Journal of traumatic stress最新文献

{"title":"Cutting-edge developments in the assessment of posttraumatic stress disorder.","authors":"Michelle J Bovin, Frank W Weathers, Siyuan Wang, Thomas Crow, Paula P Schnurr, Brian P Marx","doi":"10.1002/jts.70099","DOIUrl":"https://doi.org/10.1002/jts.70099","url":null,"abstract":"<p><p>The importance of assessment in the study of posttraumatic stress disorder (PTSD) has long been recognized. Although psychometrically strong PTSD measures are available, questions remain about current instrumentation. For example, there is limited information about the intensive longitudinal stability of assessment results or how stability and accuracy may vary across scales. Additionally, patient and clinician perceptions of the \"worst\" traumatic event frequently differ, as do estimations of PTSD symptom severity, and it is unclear if and how these differences can be aligned. In this article, we present brief examples of how each of these topics can be addressed empirically. Specifically, we discuss work on the short-term stability of the Primary Care PTSD Screen for DSM-5 (PC-PTSD-5) and provide a comparison between a clinician-administered PTSD interview (Clinician-Administered PTSD Scale for DSM-5 [CAPS-5]) and two self-report PTSD questionnaires (PTSD Checklist for DSM-5 [PCL-5], Posttraumatic Stress Diagnostic Scale for DSM-5 [PDS-5]), focusing on treatment group effects and symptom change over time. We also introduce two new measures: the Index Event Form (IEF), a new clinician-administered interview designed to guide the identification of the worst traumatic event, and the Respondent-Administered PTSD Scale (RAPS), a new questionnaire designed to align with the Revised CAPS-5 (CAPS-5-R). We end by discussing how cutting-edge developments in PTSD assessment can move the field forward.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148277962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Differentiating moral injury from posttraumatic stress disorder: Implications of the DSM-5-TR moral problems Z-code.","authors":"Seth A Mattson, John R Peteet, Shira Maguen","doi":"10.1002/jts.70089","DOIUrl":"https://doi.org/10.1002/jts.70089","url":null,"abstract":"<p><p>The rapid growth of research on moral injury (MI) has outpaced consensus on how the construct should be assessed and differentiated from related trauma syndromes such as posttraumatic stress disorder (PTSD). Building on the recently introduced Diagnostic and Statistical Manual of Mental Disorders (5th ed., text rev.; DSM-5-TR) Z-code for \"Moral, Religious, or Spiritual Problem,\" we briefly review the history of assessment and measurement of the MI construct. We then examine how this new diagnostic category can advance conceptual precision while encouraging broader recognition of moral dimensions in trauma care. We explore how understanding moral identity- defined in the new Z-code as one's sense of the goodness of themselves, others, and institutions and views of right and wrong-functions as a key mediator, linking exposure to potentially morally injurious events (PMIEs) to key symptoms of guilt, shame, and anger. Viewing MI through the Z-code lens both allows for the identification of moral problems and serves as a means to further distinguish morally laden distress from fear-based trauma. This shift has implications for future research on MI measurement; clinician training in the assessment of moral functioning; and integrating spiritual, existential, and relational dimensions into trauma care. Lastly, through analysis of an illustrative case, we propose that the study of injury in relation to one's moral identity represents a distinct diagnostic and therapeutic frontier at the intersection of the social sciences and the humanities.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148265112","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Redesigning trauma-focused interventions to address capacity challenges in mental health systems.","authors":"Carmen P McLean, Nicholas Holder, Ryan Holliday, Craig S Rosen","doi":"10.1002/jts.70090","DOIUrl":"10.1002/jts.70090","url":null,"abstract":"<p><p>Despite strong evidence supporting the use of trauma-focused evidence-based psychotherapies (EBPs) to treat posttraumatic stress disorder (PTSD), health care systems experience meaningful challenges in delivering these treatments at scale. With a focus on two large, integrated health care systems (Military Health System, Veterans Health Administration), we discuss the challenges to scaling up access to EBPs for PTSD, as well as proposed strategies to mitigate these challenges. We identify three primary barriers to delivery of EBPs for PTSD: insufficient staffing, difficulty connecting patients with EBP-trained providers, and structural inefficiencies characteristic of the weekly therapy model. We review emerging strategies to redesign the delivery of EBPs for PTSD, including accelerated delivery formats, alternative delivery settings, task-sharing, web- and app-based interventions, and the use of artificial intelligence. Taken together, these strategies represent promising opportunities to efficiently use limited staffing to increase access to EBPs for PTSD, while retaining or increasing intervention effectiveness. Further research is needed to determine how to most effectively integrate these strategies into a stepped-care model of treatment delivery, where redesigned approaches complement traditional EBP delivery models to address the real-world constraints of health care systems.