@article{antonioLatentClassesProximal2026,

title = {Latent Classes of Proximal Traumatic Exposure Among Portuguese Police and Security Professionals: Associations with PTSD Symptoms and Psychological Distress},

author = {H. António and S. Albuquerque and M. Vieira de Castro and S. Bouchard and P. Gamito and R. J. Pinto},

url = {https://www.scopus.com/pages/publications/105048524559?origin=resultslist},

doi = {10.3390/psychiatryint7040173},

issn = {26735318 (ISSN)},

year  = {2026},

date = {2026-01-01},

journal = {Psychiatry International},

volume = {7},

number = {4},

publisher = {Multidisciplinary Digital Publishing Institute (MDPI)},

abstract = {Background: Police and security professionals are routinely exposed to potentially traumatic events as part of occupational duties, placing them at increased risk for post-traumatic stress and broader psychological difficulties. This study aimed to identify latent classes of proximal traumatic exposure among Portuguese police/security professionals and examine their associations with PTSD symptoms and general psychological distress. Methods: A cross-sectional online survey was conducted with Portuguese police/security professionals (N = 644). Latent class analysis (LCA) was applied to 17 indicators of potentially traumatic events coded as directly experienced or witnessed, derived from the Life Events Checklist for DSM-5. PTSD symptoms were assessed using the PTSD Checklist for DSM-5, and general psychological distress was assessed using the Brief Symptom Inventory. Exploratory receiver operating characteristic (ROC) analyses examined whether counts of proximal traumatic events could approximate the LCA-derived classes. Results: A three-class solution was identified, comprising low proximal exposure (37.3%), moderate proximal exposure (40.7%), and high proximal/cumulative exposure (22.0%) classes. The classes reflected a graded cumulative pattern of exposure across traumatic event categories, rather than clearly distinct qualitative configurations defined by specific event types. Higher exposure classes were associated with progressively higher PTSD symptoms and psychological distress, and these associations remained significant after adjustment for sociodemographic and occupational variables. Exploratory receiver operating characteristic (ROC) analyses showed that a simple count of proximal traumatic event categories closely approximated the empirically derived class structure within the present sample. However, the resulting thresholds are sample-specific, exploratory, and should not be interpreted as validated screening cutoffs. Conclusions: Proximal traumatic exposure among police/security professionals appears to follow a graded cumulative structure associated with increased PTSD symptoms and psychological distress. The person-centered analysis provided an empirical test of whether exposure was organized according to qualitatively distinct event configurations or primarily along a cumulative gradient. In this sample, cumulative exposure burden emerged as the dominant organizing dimension. The count-based approximation requires external validation before any screening or decision-making application can be considered. © 2026 by the authors.},

keywords = {adult, Anxiety, article, cross-sectional study, decision making, Depression, DSM-5, female, Global Severity Index, hostility, human, human experiment, Latent Class Analysis, LEC-5, major clinical study, male, paranoia, phobia, police, Positive symptom distress index, Positive symptom total, posttraumatic stress disorder, posttraumatic stress disorder checklist, Proximal Traumatic Exposure, psychological distress, psychosis, PTSD, questionnaire, receiver operating characteristic, Security, security professionals, self report, sociodemographics, trauma exposure},

pubstate = {published},

tppubtype = {article}

}

@article{yee_cognitive_2025,

title = {Cognitive Remediation for Psychosis in Virtual Reality (ThinkTactic VR): Qualitative, Iterative, and User-Centered Codevelopment Study},

author = {J. Yee and H. Matheson and B. J. M. Bogie and É. D. Perron and A. Thérond and M. Charest and C. Driel and M. Goyette and Y. T. Lei and C. Noël and K. Ariaratnam and G. Collins and C. Gorman and A. -M. Cretu and S. Tremblay and M. -C. Rivard and C. Cullwick and C. Morris and D. G. Attwood and A. Baines and A. Stewart and S. Bouchard and C. R. Bowie and S. Guimond},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105013110717&doi=10.2196%2F69359&partnerID=40&md5=c5daaabcfd92d826b28327a5800609ae},

