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

{"title":"Does digital health improve equity for Latine mental health after a disaster? Evidence from a randomized trial with 2017 and 2018 hurricane survivors.","authors":"Arthur R Andrews, Laura M Acosta, Laura Perez Villagomez, Tatiana M Davison, Sandro Galea, Kenneth J Ruggiero","doi":"10.1037/tra0001980","DOIUrl":"10.1037/tra0001980","url":null,"abstract":"<p><strong>Objective: </strong>Despite experiencing traumatic events at a higher rate, Latine populations receive mental health services at a lower rate than non-Latine Whites (Center for Behavioral Statistics & Quality, 2018). Digital mental health tools, including mobile applications (\"apps\") are frequently proposed as solutions for addressing care access disparities, but significant research gaps remain to identify if and how existing tools may be used to address disparities.</p><p><strong>Method: </strong>We utilized data from a randomized clinical trial of Bounce Back Now (BBN), a mobile self-help app with 1,357 hurricane survivors from the 2017 and 2018 hurricane seasons. The resulting sample was 49.5% Latine, offering unique opportunities for important comparisons.</p><p><strong>Results: </strong>Across multiple components of the BBN, use was not significantly different between Latine and non-Latine participants (<i>p</i> > .05). Efficacy was also similar based on latent change score models (<i>p</i> > .05). Latine participants reported higher education, similar rates of past-month mental health access, and higher rates of past-month counseling/therapy compared with non-Latine Whites. Approximately, half of Latine and non-Latine participants with significant symptoms had not received mental health care in the last month.</p><p><strong>Conclusions: </strong>Together, results suggest that BBN resulted in similar rates of use and efficacy, and BBN reached a substantial proportion of those who were not receiving care across both non-Latine White and Latine participants. We outline additional suggestions for enhancing the capacity for tools like BBN to help address mental health equity.</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1535-1543"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12333541/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144799996","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integrating art-based activities in racial stress and trauma treatment: Therapists' perspectives on benefits, challenges, and techniques.","authors":"Susanne Birnkammer, Sophia M Gran-Ruaz, Claudia Calvano, Monica Mikhail, Monnica T Williams","doi":"10.1037/tra0002274","DOIUrl":"https://doi.org/10.1037/tra0002274","url":null,"abstract":"<p><strong>Objective: </strong>Racial stress and trauma profoundly affect the mental health of racialized individuals, yet culturally responsive therapeutic approaches remain underdeveloped. Art-based activities may provide alternative pathways for emotional processing and engagement. This study explored therapists' perspectives on integrating art-based activities into racial trauma treatment, focusing on clinicians trained in the Healing Racial Trauma Protocol, a manualized cognitive-behavioral intervention.</p><p><strong>Method: </strong>Semistructured interviews were conducted with 10 therapists (six Black, Indigenous, and People of Color, four White; <i>M</i>_age = 36.6 years; 70% female) who had delivered the Healing Racial Trauma Protocol. Framework analysis was used to identify themes related to prior use of art-based activities in psychotherapy, perceived benefits and barriers, client suitability, therapists' experiences of discomfort discussing race, and conditions necessary for effective integration.</p><p><strong>Results: </strong>Therapists reported multiple benefits of art-based activities, including increased engagement, emotional expression, and insight. Creative activities were considered particularly helpful for clients with limited verbal expression or tendencies toward overintellectualization. Barriers included client hesitancy, cultural considerations, and practical constraints. White therapists described discomfort navigating racial dynamics, highlighting the importance of cultural humility and supervision. Effective integration depended on flexible timing, individualized adaptation, and adequate training and support.</p><p><strong>Conclusions: </strong>Findings support a preliminary process model identifying key components for the ethical and effective integration of art-based activities into racial trauma treatment. Results inform therapist training and culturally responsive clinical practice. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":""},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149114142","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":"Exploring the relationship between changes in negative posttrauma cognitions and pain intensity in veterans undergoing intensive treatment.","authors":"Sacha McBain, Dale L Smith, Sarah Pridgen, Philip Held","doi":"10.1037/tra0002022","DOIUrl":"10.1037/tra0002022","url":null,"abstract":"<p><strong>Objective: </strong>This study examined whether improvements in posttrauma cognitions during intensive posttraumatic stress disorder (PTSD) treatment were associated with reduced pain intensity in veterans.</p><p><strong>Method: </strong>Participants included 497 veterans with PTSD enrolled in a 2-week intensive PTSD treatment program. Pain intensity and posttrauma cognitions were assessed at baseline, mid-treatment, and posttreatment. Ordinal logistic mixed effects models analyzed the association between changes in posttrauma cognitions and pain intensity, with military sexual trauma (MST) status as a potential moderator. A sensitivity analysis examined whether these associations remained after accounting for PTSD symptom change.