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-09","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148211752","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Artificial intelligence in traumatic stress treatment: The TRUST framework for ethical development, clinical applications, and research advancement.","authors":"Leigh E Ridings, Philip Held, Eric Kuhn, Shannon Wiltsey-Stirman","doi":"10.1002/jts.70092","DOIUrl":"10.1002/jts.70092","url":null,"abstract":"<p><p>Posttraumatic stress disorder (PTSD) and depression are common diagnoses following traumatic events, with several available evidence-based interventions to reduce symptomology. However, trauma populations face significant access barriers that limit their adoption and reach. Artificial intelligence (AI) technologies, such as large language models (LLMs), have the potential to enhance access, cost-efficiency, delivery, and quality of traumatic stress interventions. Their application to traumatic stress treatment and research is understudied and requires responsible and ethical development, evaluation, and monitoring to maintain service quality and delivery for trauma survivors and their providers. We present considerations for the responsible use of AI tools to ethically shape trauma-focused treatment and research, with future use cases to highlight these critical considerations. A multidisciplinary approach to trauma-based LLM development that integrates feedback and evaluation from trauma experts, clinicians, and trauma survivors and prioritizes the quality, safety, effectiveness, and equity of trauma-focused care is essential. We propose a framework, TRUST, that is informed by evidence from adjacent mental health AI applications and emerging research on digital trauma interventions, while acknowledging the limited trauma-specific AI trial data. These topics were presented at the 41st Annual Meeting of the International Society for Traumatic Stress Studies via a panel of experts in AI technologies to support trauma-focused interventions.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":" ","pages":""},"PeriodicalIF":3.4,"publicationDate":"2026-06-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13504747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148205428","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Commercial content moderation: Trauma exposure on the digital frontline.","authors":"Jeffrey Demarco, Patricia Watson, Sonya B Norman","doi":"10.1002/jts.70087","DOIUrl":"https://doi.org/10.1002/jts.70087","url":null,"abstract":"<p><p>Commercial content moderators (CCMs) serve as the hidden first responders of the internet, sifting through flagged user-generated content to keep online platforms safe. In their work, they have repetitive, frequent exposure to traumatic content, including child sexual abuse material, graphic violence, death, hate rhetoric, and more. Yet, relative to other occupations in which trauma exposure is common, the mental health effects of content moderation have received little study. This is in large part because it is a newer profession that arose with the widespread adoption of social media. In this paper, we describe the work and working conditions typical of CCMs and how these contribute to potential mental health impacts. Global labor inequities are discussed with regard to how outsourcing moderation to low- and middle-income countries with stressful working conditions may exacerbate the risk of posttraumatic stress. Research on the mental health effects of content moderation is synthesized. We propose a research agenda for preventing and mitigating the negative mental health impacts of trauma exposure that CCMs experience. Finally, the paper outlines principles for trauma-informed, psychologically safe moderation systems and discusses implications for clinicians, employers, and occupational health professionals.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":" ","pages":""},"PeriodicalIF":2.3,"publicationDate":"2026-06-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"148163816","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Religion and spirituality as pathways to resilience: The role of positive coping and postmigration stress in displaced populations","authors":"Haneen Shibli,&nbsp;Eesha Ali,&nbsp;Peter L. Rosencrans,&nbsp;Ash Holloway,&nbsp;Mohammed K. Alsubaie,&nbsp;Michael L. Dolezal,&nbsp;Alexandra B. Klein,&nbsp;Emma K. PeConga,&nbsp;Rosemary S. W. Walker,&nbsp;Alexandra R. Bowling,&nbsp;Norah C. Feeny,&nbsp;Jacob A. Bentley,&nbsp;Lori A. Zoellner","doi":"10.1002/jts.70055","DOIUrl":"10.1002/jts.70055","url":null,"abstract":"<p>Faith or spirituality may foster resilience among forcibly displaced individuals facing postmigration stress, including the loss of social networks, cultural adjustment, and uncertainty. Although prayer and community gatherings promote resilience, their role in building individual and community resilience under postmigration stress is less known. Forcibly displaced adults (<i>N</i> = 272) completed measures of positive religious coping, fate and destiny–related beliefs, and religious and spiritual struggles. Outcomes were individual and