European Journal of Psychotraumatology最新文献

{"title":"Counterfactual thinking within the first year after sexual assault: examining associations with posttraumatic stress reactions in the (Norwegian) TRUST-study.","authors":"Ines Blix, Alf Børre Kanten, Tore Wentzel-Larsen, Andrea Undset, Andrea Rustand, Siri Thoresen","doi":"10.1080/20008066.2025.2506208","DOIUrl":"10.1080/20008066.2025.2506208","url":null,"abstract":"<p><p><b>Background:</b> Counterfactual thinking (CFT), involves mental simulations of alternative outcomes to past events (e.g. 'What if … ' or 'If only … '), and is commonly observed after trauma. While CFT can be adaptive, it is also linked to psychological distress, including posttraumatic stress reactions (PTSR).<b>Objective:</b> The present study aims to examine the relationship between the frequency and vividness of upward and downward counterfactual thoughts and PTSR, in the recent aftermath of sexual assault (SA).<b>Method:</b> The sample consisted of 327 women who had experienced SA within the last year. PTSR was measured using the International Trauma Questionnaire (ITQ), while CFT was assessed through self-reported frequency and vividness of upward (event could have been less severe or avoided) and downward (event could have been worse) counterfactual thoughts.<b>Results:</b> The results revealed a significant difference in the distribution of upward versus downward CFT. Specifically, more participants reported engaging in upward CFT 'Very Often' and 'Often,' while downward CFT was reported less frequently. Vividness was higher for downward CFT. Both frequency and vividness of upward and downward counterfactuals were significantly associated with higher levels of PTSR.<b>Conclusion:</b> The present findings highlight the role of counterfactual thinking in post-assault distress and emphasize the need for targeted interventions addressing CFT in the aftermath of trauma.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2506208"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12131541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144198626","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":"Trauma exposure, prevalence and associated factors of complex PTSD in mainland China: a cross-sectional survey.","authors":"Kai Li, Yuanyuan Liu, Baoliang Zhong, Jun Tong","doi":"10.1080/20008066.2025.2502208","DOIUrl":"10.1080/20008066.2025.2502208","url":null,"abstract":"<p><p><b>Background:</b> The ICD-11 distinguishes Complex Post-Traumatic Stress Disorder (CPTSD) as a separate trauma-related disorder from PTSD. While numerous studies have examined these conditions globally, no nationwide research has yet investigated their one-month prevalence and associated factors in the general population of China.<b>Objective:</b> This study aimed to determine the one-month prevalence of ICD-11 CPTSD and identify associated factors within a general adult sample in mainland China.<b>Methods:</b> A total of 2,115 adults living in mainland China participated in an online survey. PTSD and CPTSD were assessed using the International Trauma Questionnaire (ITQ) based on ICD-11 criteria. Trauma exposure was measured via the International Trauma Exposure Measure (ITEM). Multinomial logistic regression identified associated factors for PTSD and CPTSD.<b>Results:</b> Among participants, 88.2% reported at least one traumatic exposure. The prevalence of PTSD and CPTSD was 4.9% and 4.5%, respectively. Shared predictors for both conditions included a greater number of siblings, broader interpersonal trauma exposure during adolescence, and more frequent and recent index trauma events. Specific predictors for CPTSD included female gender, older age, being left behind by migrant parents, lower socioeconomic status, and broader trauma exposure in adulthood.<b>Conclusion:</b> This study provides the first estimates of ICD-11 PTSD and CPTSD prevalence in the general population of mainland China, revealing relatively high rates compared to other mental disorders. Findings highlight key associated factors and offer intervention recommendations for at-risk groups.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2502208"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12120857/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144157432","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 FAIR intensive longitudinal data archive on prolonged grief in daily life.","authors":"Justina Pociūnaitė-Ott, Lonneke I M Lenferink","doi":"10.1080/20008066.2025.2526885","DOIUrl":"10.1080/20008066.2025.2526885","url":null,"abstract":"<p><p><b>Introduction:</b> The majority of grief research has assessed Prolonged Grief (PG) symptoms using cross-sectional surveys, which are limited in capturing within-person changes in daily grief reactions. These dynamic PG reactions can be more effectively assessed using Experience Sampling Methodology (ESM). Accordingly, this data note presents a Findable, Accessible, Interoperable, and Reusable (FAIR) archive comprising three existing ESM projects investigating PG reactions in daily life.