Search Results (116)

The transmission of trauma across generations has traditionally been explained through genetic, epigenetic, familial, and attachment-based mechanisms. While these approaches have generated valuable insights, they remain insufficient for explaining the persistence of psychological vulnerability in contexts where the original traumatic event has disappeared but maladaptive patterns continue to emerge across generations. This paper introduces the Contextual Resonance Theory of Psychopathology (CRTP), a novel cognitive–systemic framework proposing that transgenerational trauma is maintained through the recursive reproduction of trauma-shaped environments rather than exclusively through biological inheritance. According to this model, traumatic experiences generate adaptive cognitive, emotional, and behavioral responses that become embedded within family narratives, relational structures, institutional practices, and cultural expectations. Over time, these adaptations evolve into self-maintaining contextual systems that continuously communicate threat, unpredictability, and hypervigilance to subsequent generations. The theory introduces the concepts of contextual traumatic inertia, distributed psychopathology, and recursive contextual resonance to explain how vulnerability becomes socially reproduced even in the absence of direct trauma exposure. Drawing on predictive processing, ecological psychology, systems theory, and contemporary trauma research, the paper proposes that psychopathology emerges from persistent interactions between individuals and pathogenic environments rather than solely from intrapsychic dysfunction. Furthermore, a complementary mechanism termed corrective recontextualization is proposed as a pathway for reversing transgenerational vulnerability through repeated exposure to safe, predictable, and psychologically restorative contexts. The framework offers an integrative perspective capable of bridging cognitive neuroscience, developmental psychopathology, trauma studies, and mental health intervention research. Clinical, educational, organizational, and societal implications are discussed, alongside future directions for empirical validation and neurocognitive investigation. Full article

Background/Objectives: Autism spectrum disorder (ASD) is currently singularly described as a behaviourally defined neurodevelopmental diagnosis with symptoms affecting social communication and social understanding alongside the presence of restricted patterns of behaviour. Wide, and often very personal, variations in symptom intensities and differing developmental trajectories, reflective of large heterogeneity, are an important feature of the label. ASD carries enhanced risks for multiple over-represented, sometimes overlapping, comorbidities spanning behavioural, psychiatric and somatic domains. Said comorbidities often have numerous and far-reaching effects on quality of life by way of their impacts and, in extreme cases, their potential effects on life expectancy. It is of paramount importance that data on the risks of such comorbidities are available and, where possible, screening, preventive and/or treatment options implemented. Methods: In this narrative review, the authors searched databases (PubMed/Medline, ScienceDirect, Google Scholar) for papers published between 1 January 2015 and 16 February 2026 that were pertinent to comorbidity and autism. Results: We present data on the frequency of various somatic (gastrointestinal, immunological, metabolic, neurological, motor-sensory disorders), psychiatric (anxiety, mood, schizophrenia spectrum, personality, substance abuse, trauma, feeding and eating, sleeping, self-harm, neurocognitive disorders) and neurodevelopmental comorbidities (intellectual, attentional, speech and language, motor disorders) that can present alongside a diagnosis of ASD. We provide accompanying data on the magnitude of potential risk and, where available, information on comorbidity risks according to sex and age. Conclusions: This review paper deals with an extremely broad field. Limitations of the narrative review strategy are discussed alongside how the variable risk of comorbidity mimics the heterogeneity present in autism, thus inviting further investigations. Full article