community resilience, with postmigration living difficulties examined as a moderator. Positive religious coping was associated with higher individual resilience, β = .15, <i>p</i> = .018, whereas higher religious struggles were associated with lower resilience, β = -.22, <i>p</i> = .001. Postmigration stress moderated the association between spiritual struggles and individual resilience, with the negative association between spiritual struggles and resilience weakening as postmigration stress increased. Both higher positive religious coping, β = .35, <i>p</i> &lt; .001, and higher fate and destiny–related beliefs, β = .37, <i>p</i> &lt; .001, were associated with higher community resilience. Higher postmigration stress was modestly associated with higher community resilience, β = .14, <i>p</i> = .015, but did not moderate observed associations. Taken together, spirituality serves as an important social and psychological resource for forcibly displaced individuals, fostering both individual and community resilience. Under higher postmigration stress, individuals adapt by relying on available coping mechanisms, mitigating the impact of religious struggles on resilience. Programs that promote culturally meaningful religious coping and shared spiritual practices may offer community-driven pathways to resilience for populations navigating forced displacement.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"39 3","pages":"439-452"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443905","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Familial genetic risk for posttraumatic stress disorder: Associations with clinical features","authors":"Ananda B. Amstadter,&nbsp;Linda Abrahamsson,&nbsp;James E. Hart,&nbsp;Jan Sundquist,&nbsp;Kenneth S. Kendler,&nbsp;Kristina Sundquist","doi":"10.1002/jts.70053","DOIUrl":"10.1002/jts.70053","url":null,"abstract":"<p>In the present study, the novel <i>family genetic risk score</i> (FGRS) method, a reliable quantification of latent genetic risk, was applied to posttraumatic stress disorder (PTSD) to examine associations between genetic liability and clinical features of PTSD among 3,097,180 individuals in the Swedish national registries. FGRS was calculated based on lifetime PTSD status for first- through fifth-degree relatives and examined both in PTSD cases with any lifetime registration (PTSD total) and in cases with more than one registration (recurrent PTSD) in relation to sex, age at onset (AAO), recurrence, mode of ascertainment (inpatient [IP], outpatient specialty care [SC], primary care [PC]), and comorbidities. Sex differences were not found for recurrent PTSD, but for PTSD total, female registrants had a lower FGRS value compared to male registrants, <i>M</i> = -.017, 95% CI of difference [-.029-.005]. Higher FGRS was found at earlier AAO for PTSD total and recurrent PTSD, <i>p</i>s &lt; .001, and scores were higher among individuals with comorbidities, <i>p</i>s &lt; .001. Higher FGRS was related to the number of PTSD recurrences among both total PTSD and recurrent PTSD, <i>p</i>s &lt; .001 (linear effect). For both PTSD types, FGRS scores were as follows: PC &lt; SC &lt; IP, <i>p</i>s &lt; .001. The findings indicate that genetic risk for PTSD is associated with several clinical features of the disorder, which should be included in future studies of genetic risk for PTSD. Continued investigation of these clinical features in epidemiological and molecular genetic studies of PTSD is warranted to further validate the findings.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"39 3","pages":"426-438"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jts.70053","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147443912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Co-occurring daily minority stressors and dissociation among trauma-exposed sexual minority women, transgender, and nonbinary people","authors":"Kriti Behari,&nbsp;Emily C. Helminen,&nbsp;Michelle J. Zaso,&nbsp;Jillian R. Scheer","doi":"10.1002/jts.70072","DOIUrl":"10.1002/jts.70072","url":null,"abstract":"<p>Sexual minority women, transgender people, and nonbinary (SMW/TNB) people experience disproportionately high rates of traumatic stressors (e.g., child abuse, sexual violence), which are associated with adverse trauma-related mental health outcomes, such as dissociation. SMW/TNB people also experience ongoing stressors related to their minoritized sexual and/or gender identities (e.g., discrimination). Dissociation has been associated with minority stressors in studies primarily using single–time point, cross-sectional approaches. Reliance on single–time point approaches may obscure how minority stressors and trauma-related outcomes, like dissociation, covary within individuals and unfold over time. We conducted a secondary analysis of data from a 14-day daily diary study with trauma-exposed SMW/TNB participants (<i>N</i> = 57) to examine whether variations in daily minority stressors were associated with same-day fluctuations in dissociation. Results indicated minority stressors and dissociation significantly covaried over the 14-day study period. Multilevel models showed that participants’ reports of higher-than-average daily minority stressors were associated with same-day reports of higher-than-average dissociative symptoms, <i>B</i> = 0.24, 95% CI [0.07, 0.41], <i>p</i> = .007. Participants also reported small decreases in dissociation levels over the study period, <i>B</i> = −0.05, 95% CI [-0.08, -0.02], <i>p</i> = .004. The findings highlight the importance of considering the health impacts of consistent state elevations in dissociation associated with minority stressors for SMW/TNB people. Future time-varying approaches should investigate temporal sequencing of minority stressors and dissociation, assess whether minority stressors relate to dissociation independent of trauma exposure, and explore whether trauma exposure characteristics (e.g., identity-relatedness of trauma) moderate this association.