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BackgroundA variety of studies have demonstrated posttraumatic stress disorder (PTSD) symptoms in victims of bullying. Because bullying with only relational aggression, such as social exclusion, does not involve physical aggression that could explain PTSD symptoms, it remains unclear why these relational aggression situations are also linked to PTSD symptoms.ObjectiveThe aim of the present study was to investigate whether the fear-response tonic immobility (Ti) can occur during social exclusion. Since Ti, as an indicator of peritraumatic dissociation, is an important predictor of PTSD symptoms, we expected that the presence of Ti during social exclusion might contribute to possible explanations of PTSD symptoms in victims of relational aggression.MethodSocial exclusion was manipulated by a virtual Cyberball game in which participants were excluded and included by virtual confederates. During the game, Ti was measured, both physiologically (heart rate) and psychologically (subjective symptoms). Also, the underlying concepts of Ti, high levels of fear and psychological restraint (threatened sense of control), were measured.ResultsExcluded participants experienced higher levels of subjective and physiological Ti symptoms (lower heart rates) in comparison to social inclusion. Also, as expected, social exclusion resulted in higher levels of fear and psychological restraint in comparison to social inclusion.ConclusionSocial exclusion can evoke symptoms of Ti, fear, and psychological restraint, which might be important mechanisms to consider in explaining PTSD symptoms after relational forms of bullying in the absence of physical aggression.LimitationsThe sample only contains healthy, female participants. Whether our results translate to bullying victims of relational aggression is therefore not known. Also, the physiological measurement of Ti (average heart rate) was rather limited and could be expanded in future studies.

Background: Traumatic events can be related to severe transgressions or violations of moral boundaries. Moral injury (MI) has been described as 'the lasting psychological, biological, spiritual, behavioral and social impact of perpetrating, failing to prevent, or bearing witness to acts that transgress deeply held moral beliefs and expectations.' These events can provoke emotions such as remorse, guilt and shame, and affects someone's self-image and identity. Objective: The aim of the study is to evaluate a treatment protocol that addresses the specific characteristics of moral trauma in treatment of PTSD, next to anxiety. Method: Brief Eclectic Psychotherapy for Moral Trauma (BEP-MT) is an adaptation of the evidence-based Brief Eclectic Psychotherapy for PTSD (BEPP). BEP-MT integrates components of cognitive-behavioural, psychodynamic, constructivist, and systemic psychotherapy. In the current study treatment progress of a refugee Dusan was monitored. Prior to and after treatment the Clinical-Administered PTSD Scale for DSM-5, the PTSD Checklist (PCL-5), the Brief Symptom Inventory (BSI) and the Moral Injury Appraisal Scale (MIAS) were administered. Every session moral emotions were assessed on a Likert scale. Results: Whereas PTSD complaints and strong feelings of guilt and shame were manifest prior to treatment, during BEP MT a gradual decline in the intensity of the moral emotions was found. After BEP-MT Dusan no longer met criteria for PTSD and his psychological complaints diminished. Conclusion:The case of Dusan has shown it is worthwhile to address moral trauma and BEP-MT is a promising treatment protocol for patients suffering from PTSD after moral trauma. Further research is needed to examine the effectiveness of BEP-MT. Psicoterapia ecléctica breve para el trauma moral (BEP-MT): Descripción del protocolo de tratamiento y un estudio de casoAntecedentes: Los eventos traumáticos pueden estar relacionados con transgresiones graves o violaciones de los límites morales. El daño moral (DM) se ha descrito como 'el impacto duradero psicológico, biológico, espiritual, conductual y social de perpetrar, fallar en prevenir o testificar actos que transgreden creencias y expectativas morales profundamente sostenidas'. Estos eventos pueden provocar emociones como remordimiento, culpa y vergüenza, y afectan la autoimagen y la identidad de una persona. Objetivo: El objetivo del estudio es evaluar un protocolo de tratamiento que aborde las características específicas del trauma moral en el tratamiento del TEPT, junto a la ansiedad. Método: La psicoterapia ecléctica breve para el trauma moral (BEP-MT) es una adaptación de la psicoterapia ecléctica breve basada en la evidencia para el TEPT (BEPP). La BEP-MT integra componentes de psicoterapia cognitivo-conductual, psicodinámica, constructivista y sistémica. En el estudio actual, se monitoreó el progreso del tratamiento de un refugiado, Dusan. Antes y después del tratamiento, se aplicó la Escala de TEPT para el DSM-5 administrada por clínicos, la Lista de chequeo de TEPT (PC...

Vantage perspective during recall is thought to affect the emotionality and accessibility of distressing memories. This study aimed to test the effects of vantage perspective during recall on memory associated distress and intrusion development. An adapted version of the trauma film paradigm was used in an experimental design with three conditions. Participants were asked to listen to eyewitness reports of car accidents (e.g. Trauma Analogue Induction) and imagine the scenes vividly using mental imagery. Afterwards, they were asked to recall the most distressing scene from field perspective, observer perspective, or to recall a neutral image from observer perspective (control condition) (e.g. Trauma Analogue Recall). Recall from field perspective resulted in higher negative mood, stateanxiety, and a higher number of short-term intrusions compared to the observer perspective condition and control condition. Negative mood and state-anxiety were mediators in the relationship between vantage perspective and intrusions. In comparison to observer perspective, field perspective increased the amount of short-term intrusions as a result of higher levels of negative mood and state-anxiety after memory retrieval. Future research on the interaction between vantage perspective at recall and negative mood and anxiety effects is warranted.

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