Racism-Related Experiences and Traumatic Stress Symptoms in Ethnoracially Minoritized Youth: A Systematic Review and Meta-Analysis.

OBJECTIVE: Despite growing evidence demonstrating the association between racial and ethnic discrimination and traumatic stress symptoms in adult populations, the research among youth remains sparse. Drawing upon race-based traumatic stress models, and following the PRISMA-2020 guidelines, this systematic review and meta-analysis aimed to identify the state of the empirical evidence in the association between racism-related experiences and traumatic stress symptoms in ethnoracially minoritized youth. METHOD: Scientific databases were searched to identify articles with ethnoracially minoritized youth participants under age 18 years old that examined the association between racial and/or ethnic discrimination and traumatic stress symptoms. RESULTS: A total of 18 articles comprising 16 studies (N = 4,825 participants) met inclusion criteria. Studies were largely cross-sectional, used nonrandom sampling strategies, focused on Black and Latinx youth, and were conducted in the United States. Furthermore, most studies were theoretically grounded and operationalized racism-related experiences as frequency of direct, personal, everyday discrimination. Few studies examined other dimensions of racism-related experiences. The meta-analysis demonstrated a significant positive association with a medium effect size, rpooled = .356, 95% confidence interval [CI] = 0.27, 0.44, between racism-related experiences and traumatic stress symptoms. No evidence of moderation by age, sex/gender, race/ethnicity, country, or recruitment setting was detected. CONCLUSION: Racism-related experiences may confer risk for traumatic stress symptoms in ethnoracially minoritized youth. Attending to racism-related experiences is critical to improve the cultural responsiveness of trauma-informed services.

Mediators and Moderators of Active Music Engagement to Reduce Traumatic Stress Symptoms and Improve Well-being in Parents of Young Children With Cancer.

OBJECTIVE: This trial examined the effects of proximal/distal mediators and moderators of an Active Music Engagement (AME) intervention on young child/parent distress, quality of life, and family function outcomes. METHODS: Child/parent dyads (n = 125) were randomized to AME or Audio-storybooks attention control condition. Each group received 3 sessions with a credentialed music therapist for 3 consecutive days with data collection at baseline, post-intervention (T2), and 30-days later (T3). Potential proximal mediators included within session child and parent engagement. Potential distal mediators included changes in perceived family normalcy, parent self-efficacy, and independent use of play materials. Potential moderators included parent/child distress with prior hospitalizations, parent traumatic stress screener (PCL-6), and child age. Outcomes included child emotional distress and quality of life; parent emotion, traumatic stress symptoms (IES-R), well-being; and family function. Mediation effects were estimated using ANCOVA, with indirect effects estimated using the percentile bootstrap approach. Moderation effects were tested by including appropriate interaction terms in models. RESULTS: No significant mediation effects were observed. Child distress with prior hospitalizations moderated AME effects for IES-R intrusion subscale scores at T2 (P = .01) and avoidance subscale scores at T3 (P = .007). Traumatic stress screener scores (PCL-6) moderated intervention effects for IES-R hyperarousal subscale scores at T2 (P = .01). There were no moderation effects for child age. CONCLUSIONS: AME is a promising intervention for mitigating traumatic stress symptoms and supporting well-being in parents of children with cancer, particularly for parents who screen high for traumatic stress and whose children are more highly distressed with hospitalization.

Traumatic Stress-Induced Increases in Anxiety-like Behavior and Alcohol Self-Administration Are Mediated by Central Amygdala CRF1 Neurons That Project to the Lateral Hypothalamus.

Avoidance stress coping, defined as persistent internal and/or external avoidance of stress-related stimuli, is a key feature of anxiety- and stress-related disorders, and contributes to increases in alcohol misuse after stress exposure. Previous work using a rat model of predator odor stress avoidance identified corticotropin-releasing factor (CRF) signaling via CRF Type 1 receptors (CRF1) in the CeA, as well as CeA projections to the lateral hypothalamus (LH) as key mediators of conditioned avoidance of stress-paired contexts and/or increased alcohol drinking after stress. Here, we report that CRF1-expressing CeA cells that project to the LH are preferentially activated in male and female rats that show persistent avoidance of predator odor stress-paired contexts (termed Avoider rats), and that chemogenetic inhibition of these cells rescues stress-induced increases in anxiety-like behavior and alcohol self-administration in male and female Avoider rats. Using slice electrophysiology, we found that prior predator odor stress exposure blunts inhibitory synaptic transmission and increases synaptic drive in CRF1 CeA-LH cells. In addition, we found that CRF bath application reduces synaptic drive in CRF1 CeA-LH cells in Non-Avoiders only. Collectively, these data show that CRF1 CeA-LH cells contribute to stress-induced increases in anxiety-like behavior and alcohol self-administration in male and female Avoider rats.SIGNIFICANCE STATEMENT Stress may lead to a variety of behavioral and physiological negative consequences, and better understanding of the neurobiological mechanisms that contribute to negative stress effects may lead to improved prevention and treatment strategies. This study, performed in laboratory rats, shows that animals that exhibit avoidance stress coping go on to develop heightened anxiety-like behavior and alcohol self-administration, and that these behaviors can be rescued by inhibiting the activity of a specific population of neurons in the central amygdala. This study also describes stress-induced physiological changes in these neurons that may contribute to their role in promoting increased anxiety and alcohol self-administration.

