While a body of research has evidenced the role of pain coping in chronic pain adjustment, the role of coping flexibility in chronic pain adjustment has received little research attention. Coping flexibility can be conceptualized with two dimensions, cognitive and behavioral. The cognitive dimension of coping flexibility (or coping appraisal flexibility) refers to one's appraisal of pain experience when changing coping strategies whereas the behavioral dimension of coping flexibility denotes the variety of coping responses individuals use in dealing with stressful demands.

The aim of this paper is to present preliminary findings on the role of coping flexibility in chronic pain adjustment by assessing 3 competing models of pain coping flexibility (see Figs. 1–3).

Patients with chronic pain (n = 300) completed a battery of questionnaire assessing pain disability, discriminative facility, need for closure, pain coping behavior, coping flexibility, and pain catastrophizing. The 3 hypothesized models were tested using structural equation modeling (SEM). In all models tested, need for closure and discriminative facility were fitted as the dispositional cognitive and motivational factors respectively underlying the coping mechanism, whereas pain catastrophizing and pain intensity were included as covariates.

Results of SEM showed that the hierarchical model obtained the best data-model fit (CFI = 0.96) whereas the other two models did not attain an accept fit (CFI ranging from 0.70–0.72).

Our results lend tentative support for the hierarchical model of pain coping flexibility that coping variability mediated the effects of coping appraisal flexibility on disability.

The authors have not supplied their declaration of competing interest.

Research evidenced the association of pain coping strategies with short-term and long-term adjustments to chronic pain. Yet, previous studies mainly assessed the frequency of coping strategies when pain occurs whilst no data is available on one's flexibility/rigidity in using different pain coping strategies, i.e., pain coping variability, in dealing with different situations.

This study aimed to examine the multivariate association between pain coping variability and committed action in predicting concurrent pain-related disability. Specifically, we examined the independent effects of pain coping variability and committed action in predicting concurrent pain-related disability in a sample of Chinese patients with chronic pain.

Chronic pain patients (n = 287) completed a test battery assessing pain intensity/disability, pain coping strategies and variability, committed action, and pain catastrophizing. Multiple regression modeling compared the association of individual pain coping strategies and pain coping variability with disability (Models 1–2), and examined the independent effects of committed action and pain coping variability on disability (Model 3).

Of the 8 coping strategies assessed, only guarding (std β = 0.17) was emerged as significant independent predictor of disability (Model 1). Pain coping variability (std β = −0.10) was associated with disability after controlling for guarding and other covariates (Model 2) and was emerged as independent predictor of disability (Model 3: std β = −0.11) (all P < 0.05) (Tables 1 and 2).

Our data offers preliminary support for the multivariate association between pain coping variability and committed action in predicting concurrent pain-related disability, which supplements the existing pain coping data that are largely based on assessing frequency of coping.

The authors have not supplied their declaration of competing interest.

One of the most researched theories of personality is the Five Factor Model, frequently evaluated through the Big Five Inventory 44-item BFI. Although there is an Arabic version, its psychometrical properties in Kuwaiti population are yet unknown.

The objective of this study was to evaluate the psychometric properties of the BFI and its factorial structure in an Arabic non-clinical sample.

The participants were 685 first year undergraduate Kuwaitis: 305 males mean age = 22.77 ± 4.57 and 380 females; mean age = 19.61 ± 2.59). The Arabic version of BFI (John and Srivastava, 1999) was administered to participants. The internal consistency reliability, factor structure, and convergent validity of the BFI with PFQ-C (Barbaranelli, Caprara, Robasca, and Pastorelli, 2003) were assessed.

Internal consistency was satisfactory for the Neuroticism, Extraversion, and Openness to Experience, Agreeableness, and Conscientiousness subscales respectively (Cronbach's alpha = 0.83, 0.82, 0.79, 0.82, 0.90) for males and (Cronbach's alpha = 0.74, 0.83, 0.85, 0.81, 0.92) for females. The results revealed significant gender differences where the males obtained a higher score than females on extraversion and conscientiousness, while females obtained a higher score than males on neuroticism. Principal component analyses (PCA) showed that a five-component solution explains 42.27% of the total variance for males and 41.47% for females. The convergent correlations in sample between the BFI and PFQ-C (mean r = 54) for validity coefficients.

