A systematic review of person-centered approaches to investigating patterns of trauma exposure

O’Donnell, Meaghan; Schaefer, Ingo; Varker, Tracey; Kartal, Dzenana; Forbes, David; Bryant, Richard A.; Silove, Derrick; Creamer, Mark; McFarlane, Alexander C.; Malhi, Gin S; Felmingham, Kim L.; Hoof, Miranda Van; Hadži-Pavlović, Dušan; Nickerson, Angela; Steel, Zachary

doi:10.1016/j.cpr.2017.08.009

Cited by 111 publications

(113 citation statements)

References 43 publications

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“…This approach is necessary for identifying the prevalence of disorders but provides little clinical utility and information about the natural heterogeneity and course of posttraumatic stress symptoms (PTSS; Bonanno & Mancini, 2012). Increasingly, more empirically based classification methods, such as latent growth mixture modeling (LGMM) of PTSS, have been used as a person-centered approach to characterize heterogeneous symptom progression and severity over time (Bonanno & Mancini, 2012;Galatzer-Levy, 2014;O'Donnell et al, 2017). By using LGMM, researchers can identify individuals with similar symptom patterns over time, characterize distinct shared distributions within a larger heterogeneous sample, and identify various naturally occurring PTSS trajectories (Bonanno & Mancini, 2012;Muthén, 2004).…”

mentioning

confidence: 99%

Posttraumatic Stress Trajectories in World Trade Center Tower Survivors: Hyperarousal and Emotional Numbing Predict Symptom Change

Adams

Allwood

Bowler

2019

Journal of Traumatic Stress

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There is a paucity of knowledge concerning the underlying symptomatology of heterogeneous posttraumatic stress symptom (PTSS) trajectories following mass trauma, such as a terrorist attack. This study examined longitudinal PTSS trajectories using latent growth mixture modeling in 2,355 World Trade Center (WTC) tower survivors surveyed by the WTC Health Registry an average of 2.5, 5.5, and 10.5 years after the September 11, 2001 terrorist attacks. Covariates included sociodemographic characteristics, WTC‐related exposure, and other traumas/stressors. Four curvilinear PTSS trajectories were identified: low symptom (74.9%), recovering (8.0%), worsening (6.7%), and chronic (10.4%). The majority of WTC survivors (85.3%) maintained stable symptom trajectories over time, with PTSS changes occurring less often. Although WTC‐related exposure was associated with initial PTSS severity, exposure was not associated with chronicity or change of PTSS over time. Male gender and a higher number of post‐WTC disaster life‐stressors were associated with worsening symptom severity over time. Individuals with more severe hyperarousal symptoms at Wave 1, particularly of anxious arousal, were more likely to have PTSS that worsened over time, adjusted odds ratio (aOR) = 1.55. Less severe emotional numbing symptoms, particularly of dysphoria, at Wave 1, were marginally significantly associated with subsequent PTSS recovery, aOR = 0.75. Interventions that target hyperarousal and emotional numbing symptoms may mitigate a worsening of symptoms and facilitate posttraumatic recovery following future mass traumas, such as terrorist attacks. Further clinical implications are discussed.

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confidence: 99%

Posttraumatic Stress Trajectories in World Trade Center Tower Survivors: Hyperarousal and Emotional Numbing Predict Symptom Change

Adams

Allwood

Bowler

2019

Journal of Traumatic Stress

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“…Second, the assessment of trauma exposure in the Israeli population has largely centered around the communities’ exposure to terror‐ or military‐type PTEs, whereas a more comprehensive assessment of the co‐occurrence of multiple forms of trauma exposure and the potential interaction effects between conflict‐related PTEs an other types of PTEs are lacking. A recent review by O'Donnell and colleagues () showed that the co‐occurrence and heterogeneity of exposure to multiple traumas can be meaningfully represented by LCA, a type of mixture model accounting for unobserved patterns of trauma exposure by assigning individuals to mutually exclusive groups. Indeed, across the 17 studies included in the review, subpopulations of individuals with a high risk of exposure to multiple types of trauma were consistently found.…”

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confidence: 99%

“…Additionally, there were frequent reports of subpopulations with high levels of sexual interpersonal trauma exposure and subpopulations high in nonsexual interpersonal trauma exposure. Some studies found that these profiles were differentially associated with mental health outcomes, such as PTSD as defined in DSM‐IV (O'Donnell et al., ). Consequently, we might reasonably expect that mixture modeling techniques could be used to expand the field's knowledge of the association between trauma exposure and ICD‐11 PTSD and CPTSD in general as well as regarding profiles of trauma exposure in the Israeli population that differ in their association with posttraumatic symptomatology.…”

