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Background: Perceived social support (PSS) is one of the most important risk factors for the onset and maintenance of posttraumatic stress disorder (PTSD) symptoms, however the relationship between PSS and Complex PTSD (CPTSD) is unknown. The evidence-base for CPTSD treatment is currently lacking, though increasingly important given the recent publication of the ICD-11, which now allows for a formal diagnosis of CPTSD. Objective: This research aims to develop understanding of the relationship between PSS and CPTSD with a view to informing the development of new and existing treatments. Method: A cross-sectional study was undertaken with 246 individuals recruited to the National Centre for Mental Health (NCMH) cohort. Measures of PSS and PTSD/CPTSD were undertaken with this clinical sample and linear and logistic regression were conducted to assess for associations between PSS and the PTSD symptom clusters of DSM-5 and ICD-11, and to explore the predictive utility of any PSS association on the likelihood of a CPTSD presentation. Results: It was found that individuals with a presentation of CPTSD tend to exhibit lower levels of PSS, compared with individuals not presenting with CPTSD, and lower PSS had a statistically significant unique association with the likelihood of presenting with CPTSD. Conclusions: Intervention aiming to improve PSS could be particularly helpful for some individuals with CPTSD, especially those with disturbances in relationships, and there is opportunity to develop skills training within a phase-based approach to treatment that targets factors related to PSS. * Individuals with a presentation of Complex Posttraumatic Stress Disorder (CPTSD) tend to exhibit particularly low levels of perceived social support (PSS), compared with individuals not presenting with CPTSD.* Lower PSS was found to have a statistically significant unique association with the likelihood of presenting with CPTSD.* Intervention aiming to improve PSS could be particularly helpful for some individuals with CPTSD, especially those with disturbances in relationships.

Background: Two stress-related disorders have been proposed for inclusion in the revised ICD-11: Posttraumatic Stress Disorder (PTSD) and Complex PTSD (CPTSD). The International Trauma Questionnaire (ITQ) is a bespoke measure of PTSD and CPTSD and has been widely used in English-speaking countries. Objective: The primary aim of this study was to develop a Chinese version of the ITQ and assess its content, construct, and concurrent validity. Methods: Six mental health practitioners and experts rated the Chinese translated and back-translated items to assess content validity. A sample of 423 Chinese young adults completed the ITQ, the WHO Adverse Childhood Experiences International Questionnaire, and the Hospital Anxiety and Depression Scale. Among them, 31 participants also completed the English and Chinese versions of the ITQ administered in random order at retest. Four alternative confirmatory factor analysis models were tested using data from participants who reported at least one adverse childhood experience (ACE; N = 314). Results: The Chinese ITQ received excellent ratings on relevance and appropriateness. Test-retest reliability and semantic equivalence across English and Chinese versions were acceptable. The correlated first-order six-factor model and a second-order two-factor (PTSD and DSO) both provided an acceptable model fit. The six ITQ symptoms clusters were all significantly correlated with anxiety, depression, and the number of ACEs. Conclusions: The Chinese ITQ generates scores with acceptable psychometric properties and provides evidence for including PTSD and CPTSD as separate diagnoses in ICD-11. * This study provides the first Chinese translation and validation of the ITQ with a Chinese young adult sample in Hong Kong.* The latent structure of the Chinese ITQ was best supported by a six-correlated first-factor model; a two-factor second-order model was also acceptable.* Each of the six PTSD/CPTSD symptom clusters correlated significantly positively with two criterion variables - anxiety and depression.* Cumulative exposure to adverse childhood experiences was significantly associated with PTSD/CPTSD symptoms.

Background: A worldwide health threat, the COVID-19 pandemic, has highlighted the need to focus on its mental health impact. However, literature on mental health effects including post-traumatic consequences of the pandemic is scarce. Objective: The current study examined post-traumatic stress (PTS), growth (PTG), and depreciation (PTD) during the pandemic, and explored factors associated with these mental health outcomes in an adult community sample from Turkey. Method: A total of 685 participants responded to an online survey that gathered data on sociodemographic characteristics, financial loss during the pandemic, time spent at home and frequency of social media use, perception of COVID-related risks, stress, and event-related rumination. Data analysis included correlation and regression analyses. Results: Results showed that PTS, PTG, and PTD were positively correlated with each other. Younger age and being single were associated with higher PTS and PTD, and lower education levels predicted all three outcomes. Experiencing financial loss during the pandemic, more frequent social media use to follow COVID-related news and posts, and longer time spent at home during the pandemic were associated with higher PTS. Anticipating financial risks during the pandemic were associated with all outcomes while anticipating health-related risks due to COVID-19 and perceived stress levels predicted PTS and PTD but not PTG. Both intrusive and deliberate rumination were associated with higher levels of PTS and PTD, and PTG was predicted solely by deliberate rumination. Moreover, provisional PTSD was indicated in 47.9% of the participants. Membership to the provisional PTSD group was predicted by age, level of education, time spent on social media, anticipating COVID-19-related health risks, perceived stress, and event-related rumination. Conclusions: The current study provides empirical evidence for the short-term post-traumatic effects of the COVID-19 pandemic and related factors, which can help to guide mental health services during the pandemic.