The mediation role of resilience and postpartum traumatic stress disorder on parental attachment and the maternal-infant bonding.

AIMS: This study aimed to evaluate the correlation between parental attachment, resilience, postpartum traumatic stress disorder (PTSD), and maternal-infant bonding at 1 to 3 months postpartum. The mediation effect of resilience and PTSD on the postpartum parental attachment and maternal-infant bond was also evaluated. DESIGN: A cross-sectional research design was used. METHODS: A total of 400 postpartum women examined at a tertiary hospital in Wuhan from January 2021 to June 2021 were enrolled in the study. At about 1 to 3 months after giving birth, the women were asked to complete the Postpartum Bonding Questionnaire (PBQ), Connor-Davidson Resilience scale(CD-RISC), PTSD CheckList-Civilian version (PCL-C), and the Parental Bonding Instrument (PBI). The data were summarized using descriptive statistics. Mediation analyse and the Spearman correlation (r) were used to correlate the resilience and PTSD questionnaire scores. RESULTS: The care attachment dimension was significantly associated with resilience (r = 0.24, p < 0.01), PTSD (r = - 0.27, p < 0.01), and maternal-infant bonding (r = 0.10, p < 0.01), and the overprotection attachment dimension was significantly associated with resilience (r = - 0.11, p < 0.01), PTSD (r = 0.33, p < 0.01), and maternal-infant bonding (r = 0.16, p < 0.01). Resilience and PTSD can mediate the relationship between attachment and maternal-infant bonding. CONCLUSION: Parental attachment, resilience, and PTSD significantly affect maternal-infant bonding at 1 to 3 months postpartum. IMPACT: This study demonstrated that new interventions aimed at addressing PTSD symptoms and improving resilience might increase parental attachment and maternal-infant bonding after birth. However, further research is required to evaluate the success of these interventions.

Maternal steroids during pregnancy and their associations with exposure to lifetime stressful life events, prenatal stress appraisal and psychological functioning.

BACKGROUND: During pregnancy, steroids enable physiological adaptations in response to many factors, including maternal stress or psychological functioning. While stress and psychological dysfunction can have endocrine-disrupting effects beyond cortisol disruption, associations between prenatal maternal stress or related psychological dysfunction and the broader steroid milieu remain understudied. AIM: To assess associations between independent and joint maternal stress and psychological functioning measures and steroid profiles in pregnancy (22-40 gestational weeks) in the Programming of Intergenerational Stress Mechanisms (PRISM) birth cohort (n = 334). METHODS: Serum metabolomics detected 42 steroids and their metabolites, which were grouped into five classes (pregnenolone, androgens, estrogens, progestin, and corticosteroids). The Perceived Stress Scale, Life Stressor Checklist-Revised, and Edinburgh Postnatal Depression Scale indexed lifetime traumatic/non-traumatic stressors, global prenatal stress appraisal, and depressive symptoms during pregnancy, respectively. Exposures were categorized as high-low using the corresponding 3rd quartiles. We assessed associations between both individual and joint stress exposures with steroid classes using linear mixed effect models and with individual steroids using linear regressions. We also examined fetal sex-specific effects. RESULTS: High prenatal perceived stress was independently associated with lower levels of androgens and estrogens in the overall sample [ß (95%CI): androgens: -0.13 (-0.25;-0.01); estrogens: -0.16 (-0.31;-0.01)], particularly among women carrying males [androgens: -0.22 (-0.39;-0.05); estrogens: -0.28 (-0.50;-0.07)]. Results on estrogens were consistent when considering joint exposure to both greater lifetime stressors and higher prenatal perceived stress. We also found a single testosterone metabolite-5alpha-androstan-3alpha,17alpha-diol disulfate-negatively associated with both individual high perceived stress and joint exposure to high lifetime stressors and high perceived stress among women carrying males. CONCLUSIONS: Increased maternal perceived stress experienced in pregnancy was independently associated with lower maternal androgen and estrogen levels during pregnancy in the overall sample, particularly among women carrying males. Results on estrogens were consistent when we considered the joint exposure of increased lifetime stressors and higher prenatal perceived stress.

