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BackgroundThe representation of low- and middle-income countries (LMIC) in traumatic stress research is important to establish a global evidence base, build research capacity, and reduce the burden of unmet mental health needs around the world. Reviews of the traumatic stress literature up to 2002 showed trends toward globalization although LMIC were only marginally represented compared to high-income countries (HIC).ObjectiveTo examine the global nature of current traumatic stress research. In particular, we were interested in the extent to which traumatic stress research is: (1) conducted in LMIC, (2) conducted by LMIC researchers, and (3) accessible to them.MethodUsing the databases PubMed, PsychInfo, and PILOTS, we systematically searched for peer-reviewed articles on traumatic stress published in any language in the year 2012. Out of the 3,123 unique papers identified, we coded a random sample (N=1,000) for study, author, article, and journal characteristics.ResultsAlthough our sample involved research in 56 different countries, most papers (87%) involved research in HIC, with 51% of all papers describing studies in the United States. In 88% of the papers, the author team was affiliated with HIC only. Less than 5% of all author teams involved collaborations between HIC and LMIC researchers. Moreover, 45% of the articles on LMIC studies published by a HIC corresponding author did not involve any LMIC co-authors. LMIC researchers appeared to publish empirical studies in lower impact journals. Of the 1,000 articles in our sample, 32% were open access and 10% were made available via different means; over half of the papers were not accessible without subscription.ConclusionsTraumatic stress research is increasingly global but still strongly dominated by HIC. Important opportunities to build capacity in LMIC appear to be missed. Implications toward more international traumatic stress research are discussed.

Objective This study explored why, in a randomized trial of psychotherapies for posttraumatic stress disorder (PTSD), a surprisingly high percentage of study applicants presented with psychotic symptoms and what clinical implications this finding might prompt. Methods Raters reviewed the records of applicants who completed an initial psychiatric interview and compared applicants with psychotic symptoms with all other study-eligible participants and with those who ultimately were enrolled in the study. Results Of 223 consecutively evaluated individuals who applied for study entry, 38 (17%) were found ineligible because of psychotic symptoms. These individuals were more likely to be male and to have suffered child abuse, and they had taken a greater number of lifetime medications than study-eligible applicants. Most individuals with psychotic symptoms met DSM-IV criteria for PTSD. Conclusions Using a trauma-informed framework might be a helpful part of a comprehensive treatment plan for some individuals with psychotic symptoms, possibly leading to greater treatment engagement and more positive outcomes.

Bevezetés: A traumatikus események gyakori előfordulása és azok pszichére gyakorolt negatív következményei fontossá teszik a hatékony pszichológiai intervenciók alkalmazását a poszttraumás stressz zavar megelőzésére. Célkitűzés: A tanulmány célja az aktuális kutatási eredmények áttekintése traumát követő korai pszichológiai intervenciók haté-konysága tekintetében. Módszer: A szerzők irodalomkeresést végeztek a ProQuest PILOTS, a PubMed és a Web of Science adatbázisokban releváns kulcsszavak alapján, 2005 és 2015 között megjelent publikációk között. Eredmények: Huszonegy közleményt azonosítottak, amelyekből 6-ban azonnali (72 órán belül), míg a fennmaradó 15-ben egy hónapon belül megkezdett korai intervenció hatékonyságát vizsgálták. A kutatási eredmények alapján az azonnali intervenciók nem bizonyulnak hatékonynak, míg a többalkalmas kognitív viselkedésterápiás módszerek hatékonyak lehetnek a tünetek csökkentésében. Következtetések: A többalkalmas kognitív viselkedésterápia előnyben részesítendő az azonnali, együléses intervenciókkal, különösképpen a debriefi nggel szemben. Mivel tüneti csökkenés a kontrollszemélyeknél is megfi gyelhető idővel, így a célzott intervenciók csak azok esetében ajánlottak, akik magasabb kocká-zatot mutatnak a poszttraumás stressz zavar kialakulására. Orv. Hetil., 2015, 156(33), 1321-1334.Kulcsszavak: poszttraumás stressz zavar, PTSD, korai intervenció, pszichoterápia, prevenció Psychological interventions following trauma to prevent posttraumatic stress disorder A systematic review of the literatureIntroduction: Because of the high prevalence of exposure to traumatic events and its negative consequences on mental health, the importance of effective interventions to prevent posttraumatic stress disorder has been emphasized. Aim: The authors wanted to evaluate the current status of evidence regarding early psychological interventions after traumatization. Method: A search was conducted in ProQuest PILOTS, PubMed, and Web of Science for early psychological interventions that were published between 2005 and 2015. Results: Twenty-one trials were identifi ed, of which 6 presented immediate interventions (within 72 hours) and the rest early interventions within the fi rst month. Based on these research fi ndings immediate interventions are not effective, whilst multi-session cognitive behavior therapies could be effective in symptom reduction. Conclusions: Multi-session cognitive behavior therapy is preferred over immediate one session interventions especially over debriefi ng. A natural decline of symptoms was observed among controls and, therefore, targeted interventions are recommended only for people with higher risk for developing subsequent posttraumatic stress disorder.