Social support is a key protective factor against mental illness. Yet, qualitative studies have suggested that emergency medical service (EMS) personnel working in ambulance contexts underutilise workplace-provided social support. Although a possible barrier to seeking support, no previous quantitative study has examined workload’s association with support utilisation in high-strain emergency settings. This study assesses the longitudinal association between EMS personnel’s workload and utilisation of workplace-provided formal support in an ambulance context. 703 personnel from a Danish EMS organisation were invited to participate in the study. The survey data were collected from 2022 to 2023 over five survey rounds. Survey data were combined with organisational records of emergency responses from the same period, providing a measure of workload at a station level. Logistic mixed models were performed to assess associations between workload, measured by number of emergency responses, and formal support utilisation. Main analyses were performed using R-Studio (version 4.4.2). Of the 703 invited personnel, 341 participated in repeated survey rounds. At the final wave, 642 employees were eligible, corresponding to a response rate of 53.2

Exposure to adverse childhood experiences (ACEs) increases the risk of developing Disturbances in Self-Organization (DSO) symptoms among adolescents. This study examines whether world assumptions and attachment orientations mediate the relationship between ACEs and DSO symptoms in a sample of Faroese adolescents. Data were collected from 687 adolescents (mean age = 14.4 years, SD = 0.6) through self-report questionnaires. Structural equation modelling was used to test the hypothesized indirect effects. Results show that higher exposure to multiple types of ACEs is associated with lower perceptions of self-worth and world meaningfulness, which are linked to higher levels of anxious attachment, and in turn, to more pronounced DSO symptoms. These findings highlight the role of attachment orientations and world assumptions in the association between ACEs and DSO symptoms, suggesting that these variables should be considered in prevention and intervention strategies for affected adolescents.

Police officers are repeatedly exposed to critical incidents, making them vulnerable to posttraumatic stress symptoms (PTSS) during service and posttraumatic stress disorder. Trauma-related coping self-efficacy (CSE) has been identified as a protective factor in posttraumatic recovery, yet little is known about its role in high-risk occupations. This study integrates the CSE framework into the cumulative burden model and examines longitudinal associations of CSE and accumulated critical incident history (CIH) with PTSS 1 year later in 2,954 police officers, while adjusting for multiple individual and organizational risk factors. The study also examines whether CIH modifies the CSE-PTSS association. Results showed that CSE was inversely associated, and CIH positively associated, with later PTSS. A small yet significant CIH × CSE interaction was found and stratified analyses indicated stronger CSE-PTSS associations at higher levels of CIH. Notably, post hoc analyses also showed lower mean CSE among officers with the highest CIH, indicating a potentially concerning pattern between cumulative exposure and strained CSE beliefs. The study provides novel etiological insights into the interplay of CSE as a protective factor and CIH as an occupational risk, underscoring their value in organizational prevention. Given the modest effect size, the interaction warrants cautious interpretation, although main findings remained consistent across sensitivity analyses, including models accounting for exposure during the 1-year follow up. Future research is needed to clarify the mechanisms linking critical incident exposure, CSE, and PTSS, and to identify factors that strengthen CSE in policing and other high-risk occupations. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

INTRODUCTION:Treatment effects among trauma-exposed child populations (≤12 years) are understudied. Practicians must therefore rely on their own clinical experience and evidence from older children when deciding on interventions for young, traumatized children. The present study aimed to review the evidence for 12 psychological treatments employed with trauma-exposed child populations. METHODS:Systematic literature searches for quantitative studies with pre-post designs were conducted separately for each method across six databases. Results were narratively synthesized and assessed on strength of evidence and methodological quality. For TF-CBT,1 EMDR, play therapy, CPP, and Sandplay, supplementary three-level meta-analyses of controlled studies were conducted. RESULTS:A total of 127 studies involving N = 5689 children were included in the narrative synthesis with most studies concerning TF-CBT. Study methodological quality varied considerably. For five of the assessed treatments (KIDNET, the Neuro-Affective Relational Model, Somatic Experiencing®, the Sleeping Dogs Method, and Compassion-Focused Therapy), no evidence was available. The partial meta-analyses revealed a large effect size for Sandplay (k = 3), moderate-to-large effect for TF-CBT (k = 24) and small-to-moderate effects for EMDR (k = 6), play therapy (k = 10), and CPP (k = 5). DISCUSSION AND CONCLUSIONS:TF-CBT is currently the most empirically supported intervention for treating trauma-related symptoms among children ≤12 years. Findings are discussed in light of methodological limitations embedded in the literature reviewed and in relation to current international treatment guidelines for PTSD in children and youth. Future research should focus on studying treatments with meager or no evidence, developmentally sensitive method refinements and more diverse samples e.g., younger ages, cultural background, trauma type(s), and associated symptomatology.

