European Journal of Psychotraumatology最新文献

{"title":"International study of the perceived stress and psychological impact of the 7 October attacks on Holocaust survivors.","authors":"Bruno Halioua, Patrick Bantman, Rachel Rimmer, Eric Ghozlan, Muriel Vaislic, Dan Halioua, Fabienne Amson, Charles Taieb, Richard Prasquier, Jean-François Gutthman, Robert Ejnes, Stéphanie Dassa, Alexis Astruc, Marc Cohen, Samuel Sarfati, Marc Fohlen-Weill, Odile Namia-Cohen, Aline Deutscher, Jonathan Taieb","doi":"10.1080/20008066.2024.2428025","DOIUrl":"10.1080/20008066.2024.2428025","url":null,"abstract":"<p><p><b>Objective:</b> The terrorist attacks of 7 October 2023 in southern Israel had a significant impact on the mental health of Holocaust Survivors (HS), who are considered to be particularly vulnerable to traumatic events. The aim of the study was to assess the severity of perceived stress and the psychological impact of the 7 October attacks on HS.<b>Methods:</b> The study was conducted from 30 October to 15 December 2023 among HS who were contacted through HS support organisations (OSE, Aloumim). They completed a questionnaire consisting of four sections: socio-demographic data and experiences during the Holocaust, assessment of psychological stress using the Perceived Stress Scale (PSS-10), feelings of isolation, health consequences, and reactions to the 7 October attacks.<b>Results:</b> 171 HS completed the questionnaire with 61 males (35.7%) with a mean age of 86.6+/-4.4 years (min 79-max 97). 59.6%, lived outside Israel, mainly in France. The mean score on the PSS-10 was 17.7 +/-6.0 on a scale of 5 to 40. The average PSS 10 score is not significantly higher in cases of age ≤90 years (18.0 ± 6.0 vs 15.7 ± 6.4, NS), or for those living in Israel (17.2 ± 5.3 vs 18.1 ± 6.6, NS). About a quarter reported feelings of isolation or loneliness following the attacks. The impact of the 7 October attacks was particularly significant among those living outside Israel. Approximately two-thirds felt that the events had rekindled memories of their Holocaust experiences, and nearly one-third observed a decline in their health since the attacks. Among survivors living outside Israel, 86.6% expressed concern about the future safety and identity of their children and grandchildren as Jews.<b>Conclusion:</b> Identifying Holocaust survivors (HS) who are experiencing psychological distress is crucial to providing them with appropriate therapy.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2428025"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11792156/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143122505","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":"Gender differences in early posttraumatic stress disorder symptoms: a network analysis.","authors":"Line Rønning, Rachel L Zelkowitz, Marilyn L Piccirillo, Jianlin Liu, Jordan L Thomas, Jessy Guler, J Joana Kyei, Chris M Hoeboer, Jeanet F Karchoud, Miranda Olff, Anke B Witteveen, Mirjam van Zuiden","doi":"10.1080/20008066.2024.2448385","DOIUrl":"10.1080/20008066.2024.2448385","url":null,"abstract":"<p><p><b>Background:</b> Despite known gender/sex differences in the prevalence of posttraumatic stress disorder (PTSD), potential differences in the associations among PTSD symptoms between men and women in the early post-trauma period are not well-characterized.<b>Objective:</b> This study utilized network analysis to assess potential differences in the associations among PTSD symptom clusters between men and women during the early post-trauma period.<b>Method:</b> We included <i>n</i> = 475 participants (57.5% self-identified women) who recently (≤2 months) experienced an interpersonal or motor vehicle potential traumatic event in the Netherlands. Past month PTSD symptoms were measured with the PTSD Checklist for DSM-5 (PCL-5) and composited according to the five-node PTSD symptom cluster dysphoric arousal model. We estimated the network as well as indices of centrality (strength and predictability) and assessed the stability of the modelled networks in subsamples of men (<i>n </i>= 202) and women (<i>n </i>= 273). We compared network structures using the Network Comparison Test (NCT).<b>Results:</b> Results largely demonstrated adequate correlation stability for the estimated network structures for women and men. For both men and women, avoidance symptoms were among the strongest nodes with greatest predictability in the networks. In men, anxious arousal additionally showed high strength whereas re-experiencing showed high predictability. In women, re-experiencing symptoms demonstrated both high strength and predictability. The NCT demonstrated nonsignificant differences in global network structure (<i>M </i>= 0.08, <i>p</i> = .054) and strength (<i>S</i> = .073, <i>p</i> = .067). Post hoc comparisons showed an association of re-experiencing symptoms with negative alterations in cognitions and mood in men but not women (<i>E</i> = .038, <i>p</i> = .005).<b>Conclusion:</b> Results demonstrated possible modest gender differences in aspects of network structure although most elements of the network structure were similar across genders. These results help to characterize gender differences in associations among PTSD symptom clusters during the early post-trauma period, which may inform the potential relevance of future gender-sensitive early intervention strategies to ameliorate the risk for long-term PTSD.