Background: Idiopathic syringomyelia (IS) is defined by exclusion: an intramedullary fluid-filled cavity without Chiari malformation, spinal trauma, tumor, infection, or other identifiable cause. Growing evidence suggests IS is a progressively shrinking category as advanced imaging and intraoperative exploration uncover occult arachnoid or hydrodynamic substrates. To the best of our knowledge, no systematic reviews of the literature have been published on this topic. The authors aim to map operational definitions of IS, summarize proposed pathogenetic mechanisms, characterize diagnostic strategies and their yield, describe management approaches and outcomes, and identify pediatric–adult differences. Methods: A scoping review was conducted in accordance with PRISMA-ScR. PubMed and Scopus were searched from inception to May 2026. Eligible sources were original studies of any design addressing IS in pediatric or adult patients, in English. Studies on syringomyelia secondary to Chiari malformation, trauma, tumor, or infection were excluded. Data were extracted across five domains and synthesized narratively. Results: Eighteen studies (365 patients; five case reports, nine retrospective cohorts, two morphometric studies, one cine-MRI case–control, one technical note) were included. Operational definitions were markedly heterogeneous. Four pathogenetic mechanisms emerged: subarachnoid CSF obstruction with abnormal intramedullary pulse pressure, occult arachnoid pathology, posterior fossa morphometric variants overlapping with the Chiari spectrum, and persistent central canal as a developmental variant. In the four largest pediatric series (n = 214), 91–95% of children remained stable or improved on conservative management at up to 7-year follow-up, with no concordance between syrinx size change and clinical course. In symptomatic adults, targeted arachnoid lysis or web excision yielded clinical improvement in 87% of IS-occult arachnoid web patients; syringo-subarachnoid shunting was occasionally effective but risked neurological deterioration without prior substrate identification. Conclusions: The idiopathic label reflects the current limits of diagnostic investigation rather than a fixed nosological entity, since occult arachnoid or hydrodynamic substrates are identified in most adult IS cases when advanced imaging and intraoperative exploration are systematically deployed. Pathogenesis converges on a unified model of subarachnoid CSF obstruction generating abnormal intramedullary pulse pressure. Management should be driven by clinical, not radiological, evolution: arachnolysis or web excision is the primary strategy when an operable substrate is identified, while conservative management remains best supported in clinically stable patients, particularly children. Full article

Background/Objectives: The mental health of university students is a global public health priority. While pathological narcissism is increasingly recognized as a source of significant psychological suffering, its developmental and somatic correlates remain insufficiently explored. This study examines the sociodemographic, familial, and health-related correlates of pathological narcissism and its association with global psychological distress. Methods: A cross-sectional study was conducted with 888 university students (M = 21.3 years; 78.5% female) recruited from three faculties—Humanities and Social Sciences, Civil Engineering, and Medicine. Participants completed the Pathological Narcissism Inventory (PNI), Brief Symptom Inventory (BSI), and sociodemographic, familial, and health-related characteristics, including trauma exposure. Multivariable linear regressions and hierarchical regression analyses were conducted. Results: Pathological narcissism was robustly and positively associated with global psychological distress (r = 0.636, p < 0.001). Multivariable regression models identified chronic fatigue as the strongest somatic correlate of narcissistic pathology, consistent with an ego-depletion account of self-regulatory failure. Additional significant correlates included trauma history, insomnia, and prior use of psychological services. Students from the Faculty of Humanities and Social Sciences reported significantly higher narcissism scores than medical students. Poorer perceived family relationship quality was associated with higher narcissism scores. The full models accounted for 14.4% to 16.9% of the variance in narcissistic dimensions. Conclusions: These cross-sectional findings suggest that pathological narcissism is not merely a personality trait but a clinically relevant construct deeply intertwined with psychological distress and somatic exhaustion. The strong association between narcissism and chronic fatigue points to a substantial physiological cost of sustained self-regulatory effort. Findings highlight the need for integrated screening protocols in university counseling services that account for somatic symptoms (fatigue, insomnia), traumatic experiences, and family dynamics, alongside efforts to destigmatize help-seeking, given that fewer than 1% of students turn to faculty for support. Full article

Background: Inflammatory bowel disease (IBD) affects millions worldwide, imposing substantial clinical consequences and mental health implications. This burden leads to reduced quality of life (QoL) and growing pressure on healthcare systems and economies. This cross-sectional study examined the effects of childhood trauma on subjective symptoms of IBD health-related QoL, focusing on the mediating roles of emotional suppression and cognitive control, providing an integrative model for the general population. Methods: A sample of 402 Portuguese adults completed self-report measures, including the Childhood Trauma Questionnaire, the Emotion Regulation Questionnaire, the Cognitive Control and Flexibility Questionnaire, and the Short IBD Questionnaire. Multiple-step mediation analyses with bootstrapped confidence intervals tested indirect effects. Results: The two-step mediation effects indicated that childhood trauma was associated with subjective symptoms of IBD health-related QoL through both expressive suppression and cognitive control. Conclusions: These findings highlight the pivotal role of developmental, emotional and cognitive factors in understanding IBD health-related QoL in the general population, offering an opportunity to capture undiagnosed, mild, atypical, or intermittent cases, often discarded from most clinical studies. General-population-based data collection on IBD, beyond clinical settings, is vital for informed resource allocation and the design of effective screening, prevention and public health interventions that capture both diagnosed and undiagnosed cases. Full article