</p><p><strong>Results: </strong>Reductions in posttrauma cognitions were significantly associated with decreases in average (<i>b</i> = 1.01, <i>p</i> < .001), current (<i>b</i> = 1.01, <i>p</i> < .001), and worst pain levels (<i>b</i> = 1.01, <i>p</i> < .001), though effect sizes for change in pain intensity were modest (ds between 0.23 and 0.30). This association was no longer significant when adjusting for PTSD symptom changes during the program. MST history did not predict pain outcomes or moderate the association between posttrauma cognition changes and pain. When controlling for PTSD symptom change, the association between posttrauma cognitions and pain was no longer significant.</p><p><strong>Conclusions: </strong>Improvements in posttrauma cognitions were initially linked to reduced pain intensity, suggesting that trauma-focused interventions targeting negative appraisals may support pain relief. However, sensitivity analysis indicated that these effects may be accounted for by overall PTSD symptom improvement. Further studies should clarify the distinct and overlapping contributions of cognitive and symptom change in pain outcomes in veterans with co-occurring PTSD and pain. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1572-1580"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13419019/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144761082","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Measurement invariance of the Spanish University of California at Los Angeles Posttraumatic Stress Disorder Reaction Index for the Diagnostic and Statistical Manual of Mental Disorders, fifth edition-brief form in Puerto Rico following Hurricane Maria.","authors":"Evan Rooney, Rosaura Orengo-Aguayo, John Young, Regan W Stewart","doi":"10.1037/tra0001937","DOIUrl":"10.1037/tra0001937","url":null,"abstract":"<p><strong>Objective: </strong>Natural disasters are a salient source of traumatic exposures for many youth, although not all youth exposed to these traumatic experiences go on to develop posttraumatic stress symptoms or other maladaptive reactions. Given the low resource context and high need for psychological support engendered by natural disasters globally, efficient, evidentiary, culturally appropriate tools for assessing risk are needed to effectively identify youth most in need of services.</p><p><strong>Method: </strong>The present study used a sample of 96,108 Puerto Rican youth collected in 2018, 5-9 months after Hurricane Maria in 2017, to examine the psychometric properties of a Spanish translation of the University of California Los Angeles Posttraumatic Stress Disorder Reaction Index-Brief Form (RI-5-BF). Participants completed measures of hurricane exposure, posttraumatic stress symptoms, and depressive symptoms.</p><p><strong>Results: </strong>Results indicated a strong fit between the data and the four-factor <i>Diagnostic and Statistical Manual of Mental Disorders, fifth edition</i>, model of posttraumatic stress disorder (root-mean-square error of approximation = .030, 90% confidence interval [.029, .031], Tucker-Lewis index = .976, comparative fit index = .983) and multigroup factor analysis indicated measurement invariance by gender at the scalar level. Normative values for this population by grade and gender were also estimated by examining the descriptive statistics of participants' responses and convergent validity analysis indicated a strong relationship between the University of California Los Angeles Posttraumatic Stress Disorder Reaction Index-Brief Form total score and a measure of depressive symptoms (<i>r</i> = .64).</p><p><strong>Conclusions: </strong>The implications of psychometric research for improving global efforts to triage and respond to psychological distress in the aftermath of natural disasters are discussed, with an emphasis on the critical need for psychometric research to diversify through development and adaptation of instruments in global populations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1527-1534"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144008941","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":"Identifying intervention targets in the COVID-19 pandemic-related psychopathological network among adolescents: A simulating intervention study.","authors":"Li Wang, Chen Chen, Chengqi Cao, Ping Liu, Yajie Bi, Shu Luo, Emma Grace, Miranda Olff, Gabriela Lunansky","doi":"10.1037/tra0001994","DOIUrl":"10.1037/tra0001994","url":null,"abstract":"<p><strong>Objective: </strong>Network approaches to the pandemic-related psychopathology could help identify the effective targets for interventions in adolescents. However, previous studies involved only limited forms of psychopathology related to stress and trauma and relied on the traditional centrality analysis. This study aimed to identify more effective intervention targets of pandemic-related psychopathological symptoms in a large-scale sample of adolescents using a newly developed network-based simulation intervention technique.</p><p><strong>Method: </strong>Data were yielded from an online survey in China conducted 3 months after the first wave of the pandemic, and participants endorsing at least one pandemic-related psychopathological symptom measured with the Global Psychotrauma Screen for Teenagers (<i>n</i> = 32,932) were included in the analyses. Network structure was estimated using the Ising model. Simulation interventions were implemented using the NodeIdentifyR algorithm. In the NodeIdentifyR algorithm, alleviating or aggravating interventions were implemented by decreasing or increasing the probability of a symptom being present.