Search Results (1,270)

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

Background/Objectives: Personal values shape appraisal of stress and life satisfaction. We examined the relationship between perceived stress and life satisfaction among uniformed personnel in outpatient mental health care, and the role of a personal values hierarchy in this context. Methods: Cross-sectional study of 183 uniformed personnel (34 females, 149 males, age 30–66 years, M = 44.72, SD = 5.84) diagnosed with bodily distress disorder or post-traumatic stress disorder at a mental health clinic. Participants completed standardized questionnaires assessing perceived stress, satisfaction with life, coping styles, and personal values. For the Personal Value List, each value not selected by a participant was coded as 0 to avoid missing data; scores regarding symbols of happiness were not used. Reliability was evaluated via repeated measurement; two parts of a key instrument showed test–retest correlations of approximately 0.78 and 0.76. For assessing statistical significance, the bootstrap method was used (1000 resamples). Analyses were conducted in jamovi 2.3.28 using snowLatent (latent profile analysis) and medmod 1.1.0 (moderation analysis). Results: Perceived stress was negatively associated with satisfaction with life (B = −0.36, 95% CI [−0.48; −0.24], p < 0.001). Latent profile analysis extracted two personal values hierarchy profiles (AIC = 4237; BIC = 4587). Profile membership was not a significant predictor of satisfaction with life (p = 0.595) and did not moderate the relationship between perceived stress and satisfaction with life (p = 0.907). Distraction seeking was significantly higher in profile 1 (p = 0.010). Conclusions: In treated uniformed personnel, higher perceived stress is linked to lower life satisfaction. The personal values hierarchy did not moderate this relationship and was not associated with satisfaction with life; however, the personal values hierarchy was related to coping, specifically distraction seeking. 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

Psychological distress impacts a large portion of the general population. While effective treatments are available, few seek them out. This lack of treatment seeking may be due to several factors, particularly low mental health literacy (MHL). MHL is the knowledge an individual has regarding psychological disorders and their symptoms, treatments, and where to seek appropriate help when identified. The capacity to pay attention to present-moment experiences in MHL translates to the qualities of dispositional mindfulness (DM), the capacity to pay non-judgmental attention to present-moment experiences. The purpose of the present study was to evaluate the reliability and preliminary convergent validity of a newly developed, vignette-based assessment of psychological disorder recognition. A total of N = 299 participants were recruited via TurkPrime and completed measures of DM (FFMQ), MHL (MHLS), depression (PHQ-9), anxiety (GAD-7), and treatment-seeking attitudes (MHSAS). Participants were subsequently asked to read newly created vignettes based on ICD-11 criteria of major depressive, generalized anxiety, social anxiety, bipolar disorders, post-traumatic stress disorder, and schizophrenia. Participants then responded to questions assessing the recognition of disorder presence and identification. The vignettes with accompanying questions were titled the Psychological Disorder Recognition—Vignette (PDR-V) task. The PDR-V evidenced a Kuder–Richardson Formula 20 (KR-20) of 0.83, indicating excellent internal consistency. Independent sample t-tests indicated that participants with prior psychotherapy exposure, a history of mental health diagnosis, and, unexpectedly, those reporting lower education levels and no current mindfulness practice, scored significantly higher on the PDR-V. Spearman correlations revealed that higher scores on a validated MHL scale and specific facets of DM (describe, act with awareness) were positively correlated with PDR-V scores. Bipolar disorder evidenced the highest recognition as a psychological problem broadly, while social anxiety had the highest specific disorder identification accuracy rates. Generalized anxiety disorder had the lowest recognition and identification accuracy. While the PDR-V demonstrated promising preliminary psychometric properties, it also observed anomalies that warrant further investigation, as findings are limited by its cross-sectional nature. These findings suggest that the PDR-V is a versatile tool for differentiating the presence of a problem and accurately identifying the condition, supporting its potential as a reliable and sound measure. 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

Development of new therapeutic approaches and strategies for common neuropsychiatric disorders, including Major Depressive Disorder, anxiety disorders, and Post-Traumatic Stress Disorder, represent a significant global health challenge. Recent research indicates that emotional dysregulation and persistent inflammation are closely linked and serve as key pathophysiological features of these conditions. Emotional dysregulation is mechanistically coupled to locus coeruleus and norepinephrine (LC-NE) or noradrenergic system activity. Stemming from chronic stress, persistently elevated activity of the LC-NE system leads to hypervigilance, anxious states, and depressed mood. Concurrently, these symptoms are marked by systemic inflammation as indicated by elevated pro-inflammatory cytokines, and central neuroinflammation indicated by microglial activation in brain regions and networks involved in mood regulation and emotional control. In turn, chronic inflammation increases sympathetic tone and LC-NE activity resulting in a vortex of psychoneuroimmunological dysfunction that worsens mental health. Transcutaneous auricular vagus nerve stimulation (taVNS) in a non-invasive neuromodulation method uniquely positioned to address both noradrenergic dysfunction and chronic inflammation in neuropsychiatric applications. Evidence spanning the past decade demonstrates taVNS works via two complementary mechanisms. An ascending pathway engages vagal afferents projecting to the LC-NE system in the brain stem, which has been shown to modulate cortical arousal, cognitive function, mood, and stress responses. Through descending circuits, taVNS also modulates the cholinergic anti-inflammatory pathway to suppress the production of pro-inflammatory cytokines like TNF-α and IL-6 mitigating poor health outcomes caused by inflammation. By enhancing both central brain function and peripheral immune responses, taVNS has shown significant potential for recalibrating perturbed affective-cognitive processing. The present article describes and discusses recent evidence suggesting that taVNS offers a promising network-based paradigm for restoring psychoneuroimmunological homeostasis in common neuropsychiatric conditions. Full article

