What Measures are Effective in Trauma Screening for Young Males in Custody? A COSMIN Systematic Review.

Despite the available evidence identifying the high prevalence rates of potentially traumatic experiences in forensic populations, there is still a lack of evidence supporting the use of suitable assessment tools, especially for young males in custody. For services to identify, support, and offer trauma interventions to this cohort, practitioners require reliable and valid assessment tools. This systematic review (Open Science Framework registration: https://osf.io/r6hbk) identifies those tools able to provide valid, reliable, and comparable data for this cohort. Five electronic databases and gray literature were searched to identify relevant measures. Inclusion criteria: studies of tools to assess for trauma with males aged between 12 and 25 years-old in a custodial setting, any year of publication, and available in English. Exclusion criteria: studies that did not measure psychological trauma or include a standalone trauma scale, or report primary data. A three-step quality assessment method was used to evaluate the methodological quality and psychometric properties of the measures. Fourteen studies were selected for review (which included 12 measures). The studies sampled a total of approximately 1,768 male participants and an age range of 12 to 25 years. The studies reported on various types of psychometric evidence and due to the lack of homogeneity, a narrative synthesis was used to discuss, interpret, and evaluate each measure. The overall quality of the psychometric properties of the measures in this review showed that the currently available instruments for the assessment of trauma with young males in custody is limited but promising.

Factor structure of the international trauma questionnaire in trauma exposed LGBTQ+ adults: Role of cumulative traumatic events and minority stress heterosexist experiences.

Exposure to prolonged and/or multiple types of psychological trauma and stressors has been shown to be more strongly associated with ICD-11 complex posttraumatic stress disorder (CPTSD) than posttraumatic stress disorder (PTSD). Lesbian, gay, bisexual, trans- and queer adults (LGBTQ+) are at a heightened risk of exposure to traumatic events, and minority stressors including harassment, discrimination, rejection by family, and isolation. OBJECTIVE: To examine the factor structure of the international trauma questionnaire (ITQ), a self-report measure of PTSD and CPTSD, and the associations of cumulative lifetime trauma exposure assessed via the life events checklist and minority stress assessed via the daily heterosexist experiences scale, with CPTSD (three PTSD symptom clusters, three clusters reflecting disturbances in self-organization [DSO]) among LGBTQ + adults. METHOD: Participants comprised 225 LGBTQ + adults (including 74 transgender and gender diverse individuals; age range: 18-60 years; M/SD = 31.35/9.48) residing in Spain. RESULTS: Confirmatory factor analyses indicated that both a first-order six-factor model and a hierarchical two-factor model, comprising PTSD and DSO as second-order factors, fit the data best. Cumulative traumatic events score was associated with PTSD, and cumulative minority stress was associated with PTSD and DSO. Among the minority stress subscales, harassment based on gender expression was positively associated with all symptom clusters of PTSD and DSO. CONCLUSION: This is the first study to examine the role of minority stressors alongside exposure to psychological traumas in ICD-11 PTSD and CPTSD and emphasizes the inclusion of minority stressors in trauma-related assessments. (PsycInfo Database Record (c) 2023 APA, all rights reserved).

Can subjective perceptions of trauma differentiate between ICD-11 PTSD and complex PTSD? A cross-cultural comparison of three African countries. Correction to Palgi et al. (2021).

