and depressive symptomatology. Contrary to our expectations, rather than predicting externalising symptoms, higher testosterone is associated with a well-defined cluster of internalising symptoms characterized by a pessimistic and derogatory view towards oneself.

Research on the mental health of homicidally bereaved children and young people is scarce. Despite the importance of timely referral of those at risk of developing severe mental health problems, few convincing risk factors have been identified. The effectiveness of current treatment models is unclear. This study examined factors associated with posttraumatic stress (PTS)symptom severity and treatment response in a naturalistic sample of homicidally bereaved children and young people who received traumatic grief-focused cognitive behavioural therapy (TGF-CBT); and assessed whether PTS-symptoms decreased between the start and termination of treatment. Data was used from 222 children and young people aged between 8 and 25, who had completed therapy by July 2017, and for whom either start - or end scores on PTS-symptoms, or both, were available. PTS-symptoms were measured with the Children's Revised Impact of Event Scale-8 (CRIES-8). We explored associations of personal and loss-related variables with baseline symptom levels and symptom reduction during treatment, using latent growth modelling. PTS-symptoms decreased significantly from pre- to posttreatment and with a large effect size. Higher age was associated with early treatment discontinuation. Female sex was associated with higher baseline scores, and having lost a parent or sibling with lower baseline scores. Higher baseline scores were associated with larger symptom reduction during treatment. TGF-CBT shows promise in reducing PTS-symptoms following homicidal bereavement, regardless of the individual differences in personal or loss-related characteristics included in this study. However, it is important to recognize the uniqueness of children and young people confronted with homicidal loss, and to tailor treatment to their individual needs and developmental stage. More research on risk and protective factors for adverse mental health outcomes and response to treatment in children and young people bereaved by homicide is urgently needed.

Research on the prevalence of ICD-11-based complex posttraumatic stress disorder (CPTSD) in nationally representative samples is lacking, with no such studies conducted considering national Polish samples until now. The primary aim of this study was to explore profiles of study participants in terms of either PTSD or CPTSD symptoms regarding to ICD-11 diagnosis with the aid of latent profile analysis. We also investigated the relationship between the types and cumulative number of adverse childhood experiences (ACEs) with the probability of CPTSD rate in a national sample of Poles. A representative sample of Polish adults ( = 3,557) participated in this study. ACEs were assessed using the Adverse Childhood Experiences Questionnaire, while the core features of PTSD and CPTSD were measured using the International Trauma Questionnaire. The findings showed a 11% prevalence rate of probable CPTSD in the studied sample of Poles. Sexual abuse, emotional neglect, physical neglect and having the experience of a mentally ill household member were the most significant predictors of potential diagnosis. Furthermore, significant differences concerning lifestyle data were observed in the group of participants with CPTSD. The current rate of probable CPTSD in Poland is substantially higher than the respective data reported for other countries. We also noted that the ICD-11 diagnosis of CPTSD may not apply to all cultural environments. Finally, it was observed that the ACEs - CPTSD association may depend both on the ACEs types as well as on their overall cumulative character.

The 2014 Sewol ferry disaster is the only South Korean mass casualty incident broadcasted in real time and the first instance of the nation collectively experiencing a disaster through social media. Compared to the large body of literature on disaster media as a stressor, its role as a coping tool remains underexplored. We explored the associations between coping styles in disaster media use and the psychological impact of the Sewol ferry disaster among the South Korean general public. A paper-based survey of the nationwide general population ( = 876) evaluated disaster media use from the perspective of the approach-avoidance model of coping and assessed levels of posttraumatic distress and perceived growth. Participants were divided into three groups based on their coping orientation towards the media around the Sewol ferry disaster: approach-oriented (i.e. actively seeking out event-related news;  = 282; 32.2%), avoidance-oriented (i.e. intentionally avoiding event-related news;  = 69; 7.9%), and neutral (neither seeking nor avoiding event-related news;  = 474; 54.1%). The levels of posttraumatic distress and perceived growth were compared between these groups with ANCOVA controlling for age, sex, and/or the date of survey participation. Approach-oriented disaster media use was associated with both elevated posttraumatic distress and perceived growth, while avoidance-oriented disaster media use was associated with elevated posttraumatic distress without significant perceived growth. The neutral group reported the lowest levels of both posttraumatic distress and perceived growth. The findings demonstrated that not posttraumatic distress but perceived growth was the distinguishing factor between the two coping styles in disaster media use. This suggests the potential benefits of approach-oriented disaster media use, considering the salutogenic role of perceived growth in the recovery process. Future longitudinal research is required to determine the predictive role of disaster media use as coping.