The impact of physical health conditions on coronavirus disease of 2019 (COVID-19) severity in World Trade Center disaster-exposed populations remains understudied. We examined the association of type, number and diagnosis time of pre-existing health conditions with COVID-19 severity, using the WTC Health Registry (WTCHR). We analyzed 3568 WTCHR enrollees with self-reported severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in a 2021 follow-up survey. COVID-19 severity was measured by self-reported symptom duration (<2, 2–4, and >4 weeks) and hospitalization (hospitalized versus not). Pre-existing gastroesophageal reflux disease (GERD), respiratory conditions, cardiovascular conditions, and diabetes were self-reported and categorized into four groups (no diagnosis, post-9/11, pre-9/11, and undefinable). We used multinomial logistic regression and binary logistic regression to analyze the association of comorbidities with COVID-19 symptom duration and hospitalization, respectively, adjusting for post-traumatic stress disorder and demographic factors. Analysis was also conducted separately by enrollee type: rescue and recovery workers (RRW) vs. community members (non-RRW). Having all four health conditions post-9/11 was associated with longer symptom duration after SARS-CoV-2 infection (>4 weeks) among RRW (AOR: 2.66, 95% CI: 1.03–6.87). Reporting a post-9/11 respiratory condition was associated with an increased risk of being hospitalized among RRW and an increased risk of longer symptom duration (>4 weeks) among non-RRW. While post-9/11 diabetes was associated with an increased risk of longer symptom duration among RRW, post-9/11 GERD and pre-9/11 cardiovascular conditions were associated with an increased risk of longer symptom duration and being hospitalized among non-RRW, respectively. The impact of certain health conditions on COVID-19 severity varied across enrollee types and time of diagnosis. Given the lasting health impacts of 9/11-related exposures, targeted medical surveillance and proactive healthcare interventions are critical for mitigating the risk of severe COVID-19 illness in this population. Full article

Background: Post-traumatic stress disorder (PTSD) is a debilitating psychiatric condition with limited treatment efficacy. Alternating current electroacupuncture (AC-EA) represents a novel neuromodulatory approach, though its mechanisms—particularly its influence on the gut–brain axis—remain underexplored. Methods: We investigated the neurobehavioral and microbiological effects of AC-EA in a rat model of PTSD induced by single prolonged stress. Animals received AC-EA at Baihui (GV20) and Mingmen (GV4) acupoints with varying parameters (0.5 mA/20 Hz, 1 mA/20 Hz, and 1 mA/2 Hz). Behavioral tests (open field test, elevated plus maze), histopathological assessments, immunofluorescence for TLR4, and 16S rRNA sequencing of gut microbiota were performed. Results: AC-EA at 1 mA/2 Hz significantly improved exploratory behavior and reduced anxiety-like responses (p < 0.05). This regimen also restored neuronal integrity in the hippocampus and cortex and reversed PTSD-induced gut dysbiosis, enriching beneficial genera such as Ligilactobacillus. Furthermore, AC-EA downregulated hepatic TLR4 expression, indicating suppression of neuroinflammatory signaling. Conclusions: Our findings demonstrate that AC-EA exerts neuromodulatory and microbiota-rebalancing effects via the gut–brain axis, highlighting its potential as a non-invasive therapeutic strategy for PTSD and related brain health disorders. Full article

Memory constitutes a fundamental cognitive domain, and converging evidence suggests that its dysfunction represents a prominent, though not exclusive, transdiagnostic dimension across major psychiatric disorders. This review aimed to integrate neurobiological, cognitive, and clinical evidence on domain-specific memory impairments in mood, anxiety, obsessive–compulsive, post-traumatic stress, and psychotic disorders. A comprehensive search was conducted on PubMed, Scopus, and Web of Science up to November 2025 for peer-reviewed studies examining short-term, working, long-term, episodic, semantic, and prospective memory, prioritizing both landmark and recent contributions. Two recurrent transdiagnostic patterns emerged: (i) consistent impairments in working-memory control, and (ii) reduced episodic/autobiographical specificity, while procedural memory appeared relatively preserved. Disorder-specific profiles include overgeneral autobiographical memory in major depression, enduring working and episodic deficits in bipolar disorder, variable impairments in anxiety disorders, functional rather than structural memory inefficiencies in obsessive–compulsive disorder, broad mnemonic disorganization in post-traumatic stress disorder, and pervasive working and episodic deficits in schizophrenia and related psychoses. Across conditions, converging neurobiological data implicate fronto-hippocampal dysconnectivity, altered plasticity, and impaired consolidation processes. Unlike previous reviews, this work syntetisizes evidence across multiple memory systems and across major psychiatric categories, linking neurobiological mechanisms with cognitive and clinical manifestations to support a dimensional, transdiagnostic interpretation of memory dysfunction. These findings could suggest that memory dysfunction represents a recurrent and clinically relevant dimension across psychiatric conditions, warranting further mechanistic and longitudinal investigation. Full article