doi = {10.2196/69359},

issn = {23687959 (ISSN)},

year  = {2025},

date = {2025-01-01},

journal = {JMIR Mental Health},

volume = {12},

abstract = {Background: Cognitive remediation improves cognition and psychosocial functioning in individuals with psychotic disorders. The use of virtual reality (VR) to deliver cognitive remediation in immersive environments that mimic real cognitively challenging situations has the potential to increase engagement to treatment and further enhance its impact on functioning. Objective: We aimed to codevelop a cognitive remediation program in VR with individuals with psychotic disorders and health care professionals to identify and address their needs. Methods: Individuals with lived experience of a psychosis-spectrum condition (n=11) met 9 times and the health care professionals (n=7) met 3 times. Participants discussed personal and professional opinions on the challenges associated with cognitive difficulties in individuals with psychotic disorders. They also provided feedback on the program development. Results: We discerned 4 themes from the content expert working groups: the need for a program to address cognitive impairments, the key program design elements to support cognitive rehabilitation, the importance of leveraging technology as an intervention tool, and the need to improve community functioning. In total, 3 themes were identified for the health care professionals: the need for a clinically relevant program that addresses the research-to-practice gap, the need to improve patient engagement in services, and the need for a program that addresses the limited resources in health care. The needs of our end-user experts were placed at the center of the program development process. When possible, we also integrated their suggestions, like the incorporation of a virtual coach within the immersive environment. Conclusions: Individuals with lived experience and health care professionals have distinct needs, which have informed the co-design of a novel cognitive remediation program in VR, ThinkTactic VR. To our knowledge, ThinkTactic VR is one of the first co-designed and codeveloped cognitive remediation programs in VR using an iterative, user-centered approach involving both individuals with psychotic disorders and health care professionals. ©Jasmin Yee, Hannah Matheson, Bryce J M Bogie, Émilie Du Perron, Alexandra Thérond, Maëlle Charest, Catheleine van Driel, Marika Goyette, Ya Ting Lei, Chelsea Noël, Kagusthan Ariaratnam, Greg Collins, Chris Gorman, Ana-Maria Cretu, Simon Tremblay, Marie-Christine Rivard, Catherine Cullwick, Crystal Morris, David G Attwood, Alexandra Baines, Angela Stewart, Stéphane Bouchard, Christopher R Bowie, Synthia Guimond.},

keywords = {adult, article, clinical article, cognitive defect, Cognitive rehabilitation, Cognitive remediation, Cognitive remediation therapy, community functioning, health care personnel, human, neurocognition, patient engagement, program development, psychosis, qualitative research, social cognition, user-centered approach, user-centered design, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{yeeCognitiveRemediationPsychosis2025,

title = {Cognitive Remediation for Psychosis in Virtual Reality (ThinkTactic VR): Qualitative, Iterative, and User-Centered Codevelopment Study},

author = {J. Yee and H. Matheson and B. J. M. Bogie and É. D. Perron and A. Thérond and M. Charest and C. Driel and M. Goyette and Y. T. Lei and C. Noël and K. Ariaratnam and G. Collins and C. Gorman and A. -M. Cretu and S. Tremblay and M. -C. Rivard and C. Cullwick and C. Morris and D. G. Attwood and A. Baines and A. Stewart and S. Bouchard and C. R. Bowie and S. Guimond},

url = {https://www.scopus.com/pages/publications/105013110717?origin=resultslist},

doi = {10.2196/69359},

issn = {23687959 (ISSN)},

year  = {2025},

date = {2025-01-01},

journal = {JMIR Mental Health},

volume = {12},

publisher = {JMIR Publications Inc.},

abstract = {Background: Cognitive remediation improves cognition and psychosocial functioning in individuals with psychotic disorders. The use of virtual reality (VR) to deliver cognitive remediation in immersive environments that mimic real cognitively challenging situations has the potential to increase engagement to treatment and further enhance its impact on functioning. Objective: We aimed to codevelop a cognitive remediation program in VR with individuals with psychotic disorders and health care professionals to identify and address their needs. Methods: Individuals with lived experience of a psychosis-spectrum condition (n=11) met 9 times and the health care professionals (n=7) met 3 times. Participants discussed personal and professional opinions on the challenges associated with cognitive difficulties in individuals with psychotic disorders. They also provided feedback on the program development. Results: We discerned 4 themes from the content expert working groups: the need for a program to address cognitive impairments, the key program design elements to support cognitive rehabilitation, the importance of leveraging technology as an intervention tool, and the need to improve community functioning. In total, 3 themes were identified for the health care professionals: the need for a clinically relevant program that addresses the research-to-practice gap, the need to improve patient engagement in services, and the need for a program that addresses the limited resources in health care. The needs of our end-user experts were placed at the center of the program development process. When possible, we also integrated their suggestions, like the incorporation of a virtual coach within the immersive environment. Conclusions: Individuals with lived experience and health care professionals have distinct needs, which have informed the co-design of a novel cognitive remediation program in VR, ThinkTactic VR. To our knowledge, ThinkTactic VR is one of the first co-designed and codeveloped cognitive remediation programs in VR using an iterative, user-centered approach involving both individuals with psychotic disorders and health care professionals. ©Jasmin Yee, Hannah Matheson, Bryce J M Bogie, Émilie Du Perron, Alexandra Thérond, Maëlle Charest, Catheleine van Driel, Marika Goyette, Ya Ting Lei, Chelsea Noël, Kagusthan Ariaratnam, Greg Collins, Chris Gorman, Ana-Maria Cretu, Simon Tremblay, Marie-Christine Rivard, Catherine Cullwick, Crystal Morris, David G Attwood, Alexandra Baines, Angela Stewart, Stéphane Bouchard, Christopher R Bowie, Synthia Guimond.},