Objective: To clarify the longitudinal, directional relationship between event centrality and post-traumatic stress symptoms (PTSS), this study examined their cross-lagged associations over time in a sample of sexual assault survivors. Method: In total, 423 participants who had experienced a sexual assault were included in this study (98% female, age M = 26.68). PTSS and event centrality were assessed 3-, 6-, and 12-months post-study inclusion. A cross-lagged panel model (CLPM) and a random intercept CLPM (RI-CLPM) were fitted to the data across the three time points to capture both between- and within-person effects. Results: Significant cross-lagged effects were observed only from PTSS to centrality and not vice versa, both in the CLPM (β = 0.12, 95% CI [0.05,0.18]) and the RI-CLPM (β = 0.23, 95% CI [0.04,0.42]). That is, higher early levels of PTSS were predictive of higher subsequent levels of event centrality both at the between- and within-person level. Exploratory findings tentatively suggest that the cross-lagged dynamics between centrality and PTSS may vary as a function of the temporal distance from the index trauma, though results were not statistically significant. Generalizability of the findings is limited by the low diversity of the sample regarding demographic characteristics. Conclusions: These findings indicate that the longitudinal association between post-traumatic stress and event centrality is predominantly symptom-driven, with centrality functioning primarily as a consequence and not a driving force of ongoing distress. Exploratory results suggest a potential temporal dependence of these dynamics, highlighting the need for research with early-recruited cohorts.

OBJECTIVE:Accumulation of multiple trauma exposure has been linked to sensitization toward developing posttraumatic stress symptoms (PTSS). However, it remains unknown whether the frequency of critical incidents in the past continues to affect ambulance personnel over time. This study investigates whether the frequency of exposure to critical incidents in the past year is associated with higher PTSS levels at baseline, whether this effect persists at 12-month follow-up, and whether the emotional intensity of the most severe incident moderates the association. METHOD:A longitudinal survey study was conducted with 451 ambulance workers. Linear mixed models were utilized to analyze the associations between exposure to critical incidents in the past year and PTSS levels at baseline and at 3-, 6-, 9-, and 12-month follow-up. RESULTS:There was a positive association between frequency of critical incidents and PTSS levels, showing a dose-response pattern. PTSS declined across all groups over time, though less markedly among those with high exposure. An interaction between frequency and emotional intensity was found; the association between frequency and PTSS persisted only in those reporting high emotional intensity during the worst incident. CONCLUSIONS:There was a significant association between frequency of exposure and PTSS over 12 months but only for those experiencing high emotional intensity. This association remained significant when adjusting for covariates and new exposures. To understand posttraumatic stress disorder development in ambulance work, it is important to acknowledge past exposure with a focus on the interaction between a high frequency of critical incidents and the emotional intensity experienced. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Natural disasters pose significant psychological challenges, particularly for adolescents, who are developmentally vulnerable to trauma-related disorders. In 2022, widespread flooding in Southern Punjab, Pakistan, caused substantial loss. The present study evaluated the efficacy of Single-Session Acceptance and Commitment Therapy (SS-ACT) in reducing PTSD symptoms among adolescents aged 12–18 years in Taunsa, Pakistan. A two-arm randomized multiple baseline design was employed, with 85 participants equally distributed across experimental (n = 38) and control (n = 47) groups. The intervention was structured around the ACT Triflex model, emphasizing Be Present, Open Up, and Do What Matters. Outcome measures included the Child PTSD Symptom Scale (CPSS). Repeated-measures ANOVA revealed a significant reduction in PTSD symptoms in the experimental group immediately post-intervention F(3.38, 280.57) = 19.43, p < .001, η² = 0.19), with a significant time × group interaction F(3.38, 280.57) = 8.78, p < .001, η² = 0.10). Gender analyses indicated minor differences but no significant three-way interaction (time × group × gender). The findings suggest that SS-ACT is a feasible, culturally adaptable, and cost-effective intervention for post-disaster adolescent populations, and may serve as an early, stepped-care psychological support approach to help reduce acute symptoms. Implications for theory, clinical practice, policy, and future research underscore its potential integration into disaster-response frameworks and preventive mental health programs in resource-limited, disaster-prone regions.