Trauma exposure in Indonesia is high despite the fact that there is limited accessibility to mental healthcare. is a web-based trauma psychoeducation intervention that aims to provide a practical solution to overcome barriers to accessing mental healthcare. This article aimed to (1) describe the cultural adaptation process of PL for Indonesian students and (2) describe the design of the pilot randomised controlled trial (RCT) that examines the feasibility and acceptability of . First, we describe the cultural adaptation process of following the 5-phase Formative Method for Adapting Psychotherapy (FMAP) approach: (1) knowledge generation, (2) information integration, (3) review and revision, (4) mini-testing, and (5) finalisation. Focus Group Discussion (FGD) was conducted to gather the views of 15 stakeholders on psychoeducation material and trauma-related mental health problems. Based on the outcomes, we decided to utilise the informal Indonesian language, incorporate practical worksheets and infographics, which include illustrations that reflect Indonesia's cultural diversity, and provide guidance on seeking help that aligns with the mental health system in Indonesia. Second, we describe the design of a pilot RCT. Undergraduate students ( = 130) will be randomised to (1) four to seven sessions of  + Enhanced Usual Care ( + EUC;  = 65) or (2) Enhanced Usual Care only (EUC only;  = 65). Assessments will be conducted at baseline, post-intervention, and three and six-month follow-up. Additionally, 20 participants will be invited for an FGD to explore their experiences with the intervention. Quantitative data will be analysed using linear mixed-effect models, and qualitative data will be analysed using thematic analysis. Cultural adaptation is crucial for optimally developing and assessing the feasibility and acceptability of a web-based trauma psychoeducation intervention in Indonesia. The outcomes of the RCT will inform the feasibility and acceptability of web-based trauma psychoeducation in the Indonesian undergraduate student population.

Previous studies in individuals exposed to stressors, including traumatic ones, have shown inverse relations between life meaning and distress. Furthermore, meaning-related treatments can benefit (traumatic) stressor-exposed individuals. However, the evidence regarding the effect of life meaning interventions on PTSD symptoms is limited. Moreover, early post-stressor interventions preventing distress are needed. This study investigated the effects of a short, online life meaning intervention after an analogue traumatic stressor on intrusions and anxiety following the intervention, intrusions over a week, and explored distress and life meaning differences after a week. Following an analogue traumatic stressor (i.e. an aversive film),  = 237 participants were randomized to a life meaning intervention, an active or inactive control condition. Participants completed questionnaires in the laboratory, in an online seven-day diary, and at one-week follow-up. The intervention resulted in significantly lower post-intervention state anxiety and higher life meaning, but not significantly less severe wait-period intrusions than the control conditions. Intrusions in the subsequent week as well as depression, anxiety, PTSD, and life meaning after a week did not significantly differ between the conditions. This intervention showed promising temporary effects on anxiety and life meaning after a trauma analogue, but no significant longer-term effects and no effects on PTSD symptoms including intrusions. Meaning-related interventions for PTSD target stressor-related meaning-making rather than life meaning. Thus, future studies may benefit from implementing more intense interventions to extend effects on general distress, as well as stressor-addressing meaning interventions to elicit stressor-related meaning-making.

The active mechanisms of change are unclear in early-provided exposure-based interventions for psychological trauma. This study aimed to address this gap by analysing weekly data from a randomised trial involving a 3-week therapist-guided online intervention based on prolonged exposure compared to a waiting-list control group. The objective was to investigate whether changes in each of the four subscales of the Posttraumatic Stress Disorder Checklist, fifth version (PCL-5; i.e. intrusions, avoidance behaviours, negative alternations in cognitions and hyperarousal) during the three-week intervention period mediated subsequent improvements in other post-traumatic stress symptoms at the controlled 1-month follow-up. We included baseline levels of both the mediator and the outcome as well as changes in the outcome from baseline to week 3 as covariates in a mediation model. The results showed that reductions in avoidance during the intervention period mediated reduced symptom levels of intrusions, negative alternations in cognitions, and hyperarousal at week 7 (z-scores of indirect effect estimates = -0.12 to -0.07). No other PCL-5 subscales were found to be mediators of change. The results from this study highlight the importance of addressing avoidance behaviours in online exposure-based interventions provided in the early aftermath of trauma. Sensitivity analysis showed that the mediation effects were sensitive to assumptions related to mediator-outcome confounders, which could be considered a study limitation. ClinicalTrials.gov identifier: NCT03850639.