<b>Methods:</b> Participants in this archive completed three data collection phases: baseline measures (including sociodemographic and loss characteristics, and psychopathology measures), a 14-day ESM phase (rating PG reactions and contextual factors up to five times daily), and follow-up psychopathology assessments. The participants provided explicit digital consent for the use and reuse of their data in scientific research.<b>Results:</b> In total, 315 people are included in this archive, with a total of 22,050 ESM-measurement points. The majority of the participants were middle-aged, identified as women, and had completed higher education. Almost half of the sample (48.73%) experienced the loss of a partner or child, the majority of these losses were due to natural causes (70.06%), and happened less than a year ago (59.24%). The data are stored in a trusted repository.<b>Discussion:</b> This archive demonstrates that it is feasible to develop a FAIR archive including existing data on PG reactions in daily life. Given the resource-intensive nature and richness of these data, we encourage researchers to reuse and/or share ESM-data through this archive, helping to deepen our understanding of grief in natural settings.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2526885"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278458/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658793","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 analysis of young adults' beliefs about bullying: exploring associations with social anxiety and post-traumatic stress.","authors":"Belinda Graham, Anke Ehlers","doi":"10.1080/20008066.2025.2523638","DOIUrl":"10.1080/20008066.2025.2523638","url":null,"abstract":"<p><p><b>Background:</b> Bullying can be associated with emotional and social difficulties, but not all individuals experience enduring negative effects.<b>Objective:</b> This study aimed to explore beliefs about bullying, self, and other people among young adults who were bullied that may be associated with ongoing anxiety and distress related to those experiences.<b>Method:</b> Semi-structured interviews with 20 people, aged 18-29 years, who had experienced bullying were analysed using thematic analysis. The sample was split, by current symptoms of social anxiety and post-traumatic stress related to bullying, into a lower symptoms group (<i>n</i> = 12) and a higher symptoms group (<i>n</i> = 8).<b>Results:</b> Participants reported multiple types of bullying, including online. Four superordinate themes were identified in negative beliefs related to bullying experiences: personal deficiency (i.e. victimization was due to own low value or undesirable traits), social threat (i.e. wariness of others due to their negative motives or traits), acceptance is fragile (i.e. being accepted by others is transient and requires effort), and minimizing (i.e. downplaying severity and impact of past experiences). These were evident in both groups but were more frequently endorsed in the higher symptoms group.<b>Conclusion:</b> Negative appraisals related to bullying can persist into young adulthood and may influence social interactions and mental health. Interventions targeting these beliefs could mitigate negative outcomes and bolster resilience among individuals affected by bullying. Further research should explore these themes to inform effective therapeutic strategies for young adults who have been bullied.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2523638"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12278457/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144658794","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":"Stress reactivity during short trauma narratives in adolescents with post-traumatic stress disorder (PTSD) and complex PTSD.","authors":"Oswald D Kothgassner, Sarah Macura, Andreas Goreis, Diana Klinger, Bettina Pfeffer, Sofia M Oehlke, Karin Prillinger, Johanna X Kafka, Heidi Elisabeth Zesch, Anna Felnhofer, Paul L Plener","doi":"10.1080/20008066.2025.2532273","DOIUrl":"10.1080/20008066.2025.2532273","url":null,"abstract":"<p><p><b>Background:</b> Psychophysiological dysregulations and negative alterations in cognitions and mood characterize post traumatic stress disorder (PTSD) and complex PTSD (C-PTSD), contributing to an increased risk of disorder persistence and chronic health problems. However, understanding the differences in physiological stress reactivity and negative cognitive-emotional patterns between adolescents with PTSD and C-PTSD remains a notable research gap.<b>Objective:</b> This study examined group differences in autonomic nervous system (ANS) reactivity during the sharing of a short trauma narrative, including resting and recovery phases, and compared subjective experiences of stress, shame, and guilt among adolescents with PTSD, C-PTSD, and trauma-exposed controls.<b>Methods:</b> In a repeated-measures design, 52 adolescents (14-18 years) with PTSD (<i>n</i> = 17), C-PTSD (<i>n</i> = 18), and a control group (<i>n</i> = 17) were assessed for heart rate, heart rate variability, and subjective experiences of stress, shame, and guilt during a standardized trauma interview, as well as during baseline and recovery phases.