Approximately 14% of individuals develop PTSD symptoms in response to trauma. Existing literature provides substantial evidence supporting Acceptance and Commitment Therapy (ACT) in enhancing psychological flexibility and reducing PTSD symptoms. This study aimed to investigate the efficacy of ACT in managing PTSD symptoms. The PRISMA flowchart was used to guide the selection of relevant studies. A comprehensive meta-analysis was conducted to determine the effect size of ACT's efficacy. A total of 25 studies were included in the systematic review, while 20 studies were included in meta-analysis. The quality of the selected studies was independently assessed by two reviewers using a quality rating scale (Yates et al., 2005). Meta-analytic findings indicated a mean effect size of 1.274 with a 95% confidence interval of 0.906 to 1.643, reflecting a large treatment effect. However, the narrative synthesis revealed that results across studies were not directly comparable due to heterogeneous study characteristics. This study highlights the strong potential of ACT as an effective intervention for PTSD, particularly in the context of natural and human-made disasters or traumatic incidents. Despite variability across studies, the overall evidence supports ACT's use in trauma-informed care, warranting further investigation through high-quality, standardized trials.

Background Ambulance personnel are routinely exposed to emotionally demanding and high-stress situations, making adequate support initiatives crucial for their mental health. Previous research suggests that ambulance workers' subjective experience of perceived support is more strongly associated with mental health outcomes than measures of specific types of support. However, the relationship between specific types of received support and the overall perception of receiving support remains unclear. This study investigates how different types of support and the overall amount of support types used are associated with perceived support among ambulance personnel.Methods In this cross-sectional study of 389 ambulance personnel, regression analyses were applied to examine the associations between six types of received support and perceived support. We adjusted for covariables and support outside work. Additionally, a generalised linear model was used to assess the association between the total number of support types used and perceived support.Results This study demonstrates that four specific types of received support (debriefing/defusing, formal peer support, informal managerial support and informal collegial support) were significantly positively associated with perceived support among ambulance personnel (debriefing/defusing: B=2.44, SE=0.77, t=2.80, 95% CI 0.90 to 3.90; formal peer support: B=2.35, SE=1.19, t=1.83, 95% CI 0.02 to 4.67; informal managerial support: B=2.08, SE=0.80, t=2.54, 95% CI 0.48 to 3.59; informal collegial support: B=4.21, SE=1.90, t=2.87, 95% CI 0.47 to 7.83). Additionally, the number of support types used was associated with higher levels of perceived support.Conclusion These findings highlight the need for a multifaceted support strategy, focusing on both specific support types as well as availability of several parallel support initiatives, in organisational prevention strategies.

BACKGROUND:Recently, in addition to the increasing number of terrorist attacks and school shootings, mass shootings in public places by psychiatric patients have become more common. OBJECTIVE:To investigate the psychological sequelae following a mall shooting at Fields in Copenhagen according to two diagnostic manuals. METHOD:A sample of 85 adults who were present during the shooting were assessed half a year later for post-traumatic stress disorder (PTSD) with two questionnaires based on Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition (DSM-IV) and International Classification of Diseases, 11th Revision (ICD-11), respectively, together with measures of comorbid disorders, psychological factors, and social support. Hierarchical multiple regression analyses were performed to study the effects of demographics, trauma exposure, and psychological factors on PTSD. RESULTS:The number of participants who met the ICD-11 criteria for PTSD (29.7 percent) was higher than the ones who met the similar/who met the corresponding criteria according to DSM-IV (20.0 percent). The final regression model included gender, injury, sick leave, self-efficacy, and dissociation. It explained 68.1 percent of the variation of PTSD based on ICD-11 and 72.8 percent of the variation based on DSM-IV. CONCLUSION:The present study expands disaster research with finding close similarities between two diagnostic systems and aligns disaster research on findings of the role of gender, injury, and psychological factors. The results also point to the need for a proactive approach to intervention.

