Kate Porcheret

Helping professionals exposed to secondary trauma are at risk of developing secondary traumatic stress (STS), which adversely affects individual well-being and quality of care. While interventions to reduce STS are well documented, less is known about psychologically preparing professionals in advance. This scoping review examined existing literature on psychological preparedness for secondary trauma (PPST) in helping professionals, focusing on (a) how PPST is conceptualised, (b) its contributors and associated outcomes, and (c) intervention strategies to develop it. A systematic search of CINAHL, MEDLINE, PsycINFO, and Scopus was conducted for English, peer-reviewed papers published between 1990 and January 2025. Eligible studies focused on STS-related preparedness in helping professionals. Studies addressing direct trauma only, STS treatment, review articles, and animal or medical studies were excluded. Nineteen studies conducted across 11 countries between 2003 and 2024 met the inclusion criteria. The findings indicated that contemporary conceptualisations of PPST have drifted from an emphasis on predictability, controllability, and prior immunisation towards a mix of professional competence and personal coping. Where directly measured, preparedness appeared to function as a protective factor against STS, although the evidence remains small and methodologically modest. Training, social support, and organisational conditions were identified as contributors. Intervention research remains at an early stage and only partially aligns with these identified predictors. Ultimately, preparing helping professionals for secondary trauma is a shared responsibility across individuals and organisations. Conceptual consolidation and the development of validated measures must precede more systematic evaluation of preparedness interventions.

Background: Childhood trauma is a public health challenge, and there is currently a service/needs gap. Low-intensive treatments where the task of leading the treatment is partially shifted to a caregiver can help bridge this gap by freeing therapist resources. Stepping Together for Children after Trauma (ST-CT), is a novel parent-led, therapist-assisted treatment with promising results in the U.S. Also, it has shown to be feasible as a first-line intervention in Norwegian municipal services and ST-CT is well accepted by children, caregivers, and therapists.Objective: This study is the first randomized controlled trial of ST-CT by independent researchers. The study consists of three work-packages: WP1: Investigates (a) the effectiveness of ST-CT compared to therapy as usual (TAU) in reducing post-traumatic stress symptoms (PTSS), related mental health symptoms, sleep problems and increasing daily functioning; (b) the cost-effectiveness of ST-CT compared to TAU in terms of quality adjusted life years; (c) future health care utilization. WP2: Looks at change processes in ST-CT, with changes in sleep, post-traumatic cognitions and child-parent relationship as potential mediators of reductions in child PTSS. WP3: Investigates keys to implementation into regular first-line mental health services.Methods: The study has a type 1 hybrid effectiveness-implementation design. Children between 7-12 years of age with symptoms of PTSS and their caregivers are randomized to either ST-CT or TAU and participants are assessed at five time points during the first year. Sleep quality is measured with a non-contact radar 1 week pre- and post-treatment and registry data of use of prescribed medications and mental health service utilization will be collected 3 years post-inclusion. The study aims to include 160 child-parent dyads from 30 municipalities.Conclusion: Results can help gain a better understanding of the effectiveness and change processes of ST-CT and may provide important knowledge for a future dissemination and implementation.Trial registration: ClinicalTrials.gov identifier: NCT05734547.

Background: The long-term impact of mass violence attacks is practically unknown, especially in children and adolescents. In a previous study, we found that 8.5 years after a terror attack targeting mainly adolescents, nearly half of the survivors met diagnostic criteria for insomnia.Objectives: The aims of this study were to investigate: (1) whether exposure to a single mass violence event during adolescence increases the risk of insomnia almost a decade later above that expected for a non-exposed population; and (2) whether prior interpersonal violence exposure and early post-traumatic reactions predict later insomnia.Method: Participants were survivors of the 2011 Utøya Island terrorist attack (n = 279) and controls from the HUNT Norwegian general population study (n = 35,664). Early adulthood insomnia was assessed using four items from the Karolinska Sleep Questionnaire 8.5 years after the attack. Participants who had also completed earlier data collection waves for both studies (n = 116 and 2382, respectively) were included in logistic regression models testing the associations between predictors during adolescence and later insomnia.Results: Nearly a decade after the Utøya attack, 38.4% (n = 56) of the survivors reported symptoms of insomnia indicative of probable insomnia compared to 20.5% (n = 5771) of controls. Terror exposure during adolescence was a significant predictor of later insomnia [odds ratio (OR) = 3.18, 95% confidence interval (CI) = 2.05-4.87, p < .001]. Early post-trauma symptoms of anxiety and depression (OR = 1.34, 95% CI = 1.02-1.76, p = .033) and weekly headaches (OR = 1.64, 95% CI = 1.08-2.47, p = .018) were also significant predictors while controlling for background factors and other predictors.Conclusion: Long-term assessment and treatment are needed for survivors of mass violence to improve resilience and recovery.