A study in Lithuania showed that the International Trauma Interview is a valid tool for assessing and diagnosing ICD-11 posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD). The 11 th revision of the International Classification of Diseases (ICD-11) includes a new diagnosis of complex posttraumatic stress disorder (CPTSD). The International Trauma Interview (ITI) is a novel clinician-administered diagnostic interview for the assessment of ICD-11 PTSD and CPTSD. The aim of this study was to evaluate the psychometric properties of the ITI in a Lithuanian sample in relation to interrater agreement, latent structure, internal reliability, as well as convergent and discriminant validity. In total, 103 adults with a history of various traumatic experiences participated in the study. The sample was predominantly female (83.5%), with a mean age of 32.64 years (SD = 9.36). For the assessment of ICD-11 PTSD and CPTSD, the ITI and the self-report International Trauma Questionnaire (ITQ) were used. Mental health indicators, such as depression, anxiety, and dissociation, were measured using self-report questionnaires. The latent structure of the ITI was evaluated using confirmatory factor analysis (CFA). In order to test the convergent and discriminant validity of the ITI we conducted a structural equation model (SEM). Overall, based on the ITI, 18.4% of participants fulfilled diagnostic criteria for PTSD and 21.4% for CPTSD. A second-order two-factor CFA model of the ITI PTSD and disturbances in self-organization (DSO) symptoms demonstrated a good fit. The associations with various mental health indicators supported the convergent and discriminant validity of the ITI. The clinician-administered ITI and self-report ITQ had poor to moderate diagnostic agreement across different symptom clusters. The ITI is a reliable and valid tool for assessing and diagnosing ICD-11 PTSD and CPTSD.

Daily stressors, compared to traumatic events, are increasingly recognized as important risk factors for mental health. The role of general self-efficacy on the relationship between daily stress and aspects of mental health has not yet been examined. Taking into account the dual factor model of mental health, which postulates that mental health is more than the absence of psychopathological symptoms, we tested mediation effects of self-efficacy separately for positive and negative mental health. Total, direct and indirect effects were estimated using data from a large nationally representative German population sample (N = 1,031) by bootstrapped mediation analyses providing 95% bias corrected bootstrap confidence intervals. Results indicated self-efficacy as a mediator of the effects of daily stressors on mental health, with superior effect sizes for positive compared to negative mental health. Mediation effects were replicated in student samples from Germany (N=394), Russia (N=604) and China (N=8,669). Findings suggest that self-efficacy operates as a buffer of daily stress. However, a full mediation model was not supported as multiple psychological resources can have protective effects. This study provides the first transnational evidence for different stress-buffer effects for the two dimensions of mental health. El estrés cotidiano, en comparación con acontecimientos traumáticos, es reconocido cada vez más como un importante factor de riesgo para la salud mental. El papel de la autoeficacia general en la relación entre estrés diario y aspectos de la salud mental todavía no se ha examinado. Teniendo en cuenta el modelo de dos factores, que postula que la salud mental es más que la ausencia de síntomas psicopatológicos, examinamos la mediación de la autoeficacia separadamente para la salud mental positiva y negativa. Efectos totales, directos e indirectos fueron evaluados, utilizando datos de una muestra de la población alemana representativa (N=1.031). La autoeficacia es un mediador de los efectos del estrés cotidiano, con efectos superiores para la salud mental positiva. Los resultados fueron replicados en muestras de estudiantes de Alemania (N=394), Rusia (N=604) y China (N=8.669). La autoeficacia actúa como un búfer para el estrés cotidiano. Un modelo de mediación completo no fue apoyado con múltiples recursos psicológicos que pueden tener efectos protectores. Es la primera evidencia transnacional para diferentes efectos del búfer-estrés para las dos dimensiones de salud mental.