These findings suggest that the BFI is a brief measure of the Big Five personality traits and it provides satisfactory reliable and valid data.

The author has not supplied his/her declaration of competing interest.

The focus of interest in this study is to investigate the relationship between happiness and optimism, satisfaction with life, hope, depression, and anxiety. Many efficient instruments have been used in this study, however there is no study until this date that has used the Oxford Happiness Questionnaire (OHQ) within Arabic countries and Kuwaiti samples specifically.

The aim of the study is to investigate the correlations between happiness and optimism, satisfaction with life, hope, depression and anxiety.

The sample consisted of 510 students from Kuwait University, 270 females and 240 males, with a mean age of 22.8 (SD = 4.1). The OHQ 0.90 alpha was administered to participants, in addition to the Arabic version of Life Orientation Test-Revised (LOT-R) 0.70, The Satisfaction with Life Scale (SWLS) 0.78, The Hope Scale (AHS) 0.60, Beck Depression Inventory (BDI-II) 0.87 and Beck Anxiety Inventory (BAI) 0.95. Correlations were used in this study.

The results revealed that all the correlations between OHQ and other scales were significant. Positive correlations have been found with LOT-R r = 0.50, SWLS r = 0.44, and AHS r = 0.39, while there were negative correlations with BDI-II r = −0.38 and BAI r = −0.17.

It was concluded that happiness correlates positively with other personality variables: optimism, satisfaction with life and hope, while it correlates negatively with Depression and Anxiety.

The author has not supplied his/her declaration of competing interest.

Borderline personality disorder (BPD) is a severe psychiatric health problem with reputation of being difficult to deal with and to treat. Significant others (SOs) of patients with BPD show higher levels of psychological distress compared with the general population. Strengthening the coping strategies of SOs plays an important role in the recovery of the patient. Support and education for SOs is important, both for SOs themselves and for the patients recovery.

Research around support and education for SOs is of great importance not only for SOs and patients, but also for psychiatric staff, in order to offer help and support, for the whole family.

The aim was to describe significant others’ experiences of dialectical behaviour therapy-family skills training (DBT-FST), their life situation before and after DBT-FST, and measurement of their levels of anxiety and depressive symptoms.

The study had a descriptive mixed method design. Data were collected with free text questionnaires (n = 44), group interviews (n = 53) and the HAD scale (n = 52) and analysed by qualitative content analysis and descriptive and inferential statistics.

The results show that life before DBT-FST was a struggle. DBT-FST gave hope for the future and provided strategies, helpful in daily life. For the subgroup without symptoms of anxiety and depression before DBT-FST, anxiety increased significantly. For the subgroup with symptoms of anxiety and depression the symptoms decreased significantly. This indicates, despite increased anxiety for one group, that DBT-FST is a beneficial intervention and most beneficial for those with the highest anxiety and depressive symptoms.

The authors have not supplied their declaration of competing interest.

Several studies have explored the vulnerability to mood disorders that constitute some personality traits.

To study the potential relationship between mood disorders and personality disorders.

We hypothesized that personality disorders can be related to severe mood disorders.

This was a retrospective study including the period from January 2000 till September 2015 and related to patients in whom the diagnosis of mood disorder and personality one were retained according to the criteria of the DSM-IV TR while the sociodemographic and clinical were collected by a pre-established railing.

