Post-migration stressors can exacerbate post-traumatic stress disorder (PTSD) and reduce treatment effectiveness among refugees. Evidence for integrated care models in high-income settings remains limited.

To compare treatment as usual (TAU) with an add-on integrated care intervention for unemployed refugees with PTSD.

We conducted a two-arm, parallel-group superiority trial with 1:1 randomisation to TAU or TAU with an add-on integrated care intervention, delivered at a specialised out-patient clinic in Denmark (ClinicalTrials.gov NCT04244864). TAU included sessions with a psychologist and physician over 8–12 months. The integrated care intervention also included structured collaboration with employment services. The primary outcome was functioning, using the 12-item World Health Organization Disability Assessment Schedule 2.0 (WHODAS) interview. Secondary outcomes included symptoms, quality of life and post-migration stressors. Analyses followed the intention-to-treat principle, using analysis of covariance and linear regression with multiple imputations.

The study included 195 patients in treatment from 2020 to 2025. No difference was observed in WHODAS score between groups pre- to post-treatment (mean difference 0.30, 95% CI −2.40 to 3.00; P = 0.825). Similarly, no differences were found for secondary or exploratory outcomes, and overall change was limited. However, the integrated care group had a lower rate of early dropout (P = 0.042) and higher level of treatment satisfaction (P = 0.035).

Integrated care was feasible but not superior to TAU in improving outcomes for refugees with longstanding symptoms and unemployment. Future research should examine how the timing and intensity of integrated care interventions influence outcomes, including earlier implementation and adequate support for refugees with longstanding and complex needs.

Mental health issues are prevalent among children and young people (CYP) with chronic conditions like epilepsy, yet few access evidence-based psychological therapies. Evidence from the Mental Health Intervention for Children with Epilepsy (MICE) trial supports the effectiveness of a personalised modular psychological intervention, but cost-effectiveness is unknown.

To assess the cost-effectiveness of the MICE intervention compared with assessment-enhanced usual care at 12-months follow-up, taking a health and social care perspective.

We conducted a within-trial economic evaluation. Outcomes were the Strengths and Difficulties Questionnaire (SDQ; primary) and quality-adjusted life years (QALYs; secondary) for CYP, caregivers, and CYP and caregivers combined. Sensitivity analyses examined missing data and intervention-costing assumptions.

Cost-effectiveness results for the SDQ indicated that MICE had a higher probability of being cost-effective compared with control at a willingness to pay ≥£368 per unit improvement. For QALYs, MICE had a lower probability of being cost-effective for CYP compared with control (35 to 42%) across the £20 000–£30 000 per QALY threshold range. However, at the upper threshold this finding was reversed in sensitivity analyses with missing data imputed (45 to 58%) and with MICE costed at 75%, assuming the intervention partly substituted standard services (46 to 55%). Furthermore, MICE had a higher probability of being cost-effective for caregiver QALYs (52 to 63%) and combined CYP and caregiver QALYs (62 to 75%).

MICE appears to be cost-effective compared with assessment-enhanced usual care when considering QALYs for CYP and caregivers combined, though uncertainty exists across willingness-to-pay thresholds.

Schizophrenia and psychosis have high twin heritability (approximately 80%), but these general estimates may hide aetiological variation. This can be investigated by using syndromes based on key psychotic symptom combinations.

To investigate concordance, and heritability where calculable, of psychotic syndromes in multiple schizophrenia and psychosis twin samples.

We investigated concordance for positive, negative and disorganised psychotic syndromes, based on lifetime symptom ratings, in three classical schizophrenia twin samples (Fischer, Kringlen and Slater) and two psychosis samples (Maudsley register and non-register), the first four being systematically ascertained (total 317 monozygotic and 145 dizygotic probandwise pairs). We assessed concordance differences with logistic regression in generalised linear mixed models, and heritability from twin-modelling in the Maudsley register sample.

The positive syndrome, comprising delusions plus hallucinations, had 37.7–41.4% monozygotic and 6.0–6.3% dizygotic concordance, and heritability of 0.81 or 81% (95% CI 0.58–0.88), with similar results for negative and disorganised syndromes. In the systematically ascertained samples, delusions and hallucinations occurring without disorganised symptoms had nominally lower monozygotic twin concordance than when disorganised symptoms were also present (in the three schizophrenia samples: 89 pairs, odds ratio 3.47 (95% CI 1.04–1.54), p = 0.043; and the Maudsley register psychosis sample: 70 pairs, odds ratio 7.68 (95% CI 1.49–39.70), p = 0.016).