Minority stress exposure may be associated with alterations within intrinsic connectivity networks. There currently exists a limited number of neuroimaging studies directly investigating the neural correlates of minority stress. Here, we propose a novel minority mosaic framework. Systemic oppression, particularly towards sexual minorities, continues to be deeply rooted in the bedrock of many societies globally. Experiences with minority stressors (e.g. discrimination, hate-crimes, internalized homonegativity, rejection sensitivity, and microaggressions or everyday indignities) have been consistently linked to adverse mental health outcomes. Elucidating the neural adaptations associated with minority stress exposure will be critical for furthering our understanding of how sexual minorities become disproportionately affected by mental health burdens. Following PRISMA-guidelines, we systematically reviewed published neuroimaging studies that compared neural dynamics among sexual minority and heterosexual populations, aggregating information pertaining to any measurement of minority stress and relevant clinical phenomena. Only 1 of 13 studies eligible for inclusion examined minority stress directly, where all other studies focused on investigating the neurobiological basis of sexual orientation. In our narrative synthesis, we highlight important themes that suggest minority stress exposure may be associated with decreased activation and functional connectivity within the default-mode network (related to the sense-of-self and social cognition), and summarize preliminary evidence related to aberrant neural dynamics within the salience network (involved in threat detection and fear processing) and the central executive network (involved in executive functioning and emotion regulation). Importantly, this parallels neural adaptations commonly observed among individuals with posttraumatic stress disorder (PTSD) in the aftermath of trauma and supports the inclusion of insidious forms of trauma related to minority stress within models of PTSD. Taken together, minority stress may have several shared neuropsychological pathways with PTSD and stress-related disorders. Here, we outline a detailed research agenda that provides an overview of literature linking sexual minority stress to PTSD and insidious trauma, moral affect (including shame and guilt), and mental health risk/resiliency, in addition to racial, ethnic, and gender related minority stress. Finally, we propose a novel minority mosaic framework designed to inform future directions of minority stress neuroimaging research from an intersectional lens.

Background: The 2022 War in Ukraine has significantly affected the psychological well-being and daily lives of people in many countries. Objective: Two aims of this transnational study were (1) to compare psychological distress and coping strategies among people living in Ukraine, Poland, and Taiwan, (2) to examine whether the associations between various coping strategies (ie. problem-focused coping, emotion-focused coping, and avoidance) and psychological distress (ie. depression, anxiety, stress, posttraumatic stress disorder symptoms, and hopelessness about the ongoing war) differed among people of various countries during the initial stage of the 2022 War in Ukraine. Method: In total, 1,598 participants (362 from Ukraine, 1,051 from Poland, and 185 from Taiwan) were recruited using an online advertisement to complete online survey questionnaires, including the Brief Coping Orientation to Problems Experienced inventory; the 21-item Depression, Anxiety and Stress Scale; the Impact of Event Scale-Revised; and a questionnaire devised to assess the level of hopelessness about the ongoing war. Results: Psychological distress and adoption of coping strategies differed across people of various countries. Among Taiwanese and Polish respondents, avoidant coping strategies were most strongly associated with all categories of psychological distress compared with problem- and emotion-focused coping strategies. However, the associations of various coping strategies with psychological distress differed to a less extent among Ukrainian respondents. In addition, problem- and emotion-focused coping strategies had comparable associations with psychological distress among the people of Ukraine, Poland, and Taiwan. Conclusions: The 2022 War in Ukraine has affected the psychological well-being of people, especially the Ukrainians. Because of the strong association between the adoption of avoidance coping strategies and psychological distress, despite a less extent among Ukrainian respondents, adaptive coping strategies such as (problem- and emotion-focused) are suggested to help people during times of war. The 2022 War in Ukraine affected the psychological well-being in Ukraine and elsewhere. Compared with problem- and emotion-focused coping strategies, avoidant coping strategies had stronger association with psychological distress, but it varied among different cultures.