We included 28 patients (15 ♂, 13 ♀). The average age was 38 years. Eighteen (64.3%) patients (7 ♂, 11 ♀) are unemployed. Fifteen patients (10 ♂, 5 ♀) were schooled until secondary level. Seventeen patients (60.7%) were married. The bipolar I disorder (BD I) was most frequently founded (50%), followed by the major depressive disorder in 25% (n = 7) then by the bipolar II disorder in 21.4% (n = 6). A case of dysthymia was also noted. Half of the personality disorders were the borderline type, followed by the histrionic type in 28.6% (n = 8) then by the antisocial in 17.9% (n = 5) and finally one patient presented a paranoiac personality. The antisocial personality was significantly associated with the BD I (P = 0.011) and half of the patients with a pathological personality, presented a depressive symptomatology.

The personality disruption is a factor of severity of the thymic disorders. Consequences on the management of patients and their response to treatments remain available.

The authors have not supplied their declaration of competing interest.

Emotional Agility constitutes an alternative to the DSM-5 personality trait model.

The presentation outlines how Emotional Agility is conceptualised and measured through self-report and multi-rater questionnaires.

The paper highlights the development of a short Emotional Agility trait questionnaire and a corresponding behavioural measure with 18 items.

Data (n = 929) from a substantial personality questionnaire with 161 questions was utilised to create a 54 question ‘short form’ that measures the Big 5 personality factor plus Need for Achievement through 18 facet scales of 3 items each. Data on the same subjects from a 50-item criterion measure was reduced to 18 items that are structurally aligned to the 18-predictor facets.

Predictor reliabilities averaged 0.752 at Factor as well as Facet level. The unit weight sum of the 54 questions achieved an uncorrected validity of 0.28 (n = 929) against external ratings of effectiveness. Joint factor analysis showed good discrimination between the six factors. A ‘positive manifold’ of Emotional Agility scales emerged as expected which could be conceptualised as the opposite of the MMPI2 ‘Demoralisation Factor’.

The Emotional Agility approach could ground mental health assessments firmly in positive approaches that use every-day terminology. It seems preferable to vague scales claiming to measure obscure ‘clinical’ constructs through hugely overlapping items that are often not fit for purpose.

The author has not supplied his/her declaration of competing interest.

The lack of empathy is often described as one of the core characteristics of psychopaths. However, prior studies on cognitive empathy in psychopaths have led to mixed conclusions, with some indicating that psychopaths have no impairments in cognitive empathy.

This study set out to resolve this inconsistency by distinguishing the two factors that constitute the construct of psychopathy: Factor 1 (e.g., emotional callousness, lack of guilt) and Factor 2 (e.g., irresponsible lifestyle, poor behavioral controls).

The main aim of this study was to examine the differential relationship between these two factors and relevant variables including empathy, aggression, satisfaction with life.

Self-report questionnaires and two online experiments (facial affect recognition task, emotional scenario task) were administered to 306 undergraduate students to collect data about psychopathy, cognitive/affective empathy, aggression, satisfaction with life.

Correlation analysis revealed that both Factor 1 and Factor 2 had negative correlations with self-reported measures of cognitive/affective empathy, and only Factor 1 emerged as a significant predictor of both kinds of empathy. Aggression also showed a stronger positive correlation with Factor 1 than with Factor 2, regardless of subtypes (instrumental, reactive, relational, overt aggression). On the other hand, satisfaction with life was more negatively correlated with Factor 2 than Factor 1, and regression analysis revealed that only Factor 2 was a significant predictor.

This study showed Factor 1 is more important than Factor 2 in explaining both empathy and aggression in psychopath, while satisfaction with life is better explained by Factor 2 than by Factor 1.

The authors have not supplied their declaration of competing interest.

The purpose of this study was to investigate cognitive functioning in Borderline Personality Disorder subjects, with particular reference to the Working Memory functioning. The Working Memory seems to be relate to core features of the disturb. The final aim was to better understand the disorder and to implement a cognitive training to improve the deficits.

A literature search was conducted in April 2015. Pubmed and Scopus databases were used to find studies to include in the systematic review. The keywords used for the literature search were: “borderline personality disorder”, “borderline personality”, “working memory”, “executive functioning”. In each search, the keywords were used together with the logical operator “and”.

