Background: Yearning is a core symptom of prolonged grief disorder (PGD), typically manifesting as vivid counterfactual thoughts and bittersweet emotions. However, current self-report measures fail to capture the dynamic nature of yearning and are often compromised by social desirability bias. This highlights the critical need for accurate and objective tools to assess this complex emotional experience.Objective: This study aimed to develop and validate the Yearning Induction Task (YIT), an innovative experimental paradigm designed to induce yearning in bereaved individuals from China and Switzerland. We also sought to explore how cultural differences shape emotional and cognitive responses following experimentally induced yearning.Methods: A total of 231 bereaved participants (130 from China and 101 from Switzerland) were recruited. After completing baseline measures, participants were randomly assigned to either the yearning or control condition of the YIT. Momentary yearning and emotion responses were assessed both pre- and post-induction. Data were analysed using ANCOVA to examine cultural differences in the induction effect of the task.Results: The task demonstrated good interrater reliability across cultures but did not significantly alter momentary yearning levels. However, significant cultural differences emerged in emotional responses. Swiss participants predominantly showed increases in negative emotions, such as sadness, anger, and loneliness, following the yearning induction. In contrast, Chinese participants experienced a decrease in positive emotions, including happiness. In the control condition, Swiss participants reported declines in positive emotions (e.g. gratitude, love), while Chinese participants experienced an increase in happiness and a reduction in overall negative emotions.Conclusion: This study provided preliminary evidence for the reliability and validity of a novel task to induce yearning among Swiss and Chinese bereaved individuals. Cultural differences emerged in emotional responses to induced yearning, although construct validity was only partially supported. These findings highlight the importance of culturally sensitive assessment tools and interventions for yearning in PGD.

Background: Somatic symptoms, such as chronic pain, fatigue, and gastrointestinal disturbances, are commonly reported in individuals with a history of childhood maltreatment (CM), which includes various forms of abuse and neglect experienced before age 18. Although CM is strongly associated with somatic symptoms, the specific relationships between CM subtypes and these symptoms, as well as the mechanisms connecting them, remain insufficiently understood. This review examines the complex interaction between CM and somatic symptoms, which often coexist with mental disorders and significantly impact quality of life and healthcare systems. Summary: Somatic symptoms, frequently a mix of "explained" and "unexplained" conditions, are associated with personal distress and pose diagnostic challenges. CM has been linked to these symptoms through neurobiological mechanisms, such as HPA axis dysregulation and allostatic load, while theoretical models emphasize the roles of hyperawareness, cultural factors, and vulnerability in symptom development. However, existing research often fails to account for specific CM subtypes, the full range of somatic symptoms, and cultural and situational factors, leading to inconsistencies in findings. Key Messages: Bridging gaps in literature requires adopting the World Health Organization’s CM subtype definitions and ICD-11 codes (MA00-MH2Y) to encompass a broader spectrum of somatic symptoms. Employing rigorous methodologies, such as systematic reviews and meta-analyses, is essential for advancing understanding. These approaches can enhance diagnostic accuracy, support tailored interventions, and promote a biopsychosocial framework for CM research, ultimately improving patient outcomes and alleviating societal burdens.

[Background] Adjustment Disorder (AjD) is a frequent diagnosis in psychological and psychiatric consultations. Recently, the ICD-11 has introduced preoccupation and failure to adapt as core symptoms of AjD. However, empirical research that explores the various possible manifestations of preoccupation and failure to adapt in AjD patients is sparse. Therefore, the study aimed to explore patients’ experiences of the core symptoms of AjD in a qualitative study. [Method] We recruited 16 patients suffering from ICD-11 AjD who filled in self-report questionnaires to assess sociodemographic information, adjustment disorder symptoms, anxiety and depression. Then, they participated in a semi-structured interview with a trained psychologist to explore the determinants and characteristics of their preoccupation and failure to adapt symptoms. Thematic analysis was applied to analyze the responses. [Results] Six themes were identified in our analysis 1) Preoccupation triggers, 2) Preoccupations and negative emotions, 3) Strategies to stop preoccupation, 4) Consequences of preoccupation, 5) Manifestation of difficulties/failure to adapt and 6) Strategies to address difficulties/failure to adapt. [Conclusion] We found partial congruence between our data and previous conceptualizations of AjD. Preoccupations seem to be time-consuming, center around stressors and their consequences, and be associated with negative emotions. Some preoccupations reported by the patients could also be labeled as ruminations or worries. The failure to adapt symptoms seemed to be broader than the exemplary symptoms highlighted in current measures of AjD.

