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--- - |2 Convergent intraverbals represent a specific type of intraverbal in which multiple components of one speaker's verbal behavior control a specific verbal response from another speaker (e.g., Speaker 1: What wooly, horned animal lives in the high country? Speaker 2: Bighorn sheep). To foster the development of advanced language, Sunderbeg and Sundberg (2011) proposed prerequisite skills that may engender the emergence of novel, convergent intraverbals. We used a multiple‐probe design with both nonconcurrent (across participants) and concurrent (across stimulus sets) components to evaluate the effects of training these prerequisite skills on the emergence of convergent intraverbals with four children with autism. Participants showed the emergence of convergent intraverbals at mastery levels after they displayed mastery performance on all of the prerequisite skills identified by Sundberg and Sundberg, lending support to their characterization as prerequisites. We discuss these findings in terms of operant mechanisms that may facilitate the development of generative language. - Journal of Applied Behavior Analysis, EarlyView.

--- - |2 Abstract Our environment is constantly overloaded with information, although we cannot consciously process all the stimulation reaching our senses. Current theoretical models are focused on the cognitive and neural processes underlying conscious perception. However, cognitive processes do not occur in an isolated brain but in a complex interaction between the environment, the brain, and the organism. The brain‐body interaction has largely been neglected in the study of conscious perception. The aim of the present study was to explore if heart rate and skin conductance (SC) are modulated by the interaction between phasic alertness and conscious perception. We presented near‐threshold visual stimuli that could be preceded by an alerting tone on 50% of the trials. Behaviorally, phasic alerting improved perceptual sensitivity for detecting a near‐threshold stimulus (along with changes in response criterion). Following the alerting tone, a cardiac deceleration‐acceleration pattern was observed, which was more pronounced when the near‐threshold stimulus was consciously perceived in comparison with unconsciously perceived stimuli. SC results further showed some degree of subliminal processing of unseen stimuli. These results reveal that cardiac activity could be a marker of attention and consciousness interactions, emphasizing the need for taking into account brain‐body interactions for current theoretical models of consciousness. - Psychophysiology, EarlyView.

--- - |2 Abstract Prior to and during movement, oscillatory alpha activity gates cognitive resources toward motor areas of the cortex by inhibiting neuronal excitability in nonmotor areas. The present study examined the effect of manipulating target variability on this alpha gating phenomenon. Using a baseline‐test‐retention design, we measured EEG alpha power, performance accuracy, and task difficulty in 32 recreational golfers as they putted golf balls (20 per target) to one central target (baseline, retention) and four targets of different directions and extents (manipulation). For participants in the random group (n = 16), target location varied with each repetition in a random fashion, whereas for participants in the blocked group (n = 16), it was kept constant within blocks. Regional analyses revealed a focal pattern of lower central alpha and higher occipital and temporal alpha. This topography was specific to preparation for movement and was associated with performance: smallest performance errors were preceded by decreased central combined with increased occipital alpha. The random group performed worse than the blocked group and found the task more difficult. Importantly, left temporal alpha prior to movement onset was lower for the random group than the blocked group. No group differences were found at baseline or retention. Our study proved that alpha gating can be altered by manipulating intertrial variability and thereby demonstrated the utility of the alpha gating model. Our findings underscore the importance of inhibiting occipital and left temporal areas when performing movements and provide further evidence that alpha gating reflects neural efficiency during motor tasks. - Psychophysiology, EarlyView.

--- - "\n\nEnsuring that practitioners are competent in the therapies they deliver is important for training, therapeutic outcomes and ethical practice. The development of the Systemic Practice Scale (SPS) is reported – a measure to assess the competence of students as trialed by Children and Young Person's Improving Access to Psychological Therapies (CYP‐IAPT) training courses. Initial reliability assessment of the SPS with twenty‐eight supervisors of systemic practice evaluating students’ competence using an online recording of a family therapy session is detailed. The SPS was found to be a reliable measure of systemic competence across training settings. Rating variability was noted, with training and benchmarking to improve rating consistency recommended. Further research using the SPS to further establish the reliability and validity of the scale is required.\n\n\nPractitioner points\n\n\n\nSPS represents an important tool, particularly for the supervision and development of more junior staff or students\n\nInitial reliability for use of the SPS as a formative tool has been established. Further benchmarking is required if using the tool in a summative manner \n\n\n\n" - Journal of Family Therapy, EarlyView.

--- - |2 The popularity of Olympic‐style weightlifting in fitness routines is growing, but participating in these exercises with improper technique places lifters at increased risk for injury. Fitness training professionals have developed multiple teaching strategies, but have not subjected these strategies to systematic evaluation, particularly with novice lifters. Two strategies recommended by professional training organizations are akin to forward and backward chaining, which have been shown effective at teaching other novel, complex behaviors. The present study compared these forward‐ and backward‐chaining‐like strategies to teach novice lifters “the clean” and “the snatch,” two Olympic weightlifting movements frequently incorporated into high‐intensity training programs. Participants performed lifts taught with forward chaining more accurately than lifts taught with backward chaining. - Journal of Applied Behavior Analysis, EarlyView.

--- - |2 Previous researchers have taught sighted adults to match braille sample stimuli to print comparisons in a matching‐to‐sample (MTS) format and assessed the emergence of other braille repertoires, such as transcribing and reading braille following this training. Although participants learned to match to sample with braille, they displayed limited emergence of other braille repertoires. Lack of generative responding may have resulted from participants' over‐selective attending to components of compound braille characters during instruction. We taught undergraduates to construct braille characters given a print sample, which required attending to each individual braille symbol, and assessed generative braille responding. Participants met mastery of 378 braille construction responses and demonstrated modestly improved responding compared with previous research. - Journal of Applied Behavior Analysis, EarlyView.

--- - |2 Substantial research supports bidirectional links between intimate relationship discord and individual psychopathology, including depressive symptoms. However, few studies have utilized daily diary methods to capture the micro‐level processes underlying the association between couple discord and depression, particularly among populations that are at elevated risk for both interpersonal and individual dysfunction. To address this gap, we examined whether daily changes in satisfaction with relationship functioning were associated with daily changes in negative affect and positive affect over the span of 2 weeks among mental health outpatients of low socioeconomic status. Participants were 53 low‐income outpatients from community mental health clinics who completed a semi‐structured interview about the quality of their intimate relationships followed by 14 daily reports of positive and negative mood and satisfaction with relationship functioning across several domains. Growth curve analytic techniques revealed the hypothesized bidirectional relations. Decline in satisfaction with relationship functioning predicted escalation in negative affect and deterioration in positive affect over 2 weeks, and deterioration of mood predicted declining satisfaction with relationship functioning. This study extends existing knowledge about couple dysfunction and individual psychopathology by highlighting the immediate nature of this dynamic process as it unfolds over time. Resumen Gran cantidad de investigaciones respaldan las conexiones bidreccionales entre los desacuerdos en las relaciones afectivas y la psicopatología individual, incluidos los síntomas depresivos. Sin embargo, pocos estudios han utilizado los métodos de registro diario para captar los procesos a pequeñísima escala que subyacen a la asociación entre el desacuerdo entre las parejas y la depresión, particularmente entre poblaciones que tienen un riesgo elevado de disfunción interpersonal e individual. Para abordar esta brecha, analizamos si los cambios diarios en la satisfacción con el funcionamiento de la relación estuvieron asociados con los cambios diarios en el afecto negativo y el afecto positivo durante el periodo de dos semanas entre los pacientes ambulatorios de salud mental de bajo nivel socioeconómico. Los participantes fueron 53 pacientes ambulatorios de bajos ingresos de clínicas comunitarias de salud mental que se sometieron a una entrevista semiestructurada acerca de la calidad de sus relaciones afectivas seguida de 14 informes diarios de estado de ánimo positivo y negativo y de satisfacción con el funcionamiento de la relación en varias áreas. Las técnicas analíticas de la curva de crecimiento revelaron las relaciones bidireccionales planteadas como hipótesis. La disminución de la satisfacción con el funcionamiento de la relación predijo un aumento del afecto negativo y un deterioro del afecto positivo durante dos semanas, y el deterioro del estado de ánimo predijo una disminución de la satisfacción con el funcionamiento de la relación. Conclusiones: Este estudio amplía el conocimiento existente sobre la disfunción en la pareja y la psicopatología individual destacando la índole inmediata de este proceso dinámico a medida que se desarrolla poco a poco con el tiempo. 摘要 大量研究支持亲密关系不和谐以及个人精神病理学之间的双向关联,包括抑郁症状。然而,很少有研究使用每日日记方法来捕捉伴侣不和谐以及抑郁症之间联系的潜在微观过程,特别是在人际和个人功能紊乱高危人群中间。为了填补这一空白,我们在为期两周的时间里考察了低社会经济地位的精神健康门诊患者中关系功能满意度每日变化是否和积极和消极情感每日变化相关。参与者是53位来自社区精神健康门诊的低收入门诊患者。这些患者完成了一项关于亲密关系质量的办结构化采访,并后续完成了14份关于各方面积极和消极情绪以及亲密关系满意度的每日报告。成长曲线分析技术显示了假设的双向关系。在为期两周内,关系功能满意度的降低预测消极情绪升级以及积极情绪恶化,而情绪恶化预期关系功能满意度的降低。结论是:该研究通过强调该动态过程随时间发展的即时性扩展了关于伴侣功能紊乱以及个人精神病理学的已有知识。 - Family Process, EarlyView.

--- - |2 For many, binge drinking behaviors start early and become a persistent pattern of use throughout the lifespan. In an effort to strengthen understanding of etiology, this study considered the mechanisms from the self‐medication hypothesis and family socialization theory. The goal was to identify whether emotional distress is a potential shared mechanism that accounts for the development of binge drinking in different developmental periods. This study used the National Longitudinal Study of Adolescent to Adult Health (Add Health) dataset to examine binge drinking across time for n = 9,421 participants ranging in age from 11 to 18 (M = 15.39, SD = 1.62) at Wave I and ranging from 24 to 32 (M = 28.09, SD = 1.61) at Wave IV of the study. Using an autoregressive cross‐lagged model, I examined how parent‐child closeness, depressive symptoms, and binge drinking were related over three developmental periods. In examining cross‐sectional and longitudinal relations, depressive symptoms were significantly related to binge drinking more often than parent‐child closeness; however, results indicated the self‐medication model may primarily account for concurrent drinking behaviors rather than long‐term. The family socialization theory was indicated to account for some variability above and beyond the self‐medication hypothesis. No indirect association between binge drinking and the parent‐child relationship was detected through depressive symptoms, failing to support a shared mechanism between the two theories. The results provide support for a multifaceted assessment process for substance using clients, and support the use of Multisystemic Family Therapy, Multidimensional Family Therapy, and perhaps Attachment‐Based Family Therapy. Resumen Para muchos, las conductas de consumo de alcohol compulsivo comienzan temprano y se convierten en un patrón de uso persistente durante toda la vida. En un esfuerzo para fortalecer el entendimiento de la etiología, este estudio consideró los mecanismos desde el punto de vista de la hipótesis de automedicación y la teoría de socialización familiar. La meta fue identificar si la angustia emocional es un posible mecanismo compartido que explica el desarrollo de consumo de alcohol compulsivo en periodos de desarrollo distintos. Este estudio empleó el conjunto de datos del Estudio Longitudinal Nacional de Salud de Adolescentes a Adultos (conocido como Add Health) para examinar el consumo de alcohol compulsivo a lo largo del tiempo para n = 9.421 participantes con edades de 11 a 18 (M = 15.39, DE = 1.62) en la Fase I y de 24 a 32 (M = 28.09, DE = 1.61) en la Fase IV del estudio. Usando un modelo autorregresivo de correlaciones cruzadas, examiné como la cercanía padre‐hijo, los síntomas depresivos y el consumo de alcohol compulsivo se relacionaban a lo largo de tres periodos de desarrollo. En un examen de relaciones transversales y longitudinales, los síntomas depresivos se asociaron significativamente al consumo de alcohol compulsivo con mayor frecuencia que la cercanía padre‐hijo; sin embargo, los resultados indicaron que el modelo de automedicación podría ser una explicación principal de conductas concurrentes de consumo de alcohol en vez de a largo plazo. La teoría de socialización familiar se indicó con miras a explicar cierta variabilidad más allá de la hipótesis de automedicación. No se detectó ninguna asociación indirecta entre el consumo de alcohol compulsivo y la relación padre‐hijo a través de síntomas depresivos, lo que no proporciona apoyo a un mecanismo compartido entre las dos teorías. Los resultados proporcionan apoyo a un proceso de evaluación multifacética para clientes consumidores de sustancias, y apoya el uso de Terapia Familiar Multisistémica, Terapia Familiar Multidimensional, y quizás Terapia Familiar Basada en Apegos. 摘要 对很多人来说,暴饮行为很早便开始,并且在一生中形成持续使用模式。为了加强对暴饮病因学上的理解,该研究考虑了自我用药假设和家庭社会化理论的机制,目的在于确定情绪困扰是否是解释不通发展阶段暴饮发展的潜在共同机制。该研究使用国家青少年到成年期健康纵向研究数据组来考察9421名参与者,其中第一阶段年龄在11到18岁(M = 15.39, SD = 1.62),第三阶段年龄在24到32岁间(M = 28.09, SD = 1.61)。使用自动递减模型,我考察了家长‐儿童亲密度,抑郁症状,以及暴饮是如何在三个发展时期相关联。在考察横向和纵向关系时,抑郁症状比家长‐孩子亲密度和暴饮有更经常的显著联系。然而,结果显示自我用药模型可能主要解释同期发生的而不是长期饮酒行为。结果还表明家庭社会化理论解释一些超出自我用药假设的变量。暴饮和家长‐孩子关系之间没有通过抑郁症状的必然联系,从而不能支持两个理论之间的共同机制。结果为药物滥用患者多方面评估过程提供支持,并支持使用多系统家庭心理治疗,多维度家庭心理治疗,和依恋为基础的家庭心理治疗。 - Family Process, EarlyView.

--- - |2 Abstract To provide a basis for electroencephalography (EEG) neurofeedback protocols for bulimia nervosa (BN), binge‐eating disorder (BED), and obesity, this systematic review investigates alterations in EEG‐measured brain activity, specifically frequency bands. A systematic literature search with predefined search terms yielded N = 7 studies meeting the inclusion criteria. The risk of bias was assessed for all studies. In resting‐state EEG, the beta activity was elevated in fronto‐central regions in individuals with obesity and co‐morbid BED. In food‐cue conditions, both obese individuals with and without BED showed increased beta activity, suggesting increased awareness of food cues and a heightened attentional focus towards food stimuli. The level of beta activity was positively correlated with eating disorder psychopathology in resting and food‐cue conditions. In individuals with BN, there was no evidence for altered EEG spectral power. The results indicate specific alterations in EEG‐based brain activity in individuals with BED and obesity. More high‐quality studies are needed to further confirm these findings and to transfer them into EEG‐based interventions. - European Eating Disorders Review, EarlyView.

--- - |2 Abstract To date, several fMRI studies reveal activation in motor planning areas during musical auditory imagery. We addressed whether such activations may give rise to peripheral motor activity, termed subvocalization or covert singing, using surface electromyography. Sensors placed on extrinsic laryngeal muscles, facial muscles, and a control site on the bicep measured muscle activity during auditory imagery that preceded singing, as well as during the completion of a visual imagery task. Greater activation was found in laryngeal and lip muscles for auditory than for visual imagery tasks, whereas no differences across tasks were found for other sensors. Furthermore, less accurate singers exhibited greater laryngeal activity during auditory imagery than did more accurate singers. This suggests that subvocalization may be used as a strategy to facilitate auditory imagery, which appears to be degraded in inaccurate singers. Taken together, these results suggest that subvocalization may play a role in anticipatory auditory imagery, and possibly as a way of supplementing motor associations with auditory imagery. - Psychophysiology, EarlyView.

--- - |2 Abstract Metrics of heart period variability are widely used in the behavioral and biomedical sciences, although somewhat confusingly labeled as heart rate variability (HRV). Despite their wide use, HRV metrics are usually analyzed and interpreted without reference to prevailing levels of cardiac chronotropic state (i.e., mean heart rate or mean heart period). This isolated treatment of HRV metrics is nontrivial. All HRV metrics routinely used in the literature exhibit a known and positive relationship with the mean duration of the interval between two beats (heart period): as the heart period increases, so does its variability. This raises the question of whether HRV metrics should be “corrected” for the mean heart period (or its inverse, the heart rate). Here, we outline biological, quantitative, and interpretive issues engendered by this question. We provide arguments that HRV is neither uniformly nor simply a surrogate for heart period. We also identify knowledge gaps that remain to be satisfactorily addressed with respect to assumptions underlying existing HRV correction approaches. In doing so, we aim to stimulate further progress toward the rigorous use and disciplined interpretation of HRV. We close with provisional guidance on HRV reporting that acknowledges the complex interplay between the mean and variability of the heart period. - Psychophysiology, EarlyView.

--- - |2+ Abstract Introduction Evidence suggests that food addiction (FA) is prevalent among individuals with obesity seeking bariatric surgery (BS), but there is no evidence about whether FA is a predictor of weight loss (WL). We aimed to analyse the prevalence of FA in patients with obesity seeking BS and to examine whether FA could predict WL following dietary intervention before surgery. Method The study included 110 patients with obesity who underwent a dietetic intervention. Assessment included endocrinological variables, a semistructured interview to rule out mental disorders, and Yale Food Addiction Scale version 2.0 (YFAS 2.0). Results In our sample, the prevalence of FA was 26.4%. Those who met YFAS 2.0 criteria showed less WL after dietetic intervention and regain weight during dietary intervention. Conclusions FA appears to be prevalent in obesity. Our findings confirmed a lower WL throughout dietary intervention before surgery in patients who fulfilled baseline criteria for FA. Future interventions should include multidisciplinary intervention to maximize WL before and after BS. - European Eating Disorders Review, EarlyView.

