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Advances in Posttraumatic Stress Disorder (PTSD): Clinical Update

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Prof. Dr. An-Fu Hsiao

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Guest Editor

1. Tibor Rubin VA Medical Center, Physical Medicine and Rehabilitation Healthcare Group, Long Beach, CA, USA
2. Department of Medicine, Health Policy Research Institute and General Internal Medicine, University of California, Irvine, CA, USA
Interests: posttraumatic stress disorder; chronic pain; psychedelics; transcranial magnetic stimulation; holistic health

Dr. Michael Hollifield

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Guest Editor

1. Tibor Rubin VA Medical Center, Mental Healthcare Group, Long Beach, CA, USA
2. Department of Psychiatry and Behavioral Sciences, George Washington School of Medicine & Health Sciences, Washington, DC, USA
Interests: posttraumatic stress disorder; holistic health; novel interventions; trauma survivors; mind-body medicine

Special Issue Information

Dear Colleagues,

Although posttraumatic stress disorder (PTSD) is categorized primarily as a mental health disorder, emerging evidence suggests that PTSD is a systemic illness that affects the whole body–mind. Novel and innovative clinical therapies for PTSD, such as stellate ganglion block, transcranial magnetic stimulation, psychedelic-assisted psychotherapy, and others, have targeted the neurobiological disregulations and dysfunctions of the neurocircuitry, autonomic nervous system, hypothalamic–pituitary axis, and inflammatory and autoimmune systems. In this Special Issue, we examine the theory, science, and effectiveness and safety of novel mind–body interventions to decrease the symptoms, improve quality of life, and alleviate suffering for those with PTSD.

We are looking forward to your contributions to this Special Issue.

Prof. Dr. An-Fu Hsiao
Dr. Michael Hollifield
Guest Editors

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Research

17 pages, 702 KB

Open AccessArticle

Psychological Burden and Quality of Life After Pediatric Liver Transplantation: A Cross-Sectional Study

by Serkan Suren, Deniz Yavuz Baskiran, Irem Tulum, Adil Baskiran and Sezai Yilmaz

J. Clin. Med. 2026, 15(11), 3994; https://doi.org/10.3390/jcm15113994 - 22 May 2026

Abstract

Background/Objectives: Survival rates after pediatric liver transplantation have improved substantially over recent decades, yet the psychiatric consequences for recipients remain a concern that warrants closer attention. We sought to map the psychiatric symptom burden across multiple domains in this population and to determine which symptom clusters carry the greatest impact on health-related quality of life (HRQOL). Materials and Methods: Fifty liver transplant recipients between the ages of 8 and 18 were enrolled at a single center. Children and their parents completed four psychiatric measures—the CBCL, CDI, SCARED, and CRIES-13—alongside the parent-proxy PedsQL to capture HRQOL across physical, emotional, social, and school functioning domains. Correlations between instruments were calculated, and linear regression was used to determine which psychiatric variables independently predicted PedsQL Total scores. Results: Across all psychiatric measures, higher symptom scores were associated with lower HRQOL, with school functioning recording the lowest absolute PedsQL domain score, while emotional functioning demonstrated the strongest and most consistent inverse correlations with all psychiatric symptom measures across instruments. CBCL Total (r = −0.607), SCARED Total (r = −0.557), and CRIES-13 Total (r = −0.548) scores all correlated meaningfully with overall HRQOL. When entered into multivariable analysis, anxiety symptoms measured by the SCARED (β = −0.295, p = 0.032) and post-traumatic stress symptoms measured by the CRIES-13 (β = −0.400, p = 0.004) stood out as the two independent predictors of worse PedsQL Total scores. Conclusions: Even in medically stable recipients, anxiety and post-traumatic stress symptoms were independently associated with lower daily functioning scores and overall quality of life. These findings suggest that routine psychosocial screening and trauma-informed approaches may warrant integration into post-transplant care protocols, and that prospective, adequately powered studies are needed to confirm and extend these associations. Full article

(This article belongs to the Special Issue Advances in Posttraumatic Stress Disorder (PTSD): Clinical Update)

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17 pages, 360 KB

Open AccessFeature PaperArticle

Predictors of PTSD Symptom Reduction in a Secondary Analysis of a Randomized Controlled Clinical Trial

by Tyler C. Smith, Besa Smith, An-Fu Hsiao, Andrea Munoz, Chelsea Aden, Jennifer Lai-Trzebiatowski, Megan Jung, Trevor J. Murphy and Michael Hollifield

J. Clin. Med. 2026, 15(1), 90; https://doi.org/10.3390/jcm15010090 - 23 Dec 2025

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Abstract

Objective: In a secondary analysis of a randomized, sham-controlled trial, we prospectively investigated baseline comorbidities, demographics, and intervention as predictors of clinically meaningful (≥15-point) CAPS-5 reduction in PTSD symptom reduction. Methods: This four-year (2018–2022), two-arm, parallel-group, prospective randomized placebo controlled clinical trial was conducted at the Long Beach VA Healthcare System among 71 treatment-seeking 18–55-year-old Veterans with chronic combat-related PTSD. Hierarchical and backward multivariable logistic regression models were conducted to compare the predictive capabilities of discriminating between 15-point reduction or more in CAPS-5 at follow-up. Results: Hierarchical multivariable logistic modeling found demographic variables alone provided a nearly acceptable prediction of 15-point reduction (c-statistic = 0.69) while clinical assessments alone provided an acceptable prediction (c-statistic = 0.75). Together, the baseline demographic and clinical variables indicated strong prediction (c-statistic = 0.92) and the addition of the group intervention variable increased the prediction (c-statistic = 0.94). In a backwards stepwise regression retaining variables with an alpha = 0.10 significance, females (adjusted odds ratio (AOR) = 14.7), and those receiving acupuncture (AOR = 4.17), indicating better physical health (AOR = 1.14) and less pain (AOR = 0.95), were statistically more likely to result in a 15-point CAPS-5 reduction at follow-up after controlling for other variables in the model. Conclusions: In this small sample, demographic and baseline clinical variables were independently predictive of symptom reduction and, together with the acupuncture intervention, presented a near perfect prediction of PTSD symptom reduction, though further validation is warranted. Patient characteristics that may indicate a more favorable response for PTSD symptom reduction include less baseline pain, better physical functioning, females, increasing age, and sociodemographic variables including higher income and not employed. Full article

(This article belongs to the Special Issue Advances in Posttraumatic Stress Disorder (PTSD): Clinical Update)

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