Background: The aim of this article is to summarize the current state of research on the effectiveness of psychotherapeutic treatment of posttraumatic stress disorder (PTSD). Methods: The results of current meta-analyses and trend-setting individual studies are summarized and the most important forms of intervention are explained. Results: The psychotherapeutic treatment methods for PTSD are very effective, the effect sizes are large and superior to those of pharmacotherapy. Trauma exposure and cognitive restructuring are most effective. Trauma-focused procedures are generally superior to other forms of psychotherapy. A range of different cognitive behavioral procedures as well as eye movement desensitization and reprocessing are recommended. The most recent initial findings confirm a very good effectiveness for imagery rescripting methods as protective interventions without a formal confrontation with trauma. Individual therapy works better than group psychotherapy. In the group setting cognitive processing therapy has proven to be the best intervention. Trauma-focused treatment should also be used when comorbid conditions such as schizophrenia, bipolar disorder or addiction are present. Discussion: Trauma-focused psychotherapy in an individual setting is the treatment of choice for PTSD. A large selection of effective methods and well-reviewed manuals are available. The German language S3 guidelines are currently being updated.

Zusammenfassung Hintergrund Für die Beschreibung von depressionsartigen psychischen Beschwerden in verschiedenen kulturellen Weltregionen hat sich das Konzept der kulturellen Skripte als sehr nützlich erwiesen. Der Beitrag stellt erstmals das Galaxienmodell und dessen Umsetzung in der Modellvorstellung der kulturellen Skripte theoretisch vor und verbindet diese mit der kulturpsychologischen Werteforschung. Mit einer neuen, umfangreichen Serie von Forschungsprojekten sollen posttrauma-bezogene psychische Beschwerden in verschiedenen Weltregionen untersucht werden. Methoden Die Arbeit in zwei Ländern/Regionen begann mit Fokusgruppen, in denen Elemente kultureller Skripte durch traumatisierte Klienten und/oder von (therapeutischen) Experten zusammengetragen werden. Dazu wurde ein theoriegeleiteter Rahmen möglicher post-traumatischer Skriptelemente vorgegeben. In der Schweiz wurden Fokusgruppen mit Patient:innen und mit Expert:innen durchgeführt. In Ruanda und drei ostafrikanischen Ländern wurden Fokusgruppen mit Genozid-Überlebenden und anderen Traumaopfern durchgeführt. Die Auswertung fand semi-quantitativ statt. Ergebnisse Als Skriptelemente wurden in der Schweiz ca. 50 Symptome und Veränderungen genannt (z. B. Trotzdem funktionieren müssen). Als Skriptelement in Ostafrika wurden ca. 100 Symptome und Veränderungen genannt (z. B. Verlust der Menschenwürde). Erste temporale Zusammenhänge (d. h. starke Skripts) wurden für die Schweizer Skripts gefunden (z. B. Selbstentwertung – Drang zu funktionieren). In der Ostafrikanischen Studie wurden zudem den Skriptgruppierungen zugrundeliegende kulturelle Wertorientierungen erhoben (z. B. Ansehen in der Gemeinschaft). Diskussion Die hier vorgestellten illustrativen Ergebnisse belegen das Galaxienmodell und die Eignung des kulturellen Skriptkonzepts für die Traumafolgen-Erfassung. Es zeigen sich Unterschiede und Übereinstimmungen in den beiden bisher untersuchten Weltregionen. Weitere Schritte an den beiden Studien-Sites werden die temporalen Zusammenhänge und die Beziehungen zu Wertorientierungen sein. An den anderen Untersuchungssites werden die Studien in den Folgejahren gestartet.

Introduction: Cultural factors were shown to be particularly relevant for the development and expression of posttraumatic stress. Recently, the concept of cultural scripts of trauma has been introduced, which proposes that trauma sequelae elements may be sequentially linked and specifically associated with cultural factors. Furthermore, a cascade model is proposed, including trauma exposure, demographic characteristics, cultural affiliation, and trauma-related value orientations as influencing factors of posttraumatic development. The purpose of this Network Project is to investigate cultural psychological factors that contribute to the expression of posttraumatic stress.Methods: The present Network Project implements a mixed methods approach and will be conducted in 5 different study sites, including Switzerland, Israel, Georgia, China, and East Africa. In sub-study I, the cultural scripts of traumatic stress inventories (CSTIs) will be developed. These scales provide a pool of trauma sequelae elements for each cultural group. For this purpose, focus groups with trauma survivors and trauma experts will be conducted and analysed using qualitative research methods. Sub-study II implements a validation analysis of the CSTIs and the empirical investigation of a cultural cascade model. This quantitative approach will include a larger sample of individuals who experienced traumatic life events.Discussion: This contribution is timely and enriches the knowledge of trauma and culture. Future publications of this Network Project will address trauma sequelae from a cultural perspective and provide diagnostic and psychotherapeutic implications.

