European Journal of Psychotraumatology最新文献

{"title":"Network analysis of changes in post-migration stressors during treatment for refugees with PTSD.","authors":"Maja Bruhn, Henriette Laugesen Attardo, Tobias Spiller, Carsten Hjorthøj, Lene Falgaard Eplov, Jessica Carlsson","doi":"10.1080/20008066.2026.2613554","DOIUrl":"10.1080/20008066.2026.2613554","url":null,"abstract":"<p><p><b>Background:</b> Refugees resettled in high-income countries are at high risk of post-traumatic stress disorder (PTSD) and often face multiple post-migration stressors that can influence symptom severity. While individual and cumulative effects of these stressors have been examined, little is known about how they interact and change during treatment.<b>Objective:</b> To investigate changes in the structure and interconnections of post-migration stressors among refugees with PTSD before and after mental health treatment.<b>Method:</b> Participants were refugees with PTSD receiving multidisciplinary treatment at a specialised mental health clinic in Denmark, as part of a randomised controlled trial. The Post-Migration Living Difficulties Checklist (17-item Danish version) (PMLD) was completed pre- and post-treatment. Partial correlation networks were estimated for each time point, with network comparison test assessing changes in global network connectivity. Predictability of individual stressors and paired-sample t-tests for item-level change were also conducted.<b>Results:</b> Global network connectivity increased significantly from pre- to post-treatment (<i>p</i> = .004), suggesting stronger interrelations among stressors over time. Overall PMLD score did not change from pre- to post-treatment, but on item-level, financial and housing-related stress decreased (<i>p</i> = .006; <i>p</i> = .028), while concerns about returning to the country of origin in an emergency increased (<i>p</i> = .028).<b>Discussion:</b> Post-migration stressors became more interconnected during treatment, underscoring the need to address them not as isolated issues but as interdependent, mutually reinforcing challenges shaped by cultural and structural contexts. Clinically, effective support for trauma-affected refugees requires multi-level interventions that integrate legal, social, and economic determinants alongside mental health care.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"17 1","pages":"2613554"},"PeriodicalIF":4.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836408/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146046313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Influence of omega-3 fatty acids on post-traumatic stress disorder: prospective cohort study and Mendelian randomisation findings.","authors":"Ming Chen, Haozhang Huang, Yong Liu, Cailan Hou, Shiqun Chen","doi":"10.1080/20008066.2025.2605801","DOIUrl":"10.1080/20008066.2025.2605801","url":null,"abstract":"<p><p><b>Background and Objectives:</b> Omega-3 fatty acids have positive effects on mental health. This study aimed to explore the association between plasma omega-3 fatty acid levels and the risk of post-traumatic stress disorder (PTSD).<b>Methods:</b> This study explored the association between plasma omega-3 fatty acid levels and risk of developing PTSD. In total, 82,391 adults from the UK Biobank were included in this study. PTSD screening was performed using a PCL-6 score greater than 13, based on responses to the online mental health questionnaire. Multivariate logistic regression analyses were performed to evaluate the association between omega-3 fatty acid levels and the risk of PTSD. Additionally, a two-sample bidirectional Mendelian randomisation (MR) analysis was used to investigate potential causal relationships.<b>Results:</b> A significant association was found between high omega-3 fatty acid levels and a lower risk of PTSD. For each 1 unit increase in omega-3 fatty acids, the adjusted odds ratio (OR) was 0.75 (<i>p</i> = 9.05E-05); for each 1% increase in total fatty acids, the adjusted OR was 0.95 (<i>p</i> = 4.30E-07). Among the population that has experienced catastrophic traumatic exposure, the results remained consistent. MR analysis indicated that high omega-3 levels and omega-3/total fatty acid ratios were causally linked to a reduced risk of PTSD (per 1 unit increase, OR = 0.99; <i>p</i> = .029; per 1% increase, OR = 0.98; <i>p</i> = .037). Conversely, PTSD was causally associated with lower omega-3 levels (beta = -0.203, <i>p</i> = 2.12E-05) and a lower omega-3/total fatty acids ratio (beta = -0.266, <i>p</i> = 1.52E-07). Subgroup analyses revealed that females might benefit more significantly (OR = 0.64, <i>p</i> = 3.59E-07; <i>p</i>-interaction = .010).<b>Conclusions:</b> This study suggests a negative association between PTSD and omega-3 fatty acids, indicating that omega-3 supplementation may be an effective preventive and therapeutic strategy for PTSD.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"17 1","pages":"2605801"},"PeriodicalIF":4.