Reports an error in "Can subjective perceptions of trauma differentiate between ICD-11 PTSD and complex PTSD? A cross-cultural comparison of three African countries" by Yuval Palgi, Thanos Karatzias, Philip Hyland, Mark Shevlin and Menachem Ben-Ezra (Psychological Trauma: Theory, Research, Practice, and Policy, 2021[Feb], Vol 13[2], 142-148). In the article, the number of participants listed in the abstract was incorrectly reported as "2,554." The correct number is "2,524." The online version of this article has been corrected. (The following abstract of the original article appeared in record 2020-69781-001.) Background: The primary aim of the current study was to establish the cutoffs scores for the Subjective Traumatic Outlook (STO), a relatively new tool that examines the introspective worldview of those exposed to traumatic events. This tool was developed as a complementary scale to be used in conjunction with the observed-phenomenological measures of posttraumatic stress disorder (PTSD) complex PTSD (CPTSD). The present study examines the predictive power of STO for distinguishing between PTSD and CPTSD in African countries. Method: A national representative (based on age and gender) sample of 2,524 participants was drawn from 3 African countries (Nigeria, Kenya, and Ghana) who completed the International Trauma Questionnaire (ITQ) and the STO. We conducted a set of analyses examining that alignment of ITQ probable PTSD and CPTSD and different STO cutoff scores. Results: Results suggest that the STO single-factor structure was stable across countries, had a strong association with PTSD and CPTSD levels, and had predictive utility in differentiating between PTSD and CPTSD. Moreover, we found that there are different cutoffs for the STO in the different countries. Conclusion: There is a strong but distinctive association between the introspective and the observed-phenomenological approaches of PTSD and CPTSD. Our findings call for more integrative approaches for the assessment of PTSD and CPTSD and suggest that there are cultural differences in STO. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Improving the content validity of the Trauma and Adverse Childhood Experiences Survey (TRACES) and the Child and Adolescent PTSD Checklist for DSM-5 (CAPC-5): A collaborative research methodological approach.

OBJECTIVE: The current study aimed to improve the content validity of the Trauma and Adverse Childhood Experiences Survey (TRACES) and the Child and Adolescent PTSD Checklist for the DSM-5 (CAPC-5). METHOD: Two community-based collaborative research methods were used-cognitive interviewing and focus groups. Three rounds of cognitive interviews included a racially and economically diverse sample of 12 trauma-exposed youth and 12 caregivers. Three focus groups involved 19 clinicians with diverse disciplines and years of practice. Modifications to the measures were made after each round of interviews and after completion of all focus groups. RESULTS: Both methods provided beneficial information about issues with the measures. Feedback from youth, caregivers, and clinicians was distinct, though data across groups generally converged. Improvements were made to the measures in multiple areas, such as instructions and clarity. CONCLUSIONS: Incorporating feedback from multiple stakeholders increased the content validity of the TRACES and CAPC-5. Collaborative research methods provide a trauma-informed initial step in the development of assessment measures. (PsycInfo Database Record (c) 2022 APA, all rights reserved).

Effect of psychosocial trauma and stress on sexual dysfunction in women with endometriosis.

BACKGROUND: Endometrial tissue plays an important role in the regulation of female fertility and there is evidence that endometrial pathology (including endometriosis) is closely related to endocrine disorders. On the other hand, various neuroendocrine changes can be significantly affected by psychosocial stress. In connection with these findings, we tested the relationship between neuroendocrine changes, sexual dysfunction, psychosocial/traumatic stress, and dissociative symptoms in women with endometriosis. METHODS: A total of 65 patients with endometriosis were included in the study. Clinical examinations were focused on the biochemical analysis of neuroendocrine markers of endometriosis (cancer antigen 125 [CA 125] and cancer antigen 19-9 [CA 19-9]), estradiol, psychometric evaluation of sexual dysfunction, psychosocial/traumatic stress, and dissociative symptoms. RESULTS: The results showed significant Spearman correlations between the values of the revised range of sexual difficulties for sexual dysfunction (Revised Female Sexual Distress Scale), psychosocial/traumatic stress (Trauma Symptoms Checklist) (R = 0.31), and dissociative symptoms (Somatoform Dissociation Questionnaire) (R = 0.33). Positive correlations were also found between CA 125 and CA 19-9 (R = 0.63), and between CA 125 and the results of the values of the revised scale of sexual difficulties for sexual dysfunction (Revised Female Sexual Distress Scale) (R = 0.29). Also psychosocial/traumatic stress (Trauma Symptoms Checklist) significantly correlated with CA 125 (R = 0.38) and with CA 19-9 (R = 0.33). CONCLUSION: These results represent the first findings regarding the relationship of the neuroendocrine markers CA 125 and CA 19-9 and sexual dysfunction with trauma/stress-related symptoms and dissociative symptoms in women with endometriosis.

[,,It overtook my body and soul": The experience of individuals receiving health-promoting service, of psychological trauma and health-related problems].

