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

{"title":"Distinguishing moral injury from burnout, secondary traumatic stress, and depression in animal care workers: A condition differentiation analysis.","authors":"Jamie McNally","doi":"10.1037/tra0002308","DOIUrl":"https://doi.org/10.1037/tra0002308","url":null,"abstract":"<p><strong>Objective: </strong>Animal care workers operate in conditions involving substantial occupational stressors that can significantly impact their mental health and well-being. Despite a growing awareness of these stressors, moral injury, a values-based condition arising from violations of deeply held moral beliefs, has not been empirically established in this population as a relevant condition distinct from burnout and compassion fatigue, the constructs that dominate the literature. The present study examined whether moral injury is empirically distinguishable from burnout, secondary traumatic stress, and depression and whether current frameworks adequately identify morally distressed workers.</p><p><strong>Method: </strong>A sample of 291 U.S.-based animal care workers completed the Moral Injury Outcome Scale, Professional Quality of Life Scale-5, and Patient Health Questionnaire-9. Condition differentiation was evaluated through correlation, regression, classification, and profile analyses.</p><p><strong>Results: </strong>Moral injury shared 17%-39% of variance with adjacent constructs, leaving 61%-83% unique variance. After controlling for depression, the moral injury-secondary traumatic stress association became nonsignificant while the moral injury-burnout association persisted. Moral injury demonstrated incremental validity for both depression and functional impairment beyond all Professional Quality of Life Scale subscales (Δ<i>R</i>² = .073 and .012, respectively). The shame subvariant drove depression prediction (β = .39) while trust violations did not. Professional Quality of Life Scale and depression scores alone correctly classified only 66.2% of moral injury caseness, whereas adding Moral Injury Outcome Scale subscales improved classification to 84.7%.</p><p><strong>Conclusions: </strong>Moral injury is empirically distinguishable from burnout, secondary traumatic stress, and depression, while existing assessment frameworks may fail to detect nearly half of morally distressed animal care workers, with implications for clinical assessment and intervention. (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":"149114211","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":"Co-occurrence of racism-based trauma symptoms and depressive symptoms among college students of color.","authors":"Michelle Flesaker, Brett Schneider, Akilah Patterson, Anthony J Rosellini, Sarah Ketchen Lipson, Jaimie L Gradus","doi":"10.1037/tra0002042","DOIUrl":"10.1037/tra0002042","url":null,"abstract":"<p><strong>Objective: </strong>Though research has established the relationship between racial discrimination and poor mental health among young adults of color, it is undetermined whether trauma symptoms of racial discrimination are associated with mental health symptoms in college students of color specifically. We examined the co-occurrence of posttraumatic stress symptoms attributed to racial discrimination and depressive symptoms and suicidal ideation in a large, national sample of young adult college students of color.</p><p><strong>Method: </strong>We used survey data from a national sample of young adult (18-24 year old) college students in the Healthy Minds Study (<i>N</i> = 19,265). A modified version of the Trauma Symptoms of Discrimination Scale (TSDS) was validated with factor analysis and used to measure posttraumatic symptoms attributed to racial discrimination. The Patient Health Questionnaire-9 (PHQ-9) was used to measure depressive symptoms.</p><p><strong>Results: </strong>Participants had an average modified TSDS score of 12.93 (<i>SD</i> = 5.76) on the scale from 7 to 28. The mean depressive symptoms (PHQ-9) score in the sample was 9.55 (<i>SD</i> = 6.53) on a scale of 0-27, and the prevalence of suicidal ideation was 16.9%. Regression analyses revealed that posttraumatic stress symptoms attributed to racial discrimination were associated with greater depressive symptoms (adjusted β = 0.41, 95% confidence interval, CI [0.38, 0.43]) and odds of suicidal ideation (adjusted odds ratio = 1.10, 95% CI [1.08, 1.12]).</p><p><strong>Conclusions: </strong>Our results underscore the importance of addressing stress and trauma responses from racial discrimination among young adult college students of color.</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1512-1518"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12483183/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145191948","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":"The impact of social support on world assumptions and PTSD symptoms in a sample of public safety communicators.","authors":"Allie K Jessen, Michelle M Lilly","doi":"10.1037/tra0001891","DOIUrl":"10.1037/tra0001891","url":null,"abstract":"<p><strong>Objective: </strong>Although they are the first involved in emergency response, 9-1-1 public safety communicators (PSCs) are largely excluded from studies on the effects of repeated exposure to duty-related traumatic events. Studies have shown that 9-1-1 PSCs experience negative health outcomes, including posttraumatic stress symptoms (PTSS).</p><p><strong>Method: </strong>This study aimed to understand the relationship between social support, world assumptions (e.g., beliefs regarding benevolence of the world, benevolence of people, and self-worth), and PTSS in 221 9-1-1 PSCs across the United States in a 1-year longitudinal study.