{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,3]],"date-time":"2026-10-03T03:55:37Z","timestamp":1790999737572,"version":"4.1.0"},"reference-count":73,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T00:00:00Z","timestamp":1738195200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Behavioral Sciences"],"abstract":"<jats:p>Traumatic experiences are significant life events that are thought to impact one\u2019s personal life narrative and narrative identity. Individuals who have experienced trauma may display fragmented memories and decreased narrative cohesion, resulting in trauma narratives that are disjointed and poorly integrated into the larger picture of their lives. Metacognition, defined as the ability to form increasingly complex and integrated ideas about the self, others, and the wider world, offers a framework to better understand life narratives and has been proposed as a construct that allows personal narratives to evolve in response to new experiences. In this paper, we will review the alterations commonly observed in trauma narratives. We will utilize the integrated model of metacognition as a framework to understand these deviations with an eye toward clinical implications. Although treatments that focus on trauma narratives exist, we argue that the study of metacognition provides unique insights into the process of integration of traumatic experience into an evolving personal narrative and may allow for more complete treatment of trauma-related disorders.<\/jats:p>","DOI":"10.3390\/bs15020150","type":"journal-article","created":{"date-parts":[[2025,1,30]],"date-time":"2025-01-30T04:01:39Z","timestamp":1738209699000},"page":"150","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":16,"title":["Personal Narratives in Trauma-Related Disorders: Contributions from a Metacognitive Approach and Treatment Considerations"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-8698-074X","authenticated-orcid":false,"given":"Courtney N.","family":"Wiesepape","sequence":"first","affiliation":[{"name":"Austin VA Clinic, Veterans Affairs Central Texas Health Care, Austin, TX 78744, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-7616-4761","authenticated-orcid":false,"given":"Elizabeth A.","family":"Smith","sequence":"additional","affiliation":[{"name":"Department of Psychology, Indiana State University, Terre Haute, IN 47809, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew J.","family":"Muth","sequence":"additional","affiliation":[{"name":"Portland VA Medical Center, Portland, OR 97239, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2470-629X","authenticated-orcid":false,"given":"Laura A.","family":"Faith","sequence":"additional","affiliation":[{"name":"Richard L. Roudebush VA Medical Center, Indianapolis, IN 46202, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,1,30]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"100389","DOI":"10.1016\/j.ejtd.2024.100389","article-title":"World assumptions and post-traumatic symptoms: The moderating role of metacognition","volume":"8","author":"Horesh","year":"2024","journal-title":"European Journal of Trauma & Dissociation"},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"774","DOI":"10.1016\/j.beth.2019.11.003","article-title":"Predictors of dropout in cognitive processing therapy for PTSD: An examination of trauma narrative content","volume":"51","author":"Alpert","year":"2020","journal-title":"Behavior Therapy"},{"key":"ref_3","doi-asserted-by":"crossref","unstructured":"American Psychiatric Association (2022). Diagnostic and statistical manual of mental disorders (5th ed., text rev.), American Psychiatric Association.","DOI":"10.1176\/appi.books.9780890425787"},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"R608","DOI":"10.1016\/j.cub.2019.05.044","article-title":"What is cognition?","volume":"29","author":"Bayne","year":"2019","journal-title":"Current Biology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/j.brat.2019.03.003","article-title":"Predictors of attendance and dropout in three randomized controlled trials of PTSD treatment for active duty service members","volume":"118","author":"Berke","year":"2019","journal-title":"Behaviour