</p><p><strong>Results: </strong>Psychopathological symptoms were connected tightly, and depressed mood demonstrated the highest strength centrality. The NodeIdentifyR algorithm indicated that restlessness had the strongest projected effect on decreasing the sum score after alleviating interventions, and depressed mood had the strongest projected effect on increasing the sum score after aggravating interventions.</p><p><strong>Conclusions: </strong>Adolescents exposed to the pandemic would experience a range of interacted psychopathological symptoms and depressed mood, and restlessness might serve as a central node in activating and maintaining the symptoms, respectively. These findings contribute to the current understanding of psychopathology among adolescents following the pandemic and inform the development of mental health strategies for this particular population. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1383-1390"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144675541","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":"Understanding the link between racial discrimination and traumatic stress symptoms among Black youth: The role of co-rumination and racism-related vigilance.","authors":"Donte L Bernard, Chardée A Galán","doi":"10.1037/tra0002026","DOIUrl":"10.1037/tra0002026","url":null,"abstract":"<p><strong>Objective: </strong>Racial discrimination represents a pernicious source of trauma for Black youth that can critically hinder mental health. This cross-sectional study examined whether racism-related co-rumination and racism-related vigilance function as distinct and sequential pathways linking racial discrimination to traumatic stress symptoms (TSS) among a sample of Black adolescents.</p><p><strong>Method: </strong>Data were drawn from a national sample of 195 Black adolescents (<i>M</i>_age = 14.52; 49% female) who completed questionnaires assessing racial discrimination, racism-related co-rumination, racism-related vigilance, and TSS.</p><p><strong>Results: </strong>Path analyses assessed direct and indirect associations between discrimination and TSS via racism-related co-rumination and vigilance. Racial discrimination was positively associated with TSS when indirect effects were not considered. Examinations of indirect effects illustrated that discrimination was not associated with TSS through racism-related co-rumination but was via the vigilance path. Serial mediation analysis showed that racism-related co-rumination and, in turn, racism-related vigilance partially explained the link between racial discrimination and TSS.</p><p><strong>Conclusions: </strong>Findings highlight the significance of discrimination-related coping responses and underscore the need for culturally informed interventions that augment how Black youth navigate racism-related stressors.</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1519-1526"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12396505/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144966551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A qualitative study on transgenerational trauma in emerging adults.","authors":"Marlena M Salters, Lisa P Armistead, Christopher C Henrich","doi":"10.1037/tra0001852","DOIUrl":"10.1037/tra0001852","url":null,"abstract":"<p><strong>Objective: </strong>Given the potential impact on brain development and social issues related to trauma, better understanding and attending to transgenerational trauma (TT) are necessary. Typically, specific groups are examined when studying TT, which limits research on universal aspects. The present study presents qualitative data from a college sample of emerging adults between the ages of 18 and 23. This study was performed to identify potential indicators of TT.</p><p><strong>Method: </strong>The Family Impact Study Questionnaire was initially constructed after a literature review and revised after cognitive interviews from a college sample of 11 emerging adults. Fifty-six ethnically diverse participants completed the Family Impact Study Questionnaire.</p><p><strong>Results: </strong>Findings suggest 10 indicators related to TT. Six indicators, dangerous place, overprotection, parental role reversal, neglect, perceived parental burden, and resilience are consistent with current findings in the literature. Four indicators, no knowledge, no effect, concerns about transference of parental issues, parental behavior as a model, and importance of exposure expand on current findings in the literature.</p><p><strong>Conclusions: </strong>This research suggests that further development of the Family Impact Study Questionnaire into a mixed methods TT measure would help to advance knowledge of the TT construct. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1401-1408"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143024335","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":"Emotional hypervigilance: Development of a new questionnaire and examining the importance to posttraumatic quality of life.","authors":"Alison M Bacon, Alyson Norman","doi":"10.1037/tra0002065","DOIUrl":"10.1037/tra0002065","url":null,"abstract":"<p><strong>Objective: </strong>Hypervigilance is a symptom of posttraumatic stress disorder usually defined in terms of behaviors such as environment scanning and planning escape routes. The objective of Study 1 was to develop a new measure to assess the extent to which individuals employ a specifically emotional form of hypervigilance. The aim of Study 2 was to investigate whether emotional hypervigilance is associated with posttraumatic quality of life in addition to the known effects of symptoms and experiential avoidance.</p><p><strong>Method: </strong>Study 1 presents the development and initial testing (<i>N</i> = 275) of the Emotional Vigilance and Awareness Questionnaire (EVAQ). In Study 2, a nonclinical sample (<i>N</i> = 162) completed an online survey comprising the EVAQ, measures of posttraumatic symptoms, posttraumatic quality of life, and experiential avoidance.