Posttraumatic stress disorder (PTSD) symptom profiles among people who have experienced abuse

Clinicians increasingly must address the needs of clients who have experienced complex trauma. I like this study in part because of the large sample size – 6,769 American adults (M = 43.93 years, SD = 15.35, 70.9% female) from the National Epidemiologic Survey on Alcohol and Related Conditions-III who reported histories of physical or sexual abuse. Bucich, Steel, & Berle, (2022) acknowledge the need to accommodate diverse psychological responses to traumatic events. 

The abstract includes the following:

We sought to identify unique PTSD symptom profiles associated with the experience of physical and sexual abuse and to determine whether exposure in childhood, type of abuse, frequency of abuse and familial support were associated with profiles indicating increased symptom complexity. . . .  Latent Class Analysis was used to identify distinct profiles of the twenty PTSD symptoms outlined in the Diagnostic and Statistical Manual of Mental Disorders, 5th edition (DSM–5). Abuse in childhood, type of abuse, frequency of childhood abuse, emotional support in childhood and a range of demographic variables were compared across classes. Results: Five classes were educed: High All (19.6%), Threat (14.4%), Dysphoric (13.7%), Moderate Threat (29.4%) and Low Symptom (22.9%). Contrary to our hypotheses, trauma exposure in childhood did not predict class membership while type of abuse did. The High All and Dysphoric classes had greater frequency of childhood abuse, lower support in childhood, and a history of sexual abuse when compared to their less complex, predominantly fear-based counterparts (Threat and Moderate Threat classes, respectively). Conclusions: These constellations of DSM–5 PTSD symptoms may be a proxy for increased “complexity” and may indicate a need for alternative or additional therapeutic interventions. 

It seems to me that, even as an early study, it suggests ways in which diagnosticians and clinicians can collect more nuanced data from clients seeking help with PTSD.

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Childhood maltreatment and bipolar disorder

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Pregnant women’s perspectives on screening for adverse childhood experiences and resilience during prenatal care