</p><p><strong>Results: </strong>Social support was positively associated with world assumptions but negatively associated with PTSS, and PTSS were negatively related to world assumptions. Mediation models revealed that world assumptions at 6 months had indirect effects on the association between baseline social support and PTSS 1 year later.</p><p><strong>Conclusions: </strong>This study supports current conceptualizations of posttraumatic stress disorder and trauma treatments focused on identifying and challenging maladaptive beliefs. It may be beneficial to explore how public safety personnel's world assumptions impact their likelihood of reaching out for support. Because social support is largely associated with PTSS through people's assumptions about the world, other people, and themselves, interventions targeting world assumptions might be particularly advantageous for this population. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1457-1464"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543200","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":"Argentinean validation of the Early Trauma Inventory-Self-Report (ETI-SR) in an adult sample.","authors":"Angel M Elgier, Lucas G Gago-Galvagno, Ivonne A Grau-Gonzalez, Leonardo A Ortega","doi":"10.1037/tra0002298","DOIUrl":"https://doi.org/10.1037/tra0002298","url":null,"abstract":"<p><strong>Objective: </strong>Adverse childhood experiences affect long-term mental and physical health. In Argentina, the lack of validated tools limits accurate assessment of early trauma and hinders prevention strategies. This study adapted and validated the Early Trauma Inventory-Self-Report Short Form for Argentine adults and provided an initial standardized estimate of early trauma prevalence.</p><p><strong>Method: </strong>A total of 418 Argentine adults (<i>M</i> = 30.6, <i>SD</i> = 10.1; 74.4% female) completed the Early Trauma Inventory-Self-Report Short Form through web-based data collection. Confirmatory factor analyses were conducted using the weighted least squares estimator to evaluate competing models. Internal consistency was assessed using Cronbach's α and McDonald's ω coefficients. External validity was examined through correlations with age and educational level.</p><p><strong>Results: </strong>The bifactor model demonstrated the best fit to the data, supporting the presence of both a general trauma factor and specific trauma domains. Internal consistency indices were acceptable for most subscales, although lower values were observed for the general trauma dimension. Positive associations were found among trauma dimensions, and physical trauma showed significant relationships with age and educational level. High prevalence rates of early trauma were observed, with most participants reporting at least one adverse experience.</p><p><strong>Conclusions: </strong>The Early Trauma Inventory-Self-Report shows adequate psychometric properties for use in Argentina, providing preliminary support for its validity in this context. These findings contribute to addressing an important limitation in health measurement and support the development of standardized assessments for early trauma in Argentina. Further research using more representative samples is needed to confirm these results. (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":"149114213","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":"Inflexible responses to uncertainty: The mediating role of psychological inflexibility in the link between intolerance of uncertainty, traumatic stress, and somatic symptoms.","authors":"Chung Xiann Lim, Emily A Mueller, L Brooke Short, Rong Xia, Piraorn Suvanbenjakule, William H O'Brien","doi":"10.1037/tra0001860","DOIUrl":"10.1037/tra0001860","url":null,"abstract":"<p><strong>Objective: </strong>Intolerance of uncertainty (IU) and psychological inflexibility (PI) were shown to be risk factors of traumatic stress (TS) and somatic symptoms (SS) during COVID-19. The present study tested a structural equation model where PI mediated the relationships between IU, TS, and SS based on their theoretical and experimental overlaps. The contribution of all six PI facets including experiential avoidance (EA) and cognitive fusion (CF) were investigated.</p><p><strong>Method: </strong>The sample was made up of 656 participants who reported elevated scores for TS and SS. Mediation analysis was conducted via structural equation modeling to test the proposed model. A sensitivity analysis followed the mediation analysis. Follow-up hierarchical regressions were conducted to examine the individual contribution of each PI facet.</p><p><strong>Results: </strong>The overall model demonstrated a good fit (comparative fit index = .98; root-mean-square error of approximation = .07; total effects on TS and SS: β = .78, β = .60). IU was positively associated with TS and SS, and the relations were mediated by PI, with PI accounting for most of the effect. Hierarchical analyses revealed the less studied PI facets explained additional variance over and beyond EA and CF. EA and CF were no longer significant predictors of TS and SS after all PI facets were entered while controlling for IU and demographic variables.</p><p><strong>Conclusions: </strong>The findings were consistent with previous researchers positing PI as an overarching construct encompassing IU and other related psychological vulnerabilities. PI facets beyond EA and CF warrant more investigations. Clinically, PI and PI facets could be important intervention targets for high IU individuals in times of uncertainty. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1391-1400"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143543181","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":"Childhood neglect and its effect on self-conception and attachment in adulthood: A structural equation model.","authors":"Eleonora Topino, Alessio Gori","doi":"10.1037/tra0001921","DOIUrl":"10.1037/tra0001921","url":null,"abstract":"<p><strong>Objective: </strong>Neglect stands out as one of the most prevalent forms of childhood maltreatment. However, due to its less overt nature than other forms of abuse, it has received comparatively less attention in the scientific literature. To contribute in filling this gap, the present research aimed to delve deeper into the role of childhood neglect in influencing the structuring of self-image and interpersonal relationships in adulthood.</p><p><strong>Method: </strong>A total of 820 participants (<i>M</i>_age = 31.86 years; <i>SD</i> = 11.68) were included in the research. Structural equation modeling was implemented to analyze the collected data.</p><p><strong>Results: </strong>Among the participants, 27.5% fall within the range of individuals who reported experiencing emotional neglect in childhood (range from low to severe), while 18.6% fall within the range of those who reported physical neglect in childhood (range from low to severe). A significant and positive total effect in the relationship between childhood neglect and anxious attachment in adulthood was shown. Furthermore, self-concept significantly mediated this relationship. The role of age and gender as potential confounders was also controlled.</p><p><strong>Conclusions: </strong>Such data provide useful insight into the complex interplay of childhood neglect, self-concept, and attachment in adulthood, providing information that may inform and guide targeted clinical interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1420-1428"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143977563","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":"Stepped care for posttraumatic stress disorder: An open trial feasibility study.","authors":"Reginald D V Nixon, Larissa N Roberts","doi":"10.1037/tra0001828","DOIUrl":"10.1037/tra0001828","url":null,"abstract":"<p><strong>Objective: </strong>There is a need to evaluate stepped care approaches for individuals with posttraumatic stress disorder (PTSD). This pilot study tested the efficacy of combining a low-intensity program (This Way Up [TWU]) with the option to step up to an established higher intensity therapy (Cognitive Processing Therapy [CPT]).</p><p><strong>Method: </strong>This study was an open trial with participants with predominantly interpersonal trauma (<i>N</i> = 38). PTSD diagnosis and self-reported PTSD, depression symptoms, and quality of life were assessed at pretreatment, posttreatment, and 3-month follow-up for all participants (with TWU-only participants also assessed at 6 months).</p><p><strong>Results: </strong>Among the intent-to-treat sample, 24 participants only required TWU (21 completers), with 14 participants stepped up to CPT (TWU + CPT; nine completers). Significant improvements in PTSD, depression, and quality of life were observed for TWU and TWU + CPT participants, with gains maintained at follow-up. Effect sizes for PTSD outcomes (clinician- and participant-rated) ranged from medium to large, with larger reductions generally in the TWU group (e.g., PTSD gs: 1.96-3.54, vs. gs: 0.48-1.14 for TWU + CPT). Of the participants available at 3-month follow-up, 73% (<i>n</i> = 19/26) met good-end-state functioning for PTSD (TWU: 70.6%; TWU + CPT: 77.8%). Those who stepped up reported significantly greater symptoms at pretreatment than TWU-only participants.</p><p><strong>Conclusions: </strong>This stepped care approach appeared credible and feasible and demonstrated meaningful impact on mental health for participants who had predominately experienced interpersonal trauma. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1448-1456"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143524195","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":"Racial discrimination, racial trauma, and PTSD in college students.","authors":"Jennifer Valentine, Allie K Jessen, Michelle M Lilly","doi":"10.1037/tra0002041","DOIUrl":"10.1037/tra0002041","url":null,"abstract":"<p><strong>Objective: </strong>Extant literature has highlighted the links between experiences of racial discrimination and numerous symptoms of psychopathology, including posttraumatic stress disorder (PTSD) and racial trauma. This study aimed to further probe the relationship between racial discrimination, PTSD, and racial trauma through observing how the frequency of, and distress from experiences of racial discrimination relate to symptom clusters of racial trauma and PTSD, while controlling for nondiscrimination-based trauma history.</p><p><strong>Method: </strong>Participants were 303 racial minority undergraduate students who completed an online battery of questionnaires including the General Ethnic Discrimination Scale, Trauma Symptoms of Discrimination Scale, and PTSD Checklist for <i>Diagnostic and Statistical Manual of Mental Disorders, fifth edition</i>.</p><p><strong>Results: </strong>Path analysis revealed a significant relationship between the frequency and distress caused by experiences of racial discrimination and each symptom dimension of racial trauma (as captured by the Trauma Symptoms of Discrimination Scale). However, a path analysis demonstrated that only the frequency of experiences of discrimination was related to symptom clusters of PTSD.