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Research and anecdotal clinical work indicate that complex post-traumatic stress disorder (CPTSD) in families that have children and adults who have a learning disability and/or are autistic may be prevalent. This paper aims to provide a preliminary formulation of complex trauma in families.

This report is based on a review of clinical psychotherapeutic work with six families. The themes are derived from the assessment period through examining the assessment reports and clinical supervision notes for thematic patterns.

This report suggests that the prevalence of CPTSD in families of people who have a learning disability and/or are autistic needs to be researched across the family lifecycle and that there are specific factors that mediate complex trauma symptomatology.

CPTSD symptomatology in these families is inadequately conceptualised and this is one of the first papers suggesting this as a potentially helpful framework to consider the experiences of families.

This paper aims to describe a novel collaboration between a worker and a former service user in developing two support groups – an art group and an “alcoholics anonymous group” self help group – at a central London “Wet” hostel for the homeless. The paper seeks to explore the issues raised for both workers in this experience.

The paper is a jointly written case study of innovative and reflective practice. It begins with an overview of policy frameworks and research that promote and advocate inclusion practice; then gives an account of the origins and development of the collaboration initiative; and concludes with reflections from each of the participants on what they have gained from the experience.

The main challenge for professionals lies in the need for “self‐reflective” practice and to challenge their own personal investments in the maintenance of their professional role and status. For ex‐service users, the challenge is to overcome low self‐confidence, the safety of the all‐too‐familiar “service user” role, and to realise that, despite real obstacles, a productive, useful contribution can be made to society. This can therefore be seen as a journey for both parties.

Working with multiple exclusion homelessness can leave professionals feeling isolated and deskilled, leading people with complex needs to be further excluded from services that feel that they do not fit their criteria. Tackling these issues requires time for reflection on the personal issues raised.

The paper provides unique learning and insight into the development and running of support groups, resulting from the novel collaboration between a worker and a former service user.

Literature on trauma and post‐traumatic stress disorder (PTSD) has neglected the needs of people with intellectual disability, particularly those in forensic settings. The National Centre for High Secure Learning Disability Services at Rampton Hospital conducted a service evaluation on aspects of trauma experience and post‐trauma symptoms in the current population. File information and self‐reports indicated that most individuals had experienced a great deal of lifetime trauma, typically multiple types of abuse. A high rate of potentially trauma‐related symptoms was noted in files. However, file records of potentially traumatic events, including abuse, were often lacking in detail. There was limited information about the events themselves, and there was no information to suggest that any trauma‐specific assessments had been used to measure trauma exposure or symptoms. PTSD as a diagnosis was rarely considered, and there was little consideration of trauma‐specific interventions. While some individuals said that their experiences had resulted in a lot of distress, others could not talk about the past at all. This paper discusses the problem of assessing past trauma and response in a forensic intellectual disability population, and future directions for practice in forensic services. The service under study plans to address the needs of patients who have experienced trauma and abuse by conducting routine structured assessments, offering adapted evidence‐based psychological interventions where appropriate, and providing trauma‐specific education for staff to promote a compassionate approach.

Combat Stress, a charity that aims to meet the needs of veterans with psychological disability, often related to their service, is seeing growing demand for the care it offers. This paper explores the impact of post‐traumatic stress disorder on veterans. In many cases, this is associated with subsequent substance misuse. In describing Combat Stress's approach to helping these individuals, it argue that mainstream and other non‐statutory service providers should develop their screening and assessment services to help meet veterans' needs.

Psychological factors such as post-traumatic stress and depression may play an important role in the recovery after whiplash injuries. Difficulties in psychosocial functioning with limitations in everyday life may dominate for some time after the injury. Our study therefore investigates the relationships between pain, post-traumatic stress, depression, and community integration. A set of questionnaires was answered by 191 persons (88 men, 103 women) five years after a whiplash injury to assess pain intensity (visual analogue scale, VAS), whiplash-related symptoms, post-traumatic stress (impact of event scale, IES), depression (Beck depression inventory, BDIII), community integration (community integration questionnaire, CIQ), life satisfaction (LiSat-11). One or more depressive symptoms were reported by 74% of persons; 22% reported scores that were classified as mild to severe depression. The presence of at least one post-traumatic symptom was reported by 70% of persons, and 38% reported mild to severe stress. Total scores of community integration for women were statistically significantly higher than for men. The total VAS score was correlated positively to the IES (r=0.456, P<0.456), the BDI (r=0.646, P<0.001), and negatively to the CIQ (r=-0.300, P<0.001). These results highlight the view that a significant proportion of people experience both pain and psychological difficulties for a long time after a whiplash injury. These findings should be taken into consideration in the management of subjects with chronic whiplash symptoms and may support a multi-professional rehabilitation model that integrates physical, psychological, and psychosocial factors.