Three studies were included in this systematic review (Table 1). In each study, the working memory was investigated using N-back test. In two of those studies significantly differences were found between patients and healthy group in N-back task. In the third study, which used more tests to investigate working memory domain, no differences were found between the two groups.

Borderline personality disorder patients performed significantly worse on the N-back test compared to healthy controls and the impairment increased with increasing working memory load. In the third study the working memory domain was investigated using four different tests and single scores were not included therefore it was impossible to compare N-back data.

The authors have not supplied their declaration of competing interest.

Self-Concealment Scale (SCS) is composed of ten items to measure self-concealment, defined as a tendency to conceal from others personal information that one perceives as distressing or negative (Larson and Chastain, 1990).

To investigate the psychometric properties of the SCS-10 Portuguese version and of an adapted version containing two additional items specifically focused on self-concealment related do health problems (physical and psychological)–SCS-12.

The Portuguese version of the SCS-12 and other validated questionnaires designed to evaluate self-reported health, perfectionism and optimism-pessimism were administered to a convenience sample of 555 adults from the community (60.5% females; mean age = 43.49 ± 10.565).

The SCS-10 and SCS-12 Cronbach's alphas were α < 0.80. In both versions, all the items contribute to the internal consistency. The factor analysis, following the Kaiser and the Cattel's Scree Plot criteria, revealed that SCS-10 is unidimensional and that SCS-12 reliably and validly evaluates two dimensions: F1 Keeping secrets (Explained variance = 48.60%; α = 0.816), F2 Personal concealment including health problems (9.65%; α = 0.797). The pattern of correlations of the SCS dimensional and total scores was as follow: negative low correlations with physical health (@−0.20), negative moderate correlations with psychological health (@–.30), moderate correlations with self-oriented perfectionism, social-prescribed perfectionism, pessimism (@0.25) and optimism (@−0.20).

The Portuguese versions of SCS have good reliability and validity (construct and convergent-divergent). The factorial structure partially overlaps with the original. SCS could be useful for research proposes, namely in an ongoing project on the role of the mentioned personality traits on illness and health behavior.

The authors have not supplied their declaration of competing interest.

We have recently found that Perfectionism and Perseverative Negative are both correlates of psychological distress/PD and that PNT mediates the relationship between perfectionism and PD (Macedo et al., 2015).

To investigate if perfectionism and PNT are prospectively associated to PD and if PNT is a longitudinal mediator between perfectionism and PD, controlling for perceived stress and gender.

A total of 227 university students (80.1% girls) filled in the Portuguese validated versions of Perseverative Thinking Questionnaire (PTQ), Multidimensional Perfectionism Cognitions Inventory (MPCI), Profile of Mood States and Perceived Stress Scale, with an additional item to evaluate perceived social support/PSS at T0 and after approximately one year (T1) (Mean months = 12.77 ± 1.137). Only variables significantly correlated with the outcomes (Tension/Anxiety at T1 and Depression at T1) were entered in the conditional process analysis. The moderating role of perceived support on the link between Concern over Mistakes (MPCI) and psychological distress and between PTQ total score and psychological distress (anxiety and depression separately) was examined via conditional process analyses.

The estimated models were significant (F = 4.257, P = .002; F = 6.476, P < .001) explaining 15.9% of tension-anxiety and 25.5% of depression variance. A significant conditional indirect effect of PTQ total score on psychological distress at average and higher levels of perceived support was found, in both models (anxiety and depression). On the contrary, the two models showed a non-significant conditional direct effect of Concern over Mistakes on psychological distress only at any level of perceived support.

PNT prospectively mediates the relationship between negative perfectionism and PD.

The authors have not supplied their declaration of competing interest.

Section III of 5th edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-5) includes a hybrid model of personality pathology, in which dimensional personality traits (PTs) are used to derive one of six categorical Personality Disorder (PD) diagnoses. The Personality Inventory for DSM-5 (PID-5) has been developed to assess PTs within this new system.

PT is a tendency to feel, perceive, behave, and think in relatively consistent ways across time and situations. PD diagnosis is generally stated if a pattern of maladaptive PTs persists at least 5 years. Nevertheless, the PID-5 instruction does not cover duration of symptoms.