As the number of college students with left-behind experience grows, more scholars focus on their mental health and development. Most existing research highlights the negative consequences of the left-behind experience and rarely explores how individuals turn adversity into resources. In this qualitative study, semi-structured interviews were conducted with 16 college students (men: n = 5, women: n = 11; age: 20–23) who had a left-behind experience. Thematic analysis was used to examine both the negative and positive effects of the left-behind experience and the mechanisms of positive transformation. Findings suggest that left-behind experience can result in both hidden costs and cultivated resilience. Negative effects include increased emotional sensitivity, difficulty forming close relationships, and reduced feelings of belonging. Positive outcomes include greater independence, stronger responsibility, and improved social adaptability. Further analysis shows that students use three strategies—cognitive restructuring, emotional regulation, and behavioral engagement—to convert negative experiences into positive psychological resources, thereby shifting from trauma to empowerment. The study shows that left-behind experience alone does not dictate long-term outcomes. Instead, individual meaning-making and resource integration shape development. By extending resilience theory to this student group, the findings offer a strengths-based framework for psychological support and education. These findings call for university mental health services and educational policies to move beyond a deficit model and incorporate the resilience and self-regulatory strategies identified in this population. Full article

Lockdown drills have become standard practice in K-12 schools across the United States, but there are concerns about the psychological health impact, quality of implementation, and equity implications of current practices. This scoping review compiles the empirical literature on lockdown and active-threat drills to provide insight into how drills are defined and conducted, what outcomes are measured, and the remaining gaps. In accordance with well-researched scoping review methodologies, 27 peer-reviewed U.S.-based studies were aggregated from six primary areas: drill definitions and typologies, implementation practices, reported outcomes, trauma-informed and developmental considerations, equity and disability inclusion, and evidence gaps. Findings reveal wide variability among drill terminology and protocol categorization and most studies emphasize advance warning and low-realism practices. Psychological outcomes are measured much more often than objective measures of implementation fidelity or physical preparedness. Educator and staff experiences, caregiver perceptions, and longitudinal outcomes are underrepresented. Although a number of studies report developmental adaptations and disability accommodations, comprehensive equity analyses remain rare. Overall, potential psychological harms are more clearly documented than protective effects in the literature. This review emphasizes the importance of standardized drill taxonomies, fidelity measurement methods, trauma-informed mental health integration, and inclusive designs to inform school safety policy and practice. Full article

Foster parents working with children who are American Indian/Alaskan Native (AIAN) face challenges to provide trauma-informed, developmentally appropriate, and culturally relevant care for the children in their care. The Tribally Adapted National Training and Development Curriculum is a state-of-the-art training program designed to prepare foster parents to effectively parent AIAN children exposed to trauma and to provide these families with ongoing skill development necessary to understand and promote healthy child development. The current study describes the results of two focus groups (N = 11) that occurred in person in the social services office of the Salt River Pima-Maricopa Indian Community in May of 2022. Findings describe the experiences of participants that completed the tribal NTDC training and how the training impacted their readiness and experience to foster in comparison with parents of AIAN foster children who received the training-as-usual training protocol (Foster Parent College (FPC)) provided by the State child welfare authority. Full article

Growing evidence on the collateral consequences of youth incarceration, combined with increased attention to developmentally appropriate and trauma-informed care, has advanced national reform efforts aimed at rethinking youth confinement. While attention to trauma-informed care and developmentally appropriate approaches within juvenile justice systems is important, the structural barriers inherent in secure settings limit their potential. As a result, a concentrated focus on decarceration offers greater promise for promoting healthy youth outcomes. The movement toward decarceration emphasizes community-based services grounded in empirical evidence demonstrating that rehabilitation and positive adolescent development are more effectively achieved outside secure facilities. Additionally, an often-overlooked component of this shift is the role of probation, which remains the most common disposition for youth who come in contact with the justice system. Probation can either extend formal system involvement or serve as a bridge to community-based services, thereby influencing the success of decarceration efforts. This paper argues that prioritizing decarceration, while strengthening community capacity and thoughtfully restructuring probation, offers the most promising path for promoting healthy outcomes for youth, families, and communities. Full article