Research and Therapy"},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"116","DOI":"10.1016\/j.jad.2020.04.009","article-title":"Longitudinal changes in trauma narratives over the first year and associations with coping and mental health","volume":"272","author":"Booker","year":"2020","journal-title":"Journal of Affective Disorders"},{"key":"ref_7","doi-asserted-by":"crossref","unstructured":"Bremer-Hoeve, S., van Vliet, N. I., van Bronswijk, S. C., Huntjens, R. J. C., de Jongh, A., and van Dijk, M. K. (2023). Predictors of treatment dropout in patients with posttraumatic stress disorder due to childhood abuse. Frontiers in Psychiatry, 14.","DOI":"10.3389\/fpsyt.2023.1194669"},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"198","DOI":"10.1177\/1524838009334448","article-title":"The epidemiology of trauma, PTSD, and other posttrauma disorders","volume":"10","author":"Breslau","year":"2009","journal-title":"Trauma, Violence & Abuse"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1002\/cpp.2633","article-title":"The metacognitive model of post-traumatic stress disorder and metacognitive therapy for post-traumatic stress disorder: A systematic review","volume":"29","author":"Brown","year":"2022","journal-title":"Clinical Psychology & Psychotherapy"},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1176\/appi.psychotherapy.20180035","article-title":"Metacognitive Reflection and Insight Therapy (MERIT): Application to a long-term therapy case of Borderline Personality Disorder","volume":"71","author":"Buck","year":"2018","journal-title":"American Journal of Psychotherapy"},{"key":"ref_11","first-page":"14","article-title":"Post-traumatic stress disorder and acute stress disorder I: Their nature and assessment considerations","volume":"2","author":"Cahill","year":"2005","journal-title":"Psychiatry"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1037\/tra0000041","article-title":"Memory and narrative of traumatic events: A literature review","volume":"8","author":"Crespo","year":"2016","journal-title":"Psychological Trauma: Theory, Research, Practice, and Policy"},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"128","DOI":"10.1016\/j.cpr.2015.10.003","article-title":"Psychological treatments for adults with posttraumatic stress disorder: A systematic review and meta-analysis","volume":"43","author":"Cusack","year":"2016","journal-title":"Clinical Psychology Review"},{"key":"ref_14","first-page":"e39157","article-title":"Unknown, underserved, underreported: A case for differentiation in trauma disorder classification and diagnosis","volume":"15","author":"Cutlip","year":"2023","journal-title":"Cureus"},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"182","DOI":"10.1016\/j.psychres.2016.01.045","article-title":"Metacognitive capacity predicts severity of trauma-related dysfunctional cognitions in adults with posttraumatic stress disorder","volume":"237","author":"Davis","year":"2016","journal-title":"Psychiatry Research"},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"2066456","DOI":"10.1080\/20008198.2022.2066456","article-title":"Change in prevalence of post-traumatic stress disorder in the two years following trauma: A meta-analytic study","volume":"13","author":"Diamond","year":"2022","journal-title":"European Journal of Psychotraumatology"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"319","DOI":"10.1016\/S0005-7967(99)00123-0","article-title":"A cognitive model of posttraumatic stress disorder","volume":"38","author":"Ehlers","year":"2000","journal-title":"Behaviour Research and Therapy"},{"key":"ref_18","doi-asserted-by":"crossref","unstructured":"Ehlers, A., and Wild, J. (2022). Cognitive therapy for PTSD: Updating memories and meanings of trauma. Evidence based treatments for trauma-related psychological disorders: A practical guide for clinicians, Springer International Publishing.","DOI":"10.1007\/978-3-030-97802-0_9"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"9","DOI":"10.1186\/2051-6673-1-9","article-title":"Complex PTSD, affect dysregulation, and borderline personality disorder","volume":"1","author":"Ford","year":"2014","journal-title":"Borderline Personality Disorder and Emotion