Effects of shear stress path and roughness on shear creep behavior of marine clay-concrete interface.

Floating piles have been widely employed as foundations in coastal regions abounding with marine clay. A growing concern for these floating piles is their long-term performance of bearing capacity. To better understand the time-dependent mechanisms behind the bearing capacity, in this paper a series of shear creep tests was conducted to study the effects of load paths/steps and roughness on shear strain of the marine clay-concrete interface. Four main empirical features were observed from the experimental results. First, the creep process of the marine clay-concrete interface can be largely decomposed into the instantaneous creep stage, the attenuation creep stage and the uniform creep stage. Second, the creep stability time and the shear creep displacement generally increase as the shear stress level increases. Third, the shear displacement rises as the number of loading steps drops under the same shear stress. The fourth feature is that under the shear stress condition, the rougher the interface is, the smaller the shear displacement is. Besides, the load-unloading shear creep tests suggest that: (a) shear creep displacement typically contains both viscoelastic and viscoplastic deformation; and (b) the proportion of unrecoverable plastic deformation increases with increasing shear stress. These tests confirm that the Nishihara model can provide a well-defined description of the shear creep behavior of marine clay-concrete interfaces.

Moving From Traumatic Events to Traumatic Experiences in the Study of Traumatic Psychopathology.

Trauma is defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) as an event that includes "actual or threatened death, serious injury, or sexual violence" (p. 271). The list of traumatic events included in the DSM-5 represents a long history of psychiatry and psychology's attempts to define trauma and differentiate these events from less severe stressors. In this commentary, we suggest that this strict distinction between traumatic events and stressful events is not useful for public health. The current DSM-5 list of traumatic events may work well for identifying people with the most severe experiences and highest conditional probability of distress who need clinical care. However, the public health field has different priorities. If we think about posttraumatic psychological distress on a population scale, it is not only helping those with the most severe experiences that is needed; rather, public health requires paying attention to all people experiencing distressing stress and trauma reactions. We propose that context is crucial to the development of a population-relevant definition of trauma and provide examples of situations in which stressors have resulted in posttraumatic psychological distress and in which traumatic event reactions have been mitigated by the context in which they occur. We discuss trauma context from an epidemiologic perspective and conclude with recommendations for the field. This article is part of a Special Collection on Mental Health.

Crises in the Anthropocene.

2022 was a year of crises, not just one but multiple intersecting crises that caused traumatic stress in billions of people worldwide. COVID-19 is still not over. New wars have started, and the climate change impact is bigger than ever. Will the Anthropocene be an era of continued crises? This past year the European Journal of Psychotraumatology (EJPT) has again tried to contribute to how to prevent or treat the consequences of these major crises as well as other events and we will continue to do so the year to come. For instance, we will have special issues or collections addressing these big issues, such as climate change and traumatic stress, or early intervention after trauma or in times of conflict. In this editorial, we also present the past year's excellent journal metrics regarding reach, impact, and quality and the ESTSS EJPT award finalists for best paper of 2022 and look forward to 2023.

2022 was a year of multiple intersecting crises causing traumatic stress to billions of people around the world.European Journal of Psychotraumatology (EJPT) aims to contribute to how to understand, prevent or treat the consequences of these major crises.EJPT's editorial team again achieved excellent journal metrics regarding reach, impact, and quality in 2022.

History of the term 'appeasement': a response to Bailey et al. (2023).

This letter to the editor aims to address claims made by Bailey et al. [2023. Appeasement: Replacing Stockholm syndrome as a definition of a survival strategy. European Journal of Psychotraumatology, 14(1), 2161038] about the history of the concept of appeasement in relation to mammalian survival responses as well as the fawn response, by offering a brief overview and analysis of the literature.

Appeasement in political and foreign policy, social justice, ethology, psychology, and communication studies (multiple mammalian and avian species) feature elements of coregulation.The original conceptualisation of the fawn response may result in the misperception that it is unrelated to coregulation.Appeasement and coregulation can occur whether the vulnerable party initiating the appeasement is in a state that supports affiliative, distress, or shutdown behaviour.

Posttraumatic Stress and Perceived Interpersonal Provocation in Adolescents.

