Transgender and gender diverse (TGD) individuals are at an elevated risk of trauma exposure and other negative mental and physical health outcomes. The present study examined the interaction between minority stressors, reported potentially traumatic events (PTEs), and suicide risk (i.e., ideation and behavior) in a TGD sample. A convenience sample of 155 self‐identified TGD individuals completed questionnaires assessing distal (e.g., gender‐related discrimination) and proximal (e.g., internalized transphobia) gender identity–related stressors, lifetime PTE history, and suicide risk. The results of a mediation analysis demonstrated that proximal stressors partially mediated the association between distal stressors and suicide risk, B = 1.12, t(152) = 3.72, p < .01, 95% CI [0.53, 1.72], and the results of a moderated mediation analysis showed that the interaction term was not significant, and that the number of PTEs did not moderate the mediation model that examined proximal stressors as a mediator of the association between distal stressors and suicide risk, F(3, 151) = 18.74, MSE = 0.75, R2 = 0.27, B = 0.07, t(151) = 0.89, p = .371, 95% CI [‐0.08, 0.21]. These findings suggest that minority stressors may contribute to suicide risk in a TGD population above and beyond the impact of trauma exposure. Risk reduction efforts for suicide risk may be enhanced by attending to minority stressors in addition to PTEs.

The interpretation of dreams has been a topic of interest for many centuries, dating back to 350 BC (Aristoteles, 2001). Specific considerations of the meaning of nightmares have not been as richly developed as they have been for dreams. One way dream researchers have analyzed dreams is through examining the use of language in dream reports. However, this method is in its infant stages regarding its approach to understanding nightmares. Psychological constructs can be measured using a form of quantitative text analysis called Linguistic Inquiry and Word Count (Pennebaker, Boyd, Jordan, & Blackburn, 2015). This study aims to contribute to the understanding of nightmare content, specifically how nightmare content differs from that of dreams in areas of emotion, social, and perceptual processing. Transcripts of posttrauma nightmare (PTNM) reports were collected from individuals participating in a cognitive-behavioral therapy for nightmares, the exposure, relaxation, and rescripting therapy (Davis, 2008). Language use within PTNMs was compared with established norms of language use in dreams (Bulkeley & Graves, 2018). Results indicated that PTNMs differed from dreams significantly. PTNMs demonstrated increased use of negative emotion words, hearing and feeling words, and risk words. PTNMs showed decreased use of words related to friends and leisure, decreased analytical thinking, and clout. There were no differences in positive emotion words, family, death, visual and motion words. These results support the theory that PTNMs are different than dreams in important ways. The information gleaned from these PTNM reports may be used to inform treatment of trauma-related disorders.

With advances in technology, telehealth has become an acceptable way of conducting psychotherapy. During the COVID-19 pandemic, telehealth and ways to modify treatments for delivery via telehealth have become increasingly important. Researchers and clinicians have issued recommendations on providing telehealth-based care in response to the COVID-19 global pandemic. However, recommendations are limited for audio only telephone-based care, which may be the only option for specific clients. This is a case study of an older adult who completed Cognitive Processing Therapy (CPT) for military sexual trauma. Halfway through her treatment, COVID-19 resulted in transitioning from in-person services to a virtual format. Client X did not have video capabilities aside from her cell phone, and it was determined she would complete treatment via telephone-based sessions. Client X’s outcome data is presented, and the reductions in her PTSD and depressive symptoms provide preliminary support suggesting that telephone-based care may be an acceptable method of receiving CPT. Recommendations for telephone-based CPT are provided.

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Purpose of review Firearm injury is the leading mechanism of suicide among US women, and lethal means counseling (LMC) is an evidence-based suicide prevention intervention. We describe current knowledge and research gaps in tailoring LMC to meet the needs of US women.Social Determinants of Health (R Holliday, Section Editor)Recent findings Available LMC and firearm suicide prevention literature has not fully considered how LMC interventions should be tailored for women. This is especially important as firearm ownership and firearm-related suicides among women are increasing. Additional research is needed to better understand firearm characteristics, behaviors, and beliefs of US women, particularly related to perceptions of personal safety and history of trauma. Research is also needed to identify optimal components of LMC interventions (e.g., messengers, messages, settings) and how best to facilitate safety practices among women with firearm access who are not themselves firearm owners but who reside in households with firearms. Finally, it will be important to examine contextual and individual factors (e.g., rurality, veteran status, intimate partner violence) which may impact LMC preferences and recommendations. Summary This commentary offers considerations for applying existing knowledge in LMC and firearm suicide prevention to clinical practice and research among US women, among whom the burden of firearm suicide is increasing.

In adult populations, bipolar disorders (BDs) and posttraumatic stress disorder (PTSD) have overlapping symptoms, potentially leading to misdiagnosis. This misdiagnosis or failure to diagnose both co‐occurring disorders can result in individuals not receiving the proper treatment to address their symptoms. This article highlights how trauma‐informed psychological assessment can assist in differential diagnosis and improve the timely delivery of appropriate treatments. The overlapping symptoms of PTSD and BD are discussed to assist in differential diagnosis, and we suggest guidelines for conducting trauma‐informed, evidence‐based assessments to help clarify these diagnoses.

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