Dysregulation"},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"358","DOI":"10.1176\/appi.ps.201800444","article-title":"Mental health treatment delay: A comparison among civilians and veterans of different service eras","volume":"70","author":"Goldberg","year":"2019","journal-title":"Psychiatric Services"},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"21","DOI":"10.1037\/teo0000054","article-title":"Overcoming fragmentation in the treatment of persons with schizophrenia","volume":"37","author":"Hamm","year":"2017","journal-title":"Journal of Theoretical and Philosophical Psychology"},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"186","DOI":"10.1176\/appi.psychotherapy.20180031","article-title":"Metacognitive Reflection and Insight Therapy (MERIT) for persons with a schizophrenia spectrum disorder and interpersonal trauma","volume":"71","author":"Hillis","year":"2018","journal-title":"American Journal of Psychotherapy"},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"460","DOI":"10.1016\/j.jpsychires.2022.10.048","article-title":"Emotional experience and metacognition among people with schizophrenia: Analysis of session by session and outcome of metacognitive-oriented psychotherapy","volume":"156","author":"Igra","year":"2022","journal-title":"Journal of Psychiatric Research"},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"473","DOI":"10.1037\/a0035239","article-title":"Trauma narratives: It\u2019s what you say, not how you say it","volume":"6","author":"Jaeger","year":"2014","journal-title":"Psychological Trauma: Theory, Research, Practice and Policy"},{"key":"ref_25","doi-asserted-by":"crossref","unstructured":"Jirek, S. L. (2016). Narrative reconstruction and post-traumatic growth among trauma survivors: The importance of narrative in social work research and practice. Qualitative Social Work, 16, (2).","DOI":"10.1177\/1473325016656046"},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"262","DOI":"10.1080\/10926771.2013.743942","article-title":"Preliminary findings from a qualitative study of trauma survivors in treatment: Changes in personal narratives","volume":"22","author":"Kallivayalil","year":"2013","journal-title":"Journal of Aggression, Maltreatment & Trauma"},{"key":"ref_27","doi-asserted-by":"crossref","first-page":"481","DOI":"10.1177\/008124630603600304","article-title":"Healing processes in trauma narratives: A review","volume":"36","author":"Kaminer","year":"2006","journal-title":"South African Journal of Psychology"},{"key":"ref_28","doi-asserted-by":"crossref","first-page":"1418103","DOI":"10.1080\/20008198.2017.1418103","article-title":"PTSD and Complex PTSD: ICD-11 updates on concept and measurement in the UK, USA, Germany and Lithuania","volume":"8","author":"Karatzias","year":"2018","journal-title":"European Journal of Psychotraumatology"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"833","DOI":"10.1002\/da.21997","article-title":"Early interventions for PTSD: A review","volume":"29","author":"Kearns","year":"2012","journal-title":"Depression and Anxiety"},{"key":"ref_30","doi-asserted-by":"crossref","first-page":"634","DOI":"10.1177\/1049732319886285","article-title":"A complexity perspective on narrative identity reconstruction in mental health recovery","volume":"30","author":"Kerr","year":"2020","journal-title":"Qualitative Health Research"},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"1353383","DOI":"10.1080\/20008198.2017.1353383","article-title":"Trauma and PTSD in the WHO World Mental Health Surveys","volume":"8","author":"Kessler","year":"2017","journal-title":"European Journal of Psychotraumatology"},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"1048","DOI":"10.1001\/archpsyc.1995.03950240066012","article-title":"Posttraumatic stress disorder in the National Comorbidity Survey","volume":"52","author":"Kessler","year":"1995","journal-title":"Archives of General Psychiatry"},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"NP3153","DOI":"10.1177\/0886260518770652","article-title":"Self-blame and PTSD following sexual assault: A longitudinal analysis","volume":"36","author":"Kline","year":"2021","journal-title":"Journal of Interpersonal