We have explored the effect of two different types of instructions, in which duration of symptoms is or is not explicitly mentioned, on the PID-5 scores. Moreover, we have asked whether the scores differ in psychiatric patients and healthy individuals.

Differences between original and modified instructions of the Czech PID-5 version have been evaluated in a group of 62 psychiatric patients and 38 healthy controls; each respondent has been administered both instruction types in random sequence. ANOVA mixed design has been used to test the relation between groups and different sequence of administration.

We have found no consistent differences in PID-5 scores using the different types of instruction described above.

In our sample, PID-5 seems to reflect strong beliefs of a subject regardless of symptoms’ duration and could be reliably used with both types of instruction. The PID-5 represents an appropriate instrument for the assessment of maladaptive PTs.

The authors have not supplied their declaration of competing interest.

Perfectionism and cognitive emotion regulation (CER) mechanisms have been associated with perceived stress/coping, negative affect (NA) and mental problems. Comparatively, the correlates of Positive Affect (PA) have been less studied.

To compare Perfectionism, CER and Perceived distress/coping by groups with different levels of NA/PA.

A total of 344 medical students (68.4% girls) completed the Hewitt & Flett and the Frost Multidimensional Perfectionism Scales (H&F-MPS/F-MPS), the Profile of Mood States, the Perceived Stress Scale, and the Cognitive Emotion Regulation Questionnaire.

The subjects with high NA, when compared to those with low NA, showed significant higher levels of Evaluative Concerns (EC), Positive Striving (PStr), of H&F-MPS/F-MPS total and dimensions scores (excluding Organization) of Rumination, Blaming others, Self-blaming, Catastrophizing and Perceived distress (all P < 0.01). They also revealed lower levels of Positive reevaluation and planning; Positive refocusing, Putting into perspective and Perceived coping (all P < 0.01). The subjects with high and medium levels of PA, when compared to the subjects with low PA, showed significant lower levels of Perceived distress, EC, Socially-Prescribed Perfectionism, Doubts about action, Concerns over Mistakes, (all P < 0.01), Self-Oriented Perfectionism, PStr (P < 0.01, P < 0.05, respectively) and higher levels of Perceived coping, Positive reevaluation and planning, Positive refocusing, Putting into perspective (all P < 0.01) and Acceptance (P < 0.01, P < 0.05, respectively).

NA is associated with perfectionism, high maladaptive and low adaptive CER, and also with high Perceived distress/low coping, which might increase the subject's vulnerability to psychopathology. Low perfectionism, high adaptive CER and perceived coping are associated with PA and might be protective factors.

The authors have not supplied their declaration of competing interest.

Trauma narratives contain a lot of emotion words, in comparison with narratives about other autobiographical memories. Negative emotion's words, as well as words about death (as an indicator of threat perception), have been associated to a worse adjustment after trauma. However, the different kind of negative emotions reported have been rarely explored. Also, in violence victims, the use of words about abuse might indicate threat perception.

Analyzing the use of negative words and threat perception (death and abuse words) in trauma narratives from 50 battered women, compared with stressful narratives from 50 non-traumatized women, and positive narratives. The relationship between narratives aspects and symptomatology is explored.

Exploring differences in emotions and threat perception related to psychological functioning after trauma.

Battered women were asked to remember the worst violence episode, whereas non-traumatized women narrated their most stressful experience. Both groups remembered also a neutral and a positive episode. LIWC software was used to calculate the percentage of different words used.

Anger was the most used negative emotion. Anger and sadness words were more reported in stressful and trauma narratives than in positive ones. There were differences between groups in the use of death and abuse words. Anger and abuse words were associated to anxiety and depression, but not PTSD symptoms. Death words were related to a better functioning.

This study evidences the need to explore the role of different negative emotions in the posttraumatic adaptation. Also contextual aspects involved on threat perception must be considered.

The authors have not supplied their declaration of competing interest.