Background The novel concept of cultural scripts of trauma sequelae captures culture-specific expressions of posttraumatic distress (e.g., cognitive, emotional, interpersonal, psychosomatic changes) and their temporal associations. Cultural scripts of trauma sequelae complement pan-cultural (etic) diagnoses, such as posttraumatic stress disorder (PTSD) and Complex PTSD, as well as the cultural syndromes concept. Objective This study aimed to develop the cultural scripts of trauma inventory (CSTI) for German-speaking Switzerland and to explore temporal associations of script elements. Method Five semi-structured focus groups were conducted with psychotraumatologists (n = 8) and Swiss trauma survivors (n = 7). The interview schedule included open questions about different domains of potential posttraumatic changes (emotions, cognitions, worldviews, interpersonal relationships, body-related experiences, behavior, and growth). Data were analyzed using qualitative content analysis. Results The Swiss CSTI includes 57 emic elements that represent salient trauma sequelae (30 conformed with a theoretically derived item pool, 27 were newly phrased). Temporal script associations were visualized in a network, whereby self-deprecation, the urge to function and overcompensate, and the urge to hide and endure suffering had the highest number of connections. Conclusion While many posttraumatic changes identified in the present work seem to mirror pan-cultural phenomena represented in the Complex PTSD concept (e.g., self-deprecation), others (e.g., urge to function and perform, urge to hide and endure suffering) may be prominently related to Swiss culture with its value orientations. Knowledge about cultural scripts of trauma sequelae may provide a culture-specific framework that can help to understand individual experiences of distress and enable mental health practitioners to administer culturally sensitive interventions. Pending further validation, the Swiss CSTI bears the potential to advance culture-sensitive assessment of trauma sequelae.

Background The concept of cultural scripts has proven to be very useful for describing depression-like psychological complaints in different cultural regions of the world. The article presents the galaxy model and its implementation in the model of cultural scripts theoretically for the first time and connects these with cultural psychological value research. A new, extensive series of research projects aims to investigate post-trauma -related psychological complaints in various regions of the world. Methods The work in two countries/regions began with focus groups in which elements of cultural scripts were collected by traumatized clients and/or by (therapeutic) experts. For this purpose, a theory-based framework of possible post-traumatic script elements was provided. In Switzerland, focus groups were conducted with patients and experts. Focus groups were conducted with genocide survivors and other trauma victims in Rwanda and three East African countries. The evaluation was semi-quantitative. Results In Switzerland, around 50 symptoms and changes were mentioned as script elements (e. g. still having to function). Approximately 100 symptoms and changes were mentioned as script elements in East Africa (e. g. loss of dignity). The first temporal connections (i. e. strong scripts) were found for the Swiss scripts (e. g. self-devaluation - urge to function). In the East African study, cultural value orientations underlying the script groupings were also assessed (e. g. community reputation). Discussion The illustrative results presented here demonstrate the galaxy model and the suitability of the cultural script concept for recording the effects of trauma. There are differences and similarities in the two world regions examined so far. Further steps at the two study sites will be the temporal connections and the relationships to value orientations. The studies will be started at the other study sites in the following years.

Ziel dieses Artikels ist es, den Stand der Forschung zur Wirksamkeit von Psychotherapien der posttraumatischen Belastungsstörung (PTBS) kurz und prägnant wiederzugeben. Die Ergebnisse aktueller Metaanalysen und richtungsweisender Einzelstudien werden zusammengefasst sowie die wichtigsten Interventionsformen erläutert. Psychotherapien erzielen in der Behandlung der posttraumatischen Belastungsstörung eine sehr gute Wirksamkeit, die Effektstärken sind groß und denen der Pharmakotherapien überlegen. Die besten Befunde liegen für Interventionen vor, welche kognitive Umstrukturierung und Traumakonfrontation enthalten. Traumafokussierte Verfahren sind den anderen Formen von Psychotherapien überlegen. Empfohlen werden eine Reihe verschiedener kognitiv-behavioraler Verfahren sowie „eye movement desensitization and reprocessing“. Neueste erste Befunde belegen eine sehr gute Wirksamkeit für „imagery rescripting“ als schonende Intervention ohne formale Traumakonfrontation. Einzeltherapie wirkt besser als Gruppenpsychotherapie. Im Gruppensetting hat sich die „cognitive processing therapy“ als beste Intervention erwiesen. Auch bei komorbiden Erkrankungen wie Schizophrenie, bipolarer Störung oder Sucht kann und soll traumafokussiert behandelt werden. Traumafokussierte Psychotherapie im Einzelsetting ist die Behandlung der Wahl bei PTBS. Eine große Auswahl an verschiedenen wirksamen Verfahren steht zur Verfügung, gut überprüfte Manuale liegen vor. Die deutschsprachige S3-Leitlinie wird derzeit aktualisiert.