Violence"},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"432","DOI":"10.1080\/09638237.2018.1466036","article-title":"The experience and expression of anger in posttraumatic stress disorder: The relationship with metacognition","volume":"27","author":"Leonhardt","year":"2018","journal-title":"Journal of Mental Health"},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"1709709","DOI":"10.1080\/20008198.2019.1709709","article-title":"Dropout from psychological therapies for post-traumatic stress disorder (PTSD) in adults: Systematic review and meta-analysis","volume":"11","author":"Lewis","year":"2020","journal-title":"European Journal of Psychotraumatology"},{"key":"ref_36","unstructured":"Huppertz, B. (2019). Mentalization and its role in processing trauma. Approaches to psychic trauma: Theory and practice, Rowman & Littlefield."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"384","DOI":"10.1080\/15299732.2015.1005331","article-title":"Deficits in metacognitive capacity are related to subjective distress and heightened levels of hyperarousal symptoms in adults with posttraumatic stress disorder","volume":"16","author":"Lysaker","year":"2015","journal-title":"Journal of Trauma & Dissociation"},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1016\/j.jrp.2022.104267","article-title":"Psychosis and the challenges to narrative identity and the good life: Advances from research on the integrated model of metacognition","volume":"100","author":"Lysaker","year":"2022","journal-title":"Journal of Research in Personality"},{"key":"ref_39","doi-asserted-by":"crossref","first-page":"331","DOI":"10.2147\/PRBM.S198628","article-title":"Metacognitive Reflection and Insight Therapy: A recovery-oriented treatment approach for psychosis","volume":"13","author":"Lysaker","year":"2020","journal-title":"Psychology Research and Behavior Management"},{"key":"ref_40","doi-asserted-by":"crossref","first-page":"139","DOI":"10.1016\/j.adolescence.2019.08.007","article-title":"An examination of trauma narratives: Narrative rumination, self-reflection, and identity in young adulthood","volume":"76","author":"Marin","year":"2019","journal-title":"Journal of Adolescence"},{"key":"ref_41","doi-asserted-by":"crossref","first-page":"110","DOI":"10.1037\/a0025686","article-title":"The role of cumulative trauma, betrayal, and appraisals in understanding trauma symptomatology","volume":"52","author":"Martin","year":"2013","journal-title":"Psychological Trauma: Theory, Research, Practice and Policy"},{"key":"ref_42","doi-asserted-by":"crossref","first-page":"295","DOI":"10.1207\/s15327965pli0704_1","article-title":"Personality, Modernity, and the storied self: A contemporary framework for studying persons","volume":"7","author":"McAdams","year":"1996","journal-title":"Psychological Inquiry"},{"key":"ref_43","doi-asserted-by":"crossref","first-page":"339","DOI":"10.1111\/j.1467-6494.1996.tb00514.x","article-title":"Themes of agency and communion in significant autobiographical scenes","volume":"64","author":"McAdams","year":"1996","journal-title":"Journal of Personality"},{"key":"ref_44","doi-asserted-by":"crossref","first-page":"683","DOI":"10.1037\/0012-1649.41.4.683","article-title":"Late adolescent identity development: Narrative meaning making and memory telling","volume":"41","author":"McLean","year":"2005","journal-title":"Developmental Psychology"},{"key":"ref_45","doi-asserted-by":"crossref","first-page":"920","DOI":"10.1037\/pspp0000247","article-title":"The empirical structure of narrative identity: The initial big three","volume":"119","author":"McLean","year":"2020","journal-title":"Journal of Personality and Social Psychology"},{"key":"ref_46","doi-asserted-by":"crossref","first-page":"249","DOI":"10.1016\/j.cpr.2014.03.002","article-title":"Remission from post-traumatic stress disorder in adults: A systematic review and meta-analysis of long term outcome studies","volume":"34","author":"Morina","year":"2014","journal-title":"Clinical Psychology Review"},{"key":"ref_47","doi-asserted-by":"crossref","first-page":"20","DOI":"10.1016\/j.schres.2018.06.001","article-title":"Metacognition\u2014What did James H. Flavell really say and the implications for the conceptualization and design of metacognitive interventions","volume":"201","author":"Moritz","year":"2018","journal-title":"Schizophrenia Research"},{"key":"ref_48","doi-asserted-by":"crossref","first-page":"43","DOI":"10.12703\/P7-43","article-title":"The problem of dropout from \u201cgold standard\u201d PTSD therapies","volume":"7","author":"Najavits","year":"2015","journal-title":"F1000prime Reports"},{"key":"ref_49","unstructured":"Calhoun, L. G., and Tedeschi, R. G. (2006). Re-storying loss: Fostering growth in the posttraumatic narrative. Handbook of posttraumatic growth: Research & practice, Lawrence Erlbaum Associates Publishers."