Search Results (597)

Mental disorders and impairments are part of the occupational risk for emergency personnel. This study examines the impact of a deadly knife attack on police officers’ mental health. Aims: We hypothesized that police officers who knew the deceased team member would report higher levels of psychological distress compared to those who did not, regardless of the deployment status. Methods: Six months after a fatal knife attack in which a police officer was killed, a total of N = 254 officers participated in the study. Of these, n = 115 reported knowing the victim personally, n = 126 did not (n = 78 deployed; n = 176 not deployed), while n = five did not provide any information. Posttraumatic stress disorder (PTSD), posttraumatic stress symptoms (PTSS), anger and adverse childhood experiences (ACEs) were assessed using questionnaires. Chi-square tests examined group differences in probable PTSD prevalence; t-tests assessed differences in anger and Posttraumatic Stress Disorder Checklist for DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition; DSM-5; PCL-5) symptom scores. Linear regression analyses tested deployment, acquaintance with the victim, gender, and childhood emotional neglect as predictors. Results: Police officers who personally knew the deceased colleague exhibited significantly higher PTSS scores. In addition, the deployed group showed significantly higher trait anger than the non-deployed. Acquaintance with the victim and emotional neglect in childhood were significantly related to negative cognitions, whereas deployment to the knife attack or gender were not. Discussion: Police officers with a personal connection to the deceased showed significantly higher mental health impact than those with direct exposure alone, placing them in a higher-risk group due to increased exposure to feelings of guilt and shame due to their professional role. Police officers who were emotionally neglected in their childhood may be more prone to negative cognitions in adulthood, when faced with critical events. These results underline the importance of addressing risk factors in both pre-deployment training and post-event debriefing, especially with regard to anger management after major critical incidents. Full article

Background: Fibromyalgia syndrome (FMS) and post-traumatic stress disorder (PTSD) may co-occur and are associated with increased symptom burden, functional impairment, and reduced quality of life. Accumulating evidence suggests shared neurobiological mechanisms. Trauma-focused interventions targeting maladaptive memory processes may therefore represent a relevant therapeutic approach in this population. Objective: To evaluate the feasibility, tolerability, and preliminary clinical associations of a brief reconsolidation-based therapy in women with comorbid FMS and PTSD. Methods: This multicenter pilot study included adult women diagnosed with FMS and PTSD who underwent six sessions of reconsolidation therapy combining traumatic memory reactivation with propranolol administration. Clinical outcomes were assessed at baseline and at 3-month follow-up using the Fibromyalgia Impact Questionnaire (FIQ), the Impact of Event Scale–Revised (IES-R), the Montgomery–Åsberg Depression Rating Scale (MADRS), the Beck Depression Inventory (BDI), the Rosenberg Self-Esteem Scale (RSES), and the SF-36. Changes over time were analyzed using paired statistical tests and linear mixed-effects models. Results: Fourteen participants completed the intervention and follow-up assessments. The intervention was feasible and well tolerated. Changes over time were observed in fibromyalgia-related quality of life (FIQ scores), PTSD symptom severity (IES-R), and depressive symptoms (MADRS, BDI), as well as in selected SF-36 domains, including vitality, social functioning, and mental health. A progressive decrease in IES-R scores was observed across treatment sessions. Conclusions: This pilot study suggests that reconsolidation-based therapy is feasible in women with comorbid FMS and PTSD and was associated with changes in PTSD symptoms and fibromyalgia-related functional impact. Given the exploratory design and absence of a control group, these findings should be interpreted cautiously and warrant confirmation in larger, controlled trials. Full article

Background: PTSD diagnosis is challenging. Symptoms overlap with depression and panic attacks. This causes misdiagnosis and delayed treatment. Current methods lack objective biomarkers. This study presents a hybrid AI framework. It combines CNNs and SVMs. The system detects PTSD from ECG signals. Methods: ECG data from 79 participants were analyzed. Four groups were included. PTSD patients numbered 20. Depression patients numbered 20. Panic attack patients numbered 19. Healthy controls numbered 20. Wavelet transform created scalograms. Three CNN models were tested. AlexNet, GoogLeNet, and ResNet50 were used. Deep features were extracted. SVMs classified the features. Five-fold validation was performed. Statistical tests confirmed significance. Results: Hybrid models performed robustly. ResNet50 + SVM and AlexNet + SVM achieved statistically equivalent results with accuracies of 97.05% and 97.26%, respectively. AUC reached 1.00 for multi-class tasks. PTSD detection was highly accurate. The system distinguished PTSD from other disorders. Hybrid models beat standalone CNNs. SVM integration improved results significantly. Conclusions: This is the first ECG-based AI for PTSD diagnosis. The hybrid approach achieves clinical-level accuracy. PTSD is distinguished from depression and panic attacks. Objective biomarkers support psychiatric assessment. Early intervention becomes possible. Full article