Post-traumatic stress disorder (PTSD) is increasingly prevalent in individuals with adverse childhood experiences (ACE). However, the underlying neurobiology of ACE-related PTSD remains unclear. The present study investigated the brain connectivity in ACE-related PTSD using multimodal neuroimaging data. Using a total of 119 participants with ACE (70 with ACE-related PTSD and 49 ACE-exposed controls), this study acquired T1-weighted MRI, diffusion-weighted MRI, and resting-state fMRI data to examine structural and functional connectivity between groups. Joint connectivity matrix independent component analysis (Jcm-ICA) was employed to allow shared information from all modalities to be examined and assess structural and functional connectivity differences between groups. Jcm-ICA revealed distinct connectivity alterations in key brain regions involved in cognitive control, self-referential processing, and social behaviour. Compared to controls, the PTSD group exhibited functional hyperconnectivity of the right medial prefrontal cortex (PFC) of the default mode network and right inferior temporal cortex, and functional hypoconnectivity in the lateral-PFC of the central executive network and structural hypoconnectivity in white matter pathways including the right orbitofrontal region (OFC) linked to social behaviour. Post-hoc analyses using the joint brain-based information revealed that the severity of ACE, the number of traumas, and PTSD symptoms later in life significantly predicted the effects of ACE-related PTSD on the brain. Notably, no direct association between brain connectivity alterations and PTSD symptoms or the number of traumas within the PTSD group was observed. This study offers novel insights into the neurobiology of ACE-related PTSD using multimodal data fusion. We identified alterations in key brain networks (DMN, CEN) and OFC, suggesting potential deficits in cognitive control and social behaviour alongside heightened emotional processing in individuals with PTSD. Furthermore, our findings highlight the combined influence of ACE exposure, number of traumas experienced, and PTSD severity on brain connectivity disruptions, potentially informing future interventions.

Fear- and trauma-related conditions, such as post-traumatic stress disorder (PTSD) and social phobia, often manifest as socially avoidant behaviours, which commonly contribute to social and occupational disability transdiagnostically. While gold-standard treatments (i.e. exposure therapy, psychotropic medications) are effective, they are hindered by high dropout rates and limited impact on real-world functioning. Furthermore, most existing interventions only target symptom reduction, with few addressing avoidance-related deficits in social and occupational functioning. This methods paper introduces an innovative augmented reality exposure therapy (ARET) technology designed to address the limitations of traditional interventions for anxiety disorders and PTSD, by directly targeting social and occupational dysfunction through exposure to real-life social contexts. We introduce an ARET system, using artificial intelligence (AI)-driven, augmented reality (AR) technology, that enables exposure to realistic scenarios within the patient's real-world environment, fostering contextual generalization and functional improvement. Featuring holographic three-dimensional humans, precise surface mapping, wireless mobility, and telemedicine capabilities, the software provides customizable exposure scenarios to transform an environment into various spaces (e.g. grocery store, house party) with diverse human characters, as well as flexible AI-driven human interactions tailored to individual needs. We share observations and feedback from the treatment of first responders with PTSD. Patients found the technology easy to use, with immersive realism, active engagement, and strong emotional responses needed for effective exposure therapy. Advances in AI-driven character development and AR hardware accessibility support the wider adoption of ARET by clinicians. By bridging the gap between clinical interventions and real-world functioning, ARET offers a transformative approach to addressing the pervasive impact of psychiatric disorders on social and occupational outcomes.

Sexual violence is a common and harmful form of trauma. In this article collection, EJPT features research on sexual violence spanning levels of the social ecology. First, we discuss the individual-level studies in this collection, which report on sexual violence prevalence, impact, prevention, and intervention. These papers highlight best practices for assessing sexual assault (i.e., via behaviorally-specific questionnaires), indicate the substantial and enduring mental health effects of sexual violence, and suggest that a number of prevention and intervention strategies are feasible and promising. Then, we highlight studies that broaden their lens to survivors' interpersonal relationships: these studies provide new evidence for the relationship between social support and posttraumatic stress. Broadening the lens further still to community service systems, the studies in this collection highlight the utility of evaluating the functioning of service systems and obtaining input from stakeholders in these systems; they also suggest that digital technologies are a promising strategy to expand reach to interventions. Finally, at the broadest level of the social ecology, these studies suggest that there is still work to do as a society to promote positive change in terms of views of sexual violence and policies that increase access to needed help, and that such changes can impact individual survivors' experiences. Considered together, this collection clearly demonstrates that sexual violence does not happen in a vacuum, and it highlights the need for more contextually-focused research on this important social issue.