keywords = {adult, article, clinical article, cognitive defect, Cognitive rehabilitation, Cognitive remediation, Cognitive remediation therapy, community functioning, health care personnel, human, neurocognition, patient engagement, program development, psychosis, qualitative research, social cognition, user-centered approach, user-centered design, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{yeeCognitiveRemediationPsychosis2025a,

title = {Cognitive Remediation for Psychosis in Virtual Reality (ThinkTactic VR): Qualitative, Iterative, and User-Centered Codevelopment Study},

author = {J. Yee and H. Matheson and B. J. M. Bogie and É. D. Perron and A. Thérond and M. Charest and C. Driel and M. Goyette and Y. T. Lei and C. Noël and K. Ariaratnam and G. Collins and C. Gorman and A. -M. Cretu and S. Tremblay and M. -C. Rivard and C. Cullwick and C. Morris and D. G. Attwood and A. Baines and A. Stewart and S. Bouchard and C. R. Bowie and S. Guimond},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-105013110717&doi=10.2196%2F69359&partnerID=40&md5=c5daaabcfd92d826b28327a5800609ae},

doi = {10.2196/69359},

issn = {23687959 (ISSN)},

year  = {2025},

date = {2025-01-01},

journal = {JMIR Mental Health},

volume = {12},

abstract = {Background: Cognitive remediation improves cognition and psychosocial functioning in individuals with psychotic disorders. The use of virtual reality (VR) to deliver cognitive remediation in immersive environments that mimic real cognitively challenging situations has the potential to increase engagement to treatment and further enhance its impact on functioning. Objective: We aimed to codevelop a cognitive remediation program in VR with individuals with psychotic disorders and health care professionals to identify and address their needs. Methods: Individuals with lived experience of a psychosis-spectrum condition (n=11) met 9 times and the health care professionals (n=7) met 3 times. Participants discussed personal and professional opinions on the challenges associated with cognitive difficulties in individuals with psychotic disorders. They also provided feedback on the program development. Results: We discerned 4 themes from the content expert working groups: the need for a program to address cognitive impairments, the key program design elements to support cognitive rehabilitation, the importance of leveraging technology as an intervention tool, and the need to improve community functioning. In total, 3 themes were identified for the health care professionals: the need for a clinically relevant program that addresses the research-to-practice gap, the need to improve patient engagement in services, and the need for a program that addresses the limited resources in health care. The needs of our end-user experts were placed at the center of the program development process. When possible, we also integrated their suggestions, like the incorporation of a virtual coach within the immersive environment. Conclusions: Individuals with lived experience and health care professionals have distinct needs, which have informed the co-design of a novel cognitive remediation program in VR, ThinkTactic VR. To our knowledge, ThinkTactic VR is one of the first co-designed and codeveloped cognitive remediation programs in VR using an iterative, user-centered approach involving both individuals with psychotic disorders and health care professionals. ©Jasmin Yee, Hannah Matheson, Bryce J M Bogie, Émilie Du Perron, Alexandra Thérond, Maëlle Charest, Catheleine van Driel, Marika Goyette, Ya Ting Lei, Chelsea Noël, Kagusthan Ariaratnam, Greg Collins, Chris Gorman, Ana-Maria Cretu, Simon Tremblay, Marie-Christine Rivard, Catherine Cullwick, Crystal Morris, David G Attwood, Alexandra Baines, Angela Stewart, Stéphane Bouchard, Christopher R Bowie, Synthia Guimond.},

keywords = {adult, article, clinical article, cognitive defect, Cognitive rehabilitation, Cognitive remediation, Cognitive remediation therapy, community functioning, health care personnel, human, neurocognition, patient engagement, program development, psychosis, qualitative research, social cognition, user-centered approach, user-centered design, virtual reality},

pubstate = {published},

tppubtype = {article}

}

@article{maziade_negative_1995,

title = {Negative, psychoticism, and disorganized dimensions in patients with familial schizophrenia or bipolar disorder: Continuity and discontinuity between the major psychoses},

author = {M. Maziade and M. -A. Roy and M. Martinez and D. Cliche and J. -P. Fournier and Y. Garneau and L. Nicole and N. Montgrain and C. Dion and A. -M. Ponton and A. Potvin and J. -C. Lavallée and A. Pirès and S. Bouchard and P. Boutin and F. Brisebois and C. Mérette},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-0029096330&doi=10.1176%2fajp.152.10.1458&partnerID=40&md5=6fa581c2751f28442a0b6823a5669e91},