In schizophrenia and psychosis, the syndrome of delusions plus hallucinations has high twin heritability overall. Positive symptoms without disorganised symptoms may indicate relatively high environmental influences, and positive symptoms with disorganised symptoms, relatively high familial and probably genetic influences, but further confirmation is needed.

To examine how musicians express mood states through music and how these expressions are interpreted by media narratives, and how cultural analysis can be used as an educational tool to enhance psychiatric understanding of mental state, stigma and patient engagement.

A qualitative analysis was conducted using a comparative cultural analysis approach. Publicly available materials related to four artists (Amy Winehouse, Kurt Cobain, Stormzy and Florence Welch) were used. These artists were selected to reflect variation across genres, eras, genders and cultural contexts. Materials, such as song lyrics, interviews and media reporting, were thematically analysed using the Braun and Clarke framework. Patterns in emotional expression, representations of mental distress, and media framing were found. Identified themes were mapped to core psychiatric training domains, including mental state variations, stigma and culturally informed care. As no primary clinical data were collected and all materials were in the public domain, ethical approval was not required.

Three consistent themes were identified. First, musicians frequently expressed emotional distress and vulnerability using metaphors, tone and narrative rather than explicit clinical language. This suggests music can provide insight into subjective emotional states and serves as a tool for understanding the meaning and the context of an experience or emotion. Second, media portrayals often simplified or moralised these expressions, particularly in relation to substance abuse, reinforcing stigma and overshadowing the complexity of co-occurring mental health challenges. Third, disparities were observed in how distress was framed, dependent on gender, race and genre, with some artists’ experiences pathologised to a greater extent, whilst others were relatively contextualised or minimised. These findings demonstrate how cultural material can be used in education to show the limitations of symptom-only interpretation and the importance of contextual formulation – including social environment, occupational pressures and media influence. This pedagogical approach aligns with the RCPsych curriculum by enhancing reflective practice and improving cultural competence, pivotal for managing complex presentations in diverse populations.

Music and media analysis offers a potentially useful framework to augment psychiatric training by highlighting how emotional distress is expressed, interpreted and socially constructed. While music cannot be used to diagnose mental illness, it can enhance engagement and facilitate conversations around stigma, identity and help-seeking. Incorporating culturally relevant case analyses through simulated formulation workshops into education may improve recognition of non-verbal expressions of distress, encourage reflective engagement with stigma and media narratives, and promote culturally informed practices.

There is currently no national approach to physical health and activity management for individuals under forensic mental healthcare.

This study aims to document the physical health and activity management of in-patients under forensic mental healthcare across Australia, physical activity opportunities and how data are recorded. It also explores staff perspectives on physical health and activity needs of forensic in-patients.

Forensic hospital staff with expertise in managing the physical health and activity of in-patients were invited to participate in a mixed-methods study.

Twenty-two surveys were completed and 64 staff members participated in 17 focus groups. Eight themes were identified: (a) lack of a standardised approach to physical health and activity; (b) inconsistent monitoring and documentation; (c) importance of general practitioners and multidisciplinary teams; (d) need for structured, adaptable programmes and engaged staff; (e) challenges related to patients, staff, ethics and infrastructure; (f) gaps in education, engagement and awareness; (g) need to balance nutrition and eating autonomy; and (h) importance of developing and implementing interventions.

Forensic hospitals in Australia lack a standardised approach to physical health and activity management, with inconsistent monitoring. Physical activity interventions require engaged staff, resources and flexibility, yet ethical and logistical barriers complicate implementation. Solutions include investing in specialised staff, scheduling physical activity into patients’ routines and integrating information technology systems. Comprehensive policies for assessment, monitoring, nutrition, physical activity and interventions are important for improving in-patient forensic mental healthcare, and key performance indicators should be developed.

Depressive and anxiety disorders often co-occur with insomnia, creating complex treatment challenges. Although clinical guidelines recommend psychotherapy as first-line treatment for these comorbid conditions, limited access to psychological services in primary healthcare facilities in China often leads to heavy reliance on pharmacological therapy.

To the appropriateness of psychotropic medications for patients with insomnia comorbid with depressive or anxiety disorders at primary healthcare facilities in China.

This cross-sectional study included patients with documented diagnoses of insomnia comorbid depressive or anxiety disorders in 2022 at all 67 primary healthcare facilities in Dongcheng District, Beijing, China. The primary outcome was the prescribing rate of guideline-recommended psychotropic medications.