<b>Results:</b> Linear mixed-effects models revealed a significant interaction between group and time point (<i>F</i> = 4.134, <i>p</i> < .001). The C-PTSD group exhibited a significantly higher heart rate in the recovery phase compared to the PTSD (<i>p</i> = .010) and control groups (<i>p</i> = .036), alongside significantly higher subjective stress, guilt, and shame experiences. Main effects of group were identified for perceived stress (<i>F</i> = 7.543, <i>p</i> = .002), guilt (<i>F</i> = 21.779, <i>p</i> < .001), and shame (<i>F</i> = 19.309, <i>p</i> < .001), with the C-PTSD group exhibiting higher levels compared to PTSD and control groups across all conditions.<b>Conclusions:</b> Prolonged stress responses and elevated experiences of shame and guilt in adolescents with C-PTSD align with the diagnostic criteria of affective dysregulation and negative self-concept. Objective stress measures during trauma interviews may support the diagnosis of C-PTSD. Findings highlight the importance of phase-based trauma therapies that target emotional dysregulation, shame, and guilt.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2532273"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12322999/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144774901","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":"Efficacy of psychosocial interventions on social functioning in individuals with childhood maltreatment experiences: a protocol for a systematic review and network meta-analysis.","authors":"Natalia E Fares-Otero, Silvia Amoretti, Brisa Solé, Sarah L Halligan, Eduard Vieta, Stefan Leucht, Soraya Seedat, Mathias Harrer","doi":"10.1080/20008066.2025.2508548","DOIUrl":"10.1080/20008066.2025.2508548","url":null,"abstract":"<p><p><b>Background:</b> Several psychosocial interventions have shown promising effects in treating people affected by childhood maltreatment (CM); however, their comparative efficacy on social functioning remains largely unknown. To address this issue, a systematic review and network meta-analysis (NMA) will be conducted to investigate the comparative efficacy of different psychosocial interventions on global social functioning and specific domains of social functioning, including behavioural, emotional, cognitive and physiological processes. We aim to develop a hierarchical ranking of existing psychosocial interventions concerning their efficacy and acceptability which could inform treatment guidelines.<b>Methods:</b> Randomised controlled trials (RCTs) investigating psychosocial interventions for individuals with exposure to CM when they were younger than age 18 will be included. Primary outcomes will be global and domains of social functioning (measured up to 3, 6, 12 months and at the longest follow-up). Study drop-out will be a secondary outcome that will serve as a measure of acceptability. Study selection and data extraction will be performed by at least two independent reviewers. We will assess the risk of bias for each study using the Cochrane Risk of Bias tool 2 (RoB2) and evaluate the confidence in the results using Confidence in Network Meta-Analysis (CINeMA). The effects of potential moderators, such as age (children/adolescents <i>vs.</i> adults), population type (clinical <i>vs.</i> non-clinical samples), or sex (% males), socioeconomic status (low-income <i>vs.</i> middle-high-income countries), and intervention characteristics (individual <i>vs.</i> group training, number of sessions) will be analysed using subgroup-analyses or meta-regressions. Other candidate moderators/mediators (personality, post-traumatic symptoms, brain structure/function, cognitive reserve) will also be explored and narratively summarised. Sensitivity analyses will be conducted to explore further heterogeneity and assess the robustness of our findings.<b>Discussion:</b> This systematic review and NMA aims to compare multiple existing psychosocial interventions in individuals affected by CM and establish the relative rankings of these interventions for social functioning. Our results may provide practical guidance concerning the most effective psychosocial interventions to reduce the societal burden associated with CM.<b>Protocol registration:</b> PROSPERO CRD42022347034.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2508548"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12147484/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144233593","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 biobank for complex post-traumatic stress disorder (C-PTSD) and PTSD: study protocol for a cross-sectional study.","authors":"Alice Mok, Chrystal Douflias, Lena K L Oestreich","doi":"10.1080/20008066.2025.2538906","DOIUrl":"10.1080/20008066.2025.2538906","url":null,"abstract":"<p><p><b>Background</b> Complex Post-Traumatic Stress Disorder (C-PTSD) is a severe mental illness recently defined in the International Classification of Diseases 11th edition. In addition to the classic PTSD symptoms of avoidance, re-experiencing, and hypervigilance, it includes disturbances in emotion regulation, negative self-concept, and interpersonal relationships. Emerging evidence suggests C-PTSD has distinct neurobiological profiles compared to PTSD, but comprehensive investigations are lacking. This study aims to explore the neural mechanisms associated with C-PTSD, identifying distinct and shared brain alterations in C-PTSD and PTSD, while establishing a biobank incorporating neuroimaging, inflammatory, physiological, genetic, and psychosocial measures.