Background: Black transgender women experience high rates of intersectional discrimination contributing to post-traumatic stress disorder (PTSD) symptoms. While sleep typically buffers psychological distress among general populations, these relationships remain underexplored among Black transgender women, and existing protective sleep literature derives primarily from non-Hispanic White, cisgender, socioeconomically advantaged populations. Methods: This exploratory secondary cross-sectional analysis of 155 Black transgender women (aged 18+) examined whether sleep quality (Pittsburgh Sleep Quality Index) moderates associations between discrimination (Intersectional Discrimination Index) and PTSD symptoms (PTSD Symptom Checklist-DSM-5) using moderated multiple linear regression models, controlling for age (n = 139–149). Results: Contrary to expectations, better sleep quality strengthened associations between day-to-day (p = 0.0126) and major discrimination (p = 0.0235) and the PTSD symptom severity. Conclusions: These exploratory findings reveal paradoxical sleep-distress relationships among Black transgender women that contradict patterns documented among general populations, highlighting critical limitations in applying existing psychological frameworks to multiple marginalized communities. Results underscore urgent needs for culturally validated assessment instruments and comprehensive measurement of structural determinants (housing stability, economic security, and neighborhood safety) before concluding psychology in populations experiencing intersectional oppressions. Full article

Migrant populations drive Canada’s demographic expansion, making their successful integration a national priority. However, research has consistently shown that refugees and immigrants experience declining mental health and encounter significant barriers to accessing culturally appropriate mental health support. This scoping review examined the breadth of evidence on culturally adapted mental health education (MHE) programs for migrant populations, including those that integrate traditional and complementary healing practices, and their effectiveness. Systematic searches across six databases (Medline, EMBASE, PsycINFO, Global Health, CINAHL, and Scopus) identified 4075 peer-reviewed articles, with 28 studies meeting inclusion criteria. These included mental health education and awareness programs that integrate psychoeducation and skill-building. Inclusion criteria required cultural adaptation of programs through one or more approaches such as language modification, culturally adapted content, community-based delivery, or integration of traditional and complementary healing practices. Thematic analysis of the programs revealed seven key themes characterizing effective MHE programs: cultural adaptation and sensitivity, addressing unique migration-related stressors, integration of traditional and Western approaches, use of theoretical frameworks and evidence-based practices, rigorous evaluation methodologies, application of holistic frameworks, and community-based peer support models. Programs predominantly utilized psychoeducation and culturally adapted interventions, with common theoretical frameworks including cognitive–behavioral therapy and the PRECEDE–PROCEED model. Across the reviewed studies, program evaluations reported positive outcomes including increased mental health literacy, reduced stigma, enhanced coping skills, and decreased depression, anxiety, and PTSD symptoms, suggesting that culturally adapted MHE programs are acceptable and feasible interventions for migrant populations. Full article

Background: The Republic of Korean humidifier disinfectant disaster, involving toxic chemical exposure, constitutes a major social disaster causing severe trauma. While physical and psychological difficulties are documented, this study investigated the relationship between posttraumatic stress disorder (PTSD) symptoms and survivors’ daily life adaptation across children, adolescents, and adults, examining PTSD’s mediating role. Methods: The sample included 834 participants (417 exposed survivors and 417 unaffected individuals), divided into three age groups. PTSD symptoms and life adaptation were measured via self-reports. Multigroup Structural Equation Modeling (SEM) was utilized to test the indirect associations among exposure, PTSD symptoms, and life adaptation, and to examine age-group comparisons. Results: Survivors in all age groups reported higher PTSD symptoms and lower adaptive functioning compared to unaffected individuals, with the largest PTSD mean difference found in children and adults. Multigroup SEM confirmed that exposure positively impacted PTSD symptoms, and PTSD symptoms negatively impacted life adaptation across all ages. PTSD symptoms significantly mediated the exposure-life adaptation link in all groups. Critically, the direct effect of exposure on life adaptation was significant only in adults, indicating a full mediation via PTSD symptoms in children and adolescents. Conclusions: Exposure to toxic humidifier disinfectants is linked to life adaptation difficulties through elevated PTSD symptoms. These findings emphasize addressing trauma-related symptoms and suggest the utility of developmentally sensitive psychological interventions. Limitations include reliance on self- and parent-reported measures rather than clinical diagnoses, and the lack of control for external contextual factors (e.g., policy changes, media exposure). Full article