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12836410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146051075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"'Migration and grief go hand in hand' a qualitative analysis of losses and grief among first - and second-generation individuals with Turkish migration history in Germany through the lens of the minority stress model.","authors":"Anna Renner, Katja Linde, Viktoria Schmidt, Anette Kersting","doi":"10.1080/20008066.2026.2612833","DOIUrl":"10.1080/20008066.2026.2612833","url":null,"abstract":"<p><p><b>Background:</b> Individuals with migration history from Türkiye form one of the largest migrant communities in Germany, comprising around 1.5 million first generation migrants and 1.4 million second generation individuals born in Germany. Research indicates that both migration-related and contextual factors (e.g. discrimination and stigma) are linked to elevated psychological distress in this group. While these experiences can be understood within the framework of minority stress, little is known about how migration-related losses and grief intersect with such stress processes in this population.<b>Method:</b> This qualitative study employed two semi-structured focus group discussions (<i>N</i> = 18), conducted separately for first and second generation individuals with a migration history from Türkiye. With participants' consent, focus group interviews were audio-recorded, transcribed, and analysed using thematic analysis in MAXQDA. The minority stress model was extended to include migration-specific stressors.<b>Results:</b> Migration-related loss and grief are central experiences among individuals of Turkish origin in Germany, deeply shaping their sense of belonging and identity, with discrimination and structural inequalities further exacerbating their impact on mental health. The results extend the minority stress model by integrating migration-specific stressors, particularly loss and grief, illustrating their interaction with minority stress processes. Moreover, grief transforms across generations, as the second generation internalizes parental grief while also facing new stressors, particularly discrimination, emphasizing the need for an intergenerational perspective.<b>Conclusion:</b> This study highlights the complex interplay of migration-related stress, grief, and identity among individuals with Turkish migration history in Germany. By extending the minority stress model, it underscores the impact of interpersonal racism and societal rejection while emphasizing intergenerational differences. The findings provide a foundation for future research and interventions, underscoring both individual and communal resilience within the Turkish community and informing tailored mental health support for diverse migrant populations.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"17 1","pages":"2612833"},"PeriodicalIF":4.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12849801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146060837","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Development and proof-of-concept of a treatment target recommendation algorithm in the context of cognitive processing therapy.","authors":"Philip Held, Dale L Smith, Sarah A Pridgen","doi":"10.1080/20008066.2026.2623713","DOIUrl":"10.1080/20008066.2026.2623713","url":null,"abstract":"<p><p><b>Background:</b> Cognitive Processing Therapy (CPT) is an effective, widely supported treatment for PTSD, but patient response varies considerably. Optimally targeting maladaptive trauma-related beliefs (stuck points) may significantly enhance treatment outcomes. This study evaluated the feasibility of developing a recommendation algorithm that helps clinicians identify specific patient-endorsed stuck points, which, when effectively restructured, could lead to greater reductions in PTSD symptoms.<b>Methods:</b> Data were drawn from 898 veterans and service members participating in a two-week CPT-based accelerated PTSD treatment programme. Measures administered at pre-, mid-, and post-treatment included the Posttraumatic Cognitions Inventory (PTCI), PTSD Checklist for DSM-5 (PCL-5), and Patient Health Questionnaire (PHQ-9). Patients were clustered at pre- and mid-treatment using K-means based on their PCL-5 subscores and PHQ-9 and PTCI item endorsement profiles. Within each cluster, random forest and elastic net regression models identified PTCI items most predictive of PTSD symptom reductions. The algorithm's predictive utility was illustrated through simulated patient cases.<b>Results:</b> Machine learning models identified specific PTCI items within each cluster that appeared most predictive of PTSD symptom reductions. Simulations indicated that targeting these algorithm-selected cognitions could yield an additional 5-7 points improvement on the PCL-5 by mid-treatment, with further improvements of 4-6 points thereafter. Overall, following the algorithm's personalised recommendations could theoretically result in approximately 11 additional points of symptom reduction on the PCL-5 beyond expected standard improvements.<b>Conclusions:</b> This study demonstrates the feasibility of developing a data-driven recommendation algorithm that personalises CPT by identifying the most impactful stuck points to target. Prospective clinical trials are necessary to validate the algorithm's effectiveness, establish clinical utility, and facilitate implementation into routine care.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"17 1","pages":"2623713"},"PeriodicalIF":4.