--- - |2+ Background Anxiety disorders are one of the most common mental illnesses in children and associated with high healthcare utilization. We aimed to estimate 2‐year cumulative incidence of mental health–related hospitalizations, treated self‐harm, and emergency room (ER) visits in children newly diagnosed with anxiety disorders and, for context, in children without anxiety disorders. Methods We identified commercially insured treatment naïve children (3–17 years) with a new office‐based anxiety disorder diagnosis (ICD‐9‐CM) from 2005–2014 in the MarketScan claims database. We followed children for up to 2 years after diagnosis for the first of each event: mental health–related hospitalization, inpatient, treated self‐harm, and ER visits (any, anxiety‐related, injury‐related). Children without anxiety diagnoses were included as comparators, matched on age, sex, date, and region. We estimated cumulative incidence of each event using Kaplan–Meier analysis. Results From 2005–2014, we identified 198,450 children with a new anxiety diagnosis. One‐year after anxiety diagnosis, 2.0% of children had a mental health–related hospitalization, 0.08% inpatient, treated self‐harm, 1.4% anxiety‐related ER visit, and 20% any ER visit; incidence was highest in older children with baseline comorbid depression. One‐year cumulative incidence of each event was lower in the comparison cohort without anxiety (e.g., mental health–related hospitalizations = 0.5%, treated self‐harm = 0.01%, and ER visits = 13%). Conclusions Given the prevalence of anxiety disorders, 2‐year incidence estimates translate to a significant number of children experiencing each event. Our findings offer caregivers, providers, and patients information to better understand the burden of anxiety disorders and can help anticipate healthcare utilization and inform efforts to prevent these serious events. - Depression and Anxiety, EarlyView.

--- - |2+ Background Recent policy in England has called on services for children and young people's mental health and well‐being to develop and deliver local transformation plans to increase the provision of evidence‐based, outcomes‐informed and service user‐informed treatments. The role of local leadership in service transformation is poorly understood, despite evidence suggesting it is key to enacting change. Purpose To understand the role of local leaders and frontline practitioners in service transformation in child and adolescent mental health services. Methodology This study was a secondary analysis of semistructured interviews with n = 20 leaders and n = 29 frontline practitioners in child and adolescent mental health services taking part in a service transformation programme. Results Leaders’ role in service transformation in child and adolescent mental health services (CAMHS) was to: (a) foster impetus for transformation by demonstrating passion and commitment for change, (b) support practitioners in developing microsystem improvements and (c) bridging the organisation's goals with available resources. Conclusions When developing transformation plans for child and adolescent mental health services, local leaders should be transparent about reasoning and processes, enable practitioners to tailor implementation to need and provide ongoing support. Practitioner engagement needs careful planning given its crucial role in enabling collaboration that will facilitate change. - Child and Adolescent Mental Health, EarlyView.

--- - |2 In “Are we smart enough to know how smart animals are?” de Waal (2016) summarizes field studies and experiments that demonstrate a huge number of examples of complex behavior in many animal species. His avowed aim is to challenge the views of both lay people and scientists about the limits of intelligence of other species and to demonstrate much closer similarity in the achievements of other species to those of humans, thus undermining claims of human uniqueness. His general explanatory scheme is to infer human‐like cognitive processes in other species to explain complex behavior, at least when this is supported by other evolutionary considerations. This review suggests how behavior analysis might explain some of the phenomena outlined by de Waal, indicates where its explanatory system may need to expand and develop to encompass a wider range of behavior, and points to similarities as well as differences between the explanatory scheme used by de Waal and that of behavior analysis. - Journal of the Experimental Analysis of Behavior, EarlyView.

--- - |2 Abstract Similarities in neural activation patterns in obese and substance‐dependent subjects led to the food addiction concept, but studies exploiting this issue for obesity stratification are missing. We assessed brain activation in response to food cues using 18F‐2‐fluoro‐2‐deoxy‐glucose‐PET in 36 overweight women, stratified by low or high food addiction groups according to the Yale Food Addiction Scale (YFAS). Assessments were repeated after a 3‐month diet. We found greater activation in thalamus, hypothalamus, midbrain, putamen, and occipital cortex (reward), but not in prefrontal and orbitofrontal cortices (control/reward receipt) in the high‐YFAS versus low‐YFAS group. In high‐YFAS subjects, orbitofrontal responsiveness was inversely related to YFAS severity and hunger rating, and positive associations were observed between regional brain activation and lipid intake. A 3‐month diet abolished group differences in brain activation. Our data suggest that food addiction distinguishes an overweight phenotype that can be reversed by diet, opening to personalized strategies in obesity treatment. - European Eating Disorders Review, EarlyView.

--- - - Journal of Traumatic Stress, Volume 31, Issue 5, Page 627-629, October 2018.

--- - |2+ Abstract Objective While there is sufficient research and clinical evidence to support the inclusion of gaming disorder in the latest revision of the International Classification of Diseases (ICD‐11), relatively little is known about the effectiveness of first‐line psychological treatment for gaming disorder or Internet gaming disorder (IGD) as it is listed in the DSM‐5. This systematic review employed meta‐analytic techniques to determine the effectiveness of cognitive‐behavioral therapy (CBT) for IGD on four key outcomes: IGD symptoms, anxiety, depression, and time spent gaming. Method A database search identified 12 independent CBT studies. Effect size estimates (Hedges' g) with associated confidence intervals, prediction intervals and p values, for each pre‐post treatment outcome, were calculated. Study reporting quality was evaluated in accordance with the Consolidated Standards of Reporting Trials (CONSORT) guidelines. Subgroup and moderator analyses were undertaken to investigate potential sources of heterogeneity. Results CBT demonstrated high efficacy in reducing IGD symptoms (g=.92, [0.50,1.34]) and depression (g=.80, [0.21,1.38]) and showed moderate efficacy in reducing anxiety (g=.55, [0.17,0.93]) at post‐test. There was insufficient power to determine whether CBT was capable of reducing time spent gaming. Treatment gains at follow‐up were non‐significant across the four treatment outcomes. Conclusions The pooled findings suggest that CBT for IGD is an effective short‐term intervention for reducing IGD and depressive symptoms. However, the effectiveness of CBT for reducing actual time spent gaming was unclear. Given the limitations of this evidence base, there is a need for more rigorous studies to determine the potential long‐term benefits of CBT for IGD. - Clinical Psychology & Psychotherapy, Volume 0, Issue ja, -Not available-.

--- - |2 Abstract Developmental trauma disorder (DTD) has been proposed as clinical framework for the sequelae of complex trauma exposure in children. In this study, we investigated whether DTD is associated with different traumatic antecedents than posttraumatic stress disorder (PTSD). In a multisite sample of 236 children referred from pediatric or mental health treatment, DTD was assessed using the DTD Structured Interview. Trauma history was assessed using the Traumatic Events Screening Instrument (TESI). On an unadjusted basis, both DTD, odds ratios (ORs) = 2.0–3.8, 95% CI [1.17, 7.19]; and PTSD, ORs = 1.8–3.0, 95% CI [1.04, 6.27], were associated with past physical assault and/or abuse, family violence, emotional abuse, neglect, and impaired caregivers; and DTD was associated community violence, OR = 2.7, 95% CI [1.35, 5.43]. On a multivariate basis after controlling for the effects of PTSD, DTD was associated with family and community violence and impaired caregivers, ORs = 2.0–2.5, 95% CI [1.09, 5.97], whereas PTSD was only associated with physical assault and/or abuse after controlling for the effects of DTD, OR = 2.4, 95% CI [1.07, 4.99]. Exposure to both interpersonal trauma and attachment adversity was associated with the highest DTD symptom count, controlling for the PTSD symptom count. Although childhood PTSD and DTD share several traumatic antecedents, DTD may be uniquely associated with pervasive exposure to violent environments and impaired caregiving. Therefore, DTD warrants further investigation as a framework for the assessment and treatment of children with histories of interpersonal victimization and attachment adversity. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Cuando Ningún Lugar es Seguro: El Trauma Interpersonal y Adversidad Del Apego como Antecedentes de los Trastornos de Estrés Traumático y de Trauma en el Desarrollo. ANTECEDENTES DEL TRASTORNO DE TRAUMA EN EL DESARROLLO El trastorno de trauma en el desarrollo (DTD, en su sigla en inglés) ha sido un marco clínico para las secuelas de la exposición a trauma complejo en niños. En este estudio, investigamos si el DTD está asociado con antecedentes traumáticos diferentes al trastorno de estrés traumático (TEPT). En una muestra de 236 niños de diferentes lugares y derivados desde el tratamiento pediátrico o de salud mental, el DTD fue evaluado usando la Entrevista Estructurada de DTD. La historia de trauma fue evaluada usando el Instrumento de Tamizaje de Eventos Traumáticos (TESI, en su sigla en inglés). En una base no ajustada, ambos DTD, odds ratios (ORs, en su sigla en inglés) = 2.0–3.8, 95% intervalo de confianza (IC) [1.17, 7.19], y TEPT, ORs = 1.8–3.0, 95% IC [1.04, 6.27], estuvieron asociados a antecedentes pasados de abuso y/o maltrato físicos, violencia familiar, abuso emocional, negligencia, y discapacidad de los cuidadores, y el DTD estuvo asociado con violencia comunitaria, OR = 2.7, 95% IC [1.35, 5.43]. Sobre una base multivariada luego de controlar los efectos de TEPT, el DTD estuvo asociado con violencia familiar y comunitaria y discapacidad de los cuidadores, ORs = 2.0–2.5, 95% IC [1.09, 5.97], mientras que el TEPT estuvo solamente asociado con abuso y maltrato físico luego de controlar los efectos de DTD, OR = 2.4, 95% IC [1.07, 4.99]. La exposición tanto a trauma interpersonal como a adversidad del apego estuvieron asociadas con la más alta contribución a los síntomas del DTD, luego de controlar la contribución de los síntomas de TEPT. Aunque los DTD y TEPT en la infancia comparten varios antecedentes traumáticos, el DTD podría ser asociado únicamente con la exposición generalizada a ambientes violentos y cuidadores discapacitados. Por lo tanto, el DTD requiere mayor investigación como un marco para la evaluación y tratamiento de niños con historias de victimización interpersonal y adversidad de apego. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 When Nowhere is Safe: Interpersonal Trauma and Attachment Adversity as Antecedents of Posttraumatic Stress Disorder and Developmental Trauma Disorder Traditional Chinese 標題: 當四周均無安全之所:人際創傷和惡劣依附經驗作為創傷後壓力症和發展性創傷障礙的前因 撮要: 過往有研究提出, 發展性創傷障礙(DTD)為兒童經歷複雜創傷後的後遺症。本研究探索DTD是否跟創傷後壓力症(PTSD)有不同的創傷前因。236名從兒科或心理治療單位轉介的兒童組成了多站點樣本。我們以DTD結構性面談評估樣本的DTD, 並以創傷事件篩查工具(TESI)評估以往的創傷經歷。在數據未經調節下, DTD (勝算比 (ORs) = 2.0–3.8, 95% 置信區間(CI) [1.17, 7.19]) 和PTSD (ORs = 1.8–3.0, 95% CI [1.04, 6.27])都跟以下有關:過往身體受襲和/或受虐、家庭暴力、情緒虐待、忽略、照顧者殘障;而DTD跟社群暴力有關(OR = 2.7, 95% CI [1.35, 5.43])。在多變量的基礎下, 我們以PTSD的效應作對照, 發現DTD跟家庭暴力、社群暴力和照顧者殘障有關(ORs = 2.0–2.5, 95% CI [1.09, 5.97]);而我們以DTD的效應作對照後, 發現PTSD只跟身體受襲和/或受虐有關(OR = 2.4, 95% CI [1.07, 4.99])。對PTSD的症狀數量作對照後, 發現經歷了人際創傷和惡劣的依附經驗跟有最多DTD症狀相關。雖然兒童的PTSD和DTD有些相同的創傷前因, 可是, DTD可能獨特地跟暴力環境和照顧者殘障的深刻經歷有關。因此, DTD仍有待進一步研究, 才能有助我們對曾經歷人際傷害和惡劣依附經驗的兒童作評估和治療。 Simplified Chinese 标题: 当四周均无安全之所:人际创伤和恶劣依附经验作为创伤后压力症和发展性创伤障碍的前因 撮要: 过往有研究提出, 发展性创伤障碍(DTD)为儿童经历复杂创伤后的后遗症。本研究探索DTD是否跟创伤后压力症(PTSD)有不同的创伤前因。236名从儿科或心理治疗单位转介的儿童组成了多站点样本。我们以DTD结构性面谈评估样本的DTD, 并以创伤事件筛查工具(TESI)评估以往的创伤经历。在数据未经调节下, DTD (胜算比 (ORs) = 2.0–3.8, 95% 置信区间(CI) [1.17, 7.19]) 和PTSD (ORs = 1.8–3.0, 95% CI [1.04, 6.27])都跟以下有关:过往身体受袭和/或受虐、家庭暴力、情绪虐待、忽略、照顾者残障;而DTD跟社群暴力有关(OR = 2.7, 95% CI [1.35, 5.43])。在多变量的基础下, 我们以PTSD的效应作对照, 发现DTD跟家庭暴力、社群暴力和照顾者残障有关(ORs = 2.0–2.5, 95% CI [1.09, 5.97]);而我们以DTD的效应作对照后, 发现PTSD只跟身体受袭和/或受虐有关(OR = 2.4, 95% CI [1.07, 4.99])。对PTSD的症状数量作对照后, 发现经历了人际创伤和恶劣的依附经验跟有最多DTD症状相关。虽然儿童的PTSD和DTD有些相同的创伤前因, 可是, DTD可能独特地跟暴力环境和照顾者残障的深刻经历有关。因此, DTD仍有待进一步研究, 才能有助我们对曾经历人际伤害和恶劣依附经验的儿童作评估和治疗。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 631-642, October 2018.

--- - |2 Abstract There has been conflicting research regarding direct association between deployments and marital quality, particularly from the military spouse's perspective. In the current study, we sought to extend past research by examining the direct association between both military and nonmilitary experiences and military spouse marital quality using 2011–2013 baseline data from the Millennium Cohort Family Study, a large sample of military couples representing all U.S. service branches and components. Military experiences were assessed using electronic deployment records to capture the number and length of deployments since 2001, and service members reported combat experience and symptoms indicative of posttraumatic stress disorder (PTSD). Military spouses reported on service members’ recent time away from home, nonmilitary family stressors, and marital quality. Results of the logistic regression model adjusted for demographic, relationship, and military covariates indicated that most military experiences did not have a direct statistical association with low marital quality except service member PTSD, odds ratio (OR) = 1.54, 95% CI [1.17, 2.04]. Rather, nonmilitary experiences of the military spouse, including lack of social support, OR = 2.68, 95% CI [2.07, 3.47]; caregiver burden, OR = 1.56, 95% CI [1.22, 1.99]; work–family conflict, OR = 1.42, 95% CI [1.18, 1.69]; and financial strain, OR = 1.27, 95% CI [1.03, 1.55], increased odds of low marital quality. Implications of these findings include providing additional supports to address nonmilitary family stressors that are particularly salient to military spouses with an aim to promote marital quality. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) El impacto de experiencias militares y no militares en el matrimonio: Examinando la perspectiva del cónyuge militar. CALIDAD DEL MATRIMONIO EN CÓNYUGE MILITAR. Ha habido investigaciones conflictivas que establecen una asociación directa entre despliegues militares y la calidad marital, particularmente desde la perspectiva del cónyuge militar. En el presente estudio, buscamos extender la investigación pasada examinando la asociación directa entre experiencias militares y no militares y la calidad marital del cónyuge militar usando datos de referencia de 2011–2013 del Estudio de la Familia Cohorte del Milenio, compuesto por una amplia muestra de parejas militares que representan a todas las ramas y componentes del servicio militar de E.E.U.U. Las experiencias militares fueron evaluadas usando registros electrónicos de despliegues para capturar el número y la duración de despliegues desde 2001, y los miembros del servicio informaron sobre la experiencia de combate y los síntomas indicativos de trastorno de estrés postraumático (TEPT). Los cónyuges militares informaron sobre el tiempo reciente en que los miembros del servicio estuvieron fuera de casa, los factores no militares de estrés familiar y la calidad conyugal. Los resultados del modelo de regresión logística ajustado para las covariables demográficas, de relación y militares indicaron que en la mayoría de las experiencias militares no tuvieron una asociación estadística directa con la baja calidad marital, con la excepción de TEPT de un miembro del servicio, odds ratio (OR) = 1.54, IC 95% [1.17, 2.04]. Más bien, las experiencias no militares del cónyuge militar, incluida la falta de apoyo social, OR = 2,68, 95% CI [2.07, 3.47]; carga del cuidador, OR = 1.56, IC del 95% [1.22, 1.99]; conflicto trabajo‐familia, OR = 1,42, IC del 95% [1,18, 1,69]; y la tensión financiera, OR = 1.27, IC 95% [1.03, 1.55], incrementa las probabilidades de baja calidad marital. Las implicancias de estos hallazgos incluyen proporcionar apoyos adicionales para abordar los factores no militares de estrés familiar que son particularmente importantes para los cónyuges militares con el objetivo de promover la calidad matrimonial. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 The impact of military and nonmilitary experiences on marriage: Examining the military spouse's perspective Traditional Chinese 標題: 服役與非服役經歷對婚姻的影響:檢視軍人伴侶的觀點 撮要: 過往有關服役與婚姻質素的直接關連研究, 特別是檢視到軍人伴侶觀點的, 都呈現矛盾結果。本研究旨在延伸過往的研究, 檢視服役與非服役經歷跟軍人伴侶婚姻質素的直接關連。我們利用2011–2013年千禧世代家庭研究的基線數據, 當中的大型樣本為來自各個美國軍事部門的軍人夫婦。我們利用電子服役紀錄, 取得樣本自2001年起的服役次數和為期數據, 並從軍人的報告取得戰鬥經歷和象徵創傷後壓力症(PTSD)的症狀數據。軍人伴侶則報告軍人最近一次離家的為期長度、非服役相關的家庭壓力源和婚姻質素。我們對從邏輯迴歸模型得出的結果, 因應人口變量、關係和軍事共變量作調節後, 發現大多數服役經歷跟婚姻質素低並無直接的統計性關連, 除了軍人患PTSD以外(勝算比 (OR) = 1.54, 95% CI [1.17, 2.04])。反而, 軍人伴侶的非服役經歷, 包括欠缺社會支持(OR = 2.68, 95% CI [2.07, 3.47])、作為照顧者的負擔(OR = 1.56, 95% CI [1.22, 1.99])、工作與家庭需要的衝突(OR = 1.42, 95% CI [1.18, 1.69])、以及經濟困難(OR = 1.27, 95% CI [1.03, 1.55]), 加強了婚姻質素低的機會。我們基於結果的建議, 包括提供額外支援, 處理對軍人伴侶影響特別顯著的非服役相關家庭壓力源, 以提升他們的婚姻質素。 Simplified Chinese 标题: 服役与非服役经历对婚姻的影响:检视军人伴侣的观点 撮要: 过往有关服役与婚姻质素的直接关连研究, 特别是检视到军人伴侣观点的, 都呈现矛盾结果。本研究旨在延伸过往的研究, 检视服役与非服役经历跟军人伴侣婚姻质素的直接关连。我们利用2011–2013年千禧世代家庭研究的基线数据, 当中的大型样本为来自各个美国军事部门的军人夫妇。我们利用电子服役纪录, 取得样本自2001年起的服役次数和为期数据, 并从军人的报告取得战斗经历和象征创伤后压力症(PTSD)的症状数据。军人伴侣则报告军人最近一次离家的为期长度、非服役相关的家庭压力源和婚姻质素。我们对从逻辑回归模型得出的结果, 因应人口变量、关系和军事共变量作调节后, 发现大多数服役经历跟婚姻质素低并无直接的统计性关连, 除了军人患PTSD以外(胜算比 (OR) = 1.54, 95% CI [1.17, 2.04])。反而, 军人伴侣的非服役经历, 包括欠缺社会支持(OR = 2.68, 95% CI [2.07, 3.47])、作为照顾者的负担(OR = 1.56, 95% CI [1.22, 1.99])、工作与家庭需要的冲突(OR = 1.42, 95% CI [1.18, 1.69])、以及经济困难(OR = 1.27, 95% CI [1.03, 1.55]), 加强了婚姻质素低的机会。我们基于结果的建议, 包括提供额外支持, 处理对军人伴侣影响特别显著的非服役相关家庭压力源, 以提升他们的婚姻质素。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 719-729, October 2018.