Background Exposure to traumatic events can have posttraumatic effects in young children. It is challenging to identify posttraumatic symptoms. It is necessary to directly investigate the signs of traumatization in young children. The aim of the study was to investigate the links between children's externalizing and internalizing symptoms reported by caregivers and indicators of traumatization assessed by using the young children as informants.Method Study used data from 110 (59.1% girls) children aged 4 to 9 years. The children have been recruited across the social and mental health services that provide support for abused children in Lithuania. Externalizing and internalizing difficulties measured using caregiver reports with the Strengths and Difficulties Questionnaire (SDQ). Indicators of traumatization were measured with the Odense Child Trauma Screening (OCTS).Results The higher levels of indicators of traumatization were significantly related to higher conduct and externalizing problems. The traumatization indicators related to child mental representation of adults were a significant predictor of children's conduct problems.Conclusions The indicators of traumatization could be linked to externalized mental health difficulties of a child after trauma. Also, the findings might indicate that for the parents and caregivers it might be challenging to recognize internalizing symptoms, associated to traumatization.

Introduction This study investigated stalking victimization profiles among 476 help-seeking individuals in Denmark to identify distinct behavior patterns and associated psychological effects. It was hypothesized that multiple stalking behavior patterns would emerge, each linked to different mental health impairments. Methods Data were collected through the Danish Stalking Center from 2020 to 2023. Latent class analysis was used to identify stalking behavior patterns. Multinomial logistic regression examined predictors of class membership, while multivariate analysis explored associations between class membership and mental health outcomes. Results Four distinct classes of stalking behavior were identified: 1) ``High intensity stalking with gifts and moderate risk of physical aggression,'' 2) ``High intensity stalking with physical aggression,'' 3) ``Stalking with no gifts or physical aggression,'' and 4) ``Stalking with gifts and low risk of invasion and aggression.'' Victim demographics were minimal predictors of class membership, with intimate partner relationships and having children associated with specific class memberships. Mental health outcomes varied significantly across classes, revealing a dose-response pattern where higher intensity stalking behaviors corresponded to more severe mental health impacts. The ``High intensity stalking with gifts and moderate risk of physical aggression'' class reported the highest levels of post-traumatic stress disorder (PTSD) symptoms, disturbances in self-organization (DSO) symptoms, anxiety, and social life impairment. The ``High intensity stalking with physical aggression'' class showed the highest depression scores and greatest impairment in family life. There were no class-differences in risk of endorsing criteria for a probable diagnosis of PTSD or Complex PTSD. Conclusion The study reveals diverse manifestations of stalking behavior and their differential impacts on victim's mental health. The findings suggest that the presence of gifts or physical aggression is associated with more significant psychological and functional impairments. These insights can inform targeted interventions and support strategies for stalking victims.

While empirical research on understanding the risk factors and comorbidities of PTSD and complex PTSD (CPTSD) in veteran populations is growing, few studies have investigated emotion regulation (ER) difficulties and aggression in this population. This study seeks to investigate the prevalence and risk factors of PTSD and CPTSD among Danish treatment-seeking veterans. Specifically, the study aims to examine the relationship between posttraumatic symptoms, ER difficulties, and aggression in veterans, and identify potential demographic and trauma-related risk factors as set out in the World Health Organization’s ICD-11classifications.1 A sample of 142 Danish war veterans from a highly specialized trauma treatment unit participated by completing the International Trauma Questionnaire (ITQ) and questionnaires on symptomatology, trauma experiences, and medication. Hierarchical multiple linear regression analyses were employed to explore the predictability and explanatory power of independent variables significantly associated with posttraumatic symptoms. A total of 29.8% met the criteria of probable PTSD, while 56.0% met the criteria of probable CPTSD. Clinically relevant scores were reported in emotion dysregulation and posttraumatic symptoms, along with low levels of aggressive behavior. Notably, aspects of ER (Non-acceptance, Impulse, and Strategies), Somatization, and persistent Dissociation emerged as the strongest contributors to perceived PTSD symptoms. Similarly, ER Strategies, Somatization, and perceived lack of social support had the most significant individual impact on perceived CPTSD symptoms. This research supports existing literature indicating a higher prevalence of CPTSD than PTSD among treatment-seeking veterans, emphasizing challenges with dissociation, somatization, absence of social support, and difficulties in ER.