INTRODUCTION: Accumulating evidence shows that those having experienced psychological trauma have increased risk of complex health problems. In primary health care health-promoting services are offered to individuals with complex health problems, based on an individualized approach. Trauma focused approach in healthcare help individuals increase quality of life after psychological trauma. Trauma focused services are important to help improve quality of life after psychological trauma. To examine the experience of psychological trauma and health-related problems in individuals receiving health-promoting services. METHOD: Qualitative research based on the Vancouver School of phenomenology. Participants were ten, five male and five female, selected through health-promoting services. Two interviews were taken with each participant. The ACE questionnaire was used, as a screening tool for childhood psychological trauma, combined with interview-frame with open questions. RESULTS: The results were divided into six main themes: Experience of trauma; Repeated trauma; Childhood neglect; Health-related problems in child- and adulthood; Psychiatric problems in child- and adulthood; Processing and trauma-focused approach. Participants had experienced conciderable trauma as well as complex health problems in child- and adulthood. CONCLUSIONS: It is of importance that healthcare professionals pay attention to psychological traumas in relation to complex health problems to provide support for recovery. Primary health care is the first place of contact within the health care system and therefore it is important that patients' experience of trauma is taken into account. It is key to identify the signs of lifetime trauma in relation to health problems and focus the care according to the individual needs of the patient.

[An evaluation of a Hungarian questionnaire to assess childhood adversities: A pilot study].

BACKGROUND: Detection of childhood traumas is important both in clinical practice and in research. There is a pressing need for methods that are relatively simple but comprehensive, non-intrusive, and possess adequate psyc - ho metric properties. In this study we translated one of the most widely used and well-studied measure of childhood abuse and neglect and explored the psychometrical properties of this questionnaire. METHODS: The study was based on data from a clinical (N=171) and a normative (N=358) sample. In total 529 adults participated in the testing process. Beside the trauma questionnaire Parental Bonding Inventory, Impact of Events Scale and Dissociative Experiences Scale were administered. RESULTS: We examined the internal consistency of the translated trauma questionnaire. The Cronbach's a coefficients for the five subscales ranged from 0,639 to 0,934. Participants in the clinical sample reached higher scores on all trauma subscales except sexual abuse, than normative adults [PA: t (398)=-2,771; p=0,006; PN: t (398)=-5,990; p=0,000; EA: t (398)=-3,679; p=0,000; EN: t (398)=-4,759; p=0,000; total score: t (398)=-4,669; p=0,000]. Correlations among the trauma questionnaire total score and the scales of Parental Bonding Inventory indicating some medium effects (with maternal care: r=-0,661; p=0,000; with paternal care: r=-0,483; p=0,000). CONCLUSION: Our preliminary findings suggest that this trauma questionnaire is practical and facilitates the systema - tic evaluation of adverse early life events and maximizes the possibility of detecting childhood abuse and neglect.

Understanding the pathology of psychiatric disorders in refugees.

Displacement of people from their homes, families and countries is a current global crisis, with over 70 million people forcibly on the move. A substantial proportion of these people will end up in regions with a different language and culture, where they are registered as refugees or asylum seekers. Due to the underlying reasons for displacement (including conflicts, persecution or violation of human rights), displaced people are severely stress-exposed, which continues into their post-migration life and increases risk for developing psychiatric disorders such as post-traumatic stress disorder and other anxiety disorders and mood disorders. While landmark studies have illustrated the increased prevalence of psychopathology in asylum seeker and refugee populations following pre-/post-displacement stress, few studies add to our understanding of the basic biological mechanisms underpinning risk to psychiatric disorders in these populations. Additionally, the mechanisms underlying resilience despite significant adversity remain unclear. Understanding the molecular mechanisms underpinning the development of psychiatric disorders in refugees can propel treatments (both drug and non-drug) that are capable of influencing biology at the molecular level, and the design of interventions. In the following review, we summarise the status quo of research investigating the pathophysiology of psychiatric disorders in refugees, and propose new ways to address gaps in knowledge with multidisciplinary research.

Can subjective perceptions of trauma differentiate between ICD-11 PTSD and complex PTSD? A cross-cultural comparison of three African countries.