--- - |2 Abstract Across cultures, experiencing traumatic life events, particularly violence, is a salient predictor of depression. Some previous findings have shown that social support can serve as a buffer in the association between traumatic life events and depression (i.e., the buffering hypothesis) in that individuals with a high level of social support have a decreased or nonexistent association between traumatic life events and depression. The purpose of this study was to test the buffering hypothesis among a sample of 1,342 male migrant and nonmigrant market vendors in Almaty, Kazakhstan. Using multiple‐group structural equation modeling (SEM), we identified the following results: (a) higher levels of traumatic life events were associated with higher depression scores, (b) higher social support scores were associated with decreased depression scores, and (c) social support buffered the association between traumatic life events and depression among migrants and nonmigrants. The final model accounted for 45.0% and 38.4% of the variance in depression for migrants and nonmigrants, respectively. Findings suggest that social support may be an important protective factor for men in Kazakhstan who have experienced trauma and call for an incorporation of social support interventions for migrant and nonmigrant men experiencing depression. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) El apoyo social modera los efectos de los eventos de vida traumáticos sobre la depresión entre hombres migrantes y no migrantes en Almaty, Kazajistán EVENTOS DE VIDA TRAUMÁTICOS ENTRE HOMBRES EN KAZAJISTÁN En todas las culturas, experimentar eventos de vida traumáticos, en particular la violencia, es un predictor sobresaliente de la depresión. Algunos hallazgos previos muestran que el apoyo social puede servir como amortiguador en la asociación entre eventos traumáticos y depresión (es decir, “la hipótesis de amortiguación”), ya que los individuos con alto apoyo social tienen una asociación disminuida o inexistente entre eventos traumáticos y depresión. El propósito de este estudio fue probar la hipótesis de amortiguación entre una muestra de 1,342 vendedores migrantes y no inmigrantes del mercado de Almaty, Kazajstán. Usando modelos de ecuaciones estructurales multigrupo (SEM en su sigla en inglés), identificamos los siguientes resultados: (a) niveles más altos de eventos de vida traumáticos se asociaron con puntajes de depresión más altos, (b) puntajes de apoyo social más altos se asociaron con puntuaciones de depresión disminuidas, y (c) el apoyo social amortiguó la asociación entre los eventos de vida traumáticos y la depresión entre los migrantes y los no inmigrantes. El modelo final representó el 45.0% y el 38.4% de la varianza en la depresión para migrantes y no inmigrantes, respectivamente. Los hallazgos sugieren que el apoyo social puede ser un importante factor de protección para los hombres en Kazajstán que han experimentado un trauma, y ​​exige una incorporación de las intervenciones de apoyo social para los hombres migrantes y no inmigrantes que sufren depresión. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Social Support Moderates the Effects of Traumatic Life Events on Depression Among Migrant and Non‐Migrant Men in Almaty, Kazakhstan Traditional Chinese 標題: 哈薩克阿拉木圖的移民和非移民男士中, 社會支持會調節創傷性生命事件對抑鬱症構成的影響 撮要: 在不同文化裡, 創傷性的生命事件經歷, 尤其是暴力經歷, 都是抑鬱症的主要預測變量。有些過往研究反映, 社會支持能緩和創傷性生命事件與抑鬱症之間的關連(即「緩衝假設」), 即有高水平社會支持的人當中, 創傷性生命事件與抑鬱症之間的關連會減低或並無關連。本研究旨在測試緩衝假設是否真確。樣本為哈薩克阿拉木圖裡, 1,342名男性移民和非移民市集攤販。我們利用多組別結構方程模型(SEM), 得出以下發現:(a) 創傷性生命事件水平較高, 跟抑鬱症分數較高有關;(b) 社會支持分數較高, 跟抑鬱症分數減低有關;(c) 在移民和非移民當中, 社會支持緩和了創傷性生命事件與抑鬱症之間的關連。最後的模型分別解釋了移民和非移民抑鬱症45.0% 和 38.4%的方差。結果反映, 對哈薩克受創男士來說, 社會支持可能是重要的保護因素, 並反映我們對患抑鬱症的移民和非移民男士提供的干預治療裡, 有需要包含社會支持。 Simplified Chinese 标题: 哈萨克斯坦阿拉木图的移民和非移民男士中, 社会支持会调节创伤性生命事件对抑郁症构成的影响 撮要: 在不同文化里, 创伤性的生命事件经历, 尤其是暴力经历, 都是抑郁症的主要预测变量。有些过往研究反映, 社会支持能缓和创伤性生命事件与抑郁症之间的关连(即「缓冲假设」), 即有高水平社会支持的人当中, 创伤性生命事件与抑郁症之间的关连会减低或并无关连。本研究旨在测试缓冲假设是否真确。样本为哈萨克斯坦阿拉木图里, 1,342名男性移民和非移民市集摊贩。我们利用多组别结构方程模型(SEM), 得出以下发现:(a) 创伤性生命事件水平较高, 跟抑郁症分数较高有关;(b) 社会支持分数较高, 跟抑郁症分数减低有关;(c) 在移民和非移民当中, 社会支持缓和了创伤性生命事件与抑郁症之间的关连。最后的模型分别解释了移民和非移民抑郁症45.0% 和 38.4%的方差。结果反映, 对哈萨克斯坦受创男士来说, 社会支持可能是重要的保护因素, 并反映我们对患抑郁症的移民和非移民男士提供的干预治疗里, 有需要包含社会支持。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 698-707, October 2018.

--- - |2 Abstract Substantial research has linked childhood maltreatment to the development of substance use in adolescence. However, gender differences in the mechanisms that connect child abuse and neglect to substance use remain unclear. In this study, we applied multiple‐group structural equation modeling in a sample of 1,161 youths (boys, n = 552; girls, n = 609) from the Longitudinal Studies of Child Abuse and Neglect (LONGSCAN) to examine gender differences in the associations between childhood abuse and neglect exposure from ages 0–12 years and substance use severity at age 18 as mediated by early substance use at age 14 and psychological symptoms (anger, anxiety, and depression) at age 16. In both genders, neglect directly predicted substance use severity, β = .25, p < .001 for boys and β = .17, p = .007 for girls; and early substance use, β = .03, p = .002 for boys and β = .06, p = .005 for girls; and anger mediated this association, β = .10, p < .001 for boys and β = .06, p = .005 for girls. Anger mediated paths from abuse in boys, β = .06, p = .018. In girls, early substance use mediated the path from abuse to substance use severity, β = .06, p = .008, with the mediated effect and direct path from abuse to early substance use significantly moderated by gender. For substance use severity, R2 = .26 for girls and R2 = .27 for boys. These findings demonstrate the prominence of neglect in predicting substance use severity and gender differences in paths from abuse. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Trayectorias moderadas por género desde abuso y abandono infantil al uso tardío de sustancias para adolescentes. TRAYECTORIAS MODERADAS POR GÉNERO HACIA EL USO DE SUSTANCIAS Una investigación sustancial ha vinculado el maltrato infantil con el desarrollo del uso de sustancias en la adolescencia. Sin embargo, las diferencias de género en los mecanismos que conectan el abuso y el abandono infantil al uso de sustancias siguen aún poco claros. En este estudio, aplicamos modelamiento de ecuaciones estructurales multigrupos en una muestra de 1,161 jóvenes (niños, n = 552; niñas, n = 609) de los Estudios Longitudinales de Abuso y Negligencia Infantil (LONGSCAN en sus sigla en inglés) para examinar las diferencias de género en las asociaciones entre el abuso infantil y la exposición al abandono entre las edades de 0–12 años y la gravedad del uso de sustancias a los 18 años de edad mediada por el consumo temprano de sustancias a los 14 años y los síntomas psicológicos (ira, ansiedad y depresión) a los 16 años. En ambos sexos, el abandono predijo directamente la gravedad del uso de sustancias (niños, β = .25, p <.001; niñas, β = .17, p = .007) y el uso temprano de sustancias (niños, β = .03, p = .002; niñas, β = .06, p = .005), y la ira medio esta asociación (niños, β = .10, p <.001; niñas, β = .06, p = .005). La ira medió las trayectorias del abuso en los niños (β = .06, p = .018). En las niñas, el consumo temprano de sustancias medio la vía desde el abuso a la severidad del uso de sustancias (β = .06, p = .008), con el efecto mediado y camino directo desde el abuso hasta el consumo temprano de sustancias significativamente moderado por género. Para la severidad del uso de sustancias, R2 = .26 en las niñas y R2 = .27 en los niños. Los hallazgos demuestran la prominencia del abandono en la predicción de la severidad del uso de sustancias y las diferencias de género en las trayectorias desde el abuso. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Gender moderated pathways from childhood abuse and neglect to late adolescent substance use. Traditional Chinese 標題: 性別會調節由兒時受虐和忽略到青少年後期濫用藥物的路徑 撮要: 很多研究發現, 兒時受虐跟青少年時期濫用藥物有關。不過, 我們仍不清楚童年時受到虐待和忽略跟濫用藥物的關連機制中的性別差異。本研究採用多組別結構性方程模型, 樣本為兒童虐待和忽略縱貫研究(LONGSCAN)中的1,161名青少年(男子, n = 552; 女子, n = 609)。在0–12歲受虐待和忽略跟18歲的濫用藥物嚴重度之間的關連, 受14歲早期濫用藥物和16歲的心理症狀 (憤怒、焦慮症、抑鬱症) 中介影響, 而我們檢視這機制當中的性別差異。不論男女, 忽略能直接預測到濫用藥物嚴重度(男子, β = .25, p < .001; 女子, β = .17, p = .007)及早期濫用藥物(男子, β = .03, p = .002; 女子, β = .06, p = .005), 而憤怒對此關連有中介效應(男子, β = .10, p < .001; 女子, β = .06, p = .005)。男孩子中, 憤怒在虐待產生的路徑有中介效應(β = .06, p = .018)。女孩子中, 早期濫用藥物在由虐待到濫用藥物嚴重度的路徑有中介效應(β = .06, p = .008)。性別顯著地調節了中介效應以及由虐待到早期濫用藥物的直接路徑。濫用藥物嚴重度在女孩子為R2 = .26, 男孩子為R2 = .27。結果反映了兒時受忽略對預測濫用藥物嚴重度的重要性, 而兒時受虐發展出的路徑有性別差異。 Simplified Chinese 标题: 性别会调节由儿时受虐和忽略到青少年后期滥用药物的路径 撮要: 很多研究发现, 儿时受虐跟青少年时期滥用药物有关。不过, 我们仍不清楚童年时受到虐待和忽略跟滥用药物的关连机制中的性别差异。本研究采用多组别结构性方程模型, 样本为儿童虐待和忽略纵贯研究(LONGSCAN)中的1,161名青少年(男子, n = 552; 女子, n = 609)。在0–12岁受虐待和忽略跟18岁的滥用药物严重度之间的关连, 受14岁早期滥用药物和16岁的心理症状 (愤怒、焦虑症、抑郁症) 中介影响, 而我们检视这机制当中的性别差异。不论男女, 忽略能直接预测到滥用药物严重度(男子, β = .25, p < .001; 女子, β = .17, p = .007)及早期滥用药物(男子, β = .03, p = .002; 女子, β = .06, p = .005), 而愤怒对此关连有中介效应(男子, β = .10, p < .001; 女子, β = .06, p = .005)。男孩子中, 愤怒在虐待产生的路径有中介效应(β = .06, p = .018)。女孩子中, 早期滥用药物在由虐待到滥用药物严重度的路径有中介效应(β = .06, p = .008)。性别显著地调节了中介效应以及由虐待到早期滥用药物的直接路径。滥用药物严重度在女孩子为R2 = .26, 男孩子为R2 = .27。结果反映了儿时受忽略对预测滥用药物严重度的重要性, 而儿时受虐发展出的路径有性别差异。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 654-664, October 2018.

--- - |2 Abstract Although posttraumatic stress disorder (PTSD) is common in primary care patients, many do not seek mental health treatment. Existing research on barriers and facilitators to receiving PTSD treatment are not specific to primary care patients. In this study, we sought to understand the psychosocial concerns, treatment barriers, and treatment facilitators among non‐treatment‐seeking primary care veterans with PTSD who reside in both rural and urban settings. Using a concurrent triangulation design, we collected qualitative focus group and quantitative self‐report data concurrently, analyzed them separately, and merged the results for interpretation. In total, 27 veteran primary care patients with PTSD participated in 1 of 4 focus groups. A modified conventional content analysis approach was used. Team‐based coding began with three broad primary codes (psychosocial concerns, barriers, and facilitators) and subcodes were allowed to emerge from the data. Self‐report measures were used to collect clinical characteristics and barriers to care. The results expanded upon existing models of PTSD treatment initiation by (a) specifying treatment preferences, such as patient‐centered care, peer support services, and open access scheduling, and (b) presenting concerns, such as anger and core symptoms of PTSD. Results also indicated that a commonly used quantitative barriers measure may offer an incomplete picture of why veterans do not seek treatment as it does not assess how past negative treatment experiences may affect utilization. Strategies to help veterans overcome barriers to care may benefit from a focus on negative treatment‐seeking beliefs and tailoring based on a veteran's rural or urban status. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Facilitadores y barreras para la búsqueda de atención de salud mental entre veteranos de atención primaria con TEPT FACILITADORES Y BARRERAS PARA BÚSQUEDA DE ATENCIÓN EN TEPT El trastorno de estrés postraumático (TEPT) es común en pacientes de atención primaria, sin embargo no buscan un tratamiento de salud mental. Las investigaciones existentes acerca de barreras y facilitadores para recibir tratamiento en TEPT no son específicas en pacientes de atención primaria. En este estudio, hemos buscado entender las preocupaciones psicosociales, barreras y facilitadores de tratamiento entre veteranos que no buscan tratamiento de atención primaria en TEPT que residen en ambos contextos urbano y rural. Utilizando un diseño de triangulación concurrente, recolectamos datos cualitativos a través de grupos focales y cuantitativos a través de autoreportes, de manera simultánea, analizándolos de manera separada, y fusionando los resultados para su interpretación. En total 27 pacientes veteranos de atención primaria con TEPT participaron en uno de cuatro grupos focales. Se utilizó un enfoque de análisis de contenido convencional modificado. La codificación realizada en el equipo comenzó con tres amplios códigos primarios (preocupaciones psicosociales, barreras y facilitadores) y se permitió la aparición de subcódigos a partir de los datos. Las medidas de autoreportes se usaron para recopilar las características clínicas y las barreras para la atención. Los resultados amplían los modelos existentes de iniciación del tratamiento de TEPT al (a) especificar preferencias de tratamiento, tales como atención centrada en el paciente, servicios de apoyo entre pares y programación de acceso abierto, y (b) presentar preocupaciones, como enojo y síntomas centrales de TEPT. Los resultados también indican que un uso común de medir barreras cuantitativamente puede ofrecer una imagen incompleta de por qué los veteranos no buscan tratamiento, ya que no evalúa cómo las experiencias pasadas de tratamiento negativo pueden afectar la utilización. Las estrategias para ayudar a los veteranos a superar las barreras para la atención pueden beneficiarse de un enfoque en las creencias negativas sobre la búsqueda de tratamiento y la adaptación en función del contexto rural o urbano de un veterano. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Facilitators and Barriers to Seeking Mental Health Care among Primary Care Veterans with PTSD Traditional Chinese 標題: 接受初級醫療並患PTSD的退役軍人尋求心理治療的促進因素和障礙 撮要: 創傷後壓力症(PTSD)在接受初級醫療的患者中普遍, 但很多患者都不尋求心理治療。現有對於接受PTSD治療的障礙和促進因素研究, 並未特殊地檢視初級醫療患者的個案。本研究透過居於郊區和市區、接受初級醫療、患PTSD但未有尋求心理治療的退役軍人, 檢視心理社會因素、尋求治療的障礙和促進因素。我們採用同步三角驗證的模型設計, 同時收集了針對組的質性數據和自評的量化數據, 對其分開分析, 再結合結果進行詮釋。共有4個針對組和27名接受初級醫療的PTSD退役軍人參與在內。我們採用經過修改的傳統式內容分析法, 在3種廣泛的初級編碼 (心理社會因素、尋求治療的障礙和促進因素) 開始進行組別為本的編碼, 亦從數據中得出副編碼。自評測量用以收集臨床特徵和尋求治療的障礙數據。是次研究擴闊了現有對開始PTSD治療的研究模型, 因為(a)特殊地檢視治療偏好, 如以患者為中心的治療、朋輩支援計劃、開放預約;及(b)關注到如憤怒和PTSD核心症狀等因素。結果亦反映, 普遍用到的量化障礙測量並未能評估過往的負面治療經歷如何影響治療使用率, 用於研究退役軍人為何不尋求治療, 得出的結果可能不夠全面。幫助退役軍人克服治療障礙的策略, 包括針對改善他們對尋求治療的負面想法, 並因應退役軍人居於郊區或市區而調校治療服務。 Simplified Chinese 标题: 接受初级医疗并患PTSD的退役军人寻求心理治疗的促进因素和障碍 撮要: 创伤后压力症(PTSD)在接受初级医疗的患者中普遍, 但很多患者都不寻求心理治疗。现有对于接受PTSD治疗的障碍和促进因素研究, 并未特殊地检视初级医疗患者的个案。本研究透过居于郊区和市区、接受初级医疗、患PTSD但未有寻求心理治疗的退役军人, 检视心理社会因素、寻求治疗的障碍和促进因素。我们采用同步三角验证的模型设计, 同时收集了针对组的质性数据和自评的量化数据, 对其分开分析, 再结合结果进行诠释。共有4个针对组和27名接受初级医疗的PTSD退役军人参与在内。我们采用经过修改的传统式内容分析法, 在3种广泛的初级编码 (心理社会因素、寻求治疗的障碍和促进因素) 开始进行组别为本的编码, 亦从数据中得出副编码。自评测量用以收集临床特征和寻求治疗的障碍数据。是次研究扩阔了现有对开始PTSD治疗的研究模型, 因为(a)特殊地检视治疗偏好, 如以患者为中心的治疗、朋辈支持计划、开放预约;及(b)关注到如愤怒和PTSD核心症状等因素。结果亦反映, 普遍用到的量化障碍测量并未能评估过往的负面治疗经历如何影响治疗使用率, 用于研究退役军人为何不寻求治疗, 得出的结果可能不够全面。帮助退役军人克服治疗障碍的策略, 包括针对改善他们对寻求治疗的负面想法, 并因应退役军人居于郊区或市区而调校治疗服务。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 742-752, October 2018.