doi = {10.1176/ajp.152.10.1458},

issn = {0002953X},

year  = {1995},

date = {1995-01-01},

journal = {American Journal of Psychiatry},

volume = {152},

number = {10},

pages = {1458–1463},

publisher = {American Psychiatric Association},

abstract = {Objective: This study aimed to answer the following questions: 1) Can we reliably measure the psychopathologic dimensions of schizophrenia by using a lifetime frame and by rating acute and interepisode periods separately? 2) Can we reproduce in subjects with familial schizophrenia the characteristic three-factor structure of schizophrenic symptoms that has been found previously ill general groups of schizophrenic patients? 3) Is the factor structure also present in familial bipolar disorder? Method: Lifetime measures of psychotic symptoms were taken through a slightly modified version of the Comprehensive Assessment of Symptoms and History for 138 patients with highly familial DSM-III-R schizophrenia (N=51), bipolar disorder (N=44), or spectrum disorders (N=43). Symptoms were rated separately in the acute episodes and in the stabilized interepisode intervals across the patients' lives. Results: A satisfactory level of reliability was obtained. In this highly familial study group, the positive/negative factorial distinction was replicated, as was a three-factor model similar to that observed in prior general groups of schizophrenic patients. These factors were also present in bipolar affective disorder. The negative, psychoticism, and disorganized factor model applied more to the acute phase of illness than to the stabilized state. Conclusions: These findings offer an empirical basis for testing biological or genetic variables in relation to negative/positive symptom dimensions, rather than diagnoses. Observations of a shared structure for schizophrenia and bipolar disorder suggest some continuity in the causes of these disorders.},

note = {Publisher: American Psychiatric Association},

keywords = {article, clinical feature, disease association, disease predisposition, genetic variability, human, major clinical study, manic depressive psychosis, priority journal, psychiatric diagnosis, psychosis, rating scale, reliability, schizophrenia},

pubstate = {published},

tppubtype = {article}

}

@article{maziadeNegativePsychoticismDisorganized1995,

title = {Negative, psychoticism, and disorganized dimensions in patients with familial schizophrenia or bipolar disorder: Continuity and discontinuity between the major psychoses},

author = {M. Maziade and M. -A. Roy and M. Martinez and D. Cliche and J. -P. Fournier and Y. Garneau and L. Nicole and N. Montgrain and C. Dion and A. -M. Ponton and A. Potvin and J. -C. Lavallée and A. Pirès and S. Bouchard and P. Boutin and F. Brisebois and C. Mérette},

url = {https://www.scopus.com/inward/record.uri?eid=2-s2.0-0029096330&doi=10.1176%2fajp.152.10.1458&partnerID=40&md5=6fa581c2751f28442a0b6823a5669e91},

doi = {10.1176/ajp.152.10.1458},

issn = {0002953X},

year  = {1995},

date = {1995-01-01},

journal = {American Journal of Psychiatry},

volume = {152},

number = {10},

pages = {1458–1463},

publisher = {American Psychiatric Association},

abstract = {Objective: This study aimed to answer the following questions: 1) Can we reliably measure the psychopathologic dimensions of schizophrenia by using a lifetime frame and by rating acute and interepisode periods separately? 2) Can we reproduce in subjects with familial schizophrenia the characteristic three-factor structure of schizophrenic symptoms that has been found previously ill general groups of schizophrenic patients? 3) Is the factor structure also present in familial bipolar disorder? Method: Lifetime measures of psychotic symptoms were taken through a slightly modified version of the Comprehensive Assessment of Symptoms and History for 138 patients with highly familial DSM-III-R schizophrenia (N=51), bipolar disorder (N=44), or spectrum disorders (N=43). Symptoms were rated separately in the acute episodes and in the stabilized interepisode intervals across the patients' lives. Results: A satisfactory level of reliability was obtained. In this highly familial study group, the positive/negative factorial distinction was replicated, as was a three-factor model similar to that observed in prior general groups of schizophrenic patients. These factors were also present in bipolar affective disorder. The negative, psychoticism, and disorganized factor model applied more to the acute phase of illness than to the stabilized state. Conclusions: These findings offer an empirical basis for testing biological or genetic variables in relation to negative/positive symptom dimensions, rather than diagnoses. Observations of a shared structure for schizophrenia and bipolar disorder suggest some continuity in the causes of these disorders.},

keywords = {article, clinical feature, disease association, disease predisposition, genetic variability, human, major clinical study, manic depressive psychosis, priority journal, psychiatric diagnosis, psychosis, rating scale, reliability, schizophrenia},

pubstate = {published},

tppubtype = {article}

}