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12927400/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226201","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prolonged grief among Turkish migrants in Germany: prevalence and the role of migratory grief.","authors":"Viktoria Schmidt, Katja Linde, Anna Renner, Pia Marie Siegel, Anette Kersting","doi":"10.1080/20008066.2026.2627054","DOIUrl":"10.1080/20008066.2026.2627054","url":null,"abstract":"<p><p><b>ABSTRACT</b><b>Background:</b> Prolonged grief disorder (PGD) is associated with negative health outcomes and appears to be more prevalent among migrants. For migrants, bereavement also includes losses tied to their country of origin, leading to migratory grief. However, the association between migratory grief and prolonged grief has remained unexplored.<b>Objective:</b> This study investigates PGD prevalence, and its grief- and migration-related correlates among first- and second-generation Turkish migrants in Germany.<b>Method:</b> Adults (≥18) with Turkish migration background (self or parental) were included (<i>N</i> = 937). Regression analyses and comparative tests (<i>t</i>-tests, <i>χ</i>² test, Fisher's exact) were performed.<b>Results:</b> PGD prevalence was 5.97% in the first and 5.45% in the second generation. In the first generation, prolonged grief symptoms were associated with >5 losses (<i>β</i> = .201, <i>p</i> = .006), migratory grief (<i>β</i> = .300, <i>p</i> = .003) and different times since loss (<i>p</i> < .005). In the second generation, correlates included migratory grief (<i>β</i> = .197, <i>p</i> = .003) and being in the same country as the deceased (<i>β</i> = .225, <i>p</i> = .003). First and second generation differed in gender (<i>p</i> = .003), time since death (<i>p</i> = .003), country in the event of death (<i>p</i> = .003), residence status (<i>p</i> = .003), social support (<i>p</i> = .008) and chosen language of questionnaires (<i>p</i> = .003).<b>Conclusion:</b> Turkish migrants in Germany show elevated PGD prevalence, with distinct correlates across generations. Migratory grief was a significant correlate for prolonged grief symptoms in both generations, while other factors differed between generations. These findings emphasize the importance of accounting for migration-related experiences in the investigation of PGD across generations in future research.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"17 1","pages":"2627054"},"PeriodicalIF":4.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12922410/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146226145","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Towards scalable psychological first aid training: an autoethnographic exploration of the potential of large language models in simulation-based learning.","authors":"Rodrigo A Figueroa, Margarita Bernales, Chris M Hoeboer, Miranda Olff","doi":"10.1080/20008066.2026.2616976","DOIUrl":"10.1080/20008066.2026.2616976","url":null,"abstract":"<p><p><b>Background:</b> Psychological First Aid (PFA) is a widely used approach to provide psychosocial support to individuals in the aftermath of a stressful event. PFA training requires a costly, structured approach, including repetitive simulation-based training with actors. The rapid emergence of large language models (LLMs) could provide easy access to PFA simulation training, enabling trainees to practice conversations repeatedly and flexibly, learn from mistakes, and build emotional resilience. In addition, this would allow for training in geographically isolated regions where PFA training may be most needed.<b>Objective:</b> To explore the potential of LLMs for PFA simulation training.<b>Methods:</b> Using a digital autoethnography approach, we conducted three role plays with ChatGPT-3.5-turbo, an LLM-based chatbot, in scenarios addressing challenges typical of PFA training. In each role-play, the chatbot simulated an individual in the aftermath of a stressful situation, and a researcher took on the roles of both a trainer configuring a simulation session and a learner serving as a PFA provider. The chatbot's ability to respond, adapt, and facilitate the training process was evaluated using reflexive thematic analysis.<b>Results:</b> Our study showed that ChatGPT effectively portrayed realistic characters, collaborated effectively with the trainer, and provided feedback to the learner. However, we also noted challenges concerning overly stereotyped characterizations, identity confusion, and following the trainer's instructions.<b>Conclusions:</b> While utilizing LLMs for PFA simulation training demonstrates significant promise, achieving their full educational potential requires careful refinement, thorough empirical validation, and ongoing ethical oversight.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"17 1","pages":"2616976"},"PeriodicalIF":4.