Objective: The 11th version of the International Classification of Diseases (ICD-11) introduces Posttraumatic Stress Disorder (PTSD) and complex PTSD (CPTSD) as two distinct trauma-related disorders. The International Trauma Questionnaire (ITQ) is the most widely used measure of assessment and has been adapted for use in children and adolescents (ITQ-CA), but a corresponding caregiver-version is still missing. We aimed to close this gap by adapting the ITQ-CA and provide an initial validation of the ITQ – Caregiver Version (ITQ-CG). A corresponding measure of assessment from caregiver-perspective is integral for the use in child psychology, psychiatry and research. Method: Altogether, 326 children and adolescents who attended the department of child and adolescent psychiatry were rated by their caregivers using a set of standardized measures. Excluding patients due to missing data or no trauma exposure, a final sample of 223 patients was analysed. Factorial structure of the ITQ-CG and multiple forms of validity were examined using confirmatory factor, latent class and correlation analysis. Results: Confirmatory factor analysis supported the two-factor higher-order model of ICD-11 CPTSD as the factorial structure of the ITQ-CG. Convergent-divergent validity of main- and subscales of the ITQ-CG was evidenced by respective correlations with criterion variables. Latent class analysis supported the discriminant validity of the ITQ-CG, identifying a CPTSD-, PTSD-, DSO- and low symptoms-class. The CPTSD-class was associated with highest rates of comorbid psychopathology and functional impairment. Concurrent validity was evidenced by satisfactory concordance between caregiver- and child-reports. Conclusion: This study provides the construction and initial validation of the ITQ-CG to assess ICD-11 PTSD and CPTSD in children and adolescents from caregiver-perspective. We found compelling evidence for the ITQ-CGs validity, identifying it as an easy-to-use screening instrument to assess ICD-11 PTSD and CPTSD from caregiver-perspective. The ITQ-CG is freely available for clinicians and researchers.

Background: The mental health impact of the COVID-19 pandemic is well documented. However, only a few studies investigated mental health in later phases of the pandemic and after its official end. Moreover, little is known about people's psychological burden related to the pandemic and other global crises post-pandemic. Objective: Study's first objective was to compare mental health outcomes in the general population over the course of the pandemic and ten months post-pandemic. The second objective was to explore people's psychological burden regarding the pandemic, in comparison to current wars, climate crises, inflation, and poor government management and/or corruption in the post-pandemic era. Method: Participants from the general population of Austria, Croatia, Germany, Greece, and Portugal (68.8% female, Mage = 41.55) were assessed online up to four times between June 2020 and March 2024 (baseline sample: N = 7913). Adjustment Disorder New Module – 8 (ADNM-8), Patient Health Questionnaire (PHQ-2), and World Health Organization-Five Well-Being Index (WHO-5) were used to measure adjustment disorder, depression, and well-being. Prevalence rates were calculated and repeated measures ANOVAs applied to assess mental health at four time points. One-way repeated measures ANOVA was run to explore how the different global crises were related to participants’ burden. Results: Temporal variations in mental health were evident across four assessment waves, with highest levels of probable adjustment disorder and depression in winter 2020/2021 (T2). A slight improvement of mental health was found at later time points. Current wars and inflation were the greatest sources of psychological burden at the post-pandemic assessment, revealing some cross-country differences. Conclusion: Although mental health differences in the general population were not as pronounced as in the acute phase of the pandemic, psychosocial support is still needed post-pandemic. This is likely to be due to other global crises that take a toll on people's mental health.