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confidence: 99%

“…First, we aimed to use LCA to examine the association between trauma typologies and PTSD and CPTSD in a trauma‐exposed community sample of Israeli adults. Based on the review by O'Donnell and colleagues (), we predicted that there would be heterogeneity in trauma exposure and that trauma exposure would cluster in latent classes reflecting low trauma exposure, nonsexual interpersonal trauma, sexual trauma, and polyvictimization. We expected that CPTSD would be more strongly related to classes representing sexual trauma and polyvictimization (Cloitre et al., ; Hyland et al., ).…”

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confidence: 99%

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Modeling Patterns of Polyvictimization and Their Associations with Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in the Israeli Population

Vang

Ben–Ezra

Shevlin

2019

Journal of Traumatic Stress

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Although evidence is accumulating for the conceptual validity of the ICD-11 proposal for posttraumatic stress disorder (PTSD) and complex PTSD (CPTSD), our understanding of the specificity of trauma-related predictors is still evolving. Specifically, studies utilizing advanced statistical methods to model the association between trauma exposure and ICD-11 proposals of traumatic stress and differences in profiles of trauma exposure are lacking. Additionally, time since trauma and a clear memory of the trauma are yet to be examined as predictors of PTSD and CPTSD. We analyzed trauma exposure as reported by a general population sample of Israeli adults (N = 834), using latent class analysis, and the resultant classes were used in regression models to predict PTSD and CPTSD operationalized both dimensionally and categorically. Four distinct groups were identified: child and adult interpersonal victimization, community victimization-male, community victimization-female, and adult victimization. These groups were differentially related to PTSD and CPTSD, with only child and adult interpersonal victimization consistently predicting CPTSD and disturbances in self-organization. When modeled dimensionally, PTSD was associated with the child and adult interpersonal victimization and adult victimization groups, whereas only the child and adult interpersonal victimization group was predictive of PTSD when operationalized categorically. The roles of time since trauma and a clear memory of the trauma differed across PTSD and CPTSD. These findings support the use of trauma typologies for predicting PTSD and CPTSD and provide important insight into the distribution of trauma exposure in the Israeli population.

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“…Cumulative exposure to certain classes of traumatic events has recently been identified as a nuanced predictor of posttraumatic stress injuries (O'Donnell et al, 2017). Given communicators' high rate of posttraumatic symptoms, perhaps repeated workplace exposures with concurrent intense emotion work requirements, function as a particular class of chronic or traumatic exposures that make communicators uniquely vulnerable to stress-related dysregulation and disease.…”

Section: Posttraumatic Stressmentioning

confidence: 99%

The “Managed” or Damaged Heart? Emotional Labor, Gender, and Posttraumatic Stressors Predict Workplace Event-Related Acute Changes in Cortisol, Oxytocin, and Heart Rate Variability

et al. 2020

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Vital to the everyday operation of police services, police communicators (911 call-takers and dispatchers) are persistently subject to imminent challenges in the workplace; they must always be prepared to engage and deal with a wide variety of circumstances that provoke various intense emotions and physiological stress responses. Acute changes in cortisol, oxytocin, and heart rate variability are central to adaptive responses in stressful complex social interactions, but they might also be indicative of physiological dysregulation due to long-term psychosocial stress exposures. Thus, we examine acute stress-induced release of peripheral oxytocin and cortisol along with changes in heart rate variability, and how each relates to persistent workplace stressors and symptoms of posttraumatic stress. Findings indicate chronic forms of gendered workplace stress such as emotional labor, gender role stress and, posttraumatic stress each have differential associations with, and predict physiological responses to, acutely stressful events in the workplace. These associations suggest potential mechanisms through which communicators become more vulnerable to developing stress-related disorders such as posttraumatic stress injuries, especially after cumulative traumatic exposures in this context. The results also suggest potential pathways for the biological embedding of stressful gendered workplace experiences.

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A systematic review of person-centered approaches to investigating patterns of trauma exposure

Cited by 111 publications

References 43 publications

Posttraumatic Stress Trajectories in World Trade Center Tower Survivors: Hyperarousal and Emotional Numbing Predict Symptom Change

Posttraumatic Stress Trajectories in World Trade Center Tower Survivors: Hyperarousal and Emotional Numbing Predict Symptom Change

Modeling Patterns of Polyvictimization and Their Associations with Posttraumatic Stress Disorder and Complex Posttraumatic Stress Disorder in the Israeli Population

The “Managed” or Damaged Heart? Emotional Labor, Gender, and Posttraumatic Stressors Predict Workplace Event-Related Acute Changes in Cortisol, Oxytocin, and Heart Rate Variability

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