Fishing is a widely practiced recreational activity that offers psychological, physical, and social benefits, but it also poses risks such as acute trauma and chronic overuse injuries. This narrative review aims to (1) synthesize current evidence on the musculoskeletal disorders, psychological outcomes, and environmental factors associated with recreational and sport fishing; (2) identify the physical, mental, and social health benefits reported across different angling disciplines; (3) characterize acute and chronic injury risks, including overuse syndromes and environment-related hazards; and (4) highlight gaps in the literature to guide future research directions in public health, rehabilitation, and preventive medicine. Materials and Methods: A narrative review was conducted in accordance with SANRA guidelines. A structured search of PubMed, Scopus, Web of Science and Google Scholar identified studies published between 2000 and 2025. Eligible sources included population surveys, clinical studies, therapeutic angling programs, epidemiological reports, and case studies addressing physical, psychological, or injury-related outcomes in recreational or sport fishing. Studies on commercial or occupational fishing were excluded. Evidence was synthesized thematically across benefit and risk domains. A total of 565 records were identified across four databases (PubMed, Scopus, Web of Science, Google Scholar). After screening, duplication, and full-text assessment, 41 studies met the eligibility criteria and were included in the narrative synthesis. The evidence indicates significant psychological benefits of fishing, including reductions in stress, improved mood, and clinically meaningful decreases in Post-Traumatic Stress Disorder (PTSD) symptoms reported in therapeutic fly-fishing programs. Musculoskeletal outcomes were more heterogeneous: chronic conditions such as low back pain and repetitive strain injuries of the shoulder, elbow, and wrist were commonly reported among regular anglers, particularly in physically demanding disciplines. Ice and sea fishing were associated with distinct environmental risks, including hypothermia, frostbite, and rare but documented fatal incidents. The results of this narrative review highlight the therapeutic potential of both recreational and sport fishing. However, they also point to the need for greater awareness of the risk of injury and environmental hazards associated with this type of fishing. Full article

Background: Psychedelic-assisted therapy is gaining renewed attention as a potential treatment for various mental disorders. Despite increasing numbers of randomized controlled trials (RCTs) and meta-analyses, a comprehensive synthesis of the evidence across different substances and indications is lacking. This umbrella review aims to evaluate the effectiveness and safety of psychedelic-assisted therapy—primarily psilocybin, MDMA, and LSD—across major psychiatric disorders, including depression, post-traumatic stress disorder (PTSD), and substance use disorders. Methods: We systematically identified and synthesized data from 23 meta-analyses encompassing over 100 primary studies. Outcomes were standardized and re-expressed as Hedges’ g to enable cross-study comparisons. Study quality was assessed using AMSTAR2, and certainty of evidence was evaluated via the GRADE framework. Results: The number of identified meta-analyses differed markedly depending on the substance and clinical indication: psilocybin for depression (n = 9) and MDMA for PTSD (n = 10) had the strongest evidence base, while fewer meta-analyses were available for LSD in alcohol use disorder (n = 2) and depression (n = 2), ayahuasca in depression (n = 2), and MDMA in autism spectrum disorder (n = 2). Psilocybin demonstrated large effect sizes in major depression (Hedges’ g ≈ 1.05), with some evidence of sustained benefits up to six months. MDMA showed very large effects in reducing PTSD symptoms (Hedges’ g ≈ 1.24), often after 2–3 sessions. LSD yielded short-term benefits for alcohol use disorder (OR ≈ 2.0), though effects declined over time. Across studies, adverse events were generally mild and transient, with no consistent signal for serious harm. Considerable methodological variability was observed, including small and sometimes overlapping samples, heterogeneity, risk of bias, and limited long-term data. These constraints should be taken into account when interpreting the overall findings. Conclusions: Current evidence supports the short-term efficacy and safety of psychedelic-assisted therapy for selected psychiatric disorders, particularly depression and PTSD. However, the low methodological quality of studies and most meta-analyses, as well gaps in long-term safety data highlight the need for high-quality studies. Full article