Background: Underreporting is a potential source of bias. In the context of the military, the underreporting of mental health symptoms may be linked to inconsistent performance of mental health measures and heterogenous prevalence estimates. However, few studies systematically investigated the potential underreporting of mental health symptoms among military personnel. Objective: The present study systematically examined indications of underreporting symptoms of trauma-related and comorbid mental health disorders among three comparative samples of the Austrian Armed Forces. Methods: In a cross-sectional survey, 576 active duty soldiers, 764 conscripts, and 164 civilian employees rated the perceived sensitivity of items of the International Trauma Questionnaire (ITQ), several other commonly used self-report mental health measures, and the Effort-Reward Imbalance Questionnaire/short version as a control measure. Applying multilevel modelling, we tested whether mental health measures/ITQ symptom clusters would be perceived as more sensitive than the control measure across the three samples and investigated associations of demographic variables, trust in data protection and item order with sensitivity ratings. Results: All mental health measures, particularly items on alcohol use disorder and the negative self-concept symptom cluster of complex posttraumatic stress disorder (CPTSD), distrust in data protection and item order predicted perceived sensitivity. Active duty soldiers gave similar ratings as civilian employees while recruits rated the sensitivity of mental health measures lower than civilian employees in relation to the control measure. Conclusions: Although it remains unclear whether this is a specific characteristic of military populations, we conclude that military personnel may underreport mental health disorders, particularly symptoms of alcohol use disorder and CPTSD. In order to avoid biased results, strategies to reduce underreporting may be of particular importance in the field of military mental health. Further research is needed on predictors and effects of sensitivity perceptions as well as corresponding differences between civilian and military populations.

The mental health of asylum seekers and refugees, particularly those from Afghanistan, is a critical concern due to their high exposure to violence, trauma, and displacement-related stressors. Despite the significant prevalence of mental health problems, Afghan refugee populations exhibit low help-seeking behaviors and resistance to professional psychological support. This study examines the mental health status and psychological help-seek¬ing behaviors of Afghan asylum seekers and refugees in Austria, focusing on how sociodemographic and sociocultural factors influence attitudes toward seeking psychological help. Data were collected from 305 Afghan participants (155 asylum seekers and 150 refugees) using the Hopkins Symptom Checklist-25 for anxi¬ety and depression, the International Trauma Questionnaire for ICD-11 PTSD and CPTSD, and the Attitudes Toward Seeking Professional Psychological Help Scale-Short Form. Results indi¬cated high prevalence rates of anxiety (52.8%), depression (57.7%), ICD-11 PTSD (10.5%), and CPTSD (20.7%). Nearly half of those with mental health symptoms had never sought professional help, highlighting significant underutilization of services. Participants who came directly from Afghanistan exhibited signifi¬cantly more negative attitudes toward seeking psychological help compared to those from Iran or Pakistan. Young adults and indi¬viduals who had never received mental health services also dis¬played more negative attitudes. Multiple linear regression analysis identified not having received mental health services, arriving directly from Afghanistan, and being a young adult as significant factors associated with negative attitudes toward seeking psycho¬logical help. These findings underscore the need for targeted interventions, culturally sensitive approaches, and educational efforts to improve mental health service utilization among Afghan refugee populations in Austria.

Background: The COVID-19 pandemic caused multiple stressors that may lead to symptoms of adjustment disorder. Objective: We longitudinally examined relationships between risk and protective factors, pandemic-related stressors and symptoms of adjustment disorder during the COVID-19 pandemic, as well as whether these relationships differed by the time of assessment. Method: The European Society for Traumatic Stress Studies (ESTSS) ADJUST Study included N = 15,169 participants aged 18 years and above. Participants from 11 European countries were recruited and screened three times at 6-month intervals from June 2020 to January 2022. Associations between risk and protective factors (e.g. gender), stressors (e.g. fear of infection), and symptoms of adjustment disorder (AjD, ADNM-8) and their interaction with time of assessment were examined using mixed linear regression. Results: The following predictors were significantly associated with higher AjD symptom levels: female or diverse gender; older age; pandemic-related news consumption >30 min a day; a current or previous mental health disorder; trauma exposure before or during the pandemic; a good, satisfactory or poor health status (vs. very good); burden related to governmental crisis management and communication; fear of infection; restricted social contact; work-related problems; restricted activity; and difficult housing conditions. The following predictors were associated with lower AjD levels: self-employment or retirement; working in healthcare; and face-to-face contact ≥ once a week with loved ones or friends. The effects of the following predictors on AjD symptoms differed by the time of assessment in the course of the pandemic: a current or previous mental disorder; burden related to governmental crisis management; income reduction; and a current trauma exposure. Conclusions: We identified risk factors and stressors predicting AjD symptom levels at different stages of the pandemic. For some predictors, the effects on mental health may change at different stages of a pandemic.