: Prolonged Grief Disorder (PGD) has been recognized as a mental health disorder and was added to the ICD-11 and DSM-5-TR. Despite the same name, both versions of PGD differ in symptom count, content, and diagnostic algorithm. A single instrument to screen for both PGD diagnoses is critical for bereavement research and care. The study aimed to evaluate the psychometric properties of the German version of the Traumatic Grief Inventory Self-Report Plus (TGI-SR+), a self-report measure to assess PGD and PGD symptoms.: Out of a representative sample of the German general population ( = 2509), 1062 reported a significant loss and completed questions about sociodemographic and loss-related variables, the TGI-SR+, and a measure of health-related quality of life.: Item analyses demonstrated good item characteristics. Confirmatory factor analyses showed a good fit for two-factor models for PGD and PGD. Omega values demonstrated good internal consistency. In support of concurrent validity, symptoms of PGD and PGD were associated with worse health-related quality of life. In support of known-groups validity, symptoms of PGD and PGD were significantly higher among women, people with a lower educational level, more recently bereaved, those who lost a spouse or child (vs. other person), and those who lost someone due to unnatural causes (vs. natural causes). ROC analyses showed optimal cut-off scores of ≥60 and ≥65 to screen for probable caseness for PGD and PGD, respectively.: The analyses were based on a cross-sectional design, and data on retest-reliability and predictive validity is missing.: Results support the reliability and validity of the German TGI-SR+ as a screening instrument for PGD in research.

The establishment of a formal diagnosis of post-traumatic stress disorder (PTSD) for children and adolescents is the foundation for advancing pertinent clinical research and formulating proper treatment and management. However, a validated diagnostic tool for PTSD in children and adolescents is lacking in Japan. To examine the cross-cultural validity and reliability of the Japanese Clinician-Administered PTSD Scale for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), child and adolescent version (CAPS-CA-5-J). Overall, 73 children who had experienced potentially traumatic events were recruited from three medical facilities. The linguistically validated CAPS-CA-5-J was conducted by trained psychiatrists and psychologists. Additionally, children and their caretakers completed questionnaires such as the UCLA PTSD reaction index for DSM-5 (PTSD-RI-5), Depression Self-Rating Scale for Children (DSRDC), and Strength and Difficulties Questionnaire (SDQ); 16 participants were randomly selected for the inter-rater reliability assessment. Owing to missing values in the CAPS-CA-5-J and PTSD-RI-5, 68 children were included in the final analysis. Regarding reliability, the CAPS-CA-5-J showed excellent internal consistency (Cronbach's alpha coefficient = 0.90) and interrater agreement (kappa coefficient = 0.88). Convergent validity was supported by a strong correlation between the total severity scale of the CAPS-CA-5-J and the PTSD-RI-5 scores (Pearson's correlation coefficient = 0.82). Divergent validity was indicated by a moderate correlation between the CAPS-CA-5-J and DSRDC, and no correlation was found with the SDQ scores. This study is the first to validate a structured clinical interview for children and adolescents with PTSD in Japan. The psychometric properties of the CAPS-CA-5-J were good enough and comparable to those reported in previous validation studies. Therefore, the CAPS-CA-5-J can be considered reliable and valid for use in Japan.

Individuals greatly differ in their responses to acute stress, ranging from resilience to vulnerability that may yield stress-related psychopathology. Stress-related psychopathologies involve, by definition, substantial modifications across multiple behavioural domains, including impaired cognitive, affective and social functioning. Nevertheless, and despite extensive investigation of individual variability in stress responsivity, no study to date simultaneously assessed the impact of acute stress across multiple behavioural domains within a given individual. To address this critical gap, 84 healthy female participants (mean age 24.45 ± 3.02, range 19-35) underwent an established acute stress induction procedure and completed three behavioural tasks, probing the functional domains of positive, cognitive and social processing, both before and after the acute stress procedure. A novel behavioural profiling algorithm was implemented to identify individuals whose performance was substantially impacted by stress across all three functional domains. Approximately 30% of participants exhibited substantial deviation in their performance from before to after stress in all three tasks, hereon defined as stress-affected. Stress-affected participants did not differ in their psychological and physiological responses to the acute stress procedure from the other stress-unaffected 70% of the sample. However, follow-up assessments in 66 of these participants revealed higher levels of stress six months following the procedure among the stress-affected compared to the stress-unaffected group. Stress-affected individuals also reported more aversive childhood experiences, such that the odds of participants who were sexually abused at an early age to be affected behaviourally by acute stress later in life increased by more than five-fold. Taken together, these findings suggest that being affected by acute stress across multiple functional domains is associated with future stress sensitivity and past childhood sexual abuse. Probing individual differences in the impact of acute stress across domains of functionality may better align with the multi-dimensional nature of stress responsivity, uncovering latent vulnerability.