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

Introduction: The Diagnostic and Statistical Manual of Mental Disorders has been criticized for its reliability and validity, including for the major psychological injuries [Posttraumatic Stress Disorder (PTSD), chronic pain-related disorders, and neurocognitive disorders, pertinent for mild traumatic brain injury (MTBI)/persistent post-concussion syndrome (PPCS)]. Methods: This review article examines both the mental health/psychiatric and legal literature on the DSM-5 and its criticisms. The DSM-5 uses a polythetic approach, which leads to many complicating ways of expressing disorders (e.g., PTSD). Disorders related to chronic pain refer to somatic symptom disorders (e.g., with predominant pain), which leads to less focus on the chronic pain itself. The neurocognitive disorder diagnosis includes minor and major classifications, but excludes moderate ones. The international diagnostic system (International Classification of Diseases (ICD-11)) and alternate approaches to psychiatric nosology [the Research Domain Criteria (RDoC) and Hierarchal Taxonomy of Psychopathology (HiTOP)] do not help resolve these issues. Results: The comprehensive literature review undertaken indicates the limitations of the DSM-5 clinically and in court, especially for psychological injuries. The article includes tables and boxes that complement the text with specificities related to the issues raised. Conclusions: The article recommends supplementary diagnostic criteria for the three major psychological injuries (PTSD, chronic pain, and MTBI) for forensic use. This paper is an original contribution to improving the diagnostics/description and forensic use of the major psychological injuries: aside from the paper’s clinical contributions, these disorders/conditions are contentious in court, and their better specification in diagnosis, as attempted herein, is important to undertake forensically. Full article

This systematic review aimed to identify psychosocial risk factors associated with the development of complicated perinatal grief in adult women who experienced pregnancy loss. Following PRISMA guidelines, comprehensive searches were conducted in Web of Science, PubMed, Scopus, and PsycINFO databases, covering 1990–2024. A total of 34 quantitative studies comprising 7872 participants were included, mainly using cross-sectional and longitudinal designs. Findings indicate that complicated perinatal grief is a multifactorial condition influenced by personal variables (absence of living children, history of depression or PTSD, advanced maternal age, low education and income), obstetric factors (later gestational loss, multiple pregnancies, stillbirth, or neonatal death), and psychosocial factors (low social support, relationship conflict, violence, ostracism, and limited psychological care). Negative cognitions, rumination, and maladaptive coping strategies were also linked to prolonged symptoms of depression, anxiety, and post-traumatic stress. The review concludes that complicated perinatal grief is a multidimensional phenomenon determined by psychological, social, cultural, and medical factors and highlights the need to understand perinatal loss as a profoundly significant experience that affects women’s identity, relationships, and mental health. This evidence highlights the importance of emphasizing the identified risk factors that can lead to complicated grief. Full article

Background/Objectives: Nurses and nursing technicians are essential providers of patient care but remain highly vulnerable due to the demands of their profession, which can profoundly affect their professional quality of life. Understanding the risk and protective factors underlying different aspects of professional quality of life is crucial for fostering healthcare professionals’ overall well-being and ensuring high-quality care for patients. The aim of this study was to explore the relationships between professional quality of life, work-related factors, PTSD symptomatology and individual resources, including resilience and coping strategies. Methods: This cross-sectional study included 119 nurses from various nursing departments. A questionnaire comprising sociodemographic and work-related variables and four validated instruments, Professional Quality of Life Scale-5 (ProQOL-5), PTSD Checklist for DSM-5 (PCL-5), Brief-COPE and Brief Resilience Scale, was used for data collection. Results: Findings revealed moderate to high compassion satisfaction among nurses and technicians, as well as low to moderate burnout and moderate levels of secondary traumatic stress. Compassion satisfaction was positively associated with problem-focused and emotion-focused coping, whereas higher levels of compassion fatigue (burnout and secondary traumatic stress) were associated with avoidant coping, greater PTSD symptom severity, and lower resilience. Resilience, problem-focused coping, and PTSD symptom severity were identified as significant predictors of professional quality of life. Conclusions: To support nurses’ and technicians’ well-being, healthcare organizations should encourage open conversations about the emotional demands of patient care and provide interventions that promote effective coping and address PTSD symptoms, ultimately helping to reduce compassion fatigue and enhance compassion satisfaction. Full article