Among 842 patients with insomnia and depressive disorders and 1014 patients with insomnia and anxiety disorders, over 90% received psychotropic medications. Benzodiazepines were the most frequently prescribed classes (55.9 and 69.6%), followed by non-benzodiazepine hypnotics (42.5 and 42.4%), whereas medications recommended by the guideline, including antidepressants with sedative effects, selective serotonin reuptake inhibitors and selective norepinephrine reuptake inhibitors, were used infrequently. Only 29.9% of patients with insomnia and depressive disorders and 11.5% of those with insomnia and anxiety disorders received guideline-recommended pharmacotherapy, with lower concordance among older adults.

Guideline-recommended pharmacotherapy for insomnia comorbid with depressive or anxiety disorders was rarely implemented at primary care in China. This highlights the need to facilitate evidence-based practices and improve management of comorbid mental health conditions, particularly for older adults.

According to existing evidence, during menopause transition, women with psychosis may present with exacerbated psychiatric symptoms, due to age-related hormonal changes.

We aimed to (a) replicate this evidence, using age as a proxy for peri/menopausal status; (b) investigate how clinical presentation is affected by concomitant factors, including hyperprolactinaemia, dose and metabolism of prescribed antipsychotics using cross-sectional and longitudinal analyses.

Secondary analysis on 174 women aged 18–65, from the IMPaCT (Improving physical health and reducing substance use in psychosis) randomised controlled trial. We compared women aged below (N = 65) and above 40 (N = 109) for (a) mental health status with the Positive and Negative Syndrome Scale (PANSS) and Montgomery Asberg Depression Rating Scale; (b) current medications and (c) prolactin levels, at baseline and at follow-up (12/15 months later).

Women aged above 40 showed higher baseline PANSS total score (mean ± s.d. = 53.4 ± 14.1 v. 48.0 ± 13.0, p = 0.01) and general symptoms scores (28.0 ± 7.4 v. 25.7 ± 7.8, p = 0.03) than their younger counterparts. Progressive sub-analysis revealed that this age-related difference was observed only in women with non-affective psychosis (n = 93) (PANSS total score: 57.1 ± 13.6 v. 47.0 ± 14.4, p < 0.005) and in those prescribed antipsychotic monotherapy with olanzapine or clozapine (n = 25) (PANSS total score: 63 ± 16.4 v. 42.8 ± 10.9, p < 0.05).

Among all women with hyperprolactinaemia, those aged above 40 also had higher PANSS positive scores than their younger counterparts. No longitudinal differences were found between age groups.

Women aged above 40 showed worse psychotic symptoms than younger women. This difference seems diagnosis-specific and may be influenced by antipsychotics metabolism. Further longitudinal data are needed considering the menopause transition.

Understanding premorbid socioemotional trajectories in schizophrenia is crucial for early identification and potential primary prevention. Studies in adults with schizophrenia suggest similar socioemotional premorbid difficulties, but are limited by their retrospective design.

To contribute new insights into the premorbid socioemotional characteristics of schizophrenia, beyond the biases of retrospective studies, this research investigates three educational socioemotional dimensions in children who later developed the disorder.

We conducted a case–control study using prospectively collected data, examining childhood differences in perceived parental support, self-esteem and school motivation, and growth mindset (intelligence can improve through effort) among individuals who later developed schizophrenia (n = 341) and their classmates (n = 20 567). We constructed z-normalised indicators based on standardised national tests administered in fourth, eighth and tenth grades in Chile. Mixed linear models accounted for repeated measures and adjusted for educational level, gender, grade point average, school and year.

Children later diagnosed with schizophrenia reported less parental educational support compared with their classmates (β = −0.276, 95% CI −0.388 to −0.163). Only girls who later developed schizophrenia reported lower self-esteem and school motivation than their peers (β = −0.290, 95% CI −0.498 to −0.131). Contrary to our hypothesis, children who later developed schizophrenia showed a higher growth mindset (β = 0.287, 95% CI 0.077–0.497).

Our results suggest that premorbid socioemotional characteristics in schizophrenia are detectable in childhood and may vary by gender. These findings highlight the potential of educational settings as platforms for preventive interventions aimed at enhancing parental support and monitoring students’ psycho-emotional well-being, while acknowledging gender-specific developmental trajectories and heterogeneity in premorbid functioning.