<b>Methods</b> This cross-sectional study will compare three groups: individuals with C-PTSD (<i>n</i> = 40), PTSD (<i>n</i> = 30), and trauma-exposed healthy controls (<i>n</i> = 30). During a single visit, participants will undergo MRI scanning including structural, diffusion-weighted, resting-state, and task-based functional MRI. Blood samples will be collected for inflammatory marker analysis, and Genome-Wide Association Studies (GWAS). Participants will complete validated psychosocial self-report measures assessing trauma history, resilience, social support, emotion regulation, sleep quality, and mental health symptoms. Additionally, participants will wear an Actigraph smart watch for seven days to collect actigraphy-derived physiological data, including sleep patterns and heart rate variability. All de-identified data will be made openly available on the Open Science Framework upon publication of the main study findings, in accordance with ethical approvals and institutional guidelines for privacy and data security.<b>Conclusion</b> This comprehensive protocol addresses significant gaps in understanding C-PTSD through its multimodal approach. By comparing C-PTSD, PTSD, and trauma-exposed controls, the study aims to identify neurobiological markers specific to C-PTSD, potentially supporting its diagnostic distinction and informing targeted treatment approaches. Integrating neuroimaging, inflammatory, genetic, and psychophysiological measures acknowledges the complex interactions between biological systems in trauma responses. Findings may help inform future research on personalized intervention strategies by identifying potential biological profiles and resilience factors associated with trauma-related outcomes.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2538906"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344682/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820992","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":"Co-RESPOND: a federated network of cohorts on mental health and adversity during the COVID-19 pandemic. Challenges, solutions and recommendations for retrospective data harmonization.","authors":"Papoula Petri-Romão, Jutta Stoffers-Winterling, Charlotte Doerschner, Jocelyne Jurgeit, Philipp Gödde, Irwin Hecker, Maria Melchior, Diana Czepiel, Anke Witteveen, Els van der Ven, Marit Sijbrandij, Roberto Mediavilla, José Luis Ayuso-Mateos, Pierre Smith, Vincent Lorant, Anna Monistrol Mula, Josep Maria Haro Abad, Katalin Gémes, Ellenor Mittendorder-Rutz, Matteo Monzio Compagnoni, Antonio Lora, Giulia Caggiu, Claudia Conflitti, Raffael Kalisch, Klaus Lieb","doi":"10.1080/20008066.2025.2517920","DOIUrl":"10.1080/20008066.2025.2517920","url":null,"abstract":"<p><p><b>Background:</b> The SARS-Cov-2 pandemic was associated with a substantial rise in trauma and stressor exposure. The Co-RESPOND consortium (part of the EU horizon 2020-funded RESPOND project) has been initiated to study the impact on mental health, using longitudinal data of separate international cohorts.<b>Aims:</b> The Co-RESPOND initiative aims to retrospectively harmonize mental health and resilience data of ongoing longitudinal cohort studies at the individual participant level; to create an interoperable network of cohorts within a secure environment; to manage these data along with harmonization products (e.g. transformation procedures and variable dictionaries) according to the FAIR principles; and to keep this network live in order to add new data waves or to be joined by new cohorts.<b>Methods:</b> Data were harmonized retrospectively according to the Maelstrom guidance. A federated data network (FDN) was created using the OBiBa software suite.<b>Results:</b> To date, Co-RESPOND consists of nine European cohorts and one global cohort, including 50,885 individual participants. This paper presents Co-RESPOND as a case study for retrospective harmonization of decentralized data where teams collected and transformed data without prior coordination, facing methodological as well as regulatory challenges. The process of this project is outlined in detail, so it could be applied by other researchers for future projects. Its outcomes and the resulting data harmonization products are presented.<b>Conclusions and outlook:</b> The harmonized data are now ready to be shared with external partners for analyses, and Co-RESPOND is open for more partners to join. Lessons learned throughout the project will be reported, and established classification standards will be recommended for use to generate data sets that are available for joint analyses from the start.