Distressing intrusive memories of a traumatic event are the hallmark symptom of posttraumatic stress disorder. Thus, it is crucial to identify early interventions that prevent the occurrence of intrusive memories. Both, sleep and sleep deprivation have been discussed as interventions, yet previous studies yielded contradicting effects. Our systematic review aims at evaluating existing evidence by means of traditional and individual participant data (IPD) meta-analyses to overcome power issues of sleep research. Until May 16th 2022, six databases were searched for experimental analog studies examining the effect of post-trauma sleep versus wakefulness on intrusive memories. Nine studies were included in our traditional meta-analysis (8 in the IPD meta-analysis). Our analysis provided evidence for a small effect favoring sleep over wakefulness, M(log-ROM) = 0.25, p < .001, suggesting that sleep is associated with a lower number of intrusions but unrelated to the likelihood of the occurrence of intrusions. We found no evidence for an effect of sleep on intrusion distress. Heterogeneity was low and certainty of evidence for our primary analysis was moderate. Our findings suggest that post-trauma sleep has the potential to be protective by reducing intrusion frequency. More research is needed to determine the impact following real-world trauma and the potential clinical significance.

Insomnia is a global health concern, associated with many mental and physical health conditions. Prevalence of insomnia is reported to increase during adolescence and early adulthood. High levels o... Almost a decade after the Utøya Island terrorist attack, nearly half of the survivors reported insomnia.Such high levels of insomnia, in mainly adolescents transitioning to early adulthood, have im... Antecedentes: el insomnio es un problema de salud mundial, asociado con muchas afecciones de salud mental y física. Se reporta que la prevalencia del insomnio aumenta durante la adolescencia y la e... 背景: 失眠是一个全球性的健康问题, 与许多精神和身体健康状况有关。据报道, 失眠的流行率在青春期和成年早期会增加。青少年在创伤事件后长达 2.5 年中也报告了很高程度的失眠。不太清楚的是, 从青春期过渡到成年期的创伤暴露人群中失眠的流行率。目的: 评估 2011 年特岛恐怖袭击中幸存者在袭击发生后 2.5 年和 8.5 年的失眠情况, 当时大多数幸存者正从青春期晚期过渡到成年早期。方法: ...

Study objectives: Intrusive memories of psychological trauma are a core clinical feature of posttraumatic stress disorder (PTSD), and in the early period post-trauma may be a potential target for early intervention. Disrupted sleep in the weeks post-trauma is associated with later PTSD. The impact of sleep and intrusive memories immediately post-trauma, and their relation to later PTSD, is unknown. This study assessed the relationship between sleep duration on the first night following a real-life traumatic event and intrusive memories in the subsequent week, and how these might relate to PTSD symptoms at 2 months. Methods: Patients (n = 87) recruited in the emergency department completed a sleep and intrusive memory diary from the day of their trauma and for the subsequent week, with optional actigraphy. PTSD, anxiety, and depression symptoms were assessed at 1 week and 2 months. Results: A U-shaped relationship was observed between sleep duration on the first night and intrusive memories over the subsequent week: sleeping “too little” or “too much” was associated with more intrusive memories. Individuals who met Clinician-Administered PTSD Scale (CAPS) criteria for PTSD at 2 months had three times more intrusive memories in the first week immediately post-trauma than those who did not (M = 28.20 vs 9.96). Post hoc analysis showed that the absence of intrusive memories in the first week post-trauma was only observed in those who did not meet CAPS criteria for PTSD at 2 months. Conclusions: Monitoring intrusive memories and sleep in the first week post-trauma, using a simple diary, may help identify individuals more vulnerable to later psychopathology.

Introduction Emergency caesarean section (ECS) qualifies as a psychological trauma, which may result in postnatal post-traumatic stress disorder (PTSD). Maternal PTSD may not only have a significant negative impact on mother–infant interactions, but also on long-term infant development. The partner’s mental health may also affect infant development. Evidence-based early interventions to prevent the development of postpartum PTSD in mothers are lacking. Immediately after a traumatic event, memory formation is vulnerable to interference. There is accumulating evidence that a brief behavioural intervention including a visuospatial task may result in a reduction in intrusive memories of the trauma. Methods and analysis This study protocol describes a double-blind multicentre randomised controlled phase III trial testing an early brief maternal intervention including the computer game ‘Tetris’ on intrusive memories of the ECS trauma (≤1 week) and PTSD symptoms (6 weeks, primary outcome) of 144 women following an ECS. The intervention group will carry out a brief behavioural procedure including playing Tetris. The attention-placebo control group will complete a brief written activity log. Both simple cognitive tasks will be completed within the first 6 hours following traumatic childbirth. The intervention is delivered by midwives/nurses in the maternity unit. The primary outcome will be differences in the presence and severity of maternal PTSD symptoms between the intervention and the attention-placebo control group at 6 weeks post partum. Secondary outcomes will be physiological stress and psychological vulnerability, mother–infant interaction and infant developmental outcomes. Other outcomes will be psychological vulnerability and physiological regulation of the partner and their bonding with the infant, as well as the number of intrusive memories of the event. Ethics and dissemination Ethical approval was granted by the Human Research Ethics Committee of the Canton de Vaud (study number 2017–02142). Dissemination of results will occur via national and international conferences, in peer-reviewed journals, public conferences and social media. Trial registration number NCT 03576586.