The study investigated the impact of trauma exposure and of Post-Traumatic Stress Disorder (PTSD) on spatial processing and active navigation in a sample (n=138) comprising civilians (n=91), police officers (n=22) and veterans (n=27). Individuals with previous trauma exposure exhibited significantly poorer hippocampal-dependent (allocentric) navigation performance on active navigation in a virtual environment (the Alternative Route task) regardless of whether or not they had PTSD (scoring above 20 on the PTSD Diagnostic Scale). No effect of trauma exposure was found in static perspective taking (the Four Mountains task). Moreover, an associative information processing bias in those with PTSD interfered with ability to use hippocampal-dependent processing in active navigation. This study provides new evidence of impaired active navigation in individuals with trauma exposure and highlights the importance of considering the relationship between trauma and spatial processing in clinical and occupational settings.

Background Fatigue is one of the most common and debilitating symptoms of multiple sclerosis (MS) and is the main reason why people with MS stop working early. The MS Society in the United Kingdom funded a randomized controlled trial of FACETS —a face-to-face group-based fatigue management program for people with multiple sclerosis (pwMS)—developed by members of the research team. Given the favorable trial results and to help with implementation, the MS Society supported the design and printing of the FACETS manual and materials and the national delivery of FACETS training courses (designed by the research team) for health care professionals (HCPs). By 2015 more than 1500 pwMS had received the FACETS program, but it is not available in all areas and a face-to-face format may not be suitable for, or appeal to, everyone. For these reasons, the MS Society funded a consultation to explore an alternative Web-based model of service delivery. Objective The aim of this study was to gather views about a Web-based model of service delivery from HCPs who had delivered FACETS and from pwMS who had attended FACETS. Methods Telephone consultations were undertaken with FACETS-trained HCPs who had experience of delivering FACETS ( n=8 ). Three face-to-face consultation groups were held with pwMS who had attended the FACETS program: London (n=4), Liverpool (n=4), and Bristol (n=7). The interviews and consultation groups were digitally recorded and transcribed. A thematic analysis was undertaken to identify key themes. Toward the end of the study, a roundtable meeting was held to discuss outcomes from the consultation with representatives from the MS Society, HCPs, and pwMS. Results Key challenges and opportunities of designing and delivering an integrated Web-based version of FACETS and maintaining user engagement were identified across 7 themes (delivery, online delivery, design, group, engagement, interactivity, and HCP relationships). Particularly of interest were themes related to replicating the group dynamics and the lack of high-quality solutions that would support the FACETS’ weekly homework tasks and symptom monitoring and management. Conclusions A minimum viable Web-based version of FACETS was suggested as the best starting point for a phased implementation, enabling a solution that could then be added to over time. It was also proposed that a separate study should look to create a free stand-alone digital toolkit focusing on the homework elements of FACETS. This study has commenced with a first version of the toolkit in development involving pwMS throughout the design and build stages to ensure a user-centered solution.

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The influence of genes and the environment on the development of Post-Traumatic Stress Disorder (PTSD) continues to motivate neuropsychological research, with one consistent focus being the Brain-Derived Neurotrophic Factor (BDNF) gene, given its impact on the integrity of the hippocampal memory system. Research into human navigation also considers the BDNF gene in relation to hippocampal dependent spatial processing. This speculative paper brings together trauma and spatial processing for the first time and presents exploratory research into their interactions with BDNF. We propose that quantifying the impact of BDNF on trauma and spatial processing is critical and may well explain individual differences in clinical trauma treatment outcomes and in navigation performance. Research has already shown that the BDNF gene influences PTSD severity and prevalence as well as navigation behaviour. However, more data are required to demonstrate the precise hippocampal dependent processing mechanisms behind these influences in different populations and environmental conditions. This paper provides insight from recent studies and calls for further research into the relationship between allocentric processing, trauma processing and BDNF. We argue that research into these neural mechanisms could transform PTSD clinical practice and professional support for individuals in trauma-exposing occupations such as emergency response, law enforcement and the military.

One in five UK police officers suffers from Post-Traumatic Stress Disorder or Complex Post-Traumatic Stress Disorder, yet there is no gold standard measure of trauma exposure available. This study coded 4,987 exposures reported by 1,531 UK police officers, using their own language. The resulting checklist describes over 70% of typical ‘worst’ reported traumatic incidents (plus situational factors, including Covid19). The Police Traumatic Experiences Checklist is a practical tool of value for self-assessment and peer support, and can facilitate attempts by Occupational Health and management to improve monitoring and treatment access.