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2448385"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11758801/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143022554","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 interpersonal theory of suicide risk in male US service members/veterans: the independent effects of perceived burdensomeness and thwarted belongingness.","authors":"Rebecca K Blais, Kevin J Grimm","doi":"10.1080/20008066.2024.2439748","DOIUrl":"10.1080/20008066.2024.2439748","url":null,"abstract":"<p><p><b>Introduction:</b> Suicide rates remain high among US military service member/veteran (SM/V) males with overall trends showing an upward trajectory. Several empirical studies and official US government reports show that interpersonal challenges can substantially increase suicide risk. One theory, the Interpersonal Theory of Suicide (IPT), focuses thwarted belongingness, perceived burdensomeness, capability for suicide, and their interactions, as key contributors to suicide risk. Extant military studies are subscribed to specific subsamples and/or do not test the full theory. This has resulted in mixed findings or findings with limited generalizability. The current study addressed these limitations.<b>Method:</b> A convenience sample of 508 male SM/Vs completed self-report measures of lifetime suicide ideation, likelihood of making a future attempt, thwarted belongingness, perceived burdensomeness, capability for suicide, and demographics. Suicide ideation and risk was regressed on IPT variables, relevant interactions, and covariates.<b>Results:</b> The variance accounted for in suicide ideation and likelihood of a future attempt was 32% and 62%, respectively. Higher perceived burdensomeness was associated with suicide ideation, and higher thwarted belongingness had a marginally significant association with suicide ideation. The presence of suicide ideation and higher thwarted belongingness were associated with the likelihood of making a future attempt. Capability for suicide was not associated with the likelihood of making a future attempt.<b>Discussion:</b> Perceived burdensomeness, suicide ideation, and thwarted belongingness appear to individually create risk for future suicide behaviour among US military service members and veterans. Additional work is needed to establish comprehensive theories of suicide risk in this population.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2439748"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11795748/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143188654","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 journey towards a trauma informed and responsive Justice system: the perspectives and experiences of senior Justice workers.","authors":"Nicola Cogan, Dwight Tse, Melanie Finlayson, Samantha Lawley, Jacqueline Black, Rhys Hewitson, Suzanne Aziz, Helen Hamer, Cherrie Short","doi":"10.1080/20008066.2024.2441075","DOIUrl":"10.1080/20008066.2024.2441075","url":null,"abstract":"<p><p><b>Objectives:</b> There is a risk of re-traumatisation for survivors of trauma who engage with the Justice system, given their high propensity to encounter situations that trigger traumatic responses. While a growing body of research has explored the experience of trauma informed practice (TIP) from service user perspectives, little research has incorporated the views and experiences of practitioners working in the Justice system in terms of the implementation of TIP in their service setting.<b>Method:</b> An exploratory, qualitative research design based on semi-structured, in-depth interviews. One to one, online interviews were conducted with senior Justice workers (<i>n</i> = 22) who had undertaken theoretically informed TIP training and had responsibility for its implementation. Interviews were audio-recorded, transcribed and analysed using an inductive, reflexive thematic approach.<b>Results:</b> The themes identified were: (1) Supporting staff and user knowledge and well-being (training, trust, safety, reflection), (2) Recognition in the value of TIP (reflected in the resources, supervision, infrastructure and physical environment), (3) Encouraging flexible, creative and collaborative ways of working (overcoming resistance).<b>Conclusions:</b> The findings have implications at the service user, provider and organisational level. Emphasis is placed on the importance of overcoming barriers to implementing TIP through adopting a whole systems approach that encourages collaborative working while supporting staff well-being, access to ongoing TIP training, supervision and resources to establish a safe working environment. Implementing a strengths-based, non-pathologising approach to TIP service delivery within the Justice system is essential. Further longitudinal work to explore the mechanisms by which TIP can help reduce re-traumatisation to service users and providers is recommended.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2441075"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11705546/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142931061","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 echoes: factors associated with peritraumatic distress and anxiety five days following Iranian missile attack on Israel.","authors":"Boaz M Ben-David, Tchelet E Bressler, Lia Ring, Ortal Shimon-Raz, Yuval Palgi","doi":"10.1080/20008066.2024.2446070","DOIUrl":"10.1080/20008066.2024.2446070","url":null,"abstract":"<p><p><b>Introduction:</b> On 13-14 April 2024, Iran launched ∼300 drones and missiles at Israel, in an unprecedented attack. As most studies examine the effects of trauma months or years later, less is known about its effects days later. To fill this gap, this study gauged the population response, five days after the attack. Specifically, we examined the prevalence and factors associated with two precursors for later development of PTSD, peritraumatic distress (PD) and generalized anxiety disorder (GAD).