Facts on psychotraumatology

ABSTRACT

Daily news is dominated by reports of traumatic events across the world. Is trauma indeed rather the norm than the exception? What are the facts? How can we better understand, prevent and treat the consequences of trauma? This past year the European Journal of Psychotraumatology (EJPT) has again tried to address these questions. With the gold Open Access model articles in the journal are being made immediately available without any barriers to access. In Europe, promising developments with regard to Open Science emerged in 2018, for instance, cOAlition S with their ambitious Plan S boosting the transition to full Open Access. In this editorial these and other developments in the journal, such as Registered Reports as a way to reduce Questionable Research Practices (QRPs), journal metrics, and the ESTSS EJPT award finalists for best paper of 2018 are being presented.

HIGHLIGHTS

• The European Journal of Psychotraumatology (EJPT) is gold Open Access, well read, cited, and has global impact.• Plan S (put forward by cOAlition S), requires 100% Open Access from publicly funded projects that start after 2020 and will give a boost to the Open Access development.• Registered Reports are one way to reduce Questionable Research Practices (QRPs).

Las noticias del día a día están dominadas por reportajes de eventos traumáticos al rededor del mundo. ¿Es en realidad el trauma la norma  en vez de la excepción? ¿Cuáles son los datos? ¿Cómo podemos entender mejor, prevenir y tratar las consecuencias del trauma? Este último año la Revista Europea de Psicotraumatología ha intentado de nuevo abordar estas preguntas. Con el modelo gold Open Access, los artículos en la revista se ponen a disposición inmediatamente sin ningún tipo de barreras de acceso. En Europa, en el 2018 surgieron avances prometedores con respecto a las Ciencias Abiertas (Open Science), como por ejemplo, cOAlition S con su ambicioso Plan S, alentando la transición a Acceso Abierto total. En esta editorial, se presentan estos y otros desarrollos en la revista, como Informes Registrados como una forma de reducir las Prácticas de investigación cuestionable, mediciones de la revista, y los finalistas del premio ESTSS EJPT  al mejor artículo del año 2018.

每天的新闻被世界各地的创伤事件报道所主导。创伤确实如此常见而不是例外吗？哪些是事实？我们怎样才能更好地理解、预防和治疗创伤的后果？过去一年，欧洲创伤心理学期刊（The European Journal of Psychotraumatology，EJPT）继续尝试回应这些问题。使用黄金开放获取模式（gold Open Access model），期刊中的论文立时可读，没有任何获取壁垒。在欧洲，2018年出现了开放科学（Open Science）的可喜发展。例如，cOAlition S凭借其雄心勃勃的S计划 （Plan S）推动向完全开放获取的过渡。在这篇社论中将提到这些内容和期刊的其他进展：例如，注册报告（Registered Reports）作为减少可疑研究实践（Questionable Research Practices，QRPs）的方式，期刊指标，以及2018年ESTSS EJPT最佳论文奖项的入围获奖名单。

KEYWORDS:

• Psychotrauma
• PTSD
• Open Access
• impact factor
• Altmetrics
• special issues
• registered reports

PALABRAS CLAVES:

• Psicotrauma
• TEPT
• Acceso Abierto
• Métricas alternativas
• edición especial
• informes registrados

关键词:

• 心理创伤；创伤后应激障碍；开放获取；影响因子；替代计量学；特刊；注册报告

1. Facts on psychotraumatology?

Daily news reports are dominated by dramatic accidents, terrorist attacks, major disasters, children dying of famine and horrific war scenes. Every year it gets worse. Global warming, increasing migration, #MeToo and sexual harassment are filling the news. In the fascinating book by the late Rosling, Rosling Rönnlund, and Rosling (2018), with the interesting title in times of fake news and fact checks ‘Factfulness’, several misconceptions about global trends are described. It appears that our knowledge is not very fact based: ‘chimpanzee choosing answers at random consistently outguess teachers, journalists, Nobel laureates, and investment bankers’ (https://www.gapminder.org/factfulness-book/). Child mortality rates are lower than ever, average life expectancy is increasing, fewer people live in poverty, girls are better educated and there are less wars in the world.

But, unfortunately, we are not there yet. The conclusion of the most downloaded and cited paper in European Journal of Psychotraumatology (EJPT) last year is: ‘lifetime trauma exposure is the norm in most countries’ (Kessler et al., 2017). Child abuse is prevalent with long-term consequences (e.g. Clemens et al., 2018; Schnyder et al., 2017). Severe earthquakes impact mental and physical health (e.g. Li et al., 2018). Indeed, 70.4% of respondents in the worldwide WHO surveys reported lifetime traumas. Multiplying trauma prevalence by trauma-specific PTSD risk and persistence, the burden of PTSD was 77.7 person-years/100 respondents. The highest burden was reported for intimate partner sexual violence which – although relatively uncommon – is associated with high PTSD risk (Kessler et al., 2017).