--- - |2 Abstract Police officers exposed to potentially traumatic events (PTE) are at a heightened risk of developing posttraumatic stress disorder (PTSD). Little is known about trauma‐focused psychotherapy outcomes in the police. In this naturalistic study, we evaluated whether PTE exposure and baseline clinical characteristics predicted PTSD symptom reduction during treatment and residual PTSD symptoms posttreatment. In consecutive referrals to a specialized mental health service for police officers (N = 665), PTSD was measured pre‐ and posttreatment using structured clinical interviews. Treatment consisted of brief eclectic psychotherapy for PTSD. We grouped PTE as follows: injury/maltreatment, loss (colleague or private), other job‐related, other private traumatic events. Data were analyzed multivariably using structural equation modeling and logistic regression. Treatment effect size was large, d = 3.6, 95% CI [3.4, 3.8]. Police officers who reported more injury/maltreatment or private traumatic had more baseline PTSD symptoms as well as larger symptom reduction during treatment; police officers who reported more losses of loved ones showed smaller PTSD symptom reduction. Concentration problems persisted in 17.7% of police officers posttreatment, and these were predicted by baseline PTSD symptoms and loss of loved ones. Proportions of variance explained by the multivariable models ranged from 0.08 to 0.14. Our findings increase insight into the type of PTE and clinical characteristics of police officers with PTSD who benefit most from trauma‐focused treatment. Because loss of loved ones can be presumed to have a profound impact on social and interpersonal functioning, a more specific treatment focus on grief processes may further enhance efficacy. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Predictores de resultados y síntomas residuales después de la psicoterapia centrada en el trauma en policías con TEPT PREDICCIÓN DEL RESULTADO DEL TRATAMIENTO DEL TEPT EN POLICÍAS Los policías expuestos a eventos potencialmente traumáticos (PTE en su sigla en inglés) corren un mayor riesgo de desarrollar trastorno de estrés postraumático (TEPT). Poco se sabe sobre los resultados de la psicoterapia centrada en el trauma en la policía. En este estudio naturalista, evaluamos si la exposición a PTE y las características clínicas iniciales predijeron la reducción de los síntomas de TEPT durante el tratamiento y los síntomas residuales de TEPT después del tratamiento. En derivaciones consecutivas a un servicio especializado de salud mental para policías (N = 665), se midió el TEPT antes y después del tratamiento mediante entrevistas clínicas estructuradas. El tratamiento consistió en psicoterapia ecléctica breve para el TEPT. Agrupamos los PTE de la siguiente manera: lesión / maltrato, pérdida (colega o personal), otros eventos relacionados con el trabajo, otros eventos traumáticos personales. Los datos se analizaron de forma multivariada utilizando modelos de ecuaciones estructurales y regresión logística. El tamaño del efecto del tratamiento fue grande, d = 3.6, IC del 95% [3.4, 3.8]. Los policías que reportaron más lesiones / maltrato o traumatismos personales tuvieron más síntomas iniciales de TEPT y una reducción más grande de los síntomas durante el tratamiento; los policías que informaron más pérdidas de seres queridos mostraron una menor reducción de los síntomas de TEPT. Los problemas de concentración persistieron en el 17.7% de los policías después del tratamiento, y fueron pronosticados por los síntomas iniciales de TEPT y la pérdida de seres queridos. Las proporciones de varianza explicadas por los modelos multivariados variaron en un rango de 0.08 a 0.14. Nuestros hallazgos aumentan el conocimiento sobre el tipo de PTE y las características clínicas de los policías con TEPT que se benefician más del tratamiento centrado en el trauma. Debido a que se puede suponer que la pérdida de seres queridos tiene un profundo impacto en el funcionamiento social e interpersonal, un enfoque de tratamiento más específico en los procesos de duelo puede mejorar aún más la eficacia. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Predictors of outcome and residual symptoms following trauma‐focused psychotherapy in police officers with PTSD Traditional Chinese 標題: 患PTSD的警員接受聚焦創傷的心理治療後, 治療成效和剩餘症狀的預測變量 撮要: 曾經歷潛在創傷性事件(PTE)的警員有較高風險發展出創傷後壓力症(PTSD)。目前, 我們對警員接受聚焦創傷的心理治療結果認知甚少。本自然研究檢視PTE經歷及基線的臨床特徵是否能預測到治療時PTSD症狀減輕, 以及治療後剩餘的PTSD症狀。我們連續向專為警員而設的心理治療服務取得樣本(N = 665), 在治療前後透過結構性臨床面談測量其PTSD。治療是為PTSD而設的短期折衷療法。我們把PTE分為以下類別:受傷༏不良對待、喪失親友 (於工作或私人生活裡) 、其他與工作相關的創傷事件、其他私人的創傷事件。我們以結構方程模型和邏輯迴歸法, 以多變量的方式分析數據。治療效應量為大(d = 3.6, 95% CI [3.4, 3.8])。經歷較多受傷༏不良對待或私人創傷事件的警員, 基線的PTSD症狀較多, 治療時症狀減輕的幅度亦較大。有較多喪失親友經歷的警員, 症狀減輕的幅度較少。17.7%警員在治療後仍有專注力問題, 而這受基線的PTSD症狀和喪失親友所能預測。多變量模型解釋到的方差比例為0.08 至 0.14。有關接受聚焦創傷治療後獲得最大改善的PTSD警員, 本研究增加了對其PTE類別和臨床特徵的理解。由於喪失摯親通常會對社會和人際功能運作構成嚴重影響, 若能提供特殊地針對哀悼過程的治療, 應可進一步提升治療功效。 Simplified Chinese 标题: 患PTSD的警员接受聚焦创伤的心理治疗后, 治疗成效和剩余症状的预测变量 撮要: 曾经历潜在创伤性事件(PTE)的警员有较高风险发展出创伤后压力症(PTSD)。目前, 我们对警员接受聚焦创伤的心理治疗结果认知甚少。本自然研究检视PTE经历及基线的临床特征是否能预测到治疗时PTSD症状减轻, 以及治疗后剩余的PTSD症状。我们连续向专为警员而设的心理治疗服务取得样本(N = 665), 在治疗前后透过结构性临床面谈测量其PTSD。治疗是为PTSD而设的短期折衷疗法。我们把PTE分为以下类别:受伤༏不良对待、丧失亲友 (于工作或私人生活里) 、其他与工作相关的创伤事件、其他私人的创伤事件。我们以结构方程模型和逻辑回归法, 以多变量的方式分析数据。治疗效应量为大(d = 3.6, 95% CI [3.4, 3.8])。经历较多受伤༏不良对待或私人创伤事件的警员, 基线的PTSD症状较多, 治疗时症状减轻的幅度亦较大。有较多丧失亲友经历的警员, 症状减轻的幅度较少。17.7%警员在治疗后仍有专注力问题, 而这受基线的PTSD症状和丧失亲友所能预测。多变量模型解释到的方差比例为0.08 至 0.14。有关接受聚焦创伤治疗后获得最大改善的PTSD警员, 本研究增加了对其PTE类别和临床特征的理解。由于丧失挚亲通常会对社会和人际功能运作构成严重影响, 若能提供特殊地针对哀悼过程的治疗, 应可进一步提升治疗功效。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 764-774, October 2018.

--- - |2 Abstract Posttraumatic growth (PTG), the positive psychological transformations that follow traumatic events, affects both direct survivors (primary PTG) and their significant others (secondary PTG). Though primary and secondary PTG have been widely investigated in the literature, their long‐term trajectories decades after a traumatic event, especially as survivors enter older age, remain largely uninvestigated. Furthermore, it remains contested whether PTG adds up to a monolithic construct or rather consists of relatively independent components. Addressing these issues, we assessed a sample of Israeli male veterans from the 1973 Yom Kippur war (N = 349) and their wives (N = 156) at three time points over the course of nearly three decades. Both the veterans (primary survivors) and their wives (secondary survivors) reported PTG relating to the veterans' experiences during the war and/or captivity. Latent growth mixture modeling was conducted to identify trajectories of PTG on the five subscales of the Posttraumatic Growth Inventory. Long‐term trajectories of PTG followed heterogeneous patterns of fluctuation over time and particularly as participants entered older age. On most subscales, decreasing PTG scores were evident, a trend that was more pronounced among the primary survivors than the secondary survivors as primary and secondary PTG fluctuate considerably in the long‐term and seem to decrease as individuals enter older age. Furthermore, it would seem that PTG should not be considered a holistic concept but rather a conglomeration of positive changes. Implications of the findings are discussed within the context of limitations and potential intervening factors. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Desarrollo longitudinal del crecimiento postraumático primario y secundario en veteranos ancianos y sus esposas: Trayectorias por dominios específicas TRAYECTORIAS DE LOS DOMINIOS DE CRECIMIENTO POSTRAUMÁTICO Tanto los sobrevivientes directos como sus parejas experimentan crecimiento postraumático (PTG, por sus siglas en inglés), las transformaciones positivas que siguen a los eventos traumáticos, vía PTG primaria (sobrevivientes) y PTG secundaria (parejas). Aunque el PTG primario y secundario han sido ampliamente investigados en la literatura, sus trayectorias de largo plazo décadas después de un evento traumático, y especialmente en la medida que los sobrevivientes adquieren edad avanzada, permanecen en gran parte sin investigar. Más aún, permanece controvertido si el PTG se agrega a un constructo monolítico o más bien está constituido por componentes relativamente independientes. Para abordar estos problemas, evaluamos una muestra de hombres veteranos israelíes de la guerra de Yom Kippur de 1973 (N = 349) y sus esposas (N = 156) en 3 puntos de tiempo en el curso de casi 3 décadas. Tanto los veteranos (sobrevivientes primarios) como sus esposas (sobrevivientes secundarios) reportaron PTG en relación a las experiencias de los veteranos durante la guerra y/o cautiverio. Se realizó un modelo de mezcla del crecimiento latente para identificar las trayectorias del PTG en las cinco subescalas del Inventario de Crecimiento Postraumático. Las trayectorias de largo plazo de PTG siguieron patrones heterogéneos de fluctuación a través del tiempo y particularmente en la medida que los participantes alcanzaban avanzada edad. En la mayoría de las subescalas, la disminución de los puntajes de PTG fue evidente, una tendencia que fue más pronunciada entre los sobrevivientes primarios que entre los sobrevivientes secundarios mientras que el PTG primario y secundario fluctua considerablemente en el largo plazo y parece disminuir mientras los individuos alcanzan avanzada edad. Más aún, pareciera que PTG no debería ser considerado un concepto holístico sino un conglomerado de cambios positivos. Las implicancias de los hallazgos se discuten dentro del contexto de las limitaciones y potenciales factores intervinientes. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Longitudinal development of primary and secondary posttraumatic growth in aging veterans and their wives: Domain‐specific trajectories Traditional Chinese 標題: 年紀漸長的退役軍人和他們的妻子原級和次級創傷後成長的縱貫發展: 範疇特殊的軌跡 撮要: 直接生還者與其身邊重要的人同樣會經歷創傷後成長(PTG)。那是創傷事件後的正向心理改變, 由原級PTG(生還者)和次級PTG(身邊重要的人)組成。雖然過往的文獻已廣泛地檢視原級和次級PTG, 可是, 兩者在創傷事件數十年後, 特別是當生還者踏入老年時的長遠軌跡, 仍缺乏研究。再者, PTG到底是否形成整體構念, 還是由相對獨立的成份組成, 仍備受爭議。為了解以上問題, 本研究檢視曾參與1973年贖罪日戰爭的以色列男性退役軍人(N = 349)及他們的妻子(N = 156), 在接近30年裡分3個時點進行評估。退役軍人 (原級生還者) 和妻子 (次級生還者) , 都有跟退役軍人戰爭和/或受虜經歷相關的PTG。潛在成長混合模型用以找出創傷後成長量表中5個子量表的PTG軌跡。PTG的長遠軌跡有不同的起伏模式, 特別是在樣本年紀漸長時。在大多數子量表裡, PTG分數都明顯下降, 而這趨勢在原級生還者當中更為明顯。長遠來說, 原級和次級PTG一直有顯著起伏, 並似乎因樣本年紀漸長而下降。而且, PTG似乎並非一個整體構念, 而是由一些正向改變結合而成。我們亦基於結果, 討論是次研究的限制和潛在的干擾因素。 Simplified Chinese 标题: 年纪渐长的退役军人和他们的妻子原级和次级创伤后成长的纵贯发展: 范畴特殊的轨迹 撮要: 直接生还者与其身边重要的人同样会经历创伤后成长(PTG)。那是创伤事件后的正向心理改变, 由原级PTG(生还者)和次级PTG(身边重要的人)组成。虽然过往的文献已广泛地检视原级和次级PTG, 可是, 两者在创伤事件数十年后, 特别是当生还者踏入老年时的长远轨迹, 仍缺乏研究。再者, PTG到底是否形成整体构念, 还是由相对独立的成份组成, 仍备受争议。为了解以上问题, 本研究检视曾参与1973年赎罪日战争的以色列男性退役军人(N = 349)及他们的妻子(N = 156), 在接近30年里分3个时点进行评估。退役军人 (原级生还者) 和妻子 (次级生还者) , 都有跟退役军人战争和/或受虏经历相关的PTG。潜在成长混合模型用以找出创伤后成长量表中5个子量表的PTG轨迹。PTG的长远轨迹有不同的起伏模式, 特别是在样本年纪渐长时。在大多数子量表里, PTG分数都明显下降, 而这趋势在原级生还者当中更为明显。长远来说, 原级和次级PTG一直有显著起伏, 并似乎因样本年纪渐长而下降。而且, PTG似乎并非一个整体构念, 而是由一些正向改变结合而成。我们亦基于结果, 讨论是次研究的限制和潜在的干扰因素。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 730-741, October 2018.