Background: The primary aim of the current study was to establish the cutoffs scores for the Subjective Traumatic Outlook (STO), a relatively new tool that examines the introspective worldview of those exposed to traumatic events. This tool was developed as a complementary scale to be used in conjunction with the observed-phenomenological measures of posttraumatic stress disorder (PTSD) complex PTSD (CPTSD). The present study examines the predictive power of STO for distinguishing between PTSD and CPTSD in African countries. Method: A national representative (based on age and gender) sample of 2,554 participants was drawn from 3 African countries (Nigeria, Kenya, and Ghana) who completed the International Trauma Questionnaire (ITQ) and the STO. We conducted a set of analyses examining that alignment of ITQ probable PTSD and CPTSD and different STO cutoff scores. Results: Results suggest that the STO single-factor structure was stable across countries, had a strong association with PTSD and CPTSD levels, and had predictive utility in differentiating between PTSD and CPTSD. Moreover, we found that there are different cutoffs for the STO in the different countries. Conclusion: There is a strong but distinctive association between the introspective and the observed-phenomenological approaches of PTSD and CPTSD. Our findings call for more integrative approaches for the assessment of PTSD and CPTSD and suggest that there are cultural differences in STO. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Does requiring trauma exposure affect rates of ICD-11 PTSD and complex PTSD? Implications for DSM-5.

OBJECTIVE: There is little evidence that posttraumatic stress disorder (PTSD) is more likely to follow traumatic events defined by Criterion A than non-Criterion A stressors. Criterion A events might have greater predictive validity for International Classification of Diseases (ICD)-11 PTSD, which is a condition more narrowly defined by core features. We evaluated the impact of using Criterion A, an expanded trauma definition in line with ICD-11 guidelines, and no exposure criterion on rates of ICD-11 PTSD and Complex PTSD (CPTSD). We also assessed whether 5 psychologically threatening events included in the expanded definition were as strongly associated with PTSD and CPTSD as standard Criterion A events. METHOD: A nationally representative sample from Ireland (N = 1,020) completed self-report measures. RESULTS: Most participants were trauma-exposed based on Criterion A (82%) and the expanded (88%) criterion. When no exposure criterion was used, 13.7% met diagnostic requirements for PTSD or CPTSD, 13.2% when the expanded criterion was used, and 13.2% when Criterion A was used. The 5 psychologically threatening events were as strongly associated with PTSD and CPTSD as the Criterion A events. In a multivariate analysis, only the psychologically threatening events were significantly associated with PTSD (stalking) and CPTSD (bullying, emotional abuse, and neglect). CONCLUSIONS: Certain non-Criterion A events involving extreme fear and horror should be considered traumatic. The ICD-11 approach of providing clinical guidance rather than a formal definition offers a viable solution to some of the problems associated with the current and previous attempts to define traumatic exposure. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Global Psychotrauma Screen (GPS): psychometric properties in two Internet-based studies.

Background: Potentially traumatic stressors can lead to various transdiagnostic outcomes beyond PTSD alone but no brief screening tools exist for measuring posttraumatic responses in a transdiagnostic manner. Objective: Assess the psychometric characteristics of a new 22-item transdiagnostic screening measure, the Global Psychotrauma Screen (GPS). Method: An internet survey was administered with English speaking participants recruited passively via the website of the Global Collaboration on Traumatic Stress (GC-TS) (nGC-TS  = 1,268) and actively via Amazon's MTurk (nMTurk  = 1,378). Exploratory factor analysis, correlational analysis, sensitivity and specificity analysis, and comparisons in response between the two samples and between male and female respondents were conducted. Results: Exploratory factor analysis revealed a single factor underlying symptom endorsements in both samples, suggesting that such problems may form a unitary transdiagnostic, posttraumatic outcome. Convergent validity of the GPS symptom and risk factors was established with measures of PTSD and dissociative symptoms in the MTurk sample. Gender differences were seen primarily at the item level with women more often endorsing several symptoms and specific risk factors in the MTurk sample, and the GC-TS recruited sample endorsed more symptoms and risk factors than the MTurk sample, suggesting that the GPS may be sensitive to group differences. A GPS symptom cut-off score of 8 identified optimized sensitivity and specificity relative to probable PTSD based on PCL-5 scores. Conclusions: The current results provide preliminary support for the validity of the GPS as a screener for the concurrent measurement of several transdiagnostic outcomes of potentially traumatic stressors and the apparent unifactorial structure of such symptoms is suggestive of a single or unitary posttraumatic outcome. Future research is needed to evaluate whether similarly strong psychometric properties can be yielded in response to completion of the GPS in other languages.