Post-Traumatic Stress Disorder (PTSD) is consistently linked to multidimensional working memory (WM) impairments, encompassing deficits in sustained attention, verbal and visuospatial processing, and executive control, with inhibitory dysfunction emerging as a key feature. This scoping review synthesizes evidence from 39 studies examining neurobiological mechanisms, trauma-related factors, genetic and hormonal influences, gender differences, and task-specific variability. Findings indicated that PTSD is associated with altered activation and connectivity in the prefrontal cortex, hippocampus, and related neural networks, often resulting in compensatory but inefficient recruitment patterns. Emotional distraction and comorbidities such as depression, alcohol use, and traumatic brain injury can exacerbate cognitive deficits. Performance impairments are evident across both emotional and neutral WM tasks, with visuospatial and updating processes being particularly vulnerable. Risk factors include chronic trauma exposure, older age, APOE ε4 allele, and the BDNF Val66Met (rs6265) polymorphism, while modulators such as oxytocin, cortisol, and physical activity show potential cognitive benefits under specific conditions. Methodological heterogeneity and limited longitudinal data restrict generalizability. These findings underscore the importance of early screening, targeted cognitive interventions, and inclusion of underrepresented populations to refine prevention and treatment strategies for PTSD-related WM deficits. Full article

Longitudinal studies consistently demonstrate that repeated exposure to peer victimisation can have enduring consequences for children and adolescents’ mental health. Documented outcomes include elevated risks of disorders such as depression, anxiety disorders, post-traumatic stress symptoms, and self-harm or suicidality, as well as broader psychosocial difficulties such as low self-esteem, loneliness, and internalising difficulties. However, prevalence estimates and effect sizes vary widely, reflecting differences in study design, measurement strategies, follow-up length, and the operationalisation of victimisation. This systematic review synthesises findings from 24 longitudinal studies to provide a comprehensive account of the mental health and psychosocial outcomes associated with peer victimisation. Evidence was strongest for depression and anxiety disorders, where multiple population-based cohorts in the United States, United Kingdom, Ireland, and Scandinavia showed robust prospective and retrospective associations, with risks amplified by repeated or persistent exposure. Peer victimisation also functioned as a traumatic stressor, predicting later post-traumatic stress symptoms, while self-harm and suicidality were elevated in several large-scale studies, though findings were less consistent. Additional work linked victimisation to later impaired well-being, including low self-esteem and internalizing difficulties. Mediators such as rumination, hostile attributions, and internalised stigma and moderators including gender, school belonging, and family support further explained heterogeneity in outcomes. By integrating findings across diverse contexts, this review clarifies the breadth and severity of long-term consequences of peer victimisation, highlighting both psychological mechanisms and contextual buffers. These insights can inform theoretical models of victimisation as a developmental risk factor and support the design of targeted prevention and intervention strategies. Full article

Background: Post-traumatic stress disorder (PTSD) is a severe psychiatric condition prevalent among combat veterans. Its diagnosis is challenging due to the heterogeneity of clinical presentations and the complex interplay of pathogenic factors. Objective: This study aimed to develop and validate a diagnostic algorithm for combat-related PTSD by integrating clinical data with a panel of biological markers associated with blood–brain barrier disruption (anti-GFAP and anti-NSE antibodies), HPA axis dysfunction (cortisol), and neuroinflammation (IL-6, IL-8). Methods: A total of 721 male participants were enrolled: 434 veterans with PTSD (F43.1), 147 combat veterans without PTSD, and 140 non-combat military controls. All participants underwent clinical and psychometric assessment (Likert scale, HADS). Serum levels of biomarkers were measured using ELISA. Statistical analysis included non-parametric tests, correlation analysis, and binary logistic regression with Wald’s method to build a predictive model. Results: The binary logistic regression model identified cortisol and IL-6 as the most significant predictors of PTSD. The final algorithm, based on a cortisol level below 199.8 nmol/L and an IL-6 level above 0.002438 pg/mL, correctly classified 78% of patients (AUC = 0.724, 95% CI [0.669, 0.779]). Furthermore, levels of IL-4, IL-8, and cortisol positively correlated with the severity of combat stress factors, independent of physical injuries. Conclusions: We developed a novel diagnostic algorithm for combat-related PTSD based on cortisol and IL-6 levels, demonstrating high accuracy. The correlation between neuroinflammatory markers and the severity of combat exposure suggests their role as primary indicators of stress response, highlighting their utility for early risk identification and targeted interventions. Full article