},{"key":"ref_50","doi-asserted-by":"crossref","unstructured":"O\u2019Kearney, R., and Perrott, K. (2006). Trauma narratives in posttraumatic stress disorder: A review. Journal of Traumatic Stress, 19, (1).","DOI":"10.1002\/jts.20099"},{"key":"ref_51","doi-asserted-by":"crossref","first-page":"1682932","DOI":"10.1080\/20008198.2019.1682932","article-title":"Do early interventions prevent PTSD? A systematic review and meta-analysis of the safety and efficacy of early interventions after sexual assault","volume":"10","author":"Oosterbaan","year":"2019","journal-title":"European Journal of Psychotraumatology"},{"key":"ref_52","doi-asserted-by":"crossref","unstructured":"Raeder, R., Clayton, N. S., and Boeckle, M. (2023). Narrative-based autobiographical memory interventions for PTSD: A meta-analysis of randomized controlled trials. Frontiers in Psychology, 14.","DOI":"10.3389\/fpsyg.2023.1215225"},{"key":"ref_53","doi-asserted-by":"crossref","first-page":"424","DOI":"10.1080\/15248372.2011.587854","article-title":"Coherence of personal narratives across the lifespan: A multidimensional model and coding method","volume":"12","author":"Reese","year":"2011","journal-title":"Journal of Cognition and Development"},{"key":"ref_54","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1016\/j.concog.2010.03.018","article-title":"The coherence of memories for trauma: Evidence from posttraumatic stress disorder","volume":"20","author":"Rubin","year":"2011","journal-title":"Consciousness and Cognition: An International Journal"},{"key":"ref_55","doi-asserted-by":"crossref","first-page":"576","DOI":"10.1037\/h0101856","article-title":"Self-Concept Focus: A tendency to perceive autobiographical events as central to identity","volume":"9","author":"Rubin","year":"2020","journal-title":"Journal of Applied Research in Memory and Cognition"},{"key":"ref_56","doi-asserted-by":"crossref","first-page":"17","DOI":"10.1002\/acp.950","article-title":"Reliving, emotions, and fragmentation in the autobiographical memories of veterans diagnosed with PTSD","volume":"18","author":"Rubin","year":"2004","journal-title":"Applied Cognitive Psychology"},{"key":"ref_57","doi-asserted-by":"crossref","unstructured":"Santiago, P. N., Ursano, R. J., Gray, C. L., Pynoos, R. S., Spiegel, D., Lewis-Fernandez, R., Friedman, M. J., and Fullerton, C. S. (2013). A systematic review of PTSD prevalence and trajectories in DSM-5 defined trauma exposed populations: Intentional and non-intentional traumatic events. PLoS ONE, 8, (4).","DOI":"10.1371\/journal.pone.0059236"},{"key":"ref_58","doi-asserted-by":"crossref","first-page":"130","DOI":"10.1037\/ser0000706","article-title":"Translating an integrative metacognitive model of psychotherapy for serious mental illness into a group format: A pilot investigation on feasibility","volume":"21","author":"Bullock","year":"2024","journal-title":"Psychological Services"},{"key":"ref_59","doi-asserted-by":"crossref","first-page":"680","DOI":"10.1111\/bjc.12357","article-title":"Affective and cognitive theory of mind in posttraumatic stress, major depressive, and somatic symptom disorders: Association with childhood trauma","volume":"61","author":"Seitz","year":"2022","journal-title":"The British Journal of Clinical Psychology"},{"key":"ref_60","doi-asserted-by":"crossref","first-page":"166","DOI":"10.1001\/archgenpsychiatry.2011.127","article-title":"Prevention of posttraumatic stress disorder by early treatment: Results from the Jerusalem Trauma Outreach and Prevention study","volume":"69","author":"Shalev","year":"2012","journal-title":"Archives