Antecedentes: Los factores de estrés potencialmente traumáticos pueden conducir a varios resultados transdiagnósticos más allá del solo diagnóstico de TEPT, pero no existen herramientas de detección breves para medir las respuestas postraumáticas de una manera transdiagnóstica.Objetivo: Evaluar las características psicométricas de una nueva medida de cribado transdiagnóstico de 22 ítems, El Mapeo Global de Psicotrauma (Global Psychotrauma Screen o GPS en inglés).Método: Se administró una encuesta por Internet con participantes de habla inglesa reclutados pasivamente a través del sitio web de la Global Collaboration on Traumatic Stress (GC-TS) (nGC-TS = 1,268) y activamente a través de MTurk de Amazon (nMTurk = 1,378). Se realizaron análisis factoriales exploratorios, análisis correlacionales, análisis de sensibilidad y especificidad, y comparaciones en respuesta entre las dos muestras y entre encuestados masculinos y femeninos.Resultados: El análisis factorial exploratorio reveló un solo factor subyacente a la aprobación de los síntomas en ambas muestras, lo que sugiere que tales problemas pueden formar un resultado postraumático transdiagnóstico unitario. La validez convergente del síntoma GPS y los factores de riesgo se estableció con medidas de TEPT y síntomas disociativos en la muestra de MTurk. Las diferencias de género se observaron principalmente a nivel de ítem y las mujeres a menudo respaldaron varios síntomas y factores de riesgo específicos en la muestra de MTurk, y la muestra reclutada por GC-TS aprobó más síntomas y factores de riesgo que la muestra de MTurk, lo que sugiere que el GPS puede ser sensible a las diferencias de grupo. Una puntuación de corte de síntomas de GPS de 8 identificó una sensibilidad y especificidad optimizadas en relación con el probable TEPT según las puntuaciones de PCL-5.Conclusiones: Los resultados actuales proporcionan un apoyo preliminar para la validez del GPS como un filtro para la medición concurrente de varios resultados transdiagnósticos de factores estresantes potencialmente traumáticos y la aparente estructura unifactorial de tales síntomas sugiere un resultado postraumático único o unitario. Se necesitan investigaciones futuras para evaluar si se pueden producir propiedades psicométricas igualmente fuertes en respuesta al completar el GPS en otros idiomas.

Factor structure of the International Trauma Questionnaire in UK Armed Forces veterans residing in Northern Ireland.

Background: Complex Posttraumatic Stress Disorder (C-PTSD) was recently included in the revised International Classification of Diseases (ICD-11) by the World Health Organization (WHO, 2018). C-PTSD is a new trauma related disorder which may develop after prolonged and multiple exposures to trauma. It is a sister disorder of PTSD and is further characterized by symptomatology of disorganized self-organization (DSO). To qualify for the diagnosis, individuals must first meet the diagnostic criteria for PTSD, then report DSO symptoms and functional impairment. A body of work is emerging which has focused on the underlying dimensionality of C-PTSD across both adult and more recently adolescent populations from differing index trauma groups and from across several nations and cultures. However, few studies have been conducted in populations exposed to combat trauma despite the obvious prolonged and multiple nature of their trauma histories. Objective: To contribute to emerging evidence of the factor structure of ICD-11 C-PTSD in a novel population. Methods: This is the first factor analytic study to explore C-PTSD in a sample of UK Armed Forces veterans residing in Northern Ireland (N = 732). C-PTSD was measured via the ITQ and we utilized CFA to assess the fit of 7 competing models. Results: Based on established CFA fit indices, a correlated, first order, 6-factor model of C-PTSD, representing 3 PTSD and 3 DSO symptom groupings, was deemed to provide superior fit to the data compared to 6 alternative C-PTSD models. The superiority of the model was further supported by statistical comparisons of competing C-PTSD models. All factor loadings (0.866-0.998) and inter-factor correlations (.746-.975) of the optimally fitting model were statistically significant and high. Conclusion: These results provide support for the construct validity of ICD-11 C-PTSD in a unique sample of Armed Forces veterans residing in Northern Ireland.