</p><p><strong>Results: </strong>In Study 1, factor analyses resulted in a 12-item scale, which showed good psychometric properties in unifactorial and three factorial forms. Subscales reflected vigilance to emotion change, emotion awareness, and conscious emotion monitoring. The EVAQ showed incremental validity against the Brief Hypervigilance Questionnaire and positive associations with established measures of low mood and negative affect. In Study 2, EVAQ scores showed significant associations with experiential avoidance and posttraumatic quality of life.</p><p><strong>Conclusions: </strong>The EVAQ is a valid and reliable new measure for assessing hypervigilance and hyperawareness of emotion, an overlooked factor in posttraumatic symptomology, particularly when considered as a unifactorial construct. The EVAQ may be useful in research and therapeutic settings with individuals who disengage with distressing emotions and present avoidant behavior. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1429-1439"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145459794","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":"Trauma typologies and internalizing psychopathology: A hierarchical perspective on the unique role of congruent and incongruent criterion a stressors.","authors":"Travis A Cole, Laura E Ong, Benjamin Carsten, Peter C Tappenden, Anthony N Reffi, Holly K Orcutt","doi":"10.1037/tra0001873","DOIUrl":"10.1037/tra0001873","url":null,"abstract":"<p><strong>Objective: </strong>Trauma exposure poses a risk for diagnoses beyond trauma and stressor-related disorders listed in current psychological taxonomies. Alternative models, such as the Hierarchical Taxonomy of Psychopathology, posit that psychological phenomena are better organized in a hierarchical manner, with broader dimensions accounting for the covariation among lower order syndromes. Thus, the present study investigated the relationships between trauma exposure and internalizing syndromes through higher order psychological dimensions.</p><p><strong>Method: </strong>Undergraduates (N = 585) at a large midwestern university completed questionnaires, which included the Life Events Checklist for the <i>Diagnostic and Statistical Manual of Mental Disorders</i> (5th ed.), the Posttraumatic Stress Disorder Checklist for the <i>Diagnostic and Statistical Manual of Mental Disorders</i> (5th ed.), the Inventory for Depression and Anxiety Symptoms (2nd ed.), and the Childhood Trauma Questionnaire. Three structural equation models with stressors congruent and incongruent with Criterion A listed as predictors were used to examine the total, indirect, and direct effects for all internalizing indicators and first-order factors.</p><p><strong>Results: </strong>After accounting for higher order dimensions, only insomnia and panic maintained a unique portion of variance explained by trauma variety. Trauma variety and interpersonal index traumas explained unique proportions of posttraumatic stress symptoms, but not distress or fear.</p><p><strong>Conclusions: </strong>Findings support the utility of assessing stressors through shared mechanisms within a hierarchical framework and substantiate trauma-induced insomnia theories through a novel relationship between trauma variety and insomnia. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1409-1419"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12318114/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143080908","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"心理学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Engagement and completion of evidence-based psychotherapy for PTSD among American Indian/Alaska Native, Latino, and White veterans.","authors":"Madeleine S Goodkind, Alexis M Sheffield, Emily N Kuehn, Carsten B Torgeson, Minden B Sexton, Diana C Bennett","doi":"10.1037/tra0001984","DOIUrl":"10.1037/tra0001984","url":null,"abstract":"<p><strong>Objective: </strong>Among psychotherapeutic treatments for posttraumatic stress disorder, prolonged exposure, and cognitive processing therapy have distinguished themselves with their high efficacy and strong backing in the treatment literature. However, low patient retention undermines the benefit of these evidence-based psychotherapies. Underrepresentation of Latinx and American Indian/Alaska Native (AI/AN) veterans in posttraumatic stress disorder research has rendered it difficult to determine ethno-racial disparities in patient retention. Despite serving in the U.S. military at high rates, Latino and AI/AN veterans are especially underrepresented in the existing research regarding engagement and efficacy of evidence-based psychotherapies for posttraumatic stress disorder.</p><p><strong>Method: </strong>This study examined treatment selection, initiation, receipt of minimally adequate care, and completion among 708 male White, Latino, and AI/AN veterans seeking prolonged exposure or cognitive processing therapy in an outpatient Veterans Health Administration specialty clinic.</p><p><strong>Results: </strong>Analyses revealed levels of treatment retention differed significantly between ethnoracial groups. After selecting treatment, AI/AN veterans were more likely to never attend any protocol sessions and had a shorter time to attrition compared with White veterans.</p><p><strong>Conclusion: </strong>The results of this study demonstrate barriers to treatment engagement and retention experienced by different ethnoracial groups and inform culturally sensitive considerations.</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1478-1487"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145960132","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}