Die 11. Version der Internationalen Statistischen Klassifikation der Krankheiten und verwandter Gesundheitsprobleme (ICD-11) hat im Bereich der psychischen Störungen diverse Neuerungen implementiert, wie z. B. die Einführung der belastungsbezogenen Störungen als neue Störungsgruppe. Darin enthalten sind u. a. die posttraumatische Belastungsstörung (PTBS), die komplexe PTBS (KPTBS), die anhaltende Trauerstörung und die Anpassungsstörung. Das Ziel dieses Beitrages ist es, die genannten Störungsbilder differenziert darzustellen und wichtige Neuerungen im Vergleich zur ICD-10 herauszuarbeiten. Die PTBS und die Anpassungsstörung wurden in der ICD-11 neu konzeptualisiert und sind im Vergleich zur ICD-10 vereinfacht und spezifischer definiert. Die KPTBS stellt ein neues Störungsbild dar, das in ihrer Psychopathologie über die PTBS hinausgeht und eine sog. Störung der Selbstorganisation aufweist. Auch die anhaltende Trauerstörung wurde in der ICD-11 neu eingeführt und besitzt ein für Personen in Trauer spezifisches Störungsprofil.

Präokkupation bezeichnet eine zeitintensive gedankliche Beschäftigung mit vergangenen Lebensereignissen und deren Implikationen. Präokkupation wurde im ICD-11-Diagnosesystem neu eingeführt und verfügt bisher über keine umfangreiche klinische Konzeptualisierung. Erste Einordnungsversuche deuten aber darauf hin, dass sich Präokkupation von anderen Symptomen in vielerlei Hinsicht unterscheidet und einer maßgeschneiderten Behandlung bedarf.

The ICD-11 features a new group of disorders specifically associated with stress, which are interlinked by various symptoms, such as intrusive memory symptoms. Although research interest in these new ICD-11 diagnoses is growing rapidly, so far, no studies have systematically investigated the transdiagnostic distribution of stress-associated symptoms in these disorders. In the present study, 447 individuals completed a series of online questionnaires, which measured various stress-associated symptoms, e.g., flashbacks, preoccupation or yearning. Findings showed that the majority of correlations between the measured psychopathological constructs was between 0.30 and 0.60. Furthermore, with regard to specific diagnostic groups, a complex variation of stress-associated symptoms was observed, with preoccupation as a predominant symptom in all disorders. Results demonstrate that stress-associated symptoms are inherently interconnected yet possess an individual variation in different disorders. Furthermore, findings illustrate that preoccupation represents a major feature in all stress-associated disorders.

In the ICD-11, posttraumatic stress disorder (PTSD), adjustment disorder (AjD), and prolonged grief disorder (PGD) belong together to the new grouping of disorders specifically associated with stress, which are all characterized by intrusive core symptoms. As previous studies suggest that intrusive symptoms are associated with attentional biases, it is plausible that PTSD, AjD, and PGD are characterized by the same attentional biases as a transdiagnostic feature. The present study investigated 90 participants with symptoms of PTSD, AjD, or PGD. Individuals with a subclinical symptom presentation were also able to participate, resulting in an analogue sample with the group labels aPTSD, aAjD, and aPGD. All participants completed a symptom induction task to provoke symptoms related to attentional biases. Subsequently, a visual search task (VST) was implemented. This test assessed reaction times to trials that include stress-related, neutral, and generally negative stimuli. The VST featured an interference and facilitation condition to investigate different types of attentional biases. Findings showed that all groups were characterized by particularly fast reaction times to trials which included stress-related stimuli in the interference condition, which indicates a reversed attentional interference bias. This bias has not been reported before and is perhaps related to an avoidance behavior.