--- - |2 Abstract Evidence suggests that veterans with posttraumatic stress disorder (PTSD) have a poorer treatment response than nonveterans.  In this study, we explored heterogeneity in treatment response for 960 veterans in the United Kingdom with PTSD who had been offered a residential intervention consisting of a mixture of group sessions and individual trauma‐focused cognitive behavioral therapy (TF–CBT). The primary outcome was PTSD score on the Impact of Event Scale–Revised (IES–R).  Covariates included depression, anxiety, anger, alcohol misuse, functional impairment, and sociodemographic characteristics.  Follow‐up occurred posttreatment at set time points for 12 months.  We present predictors of PTSD severity at posttreatment and follow‐up obtained using a latent class growth analysis to identify different treatment trajectories.  Multinomial logistic regression models were used to identify covariates predicting class membership, and five classes were identified. Of participants, 71.3% belonged to three classes showing positive treatment responses, and 1.2% showed initial improvement but later relapsed. Additionally, 27.5% of participants were identified within a treatment‐resistant class that showed little change in severity of presentation. Depression, anxiety, and having had a combat role during military service increased the likelihood of membership in the treatment‐resistant class, odds ratios (ORs) = 1.12–1.53, 1.16–1.32, and 2.89, respectively. Additionally, participants in the treatment‐resistant class had higher pretreatment PTSD scores for reexperiencing, avoidance, and hyperarousal symptoms, ORs = 5.24, 2.62, and 3.86, respectively. Findings suggest the importance of triaging individuals and offering interventions tailored to severity of presentation. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) La Eficacia del Tratamiento para Veteranos del Reino Unido con Trastorno de Estrés Postraumático: Trayectorias de la Clase Latente de la Respuesta al Tratamiento y sus Predictores TRAYECTORIAS DE TRATAMIENTO PARA LOS VETERANOS DEL REINO UNIDO CON TEPT La evidencia sugiere que los veteranos con trastorno de estrés postraumático (TEPT) tienen una respuesta al tratamiento más pobre que aquellos que no son veteranos. En este estudio, exploramos la heterogeneidad en la respuesta al tratamiento de 960 veteranos del Reino Unido que presentaban TEPT y a quienes se les había ofrecido una intervención residencial consistente en una mezcla de sesiones grupales y terapia cognitivo‐conductual individual centrada en el trauma (TF‐CBT, en su sigla en inglés). El resultado principal fue el puntaje de TEPT en la Escala Revisada de Impacto de Eventos (IES–R, en su sigla en inglés). Las covariables incluyeron la depresión, la ansiedad, la ira, el abuso de alcohol, la discapacidad funcional, y las características sociodemográficas. El seguimiento ocurrió de forma posterior al termino del tratamiento en periodos específicos por 12 meses. Presentamos predictores de la severidad del TEPT al término el tratamiento y al seguimiento obtenidos por medio de un análisis de crecimiento de clases latentes para identificar las diferentes trayectorias de tratamiento. Modelos de regresión logística multinominales fueron usados para identificar las covariables predictoras de pertenencia a una clase, y así cinco clases fueron identificadas; de los participantes, un 71.3% perteneció a tres clases mostrando respuestas positivas al tratamiento y un 1.2% mostro una mejoría inicial pero posterior recaída. Adicionalmente, el 27.5% de los participantes fueron identificados dentro de una clase resistente al tratamiento, ya que mostraron pocos cambios en la severidad de la presentación. La depresión, odds ratios (ORs, en su sigla en inglés) = 1.12 ‐ 1.53; la ansiedad, ORs = 1.16 ‐ 1.32; y tener un rol de combate durante el servicio militar, OR = 2.89, incrementaron la probabilidad de pertenecer a la clase resistente al tratamiento. Adicionalmente, los participantes en la clase resistente al tratamiento mostraron tener puntajes de más altos de TEPT antes del tratamiento, particularmente reexperimentación, OR = 5.24; evitación, OR = 2.62; y síntomas de hiperactivación, OR = 3.86. Los hallazgos pueden sugerir la importancia de clasificar a los individuos y ofrecer intervenciones a la medida de la severidad de la presentación. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Treatment efficacy for UK veterans with post‐traumatic stress disorder: latent class trajectories of treatment response and their predictors. Traditional Chinese 標題: 患創傷後壓力症的英國退役軍人的治療成效:治療反應的潛在類別軌跡及其預測變量 撮要: 過往數據證明, 患創傷後壓力症(PTSD)的退役軍人比非退役軍人的治療成效較差。本研究透過960名患PTSD的英國退役軍人, 探索治療成效的異質性。樣本接受住院干預治療, 當中包含組別治療節段和個人的創傷聚焦認知行為治療(TF–CBT)。我們檢視的主要治療成效為於事件影響測量表(修訂版)(IES–R)的PTSD分數。共變量包括抑鬱症、焦慮症、憤怒、濫用酒精、功能性損傷和社會人口特徵。我們在樣本完成治療12個月後作跟進。我們利用潛在類別成長分析, 找出不同的治療軌跡, 並找到於完成治療及跟進期的PTSD嚴重度預測變量。多項邏輯迴歸模型用以找出可預測類別的共變量, 並得出5個類別。71.3%的樣本屬於3個正向治療成效的類別, 1.2%起初展現改善但又回復故態。27.5%的樣本屬於抗拒治療類別, 症狀嚴重度只有少量改變。以下能提升樣本屬抗拒治療類別的可能性:抑鬱症(勝算比 (ORs) = 1.12–1.53)、焦慮症(ORs = 1.16–1.32)、服役時曾參與戰鬥(OR = 2.89)。屬抗拒治療類別的樣本, 治療前以下方面的PTSD分數都較高:再體驗(OR = 5.24)、迴避(OR = 2.62)、過激反應症狀(OR = 3.86)。結果反映把患者分類, 並因應患者的嚴重度調校干預治療的重要性。 Simplified Chinese 标题: 患创伤后压力症的英国退役军人的治疗成效:治疗反应的潜在类别轨迹及其预测变量 撮要: 过往数据证明, 患创伤后压力症(PTSD)的退役军人比非退役军人的治疗成效较差。本研究透过960名患PTSD的英国退役军人, 探索治疗成效的异质性。样本接受住院干预治疗, 当中包含组别治疗节段和个人的创伤聚焦认知行为治疗(TF–CBT)。我们检视的主要治疗成效为于事件影响测量表(修订版)(IES–R)的PTSD分数。共变量包括抑郁症、焦虑症、愤怒、滥用酒精、功能性损伤和社会人口特征。我们在样本完成治疗12个月后作跟进。我们利用潜在类别成长分析, 找出不同的治疗轨迹, 并找到于完成治疗及跟进期的PTSD严重度预测变量。多项逻辑回归模型用以找出可预测类别的共变量, 并得出5个类别。71.3%的样本属于3个正向治疗成效的类别, 1.2%起初展现改善但又回复故态。27.5%的样本属于抗拒治疗类别, 症状严重度只有少量改变。以下能提升样本属抗拒治疗类别的可能性:抑郁症(胜算比 (ORs) = 1.12–1.53)、焦虑症(ORs = 1.16–1.32)、服役时曾参与战斗(OR = 2.89)。属抗拒治疗类别的样本, 治疗前以下方面的PTSD分数都较高:再体验(OR = 5.24)、回避(OR = 2.62)、过激反应症状(OR = 3.86)。结果反映把患者分类, 并因应患者的严重度调校干预治疗的重要性。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 753-763, October 2018.

--- - |2 Abstract Emerging adulthood (EA) is a developmental period marked by unique challenges that affect health including burgeoning occupational, relational, and financial stability; and increased risk taking in terms of sexual behavior(s) and substance use. Data were collected from 296 HIV‐uninfected sexual minority men with childhood sexual abuse (CSA) histories. We analyzed baseline assessment data from a multisite randomized controlled trial that tested the efficaciousness of an experimental psychosocial treatment and examined vulnerabilities known to be linked with CSA. Our analyses compared EA sexual minority men, aged 18–29, with older sexual minority men (OSMM) on posttraumatic stress disorder (PTSD) and other mental health and substance use outcomes. We found higher odds of PTSD, odds ratio (OR) = 0.57, 95% CI [0.33, 0.96]; panic disorder or panic disorder with agoraphobia, OR = 0.36, 95% CI [0.16, 0.85]; and cocaine use, OR = 0.50, 95% CI [0.25, 0.97], among OSMM and higher odds of alcohol intoxication, OR = 5.60, 95% CI [3.20, 9.82]; cannabis use, OR = 3.09, 95% CI [1.83, 5.21]; and non‐HIV sexually transmitted infections, OR = 3.03, 95% CI [1.29, 7.13], among the EA men. These results present a complex picture of health risks among sexual minority men in general and EA sexual minority men in particular. HIV seroconversion linked health risk behaviors, among sexual minority men, may be better addressed via increased attention to treating trauma and comorbid mental health and substance use problems using evidence‐based psychosocial assessments and integrated treatment platforms that are tailored to this population. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Trauma entre Hombres de Minorías Sexuales Adultas Emergentes: Implicanciones para la Evaluación y el Tratamiento del Abuso Sexual Infantil HOMBRES DE MINORIA SEXUAL Y TRAUMA La adultez emergente (AE) es un período de desarrollo marcado por desafíos únicos que afectan la salud, que incluye la creciente estabilidad ocupacional, relacional y financiera; y un incremento en la toma de riesgos en términos de comportamiento(s) sexual(es) y uso de sustancias. Los datos fueron recogidos de historias de 296 hombres de minorías sexuales, no infectados por VIH, con antecedentes de abuso sexual infantil (ASI). Se analizaron los datos de una evaluación de referencia de la Fase‐III de un ensayo controlado aleatorio de múltiples sitios que probó la eficacia de un tratamiento psicosocial experimental y examinó las vulnerabilidades que se sabe están relacionadas con ASI. Nuestros análisis compararon hombres AE de minorías sexuales, de 18–29 años, con hombres de minorías sexuales mayores (HMSM) en trastorno de estrés postraumático (TEPT) y otros resultados de salud mental y uso de sustancias. Encontramos mayores probabilidades de TEPT, odds ratio (OR) = 0.57, IC 95% [0.33, 0.96]; trastorno de pánico o trastorno de pánico con agorafobia, OR = 0.36, IC del 95% [0.16, 0.85]; y consumo de cocaína, OR = 0.50, IC 95% [0.25, 0.97], entre HMSM y mayores probabilidades de intoxicación por alcohol, OR = 5.60, 95% CI [3.20, 9.82]; consumo de cannabis, OR = 3.09, 95% CI [1.83, 5.21]; e infecciones de transmisión sexual sin‐VIH, OR = 3.03, 95% CI [1.29, 7.13], entre los hombres AE. Estos resultados presentan una imagen compleja de los riesgos de salud entre los hombres de minorías sexuales, en general, y los hombres AE de minorías sexuales, en particular. Las conductas de riesgo de salud relacionadas con la seroconversión del VIH entre hombres de minorías sexuales pueden abordarse mejor a través de una mayor atención al tratamiento del trauma, la salud mental de comorbilidades y los problemas de uso de sustancias, usando evaluaciones psicosociales basadas en evidencia y plataformas de tratamiento integrado que se adapten a esta población. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Trauma among emerging adult sexual minority men: Implications for assessment and treatment of childhood sexual abuse Traditional Chinese 標題: 處於成年初顯期的性小眾男士的創傷:童年性虐待的評估與治療研究 撮要: 成年初顯期(EA)是面對獨特挑戰的發展階段, 有可能影響健康, 如影響職業、關係和經濟穩定度, 亦可致使有較高風險的性行為和濫用藥物行為。本研究從296名未受HIV感染、曾受童年性虐待(CSA)的性小眾男士取得數據。我們進行第三期多站點隨機對照試驗, 測試一項實驗性心理社會治療的功效, 並檢視與CSA有關的弱點。我們進行基線的數據評估, 並比較處於EA(18–29歲)和年齡較高的性小眾男士(OSMM), 其創傷後壓力症(PTSD)和其他心理及濫用藥物情況。我們發現, OSMM有較高機會:患PTSD(勝算比(OR) = 0.57, 95% CI [0.33, 0.96])、患驚恐症或患畏曠症及驚恐症(OR = 0.36, 95% CI [0.16, 0.85])、服食可卡因(OR = 0.50, 95% CI [0.25, 0.97]);而EA的樣本有較高機會:酒精中毒(OR = 5.60, 95% CI [3.20, 9.82])、服食大麻(OR = 3.09, 95% CI [1.83, 5.21])、受非HIV的性感染(OR = 3.03, 95% CI [1.29, 7.13])。結果反映性小眾男士其健康風險的複雜性, 特別是處於EA階段的男士。為預防性小眾男士中, 與HIV血清轉化現象有關的健康風險行為, 我們可特別為這類人口提供實證為本的心理社會評估與綜合治療平台, 加強創傷治療和心理疾病與濫藥的共病治療。 Simplified Chinese 标题: 处于成年初显期的性小众男士的创伤:童年性虐待的评估与治疗研究 撮要: 成年初显期(EA)是面对独特挑战的发展阶段, 有可能影响健康, 如影响职业、关系和经济稳定度, 亦可致使有较高风险的性行为和滥用药物行为。本研究从296名未受HIV感染、曾受童年性虐待(CSA)的性小众男士取得数据。我们进行第三期多站点随机对照试验, 测试一项实验性心理社会治疗的功效, 并检视与CSA有关的弱点。我们进行基线的数据评估, 并比较处于EA(18–29岁)和年龄较高的性小众男士(OSMM), 其创伤后压力症(PTSD)和其他心理及滥用药物情况。我们发现, OSMM有较高机会:患PTSD(胜算比(OR) = 0.57, 95% CI [0.33, 0.96])、患惊恐症或患畏旷症及惊恐症(OR = 0.36, 95% CI [0.16, 0.85])、服食可卡因(OR = 0.50, 95% CI [0.25, 0.97]);而EA的样本有较高机会:酒精中毒(OR = 5.60, 95% CI [3.20, 9.82])、服食大麻(OR = 3.09, 95% CI [1.83, 5.21])、受非HIV的性感染(OR = 3.03, 95% CI [1.29, 7.13])。结果反映性小众男士其健康风险的复杂性, 特别是处于EA阶段的男士。为预防性小众男士中, 与HIV血清转化现象有关的健康风险行为, 我们可特别为这类人口提供实证为本的心理社会评估与综合治疗平台, 加强创伤治疗和心理疾病与滥药的共病治疗。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 665-675, October 2018.

--- - |2 Abstract Posttraumatic stress disorder (PTSD) and eating pathology are frequently comorbid, and both are independent risk factors for various medical conditions. Using population‐based data collected as part of the 2012–2013 National Epidemiologic Survey on Alcohol and Related Conditions (NESARC‐III; N = 36,309), the primary objectives of this study were to (a) identify eating pathology classes among PTSD and (b) investigate associations between maladaptive eating and medical conditions among PTSD. Using the Alcohol Use Disorder and Associated Disabilities Interview Schedule (AUDADIS–5), we assessed PTSD and maladaptive eating symptoms in accordance with the DSM‐5. We used a latent class analysis to identify maladaptive eating typologies among adults with lifetime PTSD (n = 2,339; 6.1%) and multivariable logistic regression models to examine associations between each of the six emergent maladaptive eating typologies and medical conditions. Results revealed that over 40% of individuals with PTSD endorsed indicators of maladaptive eating. In addition, each maladaptive eating typology among PTSD was significantly associated with unique sociodemographic characteristics and increased odds of medical conditions relative to no PTSD and no eating disorder, adjusted odds ratios (AORs) = 1.34–6.55, and PTSD with no eating psychopathology, AORs = 1.43–5.11. Results of this study provide a better understanding of maladaptive eating in adults with PTSD and potential medical sequelae. Results indicate maladaptive eating may be an important mechanism in the association between PTSD and medical conditions, which may inform targeted interventions among individuals with these comorbidities. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Hábitos Alimenticios Desadaptativos en el Trastorno de Estrés Postraumático: Un Examen Basado en las Tipologías y los Correlatos de Condiciones Médicas de la Población. TIPOLOGÍA DE HÁBITOS ALIMENTICIOS Y CORRELATOS MÉDICOS EN TEPT. El trastorno de estrés postraumático (TEPT) y la patología de hábitos alimenticios son con frecuencia comórbidos, y ambos son factores de riesgo independientes para diversas condiciones médicas. Se utilizaron los datos basados en la población recopilados como parte de la Encuesta Epidemiológica Nacional sobre el alcohol y condiciones relacionadas 2012–2013 (NESARC‐III; N = 36,309), los objetivos principales de este estudio fueron: (a) identificar las clases de patología de hábitos alimenticios en casos con TEPT, e (b) investigar las asociaciones entre hábitos alimenticios desadaptativos y condiciones médicas entre los casos con TEPT. Usamos el Programa de Entrevistas sobre Discapacidades de Consumo de Alcohol y Discapacidades Asociadas (AUDADIS‐5), evaluamos TEPT y los síntomas de hábitos alimenticios desadaptativos de acuerdo con el DSM‐5. Utilizamos un análisis de clase latente para identificar tipologías de hábitos alimentarios desadaptativos entre adultos con TEPT a lo largo de la vida (n = 2,339, 6.1%) y modelos de regresión logística multivariable para examinar las asociaciones entre cada una de las seis tipologías emergentes de desadaptación de hábitos alimenticios y condiciones médicas. Los resultados revelaron que más del 40% de las personas con TEPT endosaron indicadores de hábitos alimenticios desadaptativos. Además, cada tipología de hábitos alimenticios desadaptativos entre el TEPT se asoció significativamente con características sociodemográficas únicas y un aumento de las probabilidades de condiciones médicas, relativo a no tener TEPT y sin trastorno de hábitos alimenticios, odds ratios ajustados (AOR) = 1.34‐6.55, y TEPT y sin psicopatología de hábitos alimenticios, AORs = 1.43‐5.11. Los resultados de este estudio proporcionan una mejor comprensión de los hábitos alimenticios desadaptativos en adultos con TEPT y posibles secuelas médicas. Los resultados indican que los hábitos alimenticios desadaptativos pueden ser un mecanismo importante en la asociación entre el TEPT y las condiciones médicas, lo que puede orientar intervenciones específicas en individuos con este tipo de comorbilidades. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Maladaptive Eating in Posttraumatic Stress Disorder: A Population‐Based Examination of Typologies and Medical Condition Correlates Traditional Chinese 標題: 創傷後壓力症患者進食失常:類別與相關健康問題的人口為本研究 撮要: 創傷後壓力症(PTSD)和進食失常常為共病, 而兩者都是多種健康問題的獨立風險因素。我們從2012–2013年全國酒精及相關問題流行病學調查(NESARC‐III; N = 36,309) 取得人口為本的數據。本研究的主要目的為(a)找出PTSD患者進食失常的類別;(b)檢視PTSD患者當中, 進食失常和健康問題的關連。我們採用酒精使用失常和相關障礙面談量表(AUDADIS‐5), 根據DSM‐5評估樣本的PTSD與進食失常症狀;利用潛在類別分析, 找出患終生PTSD的成人(n = 2,339; 6.1%)其進食失常的類別, 並以多變項線性迴歸模型, 檢視6種進食失常類別中, 每一種跟健康問題的關連。結果顯示, 40%的PTSD患者有進食失常症狀。而且, 與無PTSD及無進食失常的樣本(已調節勝算比(AOR) = 1.34–6.55)及有PTSD但無進食心理疾病的樣本(AORs = 1.43–5.11)比較, 有PTSD和進食失常的樣本中, 各種進食失常類別都顯著地跟獨特的社會人口特徵有關, 亦顯著地與較大機會患健康問題有關。研究結果使我們對PTSD成年患者的進食失常情況及潛在的後遺症有更深理解。結果反映, 進食失常可能是PTSD與健康問題的關連裡一個重要的機制, 我們可能有需要為有此共病的人士提供針對性干預。 Simplified Chinese 标题: 创伤后压力症患者进食失常:类别与相关健康问题的人口为本研究 撮要: 创伤后压力症(PTSD)和进食失常常为共病, 而两者都是多种健康问题的独立风险因素。我们从2012–2013年全国酒精及相关问题流行病学调查(NESARC‐III; N = 36,309) 取得人口为本的数据。本研究的主要目的为(a)找出PTSD患者进食失常的类别;(b)检视PTSD患者当中, 进食失常和健康问题的关连。我们采用酒精使用失常和相关障碍面谈量表(AUDADIS‐5), 根据DSM‐5评估样本的PTSD与进食失常症状;利用潜在类别分析, 找出患终生PTSD的成人(n = 2,339; 6.1%)其进食失常的类别, 并以多变项线性回归模型, 检视6种进食失常类别中, 每一种跟健康问题的关连。结果显示, 40%的PTSD患者有进食失常症状。而且, 与无PTSD及无进食失常的样本(已调节胜算比(AOR) = 1.34–6.55)及有PTSD但无进食心理疾病的样本(AORs = 1.43–5.11)比较, 有PTSD和进食失常的样本中, 各种进食失常类别都显著地跟独特的社会人口特征有关, 亦显著地与较大机会患健康问题有关。研究结果使我们对PTSD成年患者的进食失常情况及潜在的后遗症有更深理解。结果反映, 进食失常可能是PTSD与健康问题的关连里一个重要的机制, 我们可能有需要为有此共病的人士提供针对性干预。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 708-718, October 2018.