The purpose of this study is to investigate the psychological consequences of human trafficking and to reveal the importance of appropriate post-trafficking psychological interventions. Specifically, this study provides a detailed analysis of human trafficking categories, as well as the characteristics of victims and traffickers’ motives. More recent data in the literature show that trauma-coerced attachments and complex post-traumatic stress disorder are also observed among trafficking survivors.

Each of the mentioned mental disorders is presented separately, and results are discussed throughout this study. Consequently, psychological interventions are proposed in accordance with the human trafficking category, survivors’ characteristics and needs and with the relevant personal risk factors determined among victims.

Sex trafficking can have a severe effect on a victim’s mental health, and mental health disorders are substantially higher in human trafficking victims compared to non-trafficked victims or general psychiatric population. Limitations, implications and future recommendations are discussed.

A limited number of past studies evaluated the mental health consequences and identified that survivors have a higher prevalence of anxiety disorders, depression disorders and post-traumatic stress disorder.

Post-traumatic stress disorder (PTSD) may have a detrimental impact on the individual’s ability to benefit from rehabilitative prison-based programmes, and studies have also found that there is an association between PTSD and higher rates of re-offending. Studies have also found that a significant number of cases of trauma and PTSD go undetected and therefore untreated in individuals who are incarcerated.

A literature review was carried out exploring studies that have investigated PTSD in incarcerated populations to identify current clinical considerations and recommendations.

This paper explores the key findings from the literature and highlights the important clinical implications and recommendations.

To the authors’ knowledge, this is the first paper focusing specifically on how the findings from the literature can inform clinical practice and also what factors need to be given greater consideration, going beyond the current systematic and literature reviews in the field.

This paper investigates the nature of vicarious or secondary post‐traumatic stress disorder in relation to six Dutch organisations and their personnel working in Rwanda, a country heavily affected by genocide and war. Drawing from the literature and empirical research it is argued that a systematic approach can strongly contribute to a more coherent human resource management/human resource development cycle of environmental analysis; identification of job descriptions and person specifications; relationship of jobs, persons and teams; recruitment, selection and contracting; induction and training; deployment and management of individuals and teams; and finally, debriefing and counselling. In this way, there is greater potential for the organisation to achieve objectives and enable its expatriate workforce to handle the stressful conditions in which they may find themselves.

We aimed to assess, in socio-cultural context, the level of hatred and revenge in war veterans with post-traumatic stress disorder (PTSD). The sampling frame consisted of 215 Kosova War veterans, randomly selected. The Harvard Trauma Questionnaire was used to assess the prevalence of PTSD and Manchester Short Assessment of Life was used to assess social satisfactions. The participants were asked to declare the strength of feelings of hatred and revenge in the four preceding weeks by using four items scale: not at all, a little bit/sometimes, a lot and extremely. Willingness for action of veterans was assessed using three item scale: yes, no or maybe. A probability level of 0.05 was adopted to be considered as statistically significant for differences among groups. DSM-IV-TR criteria for PTSD (very similar to DSM-V) were met by 52.6% of veterans; the data have confirmed existence of thoughts and fantasies of revenge against opposing forces by 42.8% veterans; at the same level 42.8% manifested feelings of hatred. Fantasies of taking revenge a lot was recorded by 19.5% and extremely by 1.4% of veterans, while hateful thoughts at level a lot were likely expressed by 22.3% and extreme by 2.8% of veterans. It is important to note that 84.7% were confident to act based on their beliefs. Social-economic and cultural factors have played major role in the understanding of psychological problems of traumatized individuals with a direct impact on their ability to function socially. This study has confirmed the urgent need for the establishment of psychological rehabilitation programs as well as programs for the social and economic rehabilitation of War Veterans.

Stress and the military go hand-in-hand, particularly in combat environments. While some personality traits or types weaken relationships between stress and performance, others, such as psychopathy, may strengthen them. In the present chapter, we consider the ramifications of individuals with high levels of psychopathy or psychopathic tendencies in the military with regard to both their own stress and performance and that of those around them. We discuss different reactions to psychological and physical stress, as well as the implications of psychopathic tendencies as they relate to current military issues, including gender, leadership, teamwork, turnover, post-traumatic stress disorder, and suicide. By juxtaposing relevant research findings on stress and psychopathy, we conclude that psychopathic tendencies should have neither uniformly negative nor positive effects on stress and performance in the military. Rather, effects on such individuals and the peripheral others with whom they interact will likely vary greatly depending on numerous factors.