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12865840/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146104528","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adolescents' ventral striatal reward neural activity moderates the association between lifetime trauma exposure and lower depression after 6 months.","authors":"Kristen L Eckstrand, Alex Talbot, Viraj Govani, Katherine Hart, Zachary Brodnick, Neal Ryan, Neil Jones, Mary L Phillips, Erika E Forbes","doi":"10.1080/20008066.2025.2611512","DOIUrl":"10.1080/20008066.2025.2611512","url":null,"abstract":"<p><p><b>Background:</b> Lifetime trauma exposure is associated with higher-severity depression and anhedonia. Neural reward regions develop in adolescence and influence depression and anhedonia. Reward regions may enhance the impact of trauma exposure on depression. This naturalistic, 6-month longitudinal study examined how individual differences in the function of reward regions impact associations between lifetime trauma exposure and the development of depression and anhedonia in adolescents.<b>Methods:</b> 82 participants aged 13-19 years varying in risk for depression and anhedonia reported lifetime trauma exposure, depression, and anhedonia and underwent a monetary reward fMRI task at baseline, then reported symptoms 6 months later. Neural reward activity to reward > neutral outcome (<i>p</i>_FWE<.05) was measured within the Neurosynth 'reward' mask. Univariate models examined whether activity in neural reward regions moderated the impact of lifetime trauma on the development of depression and anhedonia after 6 months, correcting for baseline symptoms.<b>Results:</b> Lifetime trauma exposure was associated with higher baseline depression (<i>β</i> = 1.676, <i>p</i> = .019) and anhedonia (<i>β</i> = 1.547, <i>p</i> < .001), and higher anhedonia at 6-months (<i>β</i> = 2.050, <i>p</i> < .001). Neural activity to reward outcome occurred in the bilateral ventral striatum (VS), anterior cingulate cortex, and right ventrolateral prefrontal cortex. Right VS activity moderated prospective relationships between lifetime trauma exposure and depression at 6 months (<i>β</i> = -3.275, <i>p</i> = .037), where greater trauma was associated with lower depression 6 months later for those with higher right VS activity.<b>Conclusion:</b> Reward neural network activity was associated with improvements in depression in individuals with more lifetime trauma exposure. Targeting reward network function or using psychosocial strategies to enhance positive affect may be an important strategy to address depression, particularly among adolescents exposed to trauma.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"17 1","pages":"2611512"},"PeriodicalIF":4.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12857722/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146085278","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study on clients' needs and wishes for an intervention aimed at preventing revictimization.","authors":"Christin Kühner, Marije van de Kieft, Anneke Goudriaan, Kathleen Thomaes, Marleen de Waal","doi":"10.1080/20008066.2025.2603875","DOIUrl":"10.1080/20008066.2025.2603875","url":null,"abstract":"<p><p><b>Background:</b> Victims of interpersonal violence have an increased risk to (a) develop post-traumatic stress disorder (PTSD), and (b) experience future interpersonal violence, a phenomenon called revictimization. Incidentally, PTSD is also a risk factor for revictimization, resulting in a vicious cycle for victims. To date, no interventions exist that effectively reduce the risk of revictimization in people suffering from PTSD. Furthermore, while the responsibility for preventing violence always resides with the perpetrator, we mostly see victims in clinical practice. We have chosen for a multi-dimensional approach to prevention by focusing on developing an intervention for potential victims.<b>Objective:</b> Our aim was to identify the skills that experts by experience would like to acquire in a novel intervention aimed at decreasing vulnerability for revictimization after trauma treatment. Secondly, this approach allowed the identification of risk factors for revictimization from a patient perspective.<b>Methods:</b> We conducted a qualitative study consisting of two focus groups with a total of <i>N</i> = 16 participants, with <i>M_age</i> = 49.0 (<i>SD</i> = 14.2) of which <i>N</i> = 8 were female. Participants were patients at a trauma expertise centre and had been victims of interpersonal violence in the past. The transcribed audio tapes were analyzed using iterative and reflexive thematic analysis.<b>Results:</b> We identified four main themes: 'emotion-focused skills', 'internal dialogue', 'communication skills', and 'managing social environment'. The results indicate that experts by experience would like to acquire skills that span emotional, cognitive, and behavioural dimensions to decrease their vulnerability for revictimization.<b>Conclusions:</b> Novel interventions aimed at decreasing vulnerability for revictimization after trauma treatment should incorporate the skills that experts by experience would like to acquire, such as awareness of emotions & bodily signals, coaching oneself, and managing the social environment, among others. Our results partially align with the evidence-based model of revictimization.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"17 1","pages":"2603875"},"PeriodicalIF":4.