--- - |2 Abstract Traumatic stress is thought to be associated with shortened telomere length (TL) in leukocytes, an age‐related marker of increased risk for cellular senescence, although findings thus far have been mixed. We assessed associations between posttraumatic stress disorder (PTSD) symptom severity, temperament, and TL in a sample of 453 White, non‐Hispanic, middle‐aged, trauma‐exposed male and female veterans and civilians. Given that prior research has suggested an association between PTSD and accelerated cellular age, we also examined associations between TL and an index of accelerated cellular age derived from DNA methylation data (DNAm age). Analyses revealed that, controlling for chronological age, PTSD was not directly associated with TL but rather this association was moderated by age, β = −.14, p = .003, ΔR2 = .02. Specifically, PTSD severity evidenced a stronger negative association with TL among relatively older participants (≥ 55 years of age). In a subset of veterans with data pertaining to temperament (n = 150), positive emotionality, and, specifically, a drive toward achievement, β = .26, p = .002, ΔR2 = .06, were positively associated with TL. There was no evidence of an association between age‐adjusted TL and accelerated DNAm age. Collectively, these results indicate that older adults may be more vulnerable to the negative health effects of PTSD but that traits such as achievement, resilience, and psychological hardiness may be protective. These findings underscore the importance of identifying reliable biomarkers of cellular aging and senescence and of determining the biological mechanisms that contribute to stress‐related disease and decline. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Síntomas del trastorno de estrés postraumático, temperamento y el camino a la vejez Celular TEPT Y ENVEJECIMIENTO CELULAR Se cree que el estrés traumático está asociado con la longitud acortada de los telómeros (LT) en leucocitos, un marcador de mayor riesgo de envejecimiento celular relacionado con la edad, aunque los hallazgos en la fecha han sido mixtos. En este estudio, evaluamos las asociaciones entre la severidad de los síntomas del trastorno de estrés postraumático (TEPT), el temperamento y LT en una muestra de 453 blancos, no Hispánicos, de mediana edad, hombres y mujeres veteranos y civiles expuestos al trauma. Dado que el trabajo previo sugiere una asociación entre el TEPT y aceleración de la edad celular, también examinamos asociaciones entre TL y un índice de edad celular acelerado derivado de los datos de metilación del ADN (edad de ADNm). Los análisis revelaron que, controlando la edad cronológica, el TEPT no se asoció directamente con la LT, sino que esta asociación fue moderada por edad, β = ‐.14, p = .003, λR2 = .02. Específicamente, la severidad del TEPT evidenció una asociación negativa más fuerte con LT entre participantes relativamente mayores (55 años de edad o más). En un subconjunto de veteranos con datos perteneciente al temperamento (n = 150), emocionalidad positiva, y específicamente un impulso hacia el logro, β = .26, p = .002, λR2 = .06, se asoció positivamente con LT. No hubo evidencia de una asociación entre la LT ajustada por edad y la edad acelerada del ADNm. En conjunto, estos resultados indican que los adultos mayores pueden ser más vulnerables a los efectos negativos para la salud de TEPT, pero que los rasgos tales como el logro, la capacidad de recuperación y la resistencia psicológica pueden ser protectores. Los hallazgos subrayan la importancia de identificar biomarcadores confiables de envejecimiento y senescencia y de determinar los mecanismos biológicos que contribuyen al estrés relacionado enfermedad y declive. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Posttraumatic Stress Disorder Symptoms, Temperament, and the Pathway to Cellular Senescence Traditional Chinese 標題: 創傷後壓力症症狀、脾氣以及導致細胞衰老的路徑 撮要: 過往研究一直認為創傷壓力跟白血球的端粒長度(TL)縮短有關, 而那是年齡相關的生物標記, 象徵細胞衰老的風險提升。可是, 目前仍未有一致的研究發現。本研究旨在檢視創傷後壓力症(PTSD)症狀嚴重度、脾氣和TL的關連。樣本為453名白人、非西班牙裔、中年、受創的男性和女性退役軍人以及平民。有見於過往有研究指PTSD跟細胞加速衰老有關, 我們亦檢視從DNA甲基化數據取得的細胞加速衰老指數(DNAm age)跟TL的關連。分析顯示, 我們對年齡作對照後, PTSD跟TL並無直接關連, 但其關連受年齡所調節(β = ‐.14, p = .003, ∆R2 = .02)。在相對年長的樣本 (55歲或以上) , PTSD嚴重度跟TL有較強的負向關連。有關退役軍人脾氣的子樣本數據(n = 150)反映, 正向情緒, 特別是對成就感的追求, 跟TL有正向關連(β = .26, p = .002, ∆R2 = .06)。並無證據顯示根據年齡調節後的TL跟DNAm age有所關連。以上結果反映, 年齡較高的成人可能有較大風險受PTSD影響健康, 但如成就感、復原力、心理韌力等特徵可能有保護作用。結果反映找出有關細胞衰老可靠的生物標記的重要性, 以及找出導致壓力相關的疾病和衰退的生理機制的重要。 Simplified Chinese 标题: 创伤后压力症症状、脾气以及导致细胞衰老的路径 撮要: 过往研究一直认为创伤压力跟白血球的端粒长度(TL)缩短有关, 而那是年龄相关的生物标记, 象征细胞衰老的风险提升。可是, 目前仍未有一致的研究发现。本研究旨在检视创伤后压力症(PTSD)症状严重度、脾气和TL的关连。样本为453名白人、非西班牙裔、中年、受创的男性和女性退役军人以及平民。有见于过往有研究指PTSD跟细胞加速衰老有关, 我们亦检视从DNA甲基化数据取得的细胞加速衰老指数(DNAm age)跟TL的关连。分析显示, 我们对年龄作对照后, PTSD跟TL并无直接关连, 但其关连受年龄所调节(β = ‐.14, p = .003, ∆R2 = .02)。在相对年长的样本 (55岁或以上) , PTSD严重度跟TL有较强的负向关连。有关退役军人脾气的子样本数据(n = 150)反映, 正向情绪, 特别是对成就感的追求, 跟TL有正向关连(β = .26, p = .002, ∆R2 = .06)。并无证据显示根据年龄调节后的TL跟DNAm age有所关连。以上结果反映, 年龄较高的成人可能有较大风险受PTSD影响健康, 但如成就感、复原力、心理韧力等特征可能有保护作用。结果反映找出有关细胞衰老可靠的生物标记的重要性, 以及找出导致压力相关的疾病和衰退的生理机制的重要。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 676-686, October 2018.

--- - |2 Abstract Safety‐seeking behaviors (SSBs) may be employed after exposure to a traumatic event in an effort to prevent a feared outcome. Cognitive models of posttraumatic stress disorder propose SSBs contribute to maintaining this disorder by preventing disconfirmation of maladaptive beliefs and preserving a sense of current threat. Recent research has found that SSBs impact children's posttraumatic stress symptoms (PTSS) and recovery. In this paper, we sought to develop and validate a novel 22‐item Child Safety Behavior Scale (CSBS) in a school‐based sample of 391 pupils (age 12–15 years) who completed a battery of questionnaires as well as 68 youths (age 8–17 years) who were recently exposed to a trauma. Of the sample, 93.1% (N = 426) completed the new questionnaire. The sample was split (n = 213), and we utilized principal components analysis alongside parallel analysis, which revealed that 13 items loaded well onto a two‐factor structure. This structure was superior to a one‐factor model and overall demonstrated a moderately good model of fit across indices, based upon a confirmatory factory analysis with the other half of the sample. The CSBS showed excellent internal consistency, r = .90; good test–retest reliability, r = .64; and good discriminant validity and specificity. In a multiple linear regression, SSBs, negative appraisals, and number of trauma types each accounted for unique variance in a model of PTSS. This study provides initial support for the use of the CSBS in trauma‐exposed youth as a valuable tool for further research, clinical assessment, and targeted intervention. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) El Desarrollo Preliminar y la Validación de una Medida Conductual de Búsqueda de Seguridad Relacionada al Trauma para Jóvenes: La Escala de Comportamiento de Seguridad Infantil (CSBS, en sigla en inglés) DESARROLLO DE LA ESCALA DE COMPORTAMIENTO DE SEGURIDAD INFANTIL Los comportamientos de búsqueda de seguridad (SSBs, en su sigla en inglés) pueden ser empleados después de la exposición a un evento traumático en un esfuerzo por evitar un resultado temido. Los modelos cognitivos del trastorno de estrés postraumático proponen que los SSBs contribuyen a mantener este trastorno al evitar la refutación de las creencias desadaptativas y preservar un sentido de amenaza actual. Las investigaciones recientes han encontrado que los SSBs tienen un impacto en los síntomas de estrés postraumático (SEPT) y en la recuperación de los niños. En este documento, buscamos desarrollar y validar una nueva Escala de Conducta de Seguridad Infantil (CSBS) de 22 ítems en una muestra escolar de 391 estudiantes (de 12 a 15 años) que completaron una batería de cuestionarios y de 68 jóvenes (de 8 a 17 años) que estuvieron expuestos recientemente a un trauma. De la muestra, el 93.1% (N = 426) completó el nuevo cuestionario. La muestra se dividió (n = 213) y utilizamos el análisis de componentes principales junto con el análisis paralelo, revelando que 13 ítems cargaron adecuadamente en una estructura de dos factores. Esta estructura fue superior a un modelo de un factor y, en general, fue un modelo de ajuste moderadamente bueno entre los índices que investigamos (utilizando el análisis factorial confirmatorio con la otra mitad de la muestra). La CSBS mostró una excelente consistencia interna, r = .90; buena confiabilidad test‐retest, r = .64; y buena validez discriminante y especificidad. En una regresión lineal múltiple, los SSBs, las evaluaciones negativas, y el número de tipos de traumas explicaron cada uno una parte de la varianza en un modelo de SEPT. Este estudio proporciona apoyo inicial para el uso de la CSBS en jóvenes expuestos al trauma como una herramienta clínicamente valiosa para futuras investigaciones, evaluaciones clínicas, e intervenciones específicas. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 The Preliminary Development and Validation of a traumarelated safety‐seeking‐seeking behaviour measure for youth: the Child Safety Behaviour Scale (CSBS) Traditional Chinese 標題: 為青少年而設的創傷相關安全感行為測量的初步設計和驗證:兒童安全感行為量表(CSBS) 撮要: 人在經歷創傷事件後, 為提防害怕的事件發生, 可能會採取尋找安全感的行為(SSBs)。創傷後壓力症的認知模型提出, SSBs會預防適應不良的信念被推翻並保持當前的威脅感, 致使病患維持。而近期研究發現, SSBs對兒童的創傷後壓力症狀(PTSS)和康復有所影響。本研究旨在設計和驗證一個新的22項兒童安全感行為量表(CSBS)。樣本屬學校為本, 有391名學生(年齡為12–15歲)完成了一系列問卷, 並有68 名青少年 (年齡為8–17歲)近期經歷了一次創傷。樣本中93.1% (N = 426)完成了新問卷。我們把樣本分開兩半(n = 213), 利用主成分分析法及平行分析法, 發現13個項目能適切地融於一個二因素模型, 它比單因素模型更好, 綜觀所有我們檢視的指數來說 (對另一半樣本進行驗證性因素分析) , 整體上是適切度為中度良好的模型。CSBS的內部一致性為極佳(r = .90);重測信度為良好 (r = .64), 判別效度和特殊性亦為良好。多元線性迴歸分析顯示, 在一個PTSS模型裡, SSBs、負向評價和創傷類別數量都分別構成獨特的方差。本研究提供了初步數據, 支持對受創青少年使用CSBS, 證明它對未來研究、臨床評估和針對性干預治療都是有用工具。 Simplified Chinese 标题: 为青少年而设的创伤相关安全感行为测量的初步设计和验证:儿童安全感行为量表(CSBS) 撮要: 人在经历创伤事件后, 为提防害怕的事件发生, 可能会采取寻找安全感的行为(SSBs)。创伤后压力症的认知模型提出, SSBs会预防适应不良的信念被推翻并保持当前的威胁感, 致使病患维持。而近期研究发现, SSBs对儿童的创伤后压力症状(PTSS)和康复有所影响。本研究旨在设计和验证一个新的22项儿童安全感行为量表(CSBS)。样本属学校为本, 有391名学生(年龄为12–15岁)完成了一系列问卷, 并有68 名青少年 (年龄为8–17岁)近期经历了一次创伤。样本中93.1% (N = 426)完成了新问卷。我们把样本分开两半(n = 213), 利用主成分分析法及平行分析法, 发现13个项目能适切地融于一个二因素模型, 它比单因素模型更好, 综观所有我们检视的指数来说 (对另一半样本进行验证性因素分析) , 整体上是适切度为中度良好的模型。CSBS的内部一致性为极佳(r = .90);重测信度为良好 (r = .64), 判别效度和特殊性亦为良好。多元线性回归分析显示, 在一个PTSS模型里, SSBs、负向评价和创伤类别数量都分别构成独特的方差。本研究提供了初步数据, 支持对受创青少年使用CSBS, 证明它对未来研究、临床评估和针对性干预治疗都是有用工具。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 643-653, October 2018.

--- - |2 Abstract In the present study, we aimed to explore neural correlates of survivors of the 2009 L'Aquila, Italy earthquake in response to being shown pictures featuring their own city before and after an earthquake as well as those of an unfamiliar city. Moreover, we explored the associations among psychological variables and brain responses to the pictures of L'Aquila after the earthquake. Our final sample (N = 30 adults) comprised 15 survivors (M age = 31.40 years, SD = 9.42) and 15 controls (M age = 30.53 years, SD = 10.01). Participants’ electroencephalographic (EEG) data were recorded during a visual task that included earthquake‐related stimuli. Participants were assessed for posttraumatic and dissociation symptoms and event‐related potential components, and low‐resolution electromagnetic tomography (sLORETA) were analyzed. Compared to the control group, source localization in survivors indicated a lower intensity of the amygdala, hippocampal, parahippocampal, and temporopolar areas in response to visual stimuli concerning the earthquake, p < .001 to p < .0001. Results indicated a reduced limbic activation in response to visual stimuli that evoked the recall of earthquake in survivors. This finding suggests that survivors likely adopted a distancing strategy toward stimuli that may have elicited an emotional activation related to collective trauma. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Correlatos neurofisiológicos del recuerdo de un trauma colectivo en sobrevivientes del terremoto de El Águila 2009 CORRELATOS NEURONALES DEL RECUERDO DE TRAUMA COLECTIVO. En el presente estudio, quisimos explorar los correlatos neuronales de los sobrevivientes al terremoto del 2009 en Italia de la región de El Águila, en respuesta a las imágenes que muestran su propia ciudad antes y después de un terremoto, así como también las de una ciudad desconocida. Aún más, exploramos la asociación entre variables psicológicas y respuestas cerebrales a las fotos de El Águila después del terremoto. Nuestra muestra final (N = 30 adultos) comprendía 15 sobrevivientes (Medad = 31.40 años, DE = 9.42) y 15 controles (Medad = 30.53, DE = 10.01). Los datos electroencefalográficos (EEG) de los participantes fueron grabados durante una tarea visual que incluyó estímulos relacionados con el terremoto. Los participantes fueron evaluados por síntomas postraumáticos y disociativos y se analizaron los componentes potenciales relacionados con el evento y tomografía electromagnética de baja resolución (sLORETA en su sigla en inglés). Comparados con el grupo control, en los sobrevivientes las fuentes localizadas indicaron una más baja intensidad para la amígdala, áreas hipo campal, parahipocampal, y témporo polar en respuesta a estímulos visuales concernientes al terremoto. Los resultados indicaron una activación límbica disminuida en respuesta a estímulos visuales que evocaban el recuerdo del terremoto en los sobrevivientes. Estos hallazgos sugieren que los sobrevivientes probablemente adoptaron una estrategia de distanciamiento hacia los estímulos que pudieran haber provocado una activación emocional relacionada con el trauma colectivo. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Neurophysiological Correlates of Collective Trauma Recall in L'Aquila 2009 Earthquake Survivors Traditional Chinese 標題: 2009年意大利拉奎拉地震生還者對集體創傷的神經生理相關因素 撮要: 本研究旨在檢視2009年意大利拉奎拉地震生還者, 對拉奎拉以及另一不熟悉的城市在地震前後的照片所產生反應的神經相關因素。我們亦檢視心理變量跟對拉奎拉地震後照片的腦部反應的關連。最終的樣本(N = 30 成人)由15名生還者(Mage = 31.40 歲, SD = 9.42)和15名對照組人士(Mage = 30.53, SD = 10.01)組成。我們在視覺實驗裡提供地震相關的刺激, 記錄樣本的腦電圖(EEG)數據。我們評估樣本的創傷後壓力症狀與離解症狀, 並分析樣本的事件相關潛在成份與低解析度電磁斷層掃描(sLORETA)。腦波來源定位反映, 生還者對地震相關的視覺刺激反應, 相比對照組, 在杏仁體、海馬體、海馬旁迴、顳極動脈區域都較弱。結果顯示, 生還者面對令他們想起地震的視覺刺激時, 邊緣系統的啟動反應會減弱。結果反映生還者大多對剌激採取保持距離的策略, 有可能使其對集體創傷有情緒啟動反應。 Simplified Chinese 标题: 2009年意大利拉奎拉地震生还者对集体创伤的神经生理相关因素 撮要: 本研究旨在检视2009年意大利拉奎拉地震生还者, 对拉奎拉以及另一不熟悉的城市在地震前后的照片所产生反应的神经相关因素。我们亦检视心理变量跟对拉奎拉地震后照片的脑部反应的关连。最终的样本(N = 30 成人)由15名生还者(Mage = 31.40 岁, SD = 9.42)和15名对照组人士(Mage = 30.53, SD = 10.01)组成。我们在视觉实验里提供地震相关的刺激, 记录样本的脑电图(EEG)数据。我们评估样本的创伤后压力症状与离解症状, 并分析样本的事件相关潜在成份与低分辨率电磁断层扫描(sLORETA)。脑波来源定位反映, 生还者对地震相关的视觉刺激反应, 相比对照组, 在杏仁体、海马体、海马旁回、颞极动脉区域都较弱。结果显示, 生还者面对令他们想起地震的视觉刺激时, 边缘系统的启动反应会减弱。结果反映生还者大多对剌激采取保持距离的策略, 有可能使其对集体创伤有情绪启动反应。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 687-697, October 2018.