of General Psychiatry"},{"key":"ref_61","doi-asserted-by":"crossref","first-page":"104428","DOI":"10.1016\/j.brat.2023.104428","article-title":"Predictors of dropout in cognitive processing therapy for PTSD: An examination of in-session treatment processes","volume":"171","author":"Shayani","year":"2023","journal-title":"Behaviour Research and Therapy"},{"key":"ref_62","doi-asserted-by":"crossref","first-page":"91","DOI":"10.1037\/1089-2680.5.2.91","article-title":"New perspectives on autobiographical memory: The integration of narrative processing and autobiographical reasoning","volume":"5","author":"Singer","year":"2001","journal-title":"Review of General Psychology"},{"key":"ref_63","doi-asserted-by":"crossref","unstructured":"Thomsen, D. K., Holm, T., Jensen, R., Lind, M., and Pedersen, A. M. (2023). Storying mental illness and personal recovery, Cambridge University Press.","DOI":"10.1017\/9781108907606"},{"key":"ref_64","doi-asserted-by":"crossref","first-page":"280","DOI":"10.1521\/psyc.67.3.280.48977","article-title":"Coping with trauma: Narrative and cognitive perspectives","volume":"67","author":"Freedman","year":"2004","journal-title":"Psychiatry: Interpersonal and Biological Processes"},{"key":"ref_65","first-page":"379","article-title":"Pierre Janet\u2019s treatment of post-traumatic stress","volume":"2","author":"Brown","year":"1989","journal-title":"Journal of Traumatic Stress"},{"key":"ref_66","doi-asserted-by":"crossref","unstructured":"Vanaken, L., Smeets, T., Bijttebier, P., and Hermans, D. (2021). Keep calm and carry on: The relations between narrative coherence, trauma, social support, psychological well-being, and cortisol responses. Frontiers in Psychology, 12.","DOI":"10.3389\/fpsyg.2021.558044"},{"key":"ref_67","doi-asserted-by":"crossref","first-page":"255","DOI":"10.1007\/s10879-016-9335-6","article-title":"Metacognitive Reflection and Insight Therapy for borderline personality disorder: A case illustration of an individual in a long term institutional setting","volume":"46","author":"Vohs","year":"2016","journal-title":"Journal of Contemporary Psychotherapy"},{"key":"ref_68","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1037\/tra0000415","article-title":"Assessing the coherence of narratives of traumatic events with latent semantic analysis","volume":"11","author":"Vrana","year":"2019","journal-title":"Psychological Trauma: Theory, Research, Practice and Policy"},{"key":"ref_69","doi-asserted-by":"crossref","first-page":"e541","DOI":"10.4088\/JCP.12r08225","article-title":"Meta-analysis of the efficacy of treatments for posttraumatic stress disorder","volume":"74","author":"Watts","year":"2013","journal-title":"The Journal of Clinical Psychiatry"},{"key":"ref_70","doi-asserted-by":"crossref","first-page":"365","DOI":"10.1016\/S1077-7229(04)80053-1","article-title":"Metacognitive Therapy for PTSD: A Core Treatment Manual","volume":"11","author":"Wells","year":"2004","journal-title":"Cognitive and Behavioral Practice"},{"key":"ref_71","unstructured":"World Health Organization (2019). International classification of diseases for mortality and morbidity statistics (11th revision), World Health Organization."},{"key":"ref_72","unstructured":"Wortham, S. (2001). Narrative in action: A strategy for research and analysis, Teachers College Press."},{"key":"ref_73","first-page":"e2413874","article-title":"Trends in diagnosed posttraumatic stress disorder and acute stress disorder in US college students, 2017\u20132022","volume":"7","author":"Zhai","year":"2024","journal-title":"JAMA"}],"container-title":["Behavioral Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/2\/150\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,8]],"date-time":"2025-10-08T10:38:40Z","timestamp":1759919920000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/2076-328X\/15\/2\/150"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,1,30]]},"references-count":73,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2025,2]]}},"alternative-id":["bs15020150"],"URL":"https:\/\/doi.org\/10.3390\/bs15020150","relation":{},"ISSN":["2076-328X"],"issn-type":[{"value":"2076-328X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,1,30]]}}}