Antecedentes: El Trastorno de Estrés Postraumático Complejo (TEPT-C) fue recientemente incluido en la revisión de la Clasificación Internacional de Enfermedades (CIE-11) por la Organización Mundial de la Salud (OMS, 2018). EL TEPT-C es un nuevo trastorno relacionado con el trauma que puede desarrollarse posterior a exposición prolongada y múltiple a traumas. Es un trastorno hermano del TEPT, y se caracteriza además por su sintomatología de desorden en la auto-organización (DSO por sus siglas en inglés). Para calificar para este diagnóstico, los individuos deben cumplir primero con criterios para TEPT, y luego reportar síntomas de DSO y deterioro funcional. Un cúmulo de trabajo está emergiendo, y se ha concentrado en la dimensionalidad subyacente del TEPT-C en poblaciones de adultos y más recientemente en adolescentes, diferenciándolas de grupos de trauma índice y en numerosas naciones y culturas. Sin embargo, se han realizado pocos estudios en poblaciones expuestas a trauma de combate pese a la naturaleza obviamente prolongada y múltiple de sus historias de trauma.Objetivo: Contribuir a la evidencia emergente de la estructura factorial del TEPT-C de la CIE-11 en una población nueva.Métodos: Este es el primer estudio analítico factorial en explorar el TEPT-C en una muestra de Veteranos de las Fuerzas Armadas del Reino Unido que residen en Irlanda del Norte (N=732). El TEPT-C fue medido mediante el ITQ (Cuestionario Internacional de Trauma por sus siglas en inglés) y se utilizó análisis factorial confirmatorio (CFA por sus siglas en inglés) para evaluar el ajuste de 7 modelos en competencia.Resultados: Basado en lo establecido por los índices de ajustes, un modelo de 6 factores correlacionado y de primer orden representando 3 agrupaciones de síntomas de TEPT y 3 agrupaciones de síntomas de DSO, fue encontrado que probó un ajuste superior a los datos comparado con los 6 modelos alternativos de TEP-C. La superioridad del modelo fue respaldada además por comparación estadística de los modelos en competencia de TEPT-C. Todas las cargas factoriales (0.866-0.998) y correlaciones inter-factoriales (.746-.975) del modelo con ajuste óptimo fueron estadísticamente significativas y altas.Conclusión: Estos resultados aportan sustento a la validez del constructo TEPT-C del CIE-11 en una muestra única de veteranos de las Fuerzas Armadas que residen en Irlanda del Norte.

A Proposal for Evaluating Psychosocial Trauma / El Trauma Psicosocial: una Propuesta Para su Evaluación

Background: The objective of the study was to design and validate the Psychosocial Trauma Scale (ETAPS) for assessing psychosocial consequences of collective violence. This instrument proposed the following dimensions: Pre-traumatic Situation, Destruction of Fundamental Beliefs, Intergroup Emotions, and Family and Community Destruction. Method: A total of 382 people participated who had been affected by political violence: civil war in El Salvador, forced displacement from Colombia and state violence from Chile. The study had three phases: (1) content validity of the items evaluated by experts; (2) exploratory factor analysis to study the structure of ETAPS, reducing the number of items; (3) convergent (post-traumatic stress symptomatology) and divergent (psychological and social well-being) validity. Results: The EFA showed that ETAPS had a slightly different internal structure from that proposed. The dimensions found were Pre-traumatic Situation and Intergroup Emotions along with two new emerging dimensions: Destruction of Sociality and Personal and Collective Self-Efficacy. Divergent and convergent validity gave expected results except for the pre-traumatic situation. Conclusions: The ETAPS dimensions show that the effects of violence are broader than the symptoms measured by clinical scales. An instrument with adequate psychometric properties was obtained which will be useful for future studies in the area. (AU)