--- - |2 Abstract Posttraumatic stress disorder (PTSD) and alcohol use disorder (AUD) frequently co‐occur and are associated with worse outcomes together than either disorder alone. A lack of consensus regarding recommendations for treating PTSD–AUD exists, and treatment dropout is a persistent problem. Acceptance and Commitment Therapy (ACT), a transdiagnostic, mindfulness‐ and acceptance‐based form of behavior therapy, has potential as a treatment option for PTSD–AUD. In this uncontrolled pilot study, we examined ACT for PTSD–AUD in 43 veterans; 29 (67%) completed the outpatient individual therapy protocol (i.e., ≥ 10 of 12 sessions). Clinician‐assessed and self‐reported PTSD symptoms were reduced at posttreatment, ds = 0.79 and 0.96, respectively. Self‐reported symptoms of PTSD remained lower at 3‐month follow‐up, d = 0.88. There were reductions on all alcohol‐related outcomes (clinician‐assessed and self‐reported symptoms, total drinks, and heavy drinking days) at posttreatment and 3‐month follow‐up, dmean = 0.91 (d range: 0.65–1.30). Quality of life increased at posttreatment and follow‐up, ds = 0.55–0.56. Functional disability improved marginally at posttreatment, d = 0.35; this effect became significant by follow‐up, d = 0.52. Fewer depressive symptoms were reported at posttreatment, d = 0.50, and follow‐up, d = 0.44. Individuals experiencing suicidal ideation reported significant reductions by follow‐up. Consistent with the ACT theoretical model, these improvements were associated with more between‐session mindfulness practice and reductions in experiential avoidance and psychological inflexibility. Recommendations for adapting ACT to address PTSD–AUD include assigning frequent between‐session mindfulness practice and initiating values clarification work and values‐based behavior assignments early in treatment. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Terapia de Aceptación y Compromiso para la co‐ocurrencia de Trastornos de Estrés Postraumático y Consumo de Alcohol en Veteranos: Resultados de un Tratamiento Piloto ACT PARA TEPT Y ALCOHOL El trastorno de estrés postraumático (TEPT) y el trastorno por consumo de alcohol (AUD, por sus siglas en inglés) ocurren frecuentemente de forma simultánea y están asociados con resultados peores cuando se encuentran juntos que cuando se encuentra cada uno por separado. Existe una falta de consenso con respecto a las recomendaciones para el tratamiento de TEPT‐AUD, y el abandono del tratamiento es un problema persistente. La terapia de aceptación y compromiso (ACT, por sus siglas en inglés), es una forma de terapia conductual basada en el transdiagnóstico, el mindfulness y la aceptación, tiene potencial como una opción de tratamiento para TEPT‐AUD. En este estudio piloto no controlado, examinamos la ACT para TEPT‐AUD en 43 veteranos; 29 (67%) completaron el protocolo de terapia individual ambulatoria (es decir, ≥ 10 de 12 sesiones). Los síntomas de TEPT autorreportados y evaluados por el médico se redujeron en el postratamiento, ds = 0.79 y 0.96, respectivamente. Los síntomas autorreportados de TEPT se mantuvieron más bajos a los 3 meses de seguimiento, d = 0.88. Hubo reducciones en todos los resultados relacionados con el alcohol (síntomas evaluados por el médico y autoinformados, total de bebidas alcohólicas, días de consumo excesivo de alcohol) en el postratamiento y el seguimiento a los 3 meses, d promedio = 0.91 (rango d: 0.65‐1.30). La calidad de vida aumentó en el postratamiento y el seguimiento, ds = 0.55‐0.56. La discapacidad funcional mejoró marginalmente en el postratamiento, d = 0.35; este efecto se volvió significativo en el seguimiento, d = 0.52. Se informaron menos síntomas depresivos en el postratamiento, d = 0.50 y seguimiento, d = 0.44. Los individuos que experimentaron ideación suicida informaron reducciones significativas en el seguimiento. De acuerdo con el modelo teórico de ACT, estas mejoras se asociaron con más prácticas de mindfulness entre sesiones y las reducciones en la evitación experiencial y la inflexibilidad psicológica. Las recomendaciones para adaptar ACT para abordar el TEPT‐AUD incluyen la asignación frecuente de práctica de mindfulness entre sesiones e iniciar el trabajo de aclaración de valores y tareas conductuales basadas en valores al principio del tratamiento. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 Acceptance and Commitment Therapy for Co‐Occurring PTSD and Alcohol Use Disorders in Veterans: Pilot Treatment Outcomes Traditional Chinese 標題: 對同時患PTSD和酒精使用失常的退役軍人採用接受與承諾療法:試驗性治療結果 撮要: 創傷後壓力症(PTSD)和酒精使用失常(AUD)經常同時出現, 構成的後果比患單一疾病更為惡劣。對於PTSD–AUD治療, 我們一直欠缺共識, 而患者中途放棄治療的問題持續。接受與承諾療法(ACT)是跨診斷、以正念和接受為本的行為療法, 有可能是用以治療PTSD–AUD的一個選項。在這非對照的試驗研究, 我們檢視43名退役軍人接受ACT以治療PTSD–AUD的情況。當中29位(67%)完成了門診獨立治療的口語記錄(即 ≥ 10節段, 共12 節段)。臨床診斷所得及自評的PTSD症狀在完成治療後都有所減少(分別為 ds = 0.79 和 0.96)。3個月後, 自評的PTSD症狀仍有減輕(d = 0.88)。在完成治療時和3個月後, 所有酒精相關的狀況 (臨床診斷及自評的症狀、酒精使用總量、大量飲酒的日數) 都有減輕, d 平均值 = 0.91 (d 值域: 0.65–1.30)。生活質素在完成治療時和跟進期都有改善(ds = 0.55– 0.56)。功能性損傷在完成治療時有少量改善(d = 0.35), 而在跟進期的改善變得顯著(d = 0.52)。樣本的抑鬱症狀在完成治療時和跟進期都有減少(d = 0.50, 跟進期 d = 0.44)。有自殺意念的樣本, 意念在跟進期顯著減輕。與ACT的理論模型相符, 以上改善跟在節段間有更多正念練習, 以及經驗迴避及心理缺乏彈性的情況減少有關。我們對於以ACT治療PTSD–AUD的建議, 包括吩咐患者在節段間經常進行正念練習, 並在療程初期開始與患者進行價值澄清及價值為本的行為練習。 Simplified Chinese 标题: 对同时患PTSD和酒精使用失常的退役军人采用接受与承诺疗法:试验性治疗结果 撮要: 创伤后压力症(PTSD)和酒精使用失常(AUD)经常同时出现, 构成的后果比患单一疾病更为恶劣。对于PTSD–AUD治疗, 我们一直欠缺共识, 而患者中途放弃治疗的问题持续。接受与承诺疗法(ACT)是跨诊断、以正念和接受为本的行为疗法, 有可能是用以治疗PTSD–AUD的一个选项。在这非对照的试验研究, 我们检视43名退役军人接受ACT以治疗PTSD–AUD的情况。当中29位(67%)完成了门诊独立治疗的口语记录(即 ≥ 10节段, 共12 节段)。临床诊断所得及自评的PTSD症状在完成治疗后都有所减少(分别为 ds = 0.79 和 0.96)。3个月后, 自评的PTSD症状仍有减轻(d = 0.88)。在完成治疗时和3个月后, 所有酒精相关的状况 (临床诊断及自评的症状、酒精使用总量、大量饮酒的日数) 都有减轻, d 平均值 = 0.91 (d 值域: 0.65–1.30)。生活质素在完成治疗时和跟进期都有改善(ds = 0.55– 0.56)。功能性损伤在完成治疗时有少量改善(d = 0.35), 而在跟进期的改善变得显著(d = 0.52)。样本的抑郁症状在完成治疗时和跟进期都有减少(d = 0.50, 跟进期 d = 0.44)。有自杀意念的样本, 意念在跟进期显著减轻。与ACT的理论模型相符, 以上改善跟在节段间有更多正念练习, 以及经验回避及心理缺乏弹性的情况减少有关。我们对于以ACT治疗PTSD–AUD的建议, 包括吩咐患者在节段间经常进行正念练习, 并在疗程初期开始与患者进行价值澄清及价值为本的行为练习。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 781-789, October 2018.

--- - |2 Abstract Emotion regulation difficulties have been theoretically and empirically linked to posttraumatic stress disorder (PTSD). Previous research, however, has focused almost exclusively on difficulties regulating negative emotions. In this study, we explored the nature of difficulties regulating positive emotions in PTSD. Participants were women who had experienced domestic violence (N = 210; 48.6% African American; Mage = 36.14 years). Higher levels of nonacceptance of positive emotions, difficulties engaging in goal‐directed behaviors when experiencing positive emotions, and difficulties controlling impulsive behaviors when experiencing positive emotions were related to a higher level of PTSD symptom severity overall and for the intrusion, avoidance/emotional numbing, and hyperarousal clusters, rs = .24–.37. The presence (vs. absence) of a probable PTSD diagnosis was related to greater difficulties engaging in goal‐directed behaviors, d = 0.54, and controlling impulsive behaviors, d = 0.34, when experiencing positive emotions. Results suggest the potential utility of assessing and treating difficulties regulating positive emotions among domestic violence–victimized women with PTSD. Resumen Spanish Abstracts by Asociación Chilena de Estrés Traumático (ACET) Un Estudio del Rol de las Dificultades para la Regulación de las Emociones Positivas en el Trastorno de Estrés Postraumático. DIFICULTADES EN LA REGULACIÓN DE EMOCIONES POSITIVAS EN TEPT Las dificultades para la regulación de las emociones han sido asociadas teórica y empíricamente al trastorno de estrés postraumático (TEPT). Las investigaciones previas, sin embargo, se han enfocado casi en forma exclusiva en las dificultades para la regulación de las emociones negativas. En este estudio, exploramos la naturaleza de las dificultades para la regulación de las emociones positivas en TEPT. Las participantes fueron mujeres que habían experimentado violencia doméstica (N = 210; 48.6% Afroamericanas; Medad = 36.14 años). Los altos niveles de rechazo de las emociones positivas, las dificultades para involucrarse en actividades dirigidas a un objetivo cuando se experimentan emociones positivas, y las dificultades para controlar los comportamientos impulsivos cuando se experimentan emociones positivas se relacionaron a un mayor nivel de severidad de los síntomas de TEPT en general y para los grupos sintomáticos de intrusión, evitación/embotamiento emocional e hiperactivación rs = .24‐.37. La presencia (vs. ausencia) de un probable diagnóstico de TEPT se relacionó a mayores dificultades para involucrarse en actividades dirigidas a un objetivo, d = 0.54, y para controlar los comportamientos impulsivos, d = 0.34, mientras se experimentan emociones positivas. Los resultados sugieren la potencial utilidad de la evaluación y tratamiento de las dificultades para la regulación de las emociones positivas entre las mujeres víctimas de violencia doméstica con TEPT. 抽象 Traditional and Simplified Chinese Abstracts by the Asian Society for Traumatic Stress Studies (AsianSTSS) 簡體及繁體中文撮要由亞洲創傷心理研究學會翻譯 An Examination of the Role of Difficulties Regulating Positive Emotions in Posttraumatic Stress Disorder Traditional Chinese 標題: 檢視創傷後壓力症裡正面情緒調節困難的影響 撮要: 情緒調節困難在理論和實證方面都跟創傷後壓力症(PTSD)有關。然而, 過往研究幾乎都只專注檢視調節負面情緒的困難。本研究探索PTSD患者調節正面情緒的困難。樣本為曾遭受家庭暴力的女性(N = 210; 48.6% 非裔美國人; Mage = 36.14 歲)。對正面情緒的抗拒水平較高、處於正面情緒時較難投入實踐目標的行為、處於正面情緒時較難控制衝動行為, 都跟整體的PTSD症狀水平較高有關, 亦與侵擾、迴避༏情感麻木和過激反應聚類有關(rs = .24–.37)。被診斷為有可能患PTSD (相比無此診斷) , 與處於正面情緒時較難投入實踐目標的行為(d = 0.54)和較難控制衝動行為有關(d = 0.34)。結果反映, 評估及治療患PTSD的家庭暴力受害女性調節正面情緒的困難, 有潛在效用。 Simplified Chinese 标题: 检视创伤后压力症里正面情绪调节困难的影响 撮要: 情绪调节困难在理论和实证方面都跟创伤后压力症(PTSD)有关。然而, 过往研究几乎都只专注检视调节负面情绪的困难。本研究探索PTSD患者调节正面情绪的困难。样本为曾遭受家庭暴力的女性(N = 210; 48.6% 非裔美国人; Mage = 36.14 岁)。对正面情绪的抗拒水平较高、处于正面情绪时较难投入实践目标的行为、处于正面情绪时较难控制冲动行为, 都跟整体的PTSD症状水平较高有关, 亦与侵扰、回避༏情感麻木和过激反应聚类有关(rs = .24–.37)。被诊断为有可能患PTSD (相比无此诊断), 与处于正面情绪时较难投入实践目标的行为(d = 0.54)和较难控制冲动行为有关(d = 0.34)。结果反映, 评估及治疗患PTSD的家庭暴力受害女性调节正面情绪的困难, 有潜在效用。 - Journal of Traumatic Stress, Volume 31, Issue 5, Page 775-780, October 2018.

--- - |2 This study examined the effects of observation‐based supervision Building Outcomes with Observation‐Based Supervision of Therapy (BOOST therapists = 26, families = 105), versus supervision as usual (SAU therapists = 21, families = 59) on (a) youth externalizing behavior problems and (b) the moderating effects of changes in family functioning on youth externalizing behaviors for adolescents receiving Functional Family Therapy (FFT). Exploratory analyses examined the impact of supervision conditions on youth internalizing problems. In 8 community agencies, experienced FFT therapists (M = 1.4 years) received either BOOST or SAU supervision in a quasi‐experimental design. Male (59%) or female (41%) adolescents were referred for the treatment of behavior problems (e.g., delinquency, substance use). Clients were Hispanic (62%), African American (19%), Non‐Hispanic White (12%), or Other (7%) ethnic/racial origins. Therapists (female, 77%) were Hispanic 45%, African American (19%), White Non‐Hispanic (30%), or other (4%) ethnic/racial backgrounds. Analyses controlled for the presence or absence of clinically elevated symptoms on outcome variables. Clinical outcomes were measured at baseline, 5 months, and 12 months after treatment initiation. Clients with externalizing behavior above clinical thresholds had significantly greater reductions in problem behaviors in the BOOST versus the SAU conditions. Clients below thresholds did not respond differentially to conditions. Supervisors in BOOST had more experience with the FFT model; as such, the observed results may be a result of supervisor experience. The BOOST supervision was associated with improved outcomes on problem behaviors that were above clinical thresholds. The findings demonstrate the importance of addressing client case mix in implementation studies in natural environments. Este estudio examinó los efectos de la supervisión basada en la observación (terapeutas de BOOST = 26, familias = 105) frente a la supervisión habitual (terapeutas de SAU = 21, familias = 59) en (a) la externalización de problemas de conducta en los jóvenes y (b) los efectos moderadores de los cambios en el funcionamiento familiar sobre la externalización de conductas de los jóvenes en el caso de adolescentes que reciben terapia familiar funcional (FFT). Los análisis exploratorios analizaron el efecto de las condiciones de la supervisión en la internalización de problemas de los jóvenes. En 8 agencias comunitarias, terapeutas experimentados en FFT (M = 1,4 años) recibieron supervisión BOOST o SAU en un diseño cuasiexperimental. Se derivó a adolescentes masculinos (59%) o femeninos (41%) para el tratamiento de problemas conductuales (p. ej.: delincuencia, consumo de sustancias). Los pacientes eran hispanos (62%), afroamericanos (19%), blancos no hispanos (12%) o de otros orígenes étnicos o raciales (7%). Los terapeutas (femeninos, 77%) eran hispanos 45%, afroamericanos (19%), blancos no hispanos (30%) o de otros orígenes étnicos o raciales (4%). Los análisis tuvieron en cuenta la presencia o la ausencia de síntomas clínicamente elevados en los criterios de valoración. Se midieron las variables clínicas al inicio, a los 5 meses y 12 meses después del inicio del tratamiento. Resultados: Los pacientes con externalización del comportamiento por encima de los límites clínicos tuvieron reducciones considerablemente mayores de los comportamientos problemáticos en las condiciones de BOOST frente a las de SAU. Los pacientes por debajo de los límites no respondieron de forma diferencial a las condiciones. Los supervisores de BOOST tenían más experiencia con el modelo de FFT; por lo tanto, los resultados observados pueden ser el resultado de la experiencia de los supervisores. La supervisión BOOST estuvo asociada con mejores resultados en los comportamientos problemáticos que estaban por encima de los límites clínicos. Los resultados demuestran la importancia de abordar la variedad de casos de pacientes en la implementación de estudios en ambientes naturales. 该研究考察了以观察为基础的监督(BOOST 咨询师 = 26, 家庭 = 105)的效果和通常监督相比(SAU 咨询师 = 21, 家庭 = 59)对于a) 青少年外在化行为问题和b) 家庭功能中变化对于接受功能家庭心理咨询(FFT)的青少年外在化行为的调节效果。探究性分析考察了监督条件对于青少年内在化问题的影响。在8个社区机构中,有经验的FFT心理咨询师(M = 1.4 年)在一个准实验设计中接收BOOST或SAU监督。男性(59%)或女性(41%)青少年被推荐接受行为问题(例如,犯法,药物滥用)治疗。患者是西班牙裔(62%),非裔美籍(19%),非西班牙裔白人(12%)or其他族裔(7%)。咨询师(女性,77%)45%是西班牙裔,19%非裔美籍,30%非西班牙裔白人,4%其他族裔背景。分析控制结果变量上临床提升症状。我们在基线,治疗后5个月和12个月测量临床结果。外在化行为高于临床基准的患者在BOOST条件下问题行为比在SAU条件下明显减少。外在化行为低于临床基准的患者在两种条件下反应没有不同。BOOST监督者在FFT模型方面经验更多;因此,观察到的结果可能是监督者经验的结果。BOOST监督和高于临床基准的问题行为改进成果有关。研究发现表明探讨自然环境中不同性质病例实施研究的重要性。 - Family Process, EarlyView.