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"39 3","pages":"517-528"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13199747/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775072","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Saliendo adelante: Understanding trauma and resilience in immigrant families from Central America","authors":"Arlene Bjugstad,&nbsp;Jodi Berger Cardoso,&nbsp;Jessica Hernández Ortiz,&nbsp;Jessica L. Borelli","doi":"10.1002/jts.70070","DOIUrl":"10.1002/jts.70070","url":null,"abstract":"<p>Fleeing extreme poverty and violence and seeking safety and survival, families have increasingly migrated to the United States from El Salvador, Guatemala, and Honduras. Limited scholarship has explored the transgenerational transmission of strategies for resilience, survival, and agency among Central American migrant families. Using constructivist grounded theory methods, this study sought to better understand these processes by exploring the transgenerational transmission of trauma and resilience in the context of forced migration and family separation within a sample of 24 mothers and youth who migrated to the United States from Central America. The findings reveal three important concepts that influence how trauma and resilience are transmitted across generations among families who have recently migrated from Central America. Youth and mothers described the transmission of trauma and resilience as multidirectional with impacts across generations. Participants also described experiencing ongoing systemic traumatization in the form of oppressive social, political, legal, and economic systems that perpetuate traumatic stress and cause family separation. Finally, the concept of <i>saliendo adelante</i>, or “moving forward,” was found to be both a process and a goal for mothers and youth, constituting an important form of transgenerational resilience. Results from this study elucidate the complex and intersecting processes that contribute to the transgenerational transmission of trauma and introduce the concept of saliendo adelante, by which immigrant families transmit family goals and build resilience in the face of adversity.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"39 3","pages":"541-552"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147674546","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The role of geographical proximity to the October 7th, 2023, attack on Israel: Mental health disorders and related risk factors","authors":"Ohad Gilbar,&nbsp;Ruth Pat-Horenczyk,&nbsp;Mario Mikulincer,&nbsp;Jonathan D. Huppert,&nbsp;Eitan Shahar,&nbsp;Miriam Schiff","doi":"10.1002/jts.70074","DOIUrl":"10.1002/jts.70074","url":null,"abstract":"<p>The current study assessed how mental health outcomes and related risk factors varied by proximity to the October 7, 2023, attacks by Hamas among a community sample from Ofakim, a town in southern Israel. Established cutoff scores on self-report measures of posttraumatic stress disorder (PTSD), major depressive disorder (MDD), and generalized anxiety disorder (GAD) were used to estimate disorder prevalence rates. Background and trauma exposure were examined as risk factors in areas that differed in geographical proximity to the attacks. Participants were randomly sampled from two areas in Ofakim during June–August 2024: Sample 1 (S1) included 388 individuals in the attacked neighborhood, and Sample 2 (S2) included 329 individuals located elsewhere in town. Probable PTSD rates were significantly higher in S1 (56.4%) than S2 (44.7%), <i>p</i> &lt; .001. The prevalence of probable MDD was 38.6% in S1 versus 28.7% in S2, <i>p</i> &lt; .001. The prevalence of probable GAD was 42.0% in S1 versus 29.0% in S2, <i>p</i> &lt; .001. In generalized linear models, there were no significant differences in mental health outcomes across neighborhoods. However, interactions between neighborhood type and risk factors emerged such that low income increased the likelihood of probable PTSD and GAD within the attacked neighborhood. The findings highlight the substantial mental health impact of mass trauma on an entire town, worsening with event proximity. Low income was a specific risk factor for individuals in the attacked neighborhood, which raises questions about whether economic support could buffer the impact of mass trauma in low-income individuals.</p>","PeriodicalId":17519,"journal":{"name":"Journal of traumatic stress","volume":"39 3","pages":"553-563"},"PeriodicalIF":2.3,"publicationDate":"2026-06-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/jts.70074","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"147775231","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}