Every traumatic event is a horrifying experience to the individual. We hope, with all the contributions in EJPT, to have been working towards more ‘facts’ with regard to understanding, prevention and improvement interventions for trauma survivors. This may be our share in making the world a better place for all those affected by trauma.

2. New developments in open science

2.1. Plan S

Since its launch, this journal has been eager to share its articles immediately and without any barriers to access, so-called gold Open Access, so that patients and their families, clinicians, researchers and policy makers can be informed about the latest development in psychotraumatology.

Interesting developments with regard to Open Science emerged in Europe in 2018. To hasten the transition to full and immediate Open Access, cOAlition S, a group of national research funding organizations, announced their ambitious Plan S. With the initial signatures of 11 funders and support from the European Commission and the European Research Council (ERC), cOAlition S signals a commitment to implement, by 1 January 2020, the necessary measures to fulfil its main principle:

By 2020 scientific publications that result from research funded by public grants provided by participating national and European research councils and funding bodies must be published in compliant Open Access Journals or on compliant Open Access Platforms (from https://www.coalition-s.org).

While fully Open Access journals such as EJPT are obviously pleased with these developments, concerns have been raised about the feasibility and ambitious timelines the plan announces. These developments also bring some insecurity, especially among young researchers who are worried about not being able to publish in prestigious high-ranking journals (e.g. Nature, Science), many of which are currently subscription-based and may not comply with Plan S. Uncertainty also exists in relation to the plan’s requirement for institutions and funders to shift their structures for research assessment from awarding publication in high ranking journals (with high impact factors) to recognizing publishing in Open Access outlets. Publishers are grappling with Plan S to identify opportunities to develop their Open Access programmes, to understand which subscription titles may be most affected, to bring attention to elements of Plan S that need further clarification and to take appropriate action.

2.2. Registered Reports

Recently the journal introduced Registered Reports as a new submission format (Spiller & Olff, 2018). Registered Reports implies inviting authors to submit their study protocols for peer review before starting their study. If their protocol passes peer review, the paper reporting on the results is provisionally accepted for publication, as long as the authors follow through with the registered methodology, independent on whether results are negative or positive, thus eliminating potential bias against negative results. It is another step toward reducing Questionable Research Practices (QRP), including ‘low statistical power, selective reporting of results and publication bias, while allowing complete flexibility to report serendipitous findings’ (Center for Open Science).

The movement toward Open Science has implications across the research lifecycle, from study design to publication and beyond, including data sharing and re-use. In a panel at the ESTSS conference 14–16 June in Rotterdam, we will discuss the exciting developments in Open Access publishing, including the ambitious EU Plan S, the use and reuse of data, and how to improve QRPs.

3. What is the journal about?

Figure 1 shows a visualization of the content of published articles in EJPT, based on author keywords using VOSviewer (van Eck & Waltman, 2017; www.vosviewer.com). Obviously, trauma and PTSD are central to the journal, but it shows clusters of areas that are being addressed like topics around complex PTSD, research methods or types of treatment. Interestingly, a neurobiology cluster shows that this type of research is mostly done in a military population. With the majority of the military population being male, this might indicate that future research should focus more on the female brain and neuroendocrine system, as would be in line with the journals gender policy (see Olff, 2016). This brief presentation is only based on PubMed author keywords. It is asking for a more detailed evaluation when the journal will reach its 10-year anniversary.

Figure 1. Visualization of content in EJPT based on PubMed author keywords to 23 January 2019 (VOSviewer).

Figure 2. Article metrics example for Kessler et al., 2017 (retrieved 21 January 2019).

Figure 3. Impact factor development European Journal of Psychotraumatology.

4. ESTSS EJPT best paper of 2018 award

Associate and guest (ex)editors, members of the Editorial board, abstract translators and members of the ESTSS board were invited to nominate papers for the ESTSS EJPT 2017 Award. Criteria were free and broad, for example: sound methodology, relevance for clinical practice, innovation, global reach, outstanding science, theoretically advancing the field, thought provoking, etc. We received 58 votes. The finalists are presented in Table 1 including some quotes of the motivations. There is quite some diversity from providing a practical update of the state of the art in different countries, to methods and technology, the PTSD diagnosis and innovations in treatment. The award winner will be announced at the ESTSS Conference in Rotterdam 14–16 June.

Table 1. Finalists for the ESTSS EJPT best paper of 2019.