--- - |2 Scene‐Based Psychodramatic Family Therapy (SB‐PFT) is an innovative treatment used with troubled adolescents and their parents to improve family relationships and reduce adolescents’ problematic behavior. It integrates the principles of family therapy, psychodrama, and multiple‐family group methodology. This research is a pilot study to obtain empirical evidence on the SB‐PFT therapeutic process by gauging the perception of change of troubled adolescents and their parents, and assess the perceived helpfulness of its methodology and techniques. Ten multiple‐family intervention groups were drawn up, with 110 participants (63 adolescents and 47 parents), and we adopted a qualitative methodology with focus groups, using an inductive analysis of 290 active constructions of participant narratives. Concerning perception of change, the adolescents reported mainly gaining in social support, prosocial attitudes, keys to problem solving, and expression of emotions due to the treatment. The parents perceived improvement in social support, keys for educational practices, emotional well‐being, and expression of emotions due to the treatment. Regarding the perceived helpfulness of methodology and techniques, both adolescents and parents highlighted the usefulness of the group methodology for gaining social support, relativizing the problem, and expressing emotions. Additionally, participants referred to role‐playing and mirror techniques as the most useful techniques. In conclusion, this first study on SB‐PFT presents and describes its treatment for troubled adolescents and their parents. The participants’ positive perception of their personal and relational change after treatment should serve to promote further studies with quantitative methodology in order to verify the effectiveness of SB‐PFT treatment. La terapia familiar psicodramática basada en escenas (SB‐PFT, por sus siglas en inglés) es un tratamiento innovador usado con adolescentes conflictivos y sus padres para mejorar las relaciones familiares y disminuir el comportamiento problemático de los adolescentes. Integra los principios de la terapia familiar, del psicodrama y de la metodología grupal multifamiliar. Esta investigación es un estudio piloto para obtener conocimiento empírico sobre el proceso terapéutico de la SB‐PFT mediante la medición de la percepción de cambio de los adolescentes conflictivos y sus padres, y para evaluar la utilidad percibida de esta metodología y técnica. Se formaron diez grupos multifamiliares de intervención con 110 participantes (63 adolescentes y 47 padres), y adoptamos una metodología cualitativa con grupos focales utilizando un análisis inductivo de 290 construcciones activas de historias de los participantes. Con respecto a la percepción de cambio, los adolescentes informaron un aumento pricipalmente del apoyo social, de las actitudes prosociales, de las claves para resolver problemas y de la expresión de emociones debido al tratamiento. Los padres percibieron una mejora del apoyo social, de las claves para las prácticas educativas, del bienestar emocional y de la expresión de emociones debido al tratamiento. Con respecto a la utilidad percibida de la metodología y las técnicas, tanto los adolescentes como los padres destacaron la utilidad de la metodología de grupo para obtener apoyo social, relativizar el problema y expresar emociones. Además, los participantes se refirieron al juego de roles y a las técnicas del espejo como las más útiles. En resumen, este primer estudio sobre la SB‐PFT presenta y describe su tratamiento para adolescentes conflictivos y sus padres. La percepción positiva de los participantes de su cambio personal y relacional después del tratamiento debería servir para promover más estudios con una metodología cuantitativa a fin de verificar la eficacia del tratamiento con la SB‐PFT. 情景为基础的心理戏剧化家庭心理咨询(SB‐PFT) 是一项应用于帮助有困扰青少年及其家长改善家庭关系并减少青少年问题行为的创新性治疗方法。该方法整合了家庭心理咨询原则,心理戏剧以及多家庭小组方法。该研究是旨在通过测量有困扰青少年及其家长感知到的变化来获得关于SB‐PFT实证证据,并评估其方法和技巧感知到的有效性的试点研究。我们组织了共110名参与者(63名青少年和47名家长)的十个多家庭干预小组。我们对焦点小组采用定性方法,使用了一项针对参与者叙述290个活性建构的感应分析。关于对于变化的感知,青少年主要报告了得到社会支持,有益于社会的态度,由于治疗获得解决问题和表达情感的钥匙。由于治疗,家长感受到社会支持,教育做法,情感健康以及情绪表达的该进。关于对于方法和技巧感受到的帮助,青少年和家长都强调了小组方法对于获得社会支持,将问题相对化以及情感表达方面的有用性。此外,参与者认为角色扮演和镜面技巧最有效。结论是,第一个关于SB‐PFT的研究描述并提出针对有困扰青少年及其家长的治疗。参与者对于治疗后个人以及关系改变正面感知会促进更多为确定SB‐PFT治疗有效性的定量方法研究。 - Family Process, EarlyView.

--- - - European Eating Disorders Review, EarlyView.

--- - |2+ Background Previous latent trajectory studies in adult bereaved people have identified individual differences in reactions postloss. However, prior findings may not reflect the complete picture of distress postloss, because they were focused on depression symptoms following nonviolent death. We examined trajectories of symptom‐levels of persistent complex bereavement disorder (PCBD), depression, and posttraumatic stress disorder (PTSD) in a disaster‐bereaved sample. We also investigated associations among these trajectories and background and loss‐related factors, psychological support, and previous mental health complaints. Methods Latent class growth modeling was used to identify distinct trajectories of PCBD, depression, and PTSD symptoms in people who lost loved ones in a plane disaster in 2014. Participants (N = 172) completed questionnaires for PCBD, depression, and PTSD at 11, 22, 31, and 42 months postdisaster. Associations among class membership and background and loss‐related variables, psychological support, and previous mental health complaints were examined using logistic regression analyses. Results Two PCBD classes emerged: mild (81.8%) and chronic (18.2%) PCBD. For both depression and PTSD, three classes emerged: mild (85.6% and 85.2%), recovered (8.2% and 4.4%), and chronic trajectory (6.2% and 10.3%). People assigned to the chronic PCBD, depression, or PTSD class were less highly educated than people assigned to the mild/recovered classes. Conclusions This is the first latent trajectory study that offers insights in individual differences in longitudinal symptom profiles of PCBD, depression, and PTSD in bereaved people. We found support for differential trajectories and predictors across the outcomes. - Depression and Anxiety, EarlyView.

--- - |2 Abstract This article presents the theoretical, clinical, and practical arguments supporting a process‐based transdiagnostic approach to psychotherapy. A working definition of “psychological process” is provided, as well as a tri‐dimensional categorization of psychological processes potentially involved in psychopathology. Guidelines are proposed to select psychological interventions based on the active psychopathological processes evidenced in a given case. We also provide a rationale to organize treatment as a set of modules, each addressing a specific psychopathological process. Next, we review the main processes that may be active in mood and anxiety disorders, and that are accessible to clinicians in regular practice. For each process, we propose a validated assessment questionnaire. Finally, we offer a free‐access web‐based instrument that allows clients to fill in these questionnaires via an internet survey, and that provides therapists with a tool to easily decode and interpret the questionnaire results, and to present them to the clients. - Clinical Psychology & Psychotherapy, Volume 0, Issue ja, -Not available-.

--- - |2+ Background The therapeutic alliance is an important factor in psychotherapy, affecting both therapy processes and outcome. Therapy transfers may impair the quality of the therapeutic alliance and increase symptom severity. The aim of this study is to investigate the impact of patient transfers in cognitive behavioural therapy on alliance and symptoms in the sessions after the transfer. Method Patient‐ and therapist‐rated therapeutic alliance and patient‐reported symptom severity were measured session‐to‐session. Differences in the levels of alliance and symptom severity before (i.e., with the original therapist) and after (i.e., with the new therapist) the transfer session were analysed. The development of alliance and symptom severity was explored using multilevel growth models. Results A significant drop in the alliance was found after the transfer, whereas no differences were found with regard to symptom severity. After an average of 2.93 sessions, the therapeutic alliance as rated by patients reached pretransfer levels, whereas it took an average of 5.05 sessions for therapist‐rated alliance levels to be at a similar level as before the transfer. Inter‐individual differences were found with regard to the development of the therapeutic alliance over time. Conclusions Therapy transfers have no long lasting negative effects on either symptom impairment or the therapeutic alliance. - Clinical Psychology & Psychotherapy, EarlyView.

--- - |2 Abstract Resistance and its extreme variation, reactance, are uniformly observed across varieties of psychotherapy. Social psychologists note that reactant individuals prove to be less so when offered a receptive and nondirective environment. We provide definitions of reactance, review its frequent measures, and offer a clinical example. A meta‐analysis of 13 controlled studies (1,208 patients) examined the degree to which treatment outcomes are enhanced when therapists offer less directive treatments to high‐reactance patients. The results revealed a large effect size (d = .79), confirming that highly reactant individuals did better in psychotherapy when the therapist assumed a reflective and nondirective stance than a directive and authoritative one. To a lesser degree, the opposite was also true. Limitations of the research and diversity considerations are noted. Practice recommendations are provided to minimize a patient’s reactant behavior. - Journal of Clinical Psychology, EarlyView.

--- - |2 Abstract In this study, we introduce the journal issue devoted to evidence‐based responsiveness and frame it within the work of the third interdivisional APA Task Force on Evidence‐Based Relationships and Responsiveness. We summarize the meta‐analytic results and clinical practices on the adaptations of psychotherapy to multiple transdiagnostic characteristics of the patient, including attachment style, culture (race/ethnicity), gender identity, coping style, therapy preferences, reactance level, religion and spirituality, sexual orientation, and stages of change. We then discuss the clinical and research process of determining what works, and what does not work, for whom. The limitations of the Task Force’s work are outlined and frequently asked questions are addressed. The article closes with the Task Force’s formal conclusions and 28 recommendations and with some reflections on fitting psychotherapy to the individual client. - Journal of Clinical Psychology, EarlyView.

--- - |2- Abstract The transtheoretical model and the stages of change are often used to adapt treatment to the individual client. The aims of this study were to review the stages of change and popular measures of change readiness in psychotherapy and to conduct a meta‐analysis of the relation between readiness measures and psychotherapy outcomes. We report data from 76 studies, encompassing 25,917 patients. Moderate‐sized effects (d = 0.41) were found for the association among multiple disorders, including substance and alcohol use, eating disorders, and mood disorders. Outcomes were a function of the pretreatment stage of change; that is, the farther a patient along the stages, the better the treatment outcomes. This review added 37 studies to the data reported in 2010, further strengthening the link between readiness and therapy outcomes. The article concludes with limitations of the research, diversity considerations, and therapeutic practices for stage matching in psychotherapy specifically and behavioral health more generally. - Journal of Clinical Psychology, EarlyView.

--- - |2 Abstract To evaluate psychological treatments for adolescent binge‐eating disorder (BED), reliable information on therapeutic process factors is needed. This study examines therapist adherence and therapeutic alliance and their associations in cognitive‐behavioural therapy (CBT) for adolescents with BED. In a randomised‐controlled efficacy trial, adherence and alliance were objectively determined based on 247 audio‐taped CBT sessions from a sample of N = 64 adolescents with BED. Variability of adherence and alliance, explained by treatment module, patient, and therapist were examined using multilevel modeling. Although adherence and alliance were excellent and unaffected by treatment module and therapist, there was significant between‐patient variability for both concepts. Adherence was negatively associated with patient's treatment expectation. Alliance was negatively associated with the number of loss of control eating episodes and positively associated with adherence. Excellent adherence supported the internal validity of CBT for adolescent BED. Associations between process factors and patient characteristics demand adequate supervision in CBT. - European Eating Disorders Review, EarlyView.

--- - |2+ Abstract Objective There is a paucity of data on disordered eating among adoptees. The aim of the present study was to explore the prevalence of symptoms of disordered eating and body image concerns among international adoptees in a large representative community survey on health‐related behaviours. Method Combining survey data from the Stockholm Public Health Cohort and Swedish population data, adult international adoptees were compared with total participant data to assess differences in disordered eating and body dissatisfaction. Results International adoptee women displayed significantly higher levels of self‐induced vomiting, loss‐of‐control eating, food preoccupation, underweight, and wish for thinness compared with nonadoptee women, albeit with small or very small effect sizes. No significant differences were found in terms of mean body mass index, cognitive restraint, or emotional eating. Conclusion International adoptee women were disproportionally affected on several measures of disordered eating, although the magnitude of these differences were generally small in absolute terms. - European Eating Disorders Review, EarlyView.

--- - |2+ Abstract Objective Assessment approaches for food addiction in younger samples have not been updated to reflect recently revised diagnostic approaches for addictive disorders. The aim of the current study is to develop a new dimensional approach to assess food addiction in adolescents that is psychometrically sound, developmentally appropriate, and reflective of the updated diagnostic criteria. Methods The dimensional Yale Food Addiction Scale for Children 2.0 (dYFAS‐C 2.0) and related measures were administered to 127 adolescents from the community in the United States. Endorsement rates for each question were reviewed, and the psychometric properties were evaluated. Results Problem‐focused symptoms had low endorsement rates and were excluded from the final version of the scale. The dYFAS‐C 2.0 demonstrated partial evidence for a one‐factor structure, had good internal consistency reliability, and was positively associated with emotional eating, external eating, and body mass index (BMI). The dYFAS‐C 2.0 also accounted for unique variance in BMI. Unexpectedly, the dYFAS‐C 2.0 was positively associated with restrained eating. Conclusions The dYFAS‐C 2.0 appears to have adequate psychometric properties for assessing food addiction in community samples of adolescents. Future research should evaluate the measure in clinical samples and investigate the association between food addiction and restrained eating over the lifespan. - European Eating Disorders Review, EarlyView.

--- - |2 Abstract Although exercise is associated with depression relief, the effects of aerobic exercise (AE) interventions on clinically depressed adult patients have not been clearly supported. The purpose of this meta‐analysis was to examine the antidepressant effects of AE versus nonexercise comparators exclusively for depressed adults (18–65 years) recruited through mental health services with a referral or clinical diagnosis of major depression. Eleven e‐databases and bibliographies of 19 systematic reviews were searched for relevant randomized controlled clinical trials. A random effects meta‐analysis (Hedges’ g criterion) was employed for pooling postintervention scores of depression. Heterogeneity and publication bias were examined. Studies were coded considering characteristics of participants and interventions, outcomes and comparisons made, and study design; accordingly, sensitivity and subgroup analyses were calculated. Across 11 eligible trials (13 comparisons) involving 455 patients, AE was delivered on average for 45 min, at moderate intensity, three times/week, for 9.2 weeks and showed a significantly large overall antidepressant effect (g = –0.79, 95% confidence interval = –1.01, –0.57, P < 0.00) with low and nonstatistically significant heterogeneity (I2 = 21%). No publication bias was found. Sensitivity analyses revealed large or moderate to large antidepressant effects for AE (I2 ≤ 30%) among trials with lower risk of bias, trials with short‐term interventions (up to 4 weeks), and trials involving individual preferences for exercise. Subgroup analyses revealed comparable effects for AE across various settings and delivery formats, and in both outpatients and inpatients regardless symptom severity. Notwithstanding the small number of trials reviewed, AE emerged as an effective antidepressant intervention. - Depression and Anxiety, EarlyView.

--- - - Psychophysiology, Volume 55, Issue 11, November 2018.

--- - - European Eating Disorders Review, EarlyView.

--- - |2+ Background Major Depression (MD) is often a chronic condition requiring a long‐term pharmacologic treatment. Despite the efficacy of antidepressants, the medication adherence in those affected is usually very poor. In this scenario, further research concerning drivers of suboptimal adherence is needed. We aimed to explore medication adherence in patients with a MD episode, and to identify sociodemographic, clinical (psychiatric antecedents, comorbidities, medication, pain, and medication side effects), and psychosocial factors (negative life events, childhood trauma, and attitudes to medication) related to adherence status. Method The Medication Adherence Rating Scale (MARS) was completed by 370 patients at hospital admission. Participants were divided into groups of optimal and suboptimal adherence based on the medication adherence behavior score (MARS's factor 1), and were compared with respect to the study variables. Results Twenty‐nine percent of participants (n = 107) were found to be optimally adherents to their medication (score = 4/4). Compared to optimally adherents, suboptimally adherents (71%) presented a significantly higher depression severity, more psychiatric hospitalizations, suicidal ideation, physical pain, negative medication side effects, and antecedents of emotional maltreatment. Suboptimally adherents also had less favorable attitudes toward medication and were less in a relationship than optimally adherents. Multivariate analyses showed that depression severity, suicidal ideation, and physical pain increase the probability of belonging to the suboptimal adherent group. Conclusion These results suggest a vicious circle in which more vulnerable patients are less adherent to medication, which could worsen the clinical picture maintaining, in turn, low adherence. More efforts are needed to develop interventions aiming to improve medication adherence in MD patients. - Depression and Anxiety, EarlyView.

--- - |2+ Abstract Background Exercise is a well‐established treatment for depression, and its use in clinical care is supported by consumers and clinicians. However, whether public health messages regarding the benefits of exercise for depression have translated to public knowledge remains unknown. This study aims to examine the community's mental health literacy, and views regarding exercise delivery for people with depression. Methods A vignette was presented as part of the telephone‐based 2017 National Social Survey (n = 1,265). Interviewees identified what (if anything) was wrong with the person described, who they should seek help from, whether exercise might be beneficial, and how exercise should be delivered for the person described in the vignette. Results are reported using descriptive statistics. Results From 1,265 respondents (response rate = 24%, n = 598 males, mean age 54.7 years [range 18–101]), almost two‐thirds correctly identified the condition described in the vignette as depression. There was widespread support for seeking help from a general practitioner. Exercise was well supported in the treatment of the person described in the vignette, with general practitioners and accredited exercise physiologists highlighted as persons to consult regarding exercise. Views regarding the type of program were consistent with current best practice recommendations. Conclusions Australian adults demonstrate a high level of exercise and mental health literacy. The high level of support for accredited exercise physiologists is evidence of the effectiveness of health promotion campaigns from peak exercise professional agencies. - Depression and Anxiety, EarlyView.