Objective Structured Clinical Examinations (OSCEs) are a major component of summative assessment for final year medical students. Psychiatry OSCEs may pose particular challenges, including time management, rapport building and completing complex tasks such as capacity and risk assessment. A psychiatry OSCE practice course has been running for final year students at Brighton & Sussex Medical School for several years, but its ongoing impact and alignment with learner needs had not been formally evaluated. This quality improvement project aimed to evaluate the course and iteratively improve it using PDSA methodology, to ensure continued effectiveness and relevance.

Aim: To assess the impact of a psychiatry OSCE practice course on students’ self-reported confidence and preparedness, and to use structured feedback to inform iterative improvements to course delivery.

Pre- and post-course questionnaires were administered across multiple cohorts. Students rated confidence across relevant domains (psychiatry knowledge, psychiatry OSCE ability, preparedness for final OSCEs) and comparator domains (general OSCE ability, preparedness for final written exam) using Likert scales. Qualitative feedback was collected on perceived challenges, preferred case types and most useful elements of the course. Anonymised pre- and post-responses were paired using participant-generated identifiers. Following feedback, targeted changes were implemented between cohorts and evaluated through subsequent PDSA cycles.

Across cohorts, students reported increased confidence and preparedness following the course, with greater improvements in psychiatry-related domains than comparator domains. Confidence in psychiatry OSCE ability showed the greatest increase, improving by a mean of 1.4 points on a 5-point Likert scale. Examiner feedback and practice with repetition were consistently rated as the most valuable components.

Time management was the most frequently anticipated challenge and was in fact cited more often post-course. In response, two key changes were introduced for later cohorts: allowing up to two minutes for students to read OSCE instructions and choose when to begin, mirroring reasonable adjustments available in summative OSCEs; and providing a two-minute verbal warning before the end of the station. In cohorts following these changes, time management was less frequently cited as the most challenging aspect post-course.

This QI project demonstrates that a psychiatry OSCE practice course improves student confidence, and that iterative, learner-informed adjustments enhance realism, inclusivity and educational value. Simple changes to timing and communication addressed key student concerns, particularly around time management and accessibility. Ongoing evaluation will aid refinement and sustainability of the course. These findings may inform design of similar courses across other medical schools.

The integrated motivational–volitional (IMV) model of suicidal behaviour has received growing empirical support, yet few studies have tested its core pathways (defeat → entrapment → suicidal ideation → suicide attempts) in clinical psychiatric adolescent populations. Evidence on volitional moderators influencing the transition from ideation to action remains limited.

This study aimed to (a) test the core pathways of the IMV model and (b) examine whether volitional moderators differentiate between adolescents with suicidal ideation and those who have attempted suicide.

In this cross-sectional study, 203 Danish adolescents aged 13–19 years were recruited from an out-patient child and adolescent psychiatry department, including patients in treatment or referred for initial assessment. Participants completed validated measures assessing IMV constructs. Path analysis tested the core pathways and multinomial logistic regression examined associations between volitional moderators and group membership (no suicidal behaviour, suicidal ideation only and suicide attempt), with Wald tests comparing effects across outcomes.

Findings supported the core IMV pathway, with the entrapment–ideation pathway being weakest. Volitional moderators were more strongly associated with suicide attempts than suicidal ideation, with significant differences confirmed by Wald tests. A dose–response pattern showed increasing likelihood of suicide attempts with greater exposure to volitional moderators; effect sizes differed significantly between ideation (odds ratio 2.21) and attempts (odds ratio 3.94).

Results support the IMV model and highlight the role of volitional moderators in differentiating between suicidal ideation and attempts. These findings support a shift towards theory-informed psychosocial assessment in clinical adolescent populations.

Employment rates remain critically low among individuals with severe mental illness. Although social cognition explains a significant portion of the variance in functional outcomes, research into social cognitive interventions has remained scarce.

To evaluate the impact of a social cognitive remediation (SCR) programme on functional and psychological outcomes over a 6-month post-intervention period.

This randomised controlled trial was conducted across three sheltered employment centres in France (2020–2024; ClinicalTrials.gov protocol record: 2019-A00124-53). We evaluated the efficacy of a 12-week SCR programme versus an active control with respect to the ratio of hours effectively worked versus those expected at 6 months post treatment (primary outcome). Secondary outcomes included patient-reported measures of self-esteem, internalised stigma, recovery and anxiety. Intention-to-treat and per-protocol effects were estimated using targeted minimum loss-based estimation, with attrition accounted for through inverse probability of censoring weights.