PTSD is associated with medical and psychiatric comorbidities. Less is known regarding differences in PTSD comorbidities and service use by gender.

To examine variations in comorbidities for PTSD by gender and implications for quality of care.

We identify the prevalence of PTSD, medical and psychiatric comorbidities diagnosed by gender within outpatient, inpatient and emergency services.

We conducted a retrospective analysis using existing medical records from all outpatient, inpatient and emergency department (ED) encounters in 2010–2012 in a safety net health care system in the US. We identified the rates of PTSD diagnosis by gender, co-occurring diagnoses in ED and inpatient care, and rate of different comorbid diagnoses following initial PTSD diagnosis.

Women in the sample had twice the likelihood of having a diagnosis of PTSD as compared to men (1.9% vs. 3.6%, P > 0.001), the most common comorbid diagnoses for ED visits were substance use disorder (SUD), depression, anxiety and pain. Men were more likely to have pain as a diagnosis in the ED as compared to women (P > 0.001). In inpatient services, men with PTSD were more likely to be diagnosed with a SUD (35% vs. 26%, P > 0.001) and women more likely diagnosed with comorbid depression (32% vs. 43%, P > 0.001). Men were more likely to have combined medical and substance use disorders and women more likely to have combined medical and psychiatric disorders.

Given the different patterns of comorbidity by gender, services should focus on tailoring services early to contend with these differences.

The authors have not supplied their declaration of competing interest.

Georgia is the Country located in Caucasian Region with two occupied territories: Abkhazia and South Ossetia. Since 1993 as a result of military actions 500,000 civilians became victims of ethnic cleansing. In October 13, 2015 the Prosecutor of the International Criminal Court, requests judges for authorization to open an investigation into the Situation in Georgia that clearly shows importance of the problem addressed by this study.

Observation of outcomes of traumatic stress among three categories of victims: IDPs, population living in the military conflict zone and civilians living in the so called “Buffer Zone”. Aim of the study was to provide comparative analysis between trauma affected different groups.

The clinical and paraclinical methods using the semi–structured clinical interview, psychological test battery and paraclinical diagnostic tests were used, analysis were provided by using the SPSS.

Based on observation in 2014–2015 n = 150 victims of war crimes were observed. Also additional stressors for all target groups were identified. Differences and similarities of psychological and somatic after effects of trauma revealed.

We can conclude that prolonged stress situation with unsecured environment and daily life under unexpected circumstances caused prolongation of PTSD alongside of behavioral changes and with damages in social adaptation. On the other hand completed trauma with leaving of native living areas and significant changes in social life in most of cases caused emotional disturbances with prolonged chronic depression and persistent fillings of grief.

The author has not supplied his/her declaration of competing interest.

Association of pro-inflammatory cytokines with severity of various psychiatric disorders is shown. Evidence suggests omega-3 fatty acids reduce psychiatric symptoms due to anti-inflammatory properties.

To evaluate if serum levels of pro-inflammatory cytokines correlate with the intensity of PTSD symptoms, and the observed change in symptoms’ severity induced by omega-3 supplementation.

We included 26 Croatian Homeland war veterans (aged 39–60) with chronic PTSD and no major comorbidity, who were on stable therapeutic sertraline dose at least three months before recruitment. Levels of pro-inflammatory cytokines (TNF-α, IL-6, and IL-1β) were determined by the enzyme-linked immunosorbent assay method. Intensity of PTSD symptomatology was assessed by Clinician-Administered PTSD Scale (CAPS), Hamilton Anxiety Scale (HAM-A) and 17-item Hamilton Depression Scale (17-HAM-D). During 12 weeks, participants took omega-3 capsules (600 mg/day) while continuing sertraline therapy.

Most participants presented with moderate PTSD evaluated by CAPS. At baseline, cytokine levels were not associated with the severity of PTSD symptoms, as measured by all three scales (P ≥ 0.209). After 12 weeks of omega-3 supplementation the severity of PTSD symptoms significantly decreased, on average by 8 to 13% on the psychometric scales per person (P < 0.001 for all). However, no association was found between the change in cytokine levels and the change in scores, induced by omega-3, on the assessed scales (P ≥ 0.730).