The term “periapical lesion” refers to a pathological change in the tissues surrounding the apex of a tooth root, defined by its anatomical location rather than a distinct disease entity. Periapical lesions may be of endodontic origin, most commonly resulting from microbial infection of the root canal system following pulp necrosis due to caries, trauma, or other insults, or of non-endodontic origin, such as developmental cysts, benign and malignant odontogenic and non-odontogenic tumors, and fibro-osseous lesions. Accurate diagnosis requires a systematic approach combining patient history, clinical examination, pulp vitality testing, and radiographic assessment; histopathological evaluation is indicated when clinical and radiographic findings are inconsistent or suspicious. The pathophysiology of these lesions involves dynamic interactions between root canal microorganisms and the host immune-inflammatory response. The primary management for endodontic periapical lesions is root canal treatment, which aims to reduce or eliminate root canal microorganisms through mechanical debridement and chemical disinfection. Persistent or extensive endodontic lesions and non-endodontic lesions may require surgical intervention. Molecular and inflammatory biomarkers have been investigated as adjunctive tools for assessing disease activity and prognosis; however, these remain largely investigational and are not yet part of routine clinical practice. Future developments in artificial intelligence, advanced imaging, molecular diagnostics, and personalized therapies may enhance the diagnosis and management of periapical lesions, although further clinical validation is required. Full article

Background: Posttraumatic stress disorder (PTSD) in ages 3–18 is associated with disturbances in attention, working memory, processing speed, and executive control, as well as persistent difficulties in affect regulation. These neuropsychological vulnerabilities might interfere with learning, peer relationships, and the consolidation of age-appropriate developmental skills. Methods: We conducted a narrative review informed by a structured literature search in PubMed, Scopus, PsycINFO, Embase, EBSCOhost, Web of Science, and Google Scholar. English-language publications from 1990 to 2025 were considered if they examined (1) neuropsychological outcomes of trauma exposure or PTSD in youth and/or (2) interventions with potential to modify neurocognitive or affective functioning, including trauma-focused cognitive behavioral therapy (TF-CBT), mindfulness-based interventions, cognitive rehabilitation strategies, and biofeedback/neurofeedback. Results: Across study designs, trauma exposure and PTSD in youth are consistently linked to impairments in attentional control and executive functioning, with downstream effects on everyday memory and academic performance. Neurobiological studies commonly implicate altered reactivity within amygdala-centered threat circuits and reduced top-down modulation by prefrontal networks, although findings vary with trauma type, developmental stage, and comorbidity. TF-CBT remains the best-supported intervention for pediatric PTSD symptoms; however, neurocognitive outcomes are measured less frequently. Mindfulness-based programs show promise for strengthening attention and emotion regulation when carefully adapted for trauma-exposed youth. Neurofeedback and targeted cognitive rehabilitation represent emerging approaches with preliminary evidence, but the literature remains heterogeneous. Conclusions: An intervention strategy that combines symptom-focused trauma therapy with explicit targeting of executive control, memory processes, and affect regulation may represent a developmentally informed clinical framework for trauma-exposed youth. Future trials need to incorporate standardized neuropsychological endpoints and examine moderators that inform treatment matching. Full article

Background/Objectives: Sleep disturbance is common among youth in the child welfare system, yet the role of placement instability and placement setting in shaping sleep outcomes remains understudied. This study examined the association between placement instability, time spent in different care settings, and sleep disturbance among children in foster care. Methods: We conducted a retrospective cohort study using longitudinal administrative child welfare data from a Midwestern U.S. state, including 20,888 youth aged 5–18 years who entered foster care between 2010 and 2020. Sleep disturbance was assessed using the Child and Adolescent Needs and Strengths (CANS) sleep item. Baseline was defined as the first CANS assessment within one month of entry into care, and follow-up as the assessment closest to discharge or the end of a three-year observation window, whichever occurred first. We estimated association using a time-lagged linear mixed-effects model predicting sleep disturbance after each placement episode, including placement instability: 1 (reference), 2, 3, or ≥4 placement(s), time since placement, time spent in care settings (kinship, foster home, treatment foster home, congregate care, institutional care), and baseline trait factor scores derived from non-sleep CANS items, while controlling for sleep at the time of placement and demographics. Results: At baseline, 2016 children had actionable sleep disturbance (CANS sleep = 2 or 3; 1701 moderate and 315 severe). By the end of follow-up, this increased to 2884 children (2372 moderate and 512 severe). In linear mixed-effects models, placement instability demonstrated a dose–response association with higher subsequent sleep disturbance relative to one placement (2 placements: β = 0.025; 3 placements: β = 0.045; ≥4 placements: β = 0.067; all p ≤ 0.02). Time spent in kinship care was associated with lower sleep disturbance (β = −0.049; p < 0.001), whereas time spent in treatment foster homes was associated with higher sleep disturbance (β = 0.035; p < 0.001). Trauma in the family, medical/developmental needs, and internalizing/sexual issues were positively associated with sleep disturbance. Time and instability interactions showed modest attenuations of instability-associated sleep disturbance over time for higher placement counts. Conclusions: Placement instability is associated with progressively worse sleep disturbance over time among youth in foster care, even after controlling for sleep status at placement and baseline functioning. Sleep disturbance may represent an actionable indicator for the child welfare system, highlighting opportunities for targeted screening and support during placement transitions. Full article