Antecedentes: el objetivo del estudio fue el diseño y validación de la Escala de Trauma Psicosocial (ETAPS) para evaluar consecuencias psicosociales de la violencia colectiva. Este instrumento propuso las dimensiones: Situación Pre-traumática, Destrucción de Creencias Fundamentales, Emociones Intergrupales, y Destrucción Familiar y Comunitaria. Método: participaron 382 personas afectadas por violencia política: guerra civil en El Salvador, desplazamiento forzado de Colombia y violencia estatal de Chile. El estudio contempló tres fases: (1) validez de contenido de los ítems evaluado por expertos; (2) análisis factorial exploratorio para estudiar la estructura de ETAPS, reduciendo el número de ítems; (3) validez convergente (sintomatología de estrés postraumático) y divergente (bienestar psicológico y social). Resultados: el AFE mostró que la ETAPS tenía una estructura interna que difería parcialmente de la propuesta. Las dimensiones encontradas fueron: Situación Pre-traumática y Emociones Intergrupales, junto con dos nuevas dimensiones: Destrucción de la socialidad y Autoeficacia personal y colectiva. La validez divergente y convergente muestra resultados esperados salvo respecto a la situación pretraumática. Conclusiones: las dimensiones de ETAPS plantean que los efectos de la violencia son más amplios que los síntomas medidos por escalas clínicas. Se obtuvo un instrumento con adecuadas propiedades psicométricas útil para futuros estudios en el área. (AU)

Identifying diseases that cause psychological trauma and social avoidance by GCN-Xgboost.

BACKGROUND: With the rapid development of medical treatment, many patients not only consider the survival time, but also care about the quality of life. Changes in physical, psychological and social functions after and during treatment have caused a lot of troubles to patients and their families. Based on the bio-psycho-social medical model theory, mental health plays an important role in treatment. Therefore, it is necessary for medical staff to know the diseases which have high potential to cause psychological trauma and social avoidance (PTSA). RESULTS: Firstly, we obtained diseases which can cause PTSA from literatures. Then, we calculated the similarities of related-diseases to build a disease network. The similarities between diseases were based on their known related genes. Then, we obtained these diseases-related proteins from UniProt. These proteins were extracted as the features of diseases. Therefore, in the disease network, each node denotes a disease and contains the information of its related proteins, and the edges of the network are the similarities of diseases. Then, graph convolutional network (GCN) was used to encode the disease network. In this way, each disease's own feature and its relationship with other diseases were extracted. Finally, Xgboost was used to identify PTSA diseases. CONCLUSION: We developed a novel method 'GCN-Xgboost' and compared it with some traditional methods. Using leave-one-out cross-validation, the AUC and AUPR were higher than some existing methods. In addition, case studies have been done to verify our results. We also discussed the trajectory of social avoidance and distress during acute survival of breast cancer patients.

Using Exploratory Structural Equation Modeling (ESEM) to Examine the Internal Structure of Posttraumatic Stress Disorder Symptoms.

Several studies have reported the factor structure of posttraumatic stress disorder (PTSD) using confirmatory factor analysis (CFA). The results show models with different number of factors, high correlations between factors, and symptoms that belong to different factors in different models without affecting the fit index. These elements could suppose the existence of considerable item cross-loading, the overlap of different factors or even the presence of a general factor that explains the items common source of variance. The aim is to provide new evidence regarding the factor structure of PTSD using CFA and exploratory structural equation modeling (ESEM). In a sample of 1,372 undergraduate students, we tested six different models using CFA and two models using ESEM and ESEM bifactor analysis. Trauma event and past-month PTSD symptoms were assessed with Life Events Checklist for DSM-5 (LEC-5) and PTSD Checklist for DSM-5 (PCL-5). All six tested CFA models showed good fit indexes (RMSEA = .051-.056, CFI = .969-.977, TLI = .965-.970), with high correlations between factors (M = .77, SD = .09 to M = .80, SD = .09). The ESEM models showed good fit indexes (RMSEA = .027-.036, CFI = .991-.996, TLI = .985-.992). These models confirmed the presence of cross-loadings on several items as well as loads on a general factor that explained 76.3% of the common variance. The results showed that most of the items do not meet the assumption of dimensional exclusivity, showing the need to expand the analysis strategies to study the symptomatic organization of PTSD.