Cytokine levels are not associated with PTSD severity or with improvement in PTSD symptomatology. At the same time, sertraline therapy supplemented with omega-3 seemed to reduce the severity of PTSD symptoms.

The authors have not supplied their declaration of competing interest.

With increasing numbers of previous traumatic experiences, a rising risk of psychiatric morbidity and in particular post-traumatic stress disorder following an acute trauma has been reported. This dose-effect relationship was called the building block effect. Most results are derived from studies on riot and prosecution victims. We investigated victims of a natural disaster with respect to the building block effect due to prior traumatization.

We assessed tourists who had been affected by the Indian Ocean Tsunami 2004 using the Post-traumatic Diagnostic Scale, the Hospital Anxiety and Depression Scale, and the Post-traumatic Growth Inventory. Outcome variables were related to the numbers or prior civil trauma according to the trauma history scale of the PDS.

We found a building block effect for the development of anxiety (P = 0.018) and by trend with PTSD symptoms (P = 0.06), but not with depressive symptoms (P = 0.436). Prior traumatization and the actual Tsunami exposure significantly explained variance of personal posttraumatic growth (P = 0.013). Prior interpersonal traumata emerged as a strong risk factor for the development of posttraumatic psychiatric morbidity.

We suggest that an increasing number of trauma is closely associated with anxiety but not with depressive disorders in the aftermath of natural disasters. For clinical practice, it is necessary to ask victims of natural disasters about prior traumatization, in particular about prior interpersonal trauma.

The authors have not supplied their declaration of competing interest.

PTSD has been associated with HPA axis alterations, mainly consisting of reduced cortisol levels, elevated CRH and enhanced glucocorticoid receptor responsiveness. These findings led to the emergence of glucocorticoid-based therapeutic options for PTSD.

To outline the different glucocorticoid-based interventions for PTSD either for prophylactic or for curative treatment.

A systematic review was performed. The Medline database was searched using the following keywords: ‘PTSD’, ‘treatment’, ‘Glucocorticoids’, ‘hydrocortisone’.

Glucocorticoid-based therapeutic for PTSD comprise preventive and curative interventions. Preventive interventions mainly consist of administering one single bolus of hydrocortisone shortly following the exposure to a traumatic event. Evidence comes from six published trials, all positive. Curative interventions include: prescribing hydrocortisone over short periods of time to treat PTSD symptoms, using Glucocorticoids to augment psychotherapy (in particular exposure therapy) for PTSD and using Mifepristone, a glucocorticoid receptor antagonist. Moreover, novel glucocorticoid receptor modulators are currently being developed and tested on animal models as a potential curative treatment for PTSD.

Use of hydrocortisone in preventing PTSD might be tempting, as is the use of hydrocortisone or Glucocorticoid receptors antagonists/modulators in treating PTSD. Yet, it should be emphasized that these interventions are not mainstream yet. They rather reflect a revolutionary new direction.

The author has not supplied his/her declaration of competing interest.

Exposure to a traumatic event is necessary but not sufficient condition for development of posttraumatic stress disorder (PTSD). This is evident from the fact that many people who experience traumatic stressors do not develop this disorder. PTSD is a multicausal phenomenon and a final end point of the combination of a number of potential causes.

To examine the different factors as potential risk factors for developing PTSD in general adult population.

The sample consisted of 640 subjects, randomly chosen in five regions of the country. The assessment has been carried out by MINI-5, Life Stressor Checklist-Revised, Brief Symptom Inventory, and Manchester Short Assessment of Quality of Life scale.

Older age, low education and lower monthly income can predict current PTSD, as well as decreased quality of life, psychiatric comorbidity and higher personal distress.

The risk and resilience factors contribute to the development/protection of developing PTSD, which is important for prevention and treatment of this disorder.

The authors have not supplied their declaration of competing interest.