Art therapy assessment benefits from analytical clarity while preserving non-directive, process-sensitive practice. Although the Expressive Therapies Continuum (ETC) is widely used to conceptualize sensory, affective, cognitive, and symbolic processes in art-making, ETC-informed assessment often relies on implicit clinical reasoning, limiting transparency and interdisciplinary communication. This article presents the developmental stage of a protocol-based Expressive Therapies Continuum Assessment Profile (ETC-AP) developed at Rīga Stradiņš University. The ETC-AP differentiates activation and inhibition patterns around integration midpoints and organizes observation in a defined five-step interpretive sequence without positioning the method as a psychometrically validated test. It combines (i) a uniform three-task, non-directive administration with a brief post-task inquiry; (ii) criteria-guided coding of observable features across three artworks and process notes; and (iii) 0–100 descriptive profile indicators to support within-case pattern description and professional dialogue. An illustrative case vignette shows how the ETC-AP can generate trauma-informed, regulation-oriented hypotheses about channel accessibility and cautious regulation-oriented sequencing, while remaining subordinate to clinical judgment and context. Key boundaries include incomplete operational coverage in some inhibition ranges, limits of static documentation for process-dependent markers, and the need for structured training materials and programmatic studies of reliability, feasibility, and sensitivity to change. Full article

The article is based on On the Move a holistic, playful movement intervention with children in Red Cross asylum centers in Denmark. Children in asylum centers in Denmark have diverse backgrounds, challenges, and resources. Common challenges due to their life situations can include potential trauma stemming from flight, migration, and/or war experienced by the children and their parents. Furthermore, they live with uncertainty regarding future relocation. These conditions may induce a state of alert, as the children’s foundations feel insecure. These circumstances can also affect the children’s emotional, cognitive, motor, and relational developmental processes. On the Move is a practice-based research project focused on examining how participation in a long-term holistic, playful movement intervention can support children in asylum centers regarding connectedness. The research project is inspired by a phenomenological understanding of body and movement, hermeneutic–phenomenological research, practitioner research, and Arts-Based Research. The data presented here is derived from scenic descriptions and interviews collected during the research project. The theoretical framework is based on the concepts of ontological security, movement philosophy and movement psychology. The article illuminates one of the main practice-based thematic findings from the research project: “Children sway—movement processes”. The article highlights challenges faced by the children due to their life situations and shows how teachers can support the children’s participation in the intervention. The article focuses both on the children’s life situations viewed by professionals and on the children’s movement processes during the intervention. In the movement processes, the children can enter a state in which they are described as being in harmony with the movements, with themselves, and with others. In this way, participating in a holistic, playful movement intervention can support the connectedness of children in asylum centers. Full article

Ectopic liver is a rare anomaly characterized by the presence of hepatic tissue outside its normal anatomical location without continuity with the main liver. Reports of this condition are sporadic in human medicine, and cases in veterinary species remain limited. This condition may arise as a congenital developmental defect or as a consequence of prior traumatic injury leading to fragmentation and displacement of hepatic tissue. This case study describes an incidental intrathoracic ectopic liver identified in a 6-year-old male cat that died of acute suppurative bacterial pneumonia. Necropsy revealed a well-demarcated, encapsulated, large mass within the middle of the caudal mediastinum, unattached to the diaphragm, lungs, or pericardium. Cytologic and histopathologic examinations confirmed the presence of hepatic tissue with preserved lobular architecture. No evidence of previous trauma or diaphragmatic defects was present, supporting the congenital origin. The accompanying severe bacterial pneumonia was unrelated to the mediastinal mass. This study highlights the diagnostic challenges associated with intrathoracic ectopic liver, which can mimic neoplastic or inflammatory masses. Awareness of this entity is essential for accurate diagnosis. Given the documented risk of malignant transformation in ectopic hepatic tissue, surgical excision and histopathological assessment should be considered whenever such lesions are detected. Full article