Of the 105 randomised participants (SCR: n = 53; control: n = 52; mean age: 35.6 [s.d. = 8.8] years; 71% male), 39 dropped out, yielding a per-protocol sample of 33 participants per arm. Attrition was 28% immediately after the intervention and 37% at 6-month follow-up. SCR was associated with a 6.5% increase in the ratio of hours worked versus those expected in the intention-to-treat analysis and a 3.6% increase in the per-protocol analysis (both P < 0.05). SCR also reduced internalised stigma at 6 months post treatment (P < 0.03).

Our findings suggest that a 3-month SCR programme improves employment maintenance and reduces internalised stigma in individuals with severe mental illness. Future research should use larger samples and improve retention to confirm these findings.

Immersive virtual reality (VR) is increasingly being explored as a potential modality for the assessment and treatment of a range of mental health conditions, including anxiety disorders. To date, many of the VR interventions that have been developed for anxiety disorders draw upon the principles of exposure therapy, and a growing body of evidence has begun to demonstrate their efficacy. However, little is known about the ways in which the individuals for whom these interventions are designed perceive and experience them, despite the importance of understanding both patient and practitioner perspectives to enable effective intervention development and evaluation. The aim of this systematic review was to identify and synthesise the existing qualitative evidence-base in relation to exposure-based immersive VR interventions for the treatment of anxiety disorders.

We systematically searched PubMed, Scopus, Medline, Embase, PsychINFO, OVID interface, MedArXiv and PsyArXiv for qualitative and mixed-methods studies reporting patient and therapist perspectives, experiences and recommendations relevant to the focus of our review. In total, 9714 abstracts were screened and 954 full-text manuscripts were retrieved, with 12 studies meeting the review inclusion criteria. The qualitative results sections of articles were coded inductively line-by-line, and the data was synthesised using thematic synthesis.

Twelve descriptive themes and four analytical themes were generated through the analysis. The analytical themes were: 1. Contingent experiences of anxiety (facilitators of and barriers to experiencing symptoms of anxiety during VR exposure); 2. Learning beyond exposure (the ways in which participants experienced benefits from VR exposure that extended beyond the intended mechanisms of change underpinning exposure therapy approaches); 3. “Somewhere between being there and not being there” (the nature of an anxiety-provoking ‘reality’ that is virtual, and how experiences of the virtual world relate to experiences of anxiety in real life); and 4. The patient, the therapist, and the Head-Mounted Device (how VR exposure-based interventions might best be positioned and delivered in the context of psychotherapy, and how VR might present both benefits and barriers for patients, therapists, and for the therapeutic relationship).

This synthesis of the perspectives, experiences and recommendations of patients and therapists in relation to exposure-based VR interventions for anxiety disorders has a range of implications, for both practice and research. These include a number of recommendations for the design, delivery and evaluation of VR interventions for anxiety disorders, ensuring they better meet the needs of the people who use them.

Discriminatory practices and barriers to care are increasingly recognised as a significant challenge for mental healthcare institutions. Yet, little research has considered what measures people with experience of using mental health services and mental healthcare service providers recommend to implement anti-discrimination within mental healthcare.

This study aims to explore the perspectives and recommendations of marginalised people with experience of using mental health services, mental healthcare service providers and psychosocial counsellors, to inform more equitable mental healthcare.

Between May 2022 and June 2023, we conducted 17 semi-structured qualitative interviews and 2 focus groups with psychosocial counsellors, people with experience of using mental health services and mental healthcare service providers. Data analysis followed structuring qualitative content analysis, combined with participatory methods.

Study participants recommended interpersonal, organisational and structural measures to address mental healthcare inequities. On an interpersonal level, they emphasised providers’ behaviour and attitudes toward discrimination. Organisationally, they called for a comprehensive intersectional care framework, fostering inclusive therapy environments, increasing staff diversity and implementing continuous anti-discrimination training. Structurally, they advocated for discrimination-critical therapy materials, revised curricula and removing barriers to medical education and healthcare.

The study yielded suggestions for anti-discriminatory, critical consciousness-based and inclusive practices on the interpersonal, organisational and structural levels of mental healthcare. It offers important insights for research devoted to implementing and evaluating such measures.

Preventing episodes involving aggression and reducing coercive measures are important goals in in-patient mental health settings. Antecedents may provide insight into how episodes are described to develop. However, most studies reflect staff perspectives, and often describe and temporally specify antecedents inconsistently.