</p><p><strong>Conclusions: </strong>Findings from the present study suggest that the frequency of experiences of discrimination is related to symptoms of racial trauma and PTSD, but that discrimination-related distress may be more closely tied to symptoms of racial trauma than PTSD. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1504-1511"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145065434","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":"Screening for psychological trauma in patients with chronic pain: An Arizona survey of primary care providers identifies systems-level barriers to implementation.","authors":"Katherine E Herder, Bennet Davis, Benjamin R Brady, Franz Rischard, Steve Nash, Todd W Vanderah, Jennifer S De La Rosa","doi":"10.1037/tra0002094","DOIUrl":"10.1037/tra0002094","url":null,"abstract":"<p><strong>Objective: </strong>Efforts to achieve optimal outcomes in patients with chronic pain (CP) are impeded by unaddressed psychological trauma. Primary care offers a practical opportunity to identify patients with unresolved trauma through screening. However, the extent of such screenings in clinical practice remains unclear. This exploratory study aimed to assess trauma screening practices among Arizona primary care providers, examine their understanding of the trauma-CP connection, and investigate perceived barriers and opportunities for improving integration into primary care workflows.</p><p><strong>Method: </strong>We conducted a cross-sectional survey of Arizona primary care providers in family and internal medicine. Data on providers' practices, comfort levels, beliefs, and perceived barriers were analyzed.</p><p><strong>Results: </strong>The final sample comprised 71 survey respondents, with some variability in item response rates. Nearly all respondents (93.4%) acknowledged the connection between unresolved psychological trauma and CP, but only 23.9% consistently screened patients with CP for trauma. Screening rates for trauma among patients with CP were significantly lower compared to screening for anxiety/depression, social determinants of health, and substance use disorder. Reported barriers included feasibility concerns related to time and staffing, lack of patient-provider trust, and limited behavioral health access.</p><p><strong>Conclusions: </strong>While awareness of the CP-trauma link is widespread, trauma screening in Arizona primary care remains insufficient. Systemic barriers, rather than individual provider factors, appear most influential. Addressing time, staffing, and behavioral health integration challenges is critical for improving screening rates. Future research should focus on systemic factors to develop scalable, sustainable solutions for integrating trauma screening into primary care. (PsycInfo Database Record (c) 2026 APA, all rights reserved).</p>","PeriodicalId":20982,"journal":{"name":"Psychological trauma : theory, research, practice and policy","volume":" ","pages":"1554-1564"},"PeriodicalIF":2.8,"publicationDate":"2026-10-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145906518","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":"Training through trauma: A multivariate analysis of burnout and associated factors among physician trainees in Guatemala.","authors":"Tyra Fainstad, Claire Bradley, Ekshika Patel, Daisy Ramirez-Estrada, Jose C Monzon, Edgar Hidalgo, Adrienne Mann, Edwin J Asturias","doi":"10.1037/tra0002285","DOIUrl":"10.1037/tra0002285","url":null,"abstract":"<p><strong>Objective: </strong>Burnout is a pervasive occupational hazard in medicine, beginning early in training and linked to depression, suicide, medical errors, and attrition. While extensively studied in high-income countries, little is known from Latin America. Guatemala faces scarce mental health resources, social inequities, and limited residency regulation. This study aimed to characterize burnout, psychological distress, and moral injury among Guatemalan physicians in postgraduate medical training (\"residents\").</p><p><strong>Method: </strong>We conducted a cross-sectional survey of residents in Guatemala (September-October 2024). Surveys included demographics and validated Spanish-language instruments assessing burnout, depression, anxiety, stress, self-compassion, impostor syndrome, and moral injury. Logistic regression identified demographic and occupational risk factors.</p><p><strong>Results: </strong>Of 1,729 eligible residents, 589 (34.1%) responded; 504 (29.1%) completed surveys. Respondents averaged 30.6 years; 54.5% were female, and 95.6% Guatemalan. Most trained at the University of San Carlos (89.6%), with a minority at Universidad Mariano Galvez and \"other.\" Distress prevalence was high: 83% reported high emotional exhaustion, 90% high depersonalization, and 95% low personal accomplishment. Moderate-to-severe depression affected 32.7%, anxiety 40.7%, stress 49.2%, and impostor syndrome 41.2%. Moral injury was nearly universal (89.3%). Harassment and frequent 24-hr shifts were strongly associated with greater burnout, depression, anxiety, and stress. Female and lesbian, gay, bisexual, transgender, queer+ residents reported higher exhaustion, stress, impostor syndrome, and lower self-compassion. Mid-level trainees had an elevated risk of exhaustion.</p><p><strong>Conclusion: </strong>Guatemalan residents face unprecedented levels of burnout and moral injury, exceeding global rates. Modifiable factors, including harassment and workload, compound structural inequities. Findings underscore the urgent need for residency reform, standardized protections, and culturally responsive mental health infrastructure. (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":"2026-09-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"149075863","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}