Little peer-reviewed research has been done on trauma exposure, Post-Traumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD) prevalence among Greenlandic children and adolescents. There is a need for a validated Greenlandic version of the International Trauma Questionnaire - Child and Adolescent version (ITQ-CA) to assess symptoms of ICD-11 PTSD and CPTSD, as well as investigations of the prevalence of these disorders. This information is imperative in a Greenlandic context, where general epidemiological knowledge on traumatic exposure and reactions is lacking. The present study examined the factor structure of the Greenlandic ITQ-CA, estimated the prevalence of trauma exposure, ICD-11 PTSD and CPTSD, and examined the relationship between potentially traumatic events (PTEs), PTSD, CPTSD, and demographic variables in a Greenlandic adolescent population. Confirmatory factor analysis of competing models of the dimensionality of the ITQ-CA was tested among Greenlandic adolescents ( = 704) aged 11-17 years ( = 13.4, SD = 1.77). Using the ITQ-CA, PTSD and CPTSD was assessed. Findings supported the factorial validity of the Greenlandic ITQ-CA although factor structure differed across boys and girls. A total of 82.8% of the adolescents had been directly exposed to at least 1 PTE ( = 3.2), and 57.0% had been indirectly exposed ( = 3.1). The estimated prevalence of PTSD and CPTSD was 7.8% and 8.5%, while an additional 13.9% and 7% reached subclinical levels. Older age, female gender, several different and cumulative PTEs significantly elevated the risk of PTSD and CPTSD. ITQ-CA is a valid tool for identifying symptoms of ICD-11 PTSD and CPTSD. Results indicate that type and quantity of direct traumatic exposure are important predictors of PTSD and CPTSD. Events not normally considered traumatic as well as non-interpersonal events are significantly associated with CPTSD symptoms.

Prevalence rates for posttraumatic stress symptoms (PTSS) in unaccompanied young refugees (UYRs) are high. Research with biological parents indicates low agreement rates between self and caregiver reports for PTSS, although caregivers play an important role as gatekeepers to ensure appropriate treatment. This study examines youth and caregiver agreement on the endorsement of different trauma types, the PTSS severity score and symptom clusters, as well as the potential association between youth factors (age, comorbidity, and duration in facility) and disagreement. The sample consisted of  = 610 UYRs, aged  = 16.75 ( = 1.33, range: 12-20) years. Of these, 91.0% were male, and 43.4% were from Afghanistan, currently residing in German children and youth welfare facilities. Agreement rates across trauma types were poor (accidental trauma: Cohen's  = .13; community violence: Cohen's  = .07; domestic violence: Cohen's  = .19; sexual abuse: Cohen's  = .38). Agreement rates for the PTSS severity score (ICC = .22) and symptom clusters were poor (re-experiencing: ICC = .27; avoidance: ICC = .02; negative alterations in cognitions and mood ICC = .12; hyperarousal: ICC = .25), with youth reporting significantly higher scores. Regression models showed that having comorbid symptoms and a shorter duration in the facility were associated with higher disagreement at the PTSS severity score (Adjusted - = .21) and across symptom clusters (re-experiencing: Adjusted - = .13; avoidance: Adjusted - = .07; negative alterations in cognitions and mood: Adjusted - = .16; hyperarousal: Adjusted-  = .16). Age was not significantly associated with disagreement rates. It is important to enhance the awareness and comprehension of caregivers regarding recognition of mental illnesses and their symptoms as well as assessing mental health among UYRs.

Parents' experiences of IPV are associated with an increased risk for their children to experience IPV. However, the factors that may contribute to intergenerational IPV, particularly between adult mothers and daughters, are still poorly understood. To fill this gap in the literature, this preliminary study examines the moderating role of social support in IPV cycles among Cameroonian mother-daughter dyads. Sixty-one mother-daughter dyads completed questionnaires individually. We performed moderation analysis to examine if the association between mothers' experiences of IPV and daughters' experiences of IPV was moderated by daughters' social support. Results showed that social support influences the strength of the association between mothers' and daughters' IPV victimization. As levels of social support reported by daughters increased, the strength of the association between their and their mothers' experiences of IPV victimization decreased. At high levels of social support, this association was no longer significant ( = 0.09,  = 0.27,  = 0.34,  > .05). Support from family and friends is important in contexts of intergenerational IPV; thus, interventions aimed at preventing and reducing IPV may aim to strengthen these informal support systems to mitigate the effect of IPV.