<b>Trial registration:</b> ClinicalTrials.gov identifier: NCT04556565.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2517920"},"PeriodicalIF":4.1,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12344710/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144820994","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":"The Reconsolidation of Traumatic Memories Protocol's adjustments to the remote treatment of injured Ukrainian military personnel in hospital settings.","authors":"Viktoriia Gorbunova, Robin Hampton","doi":"10.1080/20008066.2025.2499410","DOIUrl":"10.1080/20008066.2025.2499410","url":null,"abstract":"<p><p><b>Background:</b> Due to the Russian invasion of Ukraine and the intense battlefield combat, many Ukrainian defenders have severe gunshot and explosion injuries, which result in broken bones, spinal damage, limb loss, and more. This physically and emotionally intensive experience often leads to acute stress disorder (ASD) and/or post-traumatic stress disorder (PTSD). During post-surgical recovery, injured military personnel need trauma-centred psychotherapy, which is often unavailable because of the hospital's setting limitations.<b>Objective:</b> The article aims to present adjustments of the Reconsolidation of Traumatic Memories (RTM) (US Patent Pending Number US-2024-0148297-A1) Protocol, a structured non-pharmaceutical neuro-based treatment that targets traumatic memory, to the remote treatment of injured Ukrainian military personnel in hospital settings.<b>Method:</b> This clinical practice paper presents two cases of online administration of the RTM Protocol in hospital settings to demonstrate the main adjustments made for remote work with physically injured military personnel.<b>Results:</b> The patients were referred to receive online RTM Protocol treatment by a surgeon due to the psychiatrist-assigned ASD diagnosis, presenting in repetitive flashbacks and sleep disturbances interfering with the post-surgical recovery. Initial and post-treatment screenings using the PCL-5 showed a significant drop in scores: from 36 to 12 points for the first case and from 41 to 7 points for the second case. The patients reported improvements in their mood and sleep, as well as the disappearance of flashbacks. The main adjustments involved on-site adaptations (using the procedure room, utilising nurse assistance, ensuring a stable Internet connection) and modifications to the procedure (conducting shorter sessions, up to 45 min), delegating some Protocol administration steps to patients, and using military jargon and commands.<b>Conclusions:</b> The online administration of the RTM Protocol shows promise for treating combat-related ASD in hospital settings, providing a structured intervention for recovering military personnel, and ensuring accessibility and effectiveness in resource-limited settings.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2499410"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12090284/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144093191","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 scoping review of moral injury in refugees.","authors":"Natalie Donovan, Goran Lukic, Oliver Mason","doi":"10.1080/20008066.2025.2501369","DOIUrl":"10.1080/20008066.2025.2501369","url":null,"abstract":"<p><p><b>Background and Objective:</b> We review the empirical evidence about how moral injury, the experience of a transgression of one's moral framework, can be understood in refugee and asylum seekers.<b>Method:</b> Systematic search identified 12 studies that utilised a range of methodologies (8 quantitative, one qualitative, one mixed methods, and one case study). Study quality was assessed using critical appraisal tools: studies varied in quality from moderate to high (75-100%) with some having methodological issues or a risk of bias.<b>Results:</b> Moral injury is suggested to play a major role in psychological distress and mental health outcomes in these populations: refugees are exposed to a wide range of potentially morally injurious events (PMIEs) and suggest that it is the cognitive appraisal of the event that leads to negative psychological outcomes. Specifically, two distinct subtypes of moral injury appraisals appear pertinent to refugees: the appraisal of one's own actions as violating moral beliefs (MI-self) and the appraisal of others' actions as violating moral beliefs (MI-other).<b>Conclusions:</b> Moral injury may play a key role in understanding the psychological impact of traumatic events and stressful experiences that violate an individual's moral beliefs. Consequently, there is potential benefit in targeting moral injury appraisals in therapeutic interventions for refugee populations.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2501369"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12096692/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144110131","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}