<b>Methods:</b> Five-hundred and fifty-three participants (M_age = 57.51, SD = 13.67 years, range [30-90], 48.3% females) reported their distal and proximal exposure to traumatic events, probable PTSD due to Israel-Hamas-War, sleeping troubles, and media information consumption during the event.<b>Results:</b> Logistic regressions indicated that, after adjusting for demographics, clinical levels of PD and GAD (respectively, using the accepted cutoffs) were significantly linked to probable PTSD due to the Israel-Hamas War (PD:OR = 4.066, 95%CI: 2.236-7.393, <i>p </i>< .001; GAD:OR =<i> </i>2.397, 95%CI: 1.285-4.471, <i>p </i>= .006), sleeping troubles (PD:OR = 1.248, 95%CI: 1.186-1.314, <i>p </i>< .001; GAD:OR = 1.325, 95%CI: 1.242-1.413, <i>p </i>< .001) and media consumption (PD:OR = 1.442, 95%CI:1.17-1.777, <i>p </i>= .001; GAD:OR = 1.515, 95%CI: 1.144-2.007, <i>p </i>= .004), but not to previous trauma (life-long exposure or Israel-Hamas war).<b>Discussion:</b> Results suggest that previous psychopathology, stress-related reactions (sleeping) and actions (media consumption), rather than previous exposures to traumatic events are the primary indices related to PD and GAD in the first days after exposure to war-related traumatic events. Findings highlight the importance of early detection of reactions and symptoms following trauma exposure. The main limitation of the study is its cross-sectional design. Future longitudinal studies are needed to understand the developmental trajectory of these effects.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2446070"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721957/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946998","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":"Childhood-related PTSD: the role of cognitions in EMDR and imagery Rescripting.","authors":"","doi":"10.1080/20008066.2025.2460393","DOIUrl":"https://doi.org/10.1080/20008066.2025.2460393","url":null,"abstract":"","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2460393"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143381885","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ICD-11 posttraumatic stress disorder and complex PTSD: prevalence, predictors, and construct validity in Swiss older adults.","authors":"Myriam V Thoma, Enya Redican, Nathanael Adank, Valerie B Schneemann, Mark Shevlin, Andreas Maercker, Shauna L Rohner","doi":"10.1080/20008066.2024.2445368","DOIUrl":"https://doi.org/10.1080/20008066.2024.2445368","url":null,"abstract":"<p><p><b>Background:</b> This study assessed the prevalence rates, construct validity, predictors, and psychosocial factors linked to ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD), as assessed by the <i>International Trauma Questionnaire</i> (ITQ) in a German-speaking sample of Swiss older adults.<b>Method:</b> Participants were <i>N</i> = 1526 older adults aged 65+ (<i>M_age</i> = 72.34; <i>SD</i> = 6.20 years; age range = 65-95; female = 72.0%). Confirmatory factor analysis (CFA) tested alternative models of the latent structure of the ITQ. Risk factors and psychological outcomes associated with the ITQ subscales were also examined.<b>Results:</b> From the total sample, 86.2% had experienced at least one potentially traumatic event (PTE), with a median of three PTEs per person. Probable PTSD and CPTSD prevalence was 0.4% and 2.4%, respectively. CFA results indicated that a two-factor second-order model best captured the latent structure of the ITQ. Female gender and specific traumas, such as physical and sexual assault, were uniquely associated with PTSD. Fewer, non-specific factors were linked to disturbances in self-organization (DSO; encompassing affective dysregulation, a negative self-view, and difficulties in relationships). The PTSD and CPTSD factors were significantly associated with loneliness, anxiety, depression, and well-being.<b>Conclusions:</b> Results found that despite high trauma exposure among Swiss older adults, the prevalence of ICD-11 PTSD and CPTSD was low, with no significant gender differences. A two-factor second-order model provided the best fit for the ITQ. These findings indicate significant trauma exposure in Swiss older adults and the need for targeted interventions that address the trauma-specific and associated psychosocial challenges (i.e. loneliness, anxiety, depression, well-being) facing older adults.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2445368"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142920805","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Heterogeneity in racist events and posttraumatic mental health among Black, Indigenous, People of Color (BIPOC) first responders.","authors":"Ling Jin, Sidonia E Compton, Hawra Al-Khaz'Aly, Ateka A Contractor","doi":"10.1080/20008066.2024.2447202","DOIUrl":"10.1080/20008066.2024.2447202","url":null,"abstract":"<p><p><b>Background:</b> Black, Indigenous, People of Color (BIPOC) first responders in Canada report experiencing racism and an increased risk of trauma-related mental health symptoms.