Association of War-Related and Gender-Based Violence With Mental Health States of Yazidi Women.

Importance: Yazidi women in northern Iraq have experienced severe human rights violations through attacks by the so-called Islamic State group, with severe consequences for their health. However, no studies to date have investigated how war-related and gender-based violence, including partner violence, are associated with mental health disorders in this population. Objective: To evaluate the associations between Yazidi women's experiences of violence (ie, war violence, partner violence, enslavement) and their mental health. Design, Setting, and Participants: This cross-sectional study of 326 women was conducted in camps for displaced persons in the Kurdistan region of Iraq between January and July 2017. Participants were married women from the Yazidi population in northern Iraq who were affected by Islamic State attacks. Participants were selected via household-randomized sampling. Data analysis was conducted from December 2018 to September 2019. Exposures: Experiences of enslavement, war-related events, and intimate partner violence were measured with event checklists. Main Outcomes and Measures: Posttraumatic stress disorder (PTSD) and depression levels were measured using culturally validated instruments. Results: A total of 326 women (mean [SD] age, 34.3 [12.9] years) participated in the study. Almost all participants reported the experience of at least 1 war-related violent event (325 [99.7%]), 54 (16.6%) reported a history of abduction and sexual slavery, and 215 (66.0%) reported the experience of at least 1 type of intimate partner violence in the past year. There were no significant differences between women who did and did not experience abduction regarding exposure to intimate partner violence. Rates of PTSD and depression symptoms were high among the whole sample, and women who experienced abduction reported significantly higher levels of psychopathology than those who did not (mean [SD] PTSD score: 61.48 [12.38] vs 47.61 [14.42]; t324 = -6.91; P < .001; mean [SD] depression score: 3.07 [0.68] vs 2.43 [0.68]; t324 = -6.78; P < .001). Multivariate hierarchical regressions revealed that psychopathology was associated with exposure to war-related events (PTSD: ß = 0.29; P < .001; depression: ß = 0.27; P < .001) as well as with exposure to gender-based violence in Islamic State captivity (PTSD: ß = 0.19; P = .001; depression: ß = 0.28, P < .001) and in their marriage (PTSD: ß = 0.13; P = .008; depression: ß = 0.18; P < .001). Conclusions and Relevance: In this study, interviewed Yazidi women often experienced intimate partner violence as well as war-related and gender-based violence under Islamic State attacks and enslavement, experiences that were associated with mental health impairment. The findings underline the importance of also addressing gender-based violence within health care approaches for war-affected populations.

Neuropsychological Impact of Trauma-Related Mental Illnesses: A Systematic Review of Clinically Meaningful Results.

A trauma history is present in approximately 90% of adults in the United States. Comparatively, lifetime post-traumatic stress disorder (PTSD) prevalence is only 8.3% (Kilpatrick et al. Journal of Traumatic Stress, 26, 537-547, 2013). A neuropsychological understanding of trauma is essential to effective trauma-informed assessments and treatments. Prior reviews have focused on PTSD, specific neuropsychological domains, and statistically rather than clinically significant results. The current systematic review investigated standardized test performance across neuropsychological domains in participants with trauma histories and any psychiatric diagnosis. The review was conducted in accordance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. From 2350 records, the search returned 21 eligible studies: 8 for combat trauma, 2 for childhood trauma, 2 for intimate partner violence and sexual assault, 2 for accidental trauma, 1 for refugee trauma, and 6 for unspecified trauma. Mean neuropsychological scores ranged from low to high average, with one mean verbal memory score in the borderline range. These findings diverge from reports of between-group differences or experimental task performance, which suggest greater levels of static cognitive impairment. Current results are limited by lack of distinction between trauma types in the literature, a dearth of cognitive domains examined, wide use of self-report trauma measures, and publication and outcome reporting biases. Clinical implications for assessment and rehabilitation are discussed in relation to clinical significance, state versus trait based changes, intra-individual variability, changes from pre- to post-trauma, and within-group variability in resilience. Future directions are recommended in consideration of cultural factors, prospective and follow-up designs, and psychiatric diagnosis.