This scoping review mapped reported antecedents to episodes involving aggression and episodes involving coercive measures, and identified which appeared shared or specific to either phenomenon.

This review followed the Joanna Briggs Institute methodology and Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews guidance, and included 39 studies from systematic searches across Ovid Medline, APA PsycINFO and Scopus. Reported antecedents were extracted, standardised and mapped to six analytical domains.

The review mapped 240 antecedents, many of which appeared shared across the phenomena. Patient studies emphasised experiences of restrictive care, loss of autonomy and poor interaction quality. Staff studies emphasised immediate, observable situations related to risk management, such as patient aggression, denied requests and interpersonal conflict. Most studies did not specify the temporal boundaries of antecedents.

The perspectives represented in studies and the ways antecedents are conceptualised influence which antecedents become visible in the literature. Overlapping antecedents indicate that episodes involving aggression and episodes involving coercive measures are often described as part of the same escalation process, although patient and staff studies seem to highlight different stages. Prevention efforts therefore require attention to the entire trajectory, and to the point at which staff perceive intervention as necessary. Future studies should incorporate both perspectives, prioritise patient involvement, and more clearly define and temporally specify antecedents.

In 2018, the UK government commissioned National Health Service Talking Therapies (NHS TT) services to provide integrated mental and physical health care for individuals with a long-term condition (LTC) and coexisting depression and/or anxiety. Nevertheless, evidence on the effectiveness of NHS TT in physical LTCs remains inconsistent.

This review aims to evaluate the impact of NHS TT on mental health outcomes among adults with physical LTCs.

We conducted a systematic review and meta-analysis of quantitative studies published between 2008 and 2024. We used several databases for the search, including Embase, MEDLINE, Cochrane Library, NHS Evidence, PsycINFO, Bielefeld Academic Search Engine and ProQuest. We combined terms related to NHS TT, LTCs and mental health outcomes to identify eligible studies. The Population, Intervention, Comparison, Outcomes and Study framework guided the development of the inclusion criteria. We employed the random-effects model for meta-analysis and assessed heterogeneity bias using the I2 statistic, and the Newcastle–Ottawa scale to evaluate the overall quality of the evidence.

Twenty-four studies met the inclusion criteria. The meta-analysis revealed a significant pre–post NHS TT intervention effect on reliable improvement (odds ratio 0.77, 95% CI: 0.60–0.98) and reliable recovery (odds ratio 0.80, CI: 0.68–0.95). There were no significant differences in NHS TT accessibility (e.g. treatment engagement) between participants with and without LTCs (odds ratio 0.97, 95% CI: 0.82–1.14). However, heterogeneity between the studies was high (>90%).

The observed evidence provides reassurance for individuals with LTCs engaging with treatment; however, the association with post-treatment distress is still of concern. Furthermore, extensive and rigorous research is needed to strengthen and guide service development for individuals with LTCs, thereby improving effectiveness.

Difficulties with social cognition, particularly with mentalising, have been hypothesised to increase the risk of, and affect recovery from, trauma and post-traumatic stress disorder (PTSD). We lack a comprehensive picture of the nature of social cognitive impairments in people with PTSD.

To assess whether variation in social cognition is associated with trauma and PTSD.

Ninety-eight participants with PTSD symptoms and 99 controls were recruited from tertiary PTSD services and the Prolific online platform. All participants completed a battery of social cognition tasks covering face emotion recognition, social attribution and mentalisation. They also completed a trauma measure, PTSD screening measure and verbal IQ task. Logistic regression analyses were used to examine the relationship between social cognition and PTSD, and were adjusted for age, gender, autism and verbal IQ.

There was some evidence that hypomentalisation, measured via the Reflective Functioning Questionnaire, was associated with exposure to trauma (adjusted odds ratio 1.80, 95% CI 1.03–3.14, p = 0.040) and increased odds of PTSD symptoms (adjusted odds ratio 4.29, 95% CI 2.76–6.66, p < 0.001). Higher scores for use of mentalising language on a naturalistic video-based spontaneous mentalising task (Modified-STOMP; potentially reflecting hypermentalising) were also associated with increased odds of PTSD symptoms (adjusted odds ratio 1.65, 95% CI 1.17–2.33, p = 0.004) in the main analysis, but not in the sensitivity analysis restricted to the Prolific-only sample.

Our results show an association between mentalising difficulties and PTSD symptoms, indicating mentalising might be a target for future risk prediction.