<b>Objective:</b> Using a BIPOC first responder sample in Canada, the present study examined subgroups of BIPOC first responders based on the frequency of different types of racist events, and their relations with mental health symptoms (posttraumatic stress disorder [PTSD] symptom clusters of intrusion, avoidance, negative alterations in cognitions and mood [NACM], and alterations in arousal and reactivity [AAR]; depression severity; anxiety severity).<b>Method:</b> The sample included 196 BIPOC first responders who reported more than one traumatic experience (<i>M</i>_age= 35.30; 71.4% men).<b>Results:</b> Latent profile analyses indicated a best-fitting 3-profile solution: Low (Profile 1), Moderate (Profile 2), and High (Profile 3) Frequency of Racist Events. Multinomial logistic regression indicated that BIPOC first responders reporting more frequent racist events endorsed greater depression severity, anxiety severity, and PTSD's NACM symptom severity.<b>Conclusions:</b> Findings improve our understanding of subgroups of BIPOC first responders based on the frequency and types of racist events they experience. Results highlight the need to incorporate assessments of racism-related experiences into therapeutic work, and to target depression, anxiety, and NACM symptoms among those who encounter more racist events.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2447202"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721964/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946944","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":"Exposure to warfare and demoralization: acute stress symptoms and disengaged coping as a mediators.","authors":"Svetlana Baziliansky, Wafaa Sowan","doi":"10.1080/20008066.2024.2449308","DOIUrl":"10.1080/20008066.2024.2449308","url":null,"abstract":"<p><p><b>Background:</b> Demoralization in the face of adversity is a common existential state. However, it has not been examined in reaction to warfare, and the mediators between the extent of exposure to war and demoralization in this context are also unknown.<b>Objective:</b> This study explored the associations of indirect exposure to war, acute stress symptoms, disengaged coping, and demoralization. Additionally, it examined the serial mediation of acute stress symptoms and disengaged coping in the relationship between indirect exposure to war and demoralization.<b>Method:</b> The survey was conducted 4 weeks after the 7 October war broke out and included 393 Israeli citizens (women and men, Jews and Arabs) indirectly affected by the threatening situation in Israel. Questionnaires measured acute stress symptoms, disengaged coping, and demoralization. War-related exposure and demographic data were collected.<b>Results:</b> The analysis revealed that the higher the indirect exposure to war, the higher the acute stress symptoms, use of disengaged coping, and demoralization. Additionally, individuals with acute stress disorder had higher demoralization. The serial mediation model showed partial mediation: acute stress symptoms and the use of disengaged coping mediated the relationships between indirect exposure to war and demoralization (although the direct association between the extent of exposure and demoralization remained significant).<b>Conclusions:</b> In the face of traumatic events, such as warfare, professionals should identify individuals with high levels of acute stress symptoms and provide help to reduce the use of disengaged coping and long-term negative consequences such as demoralization.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2449308"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11731291/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142970244","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":"Maximizing expectancy violation and exposure outcomes in patients with PTSD.","authors":"Marike J Kooistra, Maartje Schoorl, Danielle A C Oprel, Willem van der Does, Rianne A de Kleine","doi":"10.1080/20008066.2024.2447183","DOIUrl":"10.1080/20008066.2024.2447183","url":null,"abstract":"<p><p><b>Background:</b> It has been proposed that maximizing expectancy violation enhances the efficacy of exposure therapy. The clinical utility of expectancy violation remains unclear and it has not yet been studied in PTSD.<b>Objective:</b> We aimed to test whether explicitly focusing on expectancy violation leads to superior exposure outcomes.<b>Method:</b> Adult treatment-seeking patients with PTSD (<i>N</i> = 60) were randomly assigned to one 90-minute exposure session focusing on either expectancy violation or a control condition without an expectancy focus. Assessments occurred before the session and one week later, measuring changes in fear responses during a script-driven imagery task, and PTSD symptoms.<b>Results:</b> Using multilevel analyses, we found no between-condition differences. On average, fear responses to the imagery and PTSD symptoms decreased over time. The expectancy violation condition exhibited a greater decrease in threat appraisal, which appeared to mediate symptom reduction.<b>Conclusions:</b> We found no evidence that explicitly focusing on expectancy violation led to superior immediate effects. However, it may lead to more changes in expectancies which could affect symptom improvement over an extended period. Further research is needed to determine whether emphasizing expectancy violation in exposure therapy for PTSD is advantageous.</p>","PeriodicalId":12055,"journal":{"name":"European Journal of Psychotraumatology","volume":"16 1","pages":"2447183"},"PeriodicalIF":4.2,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11721951/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142946947","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}