Trauma and trauma care in Europe (Schafer et al., 2018)	‘The review paper provides an important overview of the current state of trauma care systems in 15 European countries (ESTSS society members only) by including state of the art of interventions, current challenges in caring for survivors and the topics that need to be most urgently addressed. Thus, the review facilitates a European collaboration where it’s possible to benefit from history and experience and take important steps in relation to facilitating evidence-based treatment while taking cultural and economic diversity into consideration’; ‘helpful overview of posttraumatic mental health promotion across Europe’; ‘relates to the core of ESTSS’
e-PTSD: an overview on how new technologies can improve prediction and assessment of Posttraumatic Stress Disorder (PTSD) (Bourla, Mouchabac, El Hage W. & Ferreri F., 2018)	‘This paper provides a helpful overview of how novel technological methods can help researchers and clinicians identify those in need of support following trauma exposure. Not only does it review various methods, but it might also generate research ideas in the readers’; ‘ for their thought-provoking topics and their relevance in bridging up clinical practice and theoretical/technical advance’; ‘Given the increasing presence and use of digital media, it is a promising avenue for efficient early and large scale detection of PTSD symptoms’; ‘technology has the future’
Application of data pooling to longitudinal studies of early post-traumatic stress disorder (PTSD): the International Consortium to Predict PTSD (ICPP) project (Qi et al., 2018)	‘This article describes an important approach to advancing our scientific understanding of the longitudinal course of PTSD by pooling the results from individual investigators’; ‘to create an international repository database’; ‘development of a new, major resource for the field’; ‘because data harmonization is critically important for the advancement of the field’; ‘a good example of added value of pooling data and collaborating internationally’
PTSD and Complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania (Karatzias et al., 2017)	‘This comprehensive multi-national review provides the most thorough and up-to-date summary of research on the very important and controversial topic of the nature and structure of PTSD and its complex variants’; ‘aims at opening discussion for current (and future usage of) criteria and invites to keep on researching its prevalence, addressing the need of using cPTSD as a different identity from PTSD’
Effectiveness of an intensive treatment programme combining prolonged exposure and eye movement desensitization and reprocessing for severe post-traumatic stress disorder (Van Woudenberg et al., 2018)	This is one of several articles* that were described as: ‘very promising innovations in treatment’ or ‘interesting examples of novel treatment delivery modalities and as attempts to reduce patients dropping out of trauma-focused treatments before they receive an appropriate dose of treatment’ ‘It describes a fresh new perspective on delivering exposure therapy and clearly describes that controlled studies are needed, which I’m sure will be inspired by this paper’ *A five-day inpatient EMDR treatment programme for PTSD: pilot study (Mendez, Nijdam, Ter Heide, van der Aa, & Olff, 2018) Intensive prolonged exposure therapy for chronic PTSD patients following multiple trauma and multiple treatment attempts (Hendriks et al., 2018) Therapist rotation: a novel approach for implementation of trauma-focused treatment in post-traumatic stress disorder (Van Minnen et al., 2018) Moving forward in treatment of posttraumatic stress disorder: innovations to exposure-based therapy (Nijdam & Vermetten, 2018)

5. Special issues

EJPT publishes special issues (or special focus) on topics that we wish to put in the spotlight, that we feel are currently important and deserve more attention. Often Guest Editors are sought to see the papers through peer review. On the journal website open calls are listed. Papers are published one by one, from the date the call is open. Please check out the special issues page for published issues and more detail.

Currently these issues are in progress:

• Sleep, circadian systems and traumatic stress (Open for submissions)

Disruptions in sleep and the circadian system play important roles in the development and maintenance of traumatic stress. This special issue seeks to highlight and review recent advances from human and animal state-of-the-art-sleep and chronobiological research that enhances our understanding of the development and maintenance of traumatic stress and trauma-related disorders. Guest Editor: Agorastos T. Agorastos.

• Integrating and evaluating sex and gender in psychotrauma research (Open for submissions)

EJPT’s gender policy asks authors to report the sex of research subjects, justify single sex studies, discriminate between sex and gender (mostly for human research), analyse how sex or gender impact the results, and discuss sex and gender issues when relevant (Olff, 2016). Is this special issue we seek to provide state-of-the-art-research that enhances our understanding of the way sex and gender influence (mental) health experiences after exposure to trauma and how they can inform psychosocial care, ranging from public health to specialized treatment. Guest Editor: Willemien Langeland.

• Trauma and trauma sequelae in elderly (Open for submissions)

The world-wide population has been growing older for decades, but thus far trauma and its sequelae in the elderly population is a rather under-researched topic. With this special focus we aim to learn more about the long-term consequences of traumatization with respect to the assessment of disorders and their treatment, the effects of traumatization during older age, traumatic experiences over the lifespan and the impact of aging, etc. Guest Editor: Brigitte Lueger-Schuster.

