The associations of perpetration and betrayal with PTSD, controlling for danger-based combat events, highlight the limitations of conceptualizations and treatments of PTSD based on fear or helplessness as sole etiologic factors. (PsycINFO Database Record

Warzone experiences that violate deeply held moral beliefs and expectations may lead to moral injury and associated spiritual distress (Litz et al., 2009). Helping morally injured war veterans who are grappling with spiritual or religious issues is part of multicultural competence (Vieten et al., 2013) and falls within the scope of practice of mental health clinicians. Moreover, practicing clinicians report that they lack adequate knowledge of the diverse spiritual and religious backgrounds of their clients and when to seek consultation from and collaborate with spiritual/religious teachers (Vieten et al., 2016). We argue that optimal assessment and treatment of psychically traumatized military personnel and veterans requires an understanding of the idioms and perspectives of various spiritual (religious and philosophical) traditions on transgression and their recommendations for forgiveness and healing. To this end, we (a) provide an overview of the source of moral codes associated with various traditions, (b) discuss aspects of warzone events that may violate those moral codes and spiritual reactions to those violations, (c) describe spiritual traditions' approaches to making amends for transgressions, and (d) provide brief case scenarios that illustrate spiritual features of moral injury and point to circumstances in which collaboration with chaplains or clergy may be helpful for addressing aspects of moral injury.

Sexuality and intimacy difficulties are often a part of the aftermath of sexual trauma. We argue that combining techniques from evidence‐based, trauma‐focused treatment with sex‐positive techniques used in sex therapy can best help survivors reduce trauma‐related symptoms and develop or regain comfort with their sexuality. In this article, we illustrate this approach by describing the case of a survivor of sexual assault, who completed 20 sessions of treatment that combined modules of trauma‐focused therapies, Cognitive Processing Therapy (CPT), and Prolonged Exposure (PE) with sensate focus therapy, a technique often used in sex therapy. The outcome of this case suggests that clinicians who work with sexual trauma survivors may want to consider a sex‐positive approach to conceptualizing and planning the course of treatment, to achieve optimal results.

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In recent years, increasing attention has been paid to situational factors associated with childhood sexual abuse (CSA) to explain incidence of CSA, as well as to provide potential targets for prevention efforts. However, very few studies have examined situational factors associated with juvenile perpetration, despite juveniles composing a substantial proportion of offenders. In addition, no studies to our knowledge have applied a situational framework to CSA research in the Orthodox Jewish community (OJC). In the present study, we obtained data from therapists regarding 80 victims of CSA in the OJC from both the United States and Israel. We hypothesized that (a) more abusers' first perpetration would be between ages 12 and 17 than between any other age range, which corresponds to increased sexual urges, as well as increased unsupervised access to minors; (b) among juvenile offenders, the time of day of the abuse would depend on the relationship of the offender to the victim; and (c) age of the victim and grooming strategies would be associated with the frequency of abuse. Our first two hypotheses were confirmed, and our third hypothesis was partially confirmed, as younger victims tended to have higher frequency of abuse. Additionally, we discuss possible implications of significant correlations found during exploratory analyses. Our results generally support the importance of considering culturally specific situational factors when studying or developing prevention efforts for CSA.

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