Background: Parents are a key source of support for children exposed to single-incident/acute traumas and can thereby play a potentially significant role in children's post-trauma psychological adjustment. However, the evidence base examining parental responses to child trauma and child posttraumatic stress symptoms (PTSS) has yielded mixed findings. Objective: We conducted a systematic review examining domains of parental responding in relation to child PTSS outcomes. Method: Studies were included if they (1) assessed children (6-19 years) exposed to a potentially traumatic event, (2) assessed parental responses to a child's trauma, and (3) quantitatively assessed the relationship between parental responses and child PTSS outcomes. A systematic search of three databases (APAPsycNet, PTSDpubs, and Web of Science) yielded 27 manuscripts. Results: Parental overprotection, trauma communication, avoidance of trauma discussion and of trauma reminders, and distraction were consistently related to child PTSS. There was more limited evidence of a role for trauma-related appraisals, harsh parenting, and positive parenting in influencing child outcomes. Significant limitations to the evidence base were identified, including limited longitudinal evidence, single informant bias and small effect sizes. Conclusion: We conclude that key domains of parental responses could be potential intervention targets, but further research must validate the relationship between these parental responses and child PTSS outcomes. Child post-traumatic stress symptoms following acute trauma are consistently related to post-trauma parental overprotection, avoidance of trauma discussion and of trauma reminders, and promotion of distraction from trauma-related thoughts and stimuli. The findings from this review provide a potential rationale for targeting these parental domains in clinical interventions addressing children's post-traumatic stress symptoms. Future research is needed to validate the longitudinal relationship between parental response domains following children's traumatic exposure and child post-traumatic stress symptoms.

When it comes to constructing the professional profile of university students, it is essential to consider the competencies and skills necessary for their personal and social development. In this regard, both social skills and the way in which students experience and cope with stress will be paramount. These variables will be influenced by the impact of religions in environments where several converge, in turn, shape the profile of the student population. The analysis of this interaction will contribute to refining the teaching-learning process. The aim of this study, employing a quantitative, descriptive, exploratory, and correlational design, is to examine the relationship between religion and the social skills and stress levels of university students in cross-border and multi-religious environments in Ceuta and Melilla. For this endeavor, a sample of 436 students (78.9% women; Mage = 22.5, SD = 5.26) was selected, and they were administered a questionnaire comprising two scales: the Social Skills Scale and the Perceived Stress Scale. The main results indicate that religion is related to social skills, with Muslim students exhibiting higher levels of social skills in expressing feelings and anger, while students of religions with mid-lower presence present higher levels in interrupting social interactions and expressing denial. This study demonstrates the need to establish training program for these skills as a bridge of connection between religions. A la hora de construir el perfil profesional del alumnado universitario, es fundamental tener en cuenta las competencias y habilidades necesarias para su desarrollo personal y social. En este aspecto, las habilidades sociales, así como el estrés que experimenta y cómo lo afronta van a ser esenciales dentro del mismo. En entornos donde confluyen diversas religiones, analizar la influencia de estas sobre este perfil y, por tanto, sobre estas variables, contribuye a perfeccionar el proceso de enseñanza-aprendizaje. El objetivo de este estudio, mediante un diseño cuantitativo, descriptivo, exploratorio y correlacional, consistió en analizar la relación entre la religión y las habilidades sociales y el estrés del estudiantado universitario en entornos transfronterizos y multirreligiosos de Ceuta y Melilla. Para ello, se seleccionó una muestra de 436 (78.9% mujeres; Medad = 22.5, DT = 5.26) estudiantes universitarios, a la que se aplicó un cuestionario formado por dos escalas: la Escala de Habilidades Sociales y la Escala de Estrés Percibido. Los principales resultados exponen que la religión se relaciona con las habilidades sociales, siendo el estudiantado musulmán el que mostró niveles más altos de habilidades sociales sobre expresión de sentimientos y enfado, mientras que el alumnado de religiones con menor presencia manifestó niveles más altos en cortar interacciones y expresar negación. Este estudio demuestra la necesidad de establecer programas de entrenamiento de estas habilidades como puente de unión entre religiones.

Background: Despite the established efficacy of psychological therapies for post-traumatic stress disorder (PTSD) there has been little systematic exploration of dropout rates. Objective: To ascertain rates of dropout across different modalities of psychological therapy for PTSD and to explore potential sources of heterogeneity. Method: A systematic review of dropout rates from randomized controlled trials (RCTs) of psychological therapies was conducted. The pooled rate of dropout from psychological therapies was estimated and reasons for heterogeneity explored using meta-regression. Results:: The pooled rate of dropout from RCTs of psychological therapies for PTSD was 16% (95% CI 14-18%). There was evidence of substantial heterogeneity across studies. We found evidence that psychological therapies with a trauma-focus were significantly associated with greater dropout. There was no evidence of greater dropout from therapies delivered in a group format; from studies that recruited participants from clinical services rather than via advertisements; that included only military personnel/veterans; that were limited to participants traumatized by sexual traumas; that included a higher proportion of female participants; or from studies with a lower proportion of participants who were university educated. Conclusions: Dropout rates from recommended psychological therapies for PTSD are high and this appears to be particularly true of interventions with a trauma focus. There is a need to further explore the reasons for dropout and to look at ways of increasing treatment retention.