• Complementary and integrative interventions for PTSD (Open for submissions)

In this issue in progress, fascinating contributions appear that shine light on mechanisms of action or effectiveness of complementary, innovative or outside the mainstream type of interventions, for instance, ‘How do placebos work?’ by Benedetti, Piedimonte, and Frisaldi, 2018. Guest Editors: Barbara Niles and Ariel Lang.

The following issues are currently in their final stages (calls closed):

• Traumatic loss. Guest Editors: Paul Boelen and Geert E. Smid

• e-Health applications in the field of traumatic stress. Guest Editors: Heleen Riper and Anne Bakker

6. Translations

The abstracts of papers published in EJPT are being translated into many languages, with Spanish and Chinese translations being incorporated into the published article, including the pdf version. Carolina Salgado and her ACET team in Chile (Spanish) and Yulan Qing (Chinese) have been doing an outstanding job in translating every abstract within three working days.

Abstracts are also available in several other languages due to efforts of a team of translators of ESTSS’s member societies (to be found on society websites in Dutch, German, French, and Portuguese, and through newsletters in Lithuanian, Polish, Italian, Georgian and Russian). Links to abstracts are currently being built into the new website of ESTSS.

7. EJPT metrics

7.1. Article downloads and Altmetric

Article downloads by region in 2018 show that the number of downloads increased by 47% compared to last year in 2018. The number per continent shows, compared to last year, a similar distribution around the world with about one-third (35%) from North America, one-third (33%) from Northern and Central Europe and one-third from the rest of the world.

The top five most downloaded articles in 2018 were:

1. Trauma and PTSD in the WHO World Mental Health Surveys (Kessler et al., 2017)

2. A trauma-focused approach for patients with tinnitus: the effectiveness of eye movement desensitization and reprocessing – a multicentre pilot trial (Rikkert, van Rood, de Roos, Ratter, & van Den Hout, 2018)

3. Strengthening mental health care systems for Syrian refugees in Europe and the Middle East: integrating scalable psychological interventions in eight countries (Sijbrandij et al., 2017)

4. Clinical Virtual Reality tools to advance the prevention, assessment and treatment of PTSD (Rizzo & Shilling, 2017)

5. The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD (Wagenmans, Van Minnen, Sleijpen, & De Jongh, 2018)

Interestingly, highest scoring papers on Altmetric are not always the same papers as those downloaded. The scores (for an example see Figure 2) mostly reflect Twitter and LinkedIn activity and some news and blog items:

1. The impact of childhood sexual abuse on the outcome of intensive trauma-focused treatment for PTSD (Wagenmans et al., 2018)

2. Involving children in disaster risk reduction: the importance of participation (Pfefferbaum, Pfefferbaum, & Van Horn, 2018)

3. The Trauma and Life Events (TALE) checklist: development of a tool for improving routine screening in people with psychosis (Carr, Hardy, & Fornells-Ambrojo, 2018)

4. A trauma-focused approach for patients with tinnitus: the effectiveness of eye movement desensitization and reprocessing – a multicentre pilot trial (Rikkert et al., 2018)

5. PTSD and Complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania (Karatzias et al., 2017)

7.2. Citations and impact factor

EJPT was launched in December 2010 (Olff, 2010, 2018). In 2019, slightly over eight years later, we started Volume 10.

The journal’s 2017 impact factor is 4.209 (Figure 3), increasing from 3.278 in 2016, ranking 12/127 in the Psychology, Clinical and 20/142 Psychiatry JCR category.

The top three cited articles for the 2017 impact factor were:

1. Restoring large-scale brain networks in PTSD and related disorders: a proposal for neuroscientifically-informed treatment interventions (Lanius, Frewen, Tursich, Jetly, & McKinnon, 2015)

2. Psychotherapies for PTSD: what do they have in common? (Schnyder et al., 2015)

3. Mobile mental health: a challenging research agenda (Olff, 2015)

8. Editorial team

With a record number of submissions last year the journal also needed to extend the workforce for proper and timely review of our papers. We therefore extended the editorial team with two excellent new Associate Editors:

• Ananda Amstadter, Virginia Commonwealth University, USA

• Eric Bui, Harvard Medical School, USA

With Ananda and Eric we have strengthened the neurobiological side of the journal. I am very proud and grateful to have this fantastic group of Associate Editors.

New members also have joined the Editorial board. It is only because of their active involvement that we can have a first decision within several weeks. We also owe a lot to the Guest Editors and external reviewers that make this journal such a success.

With all these ambassadors for the journal in 2019 and another year of strong submissions, we hope to be contributing to ‘facts’ in psychotraumatology with regard to understanding, preventing and treating the consequences of psychotrauma.