Psychological trauma : theory, research, practice and policy最新文献

{"title":"Just-in-time adaptive ecological momentary assessment and ecological momentary interventions for posttraumatic psychopathology in the modern age of technology.","authors":"Jeffrey M Pavlacic, John Young, Christine K Hahn, Kenneth J Ruggiero, Alyssa A Rheingold","doi":"10.1037/tra0001869","DOIUrl":"https://doi.org/10.1037/tra0001869","url":null,"abstract":"<p><strong>Objective: </strong>One technique for tailoring interventions and matching evidence-based procedures to idiographic problems is just-in-time adaptive approaches, also referred to as ecological momentary intervention. These technology-based approaches involve real-time delivery of evidence-based skills when most needed, which can be tailored to individual data inputs. The current article reviews just-in-time adaptive ecological momentary assessment (JITA-EMA; Schneider et al., 2023) and ecological momentary interventions (EMIs; Heron & Smyth, 2010) with respect to the field of trauma-related psychopathology in the modern age of technology.</p><p><strong>Method: </strong>We provide a broad, narrative overview. Heterogeneity in posttraumatic psychopathology, posttraumatic psychopathology diagnostic classification models, and applicability of technology are reviewed. Next, we discuss JITA-EMA and EMI frameworks, EMA of posttraumatic psychopathology, EMI outcomes, and JITA-EMA and EMI outcomes. We conclude by discussing clinical application and considering dilemmas, ethical issues, and limitations. Future research directions and potential treatment adaptations and innovations are given.</p><p><strong>Results: </strong>JITA-EMA/Is have the potential to reinforce skill acquisition and uptake in evidence-based treatments if implemented as standalones or in conjunction with established, evidence-based interventions.</p><p><strong>Conclusions: </strong>JITA-EMA and EMIs may eventually inform clinical and research efforts by affording an understanding of how idiographic variability in biopsychosocial factors relates to changes in etiology, course, and treatment outcomes. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053337","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adverse childhood experiences and psychological, sexual, and physical forms of intimate partner violence in Nepal.","authors":"Viann N Nguyen-Feng, Kelly McKnight, Binita Shrestha, Gemma Ferguson, Prabin Nanicha Shrestha, Brian Batayeh, Irina Bergenfeld, Cari Jo Clark","doi":"10.1037/tra0001831","DOIUrl":"https://doi.org/10.1037/tra0001831","url":null,"abstract":"<p><strong>Objective: </strong>To examine the prevalence of adverse childhood experiences (ACEs) and intimate partner violence (IPV) among married couples in Nepal as well as the relationships among ACEs, IPV (psychological, sexual, physical), and psychological distress.</p><p><strong>Method: </strong>The sample comprised the control group (<i>N</i> = 720) of a cluster randomized intervention trial among married women in Nepal. Interviewers assessed ACEs, IPV, quality of life, self-efficacy, and depressive symptoms among participants. Times 2 and 3 were conducted 12 and 28 months after baseline, respectively.</p><p><strong>Results: </strong>At baseline, 24% of women reported a history of ACEs. Across time points, married Nepali women most frequently reported psychological IPV (28%-37%). Greater ACEs and IPV scores were related to less quality of life, less self-efficacy, and more depressive symptoms, |rs| = .10-.78, ps < .025. The largest bivariate correlation existed between women's self-reported experiences of psychological and physical violence, <i>r</i> = .78, <i>p</i> < .001. Across time points, structural equation modeling (comparative fit index = .93, standardized root-mean-square residual = .05; adequate fit with physical violence removed) demonstrated that psychological violence was the most consistent statistical consequent when women's ACEs served as an antecedent; married Nepali men's ACEs were related to women's later experiences of psychological and sexual IPV, although not significantly related to psychological distress.</p><p><strong>Conclusions: </strong>Although limitations in generalizability must be considered, these findings extend Western-focused trauma literature by examining ACEs and IPV in Nepal, a historically underrepresented country in this inquiry. Assessing childhood trauma history inclusive of psychological trauma across genders has research and clinical implications, including prevention efforts. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053410","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cyber abuse and posttraumatic stress disorder among racially diverse women who have resided in domestic violence shelters: A longitudinal approach.","authors":"Alejandra Gonzalez, James K Haws, Nuha Alshabani, Caron Zlotnick, Dawn M Johnson","doi":"10.1037/tra0001868","DOIUrl":"https://doi.org/10.1037/tra0001868","url":null,"abstract":"<p><strong>Objective: </strong>The present study presents a longitudinal examination of the impact of cyber abuse (CA) on posttraumatic stress disorder (PTSD) severity among a racially diverse sample of women with intimate partner violence (IPV).