Demand/withdraw communication in the context of intimate partner violence: Implications for psychological outcomes

Continuation of gender-affirming hormones in transgender people starting puberty suppression in adolescence: a cohort study in the Netherlands

Afghanistan: Decades of collective trauma, ongoing humanitarian crises, Taliban rulers, and mental health of the displaced population.

Research on mental health following disasters has led to the identification of many individual protective and risk factors for postdisaster mental health. However, there is little understanding of the exact influence that disasters have on the functioning of intimate relationships. Especially relevant are attachment styles, which are likely to play an important role in the provision and perception of social support between partners, and subsequent mental health outcomes. Heterosexual couples (N = 127) affected by the 2009 Victorian "Black Saturday" Bushfires in southeastern Australia were surveyed for disaster experiences, posttraumatic stress disorder (PTSD) symptoms, depression, and attachment style between May 2012 and January 2013, approximately 3 years after the disaster. Using actor-partner interdependence models (APIM), we examined both intrapersonal and interpersonal associations of attachment anxiety and avoidance with depression and PTSD, in combination with shared disaster exposure. Male partners' attachment avoidance was associated with depression and PTSD in both partners. By contrast, a female partner's attachment avoidance was associated with greater depression and PTSD in herself, but fewer PTSD symptoms in a male partner. Amid the chronic stressors of a postdisaster setting, the attachment avoidance of the male partner may play a particularly negative role, with his tendency toward isolation and denial becoming especially maladaptive for the couple as a whole. The female partner's attachment avoidance is likewise an important factor, but its associations with negative social support and relationship breakup must be clarified to understand its impact on partnership functioning. (PsycINFO Database Record

Dyadic effects of attachment on mental health: Couples in a postdisaster context.

Brief screening measures of mental health for war-related dysfunctional anxiety and negative persistent thinking

Abstract Background: Transgender healthcare is a rapidly evolving interdisciplinary field. In the last decade, there has been an unprecedented increase in the number and visibility of transgender and gender diverse (TGD) people seeking support and gender-affirming medical treatment in parallel with a significant rise in the scientific literature in this area. The World Professional Association for Transgender Health (WPATH) is an international, multidisciplinary, professional association whose mission is to promote evidence-based care, education, research, public policy, and respect in transgender health. One of the main functions of WPATH is to promote the highest standards of health care for TGD people through the Standards of Care (SOC). The SOC was initially developed in 1979 and the last version (SOC-7) was published in 2012. In view of the increasing scientific evidence, WPATH commissioned a new version of the Standards of Care, the SOC-8. Aim: The overall goal of SOC-8 is to provide health care professionals (HCPs) with clinical guidance to assist TGD people in accessing safe and effective pathways to achieving lasting personal comfort with their gendered selves with the aim of optimizing their overall physical health, psychological well-being, and self-fulfillment. Methods: The SOC-8 is based on the best available science and expert professional consensus in transgender health. International professionals and stakeholders were selected to serve on the SOC-8 committee. Recommendation statements were developed based on data derived from independent systematic literature reviews, where available, background reviews and expert opinions. Grading of recommendations was based on the available evidence supporting interventions, a discussion of risks and harms, as well as the feasibility and acceptability within different contexts and country settings. Results: A total of 18 chapters were developed as part of the SOC-8. They contain recommendations for health care professionals who provide care and treatment for TGD people. Each of the recommendations is followed by explanatory text with relevant references. General areas related to transgender health are covered in the chapters Terminology, Global Applicability, Population Estimates, and Education. The chapters developed for the diverse population of TGD people include Assessment of Adults, Adolescents, Children, Nonbinary, Eunuchs, and Intersex Individuals, and people living in Institutional Environments. Finally, the chapters related to gender-affirming treatment are Hormone Therapy, Surgery and Postoperative Care, Voice and Communication, Primary Care, Reproductive Health, Sexual Health, and Mental Health. Conclusions: The SOC-8 guidelines are intended to be flexible to meet the diverse health care needs of TGD people globally. While adaptable, they offer standards for promoting optimal health care and guidance for the treatment of people experiencing gender incongruence. As in all previous versions of the SOC, the criteria set forth in this document for gender-affirming medical interventions are clinical guidelines; individual health care professionals and programs may modify these in consultation with the TGD person.

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Modern war conflicts, evolutionizing from large-scale collisions of armed forces to local, low-intensity, surrogate, terroristic and information wars, are associated with less direct mortality but with growing and long-lasting mental health consequences. These consequences can be traced in not only combatants and other military contingents and veterans but even to greater extent in the civilian populations, given that many modern war conflicts have signs of civil wars or religious conflicts. While active duty military undergo preliminary selection and resilience training, civilians in the war zone or as refugees and asylum-seeking victims are even at higher risk with the greater probability of transgenerational transmission, which implies long-lasting (decades) effects. Both military and civilians suffer from a similar set of disorders and psychological consequences caused by extreme trauma, including PTSD, depression, anxiety, addictions, somatization with chronic pain, dissociation, psychosocial dysfunctions, suicidal behavior, etc. War conflicts, terroristic acts, and information wars, amplified by technologically developing mass media, the internet and social networks, seem to add to a general feeling of instability and promote more anxiety, covering even wider contingents worldwide. Military psychiatry has accumulated knowledge and practical experience that, though not always can be applied directly, are useful for identification, management, prevention, and treatment of mental health consequences of war in wider contingents. This knowledge is a one more relevant and strong reason for advocating lowering of international tension and reducing the probability of war conflicts worldwide for the sake of preserving mental health of the humanity. It also has a potential of lowering the burden of this type of diseases worldwide.

Georgios Pagkalos

Papers

Standards of Care for the Health of Transgender and Gender Diverse People, Version 8

Mental health consequences of war conflicts