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12863066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"146017984","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Information processing biases in posttraumatic stress disorder (PTSD): cross-sectional findings and exploratory investigation of bias changes following treatment.","authors":"Charlotte E Wittekind, Maximilian Jäger, Anamaria Semm, Mina Stefanovic, Götz Berberich, Till Krauseneck, Thomas Ehring, Marcella L Woud","doi":"10.1080/20008066.2026.2638717","DOIUrl":"10.1080/20008066.2026.2638717","url":null,"abstract":"<p><p><b>Background:</b> Information processing biases are ascribed an important role in the aetiology and maintenance of posttraumatic stress disorder (PTSD). While findings on attentional biases have been mixed, there are only a few studies that have used implicit measures to assess dysfunctional appraisals and their malleability over the course of treatment in PTSD.<b>Objective:</b> The primary aim was to examine whether individuals with PTSD (1) show attentional biases towards trauma-related stimuli, (2) generate more implicitly assessed dysfunctional appraisals, and (3) more strongly associate the self as traumatized and vulnerable compared to traumatized individuals without PTSD and a healthy control group. The second and exploratory aim was to explore whether biases would be reduced after treatment.<b>Method:</b> Participants included individuals with PTSD (<i>n</i> = 50), traumatized individuals without PTSD (<i>n</i> = 54), and healthy controls (<i>n</i> = 57). Attentional biases were measured with a Visual Search Task, dysfunctional appraisals with a scenario task, and trauma-related self-appraisals with two Implicit Association Tests (self-traumatized, self-vulnerability). In exploratory analyses, changes in these measures were examined across treatment.<b>Results:</b> No significant differences were found in attention allocation to trauma-related stimuli between groups. However, participants with PTSD generated more dysfunctional appraisals and demonstrated stronger trauma-related associations than both control groups. Importantly, treatment significantly reduced dysfunctional appraisals and fostered more functional self-appraisals in the IAT.<b>Conclusions:</b> Implicitly assessed dysfunctional (self-) appraisals differentiate individuals with PTSD from controls and appear responsive to treatment. Future research should clarify whether these implicit biases function as mechanisms of change and predict long-term clinical outcomes.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"17 1","pages":"2638717"},"PeriodicalIF":4.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997474/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147467177","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cumulative trauma, neural circuits, and burnout: an integrative model of healthcare worker post-traumatic stress syndromes.","authors":"Adrienne A Taren, Martin P Paulus","doi":"10.1080/20008066.2026.2636453","DOIUrl":"10.1080/20008066.2026.2636453","url":null,"abstract":"<p><p><b>Background:</b> Frontline healthcare workers (HCWs) experience unique patterns of repeated, chronic, and unpredictable traumatic event exposure, coupled with physiologic stress in the setting of shift-work circadian rhythm disruption, contributing to high rates of post-traumatic stress syndromes (PTSS) and substantial workforce and economic burden. The neurobiology underlying HCW-specific risk remains incompletely understood.<b>Objective:</b> To synthesise epidemiological, neuroimaging, physiological, and interventional evidence into a mechanistic model of HCW PTSS and to identify priorities for biomarker-guided prevention and care.<b>Method:</b> Literature for this narrative review was identified through a comprehensive search of peer-reviewed articles in PubMed, PsycINFO, and Google Scholar up to May 2025. Studies were included if they addressed (1) the epidemiology of PTSD in healthcare settings, (2) risk and protective factors specific to occupational trauma exposure, (3) neural, physiological, or molecular mechanisms associated with stress-related disorders in trauma-exposed personnel, or (4) interventions targeting PTSD/PTSS in HCWs and first responder populations.<b>Results:</b> Across studies, PTSS prevalence among HCWs is variable (≈15-74%). Repeated, chronic, and unpredictable occupational trauma, exacerbated by circadian disruption, appears to destabilise frontal-limbic circuits and systemic stress pathways, culminating in allostatic overload. Converging data suggest that multimodal biomarkers, including resting-state and task-evoked fMRI metrics, MR spectroscopy, heart rate variability, sleep architecture, cortisol and inflammatory indices can identify prodromal dysregulation and define risk stratification.<b>Conclusions:</b> Longitudinal, multimodal cohort designs are critically needed to track trajectories and evaluate neuroscientifically-informed treatment modalities for PTSS in this population. Framing HCW PTSS as an occupational neurobiological injury highlights the need to identify and prevent functional decline. A biomarker-guided strategy that links brain-circuit measures with autonomic, sleep, and molecular indices may offer a path to earlier identification, precision interventions, and improved outcomes for a critically at-need population that is essential to our workforce.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"17 1","pages":"2636453"},"PeriodicalIF":4.1,"publicationDate":"2026-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12997488/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147480161","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}