Objective: To examine the impact of posttraumatic stress on the choice of responses to and attribution of intentionality in peer provocation in adolescent boys and girls. Methods: A sample of 2678 adolescents from Northern Russia, aged 13-17 years (59.3% female; 95.7% ethnic Russian) completed self-reports on posttraumatic stress and rated hypothetical peer provocation scenarios that teenagers can encounter in their daily lives. Results: Adolescents with clinically significant levels of posttraumatic stress symptoms (n=184 (6.8%)) reported a different pattern of reactions to peer provocation as compared to all other adolescents. Boys and girls with high levels of posttraumatic symptoms reported that they would be less likely to discuss conflict situations and more likely to react with physical aggression. Compared to their male counterparts, girls with high levels of posttraumatic stress symptoms were more likely to endorse hostile intentions, avoid provocations, and were less likely to endorse verbally aggressive responses. In provocation scenarios that involved physical aggression, girls with high levels of posttraumatic stress symptoms were less likely to endorse verbal aggressive responses and more likely to endorse physically aggressive responses than girls without clinically significant levels of posttraumatic symptoms. Girls with high levels of posttraumatic stress symptoms were also more likely to avoid socially aggressive situations than non-traumatized girls, whereas boys had an opposite pattern. Conclusions: High levels of posttraumatic stress symptoms may play a significant role in the endorsement of aggressive reactions in conflicts with peers and patterns of reactions may be gender-specific. A history of posttraumatic stress should be carefully evaluated in children and adolescents seeking treatment for aggressive behavior.

The position statement of the Working Group on the diagnosis of the post-traumatic stress disorders in adults. / Stanowisko grupy roboczej dotyczace diagnozy zaburzen zwiazanych ze stresem pourazowym u osób doroslych.

Experiencing a situation of extreme danger can lead to serious stress disorders (such as PTSD) that can affect both the victims and the professional helpers. Military operations in Ukraine in the first half of 2022 started an ongoing migration crisis, resulting in the displacement of approximately 3.5 million people to Poland. It is indicated that post-traumatic stress disorders may affect up to one third of adult refugees. Exposure to traumatic stress related to assault, limitation of basic resources, fear, insecurity, death, and a sense of injustice affected the entire population of the country. As a result, refugees, healthcare professionals, uniformed services, volunteers, and NGO workers constitute a group at risk of developing stress-related disorders, including post-traumatic stress disorder (PTSD). The presented recommendations were developed by an interdisciplinary team of experts in the field of psychiatry, clinical psychology, psychotherapy, and family medicine to present systematic guidelines for diagnostic procedures in medical and psychological practice.

The association between peritraumatic distress, perceived stress, depression in pregnancy, and NR3C1 DNA methylation among Chinese pregnant women who experienced COVID-19 lockdown.

Prenatal stress can affect pregnant women in an epigenetic way during the critical period of conception of their offspring. The study aims to investigate the relationship between peritraumatic distress, prenatal perceived stress, depression, and glucocorticoid receptor (NR3C1) DNA methylation among pregnant women who experienced COVID-19 lockdown in China. Study data were collected from 30 pregnant women in Wuhan and Huanggang, China. The Peritraumatic Distress Inventory was used to measure peritraumatic distress, the Edinburgh Postnatal Depression Scale was used to measure depressive symptoms, and the Perceived Stress Scale was used to measure perceived stress. DNA methylation in the exon 1F promoter region of NR3C1 gene from the venous blood mononuclear cell genome was characterized by bisulfite sequencing. Correlation and linear regression were used for data analysis. The mean level of peritraumatic distress, perceived stress, and depression was 6.30 (SD = 5.09), 6.50 (SD = 5.41), and 6.60 (SD = 4.85), respectively, with 23.33% of pregnant women being depressed. The mean NR3C1 methylation was 0.65 (SD = 0.22). Prenatal depression was positively correlated with the degree of methylation in venous blood from the mother (r = 0.59, p = 0.001), and depression predicted methylation of NR3C1 gene at the CpG 8 site (ß = 0.05, p = 0.03). No association was found between peritraumatic distress as well as perceived stress and methylation of NR3C1. NR3C1 gene was susceptible to epigenetic modification of DNA methylation in the context of prenatal stress, and maternal depression was associated with increased NR3C1 methylation among women who experienced COVID-19 lockdown.

Using Danish national registry data to understand psychopathology following potentially traumatic experiences.