Background: Bereavement often elicits complex emotional and cognitive reactions, including guilt, unresolved relational concerns, and repetitive negative thinking. Although grief-specific rumination is recognized as a key process that can intensify prolonged grief and trauma-related responses, longitudinal evidence clarifying its mediating role remains limited. This study examines whether grief-specific rumination explains how guilt and unfinished business contribute to prolonged grief and PTSD symptoms over time. Methods: A two-wave longitudinal design was used to assess bereaved adults several months after loss and again at follow-up. Measures included guilt, unfinished business, grief-specific rumination, prolonged grief symptoms, and PTSD symptoms. Mediation analyses tested whether rumination accounted for associations between early loss-related responses (guilt and unfinished business) and psychological outcomes at follow-up. Results: Grief-specific rumination consistently emerged as the mechanism linking guilt and unfinished business with both prolonged grief and PTSD symptoms. These findings suggest that the impact of these early loss-related responses operates primarily through persistent and repetitive cognitive engagement with the loss. Conclusions: Rumination emerged as a central mechanism through which guilt and unfinished business shape bereavement-related distress. These findings highlight the importance of interventions that directly target repetitive negative thinking to promote healthier adjustment following loss. Full article

Prolonged Exposure (PE) is an effective evidence-based psychotherapy for posttraumatic stress disorder (PTSD); however, a small subset of veterans fails to achieve meaningful symptom reduction from PE. Given sleep’s role in memory consolidation, poor sleep quality may adversely affect fear extinction learning central to PE. Existing research on sleep and PE response often relies on single-item or global measures that miss nuanced sleep processes, assesses sleep as static (e.g., at baseline) rather than as a dynamic process, or focuses on concurrent rather than prospective associations. This study used a multidimensional measure of sleep quality to evaluate whether changes across several domains of sleep concurrently and prospectively predicted reduced PTSD symptoms. Sleep quality was assessed pre- and post-treatment and PTSD symptoms were measured pre- and post-treatment and at 3- and 6-month follow-ups. Changes in sleep domains were analyzed as predictors of concurrent and prospective PTSD symptoms. Improvements in overall sleep quality, subjective sleep quality, and daytime dysfunction were associated with improvements in PTSD symptom severity from pre- to post-treatment. Greater improvements in overall sleep quality and daytime dysfunction predicted lower PTSD severity at follow-up; however, greater reductions in daytime dysfunction predicted symptom increases across follow-up. Our findings highlight the importance of overall sleep quality in PE response and suggest that daytime dysfunction due to sleep problems may contribute to diminished long-term outcomes. Targeting these aspects of sleep may enhance treatment efficacy. Full article

Background/Objectives: Equine-assisted services are being increasingly utilized as complementary interventions for military veterans who have experienced trauma. However, rigorous research is lacking, and randomized controlled trials are needed. The H.O.O.V.E.S. Intensive intervention was developed for this population. This intensive program is an equine-assisted learning approach developed for veteran and active-duty military trauma survivors. The program integrates equine-assisted learning, peer mentorship and experiential learning in a residential retreat format. The primary aim of this pilot study was to determine if more rigorous studies of this intervention are warranted. Secondary aims were to assess preliminary outcomes and explore possible relationships between changes in outcome measures. Methods: This was a pilot prospective study. Inclusion criteria for the program included veteran or active-duty military status and a history of trauma exposure. Data were collected from April–October of 2024 in Ohio, USA. Six psychological instruments were administered to participants before, immediately after and 90 days and 120 days after the intervention. These were the PTSD Checklist for DSM-5 (PCL-5), the Acceptance and Action Questionnaire II (AAQII), the Positive and Negative Affect Scale (PANAS), the State-Trait Anxiety Inventory (STAI), the Beck Depression Inventory (BDI) and the Posttraumatic Growth Inventory (PTGI). Analyses were conducted to assess for significant changes across the study timeframe and for relationships among the changes in psychological instrument scores. Results: Study participants were 32 veterans with trauma histories ranging in age from 30 to 67 years old. There were statistically significant pre- to post-intervention improvements for all instruments except the PTGI, suggesting short-term increased psychological flexibility (AAQII) and positive affect (PANAS-positive) as well as decreased anxiety (STAI), negative affect (PANAS-negative), depression (BDI) and PTSD symptoms (PCL-5). Changes in BDI and PCL-5 scores persisted at 120 days post-intervention whereas changes in the AAQII, PANAS and STAI did not persist. Increased psychological flexibility was correlated with reductions in negative affect, PTSD symptoms and anxiety, as well as with increases in positive affect. Conclusions: Preliminary results reported herein suggest participation is associated with psychological benefits. Further, decreased experiential avoidance/increased psychological flexibility should be explored as an underlying mechanism potentially contributing to the benefits of participation in EAS. A randomized controlled trial of the H.O.O.V.E.S. Intensive program is warranted. Full article