</p><p><strong>Method: </strong>Using data collected from a completed randomized control trial with women who sought safety in a domestic violence shelter (W-DVS; <i>N</i> = 172), we conducted a secondary data analysis. Participants completed measures of CA, PTSD severity, and other types of IPV at each time point. To examine predictors of the latent change factor, we estimated the influence of CA on each latent change factor while controlling for other (i.e., noncyber abuse) types of IPV and treatment condition across time.</p><p><strong>Results: </strong>Initial results suggested that CA has a negative impact on PTSD severity over time for W-DVS, as CA predicted changes in PTSD severity across five time points when controlling for treatment condition and PTSD symptom severity at the previous time points. However, CA did not predict a change in symptom severity when controlling for other forms of (noncyber abuse) IPV.</p><p><strong>Conclusions: </strong>Although more CA is associated with more severe PTSD symptoms from the time women are in shelter to postshelter, 3, 9, and 15 months postshelter, this is no longer the case when overall IPV is considered. This study extends our understanding of how CA can exacerbate psychological health consequences, including PTSD severity, of W-DVS, suggesting that cyber abuse should be assessed in tandem with other IPV types rather than as a separate phenomenon. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Mapping the relationships among bullying, cyberbullying, child maltreatment, and parental intimate partner violence: A network analysis.","authors":"Wenzhou Lin, Qiqi Chen, Jianing Guo","doi":"10.1037/tra0001863","DOIUrl":"https://doi.org/10.1037/tra0001863","url":null,"abstract":"<p><strong>Objective: </strong>This study investigates the connections among various forms of violence experienced by adolescents, both online and offline, including bullying, cyberbullying, child maltreatment, and witnessing parental intimate partner violence (IPV). The aim was to elucidate the patterns of these adversities to enhance understanding from a child-centered perspective.</p><p><strong>Method: </strong>We conducted an online survey with a sample of 934 parents (<i>M</i>_age = 41.05 years, <i>SD</i> = 4.76; <i>M</i>_{child's age} = 14.37 years, <i>SD</i> = 1.84) recruited across 30 provinces and districts in China in August 2023. Network analysis was used to examine the associations among four types of bullying (physical, verbal, relational, and cyberbullying), three types of child maltreatment (physical, psychological, and neglect), and two types of parental IPV (psychological and physical).</p><p><strong>Results: </strong>Our findings revealed that cyberbullying victimization had the highest expected influence in the network, suggesting that it plays a central role in exacerbating other adversities. The four types of bullying were strongly interconnected, both online and offline. Parental psychological IPV and child psychological abuse experiences had the highest bridge expected influence in the network, indicating their role in linking various forms of victimization.</p><p><strong>Conclusions: </strong>The findings demonstrate that IPV can facilitate the transmission of adversities across different domains of a child's environment. Understanding the intercorrelations of child victimization within and beyond the home can contribute to the development of a comprehensive child protection approach. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053419","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Social media's impact on rape myth acceptance and negative affect: Moderating roles of political affiliation and gender?","authors":"Alejandra Lopez, Faith O Nomamiukor, Emily S Heinlein, Blair E Wisco","doi":"10.1037/tra0001861","DOIUrl":"https://doi.org/10.1037/tra0001861","url":null,"abstract":"<p><strong>Objective: </strong>Media portrayals of sexual violence have been associated with greater rape myth acceptance (RMA). The present study examined how social media posts rejecting or endorsing rape myths affected RMA and negative affect (NA), and moderating roles of gender and political affiliation.</p><p><strong>Method: </strong>Participants were randomized into one of three simulated Facebook newsfeed conditions that were supportive of sexual trauma survivors (#MeToo), supportive of men falsely accused of rape (#HimToo), or unrelated to sexual violence (control). Participants completed the Positive and Negative Affect Schedule before and after the social media induction and the Updated Illinois Rape Myth Acceptance Scale following the induction.</p><p><strong>Results: </strong>We found significant effects of condition on total RMA, <i>F</i>(2, 510) = 3.33, <i>p</i> = .037, and three of four RMA subscales, <i>F</i>s > 2.8, <i>p</i>s ≤ .05. Follow-up tests indicated that #MeToo did not significantly differ from control, but that #HimToo reported significantly higher RMA than control for total RMA, β = 4.45, <i>p</i> = .01, and the three significant subscales, βs > .08, <i>p</i>s ≤ .02. Further, NA significantly decreased for control and #MeToo, but not #HimToo. Effects of condition were not moderated by gender or political affiliation for either RMA or NA.</p><p><strong>Conclusions: </strong>Our findings suggest that limited exposure to #MeToo posts does not affect RMA, but that #HimToo posts consistent with rape myths may increase RMA and sustain NA for both men and women and for Democrat- and Republican-identifying participants. Further research should focus on how best to counter these harmful social media effects and extend our findings to nonstudent diverse samples. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"\"It was frightening because it could be my own grandparents\": A qualitative study of vicarious exposure to anti-Asian racism.","authors":"Joyce P Yang, Rachel Chan, Aisha Williamson-Raun, Emily R Nhan, Elizabeth L Tung","doi":"10.1037/tra0001876","DOIUrl":"https://doi.org/10.1037/tra0001876","url":null,"abstract":"<p><strong>Objective: </strong>From the beginning of the COVID-19 pandemic, there has been a proliferation of anti-Asian racism. In addition to being personal targets of racism, members of the Asian American community have also been vicariously exposed to repeated news and social media stories about anti-Asian racism. Emerging research suggests that vicarious exposure to racism during the pandemic is associated with decreased well-being, although mechanisms of action are not yet clear. The present study investigates participants' narratives about the effects of observing or hearing about anti-Asian discrimination.</p><p><strong>Method: </strong>A total of 215 Asian-identified individuals living in the United States participated in the study between September 2020 and January 2021. Conventional qualitative content analysis was used to explore themes related to the self-described experience of witnessing or learning about instances of racism and the resulting psychological consequences.</p><p><strong>Results: </strong>We describe the <i>types of racism observed,</i> ranging from avoidance to murder, and <i>targets of racial discrimination,</i> ranging from family members to strangers. Emergent themes include (a) cognitive, behavioral, and emotional symptoms of race-based stress resulting from vicarious racism, (b) decreased sense of national identity and feeling \"othered,\" (c) normalization and invisibility of anti-Asian racism, (d) model minority myth as perpetuating racism, (e) decreased intergroup harmony, (f) increased intragroup connections, and (g) shattered or displaced worldview.</p><p><strong>Conclusion: </strong>Results underscore the complexity of experiences among Asian-identified individuals who were vicariously exposed to racism during the pandemic. We offer clinical implications for providers to gain a better understanding of the mental health needs of Asian American clients. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053394","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Quantifying suicide risk in bereaved individuals.","authors":"Jeffrey M Pavlacic, Jamison S Bottomley, Joah L Williams, Alyssa A Rheingold","doi":"10.1037/tra0001870","DOIUrl":"https://doi.org/10.1037/tra0001870","url":null,"abstract":"<p><strong>Objective: </strong>Types of interpersonal loss through death, such as suicide bereavement, are associated with increased suicide risk. Quantification of suicide risk is less understood across the spectrum of traumatic (e.g., violent) and natural loss, representing a significant literature gap that could be addressed to inform the assessment of and intervention on suicide risk in bereaved adults.</p><p><strong>Method: </strong>A web panel of 2,034 adult participants was administered via Qualtrics to gather data on suicide risk across loss types in bereaved individuals. Loss groups included (a) anticipated medical causes, (b) sudden medical causes, (c) car crash, (d) suicide, (e) homicide, and (f) fatal overdose. We also included individuals reporting no significant loss.</p><p><strong>Results: </strong>Individuals with an anticipated medical loss reported the lowest suicide risk, with the highest risk reported by individuals experiencing suicide or homicide loss. Adjusting for perceived social support, individuals reporting an anticipated medical loss had lower suicide risk relative to suicide and homicide loss, while individuals with a sudden medical loss reported lower suicide risk than suicide loss. Individuals endorsing suicide loss described higher suicide risk than the no-loss group, and individuals in the homicide loss group reported higher suicide risk relative to the no-loss condition.</p><p><strong>Conclusion: </strong>Suicide risk was most elevated in traumatic loss conditions, particularly homicide and suicide loss groups. Results inform assessment and intervention surrounding bereaved individuals and suggest that individuals experiencing specific types of traumatic loss (i.e., suicide and homicide loss) are at the highest suicide risk and therefore may warrant additional screening and clinical attention. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143053422","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Investigating risk factors of dissociative and complex posttraumatic stress disorder across diagnostic systems and potential implications: Latent class analyses.","authors":"Maj Hansen, Martin Robinson, Cherie Armour","doi":"10.1037/tra0001851","DOIUrl":"https://doi.org/10.1037/tra0001851","url":null,"abstract":"<p><strong>Objective: </strong>Posttraumatic stress disorder (PTSD) and more complex posttraumatic symptomatology (i.e., dissociative PTSD [D-PTSD] and complex PTSD [CPTSD]) are differently described in the <i>Diagnostic and Statistical Manual of Mental Disorders</i> (5th ed.; <i>DSM-5</i>) and the <i>International Classification of Diseases</i> (11th ed.; <i>ICD-11</i>). Although the choice of system may affect diagnostic prevalence rates and treatment outcome, less is known about the more complex symptoms and their associated risk factors.