Research on posttraumatic psychopathology has focused primarily on posttraumatic stress disorder (PTSD); other posttraumatic psychiatric diagnoses are less well documented. The present study aimed to (a) develop a methodology to derive a cohort of individuals who experienced potentially traumatic events (PTEs) from registry-based data and (b) examine the risk of psychopathology within 5 years of experiencing a PTE. Using data from Danish national registries, we created a cohort of individuals with no age restrictions (range: 0-108 years) who experienced at least one of eight possible PTEs between 1994 and 2016 (N = 1,406,637). We calculated the 5-year incidence of nine categories of ICD-10 psychiatric disorders among this cohort and examined standardized morbidity ratios (SMRs) comparing the incidence of psychopathology in this group to the incidence in a nontraumatic stressor cohort (i.e., nonsuicide death of a relative; n = 423,270). Stress disorders (2.5%), substance use disorders (4.1%), and depressive disorders (3.0%) were the most common diagnoses following PTEs. Overall, the SMRs for the associations between any PTE and psychopathology varied from 1.9, 95% CI [1.9, 2.0], for stress disorders to 5.2, 95% CI [5.1. 5.3], for personality disorders. All PTEs except pregnancy-related trauma were associated with all forms of psychopathology. Associations were consistent regardless of whether a stress disorder was present. Traumatic experiences have a broad impact on psychiatric health. The present findings demonstrate one approach to capturing trauma exposure in medical record registry data. Increased traumatic experience characterization across studies will help improve the field's understanding of posttraumatic psychopathology.

Stressful Life Events Are Related to More Negative Interpretations, but Not Under Acute Stress.

Studies have identified deleterious effects of stress on multiple cognitive processes such as memory and attention. Little is known about the impact of stress on interpretation. We investigated how an induced acute stress and more long-term stress related to life events were associated with interpretations of ambiguous stimuli. Fifty participants answered a questionnaire indexing the number of stressful life events. A median split was used to compare those reporting few or more events. Half of participants performed an arithmetic task that induced acute stress; they were compared to a control group performing a less stressful task. We measured the interpretation of ambiguous visual stimuli, which participants had to judge as "negative" or "positive". We found a significant interaction between the number of stressful life events and the induced acute stress on the proportion of positive interpretations. In the control group, participants reporting more stressful events produced less positive interpretations than those reporting few events. In the induced stress condition, no significant difference was found. Life events tend to influence interpretation in the absence of an acute stressor, which seems to be more influent in the short term.

Conceptualizing the COVID-19, Opioid Use, and Racism Syndemic and Its Associations With Traumatic Stress.

Individually, the COVID-19 pandemic and opioid epidemic have each been responsible for hundreds of thousands of deaths. Systemic racism, including public perceptions about people who use opioids, inadequate substance abuse prevention and treatment efforts, heightened risks for COVID-19 exposure, and inadequate access to testing and health care, has contributed to the ongoing disparities underlying these health crises. Thus, the authors propose an integrative framework for conceptualizing the COVID-19, opioid use, and racism (COR) syndemic, with traumatic stress as a critical underpinning of this model. Action is needed to address trauma and the COR syndemic. Implications for research, practice, and policy are discussed.

Psychological state of a sample of patients with mood disorders during the first French COVID-19 lockdown.

Since the beginning of the COVID-19 pandemic, evidence shows the negative psychological impact of lockdown measures in the general population. It is also important to identify predictors of psychological distress in vulnerable people, particularly patients with history of depressive episodes (the most prevalent psychiatric disorder), in order to adapt mental health strategies for future lockdown measures. This study aim was to (1) compare in 69 healthy controls (HC) and 346 patients with a major depressive episode in the two previous years (PP) self-reported psychological symptoms (depression, anxiety, insomnia, suicidal ideation, traumatic stress, anger) and living conditions during the first national French lockdown, and (2) identify predictors of significant psychological distress in PP. The levels of psychological symptoms were very low in HC compared with PP, independently of the living conditions. Half of PP had no psychiatric contact during the lockdown. Loneliness and boredom were independent predictors of depression, anxiety and insomnia, whereas daily physical activity was a protective factor. Virtual contacts protected against suicidal ideation. Our results highlight the need of specific strategies to target loneliness and boredom and to improve care access, including telepsychiatry. Longitudinal studies must investigate the COVID-19 pandemic psychological impact in clinical samples.

[Progress of traumatic stress disorder in emergency rescue workers].

Emergency rescue workers are the high risk group of traumatic stress disorder. A large number of intervention studies on traumatic stress disorder have been carried out at home and abroad, but there are few applied researches on the emergency rescue population. As an occupational hazard faced by the emergency rescue population, traumatic stress disorder has not attracted enough attention. In this paper, the psychological intervention, drug intervention, psychological training and social support were reviewed.