</p><p><strong>Method: </strong>To investigate both D-PSTD and CPTSD in Northern Irish military veterans (<i>n</i> = 436) using latent class analysis and associated risk factors to gain a deeper understanding of the potential implications of applying one diagnostic system instead of the other.</p><p><strong>Results: </strong>The latent class analyses revealed a <i>DSM-5</i> four-class solution and an <i>ICD-11</i> five-class solution with both a highly symptomatic D-PTSD class (27.52%) and CPTSD class (27.9%) identified. Similar associations with risk factors were found across the diagnostic systems (e.g., medium to strong effect sizes for prior traumatic exposure, depression, anxiety, dissociation, and alcohol use).</p><p><strong>Conclusions: </strong>Both D-PTSD and CPTSD appear to be highly prevalent among Northern Irish veterans, and interestingly, similar effect sizes were found for the investigated risk factors for highly symptomatic groups across diagnostic systems. Research is needed to determine the generalizability of the results. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024336","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trajectories of change in prolonged exposure for primary care: Who most likely benefits?","authors":"Sheila A M Rauch, H Myra Kim, Ron Acierno, Carly Ragin, Bethany Wangelin, Kimberly Blitch, Wendy Muzzy, Stephanie Hart, Grace Ingham","doi":"10.1037/tra0001827","DOIUrl":"https://doi.org/10.1037/tra0001827","url":null,"abstract":"<p><strong>Objective: </strong>Prolonged Exposure for Primary Care (PE-PC) leverages an opportunity to provide evidence-based posttraumatic stress disorder (PTSD) care in the PC setting where many veterans present for services and can greatly increase treatment access. However, such acute, short-term intervention may not be effective for all PTSD patients.</p><p><strong>Method: </strong>We analyzed data from a randomized clinical trial evaluating PE-PC to determine who may or may not benefit from PE-PC. We identified both PTSD symptom and general functioning trajectories for veterans with chronic PTSD in Veterans Administration primary care settings.</p><p><strong>Results: </strong>For PTSD symptoms, four trajectory patterns emerged, and for functional impairment, three emerged. Demographics, treatment expectancy, and credibility did not predict PTSD symptom or functional impairment trajectories. While baseline depression severity and functioning were initially predictive, only baseline PTSD symptoms were predictive of PTSD symptom trajectories once this variable was considered. Similarly, while baseline depression and PTSD severity were initially predictive of functional trajectories, only baseline function was predictive of function trajectories once this variable was included.</p><p><strong>Conclusion: </strong>PE-PC may be particularly appropriate and effective for veterans presenting to primary care with moderate PTSD symptoms or functional impairment. Replication and examination of trajectories in a larger effectiveness sample is warranted. (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024415","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Moral injury in treatment-seeking police officers: A qualitative study.","authors":"Bernardette C E M Blom, F Jackie June Ter Heide, Eefje Rutten, Miranda Olff","doi":"10.1037/tra0001850","DOIUrl":"https://doi.org/10.1037/tra0001850","url":null,"abstract":"<p><strong>Objective: </strong>In their work, police officers are routinely exposed to potentially traumatic events, some of which may also be morally distressing. Moral injury refers to the multidimensional impact of exposure to such potentially morally injurious events (PMIEs). Mainly originating from a military context, there is little empirical research on moral injury in policing. The aim of this study was to gain insight into what PMIEs and moral injury in police officers entail.</p><p><strong>Method: </strong>We used a generic qualitative research approach inspired by grounded theory. Semistructured interviews were conducted with 13 treatment-seeking, trauma-exposed police officers at a Dutch national center for psychotrauma. Participants were 11 men and two women with a diagnosis of profession-related posttraumatic stress disorder, who reported being troubled by exposure to a morally transgressive event.</p><p><strong>Results: </strong>Findings were categorized into three categories in terms of PMIEs and moral injury: (1) no high stakes PMIEs, (2) high stakes PMIEs but no moral injury, and (3) high stakes PMIEs and moral injury. Within the third category, three main themes and associated subthemes emerged: (1) a sense of responsibility in death, (2) the illusion of control, and (3) a duty to remember.</p><p><strong>Conclusions: </strong>This study is the first to explore high stakes PMIEs and moral injury in trauma-exposed, help-seeking police officers. Findings show that moral injury seems a relevant clinical concept in policing. PMIEs may change their fundamental self-perception and lead to deep feelings of guilt and shame. Directions for future research include examining police officers' treatment needs and perspectives on \"moral recovery.\" (PsycInfo Database Record (c) 2025 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.7,"publicationDate":"2025-01-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}